• 대한핵의학회지
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• 제32권5호
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• pp.436-442
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• 1998

Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

• 한국방사성폐기물학회:학술대회논문집
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• 한국방사성폐기물학회 2017년도 춘계학술논문요약집
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• pp.239-240
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• 2017

• Nuclear Engineering and Technology
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• 제53권5호
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• pp.1519-1523
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• 2021

Radioactive iodine (¹³¹I) released from nuclear power plants has been a critical environmental concern for workers. The effective trapping of radioactive iodine isotopes from the off-gas stream generated from nuclear facilities is an important issue in radioactive waste treatment systems evaluation. Numerous studies on retaining methyl iodide (CH₃I¹³¹) by impregnated activated carbons under the high content of moisture have been extensively studied so far. But there have been no good results on how to remove methyl iodide at high humid conditions up to now. A new challenge is to introduce other promising impregnating chemical agents that are able to uptake enough radioactive methyl iodide under high humid conditions. In order to develop a good removal efficiency to control radioiodine gas generated from a high humid process, activated carbons (ACs) impregnated with triethylene diamine (TEDA) and qinuclidine (QUID) were prepared. In addition, the removal efficiencies of the activated carbons (ACs) under humid conditions up to 95% RH were evaluated by applying the standard method specified in ASTM-D3808. Quinuclidine impregnated activated carbon showed a much higher decontamination factor above 1,000, which is enough to meet the regulation index for the iodine filters in nuclear power plants (NPPs).

• Nutrition Research and Practice
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• 제10권2호
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• pp.167-174
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• 2016

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before $^{131}I$ administration. RESULTS: The median iodine intake was $290{\mu}g/day$ on the usual diet and $63.2{\mu}g/day$ on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1155-1159
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• 1995

Differentiated thyroid carcinoma is a slow growing tumor with relative good prognosis. But locally advanced thyroid cancer with T4 or N1b is difficult to manage. Between June 1988 and April 1995, we resected 8 advanced thyroid cancers trans-sternally. All patients had direct mediastinal extension [T4 or mediastinal lymph node metastasis [N1b with airway obstruction or dysphagia. We operated all the patients by partial or total sternotomy for mediastinal dissection along with thyroidectomy and radical neck dissection. There were some acceptable morbidities but no operative mortality. Postoperative radioactive iodine therapy was followed without side effects. Follow-up survival period was between 11 months to 81 months with 2 late mortalities [17 month, 30 month . Although definite benefit for routine mediastinal dissection in thyroid cancer has not been established, in locally advanced cases impending airway obstruction or dysphagia who have questionable effect by radioactive iodine therapy alone, aggressive mediastinal mass dissection including lymph node metastasis has the significant role to prevent the patients from suffocation & dysphagia, and to enhance the effect of followed radioactive iodine tharapy.

• 핵의학기술
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• 제17권1호
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• pp.3-6
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• 2013

Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

• 한국방사성폐기물학회:학술대회논문집
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• 한국방사성폐기물학회 2017년도 추계학술논문요약집
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• pp.215-216
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• 2017

• 한국방사성폐기물학회:학술대회논문집
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• 한국방사성폐기물학회 2012년도 추계학술논문요약집
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• pp.225-226
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• 2012

• Nuclear Medicine and Molecular Imaging
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• 제42권5호
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• pp.375-382
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• 2008

갑상선암 환자의 방사성 요오드 치료를 위한 전 단계로 시행되는 저요오드식이는 표준화된 전처지 방법으로 사용되고 있고 그 시행방법에 관련된 권고들이 최근 생겨나고 있다. 한국은 상대적으로 요오드 섭취가 많은 지역이므로 권장된 요오드 배설 기준을 만족시키지 못할 수도 있다. 이 연구에서는 갑상선의 요오드 섭취를 억제시키는 약물의 제한, 조영제가 사용된 경우에서 최소 3개월 이후로 치료 일정을 정하기, 전담 영양사에 의한 2주간의 엄격한 저요오드식이 교육을 시행하였을 때, 식이 요오드섭취가 많은 한국 갑상선암 환자들에서 소변 요오드량이 적정 수준으로 감소하는 지에 대해 전향적으로 분석하고자 하였다. 방법: 2006년 11월부터 외부 병원에서 갑상선암 진단 후 갑상선 전절제술을 시행 받고, 잔여 갑상선 제거 목적으로 고용량 방사성요오들 치료를 위해 본 연구자들의 병원에 의뢰된 환자들 중 recombinant human thyrotropin 또는 levotriiodothyronine을 사용하는 경우를 제외한 환자들을 대상으로 하였다. 요오드 함유 약물이나 갑상선의 요오드 섭취를 제한할 수 있는 약물을 점검했고, 조영제가 사용된 경우 치료 일정을 최소 3개월 이후로 결정하였으며 전담 영양사에 의한 2주간의 엄격한 저요오드식이 교육을 시행하였다. 저요오드식이 전후로 24시간 소변 내 요오드량을 측정하여 비교하였다. 또한 소변 내 크레아티닌 수치를 이용해서 24시간 소변 채집이 보다 적절한 것으로 판단되는 하부군을 대상으로 24시간 소변 내 요오드량을 비교하였다. 결과: 총 51명이 최종 분석에 포함되었다. 모든 환자에서는 24시간 소변 요오드량이 저요오드식이 전후로 $787\;{\mu}g/d$에서 $85\;{\mu}g/d$로 감소가 되었고 74.4%에서 $100\;{\mu}g/d$ 이하의 결과를 보였다. 소변 채집이 보다 적절한 하부군 14례에서는 저요오드식이 전후로 $505\;{\mu}g/d$에서 $99\;{\mu}g/d$로 감소되었고 78.6%에서 $100\;{\mu}g/d$ 이하의 결과를 보였다. 결론: 갑상선암 환자들에서 잔여갑상선제거를 위한 방사성요오드 치료 전에 2주간의 엄격한 저요오드식이를 시행하여 전향적으로 분석했을 때 24 시간 소변 내 요오드량이 평균 $99\;{\mu}g/d$로 감소하였고, 78.6%에서 $100\;{\mu}g/d$이하의 값을 보였다. 따라서 식이 요오드섭취량이 많은 한국에서는 최소 2주 이상의 엄격한 저요오드식이가 고려되어야 하며, 환자의 순응도를 높이기 위한 체계적인 교육이 뒷받침되어야 한다.

• 핵의학기술
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• 제22권1호
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• pp.28-34
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• 2018

국내 의료기관의 방사성옥소(I-131) 사용과 관련하여 배수 중 방사능농도가 원자력안전법의 허용치를 초과한 사례가 발견되어, 원인 분석 및 배수 중 방사능농도 분석을 통해 주변 환경 공공수역에 대한 관계를 평가하여 유용성에 대해 알아보고자 한다. 2014년 11월 1일부터 2015년 4월 30일까지 6개월에 걸쳐 국내 20개 병원을 대상으로 하였다. 장비는 HpGe 감마선 분광 측정기(Canberra DSA1000)를 사용하였으며, 분석방법으로는 GENIE-2000 Analysis을 이용하여 방사성옥소의 배수 중 방사능농도를 측정하여 비교 분석하였다. 연구 결과, 7개 기관이 I-131 배수 중 배출관리 기준을 초과하였음을 확인하였으며, 20개 병원의 평균 배수 중 방사능 농도는 $4.21E+4 Bq/m^3$로 나타났다. 방사능농도가 높은 병원의 특징으로는 I-131을 이용한 다수의 외래환자 진료 건수, 외래전용 화장실의 부재로 확인되었다. I-131 whole body scan 전 반드시 소변을 보게 하는 과정에서 체내에 잔류한 I-131이 배출되는 것으로 판단된다. 공공수역 내 배수 중 방사능 농도가 초과 검출되는 원인으로는 진료용 방사성옥소라 판단되며, 저용량 투여환자 외래전용 화장실 설치와 안전관리 지침서 제공 및 교육 강화의 중요성을 확인할 수 있었다. 또한 배수 중 배출관리기준과 관련하여 법적, 제도적 관리 체계 구축이 필요할 것으로 사료된다.