• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.54-60
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• 1995

Medical Internal Radiation Dose(MIRD) schema was developed for calculating the absorbed dose from the administered radiopharmaceuticals. With the biological distribution data and the physical properties of the radionuclide we can estimate the absorbed dose by the MIRD schema. For the thyroid cancer patients received $^{131}I$ therapy, the absorbed dose to the bone marrow is the limiting factor to the administered dose, and the duration of admission is deter-mined by the retained activity in the whole body. To monitor the whole body radioactivity, we used Eberline Smart 200 system using ionization chamber as a detector. With the time activity curve of the whole body, total body residence time was obtained. From the ICRP publication 53, the residence times of the source organs, such as kidney, urinary bladder content and stomach, were used to calculate the absorbed doses of the target organs, such as stomach, red marrow, bladder wall and remaineder total body. In 8 thyroid cancer patients with 175 mci of $^{131}I$ administered orally, the mean absorbed dose in the bladder wall was 375.1, in the stomach 285.1, red marrow 25.4 and total body 22.4 rad respectively. For the monitoring of the large administered activity, this method seemed to be quite useful.

• The Korean Journal of Nuclear Medicine
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• v.29 no.3
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• pp.343-349
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• 1995

Background : For biological dosimetry of radiation exposure, both observing hematologic change and calculating Ydr by chromosomal analysis as biological indicators are widely used. However, due to the lack of studies on biological dosimetry of radiation dose absorbed in the body such as in the cases of radioactive iodine therapy, the maximal and safe dose is not well known, nor is the extent to which the body can safely endure radiation exposure. Purpose : To investegate the practical applicability of hematologic changes and Ydr as an indicator for estimating radiation exposure, to patients with thyroid diseases after doses of radioactive iodine. Material and Methods : 5 patients with hyperthyroidism and 35 patients who have had thyroid cancer operation were under treatment with radioactive iodine, changes in number of lymphocytes were tracked and Ydr was calculated for more than 2 months by chromosomal analysis in peripheral lymphocytes. Results ; 1) The number of lymphocytes began to decrease 2 weeks after doses of radioactive iodine, and reached the nadir after 6 and 8 weeks, then gradually recovered. 2) The nadir count of lymphocytes was reversely correlated with the administered dosage of radioactive iodine. 3) Ydr was generally stable between 2 and 8 weeks. 4) The maximal value of Ydr was correlated with the administered dosage of radioactive iodine. 5) Ydr value at the 2nd week increased with augmented dosage of radioactive iodine. 6) Ydr value at the 2nd week was correlated with fall of lymphocyte count. Conclusion : Patients must be closely observed, because temporary bone marrow suppression and slight chromosomal aberration can be produced by even generally used dosages of radioactive iodine for diagnosis and therapy. Maximal percent fall of lymphocyte count, Ydr at the 2 week interval and maximal Ydr can be used as the biological predictor of administered dosage of radioactive iodine.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.2
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• pp.43-47
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• 2022

Purpose Radioimmunoassay implement quality control by systematizing the internal quality control system for quality assurance of test results. This study aims to contribute to the quality assurance of radioimmunoassay results and to implement systematic quality control by measuring the average CV of internal quality control and external quality control by plenty of institutions for reference when setting the laboratory's own acceptable range. Materials and Methods We measured the average CV of internal quality control and the bounce rate of more than 10.0% for a total of 42 items from October 2020 to December 2021. According to the CV result, we classified and compared the upper group (5.0% or less), the middle group (5.0~10.0%) and the lower group (10.0% or more). The bounce rate of 10.0% or more was compared by classifying the item of five or more institutions into tumor markers, thyroid hormones and other hormones. The average CV was measured by the overall average and standard deviation of the external quality control results for 28 items from the first quarter to the fourth quarter of 2021. In addition, the average CV was measured by the overall average and standard deviation of the proficiency results between institutions for 13 items in the first half and the second half of 2021. The average CV of internal quality control and external quality control was compared by item so we compared and analyzed the items that implement well to quality control and the items that require attention to quality control. Results As a result of measuring the precision average of internal quality control for 42 items of six institutions, the top group (5.0% or less) are Ferritin, HGH, SHBG, and 25-OH-VitD, while the bottom group (≤10.0%) are cortisol, ATA, AMA, renin, and estradiol. When comparing more than 10.0% bounce rate of CV for tumor markers, CA-125 (6.7%), CA-19-9 (9.8%) implemented well, while SCC-Ag (24.3%), CA-15-3 (26.7%) were among the items that require attention to control. As a result of comparing the bounce rate of more than 10.0% of CV for thyroid hormones examination, free T4 (2.1%), T3 (9.3%) showed excellent performance and AMA (39.6%), ATA (51.6%) required attention to control. When comparing the bounce rate of 10.0% or more of CV for other hormones, IGF-1 (8.8%), FSH (9.1%), prolactin (9.2%) showed excellent performance, however estradiol (37.3%), testosterone (37.7%), cortisol (44.4%) required attention to control. As a result of measuring the average CV of the whole institutions participating at external quality control for 28 items, HGH and SCC-Ag were included in the top group (≤10.0%), however ATA, estradiol, TSI, and thyroglobulin included in bottom group (≥30.0%). Conclusion As a result of evaluating 42 items of six institutions, the average CV was 3.7~12.2% showing a 3.3 times difference between the upper group and the lower group. Cortisol, ATA, AMA, Renin and estradiol tests with high CV will require continuous improvement activities to improve precision. In addition, we measured and compared the overall average CV of the internal quality control, the external quality control and the proficiency between institutions participating of six institutions for 41 items excluding HBs-Ab. As a result, ATA, AMA, Renin and estradiol belong to the same subgroup so we require attention to control and consider setting a higher acceptable range. It is recommended to set and control the acceptable range standard of internal quality control CV in consideration of many things in the laboratory due to the different reagents and instruments, and the results vary depending on the test's proficiency and quality control materials. It is thought that the accuracy and reliability of radioimmunoassay results can be improved if systematic quality control is implemented based on the set acceptable range.

• Journal of the Korean Society of Radiology
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• v.5 no.6
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• pp.343-349
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• 2011

This study was aimed to evaluate the absorbed dose in brain of dental radiography. For radiographic exposure, PLD(photoluminescence dosimetry) chips placed in Rando phantom to measurement the absorbed dose to pituitary gland, orbit, maxillary sinus and submandibular glands, thyroid gland, esophagus. Equipments were used Kodak 2200, Kodak 8000C dental radiographic systems and computed tomography(Lightspeed VCT). The absorbed doses were measured at the same exposure parameters and distance by the clinical factor(kV, mA, sec). The result were as follows ; The absorbed dose for intra-oral radiography were 0.02~2.47cGy, the greatest absorbed dose was 2.47cGy for thyroid gland in maxillary right molar projection. the lowest adsorbed dose was 0.02cGy for submandibular glands in lower anterior projection. The absorbed dose for extra-oral radiography were 0.36~3.44cGy of cephalometric method, 0.14~12.82cGy of panoramic method, 8.17~253.63cGy of computed tomography, the greatest adsorbed dose was 253.63cGy for submandibular glands in maxillary CT scan. the lowest adsorbed dose was 0.14cGy for orbit in panoramic method. As a result, extra-oral radiography was measured more than intra-oral radiography. In particular, method which used computed tomography was measured more than 100 times than intra-oral radiography highly. Therefore, you must show a guideline in extra-oral radiography and an effort to reduce absorbed dose is demanded.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.53-57
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• 2023

In general, the anatomical location and number of parathyroid glands are well known, but they are often found in a variety of locations, making it difficult to find parathyroid glands during surgery. Besides Intra-thyroidal parathyroid adenoma is extremely rare case, and it is harder to identify in surgery. We encountered a 51-year-old patient with a thyroid nodule. The results of the additional blood test and the Tc-99m MIBI were combined to determine that the left lower lobe parathyroid adenoma was highly likely. This patient was treated with left thyroid lobectomy with parathyroid identification using Near-infrared (NIR) imaging. Afterwards, the biopsy confirmed that it was a parathyroid adenoma, and has since been monitored through outpatient observation without any problem. We present this rare case with a review of related literatures.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.75-80
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• 2011

Purpose: Europe and U.S use multi-bed therapy rooms. Hereupon, this study aims to examine the safety when current one-bed therapy rooms in Seoul National University Hospital is changed into two-bed ones. Materials and Methods: This study evaluated external exposure by gamma radiation emitted from other patients and internal and external exposure caused by pollutions from other patients in case that Seoul National University Hospital installs a shielding wall between beds in existing therapy rooms. Results: When internal and external exposure was evaluated to evaluate safety of two-bed hospital rooms, 'isolation amount of patients' 5mSv exposure or below is received according to the Atomic Energy Act. Conclusion: With the increasing number of patients with thyoid cancer, patients using therapy rooms are on the rise. Therefore, improving one-person therapy rooms to two-person ones in line with international trend would increase cost reduction and management efficiency, and patients' alienation and isolation can be reduced to increase healing effects.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.20 no.2
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• pp.253-264
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• 1990

The purpose of this study was to estimate the distribution of absorbed doses of each important organs of head and neck region in panoramic radiography. Radiation dosimetry at internal anatomic sites and skin surfaces of phantom (RT-210 Humanoid Head & Neck Section/sup R/) was performed with lithium fluoride (TLD-100/sup R/) thermoluminescent dosimeters according to change of kilovoltage (65kVp, 75kVp and 85kVp) with 4 miliamperage and 20 second exposure time. The results obtained were as follows; Radiation absorbed doses of internal anatomic sites were presented the highest doses of 1.04 mGy, 1.065 mGy and 2.09 mGy in nasopharynx, relatively high doses of 0.525 mGy, 0.59 mGy and 1.108 mGy in deep lobe of parotid gland, 0.481 mGy, 0.68 mGy and 1.191 mGy in submandibular gland. But there were comparatively low doses of 0.172 mGy and 0.128 mGy in eyes and thyroid gland that absorbed dose was estimated at 85kVp. Radiation absorbed doses of skin surfaces were presented the highest doses of 1. 263 mGy, 1.538 mGy and 2.952 mGy in back side of first cervical vertebra and relatively high doses of 0.267 mGy, 0.401 mGy and 0.481 mGy in parotid gland. But there were comparatively low doses of 0.057 mGy, 0.068 mGy and 0.081 mGy in philtrum and 0.059 mGy in middle portion of chin that absorbed dose was estimated at 85kVp. According to increase of kilovoltage, the radiation absorbed doses were increased 1.1 times when kilovolt age changes from 65kVp to 75kVp and 1.9 times when kilovolt age changes from 75kVp to 85kVp at internal anatomic sites. According to increase of kilovoltage, the radiation absorbed doses were increased 1.3 times when kilovolt age changes from 65kVp to 75kVp and 1.6 times when kilovoltage changes from 75kVp to 85kVp at skin surfaces.

• Journal of the Korean Society of Radiology
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• v.16 no.2
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• pp.141-150
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• 2022

The initial co-transport and counter-transport permeate transport characteristics of calcium ion at epithelial cell membrane model in parathyroid which irradiated by high energy x-ray(linac 6 MV) was investigated. The epithelial cell membrane model used in this experiment was a polysulfonated copolymerized membrane of poly(PS-DVB: polystyrene-divinylbenzene). The difference of sorbed water in membrane, fixed carrier concentration(SO₃^2-), initial pH value, OH^- concentration were occurred at difference of Ca²⁺concentration and quantity of parathyroid hormone, respectively. The initial co-transport and counter-transport permeate flux of Cl^-, OH^-, Ca²⁺ on fixed carrier concentration(SO₃^2-) and initial pH value of irradiated membrane was found to be decreased than non-irradiated membrane. The initial co-transport and counter-transport permeate flux of Ca²⁺ on fixed carrier concentration (SO₃^2-), initial pH value, OH^- concentration in irradiated membrane were found to be decreased about 2.68 ~ 6.87 times, about 1.42 ~ 1.63 times, about 2.07 ~ 1.672 times than non-irradiated membrane, respectively. As a result, the quantity of parathyroid hormone was decreased at irradiated membrane than non-irradiated membrane. The decrease of parathyroid hormone was occurred at hypoparathyroidism and osteoporosis, parathyroiditis, and so on. As the parathyroid hormone in epithelial cell membrane model were abnormal, cell damages were appeared at cell.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.115-118
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• 2012

Purpose: The Levey-Jennings chart controlled measurement values that deviated from the tolerance value (mean ${\pm}2SD$ or ${\pm}3SD$). On the other hand, the upgraded Westgard Multi-Rules are actively recommended as a more efficient, specialized form of hospital certification in relation to Internal Quality Control. To apply Westgard Multi-Rules in quality control, credible quality control substance and target value are required. However, as physical examinations commonly use quality control substances provided within the test kit, there are many difficulties presented in the calculation of target value in relation to frequent changes in concentration value and insufficient credibility of quality control substance. This study attempts to improve the professionalism and credibility of quality control by applying Westgard Multi-Rules and calculating credible target value by using a commercialized quality control substance. Materials and Methods : This study used Immunoassay Plus Control Level 1, 2, 3 of Company B as the quality control substance of Total T3, which is the thyroid test implemented at the relevant hospital. Target value was established as the mean value of 295 cases collected for 1 month, excluding values that deviated from ${\pm}2SD$. The hospital quality control calculation program was used to enter target value. 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T of Westgard Multi-Rules were applied in the Total T3 experiment, which was conducted 194 times for 20 days in August. Based on the applied rules, this study classified data into random error and systemic error for analysis. Results: Quality control substances 1, 2, and 3 were each established as 84.2 ng/$dl$, 156.7 ng/$dl$, 242.4 ng/$dl$ for target values of Total T3, with the standard deviation established as 11.22 ng/$dl$, 14.52 ng/$dl$, 14.52 ng/$dl$ respectively. According to error type analysis achieved after applying Westgard Multi-Rules based on established target values, the following results were obtained for Random error, 12s was analyzed 48 times, 13s was analyzed 13 times, R4s was analyzed 6 times, for Systemic error, 22s was analyzed 10 times, 41s was analyzed 11 times, 2 of 32s was analyzed 17 times, $10\bar{x}$ was analyzed 10 times, and 7T was not applied. For uncontrollable Random error types, the entire experimental process was rechecked and greater emphasis was placed on re-testing. For controllable Systemic error types, this study searched the cause of error, recorded the relevant cause in the action form and reported the information to the Internal Quality Control committee if necessary. Conclusions : This study applied Westgard Multi-Rules by using commercialized substance as quality control substance and establishing target values. In result, precise analysis of Random error and Systemic error was achieved through the analysis of 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T rules. Furthermore, ideal quality control was achieved through analysis conducted on all data presented within the range of ${\pm}3SD$. In this regard, it can be said that the quality control method formed based on the systematic application of Westgard Multi-Rules is more effective than the Levey-Jennings chart and can maximize error detection.