• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.138-142
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• 2015

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the $7^{th}$ RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• CELLMED
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• v.13 no.13
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• pp.52.1-52.4
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• 2023

Objective: Case report of hypothyroidism improved by ortho-cellular nutrition therapy. Methods: A 55-year-old Korean woman diagnosed with hypothyroidism in the past, did not take any Synthyroid medication while undergoing OCNT for a year. Results: A blood test was conducted one year after the initiation of OCNT, and she was diagnosed with normal thyroid hormone level. Conclusion: Applying nutritional therapy to patients with hypothyroidism may assist in the recovery of thyroid hormone levels and the alleviation of symptoms.

• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.3
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• pp.203-211
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• 2011

Objectives: To report the effect of oriental medicine on 2 patients with secondary amenorrhea caused by autoimmune disease and thyroid grand disease. Methods: The patients who had secondary amenorrhea caused by autoimmune disease and thyroid grand disease were treated with the oriental medical treatments such as herbal medication, herbal acupuncture and moxibustion therapy. Results: After the oriental medical treatments, the patients could have their menstrual cycle again and menstrual condition was also improved. Conclusion: This case report shows that the oriental medical therapy is effective for curing secondary amenorrhea caused by autoimmune disease and thyroid grand disease.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.174-178
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• 2001

Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

• Medical Lasers
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• v.10 no.1
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• pp.37-44
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• 2021

Background and Objectives Hypothyroidism is the most common endocrine disease. On the other hand, there is no treatment that can improve the thyroid function. Low-level laser therapy (LLLT) can improve the cellular activity. The effect of hypothyroidism is not obvious. This study examined the effects of LLLT on the thyroid gland function of a propylthiouracil (PTU)-induced hypothyroidism mouse model. Materials and Methods Twenty-five male ICR mice were distributed into five groups of five animals each: Negative control (none PTU animal) and positive control (PTU animal) of unirradiated animals, and three experimental groups with LLLT (3J, 6J, and 12J). Each mouse was exposed to a distinct dose of a 632-nm laser once a week for three rounds. The positive control group and three LLLT groups were induced into a hypothyroidism state by PTU administration. The animals' thyroid-stimulating hormone and thyroxine levels were measured using an ELISA kit, and their thyroid tissue was harvested and analyzed after sacrifice at the end of the experiment. The hormone level and morphological changes in the tissue of the five groups were compared. Results The thyroid hormone levels in the control group and LLLT groups were similar. On the other hand, the thyroid tissue of the LLLT groups showed some morphological changes that were similar to those of iodine deficiency thyroid. Conclusion LLLT did not affect the thyroid gland function in PTU-induced hypothyroidism mice.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.132-139
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• 2013

Objectives: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. Methods: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). Results: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. Conclusions: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.

• Journal of Interdisciplinary Genomics
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• v.5 no.2
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• pp.32-34
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• 2023

Resistance to thyroid hormone syndrome (RTH) is a genetic disease caused by the mutation of either the thyroid hormone receptor-β (THRB) gene or the thyroid hormone receptor-α (THRA) gene. RTH caused by THRB mutations (RTH-β) is characterized by the target tissue's response to thyroid hormone, high levels of triiodothyronine and/or thyroxine, and inappropriate secretion of thyroid-stimulating hormone (TSH). THRA mutation is characterized by hypothyroidism that affects gastrointestinal, neurological, skeletal, and myocardial functions. Most patients do not require treatment, and some patients may benefit from medication therapy. These syndromes are characterized by decreased tissue sensitivity to thyroid hormones, generating various clinical manifestations. Thus, clinical changes of resistance to thyroid hormones must be recognized and differentiated, and an approach to the practice of personalized medicine through an interdisciplinary approach is needed.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.148-151
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• 2014

Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, < $0.08{\mu}IU/L$ thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.265-272
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• 2014

Purpose : To reduce the radiation dose to the thyroid that is affected to scattered radiation, the shield was used. And we evaluated the shielding effect for the thyroid during whole brain radiation therapy. Materials and Methods : To measure the dose of the thyroid, 300cGy were delivered to the phantom using a linear accelerator(Clinac iX VARIAN, USA.)in the way of the 6MV X-ray in bilateral. To measure the entrance surface dose of the thyroid, five glass dosimeters were placed in the 10th slice's surface of the phantom with a 1.5 cm interval. The average values were calculated by measured values in five times each, using bismuth shield, 0.5 mmPb shield, self-made 1.0 mmPb shield and unshield. In the same location, to measure the depth dose of the thyroid, five glass dosimeters were placed in the 10th slice by 2.5 cm depth of the phantom with a 1.5 cm interval. The average values were calculated by measured values in five times each, using bismuth shield, 0.5 mmPb shield, self-made 1.0 mmPb shield and unshield. Results : Entrance surface dose of the thyroid were respectively 44.89 mGy at the unshield, 36.03 mGy at the bismuth shield, 31.03 mGy at the 0.5 mmPb shield and 23.21 mGy at a self-made 1.0 mmPb shield. In addition, the depth dose of the thyroid were respectively 36.10 mGy at the unshield, 34.52 mGy at the bismuth shield, 32.28 mGy at the 0.5 mmPb shield and 25.50 mGy at a self-made 1.0 mmPb shield. Conclusion : The thyroid was affected by the secondary scattering dose and leakage dose outside of the radiation field during whole brain radiation therapy. When using a shield in the thyroid, the depth dose of thyroid showed 11~30% reduction effect and the surface dose of thyroid showed 20~48% reduction effect. Therefore, by using the thyroid shield, it is considered to effectively protect the thyroid and can perform the treatment.