BACKGROUND & AIMS: OBJECTIVE:When using radioiodine for hyperthyroidism there is no consensus regarding the administration of fixed or calculated doses. Guidelines do not specify the preferable approach or the parameters to use to calculate the dose. Therefore, the dose might be quite different with regard to the chosen procedure. This study was undertaken to evaluate the variability of the amount of radioiodine administered in Belgium in various cases of hyperthyroidism. DESIGN AND PATIENTS:Twenty-one Belgian nuclear medicine physicians received summarized clinical files from 10 patients suffering from overt hyperthyroidism (n = 7) or subclinical hyperthyroidism (n = 3). Five patients had homogeneous goiters, one had multinodular goiter, and four had hot nodule. Participants had to determine the radioiodine dose (millicuries, mCi) they would give in each case. RESULTS:Proposed doses varied between 2 mCi and 25 mCi. Mean proposed dose for nodular disease was 10.71 mCi; it was 6.79 mCi for homogeneous goiter. For individual cases, a difference between the lowest and the highest dose of more than 17 mCi was observed in more than 50% of the cases. CONCLUSIONS:We believe that more precise guidelines are mandatory, underlying uncertainties, controversies but recommending however, as minimal and maximal doses to administer, as well as clinical and biological parameters, if any, to be taken into account in order to modulate these doses.

背景与目标： 目的：使用放射性碘治疗甲状腺功能亢进症时，关于固定剂量或计算剂量的使用尚无共识。指南未指定用于计算剂量的首选方法或参数。因此，就所选择的程序而言，剂量可能会完全不同。进行这项研究是为了评估比利时在各种甲亢患者中施用的放射性碘的量的变异性。
设计和患者：21名比利时核医学医生从10例患有明显甲状腺功能亢进（n = 7）或亚临床甲状腺功能亢进（n = 3）的患者那里获得了总结的临床档案。 5例均患有甲状腺肿，1例患有多结节性甲状腺肿，4例患有热结节。参与者必须确定每种情况下的放射性碘剂量（毫厘米，mCi）。
结果：建议剂量在2 mCi和25 mCi之间变化。结节性疾病的平均建议剂量为10.71 mCi。均匀甲状腺肿为6.79 mCi。对于个别病例，在超过50％的病例中，观察到的最低剂量和最高剂量之间的差异超过17 mCi。
结论：我们认为，更精确的指南是强制性的，潜在的不确定性，争议，但建议作为调节这些剂量的最小和最大剂量，以及临床和生物学参数（如有），都应考虑在内。

BACKGROUND & AIMS: :A 74-year-old woman with hyperthyroidism was referred for radioiodine therapy. The patient was accidentally given 60 mCi of Lu-PSMA orally instead of I. Upon discovery of this medical event, we immediately started radiation protective actions including hydration, antiemetics, and laxatives. The patients did not have any symptoms. Static acquisition was performed from the abdominal-pelvic and head and neck regions at 20 and 90 hours after ingestion, which showed prominent intestinal activity and mild systemic activity in the kidneys, bladder, salivary, and lacrimal glands.

背景与目标： ：一名74岁甲状腺功能亢进的妇女被转介接受放射碘治疗。意外地给患者口服了60 mCi的Lu-PSMA，而不是口服。发现此医疗事件后，我们立即开始了辐射防护措施，包括水合作用，止吐药和泻药。患者没有任何症状。摄食后20和90小时，从腹部骨盆和头颈部区域进行静态采集，显示肾脏，膀胱，唾液和泪腺的肠道活动活跃，全身活动轻微。

BACKGROUND & AIMS: :The aim of the research is to explore the relationship between hyperthyroidism, iodine, antithyroid drugs (propylthiouracil) and vascular endothelial injury. In total, 136 SD rats were randomly allocated into the control group, the hyperthyroidism group, the hyperthyroidism propylthiouracil group, the hyperthyroidism low iodine group, the high iodine group, and the endothelial injury group. Rats were raised for 60 days. Afterward, indicators concerning endothelial damage were determined, including the von Willebrand Factor (vWF), thrombomodulin (TM), nitric oxide (NO), endothelin 1 (ET-1), and P-selectin, as well as the plant hemagglutinin sample type oxidized low-density lipoprotein receptor 1 (LOX-1) from the aorta and the number of endothelial progenitor cells (EPCs) in whole blood. The hyperthyroidism group had significantly higher values for vWF, TM, NO, ET-1, and P-selectin in serum and a higher number of EPCs in whole blood compared with the control group, similar to the LOX-1 expression in abdominal aorta. The hyperthyroidism low iodine group had significantly higher values for vWF, ET-1, and P-selectin in serum and a higher number of EPCs in whole blood compared with those of the control group, as was the case for LOX-1 expression in the abdominal aorta. The hyperthyroidism propylthiouracil group had significantly higher values for FT4 in the serum compared with those in the control group. The electron microscope showed that hyperthyroidism caused a certain degree of endothelial injury to the abdominal aorta in rats. Hyperthyroidism can damage the vascular endothelium and is a high-risk factor for cardio-cerebrovascular disease. Propylthiouracil could be used in the treatment of hyperthyroidism, thus protecting endothelial cells from damage.

背景与目标： ：该研究的目的是探讨甲状腺功能亢进症，碘，抗甲状腺药（丙基硫尿嘧啶）与血管内皮损伤之间的关系。将总共​​136只SD大鼠随机分为对照组，甲状腺功能亢进组，甲状腺功能亢进丙硫氧嘧啶组，甲状腺功能亢进低碘组，高碘组和内皮损伤组。将大鼠饲养60天。之后，确定了有关内皮损伤的指标，包括血管性血友病因子（vWF），血栓调节蛋白（TM），一氧化氮（NO），内皮素1（ET-1）和P选择素，以及植物血凝素样品类型从主动脉中氧化的低密度脂蛋白受体1（LOX-1）和全血中内皮祖细胞（EPC）的数量。甲状腺功能亢进组与对照组相比，血清中的vWF，TM，NO，ET-1和P-选择素的值明显较高，全血中的EPC数量较高，与腹主动脉中的LOX-1表达相似。与对照组相比，甲亢低碘组的血清中vWF，ET-1和P-选择素的值明显高于对照组，全血中的EPC数量也高于对照组。腹主动脉。与对照组相比，甲亢性丙硫氧嘧啶组的血清FT4值明显更高。电子显微镜显示甲状腺功能亢进症对大鼠腹主动脉有一定程度的内皮损伤。甲状腺功能亢进会损害血管内皮，并且是心脑血管疾病的高危因素。丙硫氧嘧啶可用于治疗甲状腺功能亢进症，从而保护内皮细胞免受损害。

BACKGROUND & AIMS: BACKGROUND:Hyperthyroidism is a disease in which excessive amounts of thyroid hormones circulate in the blood. Patients, among other things suffer from tachycardia, warm moist skin and raised body temperature. The treatment of hyperthyroidism includes symptom relief and therapy with antithyroid medications, radioiodine and thyroidectomy. Medicinal herbs are used alone or in combination with antithyroid agents to treat hyperthyroidism in China and some other countries. OBJECTIVES:To assess the effects of Chinese herbal medicines for treating hyperthyroidism. SEARCH STRATEGY:Studies were obtained from computerised searches of MEDLINE, EMBASE, The Cochrane Library, the Chinese Biomedical Database. SELECTION CRITERIA:Randomised controlled trials comparing the effects of Chinese herbal medicines alone with Chinese herbal medicines combined with antithyroid drugs, radioiodine or both. DATA COLLECTION AND ANALYSIS:Three authors interviewed authors of all potentially relevant studies by telephone to verify randomisation procedures. One author entered data into a data extraction form and another author verified the results of this procedure. MAIN RESULTS:Thirteen relevant trials with 1770 participants were included. All of them were of low quality. Fifty-two studies still need to be assessed because the original authors could not be interviewed. None of these trials analysed mortality, health related quality of life, economic outcomes or compliance. Compared to antithyroid drugs alone the results showed that Chinese herbal medicines combined with antithyroid drugs may offer benefits in lowering relapse rates, reducing the incidence of adverse effects, relieving symptoms, improving thyroid antibody status and thyroid function. Two trials investigated Chinese herbal medicine versus radioiodine and reported improvements in anxiety, tachycardia and heat intolerance. However, thyroid function - with the exception of restored thyroid stimulating hormone (TSH) - was not significantly altered. AUTHORS' CONCLUSIONS:The results suggest that traditional Chinese herbal medicines added to other routine treatment have a therapeutic potential for people with hyperthyroidism. However, due to methodological limitations, we could not identify a well-designed trial to provide strong evidence for Chinese traditional herbal medicine in the treatment of hyperthyroidism. Thus, we currently cannot recommend any single preparation or formulation for clinical use.

背景与目标： 背景：甲状腺功能亢进症是一种在血液中循环过多甲状腺激素的疾病。除其他外，患者患有心动过速，皮肤温暖潮湿和体温升高。甲状腺功能亢进症的治疗包括症状缓解和抗甲状腺药物，放射碘和甲状腺切除术的治疗。在中国和其他一些国家，药用草药可单独使用或与抗甲状腺药联合使用以治疗甲状腺功能亢进症。
目的：评估中草药治疗甲状腺功能亢进症的疗效。
搜索策略：研究是从MEDLINE，EMBASE，Cochrane图书馆，中国生物医学数据库的计算机搜索中获得的。
选择标准：随机对照试验，比较中草药单独使用，中草药与抗甲状腺药物，放射性碘或两者合用的效果。
数据收集与分析：三位作者通过电话采访了所有潜在相关研究的作者，以验证随机化程序。一位作者将数据输入数据提取表中，另一位作者验证了此过程的结果。
主要结果：包括13项相关试验，共有1770名参与者。他们都是低质量的。由于无法采访原始作者，因此仍需要评估52项研究。这些试验均未分析死亡率，与健康相关的生活质量，经济结果或依从性。结果表明，与单独使用抗甲状腺药相比，中草药与抗甲状腺药合用可能会降低复发率，减少不良反应的发生率，缓解症状，改善甲状腺抗体状态和甲状腺功能。两项试验研究了中草药与放射性碘的关系，并报告了焦虑，心动过速和热耐受性的改善。然而，除了恢复的甲状腺刺激激素（TSH）外，甲状腺功能没有明显改变。
作者的结论：结果表明，在其他常规治疗中添加传统中草药对甲亢患者具有治疗潜力。然而，由于方法上的局限性，我们无法确定一个设计合理的试验来为中草药治疗甲状腺功能亢进症提供有力的证据。因此，我们目前无法推荐任何单一制剂或制剂用于临床。

BACKGROUND & AIMS: RATIONALE:Thyrotoxic periodic paralysis is characterized by a sudden onset of hypokalemia and paralysis. This condition mainly affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle without typical symptoms such as palpitations, tremors, anxiety, and weight loss; this causes a difficulty in early diagnosis. Here, we reported a case of periodic paralysis in a patient with hyperthyroidism whose potassium level was within the normal range. PATIENT CONCERNS:A 33-year-old Taiwanese man presented to the emergency department with bilateral limb weakness (more severe in the lower limbs than in the upper limbs). On arrival, the patient's vital status was stable with clear consciousness. He denied experiencing recent trauma, back pain, chest pain, abdominal pain, headache or dizziness, or a fever episode. Physical examination showed no specific findings. Neurological examination showed weakness in the muscles of the bilateral upper and lower limbs. Muscle weakness was more severe in the proximal site than in the distal site. DIAGNOSIS:Blood examination showed normal complete blood count, normal renal and liver function, and normal potassium (3.5 mmol/L, normal range 3.5-5.1 mmol/L), sodium, and calcium levels; however, the examination showed impaired thyroid function (thyroid stimulating hormone: 0.04 uIU/mL, normal range 0.34-5.60 uIU/mL; free T4: 1.96 ng/dL, normal range 0.61-1.12 ng/dL). Brain computed tomography without contrast showed no obvious intra-cranial lesion. INTERVENTIONS:Intravenous potassium infusion (20 mEq/L) with normal saline was prescribed for the patient. OUTCOMES:After treatment, the patient felt a decrease in limb weakness. He was discharged from our emergency department with a scheduled follow-up in the endocrine outpatient department. LESSONS:TPP should be considered as a differential diagnosis in young Asian men presenting with limb paralysis that is more severe in the proximal site and in the lower limbs than in the distal site and in the upper limbs, respectively. It is important for emergency department physicians to consider TPP as a differential diagnosis as it can occur even if the patient's potassium level is within the normal range.

背景与目标： 理由：甲状腺毒性周期性麻痹的特点是突然出现低钾血症和麻痹。这种情况主要影响下肢，继发于甲状腺毒症。潜在的甲状腺功能亢进通常很细微，没有典型的症状，例如心pit，震颤，焦虑和体重减轻。这导致了早期诊断的困难。在这里，我们报道了一名甲状腺功能亢进症患者的周期性瘫痪，其钾水平在正常范围内。
患者注意事项：一名33岁的台湾男子因双侧肢体无力（下肢比上肢更严重）出现在急诊室。到达后，患者的生命状态稳定，意识清晰。他否认最近经历过外伤，背痛，胸痛，腹痛，头痛或头晕或发烧。体格检查未发现具体发现。神经系统检查显示双侧上肢和下肢的肌肉无力。与近端部位相比，近端部位的肌肉无力更为严重。
诊断：血液检查显示正常的全血细胞计数，正常的肾和肝功能以及正常的钾（3.5 mmol / L，正常范围3.5-5.1 mmol / L），钠和钙水平；然而，检查显示甲状腺功能受损（甲状腺刺激激素：0.04μuIU/ mL，正常范围0.34-5.60μuIU/ mL；游离T4：1.96μng/ dL，正常范围0.61-1.12μng/ dL）。没有对比的脑部计算机断层扫描显示没有明显的颅内病变。
干预措施：为患者开具静脉注射钾（20μmEq/ L）和生理盐水。
结果：治疗后，患者感到四肢无力减轻。他已从我们的急诊科出院，并计划在内分泌门诊部进行随访。
经验教训：TPP应该被视为亚洲年轻男性肢体麻痹的鉴别诊断，其近端部位和下肢部位比远端部位和上肢部位更为严重。对于急诊科医师而言，将TPP视为鉴别诊断非常重要，因为即使患者的钾水平在正常范围内，TPP也会发生。

BACKGROUND & AIMS: INTRODUCTION:Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature. MATERIAL AND METHODS:From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures. RESULTS:Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism. CONCLUSIONS:Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in the right lobe.

背景与目标： 简介：亚临床甲状腺功能亢进症（SCH），也称为轻度症状性甲状腺功能亢进症，最近被更频繁地诊断。这种疾病的主要内源性原因之一是自主功能的甲状腺结节（AFTN）。尽管通常无症状，但SCH会对心血管系统和骨骼造成影响，并且具有典型临床表现的发展为明显甲状腺功能亢进的风险。治疗仍然是有争议的，其益处在文献中得到了广泛的争论。
材料与方法：从459例患者中，作者选择了49例患者（占所有甲亢患者的10.6％），41例女性（83.7％）在门诊内分泌科和内分泌科进行SCH期SCH治疗的AFTN患者卢布林大学为期三年。该研究中使用的方法是对病历进行回顾性分析，并特别考虑病史，体格检查以及在诊断和治疗程序过程中获得的其他检查结果。
结果：41例（83.7％）患者出现典型的甲状腺功能亢进症状。仅8例（16.3％）无症状。报告最频繁的症状是女性的心动过速（51.2％）和男性的焦虑（50％）。甲状腺抑制药物的类型和治疗时间不影响碘131治疗的结果。在绝大多数患者（87.8％）中，放射性碘治疗是有效的。 30名患者（61.2％）达到了甲状腺功能正常，13名患者（22.5％）出现甲状腺功能减退。
结论：AFTN过程中大多数SCH患者表现为典型的甲状腺功能亢进症状。只有六分之一的病人没有症状。自主性腺瘤的数量不影响131I治疗的结果。但是，AFTN量和甲状腺量对RIT疗效的影响还需要进一步研究。在绝大多数患者中，131I治疗是一种有效的治疗方法，并且对于位于右叶的局灶性病变的患者，更经常观察到较早的治疗效果。

BACKGROUND & AIMS: :1. The effects of hyperthyroidism and hypothyroidism on the concentrations of glutamine and other amino acids in the muscle and plasma and on the rates of glutamine and alanine release from incubated isolated stripped soleus muscle of the rat were investigated. 2. Hyperthyroidism decreased the concentration of glutamine in soleus muscle but was without effect on that in the gastrocnemius muscle or in the plasma. Hyperthyroidism also increased markedly the rate of release of glutamine from the incubated soleus muscle. 3. Hypothyroidism decreased the concentrations of glutamine in the gastrocnemius muscle and plasma but was without effect on that in soleus muscle. Hypothyroidism also decreased markedly the rate of glutamine release from the incubated soleus muscle. 4. Thyroid status was found to have marked effects on the rate of glutamine release by skeletal muscle per se, and may be important in the control of this process in both physiological and pathological conditions.

背景与目标： ：1。研究了甲状腺功能亢进和甲状腺功能减退症对大鼠肌肉和血浆中谷氨酰胺和其他氨基酸的浓度以及从培养的分离的比目鱼比目鱼肌中谷氨酰胺和丙氨酸释放速率的影响。 2.甲状腺功能亢进降低比目鱼肌中谷氨酰胺的浓度，但对腓肠肌或血浆中的谷氨酰胺浓度没有影响。甲状腺功能亢进还显着增加了从比目鱼肌肉中释放谷氨酰胺的速率。 3.甲状腺功能减退症降低了腓肠肌和血浆中谷氨酰胺的浓度，但对比目鱼肌无影响。甲状腺功能减退症也显着降低了从比目鱼比目鱼肌释放谷氨酰胺的速率。 4.甲状腺状态被发现对骨骼肌本身释放谷氨酰胺的速率有显着影响，并且在生理和病理条件下对控制这一过程都可能很重要。

BACKGROUND & AIMS: :These clinical practice guidelines summarize the recommendations of the American Association of Clinical Endocrinologists for the diagnostic evaluation of hyperthyroidism and hypothyroidism and for treatment strategies in patients with these disorders. The sensitive thyroid-stimulating hormone (TSH or thyrotropin) assay has become the single best screening test for hyperthyroidism and hypothyroidism, and in most outpatient clinical situations, the serum TSH is the most sensitive test for detecting mild thyroid hormone excess or deficiency. Therapeutic options for patients with Graves' disease include thyroidectomy (rarely used now in the United States), antithyroid drugs (frequently associated with relapses), and radioactive iodine (currently the treatment of choice). In clinical hypothyroidism, the standard treatment is levothyroxine replacement, which must be tailored to the individual patient. Awareness of subclinical thyroid disease, which often remains undiagnosed, is emphasized, as is a system of care that incorporates regular follow-up surveillance by one physician as well as education and involvement of the patient.

背景与目标： 这些临床实践指南总结了美国临床内分泌学家协会对甲亢和甲状腺功能减退症的诊断评估以及这些疾病患者的治疗策略的建议。敏感的甲状腺刺激激素（TSH或促甲状腺激素）测定法已成为甲亢和甲状腺功能减退症的唯一最佳筛查方法，在大多数门诊临床情况下，血清TSH是检测轻度甲状腺激素过量或不足的最灵敏测试。 Graves病患者的治疗选择包括甲状腺切除术（目前在美国很少使用），抗甲状腺药物（经常与复发相关）和放射性碘（目前是治疗选择）。在临床甲状腺功能减退症中，标准治疗是左甲状腺素替代，必须针对个别患者量身定制。强调了对亚临床甲状腺疾病的意识，而这种意识通常仍未被诊断，同时也强调了一种护理系统，该系统结合了一名医生的定期随访监测以及对患者的教育和参与。

BACKGROUND & AIMS: OBJECTIVE:To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. METHODS:We describe detailed case reports of two men with breast enlargement who were found to have hyperthyroidism, and we review the related literature. RESULTS:Two men sought medical assistance because of unilateral tender gynecomastia. In one of these patients, thyroid, gonadal, and prostate examinations showed normal findings at the time of initial assessment, and symptoms of hyperthyroidism developed later. In our other patient with gynecomastia, other symptoms of hyperthyroidism--for example, nervousness, irritability, palpitations, and fatigue--had been present for a prolonged period but had been considered "normal" by the patient. In both patients, the hyperthyroidism was treated with radioiodine. Breast pain disappeared in both patients, and breast enlargement disappeared in one patient and was decreased in the other patient after euthyroidism was achieved. Review of the literature disclosed only two similar cases. CONCLUSION:Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.

背景与目标： 目的：介绍两例新的男性乳房发育症为甲状腺功能亢进症的初步表现。
方法：我们描述了两名发现患有甲状腺功能亢进症的男性乳房增大的详细病例报告，并复习了相关文献。
结果：两名男子因单侧嫩女性乳房发育症而寻求医疗救助。在其中一名患者中，甲状腺，性腺和前列腺检查在初次评估时显示正常，而甲状腺功能亢进症的症状随后出现。在我们的另一例男性乳房发育患者中，甲状腺功能亢进症的其他症状（例如神经质，烦躁不安，心pit和疲劳）长期存在，但被患者视为“正常”。两名患者均接受放射性碘治疗甲亢。甲状腺功能亢进后，两名患者的乳房疼痛均消失，一名患者的乳房肿胀消失，另一名患者的乳房肿胀减轻。文献回顾仅揭示了两个相似的情况。
结论：由于女性乳房发育症是甲状腺机能亢进的最初症状，因此我们认为主要症状是女性乳房发育症的患者在检查中并未进行甲状腺功能检查。

BACKGROUND & AIMS: OBJECTIVE:Subclinical hyperthyroidism (SH) has been associated with exercise intolerance, changes in cardiac morphology, atrial arrhythmias and sympathovagal imbalance. The aim of this study was to evaluate the vagal reserve and modulation by a sympathetic stimulus in nonelderly patients with SH without cardiovascular problems. DESIGN:We carried out a cross-sectional study, comparing data of the heart rate variability (HRV) of SH patients and healthy controls at rest and after vagal and sympathetic stimulation. PATIENTS:We studied 16 female patients with at least 6 months of SH and 16 healthy female controls with the same median age (40 vs. 34.5 years). MEASUREMENTS:We used the tilt test, with electrocardiographic record at rest, during the respiratory sinus arrhythmia (RSA) manoeuvre and after tilting, in order to analyse HRV in the frequency domain (%high frequency (HF) and low/high frequency ratio (LF/HF) using Biopotentials Captation System software. RESULTS:The median TSH level was 0.03 mU/l in patients and 1.37 mUI/l in controls. The median free T4 was 1.37 ng/dl in patients and 1.20 ng/dl in controls. Patients demonstrated a significantly smaller difference between %HF during the RSA and %HF at rest than controls (median -7.5 vs. 36.6, P < 0.001). There was a lower difference between LF/HF ratio after tilting and LF/HF ratio at rest in patients than in controls (1.5 vs. 5.3, P = 0.005). CONCLUSION:Subclinical hyperthyroidism affects cardiovascular autonomic balance in otherwise apparently healthy nonelderly females by blunting vagal responses.

背景与目标： 目的：亚临床甲状腺功能亢进症（SH）与运动不耐症，心脏形态变化，房性心律不齐和交感性迷走神经失调有关。这项研究的目的是评估交感神经刺激对没有心血管问题的非老年SH患者的迷走神经储备和调节作用。
设计：我们进行了一项横断面研究，比较了SH患者和健康对照在静息，迷走神经和交感神经刺激后的心率变异性（HRV）数据。
病人：我们研究了16名SH至少为6个月的女性患者和16名健康女性对照者，他们的中位年龄相同（40岁对34.5岁）。
测量：我们使用倾斜测试，在呼吸窦性心律不齐（RSA）动作期间以及倾斜之后进行静息心电图记录，以便在频域（％高频（HF）和低频/高频比（ LF / HF）。
结果：患者的平均TSH水平为0.03 mU / l，对照组为1.37 mUI / l。患者的游离T4中位数为1.37 ng / dl，对照组为1.20 ng / dl。患者表现出RSA期间％HF与静止时％HF之间的差异比对照组小得多（中位数-7.5对36.6，P <0.001）。与对照组相比，患者倾斜后的LF / HF比与静止时的LF / HF比之间的差异较小（1.5比5.3，P = 0.005）。
结论：亚临床甲状腺功能亢进症通过钝性迷走神经反应影响原本健康的非老年女性的心血管自主神经平衡。

BACKGROUND & AIMS: :Hypothyroid rats treated with human GH (hGH) were partially refractory to the latter's effects. The present study was undertaken to investigate the role of hypo- and hyperthyroidism on the GH receptor. Seven-week-old rats were rendered either hypothyroid, by methimazole, or hyperthyroid, by a daily overdose of T4, during weeks 7-14 of life. Livers were homogenized and overlaid on sucrose discontinuous density gradient. Removal of endogenous ligand from the receptor was performed by exposing the membranes to MgCl2. hGH was used with excess ovine PRL to characterize somatogenic specific binding. Lactogenic specific binding was calculated by subtracting somatogenic specific binding from the total specific binding. Creatine kinase was also measured in homogenized livers. Liver membranes of the hypothyroid rats showed a significant decline in somatogenic and lactogenic binding of hGH. This was true for both the free unoccupied binding sites and total binding after dissociation of the endogenous ligand. Replacement of T4 for 2 weeks restored hGH binding to control values. Hyperthyroid rats had high somatogenic and lactogenic hGH binding. Creatine kinase activity decreased significantly in liver homogenates of hypothyroid rats, was restored by T4 replacement, and increased significantly in hyperthyroid rats. Thus, lactogenic and somatogenic receptors are directly related to the thyroid status in vivo.

背景与目标： ：用人GH（hGH）治疗的甲状腺功能低下大鼠对后者的作用部分耐受。本研究旨在研究甲状腺功能减退和甲状腺功能亢进对GH受体的作用。在生命的7-14周内，每天服用过量的T4使7周龄的大鼠甲乙咪唑或甲亢使甲状腺功能减退。将肝匀浆并覆盖在蔗糖不连续密度梯度上。通过将膜暴露于MgCl2，从受体中去除内源性配体。 hGH与过量的绵羊PRL结合使用来表征生体特异性结合。通过从总特异性结合中减去生源性特异性结合来计算产乳原性特异性结合。肌酸激酶也在均质肝中进行了测定。甲状腺功能减退大鼠的肝膜显示生长激素和促生长素结合的生长激素显着下降。内源性配体解离后的游离未占据结合位点和总结合都是如此。更换T4 2周恢复了hGH与对照值的结合。甲状腺功能亢进的大鼠具有高的促生和促乳源hGH结合。甲状腺功能减退大鼠肝脏匀浆中的肌酸激酶活性显着降低，通过T4替代恢复，而在甲状腺功能亢进大鼠中肌酸激酶活性显着提高。因此，生乳受体和生体受体与体内甲状腺状态直接相关。

BACKGROUND & AIMS: :Intrathoracic goiter is an important cause of mediastinal masses. We present a patient with hyperthyroidism, tracheal compression, superior vena cava syndrome (SVCS) and Horner's syndrome due to intrathoracic goiter. To our knowledge, this is the first case in the literature with all of these combined findings.

背景与目标： ：胸腔内甲状腺肿是纵隔肿块的重要原因。我们介绍了由于甲状腺肿大而伴有甲亢，气管压迫，上腔静脉综合征（SVCS）和霍纳氏综合征的患者。据我们所知，这是文献中所有这些综合发现的第一个案例。

BACKGROUND & AIMS: :We aimed to analyze the potential influence of thyroid autoimmunity on visfatin/NAMPT serum concentration and its leukocyte expression in hyperthyroid patients. This is a single-center, cross-sectional study with consecutive enrollment. All patients with newly diagnosed overt hyperthyroidism in a course of Graves' disease or toxic nodular goiter were included in the study. They underwent physical examination, laboratory investigation, body composition analysis, and thyroid ultrasound. NAMPT mRNA leukocyte expressions were measured using RT-qPCR. Of the 173 patients, 95 were enrolled in further analysis [67 patients with Graves' disease (GD) and 28 with toxic nodular goiter (TNG)]. Control group consisted of 43 healthy volunteers adjusted for age, sex, and BMI. Higher NAMPT/visfatin serum concentration was found in patients with GD comparing with patients with TNG (p=0.03855). We found significant NAMPT leukocyte overexpression in GD patients (n=32) as compared to TNG patients (n=18) and euthyroid controls (n=24) (p=0.005965). Simple linear regression analysis revealed that NAMPT/visfatin serum concentration was significantly associated with NAMPT leukocyte expression, thyroid autoimmunity, age, HOMA-IR, and fat mass percentage (FM%). NAMPT leukocyte expression was related to thyroid autoimmunity, age, and TRAb levels. The stepwise multiple regression analysis revealed FM% and HOMA-IR as independent predictors of visfatin/NAMPT serum levels. In a separate stepwise multiple regression analysis, we confirmed the association between NAMPT leukocyte expression and TRAb levels. We found that fat mass percentage together with HOMA-IR are the most significant predictors of visfatin/NAMPT serum elevation in hyperthyroid patients.

背景与目标： ：我们旨在分析甲状腺自身免疫对甲状腺功能亢进患者中的visfatin / NAMPT血清浓度及其白细胞表达的潜在影响。这是一项连续注册的单中心，横断面研究。该研究包括所有新诊断为患有格雷夫斯病或中毒性结节性甲状腺肿的明显甲状腺功能亢进症的患者。他们接受了身体检查，实验室检查，身体成分分析和甲状腺超声检查。使用RT-qPCR测量NAMPT mRNA白细胞表达。在这173例患者中，有95例进行了进一步分析[67例Graves病（GD）和28例中毒性结节性甲状腺肿（TNG）]。对照组由43位经过年龄，性别和BMI调整的健康志愿者组成。与TNG患者相比，GD患者的NAMPT / visfatin血清浓度更高（p = 0.03855）。我们发现，与TNG患者（n = 18）和甲状腺正常对照（n = 24）相比，GD患者（n = 32）有明显的NAMPT白细胞过表达（p = 0.005965）。简单的线性回归分析显示，NAMPT / visfatin血清浓度与NAMPT白细胞表达，甲状腺自身免疫性，年龄，HOMA-IR和脂肪质量百分比（FM％）显着相关。 NAMPT白细胞表达与甲状腺自身免疫性，年龄和TRAb水平相关。逐步多元回归分析显示FM％和HOMA-IR是visfatin / NAMPT血清水平的独立预测因子。在单独的逐步多元回归分析中，我们确认了NAMPT白细胞表达与TRAb水平之间的关联。我们发现，脂肪质量百分比与HOMA-IR一起是甲状腺功能亢进患者中visfatin / NAMPT血清升高的最重要预测因子。

BACKGROUND & AIMS: :Since theraphy of Graves' disease is not directed towards the cause of the disease, medical theraphy is still the first choice and symptomatically effective in treating hyperthyroidism. Antithyroid drugs are effective in restoring euthyroidism in >90% of the patients durning 4-6 weeks, but 30-50% of the patients experience relapse after withdrawal. Previous prospective randomized studies evaluated prognostic parameters and the use of levothyroxine for prevention of relapse of hyperthyroidism. Recent studies have addressed the period after withdrawal amd focused on the natural course of disease. The results of a recent prospective randomized and controlled multicenter study were as follows: supplementation of levothroxine does not prevent relapse of hyperthyroidism. Basal TSH (4 weeks after withdrawal of antithyroid drugs) is the best prognostic marker. Smoking and positive TSH-receptor-antibodies at the end of antithyroid theraphy are other risk factors.

背景与目标： ：由于Graves病的治疗方法不针对疾病的病因，因此医学治疗仍然是治疗甲状腺功能亢进症的首选且在症状上有效。抗甲状腺药物可有效地在4-6周内使90％以上的患者恢复甲状腺功能正常，但是30-50％的患者在停药后会复发。先前的前瞻性随机研究评估了预后参数以及使用左甲状腺素治疗甲状腺功能亢进症的预防。最近的研究已经针对停药后的时期以及侧重于疾病的自然病程。最近一项前瞻性随机对照多中心研究的结果如下：补充左甲状腺素不能预防甲状腺功能亢进症的复发。基础TSH（停药后4周）是最好的预后指标。其他危险因素还包括吸烟和抗甲状腺治疗结束时TSH受体抗体阳性。

BACKGROUND & AIMS: OBJECTIVE:The clinical manifestations of hyperthyroidism resemble those of the hyperadrenergic state. This study was designed to evaluate the impact of hyperthyroidism on the autonomic nervous system (ANS) and to investigate the relationship between serum thyroid hormone concentrations and parameters of spectral heart rate variability (HRV) analysis in hyperthyroidism. DESIGN AND PATIENTS:Thirty-two hyperthyroid Graves' disease patients (mean age 31 years) and 32 sex-, age-, and body mass index (BMI)-matched normal control subjects were recruited to receive one-channel electrocardiogram (ECG) recording. MEASUREMENTS:The cardiac autonomic nervous function was evaluated by the spectral analysis of HRV, which indicates the autonomic modulation of the sinus node. The correlation coefficients between serum thyroid hormone concentrations and parameters of the spectral HRV analysis were also computed. RESULTS:The hyperthyroid patients revealed significant differences (P < 0.001) compared with the controls in the following HRV parameters: a decrease in total power (TP), very low frequency power (VLF), low frequency power (LF), high frequency power (HF), and HF in normalized units (HF%); and an increase in LF in normalized units (LF%) and in the ratio of LF to HF (LF/HF). After correction of hyperthyroidism in 28 patients, all of the above parameters were restored to levels comparable to those of the controls. In addition, serum thyroid hormone concentrations showed significant correlations with spectral HRV parameters. CONCLUSIONS:Hyperthyroidism is in a sympathovagal imbalanced state, characterized by both increased sympathetic and decreased vagal modulation of the heart rate. These autonomic dysfunctions can be detected simultaneously by spectral analysis of HRV, and the spectral HRV parameters could reflect the disease severity in hyperthyroid patients.

背景与目标： 目的：甲状腺功能亢进症的临床表现类似于高肾上腺素能状态。本研究旨在评估甲状腺功能亢进症对自主神经系统（ANS）的影响，并探讨甲状腺功能亢进症患者血清甲状腺激素浓度与频谱心率变异性（HRV）分析参数之间的关系。
设计与患者：招募了32例甲状腺机能亢进的Graves病患者（平均年龄31岁）和32名性别，年龄和体重指数（BMI）匹配的正常对照受试者，以接受单通道心电图（ECG）记录。
测量：通过HRV的光谱分析评估心脏自主神经功能，这表明窦房结的自主调节。还计算了血清甲状腺激素浓度与光谱HRV分析参数之间的相关系数。
结果：甲状腺功能亢进患者在以下HRV参数方面与对照组相比有显着差异（P <0.001）：总功率（TP）降低，极低频功率（VLF），低频功率（LF），高频功率（HF）和HF归一化单位（HF％）； LF的标准化单位（LF％）和LF与HF的比率（LF / HF）的增加。在纠正了28例甲状腺功能亢进症患者后，所有上述参数均恢复至与对照组相当的水平。另外，血清甲状腺激素浓度与HRV频谱参数显着相关。
结论：甲状腺功能亢进症处于交感迷走神经失调状态，其特征是交感增加和迷走神经心率调节降低。这些自主神经功能障碍可以通过HRV的频谱分析同时发现，频谱的HRV参数可以反映甲状腺功能亢进患者的疾病严重程度。