• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.368-380
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• 1999

Purpose: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). Materials and Methods: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: $49.1{\pm}10.8$). Results: Eighteen lesions of primary HPT consisted of 13 adenomas and S hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). Conclusion: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.77-85
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• 1996

Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.530-534
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• 2002

Background: In aortic surgery, division and ligation of the left brachiocephalic vein(LBV) may improve exposure of the aortic arch but controversy continues about the safety of this division and whether a divided vein should be reanastomosed after arch replacement was completed. The safety of LBV division and the fate of the left subclavian venous drainage after LBV division were studied. Material and Method: From November 1998 to January 2001, planned division and ligation of the LBV on the mid-line after median sternotomy was peformed in 10 patients during the aortic surgery with the consideration of local anatomy and distal aortic anastomosis. Assessment for upper extremity edema and neurologic symptoms, measurement of venous pressure in the right atrium and left internal jugular vein, and digital subtraction venography(DSV) of the left arm were made postoperatively. Result: In 10 patients there was improvement in access to the aortic arch for procedures on the ascending aorta or aortic arch. The mean age of patients was 62 years(range 24 to 70). Follow-up ranged from 3 weeks to 13 months. One patient died because of mediastinitis from methicilline-resistant staphylococcus aureus strain. All patients had edema on the left upper extremity, but resolved by the postoperative day 4. No patient had any residual edema or difficulty in using the left upper extremity during the entire follow-up period. No patient had postoperative stroke. Pressure difference between the right atrium and left internal jugular vein was peaked on the immediate postoperative period(mean peak pressure difference = 25mmHg), but gradually decreased, then plated by the postoperative day 4. In all DSV studies left subclavian vein flowed across the midline through the inferior thyroid venous plexus. Conclusion: We conclude that division of LBV is safe and reanastomosis is not necessary if inferior thyroid vein, which is developed as a main bridge connecting the left subclavian vein with right venous system, is preserved.

• The Korean Journal of Nuclear Medicine
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• v.22 no.2
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• pp.171-174
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• 1988

Thyrotropin binding inhibitory immunoglobulin (TBII) and thyroid stimulating antibody (TSAb) activities were measured in the thyroidal and peripheral venous blood samples at the time of subtotal thyroidectomy from twenty one patients with Graves' disease prepared for surgery with antithyroid drugs. There was no difference in TBII and TSAb activities between thyroidal and peripheral blood samples. These findings were regarded that while intrathyroidal lymphocytes are major site of thyrotropin receptor antibody (TRAb) production, similar levels are found in thyroidal and peripheral veins and that this in vivo study cannot exactly ascertain the TRAb producing site.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.24-29
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• 2018

Background and Objectives : The purpose of this study was to evaluate the impact of surgical extent on voice using acoustic and aerodynamic measurements in a serially followed thyroidectomy patients. Materials and Method : From October 2015 to January 2017, 108 patients who had undergone thyroid surgery and voice test for preoperative, 2, 3, and 6 months postoperatively were classified into five operative types. The radiological stage preoperatively and histopathological stage postoperatively were classified according to the invasion of thyroid capsule and surrounding tissue. For each classification, the results of the voice analysis according to the period were compared and analyzed. Results : The difference of voice according to surgical extent, radiological stage, and histopathologic stage showed significant difference only with Maximal phonation time (MPT) over time. However, in the analysis of interaction between each classification and period, Phonation threshold pressure (PTP) only showed significant results. Conclusion : Differences in imaging and histopathologic stages have no significant effect on recovery of voice symptoms after thyroid surgery. As the extent of operation increases, the pressure to start vocalization is relatively higher, which also varies with time after surgery.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.48-51
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• 2001

Sclerosing rnucoepidermoid carcinoma with eosinophilia(SMECE)는 1991년 Chan 등이 처음 보고한 이후로 현재까지 전세계적으로 단 17예 만이 보고된 매우 희귀한 갑상선 암종이다. 조직학적으로는 종양 내에 일부 점액성 세포와 증식된 상피성 세포들을 관찰할 수 있고, 조직내 호산구성 세포들이 자주 관찰된다. 대부분의 기질은 밀집된 섬유성 조직으로 구성되어 있으며, 하시모토 갑상선염이 동반되어 있는 것이 특장적이다. 종양의 악성도는 최초 보고인 Chan 등에 의하면 국소 재발 및 원격전이를 거의 하지 않는 예후가 좋은 암종으로 보고되었는데, 이후 여러 문헌에서 국소 침윤, 국소 재발, 원격 전이 및 사망이 발생하여 예후가 매우 불량했던 증례들을 보고한 바 있어 악성도에 대한 시각은 달라지고 있다. 본 저자들은 최근 병리적 진단이 매우 어려웠고, 국소침윤과 림프절 전이 소견을 보였으며, 수술 후 빠른 시일 내에 급속히 재발하였던 악성도가 매우 높은 sclerosing mucoepidermoid thyroid carcinoma with eosinophilia (SMECE) 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.287-295
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• 2011

Purpose: This study was done to compare educational needs for discharge after thyroid cancer surgery between patients and nurses. Methods: The participants were 107 patients who had thyroid cancer surgery and 70 nurses who have had experience of taking care of patients with thyroid cancer surgery at P hospital in Busan. The researcher reviewed the literature and conducted a preliminary survey to develop a questionnaire. Results: Although there was no significant difference in total perceived nursing discharge educational needs after thyroid cancer surgery between patients and nurses, both had a high level of nursing educational needs for discharge. The degree of patients' needs was higher than nurses in areas of dietary management after discharge and the degree of nurses' needs was higher than patients in the other areas. Although the first ranking area of educational needs was medication management for both patients and nurses, dietary management after discharge was the second ranking for patients and operation site and complication management was those for nurses. Conclusions: As the patients had different educational needs from the nurses, nurses need to focus on the patient's educational needs and provide relevant information. Educational programs should be developed and applied to post-surgical thyroid cancer patients.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.40-47
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• 2009

Purpose: Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. Materials and Methods: DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of a portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Results: Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones ($7.8{\pm}8.5$ vs. $3.6{\pm}3.1$, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX- 2 and Galectin-3. Conclusion: In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.35-40
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• 1994

A case of poorly differentiated "insular" carcinoma of the thyroid is presented and discussed with references to the literature. Un fine needle aspiration cytology of our case, the aspirates were highly cellular with tumor cells appearing as dispersed isolated cells as well as in dense clusters and syncytial formations. Occasional microfollicles containing colloid were evident. Most of nuclei were fairly uniform with considerable variability and a few showed definite atypical features. Nuclear grooving was additional features. Necrotic debris was not seen. Our cytologic findings were correlated well with histology, confirming typical insular pattern of tumor cells with the presence of occasional pleomorphic cells and papillary carcinoma-like features. With much attention to cytological features of insular carcinoma, it would be possible to diagnose a preoperative suggestive diagnosis, even though not definitive.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2003.09a
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• pp.110-110
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• 2003

후두기관외상은 두경부 부위의 다른 외상에 비해 흔하지 않은데, 이는 연골의 유연성과 후두의 가동성, 후두가 하악과 흉골사이에 위치하여 외상시 보호 받게 되는 해부학적 특성에 기인한다. 그러나, 후두는 호흡과 발성에 중요한 기관으로 조기 진단과 정확한 평가, 적절한 치료를 못할 경우 생명을 위협 할 수 있고 삶의 질에 지대한 영향을 줄 수 있다. 이에 저자들은 급성 후두기관손상으로 수술적 치료를 받은 환자를 대상으로 손상 기전 및 임상 양상, 손상부위, 손상 정도 치료 등을 알아보고 향후 치료에 도움을 얻고자 하였다. 1996년부터 2003년까지 급성 후두기관 손상으로 수술적 치료를 받은 10명을 대상으로 후향적으로 조사를 하였다. 손상정도는 Schaefer의 분류를 따랐으며 술후 결과는 발성과 기도유지로 평가하였다. 발성의 경우 수상전과 동일하거나 유사할 경우 성공(good)으로, 수상전과는 다르지만 기능을 하는 경우는 양호(fair)로, 거의 음성이 나지 않거나 알아들을 수 없는 경우 불량(poor)로 분류하였고, 기도유지는 수상전과 동일하거나 유사할 경우 성공(good)으로, 경한 흡인이나 운동 유발성 호흡곤란이 있는 경우(fair)로 발관이 되지 않는 경우를 불량(poor)으로 분류하였다. 남녀 성비는 8대 2였고 30～40대가 4명으로 가장 많았다. 손상의 원인은 둔상인 경우(4예) 교통사고가 2례, cloth line 손상 2례, 관통상(6례)는 모두 칼에 의한 좌상이었다 증상은 피하기종이 9례, 애성이 7례, 호흡 곤란이 6례로 많았으며 손상부위는 갑상연골 골절이 5례(50％), 기도손상과 갑상선 손상이 각각 4례에서 관찰되었다. 그 외에도 윤상 연골 골절과 윤상갑상막 손상 등이 관찰되었다. 또한 점막 손상이 7례에서 관찰되었다. 성대마비는 내원시 4례에서 관찰되었다 치료는 수상 후 조기수술을 시행하였고 수상 부위를 개방하여 손상된 연조직을 일차 봉합하거나, 골절을 정복 고정하였고 3례에서 스텐트를 삽입하였다. 술후 기도유지는 모두 성공적이었고 발성기능은 6례에서 성공(good)적이었고 4례에서 양호(fair)의 결과를 보였다. 양호의 결과를 보인 모든 예가 내원시 성대 움직임의 마비나 저하를 보인 예였다. 급성 후두기관손상환자에서 조기 진단과 적절한 수술적 치료는 환자의 생명을 유지시키고 술후 발성 지능의 보존에 양호한 결과를 보였다.