Volume Changes of Thy roid Nodules after Thy roxine Suppression Therapy: The Usefulness in Predicting Malignancy

PURPOSE: To evaluate the usefulness of volume change after thyroxine suppression therapy in predicting the malignancy of thyroid nodules. MATERIALS AND METHODS: We analyzed 28 cases of thyroid nodules diagnosed as benign by aspiration cytology or biopsy before thyroxine suppression therapy and which did not decrease more than 50% in volume after therapy. Using Ultrasonography we measured the volume of nodules before and after thyroxine suppression therapy and then determined volume change by calculating nodule volume suppression rate (NVSR) and comparing this beween benign and malignant nodules. All cases were surgically confirmed. N V S R ( % ) = nodule volume after treatment x 1 0 0 nodule volume before treatment RESULTS: Seventeen (60.7%) of 28 thyroid nodules which showed less than 50 % NVSR after thyroxine therapy were shown by surgical resection to be malignant, while 11(39.3 %) were benign. The malignant cases were papillary carcinoma (n=9) and follicular carcinoma (n=8), while benign cases were either follicular adenoma (n=7) or adenomatous hyperplasia (n=4). The mean volume of malignant thyroid nodules was 5.2 +/- 4 .5cm3 before thyroxine suppression therapy and 5.9 +/- 4 .5 cm3 after therapy, and that of benign nodules, 12.1 +/- 10.3 cm3 before therapy and 10.1 +/- 9.9 cm3 after. NVSR was 127.2 +/- 46.2 % in malignant nodul es and 79.4 +/- 21.0% in benign nodules, with no significant difference between the two groups (P < 0.05). CONCLUSION: Although further studies may be required, fine needle aspiration cytology or biopsy showed that among benign thyroid nodules which did not decrease more than 50 % in volume after thyroid therapy, the incidence of malignancy revealed by surgical resection was more than 60 %. Surgical exporation of these nodules is therefore highly recommended.

Correlation of Color Doppler Image and Thyroid Function Test in Diffuse Goiter

PURPOSE: To determine whether CDI can differentiate Graves' disease from other cases of thyroiditis and to determine the relationship between CDI findings and TFT. MATERIALS AND METHODS: Between October, 1995 and January, 1996, 22 cases of diffuse goiter without nodule were prospectively assessed for CDI and TFT. CDI was classified into three groups : Grade 1 (minimal), Grade 2 (moderate), and Grade 3 (marked) ; TFT was also classified into three groups : decreased, normal, and increased thyroid function. The correlation between CDI and TFT was statistically assessed ; each case was diagnosed by aspiration biopsy or clinical laboratory studies. RESULTS: All Graves' disease patients showed good correlation between marked color flows and increased thyroid function. The CDI findings of other cases of thyroiditis showed variable color flow and TFT. We found significant differences between the two disease groups. CONCLUSION: CDI can help differentiate Graves' disease from other cases of thyroiditis and additional assesment using TFT will help in the diagnosis of diffuse goiter. The "thyroidinferno" pattern is not a specific finding of Graves' disease.

Color Doppler Image of Thyroid Nodule: Differentiation Between Benign and Malignant Lesion

PURPOSE: To assess the utility of color Doppler sonography in the differential diagnosis of thyroid nodules. MATERIALS AND METHODS: Fifty patients with thyroid nodules(10 cases of follicular adenoma, 12 of adenomatous hyperplasia, 21 of papillary adenocarcinoma, and 7 of follicular adenocarcinoma) were analyzed. Colour signal analysis was performed by inspecting the signals in and around the nodules, and these were graded from 0 to III according to the degree of vascularity in internal and marginal blood flow. Peak systoic velocity (PSV) and resistive index (RI) in internal vascularity were used to analyse the flow signal. RESULTS: Internal colorsignals of malignant lesions tended to be high grade, whereas those of benign lesions tended to be low grade, with statistical significance(P<0.05). In spectral wave analysis, correlation between PSV and malignancy of thyroid nodules was statistically significant(P<0.05). The value of RI did not correlate with the malignancy of nodules, but tended to show a meaningful difference. CONCLUSIONS: Although further studies may be required, color Dopplersonography using color signal analysis and flow signals analysis is a useful imaging modality for the differentiation of benign and malignant lesions of thyroid nodules.

An Experimental Study on the Elects of Hyperthermia and Irradiation on the Rat's Kidney / 대한치료방사선과학회지

Radiological and clinical evidences indicate that hyperthermia combined with irradiation produce a significant improvement in therapeutic effect of cancer. The experiences obtained from 90 rats' kidney. A single dose of irradiation ranged from 6 Gy, 8 Gy and 10 Gy was delivered on the rat's kidney. The combined therapy group had the same irradiation after hyperthermia at 42-44 degree Cfor 30 minutes. Microscopic examination and calculation of thermal enhancement ratio were carried out, and the results were as follows: 1. In the group of hyperthermia alone, there were moderate glomerular congestion and mild tubular degeneration on light microscopic examination. 2. In the group of irradiation alone, tubular degeneration was noted in 6 Gy irradiation and its severity was increased along with radiation dose. 3. In the group of hyperthermia combined with irradiation, tubular degeneration and necrosis were appeared in 6 Gy and 10 Gy irradiation, respectively. 4. On electron microscopic examination, proximal convoluted tubular and glomerular changes in irradiation group were similar to that of combined with hyperthermia, and its severity was increased along with observation periods. 5. Thermal enhancement ratio(TER) was 1.0 after evaluation of histipathologic changes in rat's kidney with combination therapy.

An experimental system on heart resistance by split dose hyperthermia

The study was undertaken to evaluate the heat resistance by split dose hyperthermia in various time intervaland temperature. For the experiments, 96 mice were divided into 2 groups: the first, 36 mice were used to evaluatethe skine reaction of mouse tail to single dose hyperathermia, the second, 60 mice were used to evaluate heatresistance by split dose hyperthermia in variuos time intervals. The results obtained are summarized as follows;1. The ND was 101 minutes at 43degrees centigrade(C) and 24 minutes at 45degrees C. 2. For a 1degrees C increasein temperature, a half in time was required to same degree of skin reaction. 3. Heat resistance was significantlydeveloped in split dose hyperthermia at 43degrees C and 45degrees C. 4. Development, maximum and decay of heatresistance were constant regardless of change in temperature. In summary, heat resistance in split dosehyperthermia is important in study and clinical application of heat therapy in malignant disease.

A radiological study of recovery from hydronephrosis by ureteral ligation

The determination of the degree and ability of recovery of obstructive hydronephrosis is important in treatment and prediction of prognosis. Among the various methods in determination of the status of kidney, intravenous pyelography is the most important tool to evaluate the morphological and functional changes of kidney in vivo. The purpose of this experiment was the determination of process and recoverability of hydronephrosis depend on duration of unilateral uretreal obstruction. For the experiment, 32 rats were divided into 2 groups; the first group of 12 rats were used to determine the process of hydronephrosis during 1 to 4 weeks of unilateralureteral ligation and the second group of 20 rats were used to determine the recoverability of hydronephrotic kidney depend on same duration of ureteral ligation following relief of ligation. Intravenous pyelography as undertaken and renal angiography, gross and microscopic examination were added. The results obtained are summarized as follows; 1. Kidney enlargement and pelvic dilatation were progressively increased with a relation to duration of ureteral obstruction until 4 weeks. 2. Renal excretory function is not impaired until 3 weeks obstruction, but rapidly impaired to nonfunctioning in 4 weeks obstruction. 3. Renal recovery was possible following relief of ureteral ligation within 3 weeks of ureteral obstruction, but histopathological and functional recovery were impossible in 4 weeks of ureteral ligation. 4. There is no direct correlation between duration of obstruction and recoverability following relief within 3 weeks of uretral obstruction. 5. Intravenous pyelographyis a simple and accurate method to determine the degree of obstructive hydronephrosis and to evaluate morphological and functional recovery of kidney following relief of obstruction.