• International journal of thyroidology
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• v.11 no.2
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• pp.137-142
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• 2018

Background and Objectives: Radioactive iodine therapy (RAI) is an important treatment modality of Graves' disease (GD), but there is still not a consensus on the optimal dosage regimen. We studied the treatment success rate of different RAI doses, and examined which clinical markers were useful for determining the optimal RAI dosage for successful therapy in Korean patients. Materials and Methods: We retrospectively studied 123 patients with GD treated with RAI between 2004 and 2014 at Chonnam National University Hwasun Hospital. The responder group was defined as patients who developed hypothyroidism requiring levothyroxine replacement following RAI, regardless of the RAI dosage. Results: A total of 54 patients (43.9%) became hypothyroid after the first dose, and 31 needed two to four additional doses to achieve hypothyroidism. In the responder group as a whole (85 patients), the mean total dose of RAI was $15.5{\pm}7.0mCi$ and the mean thyroid volume (TV) was $35.4{\pm}23.4mL$. When divided into low dose (<15 mCi, n=46) and high dose (${\geq}15mCi$, n=39) responder groups, TV was significantly lower in the low-dose responder group ($25.7{\pm}11.4$ vs. $48.4{\pm}31.3$, p<0.001). The optimal cut-off TV for the low-dose responder group was <32.37 mL (sensitivity 80.9%, specificity 76.7%). Conclusion: TV had significant effects on the outcome of RAI in GD patients. The optimal fixed RAI dose for Korean GD patients with a large goiter (${\geq}33mL$) should be at least 15 mCi to achieve the best outcome.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.111-114
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• 2017

Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.143-146
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• 2021

A 2-year-old intact female Maltese dog was presented with generalized involuntary tremors and nystagmus without regular direction. The dog was conscious the whole time while it was trembling. Its involuntary tremors were alleviated at rest or during sleep. Magnetic resonance imaging (MRI) revealed asymmetric hydrocephalus and caudal occipital malformation. In cerebrospinal fluid (CSF) analysis, a trace of protein was found and total nucleated cell count (TNCC) was slightly increased. However, infectious pathogens were not found. In complete blood count, there was a mild leukocytosis. After the patient received anticonvulsants (midazolam, phenobarbital, KBr), diuretics (furosemide) with an anti-inflammatory drug (prednisolone, 0.5 mg/kg PO bid), and a proton-pump inhibitor (omeprazole), it showed no improvement. The patient was tentatively diagnosed with corticosteroid responsive tremor syndrome. So the anticonvulsants and diuretics were discontinued and the dose of prednisolone was increased to an immunosuppressive dose (1 mg/kg PO bid). After administering the immunosuppressive dose of prednisolone, the patient did not show nystagmus. Its tremors were much alleviated. However, they did not disappear. Five weeks later, the patient showed gradual improvement but still was trembling when moving around. Nine weeks later, its tremors were similar to before. So diazepam (0.3 mg/kg PO sid) was added to the treatment. After that, its tremors were alleviated more. Prednisolone and diazepam were maintained for about five months, with tapering of the dose of prednisolone (until 0.5 mg/kg PO sid). About 7 months later after the treatment was started, the dog was trembling rarely except when it was excited. Therefore, diazepam was discontinued. This case describes a refractory white dog shaker syndrome successfully managed with long-term administration of a steroid and diazepam.

• Progress in Medical Physics
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• v.24 no.4
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• pp.253-258
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• 2013

The purpose of this study is to evaluate and analyze the relationship between the external radiation dose reconstruction which is transmitted from the patient who receives radiation treatment through electronic portal imaging device (EPID) and the internal dose derived from the Monte Carlo simulation. As a comparative analysis of the two cases, it is performed to provide a basic indicator for similar studies. The geometric information of the experiment and that of the radiation source were entered into Monte Carlo n-particle (MCNPX) which is the computer simulation tool and to derive the EPID images, a tally card in MCNPX was used for visualizing and the imaging of the dose information. We set to source to surface distance (SSD) 100 cm for internal measurement and EPID. And the water phantom was set to be 100 cm of the source to surface distance (SSD) for the internal measurement and EPID was set to 90 cm of SSD which is 10 cm below. The internal dose was collected from the water phantom by using mesh tally function in MCNPX, accumulated dose data was acquired by four-portal beam exposures. At the same time, after getting the dose which had been passed through water phantom, dose reconstruction was performed using back-projection method. In order to analyze about two cases, we compared the penetrated dose by calibration of itself with the absorbed one. We also evaluated the reconstructed dose using EPID and partially accumulated (overlapped) dose in water phantom by four-portal beam exposures. The sum dose data of two cases were calculated as each 3.4580 MeV/g (absorbed dose in water) and 3.4354 MeV/g (EPID reconstruction). The result of sum dose match from two cases shows good agreement with 0.6536% dose error.

• The Journal of Internal Korean Medicine
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• v.36 no.1
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• pp.1-12
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• 2015

Objectives : This study was performed to investigate the anti-cancer effects of Rhus verniciflua Stokes (RVS) extracted with sterile distilled water on cholangiocarcinoma cell lines. Materials and Methods : Two cholangiocarcinoma cell lines, SNU-1079 and SNU-1196, were used in this study. Cells were treated with different concentrations of RVS for 24, 48, and 72 hours. Cell count, viability, apoptosis, and mRNA expression of Bax, Bcl-2, Mcl-1, survivin, caspase-3, and cyclin D1 and P21 were determined with an automatic cell counter (ADAM-MC), MTT assay, apoptosis assay (Annexin-V/PI staining), and RT-PCR. Results : All cells treated with RVS showed decreased cell counts in a dose-dependent manner. RVS inhibited proliferation of SNU-1196 in a dose-dependent manner, but SNU-1079 proliferation was inhibited in the long-time culture group in a dose-dependent manner. The proportion of early and late-stage apoptotic cells was increased by RVS in a dose-dependent manner in SNU-1196. In contrast, it was increased significantly in SNU-1079 treated with high-dose RVS. After treatment with RVS, the mRNA expression of Bcl-2 was decreased while Bax was increased in SNU-1079. Cyclin D1 mRNA levels were decreased in SNU-1196 in a dose-dependent manner. P21 expression was increased in all cells after the treatment with RVS. Conclusions : RVS appears to have potential as a therapeutic agent for cholangiocarcinoma.

• Journal of Radiation Protection and Research
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• v.41 no.2
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• pp.133-140
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• 2016

Backgrounds: The accident at Fukushima Daiichi Nuclear Power Plant (NPP), March 2011, caused serious radioactive contamination over wide area in east Japan. Therefore, it is important to know the effect of the accident and the status of NPP. Materials and Methods: This paper provides a review on the status of radiation dose and radioactive contamination caused by the accident on the basis of publicized information. Results and Discussion: Monitoring of radiation dose and exposure dose of residents has been conducted extensively by the governments and various organizations. The effective dose of general residents due to the accident proved to be less than a mSv both for external and internal dose. The equivalent committed dose of thyroid was evaluated to be a few mSv in mean value and less than 50 mSv even for children. Monitoring of radioactivity concentration has been carried out on food ingredients, milk and tap water, and actual meal. These studies indicated the percentage of foods above the regulation standard was over 10% in 2011 but decreasing steadily with time. The internal dose due to foods proved to be tens of ${\mu}Sv$ and much less than that due to natural $^{40}K$ even in the Fukushima area and decreasing steadily, although high level concentration is still observed in wild plants, wild mushrooms, animals and some kind of fishes. Conclusion: According to extensive studies, not only the effect of the accident but also the pathway and countermeasures against radioactive contamination have been revealed, and they are applied very effectively for restoration of environment and reconstruction of the area.

• Progress in Medical Physics
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• v.28 no.4
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• pp.181-189
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• 2017

The conventional delivery quality assurance (DQA) process for RapidArc (Varian Medical Systems, Palo Alto, USA), has the limitation that it measures and analyzes the dose in a phantom material and cannot analyze the dosimetric changes under the motional organ condition. In this study, a DQA method was designed to overcome the limitations of the conventional DQA process for internal target volume (ITV) based RapidArc. The dynamic DQA measurement device was designed with a moving phantom that can simulate variable target motions. The dose distribution in the real volume of the target and organ-at-risk (OAR)s were reconstructed using 3DVH with the ArcCHECK (SunNuclear, Melbourne, USA) measurement data under the dynamic condition. A total of 10 ITV-based RapidArc plans for liver-cancer patients were analyzed with the designed dynamic DQA process. The average pass rate of gamma evaluation was $81.55{\pm}9.48%$ when the DQA dose was measured in the respiratory moving condition of the patient. Appropriate method was applied to correct the effect of moving phantom structures in the dose calculation, and DVH data of the real volume of target and OARs were created with the recalculated dose by the 3DVH program. We confirmed the valid dose coverage of a real target volume in the ITV-based RapidArc. The variable difference of the DVH of the OARs showed that dose variation can occur differently according to the location, shape, size and motion range of the target. The DQA process devised in this study can effectively evaluate the DVH of the real volume of the target and OARs in a respiratory moving condition in addition to the simple verification of the accuracy of the treatment machine. This can be helpful to predict the prognosis of treatment by the accurate dose analysis in the real target and OARs.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.149-153
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• 1984

Postoperative radiotherapy of breast cancer makes it possible to reduce loco-regional recurrence of breast cancer. The treatment technique, which can reduce the low-dose region at the junction and lung, is required. To produce proper dose distribution of internal mammary chain and chest wall, authors tried to find the method to expose $^{60}Co\;\gamma-ray$ on internal mammary region and 7MeV electron on chest wall. Exposure time of $^{60}Co\;\gamma$ and monitor unit of 9MeV were selected so that dose of $^{60}Co$ at 4cm depth was the same as that of 7Mev electron at $80\%$ dose depth. The position and direction of electron beam were changed for $^{60}Co$ beam: $0^{\circ},\;5^{\circ}$ for 0cm seperation; $0^{\circ},\;5^{\circ},\;10^{\circ}$ for 0.5cm seperation; $5^{\circ},\;10^{\circ},\;15^{\circ}$ for 1cm seperation. The results are as followings. 1. When the seperation of two fields was increased, dose on the axis of $^{60}Co$ beam was increased and dose at the junction region decreased while the volume of lung to be exposed to high dose and hot spot size were irregularly changed. 2. The dose distribution in the target volume of internal mammary and chest wall was most ideal when the seperation of two fields was $0\~0.5cm$ and the direction of electron beam was parallel to $^{60}Co$ beam.

• Journal of Radiation Protection and Research
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• v.45 no.2
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• pp.53-68
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• 2020

Background: International organizations such as the World Health Organization (WHO) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) reported public exposure doses due to radionuclides released in the Fukushima nuclear accident a few years after the event. However, the reported doses were generally overestimated due to conservative assumptions such as a longer stay in deliberate areas designated for evacuation than the actual stay. After these reports had been published, more realistic dose values were reported by Japanese scientists. Materials and Methods: The present paper reviews those reports, including the most recently published articles; and summarizes estimated effective doses (external and internal) and issues related to their estimation. Results and Discussion: External dose estimation can be categorized as taking two approaches-estimation from ambient dose rate and peoples' behavior patterns-and measurements using personal dosimeters. The former approach was useful for estimating external doses in an early stage after the accident. The first 4-month doses were less than 2 mSv for most (94%) study subjects. Later on, individual doses came to be monitored by personal dosimeter measurements. On the basis of these measurements, the estimated median annual external dose was reported to be < 1 mSv in 2011 for 22 municipalities of Fukushima Prefecture. Internal dose estimation also can be categorized as taking two approaches: estimation from whole-body counting and estimation from monitoring of environmental samples such as radioactivity concentrations in food and drinking water. According to results by the former approach, committed effective dose due to ¹³⁴Cs and ¹³⁷Cs could be less than 0.1 mSv for most residents including those from evacuated areas. Conclusion: Realistic doses estimated by Japanese scientists indicated that the doses reported by WHO and UNSCEAR were generally overestimated. Average values for the first-year effective doses for residents in two affected areas (Namie Town and Iitate Village) were not likely to reach 10 mSv, the lower end of the doses estimated by WHO.

• Tuberculosis and Respiratory Diseases
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• v.53 no.6
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• pp.656-661
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• 2002

Amidarone is one of the most commonly prescribed anti-arrythmic agents for almost all arrythmias, whether atrial or ventricular in origin. There are several side effects associated with amiodarone therapy. These include corneal deposits, abnormal liver function tests, hyper and hypothyroidism, bluish discolorations of the skin, bone marrow suppression, coagulopathies, peripheral neuropathies, and pulmonary toxicity. Amiodarone-induced pulmonary toxicity(APT), which was first described in 1980, is potentially serious side effects that are believed to develop in 5% of patients. Doctors often assume that APT occurs only when high amiodarone doses are used for a long time, but in practice a low maintenance dose of amiodarone may also be toxic. In this report, a case of amiodarone-induced pulmonary toxicity after a long course of a low dose therapy for refractory supraventricular arrythmia is described.