Although several findings of historical writings have been made, the exact role of the thyroid was not known in the ancient times. From the middle of the nineteenth century, the anatomy and the physiological role of the thyroid were gradually elucidated, and diagnostic and therapeutic modalities were developed. It has been 100 years since Theodor Kocher was awarded the Nobel Prize for his work in pathophysiology and surgery of the thyroid. Fifty years have passed since radioactive iodine was first used for the diagnosis and the treatment of hyperthyroidism in Korea. Today, thyroid cancer is one of the most prevalent malignancy in Korean women. However, the detailed history of the thyroid disease has not been introduced in Korea. The aim of this paper is to describe the historical perspectives of the thyroid disease, especially focusing on the development of the treatment. The common thyroid disease ere named after their discoverers, such as Graves and Hashimoto. It is meaningful to understand the historical background of the thyroid gland, because the important concepts in the area of endocrinology such as hormone replacement therapy, feedback mechanisms, and the use of isotopes were first established based on the research of the thyroid.
Female ; History, 19th Century ; History, 20th Century ; Humans ; Thyroid Diseases/*history ; *Thyroid Gland/physiopathology/surgery ; Thyroid Neoplasms/history

Moyamoya-like vasculopathy develops in association with various systemic diseases and conditions, which is termed moyamoya syndrome. Relatively common diseases and conditions are related to moyamoya syndrome, including neurofibromatosis type 1, Down syndrome, thyroid disease, and cranial irradiation. Moyamoya syndrome shares phenotypical characteristics with idiopathic moyamoya disease. However, they differ in other details, including clinical presentations, natural history, and treatment considerations. The study of moyamoya syndrome can provide clinicians and researchers with valuable knowledge and insight. Although it is infrequently encountered in clinical practice, moyamoya-like vasculopathy can severely complicate outcomes for patients with various underlying diseases when the clinician fails to expect or diagnose moyamoya syndrome development. Furthermore, moyamoya syndrome could be used as a doorway to more enigmatic moyamoya disease in research. More comprehensive survey and investigation are required to uncover the secrets of all the moyamoya-like phenomena.
Cranial Irradiation ; Down Syndrome ; Humans ; Moyamoya Disease* ; Natural History ; Neurofibromatoses ; Neurofibromatosis 1 ; Thyroid Diseases

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+/-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.
Adolescent ; Antithyroid Agents ; Child ; Graves Disease ; Humans ; Hyperthyroidism ; Iodine ; Methimazole ; Natural History ; Propylthiouracil ; Recurrence ; Retrospective Studies ; Thyroid Diseases

Subclinical hypothyroidism (SCH) is a common problem in pediatric population, and the natural history of SCH varies depending on its etiology. Whether Hashimoto’s thyroiditis (HT) negatively affects the natural course of SCH was investigated in pediatric patients without concomitant diseases. Predictors for levothyroxine medication were also evaluated. Medical records of 109 children with SCH (91 girls, 5−18 years) diagnosed between 2005 and 2014 were retrospectively reviewed. Patients were classified into HT (n = 37) and isolated non-autoimmune hyperthyrotropinemia (iso-NAHT, n = 72). During median 2 years of follow-up, only 10.1% of SCH patients eventually initiated levothyroxine, and HT patients showed a higher probability of requiring levothyroxine medication than iso-NAHT patients (21.6% vs. 4.2%). Underlying HT independently predicted deterioration of thyroid function, leading to levothyroxine medication (hazard ratios [HRs], 4.6 vs. iso-NAHT, P = 0.025). High titers of anti-thyroglobulin antibodies (TGAbs) predicted later medication in the HT group (HRs, 28.2 vs. normal TGAbs, P = 0.013). Most pediatric SCH showed benign and self-remitting courses. Underlying HT significantly increases the risk for levothyroxine medication, especially with high titers of TGAbs.
Antibodies ; Child* ; Female ; Follow-Up Studies ; Hashimoto Disease ; Humans ; Hypothyroidism* ; Medical Records ; Natural History ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis* ; Thyroxine

Ophthalmic plastic and reconstructive surgery combines the precision of ophthalmic microsurgery with plastic and reconstructive surgical principles, allowing for subspecialized care of the eyelid, orbital, and lacrimal system. A foundation in ophthalmology allows the oculoplastic surgeon's knowledge and skills to safely and successfully protect the globe while achieving good functional and aesthetic results. Oculoplasty emerged following World War II, in which a high rate of ophthalmic and oculoplastic trauma occurred. Following this, more structured and specialized studies dedicated to clinical and surgical management led to the development of a highly specific and rapidly growing sub-specialty dedicated to eyelid, lacrimal, and orbital care. Stem cell treatments in oculoplasty has been spanned a wide array of subfields, ranging from reconstruction of the eyelid to the generation of artificial lacrimal glands and oncological therapeutics. Tissue engineering represents the future of regenerative and reconstructive medicine, with significant potential applications in ophthalmic plastic surgery. Difficulty remains in disease modeling for various disorders, owing to genetic and functional variation across patients as well as the complexity of several diseases. Progressive advances in the understanding of the immunopathogenesis of diseases such as thyroid eye disease and lacrimal gland carcinoma continue to spur clinical trials utilizing targeted therapies to enhance treatment outcomes. Continued investigation of the molecular mechanisms of disease will expand potential treatments. In the future, public awareness and interest in the field of oculoplasty will further grow, and personalized and optimized treatment will become a cornerstone of modern medicine.
Eye Diseases ; Eyelids ; Graves Ophthalmopathy ; History, Modern 1601- ; Humans ; Lacrimal Apparatus ; Microsurgery ; Ophthalmology ; Orbit ; Plastics ; Stem Cells ; Surgery, Plastic ; Thyroid Gland ; Tissue Engineering ; World War II

PURPOSE: Most cases of papillary microcarcinomas of the thyroid (PMC) are not palpable and are clinically asymptomatic. The natural history of the microcarcinoma is unclear and remains debatable. There is continued discussion of whether thyroid microcarcinomas should be treated surgically and to what extent surgical removal should be extended. The main goal of this study was to analyze the clinical features and to determine the appropriate surgical treatment for well differentiated PMC in one lobe of the thyroid with favorable features in regard to consideration of radical surgery. METHODS: We studied 134 patients with the histological diagnosis of PMC from March 2003 to January 2006. The tumor was defined as 10 mm or less in the greatest diameter according to the World Health Organization guidelines. For all patients we confirmed the diagnosis by ultrasoundguided fine-needle aspiration biopsy (US-FNAB) preoperatively. There were 11 men and 123 women. The age at initial treatment ranged from 22 to 74 years (mean 46). Thyroid resection was lobectomy in 31 (23.1%) and total thyroidectomy (TT) in 103 (76.9%). CCND was performed routinely at the time of thyroidectomy. Lateral neck dissection was carried out in eight patients (5.9%) who had biopsy-proven metastatic cervical lymphadenopathy demonstrated clinically or by imaging. Patient records were reviewed retrospectively. Categorical variables were analyzed using the chi-square test or Fisher's exact test. Two-sided Student's t-test was used to compare paired data. RESULTS: The mean tumor size was 6.77 mm. PMC was associated in 36.6% (49/134) with lymph node metastasis, in 20.1% (27/134) with multifocality and in 26.9% (36/134) with capsular invasion. The mean tumor size differences influenced lymph node metastasis (LNM) (P<0.05). Capsular invasion (38.8%, 19/49) and multifocality (30.6%, 15/49) were associated with LNM (P=0.018, 0.022 respectively). The subdivision of primary tumors according to size (5 mm) influenced multifocality (P=0.031). The frequency of LNM, in the contralateral central compartment of patients with lesions in one lobe of thyroid, without capsular invasion, underwent TT with CCND in 1.7% (1/59). CONCLUSION: Currently, thyroidectomy with lymph node dissection has been the recommended first line treatment for microcarcinoma of the thyroid because of the high incidence of multifocality and lymph node metastasis. However, when we excluded patients with aggressive prognostic features we could successfully perform lobectomy and isthmusectomy with ipsilateral CCND based on considerations of radical surgery (98.3%, 58/59). However, subsequent surgery for contralateral nodes or lobe metastasis would not be easy and a longer follow-up period would be required to confirm our hypothesis with regard to the long term recurrence and mortality.
Biopsy, Fine-Needle ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Mortality ; Natural History ; Neck Dissection ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroidectomy ; World Health Organization