• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.128-131
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• 2019

Acute supraglottitis is characterized by an inflammation and edema of the supraglottic region and a potential life-threatening condition because of its risk for sudden upper airway compromise. Prompt diagnosis, administration of broad spectrum antibiotics, and airway management is pivotal for reducing serious complications. In the immunocompromised host, microorganisms are more likely to elicit mucosal inflammations, thus clinicians should pay attention to those patients for prompt removal of the causes of immune disruption. Here we report a case of acute adult supraglottitis with neutropenia caused by anti-thyroid drug with a review of the related literatures.

• 대한핵의학회:학술대회논문집
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• 1985.05a
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• pp.158.1-158.1
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• 1985

• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.35-40
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• 1980

In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ($^{131}I$) and 31 patients with treatment of $^{131}I$ alone. The $^{131}I$ treatment was limited to older age, above 20 years of age, and not employed in patients with pregnancy and lactation. The patients treated with antithyroid belonged to relatively younger age, and also milder in symptoms and thyroid function tests. The remission rate of antithyroid therapy group was 97.8% within 16 months. Among them the early remission rate occured within 4 months was found to be 21.7%. The combined therapy group, having prescribed more severe cases, showed the remission rate to be 75% within 16 months. The remission rate of $^{131}I$ therapy group revealed 90.9% within 16 months. Among them the early remission rate taking place within 4 months disclosed 16.7%. The side effects of antithyroid drug, propylthiouracil, were noted as follows: itching (2.7%) skin rashes (1.3%), and adverse enlargement of goiter (10.7%). The side effects $^{131}I$ therapy were transient hypothyroidism(3.9%) permanent hypothyroidism (7.8%) and itching (2.0%).

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.77-85
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• 1996

Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.585-591
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• 2010

Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.200-205
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• 1994

그레이브스 갑상선기능항진증은 자가면역질환의 하나로 방사성 옥소가 간편하고 경제적이며 효과적인 치료법임이 알려져 있는데 방사성 옥소 투여 후 갑상선 조직의 자극 및 파괴에 따라 각종 항원의 노출의 증가와 이에 대한 자가항체의 변동이 예상된다. 저자들은 추정 갑상선 무게를 고려한 6-10 mCi의 방사성 옥소를 투여 받은 그레이브스 갑상선기능항진증 환자 90명을 2년간 추적하여 치료 전 후의 혈청 갑상선자극 면역글로불린(TBIIl)활성도와 thyroglobulin 및 antithyroglobulin antibody의 변화를 관찰하였다. 1) 대상환자 90명의 연령분포는 14-58세(중앙치 30)였으며 여자가 72명(80%)이었다. 2) 평가대상 환자 중 치료 전 TBIIl 활성도가 정상범위였던 경우는 15명(30%)이었고 증가된 경우는 35명(70%)이었다. 치료 전보다 치료 3개월 후에 TBII 활성도가 더 증가된 경우는 31명(62% )이었다. 3) TBII 활성도가 치료 전에 증가하였거나, 치료 전에 정상범위였다가 치료 3개월 후에 증가한 환자의 TBII 활성도의 동태는 치료 3개월 후에 가장 높았고 그 후 점차 감소하였다. 이들의 TBIIl 활성도가 15%이내로 정상화된 정도는 치료 후 6개월에 40%, 12개월에 82%였다. 4) 치료 전 antithyroglobulin antibody가 양성인 경우 80%에서 3개월 후에도 혈청 thyroglobulin의 동태는 치료 3개월 후에 높았다가 증가가 없었으며 치료 전 antithyroglobulin antibody가 음성인 경우 60%에서 치료 3개월 후에 혈청 thyroglobulin의 증가가 있었다. 5) antithyroglobulin antibody가 음성인 경우의 혈청 thyroglobulin의 동태는 치료 3개월 후에 높았다가 점차 감소하는 경향을 보였으며 antithyroglobulin antibody가 양성인 경우의 혈청 thyroglobulin의 동태는 치료 후 시간이 지남에 따라 점차 감소하였다. 6) 치료 전 antithyroglobulin antibody가 음성인 경우 치료 후 시간 경과에 따라 동시에 측정한 혈청 TBII 활성도와 thyroglobulin 사이에는 통계적으로 유의한 상관관계가 있었다(p<0.01). 한편 치료 전 antithyroglobulin antibody가 양성인 경우 치료 후 시간 경과에 따라 동시에 측정한 혈청 TBII 활성도와 thyroglobulin 사이에는 통계적으로 유의한 상관관계가 없었다(p= 0.16). 이상의 결과로 방사성 옥소를 투여 받은 그레이브스 갑상선기능항진증 환자에서 혈청 TBII 활성도는 항갑상선제를 투여 받은 경우와는 달리 초기에 증가하였다가 시간이 지남에 따라 점차 감소함을 알 수 있었으며 그 감소 정도는 항갑상선제만을 쓴 경우보다 더 빠를 것으로 생각된다. 따라서 혈청 TBII 활성도와 thyroglobulin은 방사성 옥소 치료효과의 관찰에 중요한 역할을 할 것으로 생각되며 특히 antithyroglobulin antibody가 음성인 경우 혈청 thyroglobulin은 혈청 TBII 활성도를 반영할 것으로 사료된다.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.175-180
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• 2009

Purpose: Detection of TSH-binding inhibitor immunoglobulin (TBII) in patients with hyperthyroidism is an important result of Graves' disease (GD) and hyperthyroidism treatment. This has been made out an inspection by commercial radio-receptor assays. To increase the sensitivity and the specificity of the assay, many results of the assay were reported. In this study we evaluated the clinical usetulness of TBII assays by the Comparative method. Material and Methods: We were measured by using healthy control group (n=30, male=20, female=10) of Seoul National University Hospital Healthcare System Gangnam Center from January to March in 2009. Similarly, We were measured by using hyperthyroid (TSH<$0.05\;{\mu}IU/mL$, FT4>1.80 ng/dL) experimental group (n=58, male=14, female=44) of division of endocrinology and metabolism department of internal medicine Seoul National University Hospital from January to March in 2009. We made a comparative study of each two assays from the first generation to the third generation. We were used of TSAb assay as a measurement of GD diagnostic technique. Results: The specificity of healthy control group was 100% according to the generation. (Specificity=100%, n=30) The sensitivity of hyperthyroid experimental group were the first generation RSR<%> (79.3%, n=58), RSR (51.7%, n=58), the second generation RSR-CT (93.1%, n=58), BRAHMSCT (98.3%, n=58), the third generation ELISA (94.6%, n=56), ECLIA (97.7%, n=58) and TS-Ab<%> (93.5%, n=46). Conclusion: We were used of TSAb assay as a measurement of GD diagnostic technique, The result of data showed a high correlation between the third generation TBII assay and the second generation TBII assay ($R^2$=0.923). Instead of the first generation assay, the second generation assay can be more useful in clincal diagnosis.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.76-82
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• 2003

Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.