• 대한핵의학회지
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• 제34권4호
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• pp.265-275
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• 2000

The thyroid gland is an interesting endocrine organ where a spectrum of tumors with different behavior arise. At one end of spectrum there is differentiated thyroid carcinoma (DTC) with excellent prognosis, whereas at the other end of the spectrum is anaplastic thyroid cancer which has universally poor outcome. Radioiodine (I-131) therapy has been in use for the treatment of thyroid diseases since 1946. It was introduced by Seidlin et al. 1) Although the use of I-131 has been vouge for a long time, its use in therapy for well differentiated thyroid cancer is still controversial 2). This is because, thyroid cancers (TC) are generally slow growing tumors, with low mortality and normal spans of survival. To record recurrence and mortality, long term follow up studies over a period of two to three decades are needed to establish definite conclusions on the acceptable mode of treatment The incidence of the disease being very low a large number of cases needed to establish a meaningful statistical data is lacking as most published reports feat with small series. Here again in the problem encountered are the differing protocols for treatment with I-131, the indications for treatment which may include or exclude ablation of residual thyroid tissue, cervical nodal and distal metastases. The dosage of I-131 used for ablation of residual thyroid tissue and metastatic disease also vary. The most reliable conclusion regarding I-131 treatment are obtained from studies reported on a large series of patients followed over a period of 2 decades or more from a single institute with a more or less unchanged protocol of management.

• 대한두경부종양학회지
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• 제13권1호
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• 대한핵의학회지
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• 제14권2호
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• pp.35-40
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• 1980

In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ($^{131}I$) and 31 patients with treatment of $^{131}I$ alone. The $^{131}I$ treatment was limited to older age, above 20 years of age, and not employed in patients with pregnancy and lactation. The patients treated with antithyroid belonged to relatively younger age, and also milder in symptoms and thyroid function tests. The remission rate of antithyroid therapy group was 97.8% within 16 months. Among them the early remission rate occured within 4 months was found to be 21.7%. The combined therapy group, having prescribed more severe cases, showed the remission rate to be 75% within 16 months. The remission rate of $^{131}I$ therapy group revealed 90.9% within 16 months. Among them the early remission rate taking place within 4 months disclosed 16.7%. The side effects of antithyroid drug, propylthiouracil, were noted as follows: itching (2.7%) skin rashes (1.3%), and adverse enlargement of goiter (10.7%). The side effects $^{131}I$ therapy were transient hypothyroidism(3.9%) permanent hypothyroidism (7.8%) and itching (2.0%).

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.155-155
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• 2018

• Nuclear Medicine and Molecular Imaging
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• 제43권6호
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• pp.572-576
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• 2009

목적: 분화 갑상선암으로 갑상선전절제술 이후 고용량 방사성요오드치료(HD-RIT)를 시행하는 환자에서 Helicobacter (H) pylori 감염에 대한 유병률을 알아보고 HDRIT가 H. pylori 제균에 영향을 미치는 지를 알아보고자 하였다. 대상 및 방법: 2008년 6월부터 2009년 2월까지 분화 갑상선암으로 갑상선전절제술과 중앙과 주변 림프절제 거술 후 최초 HD-RIT를 시행한 환자 199명(남:녀=33:166, 나이 $46.7{\pm}12.3$세)과 건강검진을 목적으로 요소호기검사(UBT)를 시행한 건강한 156명(남:녀=57:99, 나이 $48.7{\pm}14.3$세)을 대상으로 하였다. HD-RIT를 받기 위하여 입원한 환자에서 H. pylori 감염 유무를 확인하기 위하여 방사성요오드 투여 1시간 전에 UBT를 시행하였다. HDRIT 시행전 UBT에서 양성을 보인 환자에서는 HD-RIT 시행 후 4주 경과시에 추적 UBT를 시행하였다. HD-RIT 시행전과 추적 UBT 측정치의 변화는 paired Student's t test를 이용하여 p값이 0.05 미만인 경우를 통계적으로 유의 하다고 판정하였다. 결과: 건강한 대조군 156명에서 시행된 UBT에서 115명(73.7%)에서는 양성이었고, 41명(26.8%)은 음성이었다. 분화 갑상선암으로 갑상선절제술을 시행받은 대상환자 199명 중에서 103명(51.8%)이 치료전 UBT에서 양성이었고, 96명 (48.2%)이 음성으로 대조군에 비하여 H. pylori 유병율이 낮았다. 양성을 보인 103명 중 80명에 대해서 HD-RIT 후 추적 UBT를 시행하였고 76명(95.0%)에서는 여전히 양성을 보였고, 4명(5.0%)만이 음성으로 변하였다. 지속적으로 추적 UBT에서 양성을 보인 76명 중 26명 (34.2%)에서는 HD-RIT 후에 측정값이 증가하였으며 증가정도는 $66{\pm}66.1\;dpm$ 이었다. 반면에 49명(64.5%)에서는 HD-RIT 후에 측정값이 감소하였으며 감소정도는 $153.3{\pm}157.1\;dpm$ 이었고, 1명(1.3%)은 방사성 요오드 치료전후 같은 값을 보였다. 결론: 갑상선암 환자에서 H. pylori 유병률은 건강한 성인에 비하여 높지 않으며, HD-RIT가 H. pylori의 제균에 의미있는 효과는 없으나 H. pylori 감염의 정도나 분포에 영향을 줄 수 있을 것으로 생각된다.

• International journal of thyroidology
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• 제11권2호
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• pp.160-166
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• 2018

Background and objectives: Salivary hypofunction is one of the common side effects after radioiodine therapy, and its pathophysiology is salivary ductal stenosis resulting from ductal cell injury. This study aimed to develop the functional culture environment of human parotid gland ductal cells in in vitro three-dimensional perfusion culture system. Materials and Methods: We compared plastic dish culture method and three-dimensional culture system containing Matrigel and nanofiber. Morphogenesis of reconstituted salivary structures was assessed by histomorphometry. Functional characteristics were assessed by immunohistochemistry and reverse transcription polymerase chain reaction (aquaporin 5, CK7, CK18, connexin 43, and p21). In addition, we designed the media perfusion culture system and identified higher rate of cell proliferation and expression of connexin 43 in perfusion system comparing to dish. Results: Human parotid ductal cells were well proliferated with the ductal cell characters under environment with Matrigel. In the presence of Matrigel, aquaporin 5, CK18 and connexin 43 were more expressed than 2D dish and 3D nanofiber setting. In the media perfusion culture system, ductal cells in 3D culture media showed higher cells count and connexin 43 expression compared to 2D dish. Conclusion: This in vitro ductal cell perfusion culture system using Matrigel could be used to study for radioiodine induced sialadenitis model in vivo.

• 한국방사선학회논문지
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• 제7권3호
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• pp.251-257
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• 2013

고용량 옥소 치료 시 수평면, 수직면, 방위각에 따라 3차원적으로 방출되는 공간선량률을 측정하였다. 정확한 측정을 위해 기하학적 구조의 알루미늄 틀을 제작하여 100 cm 거리에서, 높이 (5 측정점), 방위각 (8 측정점), 시간적 간격 (6 측정점)을 각각 나누어서 분석하였다. 수직면상 공간선량률 분포는 $^{131}I$을 경구 투여 24 시간 후 환자로부터 거리 100 cm, 높이 100 cm 지점에서 환자군 평균 71.85 ${\mu}Sv/h$로 가장 높았다. 수분섭취를 통한 공간선량률 감쇠 정도를 두 그룹으로 나누어 실험하였다. $^{131}I$을 경구 투여 24시간 뒤 거리 100 cm, 높이 100 cm에서 공간선량률 분포가 A 실험군은 44.9 ${\mu}Sv/h$이고 B 실험군은 100.28 ${\mu}Sv/h$이다. A 실험군이 B 실험군과 비교하여 고용량 옥소 치료 시 수분섭취 정도에 따라 약 53 %의 피폭경감 효과를 확인하였다.

• 한국방사선학회논문지
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• 제6권5호
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• pp.373-381
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• 2012

방사성옥소를 이용한 갑상선 암의 치료는 지난 수 십년 동안 사용되어 왔으며 많은 치료효과를 보이면서 앞으로 지속적으로 사용되어 질 전망이고 현재 우리나라의 옥소치료병실 수는 2010년 기준 124개의 치료병실이 운영되고 있으나 아직도 부족한 실정이다. 그래서 많은 병원들이 치료병실을 개설하고 있으나 중요한건 치료병실의 수적 증가보단 현재 치료병실의 올바른 관리가 선행되어야 한다는 것이다. 따라서 병실증설에 대한 논의에 앞서 현재 적용되고 있는 치료병실의 안전관리 기준과 일부 대학병원에서 기준으로 삼고 있는 안전관리기준을 조사하여 얼마나 잘 지켜지고 있는지, 치료병실의 이용에 따른 전반적인 안전관리실태여부를 조사하여 고찰 하였다.

• 대한핵의학회지
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• 제32권1호
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• pp.109-113
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• 1998

진단적 I-131 스캔에서 유방의 섭취는 주로 수유 여성에서 보인다고 알려져 있으나 수유 여부와는 관련 없이 나타나는 경우도 보고되어 있다. 갑상선 암으로 갑상선 절제술 후 I-131 치료를 위해 시행한 진단적 스캔에서 유방의 섭취를 보인 환자에서 고프로락틴 혈증에 의한 유류증의 발견 및 이를 근거로한 뇌 단층 촬영상 Empty sella가 진단되어 이를 bromocriptine으로 치료한 후, 유방 섭취의 소실이 확인 되어 I-131 치료를 시행한 경우가 있어 이를 보고하고자 한다.

• 대한핵의학회지
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• 제35권3호
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.