• The Korean Journal of Nuclear Medicine
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• v.3 no.1
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• pp.51-58
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• 1969

To clarify the hematologic effects of the radioiodine ($^{131}I$) in therapeutic doses ($5{\sim}10$ mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ($^{131}I$) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10 mCi of radioiodine ($^{131}I$) with single or fractionated administrations. The blood pictures of peripheral blood were repeated after 3 months in 40 cases of 65 cases who had been treated with $^{131}I$. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with $^{131}I$ therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter: 35.4% Nontoxic nodular goiter: 29.7% Euthyroid: 13.8% Nontoxic diffuse goiter: 12.6% Hypothyroidism: 4.3% Thyroiditis($\bar{s}$ subacute form): 1.8% Toxic nodular goiter: 1.4% Malignancy: 1.0% 2) Age incidence: The range of distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. $80.6{\sim}82.6%$ of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence: Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in. the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with $^{131}I$ toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter. One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ($^{131}I$) does not result any residual effect on the hematopoietic function. Radioiodine ($^{131}I$) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.660-664
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• 2007

Purpose : Pleural effusion is a common complications of pediatric bacterial pneumonia. Intrapleural administration of fibrinolytic agents such as urokinase have been used in the management of complicated parapneumonic effusions. But the safety and effectiveness of intrapleural urokinase instillations in children has not been confirmed. The aim of this study is to evaluate the safety and effectiveness of intraperitoneal urokinase in children. Methods : We reviewed a total of 29 children diagnosed as parapneumonic effusion with septation by chest CT or chest ultrasonography. We divided them into two groups. Fourteen children treated with urokinase after thoracostomy (Group A) were compared with 15 children treated only with thoracostomy (Group B). The urokinase, 3,000 IU/kg/day, was injected into the pleural cavity twice a day. Results : There was no statistical difference in sex and age between the two groups. Total drainage volume during thoracostomy in group A and B was 375.5 mL and 350.0 mL, respectively. It was not statistically significant. But the amounts of pleural fluid of group A on day 1, day 2 and day 3 were 102.5 mL, 100.0 mL, and 70.0 mL respectively and those of group B on day 1, day 2 and say 3 were 120.0 mL, 50.0 mL and 15.0 mL respectively. To compare group A with group B in the amounts of drainage volume on day 1 was not statistically significant, but the amounts of drainage volumes on day 2 and day 3 in group A were statistically more significant than group B (Day 1 P=0.371, Day 2 P=0.049, Day 3 P=0.048, respectively). The duration of fever, antibiotics, thoracostomy and total hospital days. Were not statistically significant between the two groups. But the frequency of complications in Group A was statictically significantly lower than in group B. Conclusion : Intrapleural instillation of urokinase facilitates the drainage of loculated pleural effusions, especially during the first 3 days, and it could reduce complications, such as pleural thickening, surgical managements, re-positioning of tube and re-thoracostomy. So intrapleural urokinase injection was and effective and safe treatment of pleural effusion in children (P=0.014).

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.636-642
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• 2007

Purpose : Fluconazole prophylaxis for very low birth weight (VLBW) infants has been shown to reduce invasive fungal infection and its mortality. This study aims to evaluate the effect of fluconazole prophylaxis in VLBW infants on the incidence and mortality of fungal infection. Methods : VLBW infants with endotracheal intubation and central vascular access admitted to the Neonatal Intensive Care Unit (NICU) at Chonnam University Hospital were enrolled. Twenty eight infants of 7-month baseline period from January to July 2005 ('non-fluconazole group') were compared with 29 infants of a 7-month fluconazole period from January to July 2006 ('fluconazole group'). Results : Gestational age, birth weight, sex, mode of delivery, frequency of twin pregnancy, chorioamnionitis, antenatal steroid and rupture of membranes were similar between the fluconazole and non-fluconazole groups. The rate of extremely low birth weight (ELBW) infants, frequency and duration of prophylactic antibiotics, total parenteral nutrition and umbilical catheters, duration of intralipid, mechanical ventilation and nasal continuous positive airway pressure (CPAP) were also not significant. However, frequency of percutaneous central venous catheterization (PCVC) and intralipid administration, and duration of PCVC were significant between the two groups. The overall incidence and mortality of fungal infection were not different between the two groups. Although the Malassezia infection was increased in the fluconazole group (P<0.05), candida was significantly decreased compared to the non-fluconazole group (P<0.05). Conclusion : Fluconazole prophylaxis in high risk VLBW infants decreased the candida infection significantly. Antifungal prophylaxis is recommended in terms of cost effectiveness, but further study is needed to clarify the reason for the increase of Malassezia infection.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.249-260
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• 2007

Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.

• The Korean Journal of Nuclear Medicine
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• v.38 no.1
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• pp.41-51
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• 2004

PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled $N-(3-iodopropen-2-yl)-2{\beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane$ ($[^{123}I]IPT$) single photon omission computed tomography (SPECT). MATERIALS and METHODS: $[^{123}I]IPT$ SPECT Imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of $[^{123}I]IPT$. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.19-26
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• 2008

Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.329-336
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• 2004

Objectives : Iron (Fe) is an essential element in biological processes; however excessive Fe is harmful to human health. Some air pollutants contain a high level of Fe, and the human lung could therefore be over-exposed to Fe through inhaled air pollutants. This study was performed to investigate the role of metal transporters (divalent metal transporter 1, DMT1, and metal transporter protein 1, MTP1) in the lung under the environments of Fe deficiency in the body and Fe over-exposure in the lung. Methods : Rats were fed Fe deficient (FeD, 2-6 mg Fe/kg) or Fe supplemented (FeS, 120 mg Fe/kg) diet for 4 weeks, followed by a single intratracheal instillation of ferrous sulfate at low (10 mg/kg) or high (20 mg/kg) dose. Fe concentration was analyzed in the serum, lung and liver, and histopathological findings were observed in the lung at 24 hours after Fe administration. The level of DMT1 and MTP1 expression in the lung was analyzed by RT-PCR. Also, the effect of Fe deficiency in the body was evaluated on the level of Fe concentration and metal transporters compared to FeS-diet fed rats at the end of 4-week FeD or FeS diet. Results : The 4-week FeD diet in rats induced an Fe deficiency anemia with decreased serum total Fe, increased unsaturated Fe binding capacity and hypochromic microcytic red blood cells. The concentration of Fe in the lung and liver was lower in the FeD-diet fed rats than in the FeS-diet fed rats. The level of metal transporters mRNA expression was higher in the FeD-diet fed rats than in the FeS-diet. The concentration of Fe in the lung was increased in a dose-dependent pattern after intratracheal instillation of Fe into the rats, while the level of Fe in the serum and liver was not increased in the low-dose Fe administered rats. Therefore, DMT1 and MTP1 mRNA was highly expressed in both FeD-diet and FeS-diet fed rats, after intratracheal instillation of Fe. Conclusions : DMT1 and MTP1 mRNA were more highly expressed in FeD-diet fed rats than in FeS-diet fed rats. The over-exposure of Fe intratracheally induced high expression of metal transporters and increased Fe deposition in the lung in both FeD-diet and FeS-diet fed rats, but did not increase the Fe level of the serum and liver in low-dose Fe administered rats. These results suggest that the role of metal transporters in the lung might be different in a part from the duodenum under the environment of over-exposure to Fe.

• Journal of radiological science and technology
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• v.27 no.4
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• pp.55-60
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• 2004

The purpose of this study was to examine both patient exposure dose during mammography and the utility status of mammograpy equipments. The data of this study were collected through questionnaire survey for 278 medical facilities registered at Korean Hospital Association and finally 161 medical facilities's data were analyzed. According to data analysis, medical facilities of 14.9% used the average glandular dose of less than 0.5 mGy, $0.51{\sim}1.0\;mGy$ 8.6%, $1.01{\sim}1.5\;mGy$ 14.9%, $1.51{\sim}2.0\;mGy$ 11.1%, $2.01{\sim}2.5\;mGy$ 9.8%, $2.51{\sim}3.0\;mGy$ 33.3%, and 7.4% more than 3.01 mGy. It was found that medical facilities of 92.6% used less than 3 mGy, showing that this figure is similar to the limit value of 3 mGy recommended by Korea Food & Drug Administration(KFDA). Recently, international organizations such as ICRP associated with radiation protection suggests that less than 3 mGy of average mammary gland dose be used during mammography in case of using Mo target+Mo filter, film/screen system and craniocaudal projection with the breast pressed to 4.2 cm. The standard dose is being strictly observed and that of the limits is going down to 2 mGy or 1.5 mGy. The major results of this study indicate that interests and a counterplan to reduce patient dose during mammography should be considered. Based on this study, the authors of this study will continue to measure exposure dose to set a new standard for patient exposure dose during mammography.

• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.477-482
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• 2016

This study is tried to determine whether the management of medical radiation is well handled by comparison the guidelines of KFDA(korea food & drug administration) with analysis of dose indicator in mammography. As a method, it is analysed that kVp, exposure time, mAs, compressed breast thickness, average glandular dose and body mass index that were classified in the examination of both breasts by CC(cranio-caudal) and MLO(medio-lateral oblique) with EMR(electronic medical record) and dose report that were sent to the PACS(picture archiving communication system). As a result, in the site inspection according to the age, Compressed breast thickness in CC and MLO were the thickest of 45.6 mm and 49.6 mm in the 50-59 year old respectively. In the overall average compressed breast thickness, CC were 44.2 mm and MLO were 48.9 mm. MLO has more thick by 4.7 mm. In average glandular dose, CC were 1.05 mGy and MLO were 1.14 mGy. MLO has higher by 0.09 mGy than CC. As the compressed breast thickness increases 10mm, CC and MLO increases 0.15 mGy and 0.17 mGy respectively. When it was compared with the average glandular dose of 1.16 mGy per 1 film presented by KFDA, CC was showed 1.05 mGy. However, the 60 mm or more was found to exceed a 1.30 mGy. Also, As the compressed breast thickness was higher, body mass index showed high score. And in the case of 25 or more in the obese body index according to body mass index, it was showed obesity in case of the compressed breast thickness was more than 50mm.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.41-48
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• 2008

Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.