Clinical Observation on Hyperthyroidism

갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 관찰(觀察)

A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).