• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.148-151
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• 2014

Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, < $0.08{\mu}IU/L$ thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.

• 대한핵의학회지
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• 제5권1호
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• pp.33-47
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• 1971

• 한국의학물리학회지:의학물리
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• 제31권4호
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• pp.194-204
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• 2020

This study investigated and analyzed the Korean and international status of radioactive waste management for medical linear accelerators (linacs) and proceed prior research to suggest radiation safety regulations and guidelines for the safe use of radiation. We analyzed the number of linacs installed in the radiation oncology departments of 103 institutions. In addition, we analyzed the procedures and standards for disposal in Korea and foreign countries. For foreign countries, we analyzed the status based on reports from the United States, Japan, Europe, and Canada. A total of 182 linacs are installed in Korea and 95% of them use more than 10 MV of energy. In Korea, standards for managing radioactive waste from a linac, disposal procedures, and clearance criteria have yet to be established. Therefore, radioactive waste is disposed of in different ways depending on the hospitals where they originate. Japan, the US, and Canada have recommended clearance levels and procedures for linacs. Other countries have provided management guidelines for research or large-scale accelerators, but not for medical purposes. In this study, we investigated the management of radioactive waste from medical linacs in Korea and abroad. Several foreign countries have suggested a clearance level and criteria for disposing of waste storage drums. For the safe management of medical linacs, it is necessary to establish safety management regulations. In Korea, standards for disposal, such as radiation or dose limits, are required for medical linacs. A system for clearance when disposing at a medical institution should be created.

• 핵의학기술
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• 제16권2호
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• pp.12-17
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• 2012

방사성 요오드 치료병실에서 나온 환의 및 시트는 본디 방사성폐기물로서 관련 규정에 따라 일반 쓰레기와 동일하게 처리해야 하지만 사정상 일정기간 보관하여 방사능을 감쇄시킨 후 재사용하게 된다. 통상 최소보관기간 산출에 표면오염도(Bq/$m^2$)를 기반으로 하는 반출기준을 적용하고 있다. 하지만 방사선측정기를 이용하여 단위 면적당 총방사능량을 구하는 방법은 측정방법에 따라 편차와 불확실성이 상당히 커진다. 본 연구에서는 '방사성폐기물 자체처분 등에 관한 규정'에서 제시하고 있는 핵종 농도(Bq/g)를 Dose Calibrator를 이용하여 직접 측정하여 최소보관기간을 구함으로써, 환의 및 시트의 정확한 재사용 주기를 산출하고자 한다. 한편 반출기준으로 산출한 최소보관기간과 비교하여 그 차이를 살펴보았다. 본원의 방사성 요오드 치료병실에서 2011년 7월부터 2012년 3월까지 I-131을 3.7 GBq (100 mCi) 이상을 사용하여 방사성 요오드 치료를 시행한 환자 31명이 사용한 환의와 시트의 방사선 오염도를 측정하여 최소보관기간을 산출하였다. 최소보관기간은 핵종 농도를 측정하여 '방사성폐기물 자체처분 등에 관한 규정'에 따라 100 Bq/g이 되는 시점과 표면오염도를 측정하여 반출기준에 따라 허용표면오염도의 1/10, 즉 4 kBq/$m^2$되는 시점을 붕괴식에 대입하여 산출하였다. 반출기준으로 산출한 최소보관기간은 침대/담요시트는 14.2일, 베개시트는 4.6일, 환의(상(上))은 63일, 환의(하(下))는 78일 이었으며, 자체처분 기준에 따른 최소보관기간은 베개시트는 18.1일, 환의(상(上))은 43일, 환의(하(下))는 62일로 산출되었다. 표면오염도와 핵종 농도의 상관관계를 분석해 본 결과 베개시트와 환의(상(上))는 상관관계가 높게 나타났으나, 환의(하)는 낮게 나타났다. 이는 베개시트와 환의는 방사성오염이 부분에 국한 되어 측정값이 일정한 반면, 환의(하(下))는 소변에 의한 방사성오염이 여러 부분에 산재되어 있어 방사선측정기의 측정값이 상대적으로 낮게 측정된 결과로 생각 된다. 실질적으로 방사성 오염도를 측정한 결과 반출기준과 자체처분 기준을 상당량 초과하는 방사능이 존재하는 것을 확인할 수 있었다. 환의와 시트의 최소보관기간 산출에는 핵종 농도를 기준으로 하는 자체처분 기준을 적용하는 것이 더 적합하다고 할 수 있다. 방사능에 오염된 환의 및 시트는 최소 60일 정도는 보관해야 성급한 재사용에 따른 불필요한 방사선피폭 및 오염 확산을 방지할 수 있을 것으로 생각된다.

• 대한안과학회지
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• 제55권1호
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• pp.1-6
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• 2014

목적: 갑상선암에서 방사성 요오드 치료 후 발생한 코눈물길 폐쇄의 임상양상에 대해 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2011년 12월까지 갑상선암 수술 후 방사성 요오드 치료를 받은 환자 총 622명 중 눈물흘림 증상으로 성형안과에서 관류검사, 더듬자 검사 및 눈물주머니 조영술을 통해 코눈물길 폐쇄를 진단 받은 14명(18안)을 대상으로 하였다. 대상환자의 방사성 요오드 치료량과 횟수, 코눈물길 폐쇄의 임상양상, 치료법을 의무기록을 후향적으로 분석하여 확인하였다. 결과: 코눈물길 폐쇄가 진단된 환자 14명은 코눈물길 폐쇄가 발생하지 않은 환자군에 비해 평균 치료 용량($215.7{\pm}23.1mCi$, p=0.01)과 치료횟수($1.36{\pm}0.50$회, p<0.001)가 유의하게 높았다. 눈물흘림 증상 발생까지 평균 10.2개월, 진단까지 평균 18.4개월이 걸렸다. 14명(18안) 중 공통눈물소관폐쇄는 3명(3안), 코눈물관폐쇄는 11명(15안)이었다. 10명(13안)은 눈물길의 완전폐쇄가 확인되어 내시경하눈물주머니 코안연결술을 시행 받았으며, 4명(5안)은 부분폐쇄를 보여 내시경하 실리콘 관을 삽입하였다. 결론: 갑상선암에서 방사성 요오드 치료 후 코눈물길 폐쇄가 드물게 발생할 수 있다. 방사성 요오드 치료 후 눈물흘림 증상을 호소하는 환자가 있을 경우 합병증으로 코눈물길 폐쇄가 발생할 수 있음을 인지하고, 초기에 성형안과에 의뢰하여 전문적인 평가 및 치료가 시행되어야 한다.

• 대한핵의학회지
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• 제28권1호
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• pp.124-132
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• 1994

서론 : 방사성옥소는 갑상선암 환자에서 수술요법과 병용하여 많이 쓰이고 있으나 환자에 따라 방사성옥소 흡수량과 배설량, 암조직의 방사성옥소 섭취율이 차이가 나기 때문에 같은 양을 투여하더라도 치료효과나 부작용이 차이가 날 수 있다. 그러므로 본 연구에서는 체내 피폭된 물리적 선량을 측정하여 치료효과와 방사선영향의 정도를 비교하였다. 방법 : 수술요법을 시행한 분화된 갑상선암 환자 27명을 대상으로 하여 100mCi 150mCi, 200mCi의 방사성옥소를 투여하고 BEL DOSIMETRY PROTOCOL에 따라 방사선량을 구하고 반대수 용지위에 혈액 리터당 투여량에 대한 백분율의 로그값, 잔류량 백분율과 시간의 관계를 그래프로 그려 베타선량과 감마선량을 구한 뒤 총 물리학적 선량을 구하였다. 결과 : 1) 100mCi 투여군에서 물리적 선량은 평균 $56.54{\pm}13.02$ rad 이었고 150 mCi 투여군에서는 $76.83{\pm}19.97$ rad, 200mCi 투여군에서는 $95.08{\pm}25.51$ rad 이었고 각 평균값 사이에는 유의한 상관관계가 있었다. 2) 48시간후 체내 잔류율은 평균 26.34% 이었다. 3) 전이여부와 물리적 선량과의 사이에 유의한 상관관계는 없었다. 4) 갑상선 글로불린과 갑상선 자극 호르몬, Thallium scan으로 추적 관찰한 19명중 17명이 치유되었다. 5) 백혈구, 림프구, 호중구, 혈소판 모두 4-6주에 최저치로 감소한뒤 3개월내에 회복되었다. 6) 물리적 선량과 생물학적 선량 사이에 유의한 상관관계는 없었다. 결론 : 우리나라에서 수술후 갑상선암의 치료에 통상적으로 사용하는 방사성옥소의 양(100-200mCi)은 일시적 골수부전과 경도의 염색체 이상을 초래하나 혈액내방사선 조사량이 안전용량 범위(200rad)에 속하며 48시간 후 체내잔류량은 서양인과 큰 차이가 없었다.

• 동서간호학연구지
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• 제22권2호
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• pp.148-157
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• 2016

Purpose: The purpose of this study was to explore the meaning of the experience of receiving radioactive iodine therapy among patients with thyroid cancer. Methods: A qualitative research design was adopted. The participants were ten women diagnosed with thyroid cancer who had received radioactive iodine therapy within one year. Data were collected through in-depth interviews from October of 2015 to April of 2016. Individual interviews were recorded, and transcribed data were analyzed using Colaizzi's method. Results: The six categories of the experience of receiving radioactive iodine therapy were "Finally realizing having cancer," "The lonely fight that feels like prison life," "Narrower scope of life," "Lack of understanding by others," "Enduring a short, yet difficult journey," and "A turning point for a new life." Conclusion: This study provides deep insight into the experience of thyroid cancer patients who had received radioactive iodine therapy. Nurses should concern their distress during radioactive iodine treatment and manage psychological difficulties as well as physical symptoms. Support from family and health care providers may help them to overcome the hard journey.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4103-4107
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• 2015

Background: Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. Transarterial chemoembolisation (TACE) is the standardized therapy for intermediate stage HCC. However, the prognosis for HCC patients treated by TACE greatly varies. Thus, there is a critical need for finding biomarkers to predict the prognosis of HCC patients. The amino acid transporter-2 (ASCT2) is involved in tumorigenesis and progression of many malignancies. This study aimed to evaluate the predictive role of two single nuclear polymorphisms (SNPs, rs3826793 and rs2070246) in the ASCT2 gene in HCC patients treated by TACE. Materials and Methods: Two functional SNPs (rs3826793 and rs2070246) in the ASCT2 gene were selected and genotyped using the Sequenom iPLEX genotyping system in a cohort of 448 unresectable Chinese HCC patients treated by TACE. Univariate and multivariate Cox proportional hazards models and Kaplan-Meier curves were used for the prognosis analyses. Results: There was no significant association between two SNPs (rs3826793 and rs2070246) in the ASCT2 gene and overall survival of TACE treated HCC patients. However, we demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype (P=0.023). Conclusions: We demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.33-40
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• 2013

Background and Objectives:This study is to objectively compare and analyze the acoustic changes in the patients with total thyroidectomy before and after RI therapy. Subjects and Methods:For this study, a total of 50 patients with total thyroidectomy were participated as subjects. Voice samples were obtained at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis, the maximum phonation time and K-VHI (Korea-Voice handicap index) were used for subjective evaluation. Results:According to the comparison analysis of the three periods, mFo (Hz) was significantly reduced in all of the vowels /a/ and /i/ as the hormone was discontinued. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim (%) and APQ (%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI (voice handicap index). Conclusion:These results can be assumed that thyroid hormone suspension is related to the increased changes in the vocal intensity, the increase in noise and the reduction in vocal range. Emotionally, these data can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.

• 대한핵의학회지
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• 제9권1호
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• pp.59-71
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• 1975

53 patients with hyperthyroidism have been analyzed with special reference to therapeutic response to radioactive iodine ($^{131}I$) treatment. Mean effective half-life, 24 hour uptake rate and radiation dose of $^{131}I$ in hyperthyroid patients included in this study were respectively. 1. Mean effective half-life of $^{131}I\;was\;4.7{\pm}1.5$ days in the tracer dose and $5.0{\pm}1.5$ days in the therapeutic dose. 2. Mean 24 hour uptake rate of $^{131}I\;was\;72.7{\pm}11.1%$ in the tracer dose and $73.4{\pm}12.3%$ in the theapeutic dose. 3. Mean radiation dose of $^{131}I\;was\;5,319{\pm}2,648$ RAD as predicted and $5,692{\pm}2,843$ RAD as actual. A single dose of radioactive iodine treatment was satisfactory in 34 patients (radioiodine sensitive) and multiple doses of radioactive iodine treatments were required in 19 patients (radioiodine resistant). A radioiodine resistant group of patients with hyperthyroidism was distinctively characteristic in the following aspects. 1. Mean thyroid weight calculated in the resistant group ($63.9{\pm}14.0gm$) was significantly (p<0.01) greater than that of the sensitive group ($46.6{\pm}13.3gm$). 2. Mean 24 hour uptake rate of the tracer dose in the resistant group ($67.3{\pm}10.7%$) was significantly (p<0.01) lower than that of the sensitive group ($75.7{\pm}10.5%$). 3. Mean 24 hour uptake rate of the therapeutic dose in the resistant group ($68.5{\pm}13.7%$) was significantly (p<0.05) lower than that of the sensitive group ($76.1{\pm}10.9%$). 4. Mean predicted radiation dose, of $^{131}I$ in the resistant group ($3,684{\pm}1,745$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,232{\pm}2,683$ RAD). 5. Mean actual radiation dose of $^{131}I$ in the resistant group ($4,100{\pm}1,691$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,582{\pm}3,024$ RAD). 6. No significant difference was detected in terms of effective half-life of $^{131}I$ among the groups (p>0.05). 7. The average mean % difference of effective half-life, uptake rate and radiation dose measured following the tracer and therapeutic dose of $^{131}I$ were not statistically significant (p>0.05). Therefore effective half-life, uptake rate and radiation dose of the therapeutic dose of $^{131}I$ were readily predictable following the tracer dose of $^{131}I$. 8. It is concluded that the possibility of resistance to radioactive iodine treatment may be anticipated in patients with thyroid gland large in size and compromised $^{131}I$ uptake rate.