• The Korean Journal of Nuclear Medicine
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• v.11 no.1
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• pp.39-48
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• 1977

Radioactive iodine(RAI), principally $^{131}I$, effectively controls hyperthyroidism in the majority of patients. The subsequent development of hypothyroidism, however, has been of increasing concern since it was first pointed out by Chapman and Maloof in 1955. And the steady increase of late hypothyroidism during the passage of time was known with its relation with dosage of RAI. The authors have investigated the development of hypothyroidism in 935 patients with diffuse toxic goiter(DTG) who were treated with ($RAI^{131}I$) at the Seoul National University Hospital from 1960 to 1977 to reveal its relation with the number of RAI treatments, dosage of RAI, age of patients and exophthalmos with the following results. 1) The incidence of hypothyroidism by year after RAI therapy among 631 patients with DTG who were treated with single RAI regimen was 7.4%(1 year), 11.8%(2 year), 16.2%(3 year), 22.1%(4 year) and 25.5%(5 year), and that among 163 patients given multiple RAI treatments was 8.6%(1 year), 10.4%(2 year), 13.3%(3 year), 29.1%(4 year), and 54.1%(5 year)respectively showing much higher year1y increments from 4 years after RAI treatment. in comparison with the former. 2) Among 550 patients in the lower dose group treated with single RAI regimen less than 5.0mCi ($Mean{\pm}S.D.:\;4.3{\pm}0.6mCi$), the incidence of hypothyroidism by year after RAI treatment was 6.8%(1 year), 11.4%(2 year), 15.4%(3 year), while among 81 patients in the higher dose group given single RAI treatment not less than 5.5 mCi ($Mean{\pm}S.D.:\;6.3{\pm}0.5mCi$) it was 12.0%(1 year), 15.4%(2 year) and 20.4%(3 year) respectively. However, the duration till euthyroid state after RAI therapy in the two groups was $5.1{\pm}3.6$ months and $4.8{\pm}2.8$ months respectively showing no statistically signficant difference (p>0.1). 4) The incidence of hypothyroidism after RAI treatment in patients younger than 30 years of age was 4.3%(1 year) and 7.7%(2 year); in patients from 30 years to 49 years of age, 5.8%(1 year) and 11.1%(2 year); and in those older than 50 years, 11.0%(1 year) and 14.4%(2 year). The data revealed rising incidence of hypothyroidism with increase of patients' age. 4) Among 116 patients with exophthalmos the incidence of hypothyroidism by year after RAI treatment was 7.1%(1 year) and 12.1%(2 year) while that among 184 patients without exophthalmos was 7.3%(1 year) and 12.2%(2 year) respectively. With the above data the authors could conclude that the hypothyroidism in patients with DTG who were treated by RAI developed more frequently than reported by others in Korea till now, and increased with the passage of time, the yearly increments from 4 years after RAI treatment increasing markedly in the multiple dose group, and the incidence could be reduced by decreasing the administered RAI doe not increasing the duration till euthyroid state after RAI therapy.

• The KIPS Transactions:PartD
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• v.12D no.7 s.103
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• pp.1007-1016
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• 2005

A key issue for process language design is balancing the need for semantic richness with the need for ease of use. Most process modeling languages fail to satisfy above two conflicting aspects, which is an impediment to the widespread adoption of process modeling languages in the software industry despite of a variety of software process language studies. This paper describes a process modeling language RAiSE attempting to resolve such problem and presents the result of applying RAiSE to a well-known benchmark process, ISPW-6 software process example. RAiSE provides rigorous, yet clear semantics through combing essential features in various modeling paradigms and defining them in a well-structured graphical notation. Process models represented in RAiSE are interpreted and enacted by process engine implemented using CLiPS, a rule based expert system tool.

• International journal of thyroidology
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• v.11 no.2
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• pp.137-142
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• 2018

Background and Objectives: Radioactive iodine therapy (RAI) is an important treatment modality of Graves' disease (GD), but there is still not a consensus on the optimal dosage regimen. We studied the treatment success rate of different RAI doses, and examined which clinical markers were useful for determining the optimal RAI dosage for successful therapy in Korean patients. Materials and Methods: We retrospectively studied 123 patients with GD treated with RAI between 2004 and 2014 at Chonnam National University Hwasun Hospital. The responder group was defined as patients who developed hypothyroidism requiring levothyroxine replacement following RAI, regardless of the RAI dosage. Results: A total of 54 patients (43.9%) became hypothyroid after the first dose, and 31 needed two to four additional doses to achieve hypothyroidism. In the responder group as a whole (85 patients), the mean total dose of RAI was $15.5{\pm}7.0mCi$ and the mean thyroid volume (TV) was $35.4{\pm}23.4mL$. When divided into low dose (<15 mCi, n=46) and high dose (${\geq}15mCi$, n=39) responder groups, TV was significantly lower in the low-dose responder group ($25.7{\pm}11.4$ vs. $48.4{\pm}31.3$, p<0.001). The optimal cut-off TV for the low-dose responder group was <32.37 mL (sensitivity 80.9%, specificity 76.7%). Conclusion: TV had significant effects on the outcome of RAI in GD patients. The optimal fixed RAI dose for Korean GD patients with a large goiter (${\geq}33mL$) should be at least 15 mCi to achieve the best outcome.

• Journal of Korean Academy of Nursing
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• v.43 no.6
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• pp.801-811
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• 2013

Purpose: To investigate changes in Quality of life (QOL) and related factors in patients with thyroid cancer undergoing Radioactive Iodine remnant ablation (RAI). Methods: Data were collected longitudinally 3 times for 6 months (2 weeks post-surgery, post RAI, 3 months post RAI) in a hospital located in Seoul. Questionnaires were used to measure levels of physical symptoms, anxiety, depression, and QOL. Ninety-eight patients with thyroid cancer who had RAI were included in the analysis. Data were analyzed using SPSS (18.0). Results: Findings for the three data collection times respectfully were: mean scores for physical symptoms, 0.53, 1.21 and 0.62, patients with depression, 47%, 36.7% and 37.7%, patients with anxiety, 18.4 %, 19.4% and 20.4%, mean scores for QOL, 7.06, 7.01 and 7.28. QOL score was highest 3 months post RAI (p=.031). In the stepwise multiple regression analysis, depression and fatigue were predicting factors for low QOL at all data collection times. Dysponia was a predicting factor for low QOL post RAI and 3 months post RAI. Conclusion: To increase QOL, it is necessary to provide information in advance regarding physical & psychological symptoms and to develop nursing intervention programs to decrease depression and fatigue.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.138-142
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• 2015

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the $7^{th}$ RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.125-129
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• 2016

Background: Patients with differentiated thyroid cancers (DTC) who receive radioactive iodine-131 (RAI) are released from isolation when their dose rate is below the regulatory requirements. The purpose of this study was establish predicting factors for early release from the isolation facility after RAI administration in patients with DTC. Materials and Methods: This was a prospective study which included 96 (58 females and 38 males) patients with DTC who had received RAI from April 2013 till August 2015. The study was duly approved by the ethical committee of the institute. Patients who had complete information of primary tumor size (PTS), serum TSH, stimulated thyroglobulin level [sTg] with antibodies (IU/ml) at the time of RAI treatment were included. All had a normal serum creatinine level. To attain lower effective half-life good hydration and administration of soft laxative were ensured. Dose rate was measured (immediately, 24 h and 36 h) at 1 meter distance from anterior mid trunk and a dose rate <$50{\mu}Sv/h$ was considered as the releasing criterion. At 24 h 50 patients were released while the remaining 46 patients were released at 36 h. A post-ablative whole body scan (PA-WBIS) was performed 5-8 days after RAI ablation in all patients. Results: Patients released after 24 h were significantly younger, had smaller lesions with higher proportion of papillary cancer, lower sTg, lower sTg/TSH ratio and had received a lower dose of RAI as comapred to those who were discharged after 36 h. Serum TSH and gender were not found to have any significant correlation between two cohorts. ROC and multivariate analysis have shown age ${\leq}37years$, PTS ${\leq}3.8cm$, $RAI{\leq}150mCi$, $sTg{\leq}145ng/ml$ and $sTg/TSH{\leq}1.085$ as strong indepedent predictors for early release. Conclusions: We conclude that younger age (${\leq}37years$), smaller tumor size (${\leq}3.8cm$), lower RAI dose (${\leq}150mCi$), lower sTg (${\leq}145ng/ml$) and a lower sTg/TSH ratio (${\leq}1.085$) are significant independent predictors for release at 24 h after RAI treatment in DTC patients. Effective utilization of these factors could help the treating physicians to use limited number of internment facilities with higher throughput, lower cost and lower psychological stress to patients.

• Research in Community and Public Health Nursing
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• v.14 no.1
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• Proceedings of the Korea Information Processing Society Conference
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• 2003.05c
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• pp.1665-1668
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• 2003

기존 프로세스 모델링 언어들은 엄격한 의미론과 사용의 용이성이라는 프로세스 언어가 갖추어야 할 중요한 두 가지 측면을 동시에 만족시키지 못함으로써 그 동안의 다양한 연구에도 불구하고 실제 소프트웨어 산업계에서 널리 사용되지 못하고 있다. 본 논문에서는 이러한 단점을 제거한 프로세스 모델링 언어 RAiSE 를 정의하고 이를 예제 소프트웨어 프로세스에 적용한 예를 설명한다. RAiSE 는 쉽게 이해할 수 있는 그래픽 표기법을 기반으로 하여 다양한 모델링 패러다임들의 필수적인 요소들을 결합시킴으로써 이해하기 쉬우면서도 엄격하고 풍부한 의미론을 제공한다.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.183-190
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• 2009

Background: Repeated arousals during sleep have been known to be associated with excessive daytime sleepiness and cardiovascular complications. We investigated the relationship between arousal indices and clinical parameters. Methods: We retrospectively reviewed medical records of 41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome. We defined total arousal index (TAI) as the number of arousals per hour and respiratory arousal index (RAI) as the number of arousals associated with apnea or hypopnea per hour. Results: There were significant positive correlations between arousal indices and apnea-hypopnea index (AHI) (RAI vs. AHI, r=0.958, p<0.001; TAI vs. AHI, r=0.840, p<0.001). RAI and mean oxygen saturation showed a significant negative correlation with each other (r=-0.460, p=0.002). TAI revealed a significant positive correlation with mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP) (TAI vs. MSBP, r=0.389, p=0.014; TAI vs. MDBP, r=0.373, p=0.019). There was no significant correlation between arousal indices and parameters of sleepiness. RAI had a significant positive correlation with body mass index (BMI) and neck circumference (NC) (RAI vs. BMI, r=0.371, p=0.017; RAI vs. NC, r=0.444, p=0.004). When partial correlation analysis was performed to adjust for other variables, there was significant correlation between RAI and AHI (r=0.935, p<0.001). Conclusion: This study shows that respiratory arousal index could be a useful index reflecting of severity of obstructive sleep apnea syndrome. Arousal during sleep would be concerned in the development of cardiovascular complication of obstructive sleep apnea. And some anthropometric factors would contribute to the development of arousals during sleep. Further studies are needed to clarify any cause-effect relationship.

• Journal of Korean Biological Nursing Science
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• v.10 no.1
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• pp.41-52
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• 2008

Purpose: This study was to evaluate and compare the effectiveness of a progressive functional training program on ADL performance in stroke patients at home after selecting subjects through Resident Assessment Instrument for Home Care (RAI-HC). Method: Ninety stroke patients had a structured training which was 50 min in duration, six times per week for a period of 6 weeks. The subjects were divided into three groups as measured using the RAI-HC progressive functional training program group; the resident rehabilitation exercise group and the control group. Result: The study observed that the functional training program for stroke patients increased the level of activities of daily living (ADL), performance of functional fitness and balance. It also reduced blood lipid and the score of client assessment protocols (CAPs). The functional training program is expected to improve the quality of life in the stroke patients at home. Conclusion: The authors, with the results of this study concluded that, the functional training program is necessary for the stroke patients to improve their quality of life. Hence, the program should be employed immediately.