• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.247-253
• /
• 2017

Approximately 10-15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a $10.0{\times}9.5{\times}7.5cm$ sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.

• Korean Journal of Veterinary Research
• /
• v.64 no.2
• /
• pp.10.1-10.9
• /
• 2024

Hyperthyroidism, characterized by elevated thyroid hormone levels and thyroid gland hyperplasia or adenoma, is a prevalent endocrinopathy in older cats. Treatment options include antithyroid drugs, surgical thyroidectomy, and radioiodine therapy (RAIT), which is non-invasive treatment option that can achieve complete remission. However, efficacy and safety of RAIT in hyperthyroid cats have not been investigated in South Korea. This study includes 10 hyperthyroid cats with RAIT. Initial assessments comprised history, physical examination, blood analysis, and serum total T4 (tT4) concentration. Thyroid scintigraphy revealed hyperactivity and enlargement of thyroid gland at 24 hours before the RAIT. Radioiodine (RAI) was injected subcutaneously with 2 to 6 mCi, determined by the fixed dose or the scoring system based on severity of clinical signs, tT4 concentration, and thyroid size individually. After RAIT, the concentration of serum tT4 and liver enzymes were significantly decreased at discharge. However, no significant differences were noted in blood urea nitrogen, creatinine, symmetric dimethylarginine, hematocrits, and white blood cell counts pre- and post-treatment. Although 4 cats received RAI twice, clinical signs disappeared and tT4 levels decreased following the RAIT. All 10 cats achieved complete remission after 6 months without critical adverse effect. The safety and the effectiveness of RAIT was confirmed based on protocols reported other countries. Therefore, RAIT could be considered the treatment option and prevent adverse effects from medication or surgery. This preliminary study presents the first evaluation of RAIT for hyperthyroid cats using locally produced RAI in South Korea and provide valuable insight for clinicians and further studies.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1115-1118
• /
• 2016

Background: There is controversy about ablation efficacy of low or high doses of radioiodine-131 (RAI) in patients with differentiated thyroid cancers (DTC). The purpose of this prospective study was to determine efficacy of 30 mCi and 100 mCi of RAI to achieve successful ablation in patients with low to intermediate risk DTC. Materials and Methods: This prospective cross sectional study was conducted from April 2013 to November 2015. Inclusion criteria were patients of either gender, 18 years or older, having low to intermediate risk papillary and follicular thyroid cancers with T1-3, N0/N1/Nx but no evidence of distant metastasis. Thirty-nine patients were administered 30 mCi of RAI while 61 patients were given 100 mCi. Informed consent was acquired from all patients and counseling was done by nuclear physicians regarding benefits and possible side effects of RAI. After an average of 6 months (range 6-16 months; 2-3 weeks after thyroxin withdrawal), these patients were followed up for stimulated TSH, thyroglobulin (sTg) and thyroglobulin antibodies, ultrasound neck (U/S) and a diagnostic whole body iodine scan (WBIS) for ablation outcome. Successful ablation was concluded with stimulated Tg< 2ng/ml with negative antibodies, negative U/S and a negative diagnostic WBIS (triple negative criteria). ROC curve analysis was used to find diagnostic strength of baseline sTg to predict successful ablation. Results: Successful ablation based upon triple negative criteria was 56% in the low dose and 57% in the high dose group (non-significant difference). Based on a single criterion (follow-up sTg<2 ng/ml), values were 82% and 77% (again non-significant). The ROC curve revealed that a baseline sTg level ${\leq}7.4ng/ml$ had the highest diagnostic strength to predict successful ablation in all patients. Conclusions: We conclude that 30 mCi of RAI has similar ablation success to 100 mCi dose in patients with low to intermediate risk DTC. A baseline $sTg{\leq}7.4ng/ml$ is a strong predictor of successful ablation in all patients. Low dose RAI is safer, more cost effective and more convenient for patients and healthcare providers.

• Journal of Radiation Protection and Research
• /
• v.28 no.4
• /
• pp.299-309
• /
• 2003

In an accidental release of radioactive materials to the environment the contaminative influence of animal products due to the inhalation of air and the ingestion of soil of livestock, both of which are dealt with as minor contaminative pathways in most radioecological models but may not be neglected, was investigated with the improvement of the Korean dynamic food chain model DYNACON Although mathematical models for both contaminative pathways have been established for considering all animal products and incorporated into the model, investigation was limited to milk. As a result, it was found that both pathways are influential in the contamination of milk in the case of an accidental release during the non-grazing period of dairy cows. In the case of an accidental release during the non-grazing period, the inhalation of air was more influential than the ingestion of soil in the early days following an accidental release. While, it was the opposite with the lapse of time. If precipitation is encountered during an accidental release, contaminative influence due to the ingestion of soil was greater compared with the cases of no precipitation, in general, because of a stealer deposition of radionuclides onto the ground. Precipitation during an accidental release was a less influential factor in $^{131}I$ (elemental iodine) contamination compared with the $^{137}Cs\;and\;^{90}Sr$ contaminations. In the case of an accidental release during the grazing period of dairy cows, the contaminative influence due to the inhalation of air was negligible.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
• /
• v.2 no.3
• /
• pp.181-188
• /
• 2004

The contaminative influence of beef due to the inhalation of air and the ingestion of soil of livestock, both of which are dealt with as minor contaminative pathways in most radioecological models but may not be neglected, was comprehensively investigated with the improvement of the Korean food chain model DYNACON. As the results, it was found that both pathways can not be neglected at all in the contamination of beef in the case of an accidental release during the non-grazing period of livestock. The ingestion of soil was more influential in the contamination of beef than the inhalation of air over most time following an release. If precipitation is encountered during an accidental release, contaminative influence due to the ingestion of soil was far greater compared with the cases of no precipitation. This fact was more distinct for a long-lived radionuclide $^{l37}Cs$ than a short-lived radionuclide $^{131}I$ (elemental iodine). Compared with the results for milk performed prior to this study, the contaminative pathways due to the inhalation of air and the ingestion of soil were more important in beef because of longer biological half-lives. On the other hand, in the case of an accidental release during the grazing period of livestock, radioactive contamination due to the ingestion of pasture was dominant irrespective of the existence of precipitation during an accidental release. It means that contaminative influence due to the inhalation of air and the ingestion of soil is negligible, like the cases of milk.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.6
• /
• pp.516-521
• /
• 2004

Background: Radioactive iodine (RAI) therapy and whole-body scanning are the fundamentals of treatment and follow-up of patients with differentiated thyroid cancer. It is generally accepted that a Thyroid-Stimulating Hormone (TSH) level of at least 30 ${\mu}U/ml$ is a prerequisite for the effective use of RAI, and that it requires 4-6 weeks of off-thyroxine to attain these levels. Because thyroxine withdrawal and the consequent hypothyroidism are often poorly tolerated, and occasionally might be hazardous, it is important to be certain that these assumptions are correct. We have measured serial changes in serum TSH after total thyroidectomy or withdrawl of thyroxine in patients with thyroid cancer. Subjects and Methods: Serum TSH levels were measured weekly after thyroidectomy in 10 patients (group A) and after the discontinuation of thyroxine in 12 patients (group B). Symptoms and signs of hypothyroidism were also evaluated weekly by modified Billewicz diagnostic index. Results: By the second week, 78% of group A patients and 17% of group B patients had serum TSH levels ${\geq}30{\mu}U/ml$. By the third week, 89% of group A patients and 90% of group B patients had serum TSH levels ${\geq}30{\mu}U/ml$. By the fourth week, all patients in two groups achieved target TSH levels and there were no overt hypothyroidism. Conclusion: in all patients, serum TSH elevated to the target concentration (${\geq}30{\mu}U/ml$) within 4 weeks without significant manifestation of hypothyroidism. The schedule of RAI administration could be adjusted to fit the needs and circumstances of individual patients with a shorter preparation period than the conventional.

• The Korean Journal of Nuclear Medicine
• /
• v.22 no.1
• /
• pp.83-92
• /
• 1988

The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

• Korean Journal of Food Science and Technology
• /
• v.14 no.4
• /
• pp.375-381
• /
• 1982

The studies are conducted on the changes of soybean lipids in terms of physicochemical characteristics, lipid classess and fatty acid composition during the fermentation process of soybean Koji preparation for daenjang (soybean paste) in a model system using cooked soybean inoculated by Aspergillus oryzae. The total lipids contents were increased during soybean Koji preparation, generally iodine values decreased but acid values increased. Total lipids of soybean Koji consisted of about 90.6% neutral lipids, 7.6% phospholipids and 1.8%, glycolipids indicating that phospholipids contents of soybean Koji was increased when compared to those of cooked soybean. The major components of nonpolar lipids in soybean Koji were free fatty acids(39.6%) and triglycerids(29.2%). Free fatty acids increased as the triglycerides decreased during soybean Koji preparation by the hydrolysis of lipase action. The major components of polar lipids in soybean Koji were phosphatidyl choline and phosphatidyl ethanolamine. Differences were observed in the composition of the polar lipids of cooked soybean and soybean Koji. A little changes also occurred in fatty acid compositions of total lipids, triglycerides and free fatty acids fractions in soybean Koji preparation. Especially a considerable increase of linoleic acid in free fatty acid fraction was observed in soybean Koji.