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

OBJECTIVETo investigate the effect of cigarette smoking on thyroid gland volume, thyroid function and thyroid autoantibodies in the areas with different iodine intakes.

METHODSA cross-sectional epidemiological study in Panshan (mild iodine-deficient area), Zhangwu (more than adequate iodine intake area) and Huanghua (iodine-excessive area) was conducted in 3761 subjects in 1999.80.2 % of them were followed up in 2004. Questionnaires, thyroid function, thyroid autoantibodies, urinary iodine concentration,and thyroid B ultrasound were performed.

RESULTSThe prevalence of goiter was higher in smokers than in non-smokers (15.1% vs. 11.5%, P< 0.05). The average thyroid volume was higher in smokers with phenomenon more obvious in Panshan and Huanghua areas. Data from logistic analysis showed that smoking cigarette was an independent risk factor of goiter. There was no difference in serum TSH and Tg level between smokers and non-smokers. The positive rate of TPOAb (>100 IU/ml) was higher in smokers than in non-smokers(10.8% vs. 9.0 % , P <0.05) and was especially obvious in Huanghua area. Smoking was a independent risk factor of increasing positive rate of TPOAb. During the prospective observation,it was found that the incidence of positive TPOAb(>,100 IU/ml) was 7.4% in the subjects that were from non-smokers turning to smokers and 2.9% in those whose smoking behavior did not change. Logistic analysis indicated that the shifting from non-smoking to smoking was independent risk factor for the increase on high incidence of positive TPOAb.

CONCLUSIONSmoking cigarette was a independent risk factor of goiter. Smoking was also a risk factor of increasing TPOAb positive rate. Shifting from not smoking to smoking was an independent risk factor of increasing high incidence of positive TPOAb.

Autoantibodies ; blood ; Cross-Sectional Studies ; Female ; Goiter ; blood ; epidemiology ; immunology ; physiopathology ; Humans ; Incidence ; Male ; Smoking ; adverse effects ; Thyroid Function Tests ; Thyroid Gland ; physiopathology ; Thyroid Hormones ; blood

Child, Preschool ; Diagnosis, Differential ; Histiocytosis, Langerhans-Cell ; complications ; diagnosis ; physiopathology ; Humans ; Male ; Thyroid Gland ; pathology ; Thyroid Nodule ; diagnosis ; etiology ; pathology

BACKGROUNDPreparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment "sequential thyroid defunctionalization followed by thyroxine supplementation."

METHODSFour hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with "sequential thyroid defunctionalization followed by thyroxine supplementation". Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications.

RESULTSCompared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group (326 +/- 163) ml in the control group; (196 +/- 57) ml in subgroup A; (230 +/- 71) ml in subgroup B; (240 +/- 80) ml in subgroup C; and (312 +/- 97) ml in subgroup D). The postoperative complication rate of the experimental group was 8.64% (21/243) whereas that of the control group was 17.54% (40/228).

CONCLUSIONSSequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected hyperthyroid patients undergoing thyroidectomy.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Hyperthyroidism ; physiopathology ; surgery ; Male ; Middle Aged ; Thyroid Gland ; pathology ; physiopathology ; Thyroidectomy ; Thyroxine ; administration & dosage

BACKGROUNDIntraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been widely applied during thyroid surgery. However, the safe range of stimulation intensity for IONM remains undetermined.

METHODSTotal thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5-20 mA (step-wise in 5 mA increments) for 1 min. The evoked electromyography (EMG) of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope.

RESULTSThe average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs (15 mA group: 0.320 ± 0.123 mA vs. 0.315 ± 0.097 mA, P = 0.847; 20 mA group: 0.305 ± 0.101 mA vs. 0.300 ± 0.103 mA, P = 0.758). Similar outcomes were shown in average evoked EMG amplitude (15 mA group: 1,026 ± 268 μV vs. 1,021 ± 273 μV, P = 0.834; 20 mA group: 1,162 ± 275 μV vs. 1,200 ± 258 μV, P = 0.148). However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA.

CONCLUSIONSA stimulation intensity less than 15 mA might be safe for IONM of the RLN.

Animals ; Dogs ; Electromyography ; Male ; Monitoring, Intraoperative ; methods ; Recurrent Laryngeal Nerve ; physiopathology ; surgery ; Thyroid Gland ; physiopathology ; surgery ; Thyroidectomy ; methods

The basic function of vascular endothelial growth factor (VEGF) is to promote vascular growth. Recent studies show that VEGF plays a vital role in various thyroid diseases through prompting angiogenesis. But the function of VEGF and specific change condition in different thyroid disease still needs further explorations. This review mainly focuses on the molecular characteristics and clinical application of VEGF.
Angiogenesis Inducing Agents ; Animals ; Graves Disease ; metabolism ; physiopathology ; Humans ; Thyroid Diseases ; metabolism ; physiopathology ; Thyroid Gland ; blood supply ; Thyroid Neoplasms ; metabolism ; physiopathology ; Thyroiditis ; metabolism ; physiopathology ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo observe therapeutic effect of picking therapy on Graves' disease (GD) and its effects on thyroid function.

METHODSSixty cases of GD were randomly divided into a treatment group (pricking therapy group) and a control group (medication group). They were treated respectively with pricking thyroid gland high point or oral administration of tapazole. And changes of total triiodothyronine (TT3), total thyroxine (TT4), free T3 (FT3), free T4 (FT4), thyroxine receptor antibody (TRAb), supersensitive thyrotropin (S-TSH) after treatment were investigated.

RESULTSThe total effective rate was 93.33% in the treatment group and 76.67% in the control group with a significant difference between the two groups (P < 0.05). After treatment, serum TT3, TT4, FT3, FT4 and S-TSH contents had very significant change in the two groups (P < 0.01), TRAb had very significant change in the treatment group (P < 0.01) and no significant change in the control group (P > 0.05) there were significant differences in decrease of TT3, FT3, TRAb (P < 0.05) and no significant difference in decrease of TT4, FT4 and increase of S-TSH between the two groups (P > 0.05).

CONCLUSIONPricking therapy has a definite therapeutic effect on Graves' disease, which is carried out through regulating thyroid function.

Acupuncture Therapy ; methods ; Adult ; Female ; Graves Disease ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Thyroid Gland ; physiopathology ; Thyroid Hormones ; blood ; Thyrotropin ; blood

Atrial fibrillation may occur in patients with a variety of cardiovascular or chronic disease as well as in normal subjects. Many authors reported that atrial fibrillation occurs in patients with thyrotoxicosis. It is reported that a low serum thyrotrophin concentration in an asymptomatic person with normal serum thyroid hormone concentrations can be a independent risk factor for developing atrial fibrillation. But we focused on the significance of serum thyroid stimulating hormone (TSH) in the euthyroid patient with atrial fibrillation whose serum level of T3, T4, fT4, and even TSH were absolutely within normal range. On our results, there was no significant differences in age, sexual distribution, and left ventricular ejection fraction between the patients group of paroxysmal and chronic persistent atrial fibrillation (p> 0.05), but there was larger left atrial dimension (LAD) and more cases of rheumatic heart disease in the chronic persistent atrial fibrillation group and there was more cases of lone atrial fibrillation in the paroxysmal atrial fibrillation group (p< 0.05). There was no significant differences in serum levels of T3, T4, fT4 between paroxysmal and chronic persistent atrial fibrillation, but significantly lower serum TSH was found in patients with paroxysmal atrial fibrillation (p< 0.001), and these findings were more significant after the control of hemodynamic change (p< 0.001 vs p< 0.05). The discriminant value in serum TSH between the paroxysmal and chronic atrial fibrillation group was 1.568U/mL with about 76% of predictive power. There was significantly lower serum TSH in paroxysmal atrial fibrillation in all age groups (p< 0.05). There was a significantly higher prevalence of cerebral thromboembolic events in chronic persistent (27.7%) and disease-associated (15.0% atrial fibrillation than in the paroxysmal (3.3%) and lone (4.5%) atrial fibrillation group (p< 0.001). Therefore, we suggest that serum TSH below the serum concentration of 1.5U/mL can be a risk factor for developing atrial fibrillation when the serum level of T3, T4, fT4, and even TSH were within absolutely normal range.
Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Atrial Fibrillation/*blood/physiopathology ; Chi-Square Distribution ; Female ; Human ; Male ; Middle Age ; Thyroid Function Tests ; Thyroid Gland/*physiopathology ; Thyrotropin/*blood

OBJECTIVETo explore the effects on thyroid function in patients of Hashimoto's thyroiditis treated with aconite cake-separated moxibustion and option the better therapeutic program.

METHODSEighty-five cases were randomly divided into a moxibustion group (42 cases) and a western medication group (43 cases). The moxibustion group was treated by aconite cake-separated moxibustion therapy with acupoints of two groups [(1) Danzhong (CV 17), Zhongwan (CV 12), Guanyuan (CV 4); (2) Dazhui (GV 14), Shenshu (BL 23), Mingmen (GV 4)] alternatively and oral administration of 25 microg Euthyrox everyday. The western medication group was oral administration of 25 microg Euthyrox everyday. Indices of thyroid function before and after treatment and clinical effect were compared between two groups.

RESULTSThe clinical total effective rate and effective rate of thyroid function were 25.0% (10/40), 87.5% (35/40) in moxibustion group respectively, 7.53% (3/40) and 57.5% (23/40) in western medication group, with significant differences between two groups (both P < 0.05). Content of serum free thyroxine index (FT4) increased significantly in the moxibustion group after treatment (P < 0.01); content of serum supersensitive thyrotropin (S-TSH) in the moxibustion group was lower than that of western medication group, and contents of serum FT4 and free triiodothyronine (FT3) were higher than those of western medication group, but with no significant differences (all P > 0.05).

CONCLUSIONAconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) combined with oral administration of Euthyrox can improve clinical symptoms and thyroid function in patients of Hashimoto's thyroiditis, which is better than simple oral administration of Euthyrox.

Aconitum ; chemistry ; Acupuncture Points ; Adult ; Aged ; Female ; Hashimoto Disease ; blood ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Thyroid Gland ; physiopathology ; secretion ; Thyroid Hormones ; blood ; Thyrotropin ; blood ; Young Adult

OBJECTIVEAbnormal maternal thyroid function is associated with preterm birth. However, this association stays dubious in relevant individual studies for ethnic difference reasons and lack of direct supporting data. This study aimed to evaluate the relationship between preterm birth and thyroid dysfunction or autoimmunity based on ethnic differences.

METHODSRelevant studies were identified through searches of MEDLINE, Excerpta Medica, Wan Fang, China Biological Medicine disc, and China National Knowledge Infrastructure from inception to June 15, 2016. Original articles in which an incidence or prevalence of thyroid dysfunction or autoimmunity before second trimester of pregnancy could be extracted were included.

RESULTSThirty-two unique studies were included for the final meta-analysis. Patients involved were divided into two groups: Group 1 (G1) and Group 2 (G2) comprising of Asian and Caucasian populations, respectively. Positive thyroid antibodies were associated with the occurrence of preterm birth in both G1 [odds ratio (OR): 3.62, 95% confidence interval (CI): 2.83-4.65] and G2 (OR: 1.35, 95% CI: 1.17-1.56); hypothyroidism, only in G2 (OR: 1.20, CI: 1.09-1.33); and subclinical hypothyroidism or hypothyroxinemia, in neither group.

CONCLUSIONThyroid autoimmunity may be a more favorable factor leading to preterm birth among pregnant women of different ethnicities, compared with thyroid dysfunction.

Autoimmune Diseases ; ethnology ; immunology ; physiopathology ; Autoimmunity ; Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications ; ethnology ; immunology ; physiopathology ; Premature Birth ; ethnology ; immunology ; physiopathology ; Thyroid Diseases ; ethnology ; immunology ; physiopathology ; Thyroid Gland ; physiopathology