No abstract available.

No abstract available.
Humans ; Thyroid Neoplasms*

The occurrence of Graves' disease following subacute thyroiditis (SAT) is rare. The pathophysiology of it is not well known. We report a case of Graves' disease following SAT presented with creeping. A 45-year-old woman presented with neck pain, and thyrotoxic symptoms. Neck pain migrated from left lobe to right lobe of the thyroid. Thyroid scan revealed decreased uptake in the both lobes except the superior portion of the right thyroid gland. Initially, the patient was diagnosed with SAT and treated with steroid therapy. Four months later, thyroid function test showed suppressed thyroid-stimulating hormone (TSH), elevated free thyroxine (T4) and TSH receptor antibody. Thyroid scan revealed increased uptake compatible with Graves' disease. The autoimmune alteration after SAT may lead to the development of Graves' disease in the susceptible patients. These patients should be monitored for the development of Graves' disease.
Female ; Graves Disease* ; Humans ; Middle Aged ; Neck Pain ; Receptors, Thyrotropin ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis, Subacute* ; Thyrotropin ; Thyroxine

BACKGROUND: A diagnostic whole-body scan (WBS) is recommended 6 to 12 months after total thyroidectomy and radioactive iodide ablation in intermediate- or high-risk patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate the necessity of a diagnostic WBS after radioactive iodide ablation in intermediate-risk patients with DTC. METHODS: A total of 438 subjects were included in the study: 183 low-risk subjects and 255 intermediate-risk subjects according to the American Thyroid Association guideline. All subjects diagnosed with DTC received 1,100 MBq (30 mCi) activity of radioiodine (I-131) following total thyroidectomy. On follow-up, all subjects underwent a diagnostic I-131 WBS after thyroid hormone withdrawal. RESULTS: After initial radioactive iodide ablation, 95.1% of low-risk patients and 91.4% of intermediate-risk patients showed no uptake on diagnostic WBS (P=0.135). Intermediate-risk patients with stimulated thyroglobulin (Tg) levels higher than 2.0 ng/mL showed a greater rate of radioactive iodine uptake on diagnostic WBS. Four intermediate-risk patients showed recurrence during the 16 to 80 months follow-up period. Three of the four patients with recurrence showed no uptake on diagnostic WBS and had a stimulated Tg level less than 2.0 ng/mL. CONCLUSION: A diagnostic I-131 WBS after radioactive iodide ablation in intermediate-risk patients with DTC may not be necessary. A large prospective study is necessary to determine the necessity of diagnostic WBS in intermediate-risk patients with DTC.
Follow-Up Studies ; Humans ; Iodides ; Iodine ; Radioactivity ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: Visceral adipose tissue accumulation highly correlates with metabolic abnormalities and cardiovascular disease. Computed tomography (CT) is considered to be the standard method for visceral fat evaluation, but it is not used as a routine procedure. Ultrasonography (US) is a safe method, fairly inexpensive and widely available modality for measuring abdominal fat thickness. The aim of this study was to investigate the correlation between the intra-abdominal fat distance by US measurement and the visceral fat amount by CT and cardiovascular risk factors and to evaluate whether the intra-abdominal fat distance is better correlate with visceral fat amount by CT than other anthropometric parameters and to assess the cut-off value of intra-abdominal fat distance for visceral obesity in type 2 diabetic patients. METHODS: We obtained abdominal subcutaneous and intra-abdominal fat distance by using a high-resolution US (HDI 5000, ATL, Phillps, USA) at 1 cm above umbilical level in one hundred twenty-eight type 2 diabetic patients. CT scan (Light Speed plus, GE, USA) for the measurement of subcutaneous and intra-abdominal visceral fat area was also performed in the supine position at the L4-5 level. Lean body mass and % body fat were measured in a bioimpedance using DSM (Direct Segmental Measurement by 8-point electrode) method (InBody 3.0, Biospace, Seoul, Korea). We measured patient's height, weight, BMI (Body mass index), waist circumference, WHR(Waist-hip ratio) and blood pressure and also measured fasting blood glucose, HbA1c and lipid profiles. RESULTS: Abdominal subcutaneous and visceral fat distance measured by US is 2.05 +/- 0.52 cm, 4.43 +/- 1.54 cm, respectively. In pearson's correlations, visceral fat distance were correlated with BMI (r = 0.681, P < 0.001), waist circumference (r = 0.661, P < 0.001), WHR (r = 0.571, P < 0.001), triglyceride (r = 0.316, P < 0.001), HDL-cholesterol (r = -0.207, P < 0.004). US-determined visceral fat distance was also correlated with visceral fat amount by CT (r = 0.674, P < 0.001) and BMI (r = 0.610, P < 0.001), waist circumference (r = 0.626, P < 0.001), WHR (r = 0.557, P < 0.001). When we used waist circumference (men: 90 cm, women: 85 cm) as parameters for visceral obesity, the cutoff value of visceral fat distance, obtained by the receiver operating characteristic curve analysis, were 4.670 cm in men, 3.695 cm in women diabetic patients. CONCLUSION: Intra-abdominal fat distance measured by US reveals strongly correlated with visceral fat area, which is determined by CT and also well correlated with anthropometric parameters and lipid profiles. We suggest that US provided a better index compared to anthropometry for the prediction of visceral obesity and could be an alternative method for CT for visceral fat determination in diabetic patients.
Abdominal Fat ; Adipose Tissue ; Anthropometry ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Fasting ; Female ; Humans ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; Risk Factors ; ROC Curve ; Supine Position ; Waist Circumference

BACKGROUND: Thyroid cancer is a common disease and its prevalence is increasing. Recent reports have shown that an elevated thyrotropin (thyroid stimulating hormone, TSH) level is associated with thyroid cancer risk. However, the association between TSH level and thyroid cancer risk is not yet known for euthyroid patients diagnosed with papillary thyroid microcarcinoma (PTMC). METHODS: Our study included 425 patients who underwent thyroid surgery and were diagnosed with PTMC between 2008 and 2009. Control group patients were diagnosed with benign nodules < or = 1 cm in size by US-guided fine needle aspiration. Nodules with one or more suspected malignant-ultrasonographic feature(s) were excluded from this study. Patients who were not euthyroid or who took thyroid medication were also excluded. RESULTS: The mean age of all patients was 48.5 +/- 11.0 years and 88.8% were women. The mean age of those with PTMC was significantly lower than that of the control group. The mean TSH level was 1.78 +/- 0.93 mIU/L, and the mean free T4 level was 15.96 +/- 2.32 pmol/L. There was no difference in TSH level between the PTMC and control groups (1.77 +/- 0.93 mIU/L vs. 1.79 +/- 0.91 mIU/L, P = 0.829). After adjusting for age, TSH level was not correlated with tumor size (r = 0.02, P = 0.678) in the PTMC group. Moreover, the TSH level did not differ between patients with stage I and stage III-IV carcinoma (stage I, 1.77 +/- 0.95 mIU/L; stage III-IV, 1.79 +/- 0.87 mIU/L; P = 0.856). CONCLUSION: TSH levels are not elevated in euthyroid PTMC patients. Thus, further evaluation is needed before serum TSH can be used as a tumor marker for small nodules < or = 1 cm in size in euthyroid patients.
Biopsy, Fine-Needle ; Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Prevalence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyrotropin

BACKGROUND/AIMS: Overt thyroid dysfunction is well known to affect weight. However, the influence of normal-range changes in thyroid status on body mass index (BMI) is unclear. We sought to evaluate thyroid function (free T4, TSH) and its possible relationship with BMI and lipid profiles in euthyroid subjects. METHODS: A total of 1572 euthyroid women (mean age 46.2 years) who visited Daegu Catholic University Medical Centre for primary health screening participated in this cross-sectional study. Women who were not euthyroid and women who took thyroid medication were excluded. TSH, free T4, and lipid profile [total-cholesterol, triglyceride (TG), HDL-C, LDL-C] were evaluated. RESULTS: Obese euthyroid women had lower free T4 levels than did lean euthyroid women. After adjustment for age and smoking, free T4, but not TSH, was significantly negatively correlated with BMI. After adjustment for age, smoking, and BMI, free T4 was negatively correlated with TG to a significant degree. CONCLUSIONS: We demonstrated a negative correlation between free T4 within the normal range and BMI in euthyroid subjects. These findings suggest that low free T4 is associated with obesity in euthyroid subjects.
Adult ; *Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Female ; Humans ; Korea/epidemiology ; Middle Aged ; Obesity/blood/epidemiology/*physiopathology ; Pilot Projects ; Thyroid Function Tests ; Thyroid Gland/*metabolism/physiopathology ; Thyrotropin/*blood ; Thyroxine/*blood ; Triglycerides/analysis/blood ; Triiodothyronine/blood

PURPOSE: To evaluate clinical effects of laser thermal keratoplasty (LTK), LTK was performed in patients with presbyopia or hyperopia. METHODS: LTK was performed in 38 patients who was older than 45 between May and December 2001. Preoperative contact lens fitting and wearing for patients to experience the monovision was tried in all patients for one week. With LTK, we intended patients used dominant eyes for distance vision and nondominant eyes for near vision. Patients' satisfaction, refractive change and near visual acuity were evaluated for least 3 months after surgery. RESULTS: The mean improvement of near vision was 5.16 lines by test with Korean near vision chart. 79% (30 of 38) of patients were satisfied with the results of LTK. CONCLUSIONS: Monovision with LTK is thought to be a good option in patients with presbyopia.
Corneal Transplantation* ; Humans ; Hyperopia ; Presbyopia ; Visual Acuity

Objective: The purpose of this study was to evaluate and compare the association of job stress and working with video display terminal (VDT) to musculoskeletal symptoms of the neck-shoulder which were most common in white-collar workers. METHODS: From 122 workplaces, 1,790 white-collar workers with no trauma, and no history of musculoskeletal disease were selected for the study. The questionnaire survey included general characteristics, work related characteristics, Job Content Questionnaire (JCQ) and musculoskeletal symptoms. Multiple logistic regression, adjusted for age, smoking status, drinking habit, housekeeping, work time, job tenure, and work-load change, were used to evaluate the effects of job stress and VDT-work on the symptoms. RESULTS: The prevalence of neck-shoulder symptoms was overall 24.3% overall. The prevalence odds ratio of job demand (high/low) to neck-shoulder symptoms, adjusted for general and work-related factors, was 1.56 (95% confidence interval 1.12~2.17), and that of job strain (high strain/low strain) was 1.72 (1.07~2.79). However, VDT-work was not associated with neck-shoulder symptoms in the multiple logistic regression model. CONCLUSIONS: To prevent musculoskeletal disorders in white-collar workers, it is important to consider psychosocial factors such as job demand and job strain, as well as VDT-work.
Computer Terminals ; Drinking ; Housekeeping ; Logistic Models ; Musculoskeletal Diseases ; Neck* ; Odds Ratio ; Prevalence ; Psychology ; Questionnaires ; Shoulder* ; Smoke ; Smoking

PURPOSE: We retrospectively reviewed the medical records of the patients who had undergone penetrating keratoplasty after glaucoma surgery, to evaluate the surgical outcome of penenetrating keratoplasty associated with glaucoma surgery. METHODS: Twelve patients, 12 eyes were reviewed. Graft status and postoperative intraocular pressure were main outcome measures. And success was defined as thin, clear corneal graft and IOP control between 6 and 21 mmHg after at least 6 month follow-up. RESULTS: The mean age of the patients was 40 year old and male to female ratio was 9 to 3. Mean postoperative follow up time was 12 months for Penetrating keratoplasty and the mean period between glaucoma surgery and penetrating keratoplasty was 12 months. Seventy five percent(9 eyes) maintained clear corneal graft and 67%(8 eyes) showed successful IOP control and both clear graft and IOP control in 58%(7 eyes). CONCLUSIONS: Fifty-eight percent(58%) of our cases showed successful outcome. With the knowledge of better timing for a surgical intervention and an improvement of surgical techniques, there will be an increased success rate.
Adult ; Corneal Transplantation ; Female ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Keratoplasty, Penetrating* ; Male ; Medical Records ; Outcome Assessment (Health Care) ; Retrospective Studies ; Transplants