Background: Detectable serum thyroglobulin (Tg) in patients with papillary thyroid carcinoma (PTC) after total thyroidectomy implies unsuccessful surgery, indicating a high risk of recurrence. Serum Tg kinetics such have not been extensively studied. We studied suppressed thyrotropin levels and undetectable anti-Tg antibody to minimize the effects these factors on values, evaluated relationship prognosis doubling-time. Methods: Between January 1998 December 2004, 1515 PTC underwent Kuma...

Subacute thyroiditis (SAT) is a transient inflammatory disease of the thyroid. We evaluated clinical characteristics based on laboratory and imaging studies in patients with SAT before treatment.We reviewed medical records 852 (107 men 745 women) who visited our thyroid clinic at Kuma Hospital from 1996 through 2004.SAT developed most often female aged 40 to 50 years, significant seasonal clusters during summer early autumn. While rates any virus infections diseases did not differ those...

We reported that a minority of patients with low-risk papillary microcarcinoma the thyroid showed disease progression during active surveillance and older had significantly lower rates than younger patients. Here, we estimated lifetime (≤85 years old) probabilities according to age at presentation based on decade-specific rates.From 1993-2013, 1,211 aged 20-79 underwent Kuma Hospital. calculated rate 10-year point for each age-decade group (20s 70s) Kaplan-Meier method. The probability was...

Thyroidal production of triiodothyronine (T(3)) is absent in patients who have undergone total thyroidectomy. Therefore, relative T(3) deficiency may occur during postoperative levothyroxine (L-T(4)) therapy. The objective this study was to evaluate how the individual serum level changes between preoperative native thyroid function and L-T(4) therapy.We retrospectively studied 135 consecutive with papillary carcinoma, underwent Serum free T(4) (FT(4)), (FT(3)), TSH levels measured...

BackgroundWe report on the growth of papillary microcarcinoma during active surveillance and before clinical presentation.MethodsWe conducted a retrospective study 169 patients with who were enrolled in at our hospital between 2000 2004. Patients followed for median 10.1 years using serial ultrasonography (median, 12 examinations), used to calculate tumor doubling time. To contextualize rates surveillance, we calculated hypothetical time presentation. resolve limitations time, inversely...

Background: Active surveillance (AS) of low-risk papillary thyroid microcarcinoma (PMC) was adopted as a management modality in both the Japanese guidelines 2011 and American Thyroid Association 2015. AS initiated at Kuma Hospital 1993 but not immediately accepted by all physicians. This study investigated history acceptance over time. The results should assist implementation other hospitals Japan countries. Methods: included 4023 patients who were cytologically diagnosed with PMC during...

Background: Antithyroid drugs (ATDs) are prescribed as the initial therapy for majority of patients with Graves' disease in many areas world. Although, it is well known that agranulocytosis one most serious side effects ATDs, there has not yet been any conclusive evidence prevalence induced by ATDs dose related. This study was performed to determine if different depending on starting dosage disease. Methods: Until 1996, we had typically 30 mg/d methimazole (MMI) treatment at our institution....

An active-surveillance clinical trial of low-risk papillary microcarcinoma (PMC) patients has been performed at the authors' institution, Kuma Hospital, since 1993. Favorable oncological results have reported. During trial, a few were encountered with PMC that showed enlargement during pregnancy, and these cases large amount human chorionic gonadotropin (hCG) having weak thyrotropin (TSH) activity is produced, possibly affecting progression PMC. This study investigated how pregnancy delivery...

Some investigators reported that among athyreotic patients on levothyroxine (LT4) monotherapy following total thyroidectomy, the with normal serum thyrotropin (TSH) levels had mildly low free triiodothyronine (fT3) levels, whereas suppressed TSH fT3 and strongly elevated levels. The objective of present study was to clarify which these three patient groups is closer their preoperative euthyroid condition.A 133 consecutive papillary thyroid carcinoma who underwent a thyroidectomy were...

Infertile women sometimes associated with subclinical hypothyroidism (SCH). The guidelines of the American Endocrine Society, and Association Clinical Endocrinologists Thyroid recommend treatment thyroxine (T4) for patients SCH who want to have children. We examined 69 female infertile effects levothyroxine (l-T4) therapy on pregnancy rates outcomes were observed. Fifty-eight (84.1%) successfully conceived during T4 period (Group A), although 17 (29.3%) had miscarriage afterward. remaining...

PAPILLARY THYROID CARCINOMA (PTC) is a malignant epithelial tumor that exhibits follicular cell differentiation and characterized by distinctive nuclear features, including ground glass appearance, grooves, cytoplasmic inclusions, overlapping [1].PTC the most common type of thyroid carcinoma its incidence has been increasing around world due to widespread use ultrasonography-guided fine needle aspiration cytology for small lesions [2, 3].Small-sized PTC, measuring ≤ 10mm, referred as...

Background: Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) was initiated at Kuma Hospital in 1993 and has gradually spread worldwide. We previously demonstrated that AS is associated with a much lower incidence of unfavorable events than immediate surgery (IS). However, conversion (CS) raises concerns about increased surgical complications due to advanced disease. In this study, we conducted comparative analysis after IS CS. Methods: Between 2005 2019, 4635...

During active surveillance (AS), serum thyrotropin (TSH) levels may affect papillary thyroid microcarcinoma (PTMC) progression. We investigated AS outcomes according to whether levothyroxine (LT4) treatment was administered.

Medullary thyroid carcinoma (MTC) is a malignancy originating from C cells. To date, serum calcitonin measurement and fine-needle aspiration biopsy (FNAB) have been prominent diagnostic approaches to these lesions. Although an elevated level strongly suggests the presence of MTC, this examination cannot identify origin overexpression, especially in patients demonstrating multiple nodules. For treatment planning, it important know which nodule nonhereditary MTC. In study, we propose washout...

Cribriform-morular variant (CMV) is a comparably rare histological subtype of papillary thyroid carcinoma (PTC). This can be associated with familial adenomatous polyposis (FAP) due to APC gene mutations. In this study, we investigated the difference in biological characteristics between FAP-associated and sporadic CMV. Between 1991 2010, 32 patients CMV were treated Kuma Hospital. Thirty-one these underwent initial surgery for Twelve remaining 19 All female. Tumors more frequently multiple...

The prevalence of menstrual disturbances, including secondary amenorrhea, hypomenorrhea, oligomenorrhea, hypermenorrhea, polymenorrhea and irregular cycle were prospectively examined in 586 patients with hyperthyroidism due to Graves' disease, 111 hypothyroidism, 558 euthyroid chronic thyroiditis, 202 painless thyroiditis 595 thyroid tumor. In the overall patient group, did not different from that 105 healthy controls. However, severe showed a higher amenorrhea (2.5%) hypomenorrhea (3.7%)...

It is well-known that papillary thyroid carcinoma (PTC) has a generally indolent character and shows favorable prognosis unless it no high-risk features such as clinical lymph node metastasis, distant significant extrathyroid extension. In this study, we investigated the of 3,965 patients with PTC without these features. We classified into 3 groups: T-1, tumor ≤ 2 cm (n = 2,591); T-2, 2.1-4 1,123); T-3, > 4 251). Ten-year recurrence rates T-3 were 0.3, 1.3, 1.9% for (in subset who underwent...

Oral glucocorticoids are administered in moderate and severe cases of subacute thyroiditis (SAT), providing dramatic relief from pain fever. However, there have been no reports regarding the optimal dose prednisolone (PSL) for treatment SAT. In this study, we used 15 mg/day PSL as initial dosage tapered it by 5 mg every 2 weeks. We assessed effectiveness protocol.We examined 384 consecutive untreated patients with SAT who visited our thyroid clinic between February 2005 December 2008....

Postpartum thyroid dysfunction occurs in approximately 5-10% of women the general population within one year delivery. Differentiation postpartum Graves' thyrotoxicosis (PPGr) from destructive (PPDT) is essential because difference treatment measures between two. However, it sometimes difficult radioactive iodine uptake contraindicated when patients are lactating. We examined usefulness determining time onset and measurement antithyrotropin (anti-TSH) receptor antibodies blood flow.Forty-two...

Background: Although papillary thyroid microcarcinoma (PMC) is generally stable on active surveillance, conversion surgery recommended for enlarging tumors. However, it remains unclear which enlargement threshold should be considered sufficient to trigger surgery. This study analyzed changes in the growth activity of PMC, before and after enlargement. Methods: We enrolled 824 patients with whom surveillance was initiated between 2005 2011 (median duration follow-up: 6.04 years). Changes...

When the liver function tests are aggravated after starting antithyroid drugs (ATDs) in Graves' hyperthyroidism, discontinuation of ATDs is generally considered. However, a question arises whether such aggravation constitutes an adverse effect or not.The aim this study was to clarify influence thyrotoxicosis on tests, comparing results with those induced by painless thyroiditis.We prospectively studied biochemical 30 patients disease and 27 thyroiditis.Twenty-three (76.7%) untreated 14...

Recently, non-high-density lipoprotein cholesterol (non-HDL-C), a measure of total minus HDL-C, has emerged as predictor cardiovascular disease.We evaluated the effect L-T4 replacement on non-HDL-C levels in patients with primary hypothyroidism.Thirteen overt hypothyroidism and 26 subclinical participated study. The lipid profiles, including non-HDL-C, were measured before 3 months after was started.After replacement, serum concentrations all lipoproteins, exclusive (a) [Lp(a)],...

Although postoperative serum thyroglobulin (Tg) is a prognostic indicator for papillary thyroid carcinoma (PTC), it unreliable when Tg antibody (TgAb) positive. We evaluated the significance of changes in TgAb levels pre- and post-total thyroidectomy TgAb-positive PTC patients. reviewed our medical charts 225 patients whom were measured before 1-2 years after total thyroidectomy, performed between April 2002 March 2007. divided them into 3 groups based on levels. Postoperative decreased by ≥...