• Title/Summary/Keyword: Thyroid disorders

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Application of Diagnostic Laboratory Tests in the Field of Oral Medicine: A Narrative Review

  • Ji Woon, Park;Yeong-Gwan, Im
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.101-111
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    • 2022
  • The purpose of laboratory tests in the field of oral medicine can be divided into two categories: (1) medical evaluation of patients with systemic diseases that are planning to receive dental care and (2) diagnosis of patients with certain oral diseases. First, laboratory tests are commonly used to evaluate patients with systemic diseases who need dental management. A combination of multiple tests is usually prescribed as a test panel to diagnose and assess a specific disease. Test panels closely related to oral medicine include those for rheumatoid arthritis, connective tissue disease/lupus, liver function, thyroid screening, anemia, and bleeding disorders. Second, laboratory tests are used as auxiliary diagnostic methods for certain oral diseases. They often provide crucial diagnostic information for infectious diseases caused by bacteria, fungi, and viruses that are associated with pathology in the oral and maxillofacial regions. Laboratory tests for infectious diseases are composed of growth-dependent methods, immunologic assays, and molecular biology. As the field develops, further application of laboratory tests, including synovial fluid analysis in temporomandibular joint disorders, salivary diagnostics, and hematologic biomarkers associated with temporomandibular disorders and orofacial pain conditions, is currently under scrutiny for their reliability as diagnostic tools.

Analysis of online parenting community posts on expanded newborn screening for metabolic disorders using topic modeling: a quantitative content analysis (토픽 모델링을 활용한 광범위 선천성 대사이상 신생아 선별검사 관련 온라인 육아 커뮤니티 게시 글 분석: 계량적 내용분석 연구)

  • Myeong Seon Lee;Hyun-Sook Chung;Jin Sun Kim
    • Women's Health Nursing
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    • v.29 no.1
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    • pp.20-31
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    • 2023
  • Purpose: As more newborns have received expanded newborn screening (NBS) for metabolic disorders, the overall number of false-positive results has increased. The purpose of this study was to explore the psychological impacts experienced by mothers related to the NBS process. Methods: An online parenting community in Korea was selected, and questions regarding NBS were collected using web crawling for the period from October 2018 to August 2021. In total, 634 posts were analyzed. The collected unstructured text data were preprocessed, and keyword analysis, topic modeling, and visualization were performed. Results: Of 1,057 words extracted from posts, the top keyword based on 'term frequency-inverse document frequency' values was "hypothyroidism," followed by "discharge," "close examination," "thyroid-stimulating hormone levels," and "jaundice." The top keyword based on the simple frequency of appearance was "XXX hospital," followed by "close examination," "discharge," "breastfeeding," "hypothyroidism," and "professor." As a result of LDA topic modeling, posts related to inborn errors of metabolism (IEMs) were classified into four main themes: "confirmatory tests of IEMs," "mother and newborn with thyroid function problems," "retests of IEMs," and "feeding related to IEMs." Mothers experienced substantial frustration, stress, and anxiety when they received positive NBS results. Conclusion: The online parenting community played an important role in acquiring and sharing information, as well as psychological support related to NBS in newborn mothers. Nurses can use this study's findings to develop timely and evidence-based information for parents whose children receive positive NBS results to reduce the negative psychological impact.

Subclinical Hypothyroidism in Patients with Bipolar Disorders Managed by Lithium or Valproic Acid (리튬 또는 발프로산으로 치료받은 양극성장애 환자의 무증상 갑상선저하증)

  • Choi, Hyeon Man;Chang, Jae Seung;Kim, Jayoun;Kim, Jeong Hyun;Choi, Jung Eun;Ha, Tae Hyon;Ha, Kyooseob
    • Korean Journal of Biological Psychiatry
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    • v.20 no.4
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    • pp.151-158
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    • 2013
  • Objectives To investigate the pattern of subclinical hypothyroidism (SCH) in patients with bipolar disorders managed by lithium or valproic acid. Methods The study participants were 106 patients with DSM-IV bipolar disorders receiving planned maintenance treatment at the Mood Disorders Clinic of Seoul National University Bundang Hospital (aged between 17 and 64, mean duration of follow-up = 875.65 days). Using the bipolar disorder registry, thyroid function data were analyzed to assess the frequency of and the risk factors for SCH in patients managed by lithium (n = 64) or valproic acid (n = 42) for more than 5 months. Results Overall frequencies of SCH were 20.3% (13/64) in the lithium group, 14.3% (6/42) in the valproic acid group, and between the two groups there is no difference (p = 0.43). No differences were observed in the potential risk factors for SCH between the two groups including age, sex, subtype of bipolar disorder, baseline TSH, and concomitant antipsychotic use. In cases with SCH, thyroid-stimulating hormone (TSH) showed a tendency to increase at 3 month after the initiation of lithium or valproic acid. A gradual increase in the number of patients showing SCH was found within the first 3 years of medication. Conclusions With regular monitoring and careful assessment, there was no difference in the risk of SCH between lithium and valproic acid maintenance. The risk of mood stabilizer-associated SCH may gradually increase within 3 years following the commencement of medication, thereby mandating close monitoring for the first 3 years of treatment. Further studies with large sample size would be needed to confirm these findings.

Diagnostic Evaluation of Effective Thyroxine Ratio (Effective Thyroxine Ratio(E.T.R)의 진단적(診斷的) 가치(價値))

  • Lee, Myung-Chul;Choi, Sung-Jae;Ro, Heung-Kyu;Lee, Hong-Kyu;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.9 no.2
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    • pp.13-22
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    • 1975
  • The purpose of the present study is to evaluate the diagnostic value of the ETR test as compared to other thyroid function tests in normal persons, patients with thyroid disorders and patients with alterations of thyroxine-binding proteins. The ETR values were obtained from 35 cases as normal control, 63 hyperthyroid patients, 56 euthyroid patients, 23 hypothyroid patients, 10 pregnant women, 5 women taking oral contraceptive medication, 8 liver cirrhosis patients and 4 nephrotic syndrome patients. The results obtained were as follows. 1. The mean value of ETR obtained from the normal controls was $0.99{\pm}0.06$. 2. The mean ETR values of various thyroid states were $1.25{\pm}0.16$ in hyperthyroidism, $0.99{\pm}0.08$ in euthyroidism and $0.82{\pm}0.05$ in hypothyroidism and significant difference was found between these groups. 3. Seven out of 63 hyperthyroid patients(11.1%) and 2 out of 23 hypothyroid patients(8.7%) had ETR values within normal range and among the 56 euthyroid patients 6(10.7%) had ETR values outside normal range, so the diagnostic compatibility of ETR was 89.4% in thyroid diseases. 4. Even though the ETR value was well correlated with $^{131}I$-thyroid uptake rate, serum $T_3$ resin uptake rate and serum $T_4$, a high positive correlation was found (r=0.79) between ETR and $T_7$. 5. The mean ETR values from patients with alteration in TBG binding capacity were $0.99{\pm}0.05$ in pregnant women, $0.98{\pm}0.04$ in women with oral contraceptive medication, $1.04{\pm}0.09$ in liver cirrhosis patients and $0.94{\pm}0.02$ in nephrotic syndrome patients and most of them (85.2%) had ETR values within normal range. Our results, therefore, suggests that the ETR estimation does offer the simplest and most reliable single procedure for the screening and diagnosis of various thyroid diseases as a indirect indicator of serum-free thyroxine concentration without essential influence of changes in the thyroxine-binding proteins in serum.

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Human Leukocyte Antigen(HLA) Genotypes and Thyroid Autoimmunity in Korean Patients with Type 1 Diabetes (한국인 제 1형 당뇨병 환자들의 HLA 유전자형 및 자가면역성 갑상선 질환의 병발 양상)

  • Kang, So Young;Shin, Chung Ho;Yang, Sei Won;Park, Myoung Hee;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.624-633
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    • 2005
  • Purpose : This study analyzed the expression of HLA-DR and DQ genotypes and anti-thyroid autoantibodies[anti-thyroid peroxidase(TPO) and anti-thyroglobulin(TG) antibodies] in Korean patients with type 1 diabetes(T1DM) to investigate the susceptible HLA alleles to T1DM in Korea and the prevalence of thyroid autoantibodies and their significance for the development of thyroid disorders. Methods : A total of 59 Korean patients with type 1 diabetes[26 males, median age 13.7 years(range 5.7-29.9 years), diabetes duration 7.6 years(-1.7-22.5 years)] were enrolled in this study, and 200 healthy Koreans without a family history of diabetes were selected as a normal control for the comparison of HLA genotypes. Seventeen patients with anti-TPO or anti-TG were followed [median duration 3.96 years(1 day-10.7 years)] with measurement of anti-TPO, anti-TG, $T_3$, $T_4$ or free $T_4$, TSH levels and physical examinations. HLA-DR and DQ genotyping were done by PCR-SSO, PCR-SSCP, PCR-RFLP and PCR-SSP methods. Results : HLA analysis showed higher frequencies of HLA-DRB1*0301, *090102 and DQB1*0201, *030302 alleles, DRB1*0301/*090102, *090102/*090102 and DQB1 *0201/*030302, *030302/*030302, *0201/ *0302 genotypes in T1DM patients compared to controls(Pc<0.05). Fifteen(25.4 percent) had anti-TPO antibody, 12(20.3 percent) had anti-TG, 17(28.8 percent) had either autoantibody and 10(16.9 percent) had both autoantibodies. No clinical or subclinical hypothyroidism developed during follow-up after the first detection of anti-thyroid autoantibody. There was no significant correlation between thyroid autoimmunity and gender, onset age of T1DM, and diabetes duration, respectively(P>0.05). Conclusion : We thought this unique HLA-DR, DQ allele distribution might be an important factor for the low incidence of T1DM in Korea. And a high prevalence of thyroid autoantibodies in these populations suggests examinations of thyroid antibodies should be performed regularly. Optimal age for the initial screening and the frequency of re-screening for associated thyroid autoimmune diseases in T1DM remains to be determined through prospective follow-up.

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

  • Hong, Ki Hwan;Seo, Eun Ji;Lee, Hyun Doo;Yoon, Yun Sub;Lim, Seok Tae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.1
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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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Case of an Old-Age Patient with Ill-defined Severe Anorexia (원인불명의 극심한 식욕부진(食慾不振)을 호소한 고령 환자 치험례)

  • Jung, Ki-Yong;Hsia, Yu-Chun;Baik, Jong-Woo;Choi, You-Kyung;Kim, Dong-Woo;Park, Jong-Hyung;Jun, Chan-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.256-261
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    • 2008
  • Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.

Mood Stabilizers (기분안정제)

  • Kim, Young-Hoon;Jang, Tae-Soep
    • Korean Journal of Biological Psychiatry
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    • v.1 no.1
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    • pp.40-59
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    • 1994
  • The introduction of lithium salts for the treatment of mood disorder by Code in 1949 was a major therapeutic breakthrough. Yet it is far from the universal therpeutic agent in the treatment of mood disorders. Indeed, some acutely manic patients do not respond adeqately to lithium and some individuals experience breakthrough affective episodes during lithium maintenance. In the last decode, it has become c1ear that a significant number of patients with more highly recurrent disorders may require alternative or enhanced forms of prophylactic treatment. For these reasons, a variety of other drugs hove been employed for the treatment and prophylaxis of mood disorders. Efforts to develop new pharmacologic strategies for mood disorder hove included a diverse array of medications, ranging from potent benzodiazepines to novel neuroleptics and from anticonvulsants to calcium channel blockers. The anticonvulsants appear particularly useful in cases of dysphoric mania and rapid cycling state, subforms of bipolar disorder that respond quite poorly to conventional treatments. Among all of these new pharmacologic strategy, carbamazepine and sodium valproate have received the broadest clinical applications as maintenance therapies. The data documenting the short-term antimanic effectiveness of the calcium channel blocker verapamil and benzodiazepins such as clonazepam and lorazepam appear also promising. A number of other theoretically interesting, as well as clinically relevant therapies, which are not presently employed routinly, hove also been studied, including 2 blocker clonidine, atypical antipsychotic clozapine, cholinomimetics, 5-HT enhancers, thyroid and magnesium preparations. Now prophylaxis in mood disorder remains a considerable therapeutic challenge. Controlled testing of the prophylactic efficacy of compounds such as carbamazepine, valproic acid, and the calcium channel blockers represent important next step in the clinical trials for mood disorder.

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The Study of the Combination of Salvia Miltiorrhiza and Kitosan on Osteoporosis in Ovariectomized Rats (난소제거 흰쥐에서 단삼과 키토산 혼합물의 골다공증 개선효과)

  • Kim, Do-Sung;Han, Song-Hee;Lee, Yong-Chul;Park, Seong-Ju;Yoo, Wan-Hee;Kim, Hyung-Ryong;Chae, Han-Jung
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.75-80
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    • 2009
  • The preventive effect of Salvia miltiorrhiza extracts (SM) with or without high molecular weight soluble kitosan (K) on the progress of bone loss induced by ovariectomized (OVX) was studied in rats. From light microscopic analyses in histochemistry data, trabecular bone area in OVX rats was significantly decreased compared with that in sham rats. The decrease was regulated by administration of SM and especially the combination of SM and K (SM + K) for 7 weeks. In addition, the numbers of osteoblasts and osteoclasts were regulated in SM + K-administered rats but not different from those in either SM or K-administered rats. In OVX rats, free Triiodothyronine ($T_3$) and Thyroxine ($T_4$) were similar to control, ruling out the involvement of abnormal thyroid hormone. Although serum calcium is similar among all the groups, estrogen level was higher especially in SM+K-administered rats. These results strongly suggest that SM+K are effective in preventing the development of bone loss induced by OVX in rats.

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The Effect of Sleep Loss on Energy and Metabolism (호르몬수면상실이 에너지와 대사에 미치는 영향)

  • Kang, Seung-Gul
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.5-10
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    • 2012
  • The release of hormones and the metabolism of human body are controlled by the circadian rhythm related to sleep-wake cycle. Growth hormone, prolactin, thyroid stimulating hormone, cortisol, glucose, and insulin-secretion rates fluctuate according to the sleep-wake cycle. In addition, sleep is related to the appetite regulation and carbohydrate and other energy metabolism. Hypocretin (orexin), an excitatory neuropeptide, regulates waking and diet intake, and the poor sleep increases diet intake. The short sleep duration increases one's body mass index and impairs the function of the endocrine and metabolism, causing increases in the risk of glucose intolerance and diabetes. The poor sleep quality and sleep disorders have similar impact on the metabolic function. In short, the sleep loss and the poor quality of sleep have a detrimental effect on the endocrine and energy metabolism. The improvement of sleep quality by the future research and appropriate clinical treatment would contribute to the decrease of the metabolic diseases such as diabetes.