• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.206-211
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• 2000

Objectives: Any uptake of I-131 after total thyroidectomy means the remant thyroid tissue or distant metastasis of the thyroid cancer. However diffuse hepatic uptake of I-131 without abnormal uptake was showen in many cases on I-131 whole body scan. The aim of this study was to classify the liver uptake after I-131 scan and to evaluate the analysis of this finding. Materials and Methods: Between 1982 and 1998, 104 patients(l4 males, 90 females) with normal liver function underwent I-131 scan after total thyroidectomy. Prospectively we reviewed the films of the whole body scan and analysed the correlations between results of radioiodine uptake, pathologic diagnosis, prognostic factors, lymphatic metastasis, and thyroid function test. Result: Diffuse hepatic uptake was found in 44 of 104(42%) patients. 10 of 39(26%) patients on I-131 100mCi, and 34 of 63(54%) on I-131 150mCi showed hepatic uptake. 52 of 104(50%) patients was locally invasive thyroid cancer. The rate of the hepatic uptake was no significant differences with the thyroid hormone levels(T3, Free T4) and thyroglobulin between uptake group and non-uptake group. Conclusion: The rate of I-131 uptake was high in high-dose radioiodine treatment group. However, we can not find any correlation among the thyroid functions, the extent of metastasis or the extent of local invasion. We need further study to find out the causes of the hepatic uptake of I-131 after total thyroidectomy, besides liver metabolism of I-131 attached thyroid hormones.

• The Korean Journal of Nuclear Medicine
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• v.12 no.2
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• pp.23-31
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• 1978

Hyperthyroidism may be defined as those clinical conditions which result from an increase in the circulating levels of one or both thyroid hormones. Hyperthyroidism in broad sense could be classified with toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter on the basis of the circulating thyroid hormone levels. For this study, the subject included 94 cases with hyperthyroidism were presented in 77 with toxic diffuse goiter, 8 with toxic adenomatous goiter, and 9 with toxic multinodular goiter on the levels of $^{125}IT_3$ resin uptake rate and serum thyroxine ($T_4$). The observed results were as follows: 1) In the cases of hyperthyroidism including toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter, 20.21% of the patients were male and 79.79% female. The majority of the patients were in 2nd to 4th decades of their lives. 2) There were objective signs clearly manifested in hyperthyroidism including toxic diffuse goiter and toxic adenomatous goiter which were rare in the multinodular goiter. The clinical signs in toxic diffuse and toxic adenomatous goiter included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor and warm skin etc. (Table 3.) 3) The most freauent complaints of the patients with hyperthyroidism were palpitation, weight loss, increased appetite, perspiration, heat intolerance, nervousness, exertional dyspnea, and menstrual disturbance etc. (Table 4.) There was no clear difference in the incidence of symptoms between toxic diffuse goiter and toxic adenomatous goiter, but there was clear difference between toxic multinodular goiter. 4) Considering of results of $^{125}IT_3$ resin uptake rate and serum $T_4$ level in toxic diffuse goiter, toxic adenomatous goiter and toxic multinodular goiter, $^{125}I\;T_3$ resin uptake rate was $49.15{\pm}9.94%$ (mean) and serum $T_4\;21.29{\pm}7.04ug/dl$ (mean) in toxic diffuse goiter. In toxic multinodular goiter, $^{125}I\;T_3$ resin uptake rate was $32.47{\pm}6.74%$ (mean) and serum $T_4$ level $11.03{\pm}5.0ug/dl$, and then there was clear difference in the results of $^{125}I\;T_3$ resin uptake rate and serum $T_4$ between toxic diffuse goiter and toxic multinodular goiter. The levels of $^{125}I\;T_3$ resin uptake rate and serum $T_4$ in toxic adenomatous goiter were $40.32{\pm}13.08%$ (mean), $15.47{\pm}8.25ug/dl$ (mean) respectively, so there was no clear difference between toxic diffuse goiter and toxic adenomatous goiter. 5) There was no significant differnece in length and width performed with thyroid scanning in toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.33-38
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• 1969

The serum thyroxine levels were measured by method of Tetrasorb Kit in 69 subjects including 13 subjects in euthyroid state, 31 with hyperthyroidism, 5 with hypothyroidism, 13 with nontoxic diffuse goiter, and 7 with nontoxic nodular goiter. Three parameters of the thyroid function test including thyroxine ($T_4$) levels, $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were correlated with clinical manifestations and courses of the disease. 1. The serum $T_4$ levels in the normal subjects were in range of $6.0{\mu}g/dl\;to\;14.4{\mu}g/dl$. (The mean $9.4{\mu}g/dl$). 2. The diagnostic compatibility of the serum $T_4$ was 93.5% in hyperthyroidism, 100% both in hypothyroidism and in nontoxic diffuse goiter, 86% in nontoxic nodular goiter, or 95.8% in the entire series. (Table 1). 3. The diagnostic compatibility of $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were less than the serum $T_4$ levels as summarized in Tables 2 & 3. The serum $T_4$ determination by Tetrasorb Kit is a simple, accurate and very useful test of the thyroid function.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.16-20
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• 2000

The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

• The Korean Journal of Nuclear Medicine
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• v.1 no.1
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• pp.67-78
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• 1967

Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.17-22
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• 1969

The differences in the change of the uptake rate of radioactive iodine ($^{131}I$) in the thyroid gland after $Tapazole^{(R)}$ administration before $^{131}I$ treatment were analysed in 137 patients who were diagnosed as diffuse toxic goiter in the Radioisotope Clinic and Laboratory, Seoul National University Hospital since Jan. 1967 to July, 1969. The uptake rate of the therapeutic dose of $^{131}I$ was changed diffusely compared with that of the trace dose in the patients who had no $Tapazole^{(R)}$ administration before $^{131}I$ treatment. In those patients who had $Tapazole^{(R)}$ more than 20 mg/day for more than one week before $^{131}I$ treatment, the uptake rate was decreased significantly. When the patients discontinued the administration of $Tapazole^{(R)}$ 7 days prior to $^{131}I$ treatment, the uptake rate was increased in all cases.

• Toxicological Research
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• v.17 no.3
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• pp.203-213
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• 2001

We investigated the toxic effects of propylthiouracil (PTU) In Sprague-Dawley (SD) rats to develop and validate an enhanced Protocol for Test Guideline 407 as OECD Project. Twenty male and female SD rats,7 weeks old, were treated with PTU in corn oil at levels of 0, 0.1, 1 and 10 mg/kg/day for 4 weeks orally. Clinical observation, body weight changes, food uptake, water consumption, urinalysis, estrus cycle and sperm analysis, serum chemist교, autopsy findings and histopathological findings were evaluated in this study. No clinical signs and mortality were observed in the study. The body weights and food uptakes in the group treated with 10 mg/kg/day were reduced from 3 weeks after the initiation of the treatment. The levels of 3,5,3'-triiodothyronine (T3) and thyroxine (T4, 3,5,3',5'-tetraiodothyrosine) were also significantly decreased in the group treated with 10 mg/kg/day. Also, the relative and absolute organ weights of thymuses were decreased. Thyroid glands of rats in the group treated with PTU 10 mg/kg/day were bigger than those of rats in the control group. In the histopathological examination, diffuse hyperplasia and hypertrophy of thyroid follicular cells were observed in all treatment groups, leading to the reduction of lumen size and papillary enfolding of lining epithelium. The degree of lesion was increased in a dose-dependent manner. The results suggested that PTU would cause toxicity in thyroid gland and decrease the levels of T3 and T4 in SD rats. However there were no effects on the other organ including testis and uterus especially in spermatogenesis and estrus cycle. On the basis of the results, enhanced protocol for Test Guideline (TG) 407 may be sensitive and reliable to detect endocrine-active substances like PTU.

• The Korean Journal of Nuclear Medicine
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• v.4 no.2
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• pp.29-39
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• 1970

A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ among the 2,658 patients of various thyroid diseases treated over the past 10 years from May 1960 to Oct. 1969 at the Radioisotope Clinic and Laboratory, SNUH were presented and dscussed. 1. The patients examined consisted of: 929 cases (34.9%) of diffuse toxic goiter, 762 cases (28.7%) of diffuse nontoxic goiter, 699 cases (26.3%) of nodular nontoxic goiter, 58 cases (2.2%) of nodular toxic goiter and 210. cases (7.9%) of hypothyroidism. 2. There were 300 (11.4%) male and 2358 (88.6%) female, showing a ratio of 1:8. 3. The majority of patients (79.1%) were in the 3rd-5th decades of their lives. 4. The normal ranges, diagonstic values of $^{131}I$ uptake test, 48 hrs, serum activity, BMR and main subjective symptoms of various thyroid diseases were discussed. 5. In the 579 patients among 867 cases with hyperthyroidism treated with $^{131}I$, 47.8% were confirmed to be cured completely after single therapeutic doses. 6. The complications of $^{131}I$ therapy were discussed and myxedema had developed in 6.75% of our patients. 7. The results of $^{131}I$ thyroid function tests were analysed among the 160 cases of thyroid diseases which were confirmed the diagnosis with histopathological measures.

• The Korean Journal of Nuclear Medicine
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• v.38 no.5
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• pp.344-346
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• 2004

A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then acne scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

• The Korean Journal of Nuclear Medicine
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• v.15 no.2
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• pp.43-51
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• 1981

In an attempt to evaluate the diagnostic significance of the serum thyroxine binding globulin (TBG) in various thyroid disease states, the authors measured serum $T_3$ uptake, $T_3$, total $T_4\;free\;T_4$, TSH and TBG by radioimmunoassay technique, and calculated the free $T_4$ index$(FT_4I)$ and $T_4/TBG$ ratio in 10 cases of normal subjects, 11 cases of hypothyroidism, 62 cases of euthyroidism and 37 cases of hyperthyroidism. The data were analysed in the aspects of diagnostic significance in each thyroid disease state, and the results were as follows; 1. In 10 cases of normal subjects, serum TBG was $17.4\sim26.8{\mu}g/ml$, $FT_4I$ was $5.1\sim9.7$, and $T_4/TBG$ ratio was $21.9\sim49.9(Mean{\pm}S.D.)$. 2. In 62 cases of euthyroidism with diffuse and nodular goiter, $FT_4I$ was $7.26{\pm}1.82,\;T_4/TBG$ ratio was $31.47{\pm}10.42$, and there were no significant difference from those of normal subjects (p>0.5). 3. In 11 cases of hypothyroidism, the $FT_4I$ was $3.13{\pm}2.15,\;T_4/TBG$ ratio was $11.3{\pm}5.31$, significantly lower than normal controls (p<0.01). 4. In 37 cases of hyperthyroidism, the $FT_4I$ was $30.0{\pm}12.0,\;T_4/TBG$ ratio was $121.4{\pm}62.2$, significantly higher than normal controls (p<0.01). 5. There were significant correlations between the $FT_4I$ and $T_4/TBG$ ratio, total $T_4\;and\;T_4/TBG$ ratio, in each thyroid function states. 6. The $FT_4I$ showed 100% of diagnostic value in hyperthyroidism, 89.2% in euthyroidism, and 80% in hypothyroidism group. The $T_4/TBG$ ratio showed 100% of diagnostic value in hyperthyroidism and hypothyroidism, and 80.6% in euthyroidism group. The above results suggest that $T_4/TBG$ ratio and $FT_4I$ showed same diagnostic value in hyperthyroidism group, but $T_4/TBG$ showed higher diagnostic significance than $FT_4I$ in hypothyroidism.