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Serial Changes of Serum Thyroid-Stimulating Hormone after Total Thyroidectomy or Withdrawal of Suppressive Thyroxine Therapy in Patients with Differentiated Thyroid Cancer (분화성 갑상선 암 환자에서 갑상선 전절제술후 또는 갑상선 호르몬 억제 요법 중단에 따른 갑상선 자극호르몬의 변화)

  • Bae, Jin-Ho;Lee, Jae-Tae;Seo, Ji-Hyoung;Jeong, Shin-Young;Jung, Jin-Hyang;Park, Ho-Yong;Kim, Jung-Guk;Ahn, Byeong-Cheol;Sohn, Jin-Ho;Kim, Bo-Wan;Park, June-Sik;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.516-521
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    • 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.

Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan (분화 갑상선암 수술 후 최초 고용량 방사성옥소 치료시 투여용량 결정: 병리적 병기, 혈청 갑상선글로불린치와 I-123 전신 스캔의 유용성 비교)

  • Jeong, Hwan-Jeong;Lim, Seok-Tae;Youn, Hyun-Jo;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.301-306
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    • 2008
  • Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.

Developing a Scale for Measuring the Corporate Social Responsibility Activities of Korea Corporation: Focusing on the Consumers' Awareness (한국형 기업의 사회적 책임활동 측정을 위한 척도 개발 연구: 소비자 인식을 중심으로)

  • Park, Jongchul;Kim, Kyungjin;Lee, Hanjoon
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.27-52
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    • 2010
  • It is not new that today's business organizations are expected to exhibit ethical and moral management and to carry out social responsibility as a good corporate citizen. Since South Korea emerged as a newly industrialized country during the 1980s, Korean corporations have become active in carrying out their social responsibility as a good corporate citizen to society. In spite of the short history of corporate social responsibility, Korean companies have actively participated in corporate philanthropy. Corporations' significant donations to various social causes, no-lay-off policies, corporate volunteerism and green marketing are evidences of their commitment to corporate citizenship. Corporate social responsibility is now an essential management practice whereby corporation can strengthen its sustainable value creation processes by enhancing the trust assets underlying the relationships between the business and the stakeholders. Much of the conceptual work in the area of corporate social responsibility(CSR) has originated from researches conducted in the management field. Carroll(1979) proposed that corporations have four types of social responsibilities: economic, legal, ethical and philanthropic responsibility. Most past research has investigated CSR and its impact on consumers' attitudes toward the corporations and corporate performances. Although there exists a large body of literature on how consumers perceive and respond to CSR, the majority of past studies were conducted in the United States. The stability and applicability of past findings need to be tested across different national/cultural settings, especially since corporate social responsibility is a reflection of implicit conformation with the expectations and criticism that society may have toward a corporation(Matten and Moon, 2004). In this study, we explored whether people in Korea perceive CSR of Korean corporations in the same four dimensions as done in the United States and what were the measurement items tapping each of these four dimensions. In order to investigate the dimensions of CSR and the measurement items for CSR perceived by Korean people, nine focus group interviews were conducted with several stakeholder groups(two with undergraduate students, two with graduate students, three with general consumers, and two with NGO groups). Scripts from the interviews revealed that the Korean stakeholders perceived four types of CSR which are the same as those proposed by Carroll(1979). However we found CSR issues unique to Korean corporations. For example for the economic responsibility, Korean people mentioned that the corporation needed to contribute to the economic development of the country by generating corporate profits. For the legal responsibility, Koreans included the "corporation need to follow the consumer protection law." For the ethical responsibility, they considered that the corporation needed to not promote false advertisement. In addition, Koreans thought that an ethical company should do transparent management. For the philanthropic responsibility, people in Korea thought that a corporation needed to return parts of its profits to the society for the betterment of society. The 28 items were developed based on the results of the nine focus group interviews, while considering the scale developed by Maignan and Ferrell(2001). Following the procedure proposed by Churchill(1979), we started by developing an item poll consisting of 28 items and purified the initial pool of items through exploratory, confirmatory factor analyses. 176 samples were sued for this analysis. Confirmatory factor analysis was performed on the 28 items in order to verify the underlying four factor structure. Study 1 provided new measurement items for tapping the Korean CSR dimensions, which can be useful for the future studies exploring the effects of CSR on Korean consumers' attitudes toward the corporations and corporate performances. And we found the CSR scale(17 items) has good reliability, discriminant validity and nomological validity. Economic Responsibility: "XYZ company continuously improves the quality of our products", "XYZ company has a procedure in place to respond to customer complaint", "XYZ company contributes to the economic development of our country by generating profits", "XYZ company is eager to hire people". Legal Responsibility: "XYZ company's products meet legal standards", "XYZ company seeks to comply with all laws regulating hiring and employee benefits", "XYZ company honors contractual obligations to its suppliers", "XYZ company's managers try to comply with the law related to the business operation". Ethical Responsibility: "XYZ company has a comprehensive code of conduct", "XYZ company does not promote a false or misleading advertisement", "XYZ company seems to conduct a transparent business", "XYZ company does a fair business with its suppliers or sub-contractors". Philanthropic Responsibility: "XYZ company encourages partnerships with local businesses and schools", "XYZ company supports sports and cultural activities", "XYZ company gives adequate contributions to charities considering its business size", "XYZ company encourages employees to support our community". Study 2 was condusted for comprehensive validity. 655 samples were used for this anlysis. Collected samples were tested by factor analysis and Crnbach's Alpha coefficiednts and were found to be satisfactory in terms of validity and reliability. Furthermore, fitness of the measurement model was tested by using conformatory factor analysis. χ2=880.73(df=160), GFI=0.891, AGFI=0.854, NFI=0.908, NNFI=0.913, RMR=0.059, RMESA=0.070. We hope that CSR scale could greatly facilitate research on Corporate social resposibility, it is by no means the final answer.

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Conjunction of Consciousness and The Unconscious·Individuation and Circumambulation of The Psyche: Focusing on the Hexagram Bi, Pi (比) and Hexagram Gon, Kun (坤) (의식과 무의식의 통합 및 개성화와 정신의 순환: 수지비괘(일양오음괘)와 중지곤괘를 중심으로)

  • Hyeon Gu Lee
    • Sim-seong Yeon-gu
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    • v.38 no.1
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    • pp.1-44
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    • 2023
  • Hexagram Bi (比 ䷇ 8) is one of the hexagrams comprised of one-unbroken line and five-broken lines. The hexagrams of one-unbroken and five-broken lines symbolize the relationship and dynamics between one yang-consciousness and the five-yin unconsciousness. The hexagram of one-unbroken line and five-broken lines has six different images depending on the position of the one unbroken line from the beginning line to the top line. In terms of psychology, this means that the position change of one yang line in relation to five yin lines may symbolize the function of consciousness which clarifies and determines the content of the psyche. In addition, the flow of psychic energy can be examined through the process of one unbroken line's movement. In other words, the psychic contents of the beginning line of hexagram Bok (復 ䷗ 24), which is the beginning of the hexagram of one-unbroken line and five-broken lines, proceed sequentially, and then arrive at the process of the last sixth, hexagram Bak (剝 ䷖ 23) through the fifth, the hexagram Bi (8). That is, it can be said that the content of the hexagram and the line determined according to the position of one unbroken line show a certain psychic flow. As a result, the first hexagram Bok (復 ䷗ 24), after recovering and starting newly, means the beginning of consciousness. After that the process of proceeding with the second, third, and fourth lines represents the flow of consciousness. And in the fifth place, the fifth line of hexagram Bi, it reaches its peak and is placed in the optimal state of consciousness because of its right and centered position at this hexagram Bi. Like nature, the psyche gradually enters the path of decline from the highest state, which leads to the last sixth, the top line of hexagram Bak. However, the top line of the hexagram Bak, where everything falls off, contains the content of starting again in its top line. It is the beginning line of hexagram Bok to inherit this. This means the circumambulation of the psyche that changes from a psychologically difficult state of depression to a stage of recovery. There is a stage that must be passed in this circulation process, and that is the hexagram Gon (坤 ䷁ 2). October(tenth month)'s hexagram Gon is placed between hexagram Bak, the ninth month of the lunar calendar, and hexagram Bok, the eleventh month of the lunar calendar. This represents that the flow of recovery must go through a maternal process of hexagram Gon. The retreat to the psychological uterus is inevitable in regenerating the psyche. This process flows from the hexagram Bak and through hexagram Gon to the hexagram Bok. At this situation the hexagram Gon acts the absolutely necessary role. In addition, the main body of the hexagrams of one-unbroken and five-broken lines, including the Bi hexagram, is also the Gon hexagram composed of six-broken lines. In other words, all six hexagrams of one-unbroken and five-broken lines have a certain relationship with the Gon hexagram, and it would be meaningful to look at the correlation between the unbroken lines of the hexagrams of one-unbroken and five-broken lines and the corresponding broken lines of the hexagram Gon. This can be said to be the dynamics of the maternal unconscious connected to the state of consciousness in six forms. Therefore, each hexagram of one-unbroken and five-broken lines symbolizes the expression of the integration the mother archetype with the consciousness. Revealing this well is the meaning of the hexagram of one-unbroken and five-broken lines. Its hexagram image consists of a combination of Gon (☷), which symbolizes the mother, and the thunder (☳) the eldest son, the water (☵) the middle son and the mountain (☶) the third son. As a result, the hexagram Bok (復 ䷗ 24), Sa (師 ䷆ 7), Gyeom (謙 ䷠ 15), Ye (豫 ䷏ 16), Bi (比 ䷇ 8) and Bak (剝 ䷖ 23) are sequentially created in the order of the unbroken line. This is symbolically the evolutionary process of consciousness. In this way, the hexagrams of one-unbroken and five-broken lines, which mean the conjunction of mother and son, represent the advancing relationship between the maternal unconscious and consciousness. In addition, the relationship with the mother according to the position of the son is related to the dynamics of mother archetype to the attitude of consciousness. The psychological meaning can be deduced from the flow of six lines of hexagrams of one-unbroken and five-broken lines. And the state in which the activation of the consciousness is at its peak is the fifth line of the hexagram Bi, and comparing it with the contents of the corresponding fifth line of hexagram Gon not only can find the state and meaning of the conjunction of consciousness and the maternal unconscious, but the entire flow can be compared to the individuation process.