• Title/Summary/Keyword: assessment standard

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Vitamin D analysis in the Korean total diet study and UV/sun light irradiated mushrooms (한국형 총식이조사 및 UV/태양광 조사 버섯에서의 비타민 D 분석)

  • Min-Jeong Seo;In-Hwa Roh;Jee-Yeon Lee;Sung-Ok Kwon;Cho-Il Kim;Gae-Ho Lee
    • Food Science and Preservation
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    • v.30 no.1
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    • pp.109-121
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    • 2023
  • This study was conducted to evaluate vitamin D intake of Koreans in a total diet study (TDS) and to determine the effect of irradiation on vitamin D synthesis in mushrooms. For analysis, sample were saponified and extracted with hexane, and vitamin D was quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the validation results, the recovery of the National Institute of Standards and Technology (NIST) standard reference sample (SRM) 1849a was 96.7% and the z-score of -1.6 was obtained by the Food Analysis Performance Assessment Scheme (FAPAS) proficiency test (PT) 21115. Vitamin D2 was not detected in any samples, and the highest level of vitamin D3 was detected in mackerel and anchovies ranging from 24.2 to 120.2 ㎍/kg. The mean daily intake of vitamin D was 0.99 ㎍/day, as estimated from the vitamin D contents of the analyzed foods and their corresponding intake. The adequate intake (AI) of vitamin D based on the Dietary reference intakes for Koreans provided by the Ministry of Health and Welfare is 5-15 ㎍/day for Koreans aged 6 to 75 years. Compared with this AI, vitamin D intake of Koreans estimated in this study was inadequate. For that, the increased vitamin D content in ultraviolet (UV)/sun light irradiated mushrooms warrants further research to increase vitamin D intake of Koreans through diet.

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

  • Eun Ju Ha;Sae Rom Chung;Dong Gyu Na;Hye Shin Ahn;Jin Chung;Ji Ye Lee;Jeong Seon Park;Roh-Eul Yoo;Jung Hwan Baek;Sun Mi Baek;Seong Whi Cho;Yoon Jung Choi;Soo Yeon Hahn;So Lyung Jung;Ji-hoon Kim;Seul Kee Kim;Soo Jin Kim;Chang Yoon Lee;Ho Kyu Lee;Jeong Hyun Lee;Young Hen Lee;Hyun Kyung Lim;Jung Hee Shin;Jung Suk Sim;Jin Young Sung;Jung Hyun Yoon;Miyoung Choi
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.2094-2123
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    • 2021
  • Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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Assessment of Demand and Use of Fresh-Cut Produce in School Foodservice and Restaurant Industries (학교급식 및 외식업체에서의 신선편이 농산물 사용실태 및 요구도 평가)

  • Sun, Shih-Hui;Kim, Ju-Hee;Kim, Su-Jin;Park, Hye-Young;Kim, Gi-Chang;Kim, Haeng-Ran;Yoon, Ki-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.6
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    • pp.909-919
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    • 2010
  • The purpose of this study was to investigate the demand and use of fresh-cut produce in school foodservice and restaurant industries. The subjects of this survey study were 200 school nutritionists and 70 cooks or managers in the restaurant industry nationwide. The data were collected by means of self-administered or e-mail questionnaires. Data analysis was completed using the SPSS window (ver. 12.0) program including frequency, $\chi^2$-test and t-test. Survey questions assessed the general characteristic of respondents, and the supply, use, and demand of fresh-cut produce in school foodservice and restaurant industries. Over 74% of the subjects have used fresh-cut produce. Most of the school foodservice (84.0%) kept fresh-cut produce for one day, while restaurant industry (28.3%) kept them up to three days. The nutritionists of school foodservice and managers of restaurant industry considered origin and date of production as the most important factor, respectively, when fresh-cut produce were being used. Fresh-cut root vegetable, such as potato and carrot was used mostly. The main reason not to use the fresh cut produce was due to the distrust of the fresh-cut produce safety in school foodservice and cost in restaurant industry. The main problem in fresh-cut produce use was the need of rewashing (29.9%) in school foodservice and irregular size (39.0%) in restaurant industry. These results indicate that the quality standard and size specification must be prepared with production guideline of safe fresh-cut produce.

Usefulness Evaluation of Open Mouth View when PET/CT scan In Tongue Cancer Patients (Tongue Cancer 환자에서 PET/CT 검사 시 Open Mouth 촬영법의 유용성 평가)

  • Kim, Jae Hwan;Yun, Jong Jun;Jung, Ji Wook;Kim, Jung Wook;Hwang, Ju Won;Ji, Hye In
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.14-20
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    • 2016
  • Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

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Current Status of Children Born from Renal Transplanted Mother (신이식을 받은 산모로부터 출생한 소아의 성장상태)

  • Ki Mina;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Moon Jang Il;Kim Soon Il;Kim Yu Seun;Park Kiil;Park Young Won
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.77-83
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    • 2000
  • Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

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The Factors Affecting on the Franchisor's Performance and Its Intention of Recontracting with Franchisees : Focused on the Chinese Franchise Market (프랜차이즈 본부의 성과 및 재계약의도에 영향을 미치는 요인들에 관한 연구 : 중국프랜차이즈 시장을 중심으로)

  • Shuai, Su;Seo, Sang-Yun;Lee, Hoon-Yong
    • Journal of Distribution Research
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    • v.17 no.3
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    • pp.1-24
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    • 2012
  • Franchises have recently emerged as the most rapidly expanding industry positioned to create a large impact in the domestic economic. The Chinese franchise industry developed rapidly in the period prior and subsequent to WTO accession with more than 50% of new franchises brands emerging since 2000. M&A transactions in the Chinese franchise industry have progressed actively. In the period from 2005-2007, due to the wholesale and retail market opening in accordance with the guidelines laid forth within the MOU by the WTO the Chinese franchise market is now the largest market in the world all despite a short history of only 20 years. The amount of franchise market research on China is disproportional to its current size and development potential. Beginning in the 1990s, market research conducted by the International Franchise Association focused on emerging markets in Eastern Europe and China. While the research dealt with the Chinese investment environment, it insufficiently explained the market region and cultural environment. The purpose of this research is (i) to investigate the determinants of the performance of franchise systems in China and (ii) new contract renewals based on performance factors. This study will complement existing research in terms of the franchisee perspective. This study may also prove of the benefit to the franchise companies entering the Chinese franchise market enabling them to develop an effective strategy. This study shows that support, incentives, and system standardization by franchisor yielded a positive effect on management performance. This is consistent with previous studies by Shin (2000) and Kim (2008) targeting Korean franchises. Therefore, in the Chinese market, the franchisor must focus on support, incentives, and system standardization rather than concentrate only on the recruitment of franchisees in order to improve revenue. Hypotheses regarding franchisor control have been dismissed in existing research, in the opinion of this study, due to their complexity and inability to control the merchant as a one-kind-assessment-standard. Our findings show that the franchisees' financial condition, management ability and entrepreneurial spirit, among franchisee's characteristics, have a positive effect on franchisor's business performance and satisfaction for the franchisee. This is consistent with previous studies on headquarters' management performance of Lussier (1996), Heo and Jang (2008), and franchisees' financial condition, management ability and entrepreneurial spirit effect on franchisor's satisfaction of Weaven and Franzer (2007), Kim (2009), Han (2009), and Yoon etc. (2008). Therefore, when permitting a franchisee, financial condition, management ability, entrepreneurship of the franchisee should be carefully considered. Among relational factors between franchisor and franchisee, trust has the positive influence on the management performance of the franchisor while conflict has a negative effect. However, trust, commitment and conflict factors have been shown not to have any impact on the satisfaction of the franchise headquarters. This result is consistent with the previous studies of Pavlou and Ba (2000), Morrison (1999), Weaven and Frazer (2007), Kim and Park (1994), Sohn (2007) which show that trust between franchisor and the franchisees have a positive effect and that conflict has a negative impact on franchisor's management performance. Other factors causing a negative effective on the franchisor's management performance are a rapid environmental changes and uncertainty in the business. This is consistent with Campbell et al (2007), Kim and Kim (2009), Han and Baek (2008). Finally, the high management performance and satisfaction of the franchise headquarters has a positive effect on the intention of franchise renewal. In the case of large markets such as China, the franchisor's strategy and the role is very important. In this study, we also investigated the characteristics of franchisor and franchisee, relationship, and environmental uncertainty affecting on the management performance and satisfaction of franchisor. Recently, Korean franchises are attempting to enter foreign markets through the rise in popularity of Korean culture and entertainment commonly referred to as the Korean wave. This study provides recommendations for Korean franchises intending on entering the Chinese market. First, in order to achieve stable profits, the franchise corporation needs to support the operation of the individual franchisee through incentives and standardization of services. Second, because trust between the franchisor and franchisee has a positive effect on management performance, on-going discussion and cooperation is necessary to reduce the level of conflict.

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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Application of OECD Agricultural Water Use Indicator in Korea (우리나라에 적합한 OECD 농업용수 사용지표의 설정)

  • Hur, Seung-Oh;Jung, Kang-Ho;Ha, Sang-Keun;Song, Kwan-Cheol;Eom, Ki-Cheol
    • Korean Journal of Soil Science and Fertilizer
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    • v.39 no.5
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    • pp.321-327
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    • 2006
  • In Korea, there is a growing competitive for water resources between industrial, domestic and agricultural consumer, and the environment as many other OECD countries. The demand on water use is also affecting aquatic ecosystems particularly where withdrawals are in excess of minimum environmental needs for rivers, lakes and wetland habits. OECD developed three indicators related to water use by the agriculture in above contexts : the first is a water use intensity indicator, which is expressed as the quantity or share of agricultural water use in total national water utilization; the second is a water stress indicator, which is expressed as the proportion of rivers (in length) subject to diversion or regulation for irrigation without reserving a minimum of limiting reference flow; and the third is a water use efficiency indicator designated as the technical and the economic efficiency. These indicators have different meanings in the aspect of water resource conservation and sustainable water use. So, it will be more significant that the indicators should reflect the intrinsic meanings of them. The problem is that the aspect of an overall water flow in the agro-ecosystem and recycling of water use not considered in the assessment of agricultural water use needed for calculation of these water use indicators. Namely, regional or meteorological characteristics and site-specific farming practices were not considered in the calculation of these indicators. In this paper, we tried to calculate water use indicators suggested in OECD and to modify some other indicators considering our situation because water use pattern and water cycling in Korea where paddy rice farming is dominant in the monsoon region are quite different from those of semi-arid regions. In the calculation of water use intensity, we excluded the amount of water restored through the ground from the total agricultural water use because a large amount of water supplied to the farm was discharged into the stream or the ground water. The resultant water use intensity was 22.9% in 2001. As for water stress indicator, Korea has not defined nor monitored reference levels of minimum flow rate for rivers subject to diversion of water for irrigation. So, we calculated the water stress indicator in a different way from OECD method. The water stress indicator was calculated using data on the degree of water storage in agricultural water reservoirs because 87% of water for irrigation was taken from the agricultural water reservoirs. Water use technical efficiency was calculated as the reverse of the ratio of irrigation water to a standard water requirement of the paddy rice. The efficiency in 2001 was better than in 1990 and 1998. As for the economic efficiency for water use, we think that there are a lot of things to be taken into considerations to make a useful indicator to reflect socio-economic values of agricultural products resulted from the water use. Conclusively, site-specific, regional or meteorogical characteristics as in Korea were not considered in the calculation of water use indicators by methods suggested in OECD(Volume 3, 2001). So, it is needed to develop a new indicators for the indicators to be more widely applicable in the world.

Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan (분화 갑상선암 수술 후 최초 고용량 방사성옥소 치료시 투여용량 결정: 병리적 병기, 혈청 갑상선글로불린치와 I-123 전신 스캔의 유용성 비교)

  • Jeong, Hwan-Jeong;Lim, Seok-Tae;Youn, Hyun-Jo;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.301-306
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    • 2008
  • Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.