• 제목/요약/키워드: freeT_4$andTSH

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임신 및 각종 갑상선질환에서 갑상선 기능 판정에 관한 연구 - 혈청유리 $T_4$의 진단적 의의에 관한 고찰 - (Thyroid Function Test in Thyroid Diseases and Pregnancy - The diagnostic value of free thyroxine by RIA -)

  • 유명희;윤휘중;신영태;이종철;정순일;조보연;이문호;이명철
    • 대한핵의학회지
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    • 제15권1호
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    • pp.1-11
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    • 1981
  • To evaluate the diagnostic accuracy of the measurement of free thyroxine (FT4) by radioimmunoassay, we measured free $T_4\;and\;T_4,\;T_3,\;T_3RU$, TSH and TBG serum levels by radioimmunoassay in 18 healthy persons and 52 patients with various thyroid diseases and 11 normal pregnant women. The results are as follows. 1. In 19 cases of overt hyperthyroidism, $T_3,\;free\;T_4$ and FTI, $T_4/TBG$ ratio reflect hyperfunction in all cases. $T_4$ is increased in 94% (18/19) and TBG and TSH are decreased in 79% (15/19). 2. In 8 patients with overt hypothyroidism, TSH is increased in all cases and free $T_4$ and FTI is decreased in all cases. $T_4$ is decreased in 87.5% (7/8), $T_3$ is decreased in 75% (6/8) and $T_4/TBG$ ratio is decreased in 62.5% (5/8). 3. In 5 patients who are clinically in euthyroid state after treatment of hyperthyroidism, $T_4,\;free\;T_4$, FTI and TSH are in the normal range in all cases and $T_3$ is normal in 60% (3/5) and slightly increased in 40% (2/5). 4. In 10 patients who showed clinically borderline hypothyroidism after treatment of hyperthyroidism, TSH is increased in all cases and free $T_4$ and FTI are decreased in all cases, but $T_4\;and\;T_3,\;T_4/TBG$ ratio are in the normal limit in all cases. So after treatment of hyperthyroidism, TSH, free $T_4$ or FTI are recommended as optimal thyroid function test. 5. In normal pregnancy, free $T_4$, FTI and $T_4/TBG$ ratio reflect normal function, but the other parameters revealed unreliable due to the influence of increased TBG. Also TBG and TSH level in pregnancy is increased significantly compared with normal healthy control group. 6. The coefficients of correlation between free $T_4$ and FTI were 0.862 (p<0.001) and 0.685 (p<0.001) between free $T_4\;and\;T_4/TBG$ ratio. In most patients, diagnostic value of free $T_4$ was comparable and even superior to FTI, so free $T_4$ measurement can be used routinely with thyrotropin assay in the diagnosis of hypothyrodism or with $T_3$ for the diagnosis of hyperthyroidism.

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Changes in the thyroid hormone profiles in children with nephrotic syndrome

  • Jung, Sun Hee;Lee, Jeong Eun;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.85-89
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    • 2019
  • Purpose: We compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission. Methods: This study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4. Results: Of the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8 had subclinical hypothyroidism, and 2 had low T3 syndrome. The mean serum T3, T4, and free T4 levels in the nephrotic phase and after remission were $82.37{\pm}23.64$ and $117.88{\pm}29.49ng/dL$, $5.47{\pm}1.14$ and $7.91{\pm}1.56{\mu}g/dL$, and $1.02{\pm}0.26$ and $1.38{\pm}0.23ng/dL$, respectively; the levels were significantly lower in the NS nephrotic phase (P=0.0007, P<0.0001, and P=0.0002). The mean serum TSH levels during the nephrotic phase and after remission were $8.05{\pm}3.53$ and $4.08{\pm}2.05{\mu}IU/mL$, respectively; they were significantly higher in the nephrotic phase (P=0.0005). The urinary protein/creatinine ratio during the nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin and serum T3 levels during the nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations all disappeared after remission. Conclusion: Abnormal thyroid hormone profile findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.

갑상선(甲狀腺) 기능(機能)상태에 따른 혈청(血淸) 갑상선자극(甲狀腺刺戟)홀몬의 변동(變動)에 관(關)한 연구(硏究) (The Changes of Serum TSH in Various States of Thyroid Function)

  • 노흥규
    • 대한핵의학회지
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    • 제9권2호
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    • pp.1-11
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    • 1975
  • The serum concentrations of thyrotropin (TSH) were measured by means of radioimmunoassay, in 98 cases of normal controls, 51 cases of hyperthyroidism, 80 cases of primary hypothyroidism and 4 cases of secondary hypothyroidism to evaluate the diagnostic significance in various functional states of the thyroid. The obtained data were analyzed in correlation with other thyroid function test values in various phases of the functional thyroid diseases. The results were as follows: 1) The serum TSH concentration in normal control group was $<1.3{\sim}8.0{\mu}U/ml$. 2) The measurement of serum TSH was more significant in diagnostic accuracy compared with that of serum $T_4(75.0{\pm}12.2%)$. Free $T_4$ Index ($64.2{\pm}15.2%$), serum $T_3(41.0{\pm}21.0%)\;or\;T_3$ resin uptake ($41.1{\pm}15.8%$) in evaluation of primary hypothyroidism. 3) In case of overt hypothyroidism, the serum TSH and $T_4$ were both abnormal, compatible with the clinical diagnosis, while in case of preclinical or mild hypothyroidism, the serum $T_4(41.2{\pm}23.8%)\;or\;50.0{\pm}25.0%)$ was much less reliable than serum TSH. 4) In the treatment of primary hypothyroidism with desiccated thyroid, the administration of 1 grain of the hormone per day was sufficient to suppress the serum concentration of TSH to normal range. It showed that the measurement of serum TSH concentration was a significant criteria in evaluating the efficiency of the treatment of hypothyroidism. 5) The measurement of serum TSH concentration is a very significant method in the early detection of hypothyroidism induced during or after the treatment of the hyperthyroidism with antithyroid drugs or radioactive Iodine ($^{131}I$).

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Guinea pig에서 alcohol과 paraquat에 의한 갑상선 독성에 미치는 selenium의 방어 효과 (Protective effect of selenium on alcohol and/or paraquat-induced thyroid toxicity in guinea pigs)

  • 김진상;강형섭
    • 대한수의학회지
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    • 제36권1호
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    • pp.209-219
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    • 1996
  • This study examined the effect of alcohol(AL) and/or paraquat(PQ) on serum TSH, thyroid hormones and enzyme activities, and the protective effect of selenium(SE) againse alcohol and/or paraquat-induced thyroid toxicity in guinea pigs. The experomental group consisted of control, 15% alcohol(AL), 4ppm sodium selentite(SE), 200ppm paraquat(PQ), AL+PQ, AL+SE, PQ+SE and AL+PQ+SE mixed in drinking water-fed guinea pigs for 4 weeks. The morphological changes of thyroid gland were studies on paraffin-embedded sections stained with H-E stain. Body weight losses, high serum concentration in TSH and cholesterol, and low values on triiodothyronine($T_3$), thyrozine($T_4$), free $T_4$ and alkaline phosophatase(ALP) were produced in the groups fed AL and/or PQ. We also noted that AL+PQ-fed group was marked increase in serum TSH. In AL or AL+PQ-fed groups when cpmpared to control group had increased the ratio of thyroid weight to body weight(ratio Twt/Bwt), whereas the ratio Twt/Bwt was decresed in SE or PQ-fed groups. However, the serum TSH, $T_3$,$T_4$ free $T_4$ and cholesterol values, and the ratio Twt/Bwt were reversed in groups given the combination of SE, compared with AL and/or Pq-fed groups, also ALP values were reversed in groups given the combination of SE, compared with AL or AL+PQ-fed groups. In microscope, morphological changes showed a remarkable between the AL or PQ-fed group and controls. In AL+PQ+SE-fed guinca pig, follicular colloid is high density in thyroid follicle and increased in connective tissue around the thyroid cells, and thyroidal epithelia were composed of cuboidal or columnar epithelium. The indicated that the morphological changes of thyroid were direct action in the thyroid cell. The results of this study confirmed that the toxic effect of AL or PQ on thyroid occur independently of changes in liver function, and that SE confers marked protection against AL or PQ-induced thyroid toxicity.

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울트라마라톤이 뇌하수체 전엽 및 갑상선 호르몬에 미치는 영향 (Effect of Ultramarathon on the Anterior Pituitary and Thyroid Hormones)

  • 신경아;김영주
    • 대한스포츠의학회지
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    • 제36권4호
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    • pp.214-220
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    • 2018
  • Purpose: The purpose of this research is to study changes in pituitary hormone in anterior lobe and thyroid hormone before, after, and during recovery time in severe 100 km ultramarathon. Methods: Healthy middle-aged runners (age, $52.0{\pm}4.8$ years) participated in the test. Grade exercise test is done, and then blood is taken from those participants before and after completing 100 km ultramarathon at the intervals of 24 hours (1 day), 72 hours (3 days), and 120 hours (5 days) to analyze their luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and free thyroxine (Free T4). Results: For LH, it decreased more significantly at 100 km than pre-race. However, after 1 day result increased more than that of 100 km. At 3 days, it was significantly higher than pre-race and 100 km, recovering at 5 days. In terms of FSH, it decreased at 100 km, 1 day, and 3 days more than pre-race but recovered at 5 days. TSH was higher at 1 day and 5 days compared to pre-race. T3 was only higher at 100 km than pre-race. T4 was higher till 5 days at 100 km than pre-race. Free T4 increased more significantly at 100 km than pre-race. Conclusion: In terms of severe long distance running, LH and FSH which belong to hormone from anterior lobe as well as T3, T4, and Free T4 which belong to thyroid hormone showed their variation within the standard range. However, TSH showed abnormal increase from enhanced concentration of blood after marathon becoming hyper-activation even during the recovery period.

제대혈 갑상선 자극호르몬과 갑상선 호르몬 농도에 영향을 주는 주산기 인자들 (Perinatal Factors Affecting Thyroid Stimulating Hormone(TSH) and Thyroid Hormone Levels in Cord Blood)

  • 김은영;박상기;송창훈;임성철
    • Clinical and Experimental Pediatrics
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    • 제48권2호
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    • pp.143-147
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    • 2005
  • 목 적 : 갑상선 기능은 여러 질환이나 스트레스에 의해서 영향을 받는 것으로 알려져 있다. 저자들은 분만 전과 분만 동안의 여러 인자와 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도와의 상관관계를 알아보고자 본 연구를 시행하였다. 방 법 : 총 130명의 신생아를 대상으로 분만 즉시 제대혈을 10 mL 채취하여 갑상선자극호르몬, $T_3$와 유리 $T_4$ 농도를 방사면역학적 방법(CIS bio international kit, Germany)으로 측정하였다. 재태연령, 출생체중, 가사, 분만방식, 산모의 당뇨병 유무, 산모의 전자간증 유무 등에 따라 갑상선자극호르몬과 갑상선 호르몬 농도를 비교하였다. 결 과 : 1) 제대혈 갑상선자극호르몬 농도는 재태연령 34주 이하 $1.73{\pm}0.48{\mu}IU/mL$, 34주-37주 $2.60{\pm}0.51{\mu}IU/mL$, 38주 이상 $4.26{\pm}0.40{\mu}IU/mL$으로 재태연령의 증가에 따라 증가하였다(P<0.05). 2) 분만형태를 비교하면 질식 분만 군 $4.42{\pm}0.66{\mu}IU/mL$, 제왕절개 분만 군 $3.31{\pm}0.33{\mu}IU/mL$로 질식 분만 군에서 높았다(P<0.05). 3) 가사에 따른 갑상선자극호르몬 농도는 가사가 있는 군 $5.18{\pm}0.93{\mu}IU/mL$로 가사가 없는 군 $2.97{\pm}0.84{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 4) 산모의 당뇨병에 따른 갑상선자극호르몬 농도는 당뇨병 군 $8.91{\pm}1.25{\mu}IU/mL$, 없는 군 $4.32{\pm}0.42{\mu}IU/mL$으로 산모 당뇨병 동반시 유의하게 높았다(P<0.05). 5) 산모에게 전자간증이 있는 군의 갑상선자극호르몬 농도는 $5.28{\pm}0.42{\mu}IU/mL$, 없는 군 $3.65{\pm}0.46{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 6) $T_3$와 유리 $T_4$ 농도는 가사 군에서 없는 군보다 유의하게 낮았다(P<0.05). 7) 각 변수 간의 영향을 배제하였을때 임신주수, 1분 Apgar 점수, 산모의 당뇨병만이 독립적으로 제대혈의 갑상선자극호르몬 농도에 영향을 미치는 것으로 나타났다. 결 론 : 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도는 산모의 당뇨병이나 산모 전자간증과 같은 분만 전 요인과 태아에게 저산소증을 초래할 수 있는 분만시 스트레스와 밀접한 연관이 있다.

가족 발생적인 갑상선이상의 방사성면역 측정법에 의한 TSH 평가 (An Evaluation by TSH Radioimmunoassay on Familial Thyroid Disorders)

  • 김지열
    • 대한핵의학회지
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    • 제23권1호
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    • pp.1-6
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    • 1989
  • The occurrence of thyroid disorders is connected with iodine deficiency, defective synthesis or releasing of thyroid hormone and endemicity. Genetic factors are known as a single gene defects, interaction of multiple genes with environmental factors, as well as chromosomal aberrations. Diofnosis thyroid disorders is enforced by I-131 uptake test, thyroid scanning with I-131 or Tc-99 m and serum radioimmunoassays of T3, T4, free T4 and TSH. They were largely classified as hypothyroidism, hyperthyroidism, simple goiter and normal. The pedigree of 58 families was drawn by propositus, and then the correlation between thyroid disorders and TSH levels was analyzed. The results are as follows: 1) The offsprings and their mothers of 15 families were hypothyroidism, THS level was 5 folds for offsprings and 4 folds for mothers in comparison with control group. 2) 13 families were hyperthyyroidism in siblings but their mothers were normal in thyroid function, TSH level of the siblings was lower than control group. 3) Though the offsprings and their mothers of 10 families were similar to TSH level of control group, they are all simple goiter, familial thyroid disorders, in other thyroid function test. The familial thyroid disorders suggested that these transmitted from mothers to offsprings with X-linked dominant or autosomal dominant inheritance.

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체질(體質)에 따른 혈중(血中) Hormone 특성(特性)에 관한 연구(硏究) (A Study on the Specific Hormone Characteristics on the Blood in Four Types of Physical Constitution)

  • 김대성;김경요;한종현
    • 사상체질의학회지
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    • 제4권1호
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    • pp.193-212
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    • 1992
  • Comparative hormones quantities on the blood analysis was carried out to investigate the hormones specific characters on the blood in four types of physical constitution. Thyroid-stimulating (TSH), triiodothyronine($T_3$), triiodothyronine uptake($T_3$ uptake), free triiodothyronine(free $T_3$), thyroxine($T_4$), free thyroxine (free $T_4$), thyroxine-binding globulin(TBG), adrenocorticotropic hormone(ACTH), luteinizing hormone(LH), testosterone were measured. The results obtained were summarized as follows: 1. The value of thyroid-stimulating hormone(TSH) on the constitution didn't shown significant difference, while the value of So-EUM-IN was increased and SO-YANG-IN was decreased. 2. The value of triiodothyronine($T_3$) on the constitution didn't shown significant difference, while the value of TAE-EUM-IN was decreased. 3. The value of triiodothyronine uptake($T_3$ uptake) on the constitution didn't shown significant difference, but between the value of TAE-EUM-IN and SO-EUM-IN, TAE-EUM-In and SO-YANG-IN showed significant difference. 4. The value of free triiodothyronine(free $T_3$) on the constitution didn't shown signifcant difference, but between the value of TAE-EUM-IN and SO-EUM-In, TAE-EUM-In and SO-YANG-IN showed significant difference. 5. The value of thyroxine($T_4$) on the constitution didn't shown significant difference, while the value of TAE-EUM-IN and SO-YANG-IN showed difference. 6. The value of free thyroxine(free $T_4$) on the constitution didn't shown significant difference, but between the value of TAE-EUM-IN and SO-YANG-IN showed significant difference. 7. The value of thyroxine-binding globulin(TBG) on the constitution didn't shown significant difference. 8. The value of adrenocorticotropic hormone(ACTH) on the constitution didn't shown significant difference. 9. The value of luteinizing hormone(LH) on the constitution didn't shown significant difference, but between the value of TAE-EUM-IN and SO-EUM-IN, TAE-EUM-IN and SO-YANG-IN showed significant difference. 10. The value of testosterone on the constitution didn't shown significant difference.

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정상기능 갑상선 결절 환자에서 갑상선 유두암의 의미 있는 예측인자로서 혈청 갑상선 자극호르몬의 역할 (The Role of Serum Thyrotropin Level as a Meaningful Predictor of Papillary Thyroid Cancer in Patients with Nontoxic Nodular Goiter)

  • 문신제;박정환;이유화;홍상모;이창범;박용수;김동선;최웅환;안유헌
    • 대한두경부종양학회지
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    • 제27권2호
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    • pp.198-203
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    • 2011
  • Background and Objectives : Distinguishing benign from malignant lesion in thyroid noddex is important but clinically difficult. FNAB is the first investigation of choice. However, cytologic results are often indeterminable. In those cases, additional molecular biologic tests are helpful. If serologic tests are available to predict malignancy, it can be useful to fortify accurate diagnosis. We analyzed whether TSH or FreeT4 level could be used as a predictor of malignancy. Materials and Methods : From January 2008 to March 2009, 540 patients received one of thyroidectomy in a single center. We only included 167 patients from 18 to 65 years old without cardiopulmonary or renal disorders. All the patients were in euthyroid state and took no medications, which affect the thyroid function. We reviewed charts retrospectively to find out differences in TSH level and FreeT4 level between the benign and malignant groups. Results : In this study, all the patients with malignancy had the papillary cancer. In benign group, average TSH level came out to be 1.48mU/L, whereas the average TSH level of malignant group was 1.98 mU/L. Moreover, the higher the cancer stage was, the higher the TSH level was. Although we have adjusted factors that can affect TSH level(age, sex, race, goiter type), we still received the same result. The risk of malignant cancer increased in proportion with TSH level within the normal range. In free T4 level, there was no difference between benign and malignant group. Conclusion : We propose that TSH level can play a role as one of the predictors for thyroid cancer. However, there is limitation because all the patients with malignancy in this study have papillary cancer. Thus, we can apply this result only in papillary cancer, and we need more study for other types of thyroid cancer.

소양인(少陽人) 갑상선기능항진증 환자 1례에 대한 임상보고 (A Case Study of Soyangin Hyperthyroidism Patient)

  • 이진욱;최재송;장문희;안택원
    • 혜화의학회지
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    • 제21권2호
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    • pp.149-156
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    • 2013
  • 1. Objectives This study is about a "Soyangin" hyperthyroidism patient with palpitation, facial flushing, fatigue, hand tremor and vertigo etc. In this case, we evaluated the effect of Oriental medicine treatment for hyperthyroidism. 2. Methods This patient was treated by Sasang constitutional herbal medication based on "Donguisusebowon". Acupuncture and west medications were used together. We evaluated the clinical progress through two method, Blood Test(T3, Free T4, TSH) and VAS(Visual Analogue Scale). 3. Results During 2months treatment, chief complaints, symptoms and blood test results(T3, Free T4, TSH) of this patient were improved. 4. Conclusion This study shows that Yangkyuksanhwa-tang is an effective treatment for "Soyangin" hyperthyroidism patient.