Biomedical subjects

Junichi Tajiri

Publications and source records attributed to Junichi Tajiri.

7 recordsLinked to original sources

PubMed2006

Radioactive iodine therapy for goitrous Hashimoto's thyroiditis.

CONTEXT: Hashimoto's thyroiditis is an autoimmune disease that can produce marked clinical symptoms when patients have large diffuse goiters. DESIGN: This retrospective cohort study was designed to evaluate whether radioactive iodine (RAI) is effective for Hashimoto's thyroiditis with a large goiter. Starting in November 1999, 13 Hashimoto's patients with large goiters, whose thyroiditis was refractory to TSH suppression therapy with thyroid hormone administration [two men and 11 women with a mean age of 61.2 +/- 8.9 yr (50-79 yr)], were recruited for the present study. The duration of symptomatic goiter before undergoing RAI was 12.0 +/- 7.9 yr (4-33 yr). Thirteen millicuries of 131I was administered two to six times, at an interval of 1-6 months on an outpatient basis. Thyroid weight was measured ultrasonographically, or by computed tomography if ultrasound was not possible due to the large size of the goiter. RESULTS: RAI was administered an average of 4.7 +/- 1.4 times (two to six times), with a total dose of 59.8 +/- 17.3 mCi (25.0-78.0 mCi). The observation period was 47.9 +/- 13.4 months (26-66 months) after the first RAI. The average weight of the thyroid gland was 125.3 +/- 57.7 g (42.9-269.4 g) before the first RAI, decreasing significantly to 49.7 +/- 25.8 g (18.3-93.3 g) after the last RAI (P < 0.001, paired Student's t test). The percent reduction from baseline was 58.7 +/- 14.2% (35.7-84.0%). None of the patients showed an increase in goiter size or complained of a pressure sensation after any of the RAI treatments. CONCLUSION: RAI is effective in Hashimoto's thyroiditis with a large goiter.

Aged↗

PubMed2006

[Simple goiter].

Explore the source record for details and available documents.

Diagnosis, Differential↗

PubMed2006

[Radioiodine treatment of patients with autonomously functioning thyroid nodules at outpatient clinic].

OBJECTIVES: This retrospective study was aimed at evaluating the efficacy of radioiodine (RI) treatment for patients with autonomously functioning thyroid nodules (AFTN). METHODS: The subjects were 38 patients including 26 cases of toxic adenoma (TA) and 12 cases of toxic multinodular goiter (TMNG), who attended our clinic from July 1999 to April 2005. RI treatment was performed in the outpatient clinic. Thirteen mCi (481 MBq) of 131I were administered to all patients, and additional administrations were performed at an interval of 3 to 4 months when not sufficient. Patients with TA were followed for 31.9 +/- 18.7 months (5-68 months) and those with TMNG for 40.5 +/- 18.3 months (10-63 months). A curative effect was defined as absence of TSH suppression. RESULTS: After RI treatment, hyperthyroidism improved, associated with reduction in size of the goiter or nodes in all 38 cases. Hypothyroidism was observed in one of 19 patients with TA in whom RI was performed under a suppressed TSH level, while all 6 patients whose serum TSH levels were not suppressed at the time of the treatment, developed into hypothyroidism (p < 0.001). CONCLUSION: RI treatment was effective in patients with AFTN. RI is an alternative treatment of AFTN. Development of hypothyroidism in patients with TA can be prevented by maintaining a suppressed TSH level when RI is administered.

Adult↗

PubMed2006

[Issues of side effects induced by antithyroid drugs].

Antithyroid drugs have been widely used in the treatment of hyperthyroidism. However, these drugs are known to have significant side effects. There are minor side effects such as skin rash or urticaria and major side effects. Especially, agranulocytosis and MPO-ANCA related vasculitis syndrome are the most serious, and although it occurs infrequently, it is clinically important, and clinicians must be alert to it when using antithyroid arugs. The author describes about the issues of side effects induced by antithyroid drugs.

Agranulocytosis↗

PubMed2005

Antithyroid drug-induced agranulocytosis: how has granulocyte colony-stimulating factor changed therapy?

This study examined whether granulocyte colony-stimulating factor (G-CSF) is beneficial for the treatment of antithyroid drug-induced agranulocytosis. From January 1975 to December 2001, 30,798 patients with Graves' disease were treated with antithyroid drugs at Noguchi Thyroid Clinic & Hospital Foundation. During this period, 109 patients (0.35%) were found to have agranulocytosis caused by antithyroid drugs. In the symptomatic group, the recovery time from agranulocytosis was significantly shorter after the introduction of G-CSF (5.5 +/- 3.5 days, n = 19) compared to the symptomatic group before its introduction (9.2 +/- 4.4 days, n = 37, p < 0.01). In the asymptomatic group, the recovery time from agranulocytosis was significantly shorter after the introduction of G-CSF (2.3 +/- 1.9 days, n = 15) compared to the asymptomatic group before the introduction of GCSF (5.4 +/- 4.3 days, n = 34, p < 0.05). However, G-CSF therapy was ineffective in severe cases with granulocyte count below 0.1 x 10(9)/L and symptoms. We recommend that G-CSF therapy should be applied only in asymptomatic patients and symptomatic patients with granulocyte count above 0.1 x 10(9)/L, and not for symptomatic patients with granulocyte count below 0.1 x 10(9)/L. In conclusion, G-CSF therapy shortens the period of recovery from antithyroid drug-induced agranulocytosis and benefits patients, except those with symptoms and a granulocyte count below 0.1 x 10(9)/L.

Agranulocytosis↗

PubMed2005

[Radioiodine treatment in patients with Graves' disease at outpatient clinic: special reference to safety and short-term outcome].

PURPOSE: This retrospective study was aimed at revealing the safety and short-term outcome of radioiodine treatment in patients with Graves' disease at outpatient clinic. METHODS: From July 1999 to April 2002, 511 patients with Graves' disease were treated with radioiodine at the outpatient clinic of Tajiri Thyroid Clinic, Kumamoto. Of them, 73 patients dropped out or were referred to another medical institution. In the remaining 438 patients [100 men and 338 women; 44.6 +/- 15.4 (mean +/- SD) (14-82) years old], the safety of radioiodine treatment at the outpatient clinic and the treatment outcome until April 2003 was examined. The dosage was determined based on radioactive iodine uptake (3 hours) and thyroid volume measured by ultrasound. The initial dosage was 6.7 +/- 3.3 (1.2-13.5) mCi. Five months later, it was evaluated whether or not radioiodine should be administered a second time. All patients were treated at the outpatient clinic. RESULTS: There was no particular problem associated with treatment. Patients with a large goiter could be successfully treated with divided doses. After 12-45 (30.1 +/- 9.3) months of radioiodine, thyroid function status was as follows; hyperthyroidism: 7 patients (1.6%), subclinical hyperthyroidism: 78 patients (17.8%), euthyroidism: 108 patients (24.7%), subclinical hypothyroidism: 116 patients (26.5%), hypothyroidism: 129 patients (29.4%). CONCLUSION: It was concluded that radioiodine treatment in patients with Graves' disease at outpatient clinic was safe and showed a satisfactory short-term outcome.

Administration, Oral↗

PubMed2004

Antithyroid drug-induced agranulocytosis: special reference to normal white blood cell count agranulocytosis.

This retrospective study was aimed at revealing the incidence of normal white blood cell (WBC) count agranulocytosis in patients treated with antithyroid drugs (ATDs). From January 1975 to December 2001, 109 patients (0.35%) presented with ATD-induced agranulocytosis at our clinic. In 18 patients (16.5%), the WBC count exceeded 3.0 x 10(9)/L at the onset of agranulocytosis. Ten showed a downward trend in WBC count (3.0-3.9 x 10(9)/L) after the initiation of ATDs. Four had symptoms of infection. In the remaining 4 patients, routine WBC and granulocyte count monitoring detected an agranulocytosis. During the first 3 months of ATD treatment, 3347 patients (10.9%) had WBC count 3.0-3.9 x 10(9)/L even once with no symptom and normal granulocyte count and 26672 patients had WBC count >or= 4.0 x 10(9)/L with no symptom and normal granulocyte count. When agranulocytosis was found, twelve patients with normal WBC count agranulocytosis (0.36%) had WBC count 3.0-3.9 x 10(9)/L with no symptom, whereas only 2 patients with agranulocytosis (0.008%) had WBC count >or= 4.0 x 10(9)/L with no symptom. In conclusion, clinicians should take normal WBC count agranulocytosis into consideration at least during the first 3 months of antithyroid drug therapy, especially when WBC count is 3.0-3.9 x 10(9)/L.

Adult↗