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The Eye/Brain Radioactivity Ratio for Assessment of Graves' Ophthalmopathy (Graves병 안구증에서 $^{99m}Tc-DTPA$ 뇌신티그라피를 이용한 안구/뇌 방사능비에 관한 연구)

  • Lee, B.W.;Sung, S.K.;Park, W.;Suh, K.S.;Choi, D.J.;Kim, J.S.
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.27-31
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    • 1988
  • In Graves' disease, changes in orbital tissue and structure are casued by inflammatory infiltation, which induces increase of capillary permeability and breakdown of blood-tissue barriers. Using the uptake of $^{99m}Tc-DTPA$ in inflammatory lesion, Eye/Brain radioactivity ratios in brain scintigraphy were evaluated in 15 normal controls and 40 Graves' patients. The results were as follows; 1) Eye/Brain radioactivity ratio was significantly higher in Graves' ophthalmopthy group than in control group (p < 0.005). 2) In Graves' ophthalmopathy, Eye/Brain radioactivity ratio was significantly higher in active (progressive) group than in inactive (non-progressive) group (p < 0.05). 3) There was no correlation between class of ATA classification of Graves' ophthalmopathy and Eye/Brain radioactivity ratio. 4) There was no correlation between Eye/Brain radioactivity ratio and serum activity of TBII. In conclusion, Eye/Brain radioactivity ratio using $^{99m}Tc-DTPA$ brain scintigraphy may be useful to determine the activity of Graves' ophthalmopathy and whether treatment of Graves' ophthalmopathy is necessary or not.

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Sweet's Syndrome Associated with Graves' Disease

  • Yong, Ho Jin;Kang, Mi Il;Kim, Dohee
    • International journal of thyroidology
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    • v.10 no.1
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    • pp.50-55
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    • 2017
  • Sweet's syndrome, or acute febrile neutrophilic dermatosis, occurs in association with autoimmune diseases such as Hashimoto's thyroiditis but is rare in Graves' disease, in which all cases are induced by propylthiouracil (PTU). We report a case of Sweet's syndrome in a patient with Graves' disease treated with methimazole (MMI) during three weeks. A 34-year-old man presented with the acute onset of high fever, skin rashes on the whole body, arthralgia, and acroparesthesia. Laboratory results showed leukocytosis and elevated C-reactive protein. MMI first stopped and antibiotics and antihistamine therapy started, but his symptoms dramatically improved after oral prednisolone. Graves' disease has again been treated by MMI because of his aggravated ophthalmopathy. After one year of retreatment with MMI, there has been no recurrence of Sweet's syndrome, supporting that Sweet's syndrome in this case was not related to MMI exposure. To our knowledge, this is the first report of Sweet's syndrome associated with Graves' disease per se but not PTU or MMI use.

Comparative Study on the Long-Acting Thyroid Stimulator in Graves' Disease (Graves 병(病)에 있어 Long-Acting Thyroid Stimulator(LATS)에 관(關)한 연구(硏究))

  • Kim, Dong-Sup;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.7 no.2
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    • pp.13-26
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    • 1973
  • In order to study the role of LATS in the pathogenesis of the Graves' disease, the serum activity of the LATS was determined by the bioassay of the modified McKenzie method. The subjects examined in the study consisted of 76 individuals including 12 cases of normal control, 54 cases with typical Graves' disease and 10 cases of chronic thyroiditis. The data observed in the patients with the Graves' disease were analyzed in comparison with the clinical features, laboratory findings, and responsiveness to the treatment. The results obtained are as follows: 1. None of the subjects which did not have the Graves' disease showed a positive LATS activity, except one case with the chronic thyroiditis. 2. Twenty-two out of the 54 cases with the Graves' disease showed positive results for LATS(40.7%). The positivity was significantly higher in the patients who had been treated with anti. thyroid regimen but still showed hyperthyroidism than in the patients who had not been treated. 3. The activity of LATS was gradually decreased or even became absent as the hyperthyroidism was corrected after the treatment. 4. No significant difference was noticed in age & sex between the positive and negative groups of LATS. 5. There was no evidence of significant correlation between the LATS activity and clinical features.

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Two adolescent patients with coexistent Graves' disease and Moyamoya disease in Korea

  • Cheon, Chong Kun;Kim, Su Yung;Yoo, Jae-Ho
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.287-291
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    • 2014
  • Moyamoya disease is a cerebrovascular condition that results in the narrowing of the vessels of the circle of Willis and collateral vessel formation at the base of the brain. Although relationships between Graves' disease and cerebrovascular accidents in Moyamoya disease are obscure, the coexistence of the two diseases is noteworthy. Moyamoya disease has been rarely reported in adolescent patients with thyrotoxicosis. Recently, we encountered two adolescent Korean patients with Moyamoya disease associated with Graves' disease who presented with episodic right-sided hemiparesis and syncope. These two girls who had Graves' disease had no history of other diseases or head trauma. A thyroid function test revealed a euthyroid state and a high thyroid-stimulating hormone (TSH) receptor antibody titer at that time. The patients were diagnosed with Moyamoya disease based on brain magnetic resonance angiography and cerebral four-vessel angiography. The patients underwent cranial revascularization by encephalo-duroarterio-synangiosis as soon as a diagnosis was made, which resulted in successful symptom resolution. They fared well and had no additional neurological symptoms as of their last follow-up visits. Here, we report these two cases of confirmed Moyamoya disease complicated by Graves' disease with a review of the literature, and discuss the possible association between the two diseases. To our knowledge, this is the first report in South Korea on Moyamoya disease associated with Graves' disease in adolescents with a euthyroid.

A Study on the Costume of Stone Statues in Royal tombs and Graves in Shilla Dynasty (통일신라기 능묘석사에 나타난 복식연구)

  • 이순원
    • Journal of the Korean Society of Costume
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    • v.30
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    • pp.183-200
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    • 1996
  • The purpose of this study is to examine the custume of Stone statues in roylal tombs and graves in Shilla dynasty. Stone statues in royal tombs and graves in Shilla dynasty. Stone statues in royal tombs and graves are divided into statues of the twelve horary signs(十二支像) and stone figure of a man(石人像). The results are as follows. 1. Statues of the twelve horary signs are found eleven in royal tombs and graves. First statues of the twelve horary signs in assumed Shinmunwangrung(推定神文王陵) wear long robe(長袍) pants(袴) skirt(裙) It says that the costume element of Shilla and the costume element of Tang are mixed. But statues of the twelve horary signs was developed as a tutelary god. Statues of the twelve horary signs in Kimyoushinmyo(金庾信墓) wear jacket pants(袴) instead of long robe(長袍). Also as attaching instead of long robe. Also as attaching other color cloth in collar of jacket or not they are showing dress of mulitary officer. next statues of the twelve horary signs in Hondokwangrung(憲德王陵) wear long robe(長袍) pants(袴). it says that they imitate assumed Shinmunwangrung(推定神文王陵) Kimyoushinmyo(金庾信墓). And statues of the twelve horary signs in the rest of royal tombs and graves put on decorative armor. 2. Stone figure of a man are found is Song-dokwangrung(聖德王陵) Wonsongwangrung(元聖王陵), Hungdokwangrung(興德王陵) and divided into two types. Type 1 wear long robe(長袍) and Yangdang(裲襠). They stend for the best dress uniform of military officer. Type 2 wear Danreong(團領) with side slash. They stend for common soldier.

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Postoperative Complications of Surgical Treatment for Graves' Disease (그레이브스병의 갑상선 절제술후 합병증)

  • Chang Hang-Seok;Kim Jong-Kwan;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.61-65
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    • 1999
  • Introduction: The surgical treatment of Graves' disease has several advantage such as rapid and long lasting therapeutic effect, relatively low incidence of postoperative hypothyroidism and recurrence. Because of less frequent but serious postoperative complications, the operation have not been casually used for treatment of Graves' disease. Hypoclacemia, hoarseness and hematomas are common complications after operative treatment. However, the causative mechanisms of these complications have not been well explained. Objective: We aimed to analyze the risk factors affecting the occurance of complications in surgical treatment for Graves' disease and to evaluate what are the causative mechanisms of postoperative complications. Patients and Methods: From January 1985 to December 1998, a total of 668 surgically treated patients for Graves' disease were enrolled in this study. The incidence of postoperative complications were analyzed in relation to types of surgery, preoperaive preparation, specimen weight, bleeding amount and remnant weight. Results: Postoperative complication was developed in 108(16.2%) of 668 patients. The most common complication was transient hypocalcemia in 85 cases(12.7%). Other complications were: Hematoma in 9 cases(1.3%), transient hoarseness in 5 cases(0.7%), permanent hypocalcemia in 6 cases(0.9%), permanent hoarseness in 3 case(0.4%). The important etiologic factors affecting the occurance of complications were preoperative preparation, perioperative thyroid weight, and remnant thyroid weight. Since 1993, the incidence of complication was more decreased than that in before. Conclusion: To decrease the incidence of postoperative complications of Graves' disease, the patients should be selected carefully, sufficient preoperative preparation should be achieved, and the operation should be performed by well-experienced surgeons.

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Symptomatic Hypocalcemia After Subtotal Thyroidectomy for Graves' Disease (그레이브스병의 갑상선 아전절제술후 저칼슘혈증)

  • Kim Seung-Il;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.185-190
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    • 1995
  • Transient and permanent hypocalcemia after various types of thyroidectomy are well-known complications, and are more common after bilateral subtotal thyroidectomy for Graves' disease. However, their causative mechanisms are not well explained. Four hundred thirty patients with Graves' disease who underwent bilateral subtotal thyroidectomy from January 1983 through December 1992 were analyzed to determine the incidence and risk factors for the development of postthyroidectomy hypocalcemia. Of the 430 patients underwent bilateral subtotal thyroidectomy, symptomatic transient and permanent hypocalcemia developed in 24.2 % (104/430) and 0.5 % (2/430), respectively. With analysis of potential risk factors, the increase in incidence of the postthyroidectomy hypocalcemia was found to be statistically related to the larger thyroid gland, the larger amount of blood loss during thyroidectomy, the smaller remnant thyroid tissue, the higher levels of serum alkaline phosphatase and TBII titers. Our data suggest that impairment of parathyroid gland blood supply, degree of thyrotoxic osteodystrophy and autoimmune process of each patient are regarded as main mechanisms of postthyroidectomy hypocalcemia in patients with Graves' disease.

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Massive cerebral venous sinus thrombosis secondary to Graves' disease

  • Son, Hye-Min
    • Yeungnam University Journal of Medicine
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    • v.36 no.3
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    • pp.273-280
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    • 2019
  • Cerebral venous sinus thrombosis (CVT) is a rare cerebrovascular condition accounting for 0.5-1% of all types of strokes in the general population. Hyperthyroidism is associated with procoagulant and antifibrinolytic activity, thereby precipitating a hypercoagulable state that predisposes to CVT. We report the case of a 31-year-old Korean man with massive CVT and diagnosis of concomitant Graves' disease at admission. Early diagnosis and prompt treatment of CVT are important to improve prognosis; therefore, CVT should be considered in the differential diagnosis in all patients with hyperthyroidism presenting with neurological symptoms.

Successful Surgical Treatment of Cardiac Complication of Graves Disease

  • Min, Jooncheol;Kim, Woong-Han;Jang, Woo Sung;Choi, Eun Seok;Cho, Sungkyu;Choi, Kwang Ho
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.294-297
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    • 2014
  • Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.