• The Korean Journal of Nuclear Medicine
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• v.9 no.2
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• pp.29-37
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• 1975

In an attempt to establish the diagnostic value of Achilles tendon reflex and to determine the normal value of Achilles tendon reflex time in normal Korean, the author measured the Achilles tendon reflex time by photomotograph. This study was carried out in 272 cases with various thyroid diseases and 340 normal Korean. 1) The Achilles tendon reflex time in normal Korean was like this, between 11 years old and 20 years old; male (62cases); $250{\pm}27$ msec, female (36 cases); $266{\pm}27$ msec, between 21 years old and 30 years old; male (38 cases); $271{\pm}27$ msec, female (21 cases); $284{\pm}27$ msec, between 31 years old and 40 years old; male (26 cases); $275{\pm}25$ msec, female (29 cases); $291{\pm}27$ msec, between 41 years old and 50 years old; male (20 cases); $286{\pm}35$ msec, female (24 cases); $307{\pm}42$ msec, between 51 years old and 60 years old, male (20 cases); $296{\pm}33$ msec, female (20 cases); $318{\pm}46$ msec, over 61 years; male (24 cases) $301{\pm}33$ msec, female (20 cases); $325{\pm}35$ msec. The Achilles tendon reflex time was delayed with increasing age and delayed in the female. 2) The Achilles tendon reflex time was markedly shortened to $221{\pm}20$msec in untreated hyperthyroidism. 3) The Achilles tendon reflex time was markedly delayed to $435{\pm}59$msec in hypothyroidism. 4) The Achilles tendon reflex time was not changed significantly in.other thyroid diseases with normal thyroid function. 5) The Achilles tendon reflex time showed good,correlationship with ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. 6) Reproducibility of Achilles tendon reflex: time was good, and no significant difference between left and right was noted. 7) Diagnostic accuracy of Achilles tendon reflex time was 71% in hyperthyroidism and 90% in hypothyroidism. 8) The Achilles tendon reflex time showed useful test to evaluate the clinical course of the hyperthyroidism.

• The Korean Journal of Nuclear Medicine
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• v.12 no.1
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• pp.17-28
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• 1978

A simplified photoelectric apparatus producing graphic records of the free Achilles tendon reflex allowed us to study the reflex quantitatively in subjects with normal and abnormal thyroid function. In this study Achilles tendon reflex times were tested in 340 normal Korean persons, 89 hyperthyroid patients, 19 hypothyroid patients and 85 other thyroid disease patients who were euthyroid in thyroid function tests. In normal Korean persons, the Achilles tendon reflex time was delayed with increasing age and slower in female than in male. They showed good correlationship with various thyroid function tests which included ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. Diagnostic accuracy of them was 71% in hyperthyroidism and 90% in hypothyroidism. Finally the serial measurements of them were very useful tests in evaluating the clinical coures of hyperthyroidism and hypothyroidism once treatment was begun.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.22-29
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• 2000

Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of $3.7{\sim}9.3$ GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.

• Proceedings of the KSAR Conference
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• 2000.10a
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• pp.10-12
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• 2000

Members of the glycoprotein family, which includes CG, LH, FSH and TSH, comprise two noncovalently linked $\alpha$- and $\beta$-subunits. Equine chorionic gonadotropin (eCG), known as PMSG, has a number of interesting and unique characteristics since it appears to be a single molecule that possesses both LH- and FSH-like activities in other species than the horse. This dual activity of eCG in heterologous species is of fundamental interest to the study of the structure-function relationships of gonadotropins and their receptors. CG and LH $\beta$ genes are different in primates. In horse, however, a single gene encodes both eCG and eLH $\beta$-subunits. The subunit mRNA levels seem to be independently regulated and their imbalance may account for differences in the quantities of $\alpha$ - and $\beta$ -subunits in the placenta and pituitary. The dual activities of eCG could be separated by removal of the N-linked oligosaccharide on the $\alpha$-subunit Asn 56 or CTP-associated O-linked oligosaccharides. The tethered-eCG was. efficiently secreted and showed similar LH-like activity to the dimeric eCG. Interestingly, the FSH-like activity of the tethered-eCG was increased markedly in comparison with the native and wild type eCG. These results also suggest that this molecular can implay particular models of FSH-like activity not LH-like activity in the eCG/indicate that the constructs of tethered molecule will be useful in the study of mutants that affect subunit association and/or secretion. A single-chain analog can also be constructed to include additional hormone-specific bioactive generating potentially efficacious compounds that have only FSH-like activity. The LH/CG receptor (LH/CGR), a membrane glycoprotein that is present on testicular Leydig cells and ovarian theca, granulosa, luteal, and interstitial cells, plays a pivotal role in the regulation of gonadal development and function in males as well as in nonpregnant and pregnant females. The LH/CGR is a member of the family of G protein-coupled receptors and its structure is predicted to consist of a large extracellular domain connected to a bundle of seven membrane-spanning a-helices. The LH/CGR phosphorylation can be induced with a phorbol ester, but not with a calcium ionophore. The truncated form of LHR also was down-regulated normally in response to hCG stimulation. In contrast, the cell lines expressing LHR-t63I or LHR-628, the two phosphorylation-negative receptor mutant, showed a delay in the early phase of hCG-induced desensitization, a complete loss of PMA-induced desensitization, and an increase in the rate of hCG-induced receptor down-regulation. These results clearly show that residues 632-653 in the C-terminal tail of the LHR are involved in PMA-induced desensitization, hCG-induced desensitization, and hCG-induced down-regulation. Recently, constitutively activating mutations of the receptor have been identified that are associated with familial male-precocious puberty. Cells expressing LHR-D556Y bind hCG with normal affinity, exhibit a 25-fold increase in basal cAMP and respond to hCG with a normal increase in cAMP accumulation. This mutation enhances the internalization of the free and agonist-occupied receptors ~2- and ~17-fold, respectively. We conclude that the state of activation of the LHR can modulate its basal and/or agonist-stimulated internalization. Since the internalization of hCG is involved in the termination of hCG actions, we suggest that the lack of responsiveness detected in cells expressing LHR-L435R is due to the fast rate of internalization of the bound hCG. This statement is supported by the finding that hCG responsiveness is restored when the cells are lysed and signal transduction is measured in a subcellular fraction (membranes) that cannot internalize the bound hormone.

• Korean Journal of Animal Reproduction
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• v.24 no.2
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• pp.125-142
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• 2000

13). Analysis of a purified preparation of eCG revealed that its $\beta$ -subunit consists of 149 amino acids, which was confirmed by the molecular cloning of its cDNA. There seem to be at least four to six, or even as many as 11, O-glycosylation sites on the extended C-tenninal region of the eCG $\beta$-subunit. Interestingly, eCG is a unique member of this family, as it appear to be a single molecule that possesses both LH- and FSH-like activities. Using the cDNA prepared from mRNA extracted from equine placental and pituitary tissues, we cloned the cDNA of eCG $\alpha$- and $\beta$ -subunits and eFSH $\beta$ -subunit. The mRNA expression of each subunit seems to be independently regulated, which may account for differences in the quantities of $\alpha$ - and $\beta$ -subunits in the placenta and pituitary. Thus, eCG is a distinct molecule from the view points of its biological function and glycoresidue structures. Recombinant eCGs including the mutants which lack oligosaccharides will be useful tools for analyzing the structure-function relationships of gonadotropins in the horse as well as other species. Similar experiments will also clarify the proposed structure and biological functions for the glycoprotein hormones. These experimental are now possible, and hopefully a resolution of the existing controversy will be forthcoming in the near future.

• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.120-127
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• 2003

Purpose: To evaluate diagnostic sensitivity of nuclear imaging in the detection of residual thyroid tissue and metastatic lesion, we have compared neck scintigrams with Tc-99m pertechnetate (Tc-99m scan) and high dose I-131 iodide (I-131 scan) in patients with differentiated thyroid cancer. Subjects and Methods: One hundred thirty-five thyroidectomized patients for differentiated thyroid cancer were enrolled in this study. Twenty-three had a previous history of radioiodine therapy. Planar and pin-hole images of anterior neck with Tc-99m were acquired at 20 minutes after injection, followed by I-131 scan three days after high-dose radioiodine therapy within 7 days interval. Patients were asked to discontinue thyroid hormone replacement more than 4 weeks. Results: All subjects were in hypothyroid state. Seventy out of 135 patients (51.9%) showed concordant findings between Tc-99m and I-131 scans. I-131 scan showed higher number of uptake foci in all of 65 patients showing discordant finding. Tc-99m scan showed no thyroid bed uptake in 34 patients, whereas 23 of them (67.6%) showed bed uptake in I-131 scan. Tc-99m scan did not show any uptake in thyroid bed in 11 of 112 patients without previous history of radioiodine therapy, but 9 of them showed bed uptake in I-131 scan. Tc-99m scan showed no bed uptake in all of the 23 patients with previous history of radioiodine therapy, in contrast 14 of them (60.9%) showed bed uptake in I-131 scan. Conclusion: These results suggest that Tc-99m scan has poor detectability for residual thyroid tissue or metastatic lesion in thyroidectomized differentiated thyroid cancer patients, compared to high dose I-131 therapy scan. Tc-99m scan could not detect any remnant tissue or metastatic lesion in patients with previous history of radioiodine treatment, especially.

• Korean Journal of Animal Reproduction
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• v.24 no.4
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• pp.357-364
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• 2000

Members of the glycoprotein family, which includes CG, LH, FSH and TSH, comprise two noncovalently linked $\alpha$- and $\beta$-subunits. Equine chorionic gonadotropin (eCG), known as PMSG, has a number of interesting and unique characteristics since it appears to be a single molecule that possesses both LH- and FSH-like activities in other species than the horse. This dual activity of eCG in heterologous species is of fundamental interest to the study of the structure-function relationships of gonadotropins and their receptors. CG and LH $\beta$ genes are different in primates. In horse, however, a single gene encodes both eCG and eLH $\beta$ -subunits. The subunit mRNA levels seem to be independently regulated and their imbalance may account for differences in the quantities of $\alpha$ - and $\beta$-subunits in the placenta and pituitary. The dual activities of eCG could be separated by removal of the N-linked oligosaccharide on the $\alpha$-subunit Asn 56 or CTP-associated O-linked oligosaccharides. The tethered-eCG was efficiently secreted and showed similar LH-like activity to the dimeric eCG. Interestingly, the FSH-like activity of the tethered-eCG was increased markedly in comparison with the native and wild type eCG. These results also suggest that this molecular can implay particular models of FSH-like activity not LH-like activity in the eCG/indicate that the constructs of tethered molecule will be useful in the study of mutants that affect subunit association and/or secretion. A single-chain analog can also be constructed to include additional hormone-specific bioactive generating potentially efficacious compounds that have only FSH-like activity. The LH/CG receptor (LH/CGR), a membrane glycoprotein that is present on testicular Leydig cells and ovarian theca, granulosa, luteal, and interstitial cells, plays a pivotal role in the regulation of gonadal development and function in males as well as in nonpregnant and pregnant females. The LH/CGR is a member of the family of G protein-coupled receptors and its structure is predicted to of a large extracellular domain connected to a bundle of seven membrane-spanning a-helices. The LH/CGR phosphorylation can be induced with a phorbol ester, but not with a calcium ionophore. The truncated form of LHR also was down-regulated normally in response to hCG stimulation. In contrast, the cell lines expressing LHR-t631 or LHR-628, the two phosphorylation-negative receptor mutant, showed a delay in the early phase of hCG-induced desensitization, a complete loss of PMA-induced desensitization, and an increase in the rate of hCG-induced receptor down-regulation. These results clearly show that residues 632~653 in the C-terminal tail of the LHR are involved in PMA-induced desensitization, hCG-induced desensitization, and hCG-induced down-regulation. Recently, constitutively activating mutations of the receptor have been identified that are associated with familial male-precocious puberty. Cells expressing LHR-D556Y bind hCG with normal affinity, exhibit a 25-fold increase in basal cAMP and respond to hCG with a normal increase in cAMP accumulation. This mutation enhances the internalization of the free and agoinst-occupied receptors ~2- and ~17- fold, respectively. We conclude that the state of activation of the LHR can modulate its basal and/or agonist-stimulated internalization. Since the internalization of hCG is involved in the termination of hCG actions, we suggest that the lack of responsiveness detected in cells expressing LHR-L435R is due to the fast rate of internalization of the bound hCG. This statement is supported by the finding that hCG responsiveness is restored when the cells are lysed and signal transduction is measured in a subcellular fraction (membranes) that cannot internalize the bound hormone.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.124-132
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• 1994

Radioactive iodine has been widely used in patients with thyroid cancer combined with surgical treatment. However, due to individual variations in absorption and excretion and uptake by tumor tissue of radioactive iodine, there are differences in therapeutic effect and adverse effects even if the same doses are administrated. So this study compared the therapeutic effect and radiation hazard by measuring internal radiation dose. Of total 27 patients with well differentiated thyroid cancer who had been thyroidectomized, we administered radioactive iodine 100 mCi, 150 mCi, 200 mCi. According to BEL DOSIMETRY PROTO-COL, beta and gamma ray dose were estimated from a pelt of the logarithm of the percent of dose per liter of whole blood versus day, and percent dose retained versus day using somilogarithmic paper, respectively. 1) Physical dose to whole blood averaged $56.54{\pm}13.02$ rad in 100 mCi administered group, $76.83{\pm}19.97$ rad in 150 mCi administered group, $95.08{\pm}25.51$ rad in 200 mCi administered group and there has been a significant correlation among the groups. 2) Mean percent dose retained 48 hours later was 26.34%. 3) There was no significant correlation of physical dose between absence and presence of metastasis. 4) 17 of 19 patients who has been followed up with TSH and serum throglobulin, Thallium scan were successfully ablated by radioactive iodine. 5) Leukocyte, lymphocyte, neutrophil, platelet counts all deelined in 4.6 weeks and most of all were restored 3 months later. 6) There was no significant correlation between physical dosimetry and biologic dosimetry. Generally administered doses of radioactive iodine (100-200 mCi) to patients with thyroid cancer postoperatively had developed transient bone marrow suppression and minimal chromosomal aberration, but they were within safety dose to blood (200 rad). And there has been no significant differences in residual dose 48 hours later between Korean and western people.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.98-103
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• 2014

Purpose: The effective half life of I-131 is useful to calculate radiation dose, period of hospitalization, and exposure dose of surrounding people from patient. However, it is difficult to measure. This study estimates the effective half life in whole body and thyroid in using of value of residual radioactivity obtained from the early and delay images of Dual time I-131 whole body scan. Also, the correlations between the effective half life and serum creatinine, GFR, and administration dose were investigated in this study. Materials and Methods: The targets were 50 patients administration high dose of I-131 from February to August in 2013, having normal range of serum creatinine and over $30{\mu}IU/mL$ of TSH levels. After administration radioactive I-131, the early scan in the 3rd day and the delay scan in the 5-6th days were performed. To measure the residual radioactivity in the whole body and thyroid, ROI was set and then background radioactivity was corrected to estimate. The effective half life was estimated by calculating the ratio of measured values between the early and delay images. To compare the effective half lives of the whole body and thyroid, it was analyzed by Independent t-test, and each correlation of the effective half life, GFR, serum creatinine, and the dose of administration were analyzed by calculating the pearson's correlation coefficient. All of the analysis were determined to be statistically significant when P<0.05. Results: The effective half life of the whole body was $17.06{\pm}5.50$ hours and of the thyroid was $17.22{\pm}5.41$ hours. The two effective half life did not show significant difference (P=0.887). As the value of GFR was increased, the effective half life of whole body (r=-0.407, P=0.003) and of thyroid (r=-0.473, P=0.001) were significantly decreased; as the value of serum creatinine was increased, the effective half life of whole body (r=0.309, P=0.029) and of thyroid (r=0.371, P=0.008) were significantly increased. In the administration dose, effective half life did not have correlations. Conclusion: The effective half life of I-131 of patients treated for their thyroids were estimated only by using the images of Dual time I-131 whole body scan. Also, the correlations with the effective life, GFR, and serum creatinine were examined. This study might be utilized for a study on optimization for the period of hospitalization of patients treated by high dose of I-131 and on evaluation for internal absorbed dose of MIRD schema in application of the effective half life.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.185-195
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• 1991

Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.