• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.543-556
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• 2009

Purpose: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point $^{18}F$-FDG PET/CT imaging. Materials and Methods: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point $^{18}F$-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (${\Delta}%SUVmax$) and lesion to background ratio of SUVmax (${\Delta}L:B$% ratio) between both time points. The mean time interval between scans was $23.4{\pm}4.4$ minutes (thyroid to thyroid interval: $10.7{\pm}4.4$ minutes). Results: The mean of SUVmax of PTMCa was increased from $4.9{\pm}4.3$ to $5.3{\pm}4.7$ (p<0.001) and ${\Delta}%SUVmax$ was $12.3{\pm}23.6%$. But, the mean of SUVmax of benign nodules was no definite change ($2.1{\pm}1.0$ to $2.1{\pm}1.3$, p=0.686) and ${\Delta}%SUVmax$ was $-0.3{\pm}20.5%$. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point $^{18}F$-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011). Conclusion: Dual time time $^{18}F$-FDG PET/CT imaging was more useful than single time point $^{18}F$-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point $^{18}F$-FDG PET/CT imaging or was smaller than 0.5 cm.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.265-272
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• 2014

Purpose : To reduce the radiation dose to the thyroid that is affected to scattered radiation, the shield was used. And we evaluated the shielding effect for the thyroid during whole brain radiation therapy. Materials and Methods : To measure the dose of the thyroid, 300cGy were delivered to the phantom using a linear accelerator(Clinac iX VARIAN, USA.)in the way of the 6MV X-ray in bilateral. To measure the entrance surface dose of the thyroid, five glass dosimeters were placed in the 10th slice's surface of the phantom with a 1.5 cm interval. The average values were calculated by measured values in five times each, using bismuth shield, 0.5 mmPb shield, self-made 1.0 mmPb shield and unshield. In the same location, to measure the depth dose of the thyroid, five glass dosimeters were placed in the 10th slice by 2.5 cm depth of the phantom with a 1.5 cm interval. The average values were calculated by measured values in five times each, using bismuth shield, 0.5 mmPb shield, self-made 1.0 mmPb shield and unshield. Results : Entrance surface dose of the thyroid were respectively 44.89 mGy at the unshield, 36.03 mGy at the bismuth shield, 31.03 mGy at the 0.5 mmPb shield and 23.21 mGy at a self-made 1.0 mmPb shield. In addition, the depth dose of the thyroid were respectively 36.10 mGy at the unshield, 34.52 mGy at the bismuth shield, 32.28 mGy at the 0.5 mmPb shield and 25.50 mGy at a self-made 1.0 mmPb shield. Conclusion : The thyroid was affected by the secondary scattering dose and leakage dose outside of the radiation field during whole brain radiation therapy. When using a shield in the thyroid, the depth dose of thyroid showed 11~30% reduction effect and the surface dose of thyroid showed 20~48% reduction effect. Therefore, by using the thyroid shield, it is considered to effectively protect the thyroid and can perform the treatment.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.32-37
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• 2011

서 론 : 미세갑상선유두상암종 환자에서 불필요한 예방적 중앙 림프절절제술을 피하기 위해서 림프절 전이를 수술 전에 예측하는 수단이 필요하다. 림프관 생성 및 성장의 조절에 VEGF-C/D, VEGFR-3 pathway, podoplain이 관여된다는 사실이 밝혀져 있다. 림프관 생성 및 성장과 관련된 인자인 VEGF-C/D, podoplanin에 대한 면역조직화학염색과 반정량적 분석을 통해 미세갑상선유두상암종에서 림프절전이와의 관련성을 확인하고자 하였다. 대상 및 방법 : 2006년 9월부터 2008년 6월까지 본원에서 미세갑상선유두상암종으로 진단받고 1인 술자에 의해 갑상선 전 절제술 및 예방적 중앙 림프절절제술을 받은 104명의 환자 중 중앙 림프절 전이가 있었던 환자와 없었던 환자를 각각 25명씩 무작위로 선별하여 종양부위에 면역화학염색을 실시하여 림프관생성인자의 발현 정도를 비교하였다. 결 과 : 대상군 50예 중 VEGF-C/D는 50예(100%) 모두 발현이 되었고 podoplanin은 33예(66%)에서 발현이 되었다. 그 중 VEGF-C는 10예(20%)에서 약한 양성, 37예(74%)에서 중등도 양성, 3예(6%)에서 강한 양성소견을 보였고 VEGF-D는 9예(18%)에서 약한 양성, 37예(74%)에서 중등도 양성, 4예(8%)에서 강한 양성소견을 보였다. 중앙 림프절 전이 음성 환자 군과 양성 환자 군으로 분류하였을 때 VEGF-C/D의 발현율의 차이는 p-value가 각각 0.48, 1.00으로 통계적으로 유의한 차이를 보이지 않았다. 50예 전체를 대상으로 하여 종양의 개수, 최대크기, 검출된 전체 림프절의 수, 양성 림프절의 수, 주변조직 침범여부에 따른 VEGF-C/D의 발현도 통계적으로 유의한 차이를 보이지 않았다. Podoplanin의 경우 염색 여부에 따라 양성군과 음성군으로 나누어 분석하였을 때 종양의 개수, 최대크기, 검출된 림프절의 수, 양성 림프절의 수, 주변조직 침범여부도 통계적으로 유의한 차이를 보이지 않았다. 결 론 : VEGF-C/D는 대상군 전체(100%)에서 발현이 되었고 podoplanin은 66%에서 발현이 되었다. 림프관 생성인자로 알려진 VEGF-C/D및 podoplanin이 미세갑상선유두상암종에서 많이 발현이 되는 것으로 보아 위 인자들이 림프절 전이를 일으키는 인자 중 하나로 생각된다. 하지만 미세갑상선유두상암종에서 중앙 림프절 전이를 예측할 수 있는 인자로 부적합 한 것으로 생각되며 향후 더 많은 증례를 통해 관련성 여부에 대한 연구가 필요하고 또 다른 인자의 관련성에 대해서 연구가 필요하겠다.

• Nuclear industry
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• v.35 no.9
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• pp.46-52
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• 2015

1975년 우라늄협회로 출발한 세계원자력협회(WNA)는 원자력을 평화적으로 이용하는 것을 적극 지원하고, 원자력 발전과 핵연료주기 전반에 걸친 원자력 산업 발전을 위하고자 설립한 세계적 민간 기구로, 우라늄 채광부터 변환, 농축, 핵연료 제조, 원자력발전 운영, 기자재(설비) 제작 및 사용후핵연료 처분에 이르기까지 원자력발전의 전 주기 산업을 촉진하고 관련 정보를 지원하고 있다. 2001년 지금의 명칭으로 변경한 WNA는 전 세계 원자력산업체와 원자력 관련 기관, 대학 등 175개 회원사를 두고 상호 협력과 전문 인력 교육 기반 강화, 국제화에 적극 나서고 있으며, 원자력산업 정보 제공과 교환을 위해 관련 보고서와 자료도 수시로 발행하고 있다. 2013년부터 WNA를 이끌고 있는 아그네타 라이징 사무총장은 지난 11월 영국 런던 소재 WNA를 방문한 <원자력신문>과의 인터뷰를 통해, 원전과 주변지역 주민의 갑상선암 발병에 대한 인과 관계에 대하여 "갑상선암 발병이 원전과 연관성 있다는 주장은 과학적 근거가 없다"고 단호히 말하고, "한국과 유사한 사례가 해외 원자력계(과학계)와 의학계에 보고된 적이 있냐"는 질문에 "해외에서 정상 운영되고 있는 원전 시설은 국제방사선방호위원회(ICRP)의 엄격한 기준(ICRP-60)이 적용하고 있으며, 방사선 방호와 관련된 연구보고서(논문)를 꾸준히 내고 있지만 원전 주변 주민에 대한 여러 역학 조사에서도 갑상선암이 증가했다는 사례는 보고된 바 없다"고 말했다. 또한 "실제로 일본 원폭 생존자 연구와 체르노빌 원전 주변 주민 연구에 의하면 20세 이상의 성인에서 방사선 노출에 의해 갑상선암이 증가한다는 증거는 없었다."면서 "체르노빌 사고와 후쿠시마 원전 사고 이후 방사선 누출로 인해 방사선이 갑상선암의 발생률을 증가시키는 것으로 알려졌지만 실제로 원전에서 발생하는 방사능은 갑상선암을 유발시킬 수 있는 양에 비해 아주 적다. 그럼에도 원전 시설에서 나오는 방사능 수치에 대해 제대로 밝히는 기관이 없기 때문에 원전 주변에 살아도 영향을 받는 것으로 오해할 수 있다."고 덧붙였다. 아그네타 라이징 사무총장은 스웨덴 출신의 방사선 방호 전문가로, 스웨덴 국영기업 Vattenfall AB 그룹에서 원자력 에너지 환경 분야 최고 전문가로 활동했으며, 스웨덴원자력학회, 유럽원자력학회, 세계여성원자력전문인회(WiN-Global) 회장 등을 역임했다. 인터뷰 전문을 게재한다.

• Journal of the Korean Society of Radiology
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• v.13 no.6
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• pp.889-894
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• 2019

Upper gastrointestinal series is an examination that uses X-rays. It is important to defend against exposure to radiation during upper gastrointestinal examination because the organs, such as thyroid gland, lens, breasts, and gonads, with relatively high biological sensitivity to radiation are distributed on the examination area. We have made a whole body phantom that can change the depth of organs. radiation dose of eye, thyroid gland, breast and gonads were measured by the same procedure as the actual upper gastrointestinal examination. When performed only fluoroscopy the mean dose reduction of lens, thyroid gland, breast and gonads was 62.2%. The mean dose reduction of lens, thyroid gland, breast and gonads was 59.0% when both fluoroscopy and spot shoot were performed. Therefore, when performed upper gastrointestinal examination it was confirmed that shielding of the lens, thyroid gland, breast and gonads was effective in decreasing the exposure dose. The manufactured human phantom can be used in measuring radiation dose for deep organ because it can adjust the height corresponding to the organs located in the human body.

• Journal of the Korea Convergence Society
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• v.12 no.4
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• pp.317-326
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• 2021

This study is a systematic review of literature to analyze the characteristics and outcome variables of intervention research programs for domestic thyroid patients. We systematically reviewed the literature published until 2019 in five domestic databases. Six of the 824 confirmed articles were extracted according to the selection criteria. The results of this study were classified into education, activities, and counseling. Education and counseling therapy had a significant effect on psychosocial and physiological variables. Activity therapy had a significant effect on physiological variables. This study presented the basis for the development and implementation of various intervention programs for domestic thyroid patients and can be used for the study of the convergence program development considering physiological and psychosocial problems of the thyroid patients.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.225-231
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• 1997

Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.337-341
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• 2005

Thyrotropin receptor(TSHR) mutations must be considered when congenital hyperthyroidism has persisted, but there has been no evidence for autoimmunity. TSHR mutations leading to constitutive activation of the thyroid gland were identified as the molecular cause of autosomal dominant nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. We report two cases of hyperthyroidism caused by germline TSHR mutation who presented with exessive sweating and no evidence of autoimmune thyroid disease. They were brothers and their mother had undergone thyroidectomy because of hyperthyroidism. Direct sequencing of the polymerase chain reaction-amplified exon 10 of the TSHR genomic DNA revealed a transition of GCT to GTT, resulting in an exchange of alanine 627 to valine in the patients and their mother. This might be a novel mutation or polymorphism, but we did not perform any functional gene study. But considering the clinical profiles, we can conclude that hyperthyroidism of these two brothers might come from the point mutation described above.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.202-206
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• 2010

There are various local and systemic factors which alter the rate of tooth eruption movement. Thyroid hormone has been reported to have proportional relationship with the rate of tooth eruption. The main function of thyroid hormone is the regulation of basal metabolism, but it also affects the rate of tooth eruption. In this report, we will present a case of an 11-year-old girl, who showed sudden increase in orthodontic tooth movement of the impacted canine at certain points, which coincided with the hyperthyroid period. It shows possible relationship between the serum level of thyroid hormone and the rate of orthodontic tooth movement.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.18-21
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• 2015

기관을 침범한 갑상선 악성종양을 제거한 후에 성문하부에 비교적 큰 기관 결손이 발생할 수 있다. 단단문합술은 넓은 부위의 결손부를 재건하는 방법으로 널리 받아들여지고 있지만, 문합부 파열, 반회후두신경마비, 재협착 등의 합병증이 발생할 수 있다. 본 증례는 기도를 침범한 갑상선 유두암종을 제거한 후 윤상연골과 기관연골의 비교적 큰 결손부를 흉쇄유돌근 근골막피판을 사용하여 안전하게 재건한 사례이다. 55세 남자 환자가 기도를 침범한 갑상선 유두상암으로 내원하였으며 기도침범은 윤상연골(둘레의 약 30%)과 4개의 기관연골(둘레의 약 50%)을 해당하는 넓은 부위였다. 수술 전 기관절개술을 시행하여 주위 기관연골의 상태가 좋지 않아 단단문합술 시행 후 문합부 파열 가능성이 있다고 판단하여 흉쇄유돌근 근골막피판을 이용하여 재건하기로 계획하였다. 갑상선 절제술, 경부림프절 절제술, 흉쇄유돌근 근골막피판을 이용한 재건술을 시행하였으며 수술 후 12일째 별다른 문제없이 퇴원하였다. 환자는 수술 후 현재 22개월 간 기도 협착 등의 별다른 합병증 없이 지내고 있다. 흉쇄유돌근 근골막피판은 성문하부나 기관지 전외측벽의 비교적 큰 결손부를 재건하는 데 유용하게 사용될 수 있다.