Brain metastasis is extremely rare in thyroid papillary carcinoma which has an indolent clinical course and results in good prognosis. A 24-year-old man presenting with seizure attack is described. He had been treated under the diagnosis of thyroid papillary carcinoma with total thyroidectomy, postoperative internal radiation with radioactive iodine, and thyroid hormone replacement. Although $^{99m}$Tc brain spect and $^{131}$I whole body scan did not revealed any significant lesion, brain CT and MRI showed lcm sized mass in frontal lobe. Stereotactic craniotomy and removal of the tumor, which was histologically proven metastatic lesion from thyroid papillary carcinoma, was done with satisfactory improvement.
Kim, Cheol-Su;Lee, Sang-Kuk;Lee, Dong-Myung;Choi, Seok-Won
Journal of Radiation Protection and Research
/
v.44
no.3
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pp.118-126
/
2019
Background: Government conducts environmental radioactivity surveillance for verification purpose around nuclear facilities based on the Nuclear Safety Law and issues a surveillance report every year. This study aims to evaluate the short and the long-term fluctuation of radionuclides detected above MDC and their origins using concentration ratios between these radionuclides. Materials and Methods: Sample media for verification surveillance are air, rainwater, groundwater, soil, and milk for terrestrial samples, and seawater, marine sediment, fish, and seaweed for marine samples. Gamma-emitting radionuclides including $^{137}Cs$, $^{90}Sr$, Pu, $^3H$, and $^{14}C$ are evaluated in these samples. Results and Discussion: According to the result of the environmental radioactivity verification surveillance in the vicinity of nuclear power facilities in 2017, the anthropogenic radionuclides were not detected in most of the environmental samples except for the detection of a trace level of $^{137}Cs$, $^{90}Sr$, Pu, and $^{131}I$ in some samples. Radioactivity concentration ratios between the anthropogenic radionuclides ($^{137}Cs/^{90}Sr$, $^{137}Cs/^{239+240}Pu$, $^{90}Sr/^{239+240}Pu$) were similar to those reported in the environmental samples, which were affected by the global fallout of the past nuclear weapon test, and Pu atomic ratios ($^{240}Pu/^{239}Pu$) in the terrestrial sample and marine sample showed significant differences due to the different input pathway and the Pu source. Radioactive iodine ($^{131}I$) was detected at the range of < $5.6-190mBq{\cdot}kg-fresh^{-1}$ in the gulfweed and sea trumpet collected from the area of Kori and Wolsong intake and discharge. A high level of $^3H$ was observed in the air (Sangbong: $0.688{\pm}0.841Bq{\cdot}m^{-3}$) and the precipitation (Meteorology Post: $199{\pm}126Bq{\cdot}L^{-1}$) samples of the Wolsong nuclear power plant (NPP). $^3H$ concentration in the precipitation and pine needle samples showed typical variation pattern with the distance and the wind direction from the stack due to the gaseous release of $^3H$ in Wolsong NPP. Conclusion: Except for the detection of a trace level of $^{137}Cs$, $^{90}Sr$, Pu, and $^{131}I$ in some samples, anthropogenic radionuclides were below MDC in most of the environmental samples. Overall, no unusual radionuclides and abnormal concentration were detected in the 2017's surveillance result for verification. This research will be available in the assessment of environment around nuclear facilities in the event of radioactive material release.
In this study, the radiation dose rate was measured by time and distance and evaluated whether radiation dose rate was suitable for domestic and international discharge criteria. In addition, the radiation dose emitted from the patient was measured with a glass dosimeter to evaluate the exposure dose if the caregiver stays in the isolated ward by placing a humanoid phantom instead of the caregiver at a distance of 1 m from the patient, on the second day of treatment. After 23 hours of isolation, the radiation dose rates at a distance of 1 m were 20.54 ± 6.21 µSv/h at 2.96 GBq administration and 27.94 ± 12.33 µSv/h at 3.70 GBq administration. The radiation dose rates at a distance of 1 m were 25.90 ± 2.21 µSv/h when 2.96 GBq was administered and 34.22 ± 10.06 µSv/h when 3.70 GBq was administered after 18 hours of isolation. However, if the isolation period is short may cause unnecessary radiation exposure to the third person. The reading of the attached dosimeter from the morning of the second day of treatment until removal was 0.01 to 0.95 mSv, which is a surface dose determined by the International Commission on Radiation Units and Measurements. And the depth dose was 0.01 to 0.99 mSv. On the second day of treatment, even if the patient caregivers stayed in the isolation ward, the exposure dose of the patient family did not exceed the effective dose limit of 5 mSv recommended by the ICRP and NCRP.
Objectives: It is certain that Radioactive iodine thyroid uptake(RAIU) rate should be measured with the standard counts considering the thyroid gland depth in enlarged thyroid patients for the variation from geometric factors. The purpose of this paper is to consider the effects of geometric factors according to detector to source distance and the effective thyroid depth on RAIU rate with experiment test. Materials and Methods: I-131 370 kBq ($10{\mu}Ci$) point source was measured by Captus-3000 thyroid uptake system (Capintec, NJ, USA) with a change Detector-Source Distance from 20 cm to 30 cm at an interval of 1 cm. And we changed the Neck phantom surface-Source Depth in the phantom with 1 cm, 2 cm, 5 cm using the neck phantom in order to reproduce the effective thyroid depth. Results: Every experimental group follows power curve as inverse square curve ($$R2{\geq_-}0.915$$). The average count rates in the case not using a phantom and the every case applied the effective thyroid depth using a phantom was not identical each other. There was significant fluctuations upon the effective thyroid depths applied the effective thyroid depth above 1 cm in $364.4 keV{\pm}10%$ energy ROI (p<0.01). There was not significant difference between the count rates of 1 cm and 2 cm in $364.4keV{\pm}20%$ and $637.1keV{\pm}6.2%$ (p=0.354, p=0.397). In assumed RAIU rate from regression equation, $364.4keV{\pm}20%$ was lower difference than $364.4keV{\pm}10%$ as 6.42% and 5.09% per 1 cm. Every change of count rate upon depth appears decreased line on Linear Regression, but the case of $284.3keV{\pm}10%$ increased only. And also, The graphs of coefficient of variation upon depth increased as straight line on every experimental group. Conclusion: The result appears that application of $364.4keV{\pm}20%$ energy ROI is more suitable for reducing error from the effective thyroid depth. And also, we can estimate the error of 20 cm should be highly reduced than 30 cm for Inverse Square Law. Therefore, If there is not information of the thyroid depth, it is considered that the error from thyroid depth can reduce through set up energy ROIs for $364.4keV{\pm}20%$, and increase Detector-Source Distances.
Hwang, Dong Hun;Oh, Shin Hyun;Kim, Jung Yul;Kang, Chun Koo;Kim, Jae Sam
The Korean Journal of Nuclear Medicine Technology
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v.21
no.1
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pp.70-75
/
2017
Purpose Radioactive iodine thyroid uptake (RAIU) rate is an examination which determines and seeks about general functions of thyroid gland. The size of thyroid gland is normally different between each person, also patients having thyroid diseases have had a variety of size of thyroid gland compared with others. The purpose of this study will investigate about the counting rate which is effected by the geometric factors through the length and volume changes of the source in RAIU rate. Materials and Methods I-131 185 kBq ($5{\mu}Ci$) were placed in a cylindrical phantom of 0.5 cm, 1 cm, 1.5 cm, and 3 cm in diameter, respectively, and saline was added to gradually increase the length by 1 cm in the horizontal and vertical directions to give a change in volume. The source was measured 20 times for 20 seconds from a distance of 25 cm to $364.4keV{\pm}20%$ energy ROI with Captus 3000 thyroid uptake system (Capintec, NJ, USA). Results When the source was located in the transverse direction of the detector, the consequence of one-way ANOVA is that even though the length of source is increased each diameter, there is mostly no significant difference. When the source was located in the longitudinal direction and the counting rate of length 1 cm at all diameter is set to 100%, the average is 92.57% for length 2 cm, 86.1% for 3 cm, 80.69% for 4 cm, 74.82% for 5 cm, and 69.68% at 6 cm. Conclusion According to this study, it is expected that the gap of RAIU rate has been depended on the thickness of thyroid gland as well as the diameter of the beaker. We know that the change of the volume with the increase of the length of the source had less effect on the change of the counting rate. Thus, in order to reduce the error in the measurement of the counting rate with the thyroid uptake rate equipment, an accurate counting rate can be relatively measured if the counting rate which is measured is corrected by thickness or the distance between the thyroid and the thyroid uptake rate equipment is changed.
Purpose: All acts which are enforced from the radioactive iodine therapeutic team is a in its own way principle and provision. Therefore unification of all acts can not be appropriately. We will make the standard coherence. Materials & Methods: From 5 November, 2007 to 17 November 2007, we conducted a questionnaire survey of the nuclear medicine manager of 30 hospitals. The contents of a questionnaire is medical treatment section, patient management, prosecuting attorney section, waste management and safety supervision in about the patient and a questionnaire was drawn up in the method which selects an item. Results: 30 hospital agencies are operating purely for I-131 high dose ablation therapy. Diagnostic study and daily schedule had the difference of some. The most of education for the patients took charge of doctor and nurse. The satisfaction of education was evaluated as the high thing. The safety supervision of waste management accomplishment and Safety supervision the patient and the worker observed on the basis of atomic energy law. Conclusion: Specific standards with sufficient amount of information and practical contents should have been presented through the following data. However, it seems to be lacking in many aspects. Nevertheless, respondents rated 70.9%, which is relatively high, on the value of clinical utilization, and I am very thankful for the evaluation. For many years from now, it may seem necessary for a lot of research on the specific matters based on these data to be conducted.
Lee, Wanno;Ji, Sang-Yun;Kim, Jin Kyu;Lee, Yun-Jong;Park, Jun Cheol;Moon, Hong Kil;Lee, Ju-Woon
Journal of Radiation Industry
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v.5
no.4
/
pp.337-345
/
2011
In order to provide an effective preparedness for a nuclear or radiological emergency happening in the domestic or neighborhood countries and to solve the vague fear of the people for the ingestion of radioactive livestock products, the establishment of national guideline level for radionuclides in feed is urgently necessary. This is because it is important to secure the safety and to manage the crisis in the agricultural, fishery and food sector by performing the effective safety control during and after nuclear incident. This study was performed to investigate the report cases of international organizations and foreign countries to set up a domestic control standard for managing radioactive substances that may be contaminated in animal feeds due to the nuclear power plant incident. In addition, an attempt was made to provide a useful reference that can help prepare a domestic control standard, using a coefficient that can consider the transfer into livestock through the intake of radioactive contaminated animal feeds. The standard radioisotopes investigated were confined to radioactive cesium ($^{137+134}Cs$) and iodine ($^{131}I$). Guideline level for the radionuclides was calculated by using the transfer coefficient factor and the maximum daily intake of animal feed provided by IAEA. For example, the maximum daily intake of animal feed was set as $25kg\;d^{-1}$ for dairy cows, $10kg\;d^{-1}$ for beef cattle, $3.0kg\;d^{-1}$ for pigs and $0.15kg\;d^{-1}$ for chickens. The result values for radioactive cesium were calculated as $8,696Bq\;kg^{-1}$, $4,545Bq\;kg^{-1}$, $1,667Bq\;kg^{-1}$ and $2,469Bq\;kg^{-1}$, respectively. The results for radioactive iodine showed the ranges between $741Bq\;kg^{-1}$ and $76,628Bq\;kg^{-1}$. These data can be utilized as a scientific reference for the preparation of a crisis management manual for the emergency control due to nuclear power plant accident in Korea and neighboring country. These results will contribute to establish the safe feed management system at national level as manual for responding the radioactive exposure of agricultural products and animal feeds, which are currently not established.
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.
Jo, Ki Won;Koh, Jang Hyun;Lee, Mi Young;Jung, Feel Moon;Shin, Young Goo;Yong, Suk Joong;Chung, Choon Hee
Tuberculosis and Respiratory Diseases
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v.62
no.5
/
pp.417-420
/
2007
Sarcoidosis is a multisystemic granulomatous disease with an of unknown etiology, involving bilateral hilar lymphadenopathy, pulmonary, skin and eye lesions. However, involvement of the endocrine system in sarcoidosis is quite rare, and the coexistence of both diseases is extremely unusual. We describe a 60-year-old woman presenting with sarcoidosis and Graves' disease. She was admitted for evaluation of dry cough, dyspnea, palpitation and general weakness. Both thyroid glands were enlarged diffusely. The thyroid function tests showed suppressed serum thyrotropin and an increased thyroid hormone level. The levels of the TSH receptor antibody, anti-thyroglobulin antibody and anti-microsomal antibody were higher than normal. The radionuclide scan($^{131}I$) showed increased iodine uptake. The chest X-ray revealed pulmonary hilar enlargement and high resolution CT showed both hilar lymph nodes enlargement and tiny parenchymal nodules. The transbronchial lung biopsy showed a noncaseating granuloma without necrosis. We report this case of pulmonary sarcoidosis plus Graves' disease with a review of the relevant literatures.
The serum concentrations of thyrotropin (TSH) were measured by means of radioimmunoassay, in 98 cases of normal controls, 51 cases of hyperthyroidism, 80 cases of primary hypothyroidism and 4 cases of secondary hypothyroidism to evaluate the diagnostic significance in various functional states of the thyroid. The obtained data were analyzed in correlation with other thyroid function test values in various phases of the functional thyroid diseases. The results were as follows: 1) The serum TSH concentration in normal control group was $<1.3{\sim}8.0{\mu}U/ml$. 2) The measurement of serum TSH was more significant in diagnostic accuracy compared with that of serum $T_4(75.0{\pm}12.2%)$. Free $T_4$ Index ($64.2{\pm}15.2%$), serum $T_3(41.0{\pm}21.0%)\;or\;T_3$ resin uptake ($41.1{\pm}15.8%$) in evaluation of primary hypothyroidism. 3) In case of overt hypothyroidism, the serum TSH and $T_4$ were both abnormal, compatible with the clinical diagnosis, while in case of preclinical or mild hypothyroidism, the serum $T_4(41.2{\pm}23.8%)\;or\;50.0{\pm}25.0%)$ was much less reliable than serum TSH. 4) In the treatment of primary hypothyroidism with desiccated thyroid, the administration of 1 grain of the hormone per day was sufficient to suppress the serum concentration of TSH to normal range. It showed that the measurement of serum TSH concentration was a significant criteria in evaluating the efficiency of the treatment of hypothyroidism. 5) The measurement of serum TSH concentration is a very significant method in the early detection of hypothyroidism induced during or after the treatment of the hyperthyroidism with antithyroid drugs or radioactive Iodine ($^{131}I$).
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