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대한갑상선학회> International Journal of Thyroidology

International Journal of Thyroidology update

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수록정보
수록범위 : 1권1호(2008)~12권2호(2019) |수록논문 수 : 314
International Journal of Thyroidology
12권2호(2019년 11월) 수록논문
최근 권호 논문
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KCI등재

1분화갑상선암과 방사성요오드: 과거, 현재 그리고 미래

저자 : 이재태 ( Jaetae Lee ) , 조일 ( Il Jo )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 71-78 (8 pages)

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Radioiodine has been known as an important and safe armamentarium in the diagnosis and treatment of differentiated thyroid cancer (DTC) for more than 70 years. The 2015 guidelines from the American Thyroid Association (ATA) for adults with thyroid nodules and DTC seem to be the most comprehensive guidelines in the thyroid cancer field. The 2015 ATA guidelines provided an advance in evidence-based management of DTC, and resulted in a significant change in the patterns of practice regarding the application of the radioiodine. However, the 2015 ATA guidelines also provoked much controversy because a substantial portion of the recommendations announced were not based on sufficiently strong evidence. While the number of radioiodine administrations in Korea in the year of 2018 has decreased to a level less than 50% of that in 2013, in this review, we address some of the current issues and controversies regarding the application of radioiodine for the diagnosis, ablation and treatment of DTC, especially related to the 2015 ATA guidelines. Possible strategies for the achievement of better quality in radioiodine imaging and improvement in treatment efficiency that can be used in the near future are also discussed here.

KCI등재

2그레이브스병의 내과적 치료

저자 : 정현경 ( Hyun-kyung Chung )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 79-84 (6 pages)

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Among the three treatment modalities of Graves' disease which include antithyroid drug (ATD), radioactive iodine and surgery, the ATD is most commonly preferred in Korea due to ease of use and definite curative effects on the thyrotoxic symptoms. However, several uncertainties about ATD remain: for example, the mechanism of actions on immune modulation, differences in the effects of drugs among individuals and associated factors in the view of remission. In recent years, long-term ATD treatment has been confirmed as an effective and safe therapy modality in adults, and several treatment guidelines have been released which accept long-term ATD therapy as an acceptable alternative to ablative therapy in Graves' patients. In this review, we summarize the recent progress in understanding the clinical role of ATD and emerging new antithyroid drugs focusing on immunomodulation.

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3그레이브스병에서 방사성요오드 치료의 최신지견

저자 : 정신영 ( Shin Young Jeong )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 85-90 (6 pages)

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Radioiodine (RAI) has been used for the treatment of hyperthyroidism and is usually administered orally as sodium iodide (I-131) in solution or a capsule. However, this results in RAI being rapidly incorporated into the thyroid cells, and extensive local tissue damage occurring via beta emissions of I-131. The incidence rate of hypothyroidism is 5-50% at the first year after RAI therapy and is positively associated with the dosage of RAI. RAI has been used since 1960 in Korea; however, there have been few well-designed prospective trials, leaving many questions about indications, optimal dose, efficacy, and side-effects. This review summarizes the latest research pertaining to clinical questions about indications, optimal dose, efficacy, and side-effects.

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4갑상선안병증의 치료

저자 : 이정규 ( Jeong Kyu Lee )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 91-96 (6 pages)

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Graves' ophthalmopathy (GO) is an autoimmune disease associated with orbital inflammation and fibrosis which can result in lid retraction, soft tissue swelling, and proptosis. Treatment should rely on a thorough assessment of the activity and severity of GO. Control of risk factors for GO progression and topical treatments for dry eye are recommended for all patients. In mild GO, a careful observation is usually sufficient. In moderate-to-severe and active GO, high-dose intravenous glucocorticoids can be considered an initial treatment. The most common schedule for intravenous glucocorticoids is a cumulative dose of 4.5 g of methylprednisolone, divided into 12 weekly infusions (6 weekly infusions of 0.5 g, followed by 6 weekly infusions of 0.25 g). Orbital radiation has been shown to be an effective secondary treatment in patients with active GO unresponsive to intravenous glucocorticoids. Rehabilitative surgery is needed in patients with GO when the disease is associated with a significant impact on quality of life or visual function after the disease has been inactive for at least 6 months.

KCI등재

5암면역치료 연관 내분비 이상반응

저자 : 김하나 ( Hana Kim ) , 조선욱 ( Sun Wook Cho ) , 박영주 ( Young Joo Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 97-104 (8 pages)

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Cancer immunotherapy has emerged as a promising therapy for a wide variety of tumors. Immune checkpoint inhibitors including anti cytotoxic T lymphocyte antigen 4 (CTLA-4), programmed death 1 (PD-1) and programmed death ligand-1 (PD-L1) monoclonal antibodies have proven to be especially effective in various advanced cancers. However, cancer the immunotherapy disturbs the immune system and may also cause immune related side effects (IRAE) distinguished from cytotoxic chemotherapy toxicity. Among them, endocrine IRAE has been reported with a higher incidence than other organ IRAE. We focus on the most relevant and new aspects related to endocrine IRAE due to cancer immunotherapy in this review.

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Background and Objectives: This study was to investigate the association between the previous history of seaweed intake after childbirth and subclinical hypothyroidism (SCH) occurrence in Korean women based on the latest nationally representative epidemiological survey data, the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI). Materials and Methods: This study used data from KNHANES VI, a cross-sectional, nationally representative survey that comprises a health interview survey, health examination survey, and nutrition survey. Of the initial 22,948 Korean participants enrolled in KNHANES VI, 2,046 women were selected for this analysis. To examine SCH, the thyroid-stimulating hormone (TSH) reference range was defined using a population-based TSH range. Results: Subclinical hypothyroidism was increased in those who consumed seaweed soup after childbirth, but this was not significant (OR 1.3, CI: 0.80-2.13, p=0.293). However, the odd ratio for SCH differed according to the duration of seaweed soup consumption. When seaweed soup was consumed within 1 week after birth, the OR was increased in the crude model (OR 2.61, CI: 1.39-4.89, p=0.002), but this was no longer significant in the adjusted model (OR 1.89, CI: 0.79-4.50). Conclusion: The notable finding from this study is that the previous history of excessive seaweed consumption during post-partum period may not be a risk factor for SCH in Korean women.

KCI등재

7갑상선암 환자의 수술 후 직업 변화 및 휴직 기간과 관련된 요인

저자 : 박경아 ( Kyung Ah Park ) , 오영자 ( Young Ja Oh ) , 추상희 ( Sang Hui Chu ) , 이용상 ( Yong Sang Lee ) , 장항석 ( Hang-seok Chang ) , 박정수 ( Cheong Soo Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 113-119 (7 pages)

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Background and Objectives: Most thyroid cancers progress slowly, have high survival rates, and have good prognosis. Therefore, the management of patients with thyroid cancer should be viewed from a long-term perspective, taking into account a return to normal social life. Cancer patients have a higher risk of unemployment than the general population, and so unemployment can be an economic problem for thyroid cancer patients. However, there have been few studies on factors affecting return to work in thyroid cancer patients. The purpose of this study is to investigate occupational changes and the period of leave of absence for patients with thyroid cancer and to identify factors that affect the return to work after surgery. Materials and Methods: A total of 427 questionnaires of thyroid cancer patients were used for the analysis. The occupational changes and sick leave periods were analyzed according to general characteristics, disease-related characteristics, and side effects. Results: The factors related to occupational change and leave of absence in thyroid cancer patients were sex and type of occupation. Women had more occupational changes and longer leave of absence than men, office workers had the least change in occupation, and professional workers had a longer period of sick leave. Fatigue was the primary side effect that affected the leave of absence. Conclusion: Occupation is very important in the life of a thyroid cancer patient. Informing the patient of possible complications and planning proper leave of absence will help the patient return to work and improve the quality of life.

KCI등재

82 cm 이하의 저위험군 갑상선유두암 환자에서 갑상선엽절제술과 갑상선전절제술의 비교연구

저자 : 박한송 ( Han Song Park ) , 이형신 ( Hyoung Shin Lee ) , 성정화 ( Jung Hwa Sung ) , 황현정 ( Hyun Jung Hwang ) , 김성원 ( Sung Won Kim ) , 이강대 ( Kang Dae Lee )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 120-126 (7 pages)

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Background and Objectives: The controversy over the optimal extent of thyroidectomy for papillary thyroid carcinoma (PTC) has persisted over a long time period. Particularly, there is a lack of consensus in low-risk PTC sized >1 cm and ≤2 cm. In this retrospective study, we analyzed the oncologic outcomes between hemi-thyroidectomy and total thyroidectomy in patients with low-risk PTC sized 2 cm or less. Materials and Methods: A retrospective chart review of 1107 patients who were diagnosed as unilateral low-risk PTC with maximal tumor size 2 cm or less and initially underwent either hemi-thyroidectomy (n=550) or total thyroidectomy (n=557) was conducted. All patients underwent ipsilateral prophylactic central neck dissection. Patients had no evidence of gross extrathyroidal extension or lymph node metastasis. Clinicopathologic factors and recurrence rate were compared according to the surgical extent and factors correlated to recurrence were analyzed. Results: While the total thyroidectomy group had more aggressive clinicopathologic factors such as minimal extrathyroidal extension, multifocality, and lymph node metastasis, recurrence rate was higher in the hemi-thyroidectomy group (p=0.006). However, when the contralateral lobe recurrence was excluded there was no difference in recurrence between the two groups (p=0.597). In patients with tumor sized >1 cm and ≤2 cm there was no significant difference in recurrence between the two groups (p=0.100). Conclusion: Total thyroidectomy may not decrease recurrence in patients with PTC presented with unilateral tumor sized >1 cm and ≤2 cm. Hemi-thyroidectomy could be considered the treatment of choice in these patients when they are presented as a low-risk group.

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9A Case of Severe Pneumocystis Pneumonia in a Thyroid Cancer Patient Receiving Lenvatinib

저자 : Mei Hua Jin , Won Gu Kim , Tae Yong Kim , Won Bae Kim , Young Kee Shong , Min Ji Jeon

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 127-131 (5 pages)

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Lenvatinib is a multitargeted tyrosine kinase inhibitor approved for use in patients with iodine-131-refractory thyroid cancer. The common adverse events of lenvatinib include hypertension, proteinuria, fatigue, and diarrhea. To date, no report on Pneumocystis pneumonia (PCP) in patients receiving lenvatinib has been published. Here, we present a case of severe PCP that led to the death of a 79-year-old woman who was diagnosed with poorly differentiated thyroid cancer and received lenvatinib. The development of PCP should be considered when patients taking lenvatinib show clinical symptoms of pneumonia, and regular chest X-ray follow-up is needed for patients receiving lenvatinib.

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10Subtotal Parathyroidectomy for Tertiary Hyperparathyroidism: a Case Report and Literature Review

저자 : Younil Jang , Gheun-ho Kim , Jung Hwan Park , Kyung Tae

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 12권 2호 발행 연도 : 2019 페이지 : pp. 132-136 (5 pages)

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Despite the correction of secondary renal hyperparathyroidism after successful kidney transplantation, some recipients have persistent hyperparathyroidism due to autonomous hypertrophied parathyroid glands. St. Goar first identified and termed this disease as tertiary hyperparathyroidism. Surgery, either subtotal parathyroidectomy or total parathyroidectomy with autotransplantation, is the main treatment for tertiary hyperparathyroidism. Here, we report a case of a patient with tertiary hyperparathyroidism after two times of kidney transplantation who underwent subtotal parathyroidectomy and also review the relevant literature.

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