• 핵의학기술
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• 제17권1호
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• pp.3-6
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• 2013

Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

• 대한두경부종양학회지
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• 제28권2호
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• pp.143-145
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• 2012

Follicular thyroid cancer(FTC) accounts for about 10-15% of thyroid cancer. Distant metastasis is common, usually to lung, bone and brain. 71-years-old man visited neurosurgery outpatient department. He complained of recent 6kg weight loss, left upper extremity pain with weakness and back pain. The radiologic findings showed multiple bone metastasis including thoracic spine and left scapular resulting from FTC. There was a probable brain metastatic lesion on right temporal fossa. The core biopsy of thyroid and thoracic spine(T11) confirmed metastatic follicular carcinoma. Radioactive iodine therapy and radiotherapy was done following total thyroidectomy. We report a unique case of multiple bone metastasis from follicular carcinoma of thyroid with literature review.

• 대한두경부종양학회지
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• 제14권2호
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• pp.253-259
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• 1998

The increasing risk of subsequent malignancy after treatment of malignant lymphoma is well known, which is mainly due to longer survival of these patients. Radiotherapy at an early stage of Hodgkin's disease or non-Hodgkin's lymphoma is accepted to be associated with future occurrence of secondary thyroid cancer. Nevertheless, the synchronous presentation of these malignancies is extremely rare. Well differentiated thyroid cancer, a slow-growing tumor that responds to therapy with surgery and radioactive iodine, is associated with prolonged survival. therefore, it is important to make this diagnosis in patients who show evidence of malignant lymphoma. Furthermore, appropriate treatment must be considered for thyroid cancer to improve the prognosis of these patients. We herein reported 4 cases of synchronous thyroid cancer and malignant lymphoma in patients who had not previously recieved radiotherapy or chemotherapy.

• 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.

• Journal of Yeungnam Medical Science
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• 제32권2호
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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.

• 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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• 제29권2호
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• pp.79-82
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• 2013

Thyroid cancer is known as its relatively high cure rate after surgical treatment and spinal metastasis of thyroid cancer is extremely rare as the prevalence is only 2-13%. Spinal metastasis is usually asymptomatic and discovered incidentally in most cases. A 66-year-old man was diagnosed as thyroid papillary cancer with spinal metastasis. We treated the patient by surgery, adjuvant radiotheraphy and radioactive iodine therapy. C6 corpectomy was followed for the residual spinal metastasis by the department of neurosurgery. The patient had no functional complication by the surgical process. At 24 months after surgery, there was no sign of recurrence and the patient led social life without any discomfort. We present this case with a review of the related literatures.

• Nuclear Medicine and Molecular Imaging
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• 제42권5호
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• pp.375-382
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• 2008

갑상선암 환자의 방사성 요오드 치료를 위한 전 단계로 시행되는 저요오드식이는 표준화된 전처지 방법으로 사용되고 있고 그 시행방법에 관련된 권고들이 최근 생겨나고 있다. 한국은 상대적으로 요오드 섭취가 많은 지역이므로 권장된 요오드 배설 기준을 만족시키지 못할 수도 있다. 이 연구에서는 갑상선의 요오드 섭취를 억제시키는 약물의 제한, 조영제가 사용된 경우에서 최소 3개월 이후로 치료 일정을 정하기, 전담 영양사에 의한 2주간의 엄격한 저요오드식이 교육을 시행하였을 때, 식이 요오드섭취가 많은 한국 갑상선암 환자들에서 소변 요오드량이 적정 수준으로 감소하는 지에 대해 전향적으로 분석하고자 하였다. 방법: 2006년 11월부터 외부 병원에서 갑상선암 진단 후 갑상선 전절제술을 시행 받고, 잔여 갑상선 제거 목적으로 고용량 방사성요오들 치료를 위해 본 연구자들의 병원에 의뢰된 환자들 중 recombinant human thyrotropin 또는 levotriiodothyronine을 사용하는 경우를 제외한 환자들을 대상으로 하였다. 요오드 함유 약물이나 갑상선의 요오드 섭취를 제한할 수 있는 약물을 점검했고, 조영제가 사용된 경우 치료 일정을 최소 3개월 이후로 결정하였으며 전담 영양사에 의한 2주간의 엄격한 저요오드식이 교육을 시행하였다. 저요오드식이 전후로 24시간 소변 내 요오드량을 측정하여 비교하였다. 또한 소변 내 크레아티닌 수치를 이용해서 24시간 소변 채집이 보다 적절한 것으로 판단되는 하부군을 대상으로 24시간 소변 내 요오드량을 비교하였다. 결과: 총 51명이 최종 분석에 포함되었다. 모든 환자에서는 24시간 소변 요오드량이 저요오드식이 전후로 $787\;{\mu}g/d$에서 $85\;{\mu}g/d$로 감소가 되었고 74.4%에서 $100\;{\mu}g/d$ 이하의 결과를 보였다. 소변 채집이 보다 적절한 하부군 14례에서는 저요오드식이 전후로 $505\;{\mu}g/d$에서 $99\;{\mu}g/d$로 감소되었고 78.6%에서 $100\;{\mu}g/d$ 이하의 결과를 보였다. 결론: 갑상선암 환자들에서 잔여갑상선제거를 위한 방사성요오드 치료 전에 2주간의 엄격한 저요오드식이를 시행하여 전향적으로 분석했을 때 24 시간 소변 내 요오드량이 평균 $99\;{\mu}g/d$로 감소하였고, 78.6%에서 $100\;{\mu}g/d$이하의 값을 보였다. 따라서 식이 요오드섭취량이 많은 한국에서는 최소 2주 이상의 엄격한 저요오드식이가 고려되어야 하며, 환자의 순응도를 높이기 위한 체계적인 교육이 뒷받침되어야 한다.

• Medical Lasers
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• 제10권1호
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• pp.37-44
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• 2021

Background and Objectives Hypothyroidism is the most common endocrine disease. On the other hand, there is no treatment that can improve the thyroid function. Low-level laser therapy (LLLT) can improve the cellular activity. The effect of hypothyroidism is not obvious. This study examined the effects of LLLT on the thyroid gland function of a propylthiouracil (PTU)-induced hypothyroidism mouse model. Materials and Methods Twenty-five male ICR mice were distributed into five groups of five animals each: Negative control (none PTU animal) and positive control (PTU animal) of unirradiated animals, and three experimental groups with LLLT (3J, 6J, and 12J). Each mouse was exposed to a distinct dose of a 632-nm laser once a week for three rounds. The positive control group and three LLLT groups were induced into a hypothyroidism state by PTU administration. The animals' thyroid-stimulating hormone and thyroxine levels were measured using an ELISA kit, and their thyroid tissue was harvested and analyzed after sacrifice at the end of the experiment. The hormone level and morphological changes in the tissue of the five groups were compared. Results The thyroid hormone levels in the control group and LLLT groups were similar. On the other hand, the thyroid tissue of the LLLT groups showed some morphological changes that were similar to those of iodine deficiency thyroid. Conclusion LLLT did not affect the thyroid gland function in PTU-induced hypothyroidism mice.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.39.1-39.6
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• 2019

Background: Radioiodine therapy has been widely used for thyroid disease patients, but hyposalivation and xerostomia may occur in 10~30% of patients. Sialocentesis is a procedure that removes inflammatory substances in the salivary duct and expands the duct for the secretion and delivery of saliva. In this study, thyroid disease patients treated with radioactive iodine were selected among the patients with xerostomia who visited the hospital, and the effect of sialocentesis was compared and analyzed. And then, comparison between the radioiodine therapy-experienced group and the non-radioiodine therapy-experienced group was conducted. Results: In this study, we studied xerostomia patients who underwent radioiodine therapy due to thyroid diseases and who underwent sialocentesis at the Korea University Anam Hospital. Sialocentesis is conducted by one surgeon. The study also compares the clinical symptoms before and after the surgery. After the procedure, the discomfort due to xerostomia was reduced, and the symptom was improved effectively. Conclusions: The results of this study showed that sialocentesis has a clinical effect in the treatment of xerostomia, which is a side effect of radioiodine therapy. In addition, the possibility of further clinical application of sialocentesis in the future is found.