• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.125-131
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• 1995

The authors present 15 cases in which the diagnosis of thyroid cancer was established pathologically among 300 cases of Graves' disease diagnosed clinically at Chosun University Hospital, from January 1982 to December 1994. These cases were analyzed in order to establish guidelines for prophylactic node dissection as part of the initial management of thyroid cancer in patients with Graves' disease. The analysis revealed the following: 1) The average age of the 15 patients was 34.5 years and the male: female ratio was 1 : 4.0. 2) In 8 of the 15 cases(53.5 %) the occult thyroid carcinoma measured less than 1.5cm. 3) The degree of invasivensess manifested in these fifteen cases may be summarized as follows: In Group 1(6 cases) there was absence of microscopic capsular invasion and of lymphnode metastasis. In Group 11(4 cases) threre was microscopic capsular invasion but absence of lymphnode metastasis: In Group III(4 cases) there was either extrathyrodal soft tissue invasion or regional lymph node metastasis: and in Group IV(1 case) there was lymphnode invasion and distant metastasis. 4) Thirteen patients underwent either subtotal or near total thyroidectomy, and 2 patients underwent total thyroidectomy. Seven patients underwent some type of neck dissection, as follows: anterior compartment dissection in one of the cases in Group I; functional neck dissection in two cases and jugular node dissection in one case in Group II; and anterior compartment dissection in one case and modified radical neck dissection in two cases in Group III. 5) The author propose the following guidelines for prophylactic initial node dissection when a unexpected coexisting thyroid carcinoma in encountered on the frozen section during the surgical management of Graves' disease; Group I cases do not require initial neck dissection in group II, anterior compartment dissection in sufficient. In Group III, either jugular node dissection or functional neck dissection should be performed, and followed by postoperative Ra$^{131}$I therapy, Group IV requires Ra$^{131}$I therapy with or without modified radical neck dissection depending in the patient's condition.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.3
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• pp.623-627
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• 2005

Abnormal thyroid cell proliferation has a very important role in hypothyroidism. Thyroid stimulating hormone (TSH) stimulates proliferation and maintains differentiated function in thyroid follicular cells. A functioning rat thyroid cell line (FRTL) was used to study the effect of Gamgung-tang (GGT, Glycyrrhizae Radix, black beans, Angelicae Radix and Cnidii Rhizoma) on proliferation and cAMP accumulation of thyrocytes. Proliferation of cell was assessed by DNA synthesis and incorporation of $[^3H]thymidine$ into DNA. The concentration of cAMP was measured simultaneously with growth assessment. Extract of GGT ($0.15{\sim}0.9\;mg/ml$ increased DNA synthesis in a dose-dependent manner. GGT at 0.6 (p<0.05) and 0.9 mg/ml (p<0.01) significantly increased $[^3H]thymidine$ incorporation. A comparable effect was observed with TSH. GGT also enhanced cAMP accumulation. These results indicate that GGT increases the proliferation of thyrocytes and may be considered a promising agent for the treatment of autoimmune thyroid disease.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.9-17
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• 1995

This study was retrospectively reviewed and analysis of postoperative local complication on all patient undergoing thyroid operation of 242 cases of thyroid disease, at Department of General Surgery, Chosun University Hospital from January 1988 to December 1992. The result were follow: Postoperative local complication are as follow; 52 cases of transient hypocalcemia, 7 cases of thansient hoarseness, 3 cases of permanent hypocalcemia, 2 cases of permanent hoarseness, and other local complication were postoperative bleeding with airway obstraction, hematoma, infection. In pathologic classification according to complicative patients; The most common frequency of complication in benign disease was Graves' disease with 13 cases(54.2%), and the most frequency of complication in malignance disease was follicalar adenocarcinoma with 7 cases(53.9%). The frequency of complication according to operation procedure were unilateral lobectomy in 31 cases(19.9%), subtotal thyroidectomy in 15 cases(39.5%), near total thyroidectomy in 12 cases (44.4%), and total thyroidectomy in 10 cases(55.6%). There was a significant relationship between extent of operative procedure and frequency of complication. The incidence of local complication after thyroid resection was 57 of 196(29.1%) in the benign disease that was 15 of 26(57.7 %) in the intrathyroidal carcinoma and 13 of 20(65.0%) in the extrathyroidal carcinoma. There was significant different in frequency of local complication according to invasion and malignance of pathologic lesion. The most frequent complication after thyroid resection is transient hypocalcemia ; 39 of 196(19.9%) in the benign disease, 7 of 26(26.9%) in the intrathyroida1 carcinoma, and 6 of 10(30.0%) in the extrathyroidal carcinoma. Their complication rate increased in direct relationship to the invasion and malignance of pathologic lesion, but there was no statistically significant. Transient hypocalcemia was encountered in 52 cases of the total 242 patient(21.9%) ; 29 of 156(18.6%) after unilateral lobectomy, 9 of 38(23.7%) after subtotal thyroidectomy, and 5 of 18(27.8 %) after total thyroidectomy. The relation ship between temporal hypocalcemia and the extent of surgery was not statistically significant.

• Korean Journal of Radiology
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• v.24 no.1
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• pp.22-30
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• 2023

Ultrasonography (US) is a primary imaging modality for diagnosing nodular thyroid disease and has an essential role in identifying the most appropriate management strategy for patients with nodular thyroid disease. Standardized imaging techniques and reporting formats for thyroid US are necessary. For this purpose, the Korean Society of Thyroid Radiology (KSThR) organized a task force in June 2021 and developed recommendations for standardized imaging technique and reporting format, based on the 2021 KSThR consensus statement and recommendations for US-based diagnosis and management of thyroid nodules. The goal was to achieve an expert consensus applicable to clinical practice.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.303-310
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• 2013

Thyroid nodular disease is the most frequently appeared in thyroid disease. Thyroid ultrasonography offers location of nodules, size, the number, information of internal echo characteristic. Thus, it makes possible to sort high-risk nodule containing high possibility about thyroid cancer and to induct precisely when take a Fine Needle Biopsy Aspiration. On thyroid nodule, the case which is diagnosed as malignant is less than 5% but screening test is very important on ultrasound and also must be reduced unnecessary procedure. Therefore, in this study an approach for describing a region is to quantity its texture content. We applied TFA algorithm on case which has been pathologically diagnosed as papillary thyroid cancer. we obtained experiment image which set the ROI on ultrasound and cut the $50{\times}50$ pixel size, histogram equalization. Consequently, Disease recognition detection efficiency of GLavg, SKEW, UN, ENT parameter were high as 91~100%. It is suggestion about possibility on CAD which distinguishes thyroid nodule. In addition, it will be helpful to differential diagnosis of thyroid nodule. If the study on additional parameter algorithm is continuously progressed from now on, it is able to arrange practical base on CAD and it is possible to apply various disease in the thyroid US.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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• pp.133-141
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• 1987

To evaluate the values of the thyroid autoantibody measured by radioimmunoassay (RIA) and compare it with hemagglutination method (HA) in the normal and the thyroid disease, data were obtained from total 618 persons; 236 healthy persons, 217 patients with Graves' disease (including 113 patients with undertreated Graves' disease), 100 Hashimoto's disease, 31 thyroid nodule, and 34 simple goiter. RSR kit made in England was used and could be detected to at least 3 U/ml. The positive rates of normal group were antimicrosomal antibody (AMA) 31.8%, antithyroglobulin antibody (ATA) 44.5% by RIA and there was no considerable change in sex and age distribution. In Graves' disease, the positive rates of AMA and ATA were 90.4, 76.9% by RIA, 85, 39% by HA. In Hashimoto's disease, 94,91 % by RIA, and 87,48% by HA, respectively. The autoantibody titer by RIA in thyroid autoimmune disease as well as in normal group was more senisitive than that by HA, especially in ATA. There were linear relationships between the titer of RIA and that of HA in AMA of Graves' disease and AMA and ATA of Hashimoto's disease. There was no relationship among thyroid autoantibody, free $T_4$ index, TBII, and TSH. The titers of AMA and ATA were found to decrease in patients with Graves' disease during the course of antithyroid drug therapy. Of the 236 normal subjects, thirty-seven (15.7%) had concentrations of above 7.5 U/ml in AMA, forty. four (18.6%) above 9 U/ml in ATA. These values were considered as the upper limit for the normal range. In Graves' disease, 82.7, 53.8% were above 7.5, 9 U/ml, respectively; In Hashimoto's disease, 82, 79% were positive. We conclude that RIA was more sensitve than HA in measuring the thyoird autoantibody, but we will study further more for determining the normal range and its interpretation.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.530-548
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• 2020

Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.1-5
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• 2024

The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.

• 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.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.292-297
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• 2005

Purpose : It is known that 3-50 percent of type 1 diabetes mellitus(T1DM) patients develop autoimmune thyroid disease. We analyzed the clinical characteristics of autoimmune thyroid disease(AITD) developed in patients with T1DM in Korean. Methods : The medical records of 139 patients, who were followed up in Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1981 to Jul. 2004, were analyzed retrospectively. Results : Forty-four males and 95 females were enrolled. At least one of the autoantibodies for thyroid was positive in 54 cases. The detection rate for AITD was not correlated with sex ratio, control of T1DM, body mass index, age at diagnosis of T1DM, and familial history of thyroid disease, between two groups. In the male group, AITD was more frequently found at a younger age than in the female group. The frequency of AITD was significantly higher in the goiter group without sex differences. In the thyroid disease group, 40 patients(74.0 percent) were euthyroid, seven patients(12.9 percent) were hypothyroid, and seven patients(12.9 percent) were hyperthyroid. Conclusion : We should monitor thyroid function and autoantibodies routinely in T1DM patients who develop goiters, or young boys with T1DM.