• 제목/요약/키워드: thyroid therapy

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두개골 또는 뇌로 전이된 갑상선암 - 7례 분석 - (Skull or Brain Metastasis from Thyroid Carcinoma - Analysis of 7 Cases -)

  • 김석철;정신;김재성;이정길;김태선;김재휴;김수한;강삼석;이제혁;박재우;이민철
    • Journal of Korean Neurosurgical Society
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    • 제30권1호
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    • pp.89-94
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    • 2001
  • Skull or brain metastasis from thyroid carcinoma is rare. Between Jan. 1993. and Jan. 2000. the authors experienced 7 cases of skull(4 cases) or brain(3 cases) metastasis from thyroid carcinoma. Clinical characteristics, radiologic findings and pathologic features were analyzed retrospectively. Among 4 cases of skull metastasis, 3 cases were follicular carcinoma and one was papillary carcinoma with follicular variant. All cases of brain metastasis were papillary carcinoma. We treated the patients by combination with surgical resection, radioactive iodine therapy and radiation therapy. Characteristics of skull or brain metastasis from thyroid carcinoma is reviewed with a pertinent literature.

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Changes in the thyroid hormone profiles in children with nephrotic syndrome

  • Jung, Sun Hee;Lee, Jeong Eun;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.85-89
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    • 2019
  • Purpose: We compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission. Methods: This study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4. Results: Of the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8 had subclinical hypothyroidism, and 2 had low T3 syndrome. The mean serum T3, T4, and free T4 levels in the nephrotic phase and after remission were $82.37{\pm}23.64$ and $117.88{\pm}29.49ng/dL$, $5.47{\pm}1.14$ and $7.91{\pm}1.56{\mu}g/dL$, and $1.02{\pm}0.26$ and $1.38{\pm}0.23ng/dL$, respectively; the levels were significantly lower in the NS nephrotic phase (P=0.0007, P<0.0001, and P=0.0002). The mean serum TSH levels during the nephrotic phase and after remission were $8.05{\pm}3.53$ and $4.08{\pm}2.05{\mu}IU/mL$, respectively; they were significantly higher in the nephrotic phase (P=0.0005). The urinary protein/creatinine ratio during the nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin and serum T3 levels during the nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations all disappeared after remission. Conclusion: Abnormal thyroid hormone profile findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.

그레이브스병 환자에 대한 안전백호탕의 임상적 유효성 안전성 연구 (The Clinical Study of Ahnjeonbaekho-tang on Patients with Graves' Disease)

  • 이병철;한양희;신선미;안세영;조충식
    • 대한한방내과학회지
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    • 제39권1호
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    • pp.9-21
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    • 2018
  • Objective: Graves' disease, the most common cause of primary hyperthyroidism, is a thyroid specific autoimmune disorder. When resistance to medication is shown in spite of long term therapy with anti-thyroid drugs, radioactive iodine therapy would be chosen in Western medicine. However, this therapy has often been reported to cause patients have hypothyroidism, thus requiring them to take levothyroxine for the rest of their lives. In this study, we evaluate the clinical efficacy and safety of Ahnjeonbaekho-tang (AJBHT) on patients with Graves' disease. Methods: We prescribed AJBHT for 3 months to two groups: patients who had been taking antithyroid drugs were administered AJBHT after discontinuing the antithyroid drugs ($Com-Tx{\rightarrow}Single-Tx$), and patients who had not been taking antithyroid drugs were started with AJBHT (Single-Tx) immediately. We evaluated the thyroidal function test (TFT) and visual analogue scale (VAS) for clinical symptoms for 3 months. Results: Serum T3 and fT4 were significantly decreased in both groups and remission rate of thyroidal hormones were significantly improved in the Single-Tx group. The clinical symptoms of palpitation, fatigue, and heat intolerance were significantly improved in both groups. In the safety analysis, all patients were in normal range of liver, renal function blood test and common blood count. Conclusion: From these results, we suggested that AJBHT was effective on TFT and clinical symptoms of Graves' disease. The study supports that AJBHT may be a useful agent for patients with Graves' disease who are resistant to antithyroid medication or radioactive iodine therapy, and for patients at first diagnosis.

적갑상선 전절제술 환자의 방사성 동위원소치료 전.후 음성의 변화에 대한 연구 (Voice Analysis before and after Radioactive Iodine Ablation in Patients with Total Thyroidectomy)

  • 홍기환;서은지;이현두;윤연섭;임석태
    • 대한후두음성언어의학회지
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    • 제24권1호
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    • pp.33-40
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    • 2013
  • Background and Objectives:This study is to objectively compare and analyze the acoustic changes in the patients with total thyroidectomy before and after RI therapy. Subjects and Methods:For this study, a total of 50 patients with total thyroidectomy were participated as subjects. Voice samples were obtained at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis, the maximum phonation time and K-VHI (Korea-Voice handicap index) were used for subjective evaluation. Results:According to the comparison analysis of the three periods, mFo (Hz) was significantly reduced in all of the vowels /a/ and /i/ as the hormone was discontinued. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim (%) and APQ (%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI (voice handicap index). Conclusion:These results can be assumed that thyroid hormone suspension is related to the increased changes in the vocal intensity, the increase in noise and the reduction in vocal range. Emotionally, these data can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.

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분화성 갑상선암에서 수술 후 I-131을 이용한 잔여 갑상선 조직의 제거 성적 (Ablation of Remnant Thyroid Tissue with I-131 in Well Differentiated Thyroid Cancer After Surgery)

  • 김유경;이동수;조보연;정재민;이명철;고창순;정준기
    • 대한핵의학회지
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    • 제31권3호
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    • pp.339-345
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    • 1997
  • 저자들은 1984년부터 1996년까지 서울대학교병원에서 분화성 갑상선암으로 수술을 시행한 후 I-131을 이용하여 수술 후 잔여 갑상선 제거를 받은 350명을 관찰하여 다음과 같은 성적을 얻었다. 1) 분화성 갑상선암 수술 후 30mCi I-131을 평균 $2.6{\pm}1.7$회 투여하며 51%에서, 75mCi 이상 I-131을 평균 $1.6{\pm}1.1$회 투여하여 72%에서 성공적으로 잔여갑상선 조직을 제거하였다. 2) 30mCi 저용량 사용 시 1회 치료의 24%, 2회 치료 22%, 2회 치료 25%, 4회 치료 8%, 5회 치료19%, 6회 이상의 치료로 19%의 환자에서 성공적으로 잔여 갑상선 조직을 제거하였다. 3) 입원 치료가 필요한 75mCi 이상의 고용량 I-131 치료에서는 1회 치료군의 53%, 2회 58%, 3회 0%, 4회 이상 치료군에서 44%의 환자에서 잔여 갑상선을 완전히 제거하였다. 4) 갑상선 전절제 후 78%, 아절제 후 62%, 한엽 및 협부 절제 후 54%, 한엽이하 절제 시 33%에서 수술 후 잔여 갑상선을 제거하여 수술 후 잔여 갑상선 조직이 적을수록 I-131 효과가 있었다. 결론적으로 이 연구에서 수술 후 30mCi I-131을 이용한 경우의 일부에서는 잔여 갑상선의 제거는 충분히 이루어지지 않아, 재발의 위험도가 높은 군에서 분화성 갑상선 암 환자의 치료시 적극적인 수술로 갑상선 전절제 후 고용량의 방사성 옥소 치료가 바람직하리라 여겨진다.

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갑상선암 환자에서 관찰된 뇌수막종의 위양성 옥소 섭취 (False-positive I-131 Uptake in Meningioma)

  • 정신영;서지형;배진호;황정현;안병철;이재태;이규보
    • 대한핵의학회지
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    • 제38권3호
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    • pp.272-273
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    • 2004
  • We experienced a case with meningioma showing false positive I-131 uptake. A 55-years old female patient underwent high dose (150 mCi) radioactive iodine therapy to ablate remnant tissue after total thyroidectomy for papillary thyroid cancer. in addition to intense tracer uptake in thyroid bed, there was mild but focal abnormal uptake in left frontal lobe of the brain on post-therapy I-131 whole body scan. Subsequent brain MR imaging showed single mass lesion in left frontal lobe and the mass was resected under the impression of brain metastasis of thyroid carcinoma. Pathologic report confirmed meningioma from the surgical specimen.

Treatment of Malignant Melanoma by Downregulation of XIAP and Overexpression of TRAIL with a Conditionally Replicating Oncolytic Adenovirus

  • Li, Xin-Qiu;Ke, Xian-Zhu;Wang, Yu-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1471-1476
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    • 2012
  • Background and Aim: Currently available systemic therapies for malignant melanoma produce low response rates in patients, and more effective treatment modalities are clearly needed. The tumor necrosis factor (TNF)-related apoptosis-inducing ligand has a significant impact on therapy for patients with X-linked inhibitor of apoptosis protein-downregulation malignant melanoma. The primary objective of this study was to assess its therapeutic potential. Materials and Methods: We employed a conditionally replicating oncolytic adenoviral vector, named CRAd5.TRAIL/siXIAP, with the characteristics of over-expression of the therapeutic gene TRAIL and downregulation of XIAP in one vector. B16F10-luc cells were employed to detect anti-tumor activity of CRAd5.TRAIL/siXIAP in vitro and in vivo. Results: CRAd5.TRAIL/siXIAP enhanced caspase-8 activation and caspase-3 maturation in B16F10 cells in vitro. Furthermore, it more effectively infected and killed melanoma cells in vitro and in vivo than other adenoviruses. Conclusion: Taken together, the combination of upregulation of TRAIL and downregulation of siXIAP with one oncolytic adenoviral vector holds promise for development of an effective therapy for melanomas and other common cancers.

Long-term management of Graves disease: a narrative review

  • Hyo-Jeong Kim
    • Journal of Yeungnam Medical Science
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    • 제40권1호
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    • pp.12-22
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    • 2023
  • Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

일부 대학병원 방사성옥소 치료병실의 안전관리로 본 실태 고찰 (Radioactive Iodine Therapy Room a Part University Hospital of the Actual Conditions of Safety Management Consideration)

  • 한상현;이상호
    • 한국방사선학회논문지
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    • 제6권5호
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    • pp.373-381
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    • 2012
  • 방사성옥소를 이용한 갑상선 암의 치료는 지난 수 십년 동안 사용되어 왔으며 많은 치료효과를 보이면서 앞으로 지속적으로 사용되어 질 전망이고 현재 우리나라의 옥소치료병실 수는 2010년 기준 124개의 치료병실이 운영되고 있으나 아직도 부족한 실정이다. 그래서 많은 병원들이 치료병실을 개설하고 있으나 중요한건 치료병실의 수적 증가보단 현재 치료병실의 올바른 관리가 선행되어야 한다는 것이다. 따라서 병실증설에 대한 논의에 앞서 현재 적용되고 있는 치료병실의 안전관리 기준과 일부 대학병원에서 기준으로 삼고 있는 안전관리기준을 조사하여 얼마나 잘 지켜지고 있는지, 치료병실의 이용에 따른 전반적인 안전관리실태여부를 조사하여 고찰 하였다.

렌바티닙 사용과 관련된 고혈압과 단백뇨의 관리: 증례 보고 (Management of Hypertension and Proteinuria after Treatment with Lenvatinib for Radioiodine Refractory Papillary Thyroid Carcinoma: a Case Report)

  • 송의연;김원구
    • International journal of thyroidology
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    • 제11권2호
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    • pp.78-81
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    • 2018
  • Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.