• Title/Summary/Keyword: Thyroid, intervention

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Patient Exposure Dose Reduction in Coronary Angiography & Intervention (심혈관조영술 및 중재술 시 환자 선량 감소방안)

  • Lim, Do-Hyung;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.45 no.1
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    • pp.69-76
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    • 2022
  • This study, the method of reducing the exposure dose by changing the geometrical requirements among the preceding studies and the method of directly wearing a protector on the patient were used to expose the patient. A comparative experiment was conducted on the method of reducing the dose and the most effective method for reducing the exposure dose was investigated. Using the phantom, the dose of the lens, thyroid gland, and gonad gland in the 5 views most used in coronary angiography and intervention accumulated 5 times for 10 seconds at 60~70 kV, 200~250 mA as an automatic controller of the angiography system, and measured by Optically Stimulated Luminescent Dosimeter(OSLD). SID 100 cm and Cine 15 f/s as a control group the experiment was conducted by dividing the experimental group into 3 groups: a group lowered to Cine 7.5 f/s, a phantom protector, and a group lowered to 95 cm SID. As a result of the experiment, showing decrease in exposure dose compared to the control group. Lowering the cine frame may be the simplest and most effective method to reduce the exposure dose, but there is a limit that it cannot be applied if the operator judges that the diagnostic value is small or feels uncomfortable with the procedure. Conclusion as fallow reducing the exposure dose by directly wearing protector is the next best solution, and it is hoped that the conclusions obtained through this study will help reduce the exposure dose to unnecessary organ.

Hyperplastic Autotransplanted Parathyroid Tissue Migrating into Fatty Tumor after Total Parathyroidectomy

  • Reza, Joseph Arturo;Wiese, Georg Kristof;Portoghese, Joseph Dominic
    • Journal of Endocrine Surgery
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    • v.18 no.4
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    • pp.236-239
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    • 2018
  • Secondary hyperparathyroidism (SHPTH) occurs commonly in patients with end-stage renal disease (ESRD). Uncontrolled SHPTH is associated with complications of calcium deposition including calciphylaxis and elevated rates of cardiovascular morbidity. Current treatment recommendations for medically refractory disease include total parathyroidectomy, often with autotransplantation (TPTH+AT) of minced parathyroid gland. Surgical intervention is associated with a reduction in cardiovascular mortality. We report a case of a 56-year-old man with ESRD who developed SHPTH and underwent TPTH+AT of parathyroid tissue into the right brachioradialis muscle. Over the course of 7 years he developed a mass at the site of the autotransplanted gland as well as recurrent refractory hyperparathyroidism with increased forearm uptake noted on sestamibi scan. After excision of this mass, pathology demonstrated hyperplasia of the minced gland fragments which were embedded within a mass of fibroadipose tissue rather than the muscle tissue it was originally transplanted in.

A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra;Jung, Seung Wook;Jung, Hwi-Dong;Lee, In Yong;Yong, Tai-Soon;Jeong, Su Jin;Kim, Hyun Sil
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.433-437
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    • 2017
  • Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

A Review of Herbal Medicine Treatments on Aftereffects of Thyroidectomy (갑상선 절제술 후 후유증의 한약 치료에 대한 최신 임상 연구 동향)

  • Soo-duk Kim;Min-jo Seo;Su-na Park;Hye-ri Jo;So-hyeon Ryu;Geon-sik Kong;Yo-sup Choi
    • The Journal of Internal Korean Medicine
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    • v.45 no.4
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    • pp.615-634
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    • 2024
  • Objectives: This study summarizes the current trends and results in clinical studies on herbal medicine treatments after thyroidectomy. Methods: Studies published between 2019 and 2024 were searched for on the China National Knowledge Infrastructure (CNKI), PubMed, and Research Information Sharing Service (RISS). The studies were analyzed according to year, study design, characteristics of the patients, and traditional Chinese medicine (TCM) intervention. A meta-analysis was conducted and classified according to the outcome measurements, such as the total effective rate (TER), thyroid stimulating hormone (TSH), free T4 (FT4), self-rating depression scale (SDS), CD3+, CD4+, and CD8+. CD8+. Results: A total of 18 randomized controlled trials (RCTs) and 5 non-randomized controlled trials were reviewed. The most common herbal prescriptions were decoctions made from Yangyin Sanjie (Yangeumsangyeol-tang), Yiqi Sanjie (Ikgisangyeol-tang), Yiqi Yangyin Sanjie (Ikgiyangeumsangyeol-tang), Yiqi Yangyin (Ikgiyangeum-tang), and Huiyan Zhuyu (Hoeyeomchugeo-tang). The most frequently used herbs were Prunellae Spica, Scrophulariae Radix, and Astragali Radix. The meta-analysis found that the group using both herbal and Western medicine was benefited more than the group using Western medicine alone (RR: 1.28, 95% CI: 1.20-1.37, P<0.00001). The experimental group had higher TSH, CD3+, and CD4+ levels, while FT4, SDS, and CD8++ were lower. However, due to high study heterogeneity, the results were not statistically significant. Conclusion: Complications after thyroidectomy include hypothyroidism, hypoparathyroidism, and psychological aftereffects. Herbal and conventional treatments showed potential in improving hormone levels, immune function, and depression, but statistical significance was limited due to study variability. These results should be interpreted cautiously given the risk of bias in the trials.

Reducing Radiation Exposure Dose on Operator by Using Lateral Protection in Neuro-Intervention (뇌혈관 중재적시술에 있어 측방향 차폐체를 이용한 시술자 피폭 선량 저감화 방법 연구)

  • Kim, Jongdeok;Ahn, ByeoungJu;Lee, Junhaeng
    • Journal of the Korean Society of Radiology
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    • v.8 no.1
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    • pp.1-10
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    • 2014
  • The bi-plane cerebrovascular angiography radiation is done the radiation exposure at the forward and lateral direction as opposed to the one of the source. So, the exposure dose of radiation workers increases further. Therefore, the medical diagnostic radiation workers as well as patients is interested to ways to reduce the dose. The exposure dose of cerebral angiography and interventional radiology must be considered the primary radiation of X-ray tube directly, scattered primary radiation between lateral tube and lateral detector and relatively small secondary scatter radiation in the walls of room. The aim of study is that the exposure dose of primary and scatter radiation reduce as much as possible to install protection device of lateral protection than common shielding of table and ceiling. As a result, the dose of fluoroscopy was reduced approximately 3.64 times the gonads, thyroid approximately 3.13 times, 4.42 times around eyes. And the dose of DSA was reduced approximately 4.98 times the gonads, thyroid approximately 3.00 times, 1.67 times around eyes. Consequently, medical practitioners can be helpful for radiation dose-exposure for the lateral protection of bi-plane cerebrovascular angiography more than the common shield method in cerebrovascular angiography and interventional radiological procedures.

2020 Korean Dietary Reference Intakes of selenium and a review of selenium database of foods by evaluating of selenium contents of the recommended menus (셀레늄의 2020 한국인 영양소 섭취기준 개정 및 권장식단의 셀레늄 함량 평가를 통한 식품의 셀레늄 데이터베이스 검토)

  • Choi, Kyungsuk;Lee, Okhee
    • Journal of Nutrition and Health
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    • v.55 no.4
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    • pp.430-440
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    • 2022
  • Selenium is an important trace mineral that plays an essential role in maintaining the body's immunity with oxidative stress defense and antioxidant activity, immunity, thyroid hormone control, defense against drug or heavy metal harm, and reducing the risk of chronic diseases. A selenium deficiency increases the risk of various chronic diseases, such as cancer, cardiovascular disease, diabetes, neurological disease, osteoarthritis, muscle necrosis and weakness, thyroid disease, and inflammatory diseases. This paper explains the criteria for establishing and revising selenium in the 2020 Dietary Reference Intake for Koreans (KDRIs) and reviews the current status of the selenium database and suggestions for setting the 2025 KDRIs in the future. In the 2020 KDRIs, the selenium intake with the maximum plasma selenoprotein P level was used as the criteria. The weight and coefficient of the variation were applied to the Chinese' reported values. Compared to 2015 KDRIs, there were some revisions in the selenium dietary reference intakes by gender and age according to the change in reference weight. To improve and revise selenium dietary reference intakes in the future, a selenium intervention study is needed to determine the maximum level of plasma selenoprotein P in Koreans. In addition, a revision of the selenium database of the nutritional assessment program (CAN-Pro 5.0) is needed. An analysis of the selenium content of foods should be expanded to assess the selenium intake accurately. In addition, research on the relationship between selenium intake and the biological indicators in the body is required for healthy people and subjects of special environments, such as patients and athletes with various oxidative stress.

Extensive gingival necrosis and sequestration of the alveolar bone caused by methimazole-induced neutropenia and three-year follow-up

  • Kim, Eun-Cheol;Park, Joon Bong;Hong, Ji-Youn;Kang, Kyung Lhi
    • Journal of Periodontal and Implant Science
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    • v.45 no.2
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    • pp.76-80
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    • 2015
  • Purpose: Methimazole is an anti-thyroid drug that can cause life-threatening neutropenia in rare situations. The aim of this case report is to describe a set of oral complications associated with methimazole-induced neutropenia and the healing of the gingiva after proper treatment. Methods: A 31-year-old female patient hospitalized for systemic symptoms of sore throat and fever and showing extensive gingival necrosis with pain was referred to the Department of Periodontics from the Department of Endocrinology. Methimazole-induced neutropenia was diagnosed based on blood test results and her medical history. Methimazole was discontinued and a range of treatments was administered, including the injection of granulocyte colony stimulating factor. Results: After systemic treatment, the gingiva began to heal as the neutrophil count increased. Approximately one year later, the gingiva had returned to a normal appearance. Twenty-one months after treatment, sequestra of the alveolar bone that had broken through the gingiva were removed. Periodic supportive periodontal treatment has been continued uneventfully. Conclusions: The oral manifestations of gingival necrosis and ulcerations, in combination with systemic symptoms such as fever and sore throat, are the critical signs presented in the early stages of drug-induced neutropenia. Therefore, dentists need to be aware of these oral complications in order to make an accurate diagnosis and to ensure that prompt medical intervention is provided.

Comparisons of Body Image, Depression, and Climacteric Symptoms among Middle-Aged Women with and without Thyroidectomy (갑상선절제술을 받은 중년여성과 받지 않은 중년여성의 신체상, 우울, 갱년기 증상 비교)

  • Yun, Byeong Sook;Back, Ji Eun;Lee, June Sang;Park, Mi Jeong;Lim, Young Mi
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.5-14
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    • 2008
  • Purpose: The purpose of this study was to compare body image, depression, and climacteric symptoms among middle-aged women with and without thyroidectomy. Method: The research design was a comparative descriptive study using a self-report questionnaire. A total of 102 women aged 40~59 years were recruited using a convenient sampling method. A total of 52 women out of 102 were within a year after thyroidectomy due to benign disease. The rest of the subjects were healthy women without any previous diseases in thyroid. The instruments included Body Image Concern Inventory, Climacteric symptoms, and Center for Epidemiological Studies Depression Scale. The data were analyzed by descriptive statistics, t-test, $x^2$-test, one-way ANOVA, and correlation analysis. Results: There were no significantly differences in age, education, menstruation states between women with and without thyroidectomy. The demographic characteristics of two groups were homogeneous. There were significantly statistical differences in body image (t= 8.456, p=.000), and depression (t=3.142, p=.002) between the groups. There was, however, no significantly differences of climacteric symptoms. In addition, in women with thyroidectomy, no significant associations were found among body image, depression, and climacteric symptoms. Conclusion: The findings demonstrated the need to develop an effective nursing intervention to increase body image and to reduce depression in middle-aged women after thyroidectomy.

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Comparison of Operator Radiation Exposure Dose undergoing Cardiac Angiography and Cardiac Intervention (심장혈관 중재적 시술의 시술자 피폭 선량에 관한 연구)

  • Kim, Jungsu;Kwon, Soonmu;Jung, Haekyoung;Lee, Bongki;Ryu, Dongryeol;Kwon, Hoseok;Cho, Byungryul
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.181-186
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    • 2016
  • Cardiac angiography(CA) or cardiac intervention(CI) is one of the major examination methods applied to the detection of cardiovascular diseases using X-rays. These CA and CI procedures require radiation exposure to patients and physicians. We evaluated the radiation dose to cardiac operator during the each case of CA and CI procedures. The number of patients is 113 patients in CA and 34 patients in CI. Mean fluoroscopy time, mean cine time, and mean total cumulative dose area product(DAP) in patients during CA and CI was 165.9 sec vs. 1200.0 sec, 30.31 sec vs 107.5 sec, and $37130.3mGy.cm^2$ vs $213312.6mGy.cm^2$, respectively. Mean dose of thyroid, over chest apron and under chest apron in operator during CA and CI was 15.84 uSv vs 89.81 uSv, 20.16 uSv vs 123.20 uSv, and 0.30 uSv vs 2.40 uSv, respectively. Mean effective dose of operator during CI was about 6 times greater than during CA. Also there was significant inter-relationship between fluoroscopy or cine time and effective dose in operator during CA and CI(p=0.001 and p=0.001, respectively).

Salivary Flow According to Elderly's Whole Health and Oral Health Status: According to Application of Oral exercise and Salivary Gland Massage

  • Oh, Ji-Young;Noh, Eun-Mi;Park, Hye-Young;Lee, Min-Kyung;Kim, Hye-Jin
    • Biomedical Science Letters
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    • v.25 no.3
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    • pp.218-226
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    • 2019
  • In old age, measures to cope with the natural phenomenon of aging and various diseases of the elderly due to the deterioration of physical function are also a challenge for this society. While interest in systematic health is increasing, it is true that awareness and interest in oral-related diseases is relatively lacking. This study aims to present basic data necessary to improve the quality of life for senior citizens aged 65 or older by improving the oral dryness caused by systemic health. By research method, improve oral dryness caused by whole-body health with the elderly over 65 and promote their oral health, inducing the increase of the salivary flow rate through oral health care education, oral exercise, and salivary gland massage. First, on the DMSQ according to the general characteristics of the elderly, the recognition of the whole body and oral health status, independent sample t-test and One-way ANOVA were conducted. Second, on changes in the salivary flow rate and saliva pH according to the general characteristics of the elderly, recognition of oral and whole-body health status, and whole-body health, paired samples t-test was conducted. Studies have shown that salivary gland flow increased significantly after oral exercise and salivary gland massage, the salivary flow rate significantly increased. In all variables of the recognition of the oral health status, the salivary flow rate increased after oral exercise and salivary gland massage, and in the whole-body health, regardless of hypertension, diabetes, cardiovascular disorders, and osteoporosis, the salivary flow rate increased after oral exercise and salivary gland massage, and the salivary flow rate increased after oral exercise and salivary gland massage if the subjects responded that they did not have thyroid abnormality, anemia, abnormalities of breathing, hypotension, gastrointestinal disturbance, or kidney diseases. As a comprehensive analysis of this study, many felt oral dryness when they had a problem with the whole-body health, and many felt oral dryness when they had a problem with oral health cognition. After applying oral exercise and salivary gland massage as intervention methods in the oral health care for the elderly, the salivary flow rate significantly increased, and it is judged that the methods were very effective for controlling oral dryness. Furthermore, it is judged that the factors affecting oral health, whole-body health, and oral dryness would be identified, which would be helpful for the promotion of whole-body health and oral health. It is judged that continuous research would be needed so that measures for the application of the oral care program and system for the elderly would be prepared in the future.