• Nuclear Engineering and Technology
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• 제50권8호
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• pp.1355-1363
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• 2018

Many radionuclides exist in normal environment and artificial radionuclides also can be detected. The radionuclides ($^{131}I$) are widely used for labeling compounds and radiation therapy. In Korea, the radionuclide ($^{131}I$) is produced at the Radioisotope Production Facility (RIPF) at the Korea Atomic Energy Research Institute in Daejeon. The residents around the RIPF assume that $^{131}I$ detected in environmental samples is produced from RIPF. To ensure the safety of the residents, the radioactive concentration of $^{131}I$ near the RIPF was investigated by monitoring environmental samples along the Gap River. The selected geographical places are near the nuclear installation, another possible location for $^{131}I$ detection, and downstream of the Gap River. The first selected places are the "front gate of KAERI", and the "Donghwa bridge". The second selected place is the sewage treatment plant. Therefore, the Wonchon bridge is selected for the upstream of the plant and the sewage treatment plant is selected for the downstream of the plant. The last selected places are the downstream where the two paths converged, which is Yongshin bridge (in front of the cogeneration plant). In these places, environmental samples, including sediment, fish, surface water, and aquatic plants, were collected. In this study, the radioactive iodine ($^{131}I$) detection along the Gap River will be investigated.

• International journal of thyroidology
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• 제11권2호
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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.

• 대한한방내과학회지
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• 제39권1호
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• pp.9-21
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• 2018

Objective: Graves' disease, the most common cause of primary hyperthyroidism, is a thyroid specific autoimmune disorder. When resistance to medication is shown in spite of long term therapy with anti-thyroid drugs, radioactive iodine therapy would be chosen in Western medicine. However, this therapy has often been reported to cause patients have hypothyroidism, thus requiring them to take levothyroxine for the rest of their lives. In this study, we evaluate the clinical efficacy and safety of Ahnjeonbaekho-tang (AJBHT) on patients with Graves' disease. Methods: We prescribed AJBHT for 3 months to two groups: patients who had been taking antithyroid drugs were administered AJBHT after discontinuing the antithyroid drugs ($Com-Tx{\rightarrow}Single-Tx$), and patients who had not been taking antithyroid drugs were started with AJBHT (Single-Tx) immediately. We evaluated the thyroidal function test (TFT) and visual analogue scale (VAS) for clinical symptoms for 3 months. Results: Serum T3 and fT4 were significantly decreased in both groups and remission rate of thyroidal hormones were significantly improved in the Single-Tx group. The clinical symptoms of palpitation, fatigue, and heat intolerance were significantly improved in both groups. In the safety analysis, all patients were in normal range of liver, renal function blood test and common blood count. Conclusion: From these results, we suggested that AJBHT was effective on TFT and clinical symptoms of Graves' disease. The study supports that AJBHT may be a useful agent for patients with Graves' disease who are resistant to antithyroid medication or radioactive iodine therapy, and for patients at first diagnosis.

• 한국산학기술학회논문지
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• 제11권12호
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• pp.4935-4944
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• 2010

본 연구의 목적은 방사성요오드 치료를 받는 갑상선암환자가 전처치기 및 입원치료기간 중 경험한 방사성 요오드 치료와 관련한 지각된 어려움, 의료진으로부터 제공받은 방사성요오드 치료정보 수준 및 치료과정에 대한 만족도를 파악하는 것이다. 조사대상은 갑상선전절제술과 방사성요오드 치료를 받은 총 165명의 갑상선암환자이었다. 구조화된 설문지와 개방형 질문을 이용해 수집된 자료는 기술통계와 내용분석법으로 분석하였다. 연구결과 방사성요오드 치료 전처치기 및 입원치료기에 환자들이 가장 빈번히 지각한 어려움은 갑상선 특이적 증상이었으며(38.2% vs 43.0%) 방사성요오드 치료와 관련한 의료진의 정보제공 수준은 보통 이상으로 평가하였다(평균$3.63{\pm}0.80$점). 방사성 요오드 치료과정에 대한 만족도는 중등도 수준(평균$6.43{\pm}2.21$점)으로 의학적 관심과 환자요구에 대한 의료진 대처절차에서 만족도($7.64{\pm}2.37$점)가 가장 높았다. 그러나 정보 적절성($5.67{\pm}2.78$점)에서 가장 낮았다. 따라서 방사성요오드 치료를 받는 갑상선암환자를 위한 간호중재 프로그램은 갑상선 특이적 증상과 관련한 환자의 요구를 지지할 수 있고 방사성요오드 치료절차에 대한 환자의 이해를 증진시킬 수 있도록 개발되어져야 하며 이를 통해 환자들은 치료 행위에 효과적으로 참여할 수 있는 역량을 가질 수 있을 것이다.

• 한국방사선학회논문지
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• 제6권5호
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• pp.373-381
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• 2012

방사성옥소를 이용한 갑상선 암의 치료는 지난 수 십년 동안 사용되어 왔으며 많은 치료효과를 보이면서 앞으로 지속적으로 사용되어 질 전망이고 현재 우리나라의 옥소치료병실 수는 2010년 기준 124개의 치료병실이 운영되고 있으나 아직도 부족한 실정이다. 그래서 많은 병원들이 치료병실을 개설하고 있으나 중요한건 치료병실의 수적 증가보단 현재 치료병실의 올바른 관리가 선행되어야 한다는 것이다. 따라서 병실증설에 대한 논의에 앞서 현재 적용되고 있는 치료병실의 안전관리 기준과 일부 대학병원에서 기준으로 삼고 있는 안전관리기준을 조사하여 얼마나 잘 지켜지고 있는지, 치료병실의 이용에 따른 전반적인 안전관리실태여부를 조사하여 고찰 하였다.

• 대한두경부종양학회지
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• 제37권2호
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• pp.1-9
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• 2021

Thyroid cancer refers to various cancers arising from thyroid gland. Differentiated thyroid cancers (DTCs) include papillary, follicular, and Hurthle cell carcinomas and represent cancers retain normal thyroid functions such as iodine uptake. Radioactive iodine (RAI) is generally used for upfront treatment of metastatic DTCs, but RAI refractory DTCs remain to be clinical challenges. Sorafenib and lenvatinib were approved for the treatment of RAI refractory DTCs and more recently, genomics-based targeted therapies have been developed for NTRK and RET gene fusion-positive DTCs. Poorly differentiated and anaplastic thyroid cancers (ATCs) are extremely challenging diseases with aggressive courses. BRAF/MEK inhibition has been proven to be highly effective in BRAF V600E mutation-positive ATCs and immune checkpoint inhibitors have shown promising activities. Medullary thyroid cancers, which arise from parafollicular cells of thyroid, represent a unique subset of thyroid cancer and mainly driven by RET mutation. In addition to vandetanib and cabozantinib, highly specific RET inhibitors such as selpercatinib and pralsetinib have demonstrated impressive activity and are in clinical use.

• 대한핵의학회지
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• 제36권4호
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• pp.209-223
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• 2002

By considering the biological properties of a tumor, it should be possible to realize better results in cancer therapy. PET imaging offers the opportunity to measure tumor growth non-invasively and repeatedly as an early assessment of response to cancer therapy. Measuring cellular growth instead of energy metabolism showed offer significant advantages in evaluating therapy. Thymidine and its derivative nucleoside compounds can be changed to mono, di- and tri- phosphate compounds by thymidine kinase and then be incorporated into DNA. Their bindings are increased in highly proliferating cells due to the high DNA synthesis rate. To evaluate cell proliferation, many kinds of thymidine and uridine derivatives have been labeled with positron emitter and radioactive iodine. Compared to radiopharmaceuticals which have radioisotope labeled base ring such as pyirmidine, the radiopharmacuticals which have radioisotope labeled sugar ring are more stable in vivo and have metabolic resistance. The biological properties such as DNA incorporation ratios are highly dependent on their chemical structures and metabolic processes. This overview describes synthesis of radiopharmaceuticals and their biological properties for imaging of tumor cell proliferation.

• 대한두경부종양학회지
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• 제38권1호
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• pp.1-9
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• 2022

Thyroid cancer is one of the slow-growing tumors with excellent oncological outcomes. However, a small set of patients with unexpectedly severe outcomes are usually ignored. Anaplastic thyroid cancer (ATC) remains one of the most aggressive and lethal solid tumors. Recently, dabrafenib and trametinib combination therapy or neoadjuvant BRAF induction therapy has shown promising results. In addition, a combination of targeted drugs, immunotherapy, surgery, and radiation therapy can improve overall survival in ATC patients. Another disease for which there is no breakthrough treatment is radioactive iodine-refractory differentiated thyroid cancer (DTC). To date, multikinase inhibitors (sorafenib, lenvatinib) targeting the growth factor signaling pathway have been developed and approved as anticancer agents for patients with advanced DTC. This review includes results from multikinase inhibitors to the emergence of new target molecules, including rearrangements during transformation (RET) and tropomyosin receptor kinase (TRK).

• 대한핵의학회지
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• 제14권2호
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• pp.35-40
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• 1980

In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ($^{131}I$) and 31 patients with treatment of $^{131}I$ alone. The $^{131}I$ treatment was limited to older age, above 20 years of age, and not employed in patients with pregnancy and lactation. The patients treated with antithyroid belonged to relatively younger age, and also milder in symptoms and thyroid function tests. The remission rate of antithyroid therapy group was 97.8% within 16 months. Among them the early remission rate occured within 4 months was found to be 21.7%. The combined therapy group, having prescribed more severe cases, showed the remission rate to be 75% within 16 months. The remission rate of $^{131}I$ therapy group revealed 90.9% within 16 months. Among them the early remission rate taking place within 4 months disclosed 16.7%. The side effects of antithyroid drug, propylthiouracil, were noted as follows: itching (2.7%) skin rashes (1.3%), and adverse enlargement of goiter (10.7%). The side effects $^{131}I$ therapy were transient hypothyroidism(3.9%) permanent hypothyroidism (7.8%) and itching (2.0%).

• Nuclear Engineering and Technology
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• 제56권6호
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• pp.2247-2257
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• 2024

To investigate the impact of the recently released pediatric reference voxel phantoms (0-, 1-, 5-, 10-, 15-year-old males and females) of the International Commission on Radiological Protection (ICRP) on organ dose estimates for radioactive iodine (RAI) treatment in pediatric patients, we calculated and analyzed pediatric-specific iodine131 S values (r_T ← thyroid) for the 30 radiosensitive organs by conducting Monte Carlo simulations using the Geant4. The gender dependency in the S values was frequently seen for the 15-year-old phantoms with higher S values of female than male. In addition, the age dependency in the S values was observed for most target organs; that is, the S values tend to decrease for older ages (e.g., ~120 times for the gonads between the adult and newborn) due mainly to the inter-organ distances generally longer for older ages. Moreover, we observed that the iodine-131 S values tend to be significantly greater by up to ~145.5 times than those of the stylized phantoms that have been widely used for organ dose estimates of pediatric RAI patients. We believe that the pediatric-specific iodine-131 S values (r_T ← thyroid) of the ICRP pediatric reference voxel phantoms should be beneficial to improve the dosimetry of pediatric RAI patients.