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PubMed1998

[The manifestations of 496 cases with thyroid-related immune orbitopathy and normal thyroid function].

OBJECTIVE: To observe the clinical manifestations of thyroid-related immune orbitopathy (TRIO) with normal thyroid function. METHODS: 496 cases with TRIO were collected from 1973 to 1994 and their clinical manifestations were analyzed. RESULTS: The clinical manifestations showed that males are more than females. The disease occurred in middle aged persons with unilateral exophthalmos as the primary early manifestation. Most of the cases had the signs of eyelids and extraocular muscle involvement. CONCLUSIONS: The thyroid-related immune orbitopathy with normal thyroid function can be named thyroid-related immune orbitopathy-II. The clinical characteristics of this disease are unilateral, of signs of eyelids, exophthalmos and enlargement of eye muscles. The pseudo-tumors of the orbit are mainly considered for differential diagnosis.

Adolescent↗
PubMed1992

Unilateral versus bilateral thyroid resection in differentiated thyroid carcinoma.

Risk-group definitions have been developed recently in an attempt to clarify which operation to do for whom in differentiated thyroid carcinoma. The authors attempted to confirm the validity of an age-based risk-group definition for identifying patients at high risk of death from thyroid carcinoma and to test whether the degree of surgical resection in either high- or low-risk groups affected patient survival. An age-based risk-group definition was used in the retrospective analysis of 161 patients with differentiated thyroid carcinoma seen at the Saskatoon Cancer Centre, University of Saskatchewan, between 1933 and 1964. A significant difference was found in the death rate between low- and high-risk groups (4.3% versus 47% respectively). This confirms the validity of such an age-based risk-group definition. Although a long-term survival benefit was suggested with the use of bilateral thyroid resection in high-risk patients, the difference was not significant. In low-risk patients, there was no difference in the survival rate between patients who underwent unilateral or bilateral thyroid resection, followed up for as long as 55 years.

Adenocarcinoma↗
PubMed2004

The expression and distribution of S-100 protein and CD 83 in thyroid tissues of autoimmune thyroid diseases.

To investigate the expression and distribution of S-100 protein and CD 83 in the thyroid tissues of autoimmune thyroid diseases (ATDs), and to study the role of the dendritic cells in the pathogenesis of ATDs, immunohistochemical staining was used on pathological tissues of 20 patients with Hashimoto's thyroiditis (HT) and 20 patients with Graves' disease (GD) to check the expression and distribution of S-100 protein and CD 83. Compared with control group (20 cases of thyroid follicular adenoma, TFA), the higher expressions of S-100 in HT (139.38+/-5.92 vs 59.47+/-11.69) and GD (119.42+/-14.48 vs 59.47+/-11.69) were observed respectively (p<0.001). The increased positive expressions of CD 83 which is known as a marker of mature and activated DCs in HT (22.58+/-13.96 vs 5.19+/-8.08) and GD (29.92 +/-14.43 vs 5.19+/-8.08) were also found respectively (p<0.001). Serum TPO antibody (TPO-Ab, 67.3+/-11.6%) and Tg antibody (Tg-Ab, 59.8+/-10.1%) in HT were higher than those in GD (28.4+/-5.7%, 23.1+/-4.9%) and TFA (6.1+/-3.4%, 7.2 +/-4.6%) (p<0.01). Serum TR-Ab in GD (16.3+/-5.6 U/L) was higher than those in HT (4.8+/- 2.3 U/L) and TFA (2.5+/-1.2 U/L) (p<0.01). Our findings suggest that the high expression of DCs' markers may be related to the pathogenesis of HT and GD. The upregulation of both the number and the matured functions of DCs, may lead to present more antigens and to produce more auto-antibodies (such as Tg-Ab and TPO-Ab in HT, TR-Ab in GD), which may be involved in pathogenesis of the autoimmune thyroid diseases.

Adult↗
PubMed1975

Thyroidal autoregulation. Iodide-induced suppression of thyrotropin-stimulated cyclic AMP production and iodinating activity in thyroid cells.

In continuing our study of the thyroidal autoregulation phenomenon, we have investigated the effects of iodide on several thyroidal responses to thyrotropin. Thus, we have found that the 2--4-fold thyrotropin stimulation of protein iodination in beef thyroid cells was reduced about 30% by 4 h of preincubation with 10 muM iodide, and virtually abolished with 50 muM iodide. Similarly the 8-fold thyrotropin stimulation of cyclic AMP accumulation in the cells was reduced about 30% by 3 h of preincubation with 50 muM iodide. It appears therefore that the so-called autoregulation of the thyroid gland does include influences of iodide on the thyrotropin stimulation of cyclic AMP production, iodide transport, and protein iodination which can be demonstrated in vitro in the dispersed thyroid cell system. Two other effects of thyrotropin, namely, the stimulation of [14C]leucine incorporation into protein and of iodide efflux were not at all affected by treatment with excess iodide, and hence may not be subject to the autoregulatory influence of iodide.

Animals↗
PubMed1991

The peak systolic velocity of the common carotid artery and superior thyroid artery as an indicator of thyroid function.

We investigated the efficacy of color duplex ultrasound in the detection of the thyroid's functional state on 132 consecutive patients referred for morphological examination of the thyroid gland. The patients were classified into 3 groups: Group A (euthyroid, n = 108), Group B (diffuse toxic goiter, n = 16) and Group C (hyperthyroidism on medical treatment for 1 to 4 months, n = 8), according to the serum thyroid hormones' determination and the patient's clinical history. The peak systolic velocity (Vmax) of the bilateral common carotid arteries (CCAs) and superior thyroid arteries (STAs) were measured. The Vmax of CCAs was 90.33 +/- 23.13 cm/sec (mean +/- standard deviation), 148.44 +/- 28.97 cm/sec and 84.75 +/- 13.58 cm/sec in Groups A, B and C. The hyperthyroid patients had a significantly higher Vmax of CCAs than the euthyroid subjects (p less than 0.001) and those hyperthyroid patients receiving medical treatment (p less than 0.001). The Vmax of STAs was 32.4 +/- 13.49 cm/sec for the non-nodular lobes and 38.78 +/- 13.76 cm/sec for the nodular lobes in the euthyroid subjects. There was no difference between the non-nodular and nodular lobes. The Vmax of STAs was 91.69 +/- 32.02 cm/sec and 62.75 +/- 18.19 cm/sec for Groups B and C; both were higher than the euthyroid (p less than 0.001 and p less than 0.05 respectively). Patients with hyperthyroidism had a lower Vmax of STAs after medical treatment (Group B vs Group C, p less than 0.01). It is our conclusion that cases of hyperthyroidism have a higher volume of blood flow of both the common carotid arteries and thyroid arteries than the euthyroid cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Global 99mTc uptake in the differential diagnosis of a normal thyroid,goiter with euthyroidism and thyroid autonomy in an area of iodine deficiency].

Global TcTU was determined in 568 patients without any specific thyroid drug intake--54 with normal thyroid, 274 with goitre and euthyroidism and 240 with thyroid autonomy. 57 patients with autonomy and overt hyperthyroidism were the only group with TcTU values significantly higher than normals. Common to all groups was a large scatter of the TcTU values. In 332, the effects of individual iodine supply were studied by measuring the iodine concentration in spot urine samples. There was a significant inverse correlation between the TcTU values and the urinary iodine excretion in the groups of normal thyroids and of goitres with euthyroidism. In the group with autonomy an effect of iodine supply could only be seen in cases of greatly increased urinary iodine excretion, resulting in very low TcTU values. Out of 20 patients with autonomy and iodine contamination, only 4 showed overt hyperthyroidism. The large scatter of TcTU values in all groups may be explained by the persistent iodine deficiency as well as by the frequent exposure to unknown amounts of iodine in patients with thyroid disease. Therefore, the spontaneous TcTU alone cannot identify a small group of patients with autonomy and high risk of iodine-induced hyperthyroidism, from a very large group of patients with goitre.

Adult↗
PubMed1990

[Analysis on the traditional Chinese medicine syndromes of the patients with autoimmune thyroid diseases. Changes in the thyroid and immune functions in 109 cases].

Eighty-nine cases of hyperthyroidism and 20 cases of hypothyroidism caused by Hashimoto's thyroiditis were observed in order to analyse the thyroid and immune functions of the patients, and their relationship with the syndromes of TCM. The results showed that, in the patients with Yin deficiency syndrome, the contents of total T4, T3 were higher than normal and TSH lower than normal, while in Yang deficient patients, the contents of total T4, T3 were lower than normal and TSH higher than normal. This results suggested that the states of thyroid functions were closely related to the TCM syndromes. It was also found that the percentage of OKT 4+ cells and the self-recognizing ability of lymphocytes were lower than normal in patients with hyperthyroidism and Yin deficiency. While in patients with hypothyroidism and Yang deficiency, they were higher than normal. These meant that the abilities of lymphocyte autoreaction in Yin deficient patients were in contrary tendency with those in Yang deficient patients. The former had the manifestation of over-inhibition while the latter, hyperaction. Besides, the contents of auto-antibodies were higher than normal in both the patients with hyperthyroidism and hypothyroidism, which manifested itself as a common character of autoimmune thyroid diseases. The results indicated that there were common characters as well as individual characters of thyroid and immune functions between hyperthyroid patients and hypothyroid patients, and these characters might well be the material bases of various syndromes in TCM.

Adult↗
PubMed1986

Autoantibodies to thyroid peroxidase in patients with chronic thyroiditis: effect of antibody binding on enzyme activities.

Using thyroid peroxidase (TPO), which was purified from the thyroid of patients with Graves' disease, we attempted to determine whether sera from patients with chronic thyroiditis contained antibodies to the enzyme. When the binding was tested by ELISA, sera from patients with chronic thyroiditis revealed high binding activities to TPO. When TPO was incubated with IgG from sera followed by treatment with protein A-Sepharose and centrifugation, the remaining TPO activities in the supernatant fraction were lower in most of the patients, as compared to normal controls. Moreover, IgG purified by DEAE-cellulose chromatography from sera in patients interfered with the TPO activities. Titres of anti-TPO antibodies correlated well with those of anti-microsome antibodies. These results indicate the presence of autoantibodies to TPO in sera of most patients with chronic thyroiditis and that TPO may be one component of microsome antigen complexes recognized by the autoantibodies. Studies on the inhibition of TPO by IgG isolated from sera of patients using guaiacol and iodide assays revealed that at least three epitopes of TPO molecule were recognized by autoantibodies and that the antigenic determinants on TPO molecule recognized by autoantibodies could be heterogeneous in patients.

Adolescent↗
PubMed1989

[Thyroid dysfunction and thyroid antibodies in a population group over the age of 70. A prevalence study from Oslo and Naeröy].

The prevalence of thyroid dysfunction and thyroid antibodies was investigated in a small rural community (Naerøy) and in Oslo. Attendance rates in Naerøy and Oslo were 99 and 71%, respectively. The prevalence of undiagnosed latent hypothyroidism and primary hypothyroidism was 4.0 and 5.3% in women in Oslo and Naerøy respectively and 0 and 3.5% in men. Undiagnosed hyperthyroidism was detected in 1.2% of men in Naerøy and in 1% of women in Oslo. Antibody to the thyroid microsomal antigen in titre greater than or equal to 400 was detected in 10.2 and 17.5% of women and 7.3 and 7.2% of men in Oslo and Naerøy, respectively. Among women with antibody to the thyroid microsomal antigen in both Oslo and Naerøy, and among men in Naerøy, the prevalence of past or present thyroid dysfunction was increased.

Age Factors↗
PubMedDate not supplied

Cytochemical assessments of the nuclear DNA distribution pattern by means of image and flow cytometry in thyroid neoplasms and in non-neoplastic thyroid lesions. A comparative methodological study.

The two most prevalent techniques for cytochemical DNA assessment of the nuclear DNA distribution pattern in neoplastic cells are image cytometry (ICM) and flow cytometry (FCM). The aim of the present study was to compare the results of nuclear DNA assessments, obtained by means of these two methods, in fresh surgical biopsy specimens from the thyroid gland, both in neoplasms and in nonneoplastic lesions. Material for DNA analysis was taken preoperatively by fine needle aspiration (FNA) biopsy from 13 papillary thyroid carcinomas and analyzed by the two methods. Surgical specimens were taken from 48 papillary thyroid carcinomas (one of which showed low differentiated papillary and anaplastic giant cell formations at autopsy), 2 follicular carcinomas, 66 follicular adenomas, 7 medullary carcinomas as well as from the nodules of 17 non-toxic colloid goitres and 19 specimens from the diffusely hyperplastic thyroid parenchyma in patients with hyperthyroidism. For the ICM assessments, FNA biopsies or imprints were made from the macroscopically identified fresh thyroid biopsy specimens; for the FCM assessments FNA specimens from the same region were used. In 155 out of the 159 specimens the results obtained by means of the two methods were the same. The DNA distribution pattern in 106 of the neoplasms and in all the 36 non-neoplastic lesions were of the "euploid" type (i.e. "diploid" or diploid/tetraploid"), whereas that of 17 neoplasms were of the "aneuploid" type. Fifteen of the histopathologically benign follicular adenomas showed a cytochemical DNA distribution pattern that by means of FCM was of the "aneuploid" type.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Amiodarone-induced thyroid dysfunction: diagnostic role of free serum thyroid hormone levels and pathogenetic significance of antithyroid antibodies.

Forty-six patients treated with amiodarone hydrochloride for a mean period of 41 +/- 3.5 months, with an average daily dose of 240 +/- 57 mg/day, have been studied. Thyroid function was assessed clinically and by laboratory tests, which included free-triiodothyronine (free-T3), free-thyroxine (free-T4) and thyrotropin. Antimicrosomal and antithyroglobulin antibodies were also looked for. Three patients (6.5%) were found to be hyperthyroid and two (4.3%) hypothyroid. Of the 41 clinically euthyroid patients, 19 (46.3%) showed one or more abnormalities in the thyroid function tests. In this group, only free-T4 was found significantly increased (p less than 0.05) as compared to both control populations. Antimicrosomal antibodies (titre greater than or equal to 1:1600) were present in 4 of 41 (9.7%) euthyroid patients, but not in hyper- or hypothyroid patients. There were no antithyroglobulin antibodies in any patients. Free hormone measurements have proved to significantly correlate with the clinical picture. Increases in free-T3 and free-T4 are the main features of hyperthyroidism, while a reduction in free-T4 serum level was specific for hypothyroidism. There are probably several mechanisms responsible for hyperthyroidism and some genetically controlled defects in synthesis and release of thyroid hormones might be among these. The presence of antithyroid antibodies could be due to deposits of amiodarone in the thyroid gland, with a consequent release of antigen from the follicle cell, but only in those patients with genetically determined defects in immunological surveillance could an autoimmune thyroiditis, with consequent hypothyroidism, develop.

Adult↗
PubMed1986

Natural evolution of thyrotropin and thyroid hormones concentrations in hypothyroid newborns with thyroid agenesis or ectopy during the first month of life.

Thyroid hormones and thyrotropin concentrations obtained by different screening programs at different times after birth were pooled to study their natural evolution in congenitally hypothyroid newborns with thyroid ectopy or agenesis. In filter paper blood spots, the T4 concentrations were higher in the group with thyroid ectopy whereas it was the opposite for the TSH values. Serum T4 decreased progressively in cases of thyroid agenesis. In ectopy, serum T4 remained stable after 2 weeks whereas the T3 concentration increased into the normal range. Thus, even at five weeks of age, the T4 levels of infants with ectopic thyroid are still in the hypothyroid range despite thyrotropin overstimulation.

Aging↗
PubMed1985

[Clinical study on pulmonary metastases of differentiated thyroid carcinoma--with special reference to the extent of thyroid resection and RI therapy].

Prognosis of differentiated thyroid carcinoma is favorable unless distant metastasis develops. We have experienced 70 cases of differentiated thyroid carcinoma with pulmonary metastases and analysed the outcome of treatment of patients, with special reference to the extent of thyroid resection and postoperative ablative RI therapy. The following results were obtained: Of the 42 survivors 22 (52.4%) received total thyroidectomy, whereas 23 of 28 expired patients underwent less-than-total thyroidectomy. A total of 42 patients underwent radioiodine treatment following thyroid resection. 17 out of 18 patients who had received total thyroidectomy survived. On the other hand, only 11 out of 24 patients who had received less-than-total thyroidectomy survived. In the non-RI treatment group, prognoses were unfavorable in both total and less-than-total thyroidectomy groups. From these results, it is emphasized that ablative doses of RI should be given to patients with pulmonary metastases of differentiated thyroid carcinoma after total thyroidectomy.

Adolescent↗
PubMed1980

[Effect of thyrotropic hormone on the membrane potential of thyroid gland cells and thyroid hormone secretion with aging].

Effect of thyrotropic hormone (TTH) on membrane potential (MP) of thyroid cells and thyroid hormone secretion was studied in experiments on male rats of two age groups (7--12- and 27--32-month-old animals). It was found that during the first 3 hours after TTH administration (5 U/100 g i. v.) the depolarization of secretory cell membranes of adult rats was done pronounced and developed more rapidly than in old ones and that an increase in free thyroxin (T4) correlation with MP changes with time. In a dose of 0.5 U/100 g TTH caused a significant rise in T4 secretion only in old rats. The cAMP level in the thyroid gland declined with aging. In a dose of 5 U/100 g TTH provoked a significant increase in the cAMP content in adult rats and had no effect on its content in old ones. A relationship between the MP level of thyroid secretory cells and thyroid hormone secretion is discussed.

Age Factors↗
PubMed1984

Analysis of thyroid carcinoma in patients with cold thyroid nodules: a review.

It is generally accepted that the risk of thyroid carcinoma is more likely when solitary cold nodules are seen on a thyroid scan, while the presence of thyroid carcinoma in hyperfunctioning nodules has been found to be quite rare. This article attempts to establish the incidence of thyroid carcinoma in patients with solitary cold nodules on thyroid scans. The records of 110 consecutive patients who underwent thyroidectomy procedures were reviewed. Of 53 patients with solitary cold nodules, nine had carcinoma, an incidence of 17 percent.

Adolescent↗
PubMed1981

[Thyroid hormones and thyroid reserve in preclinical hypothyroidism].

Preclinical hypothyroidism (i.e. basal thyroxine within the normal laboratory range, basal TSH normal or elevated and exaggerated TSH response to TRH) is a biochemical constellation of uncertain clinical relevance. The oral TRH test with simultaneous measurements of TSH and thyroid hormones before and 3 h after 40 mg TRH provides information about both pituitary and thyroid reserve. In a group of female patients with preclinical hypothyroidism, basal thyroxine but not triiodothyronine was found to be clearly diminished compared with a group of healthy female controls, indicating a slight thyroid hormone deficiency. Furthermore, a progressively reduced thyroid reserve of T4 and especially of T3 was seen to be closely related to elevation of basal TSH as an expression of thyroid cell insufficiency. These data emphasize the clinical importance of TSH elevation despite normal thyroxine levels as a better individual sign of impending primary hypothyroidism.

Female↗
PubMed1994

A novel C-terminal domain in the thyroid hormone receptor selectively mediates thyroid hormone inhibition.

Resistance to thyroid hormone (RTH) action is due to mutations in the beta-isoform of the thyroid hormone receptor (TR-beta). RTH patients display inappropriate central secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus and thyrotropin (TSH) from the anterior pituitary in association with abnormal peripheral tissue responses to thyroid hormone. Whether TR-beta mutations cause a selective form of RTH, which only leads to abnormal pituitary TSH secretion (PRTH), is unclear. In a patient with PRTH, a novel mutation of a conserved arginine residue adjacent to the ninth heptad of TR-beta selectively disrupts TR homodimer formation. The mutant TR displays normal or enhanced function on stimulatory thyroid hormone response elements found in peripheral tissues, but has defective function on inhibitory thyroid hormone response elements found in the TRH and TSH subunit genes and explains the PRTH phenotype. This is the first report of a mutation in a member of the nuclear receptor superfamily that selectively abolishes hormone-dependent inhibition and localizes a novel C-terminal domain necessary for this property.

Amino Acid Sequence↗
PubMed1994

[Exophthalmometry and thyroid disease. The value of the Hertel measurement evaluated by a group of patients with thyroid diseases and a control group].

Exophthalmometry values from routine referrals to a hospital eye clinic are analysed, including adult patients with and without thyroid disease. In thyroid disease without eye motility complaints (n = 90) the median exophthalmometry value was 18 mm (range 12-28 mm). Thyroid patients with eye muscle involvement (diplopia, n = 47) had significantly higher values (median 22 mm, range 15-31 mm) but did not differ significantly from a subgroup of 51 patients without thyroid disease, but with "big eyes" as a (presumably) physiological finding (median value 20 mm, range 16-25 mm). The above three categories were all excluded from the control group (n = 203) which had 16 mm as median value, range 11-23 mm. Mean values were 16.0 +/- 1.8 mm in the females and 16.5 +/- 2.3 mm in the male controls. A side difference in exophthalmometry value > or = 2 mm appeared in 34% of thyroid patients with eye muscle involvement. This appeared in only a few per cent in the three other groups. Due to the wide overlap between groups, the solitary exophthalmometry reading is of limited diagnostic value, while the importance of exophthalmometry is evident when following the individual patient with orbital disease.

Adolescent↗