• Radiation Oncology Journal
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• v.35 no.2
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• pp.112-120
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• 2017

Purpose: To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. Materials and Methods: Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). Results: The age range was 26-87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. Conclusion: Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.2
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• pp.49-54
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• 2017

Purpose The high-dose administration of I-131 has been standing for the basic therapy method of thyroid cancer. In korea, it is not necessary for patients to be hospitalized if the administration dose are under 1.2 GBq. However, if the dose are over 1.2 GBq, the patients should be stay in special ward with radiation shield. In such cases, the radioactivity level upon release should be under a dose of $70{\mu}Sv/hr$ at a distance of approx. 1m. This regulation bring the patients to stay for about 2 to 3 days in ward before the release. Materials and Methods Using the inpatients' release data of severance hospital, an inpatient-days were retrospectively calculated and compared with practical data and estimate the inpatient-days with the conditions of korea ($70{\mu}Sv/hr$), Japan ($30{\mu}Sv/hr$), germany ($3.5{\mu}Sv/hr$ at a distance of approx. 2 m), and other european countries. Results When a effective half-life of 15.4 was used, the expected inpatient-days were calculated as 2.15 days in the condition of Japanese regulation and 1.37 days in the condition of korean regulation. The practical inpatient-days of patients in Severance hospital were 1.32 days. Conclusion As ICRP 94 has been mentioned that the release of patients administrated with I-131 for the therapy should be carefully considered because each patients has different thyroid uptake rate and their conditions with family members after the release from the ward. Nonetheless, efforts to bring more aquate data which is for getting closer to the practical data should be continuously studied.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.471-476
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• 2022

The purpose of this study was to study the probability of cancer occurrence due to photoneutron dose exposure of the colon and thyroid gland, which are normal organs, in 3D CRT, IMRT 5 portals, and IMRT 9 portals, which are radiotherapy methods for prostate cancer. The total prescribed dose for prostate cancer was 6600 cGy, 220 cGy per dose, and 30 divided irradiations were applied for the total number of times. After setting up the Rando phantom on the treatment table (couch) of the medical linear accelerator used in the experiment, an optically stimulated luminescence albedo neutron dosimeter was placed on the corresponding area of the large intestine and thyroid gland of the phantom for measurement. During 3D CRT of prostate cancer, the probability of secondary cancer due to photoneutron dose to the colon and thyroid gland, which are normal organs, was 1.8 per 10,000 people. And IMRT 5 portals were 8.7 per 10,000 people, which was about 5 times larger than 3D CRT. IMRT 9 portals derived the result that there is a probability that 1.2 people per 1,000 people will develop cancer. Based on this study, the risk of secondary radiation exposure due to the dose of photoneutrons generated during radiation therapy is studied, and it is thought that it will be used as useful data for radiation protection in relation to the stochastic effect of radiation in the future.

• International journal of thyroidology
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• v.10 no.1
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• pp.50-55
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• 2017

Sweet's syndrome, or acute febrile neutrophilic dermatosis, occurs in association with autoimmune diseases such as Hashimoto's thyroiditis but is rare in Graves' disease, in which all cases are induced by propylthiouracil (PTU). We report a case of Sweet's syndrome in a patient with Graves' disease treated with methimazole (MMI) during three weeks. A 34-year-old man presented with the acute onset of high fever, skin rashes on the whole body, arthralgia, and acroparesthesia. Laboratory results showed leukocytosis and elevated C-reactive protein. MMI first stopped and antibiotics and antihistamine therapy started, but his symptoms dramatically improved after oral prednisolone. Graves' disease has again been treated by MMI because of his aggravated ophthalmopathy. After one year of retreatment with MMI, there has been no recurrence of Sweet's syndrome, supporting that Sweet's syndrome in this case was not related to MMI exposure. To our knowledge, this is the first report of Sweet's syndrome associated with Graves' disease per se but not PTU or MMI use.

• The Journal of Korean Medicine
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• v.26 no.4
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• pp.122-129
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• 2005

Objectives: Graves' disease is the most common cause of hyperthyroidism, and its pathogenesis includes thyroid specific autoimmunity. Anti-thyroid drugs are widely used for regulating the thyroid function. However, in spite of long-term therapy with anti-thyroid drugs, about 40$\sim$$70\%$ of the treated patients have a relapse, and some suffer adverse effects. In this study, to evaluate the clinical efficacy of Ahnjeonbaekho-tang(AJBHT) on Graves' disease patients, we performed the clinical study prospectively. Methods: Through the thyroid function test(TFT) of 54 patients diagnosed as Graves' disease in other hospitals, 21 patients were assigned into the study. After the withdrawal of anti-thyroid drugs, AJBHT was administerd to patients for 2 months. At the same time, TFT, TSH binding inhibiting immunoglobulin(TEII) level and visual analogue scales (VAS) about fatigue and palpitation were measured before and after administration. Thirteen patients have completed the entire follow-up of this study over two months. Results: Serum levels of T3 and FT4 were significantly improved by AJBHT(T3: 298.85$\pm$79.60 ng/dl 181.15$\pm$33.92 ng/dl p<0.0001, FT4: 2.78$\pm$1.06 ng/dl$\rightarrow$1.78$\pm$0.83 ng/dl p<0.05). However, there were no significant changes in TSH and TBII values. And the VAS scores of fatigue and palpitation also were significantly improved(5.80$\pm$3.01$\rightarrow$3.60$\pm$2.63, p<0.05; 6.19$\pm$2.09$\rightarrow$3.60$\pm$2.46, p<0.01). Patients' age was related to the post-treatment FT4 values(p<0.05). Conclusions: From these results, we suggest that AJBHT is effective on the TFT and the symptoms of Graves' disease, and is a safe alternative drug for Graves' disease patients.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1859-1862
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• 2014

Recently, the main therapy of medullary thyroid cancer (MTC) is surgical, but by which way there is a poor prognosis with a mean survival of only 5 years. In some cases, some researchers found that it is the medullary thyroid cancer stem cells (MTCSCs) that cause metastasis and recurrence. This study aimed to eradicate MTCSCs through administration of all-trans-retinoic acid (ATRA). Here we demonstrate that MTCSCs possess stemlike properties in serum-free medium. The ABCG2, OCT4 and sodium iodide symporter (NIS) were changed by ATRA. Additionally, we found that ATRA can increase the expression of NIS in vivo. All the data suggested that ATRA could increase the iodine uptake of MTCSCs through NIS.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.624-631
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• 2007

Hypothyroidism is a common disease of the endocrinal system, characterized by fatigue, cold intolerance, bradycardia, and so on. Subclinical hypothyroidism is a common biochemical abnormality which can be found in routine screening tests of thyroid function. It is defined as an asymptomatic state which characterized by normal free thyroxine(FT4) and elevated thyroid stimulating hormone(TSH) levels. The purpose of this study was to evaluate the effect of treatment with palmijihwang-tang and to observe the changes in triiodothyronine(T3), free thyroxine(FT4), thyroid stimulating hormone(TSH) level and VAS of cold intolerance, hoarseness, dry skin. After the treatment, triiodothyronine(T3) increased from 57.12ng/dl to 120.53ng/dl. Free thyroxine(FT4) increased from 12.59pg/ml to 14.21pg/ml. Thyroid stimulating hormone(TSH) decreased from 10.61mU/L to 1.57mU/L. Cold intolerance, hoarseness and dry skin changed for the better. These results support a role for oriental medical therapy in treating subclinical hypothyroidism. Further case studies of herbal treatment of this ailment are needed.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.74-80
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• 1997

We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.64-68
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• 2008

Purpose：The chronic use of immunosuppressive therapy in transplant recipients can increase the long-term risk of carcinoma. The aim of this study was to determine the incidence, biological behaviors, and treatment outcomes in PTC(papillary thyroid carcinoma) in renal allograft recipients. Material and Methods：The present study examined the incidence and biological behavior of PTCs in RA recipients. A total of 1,739 RA patients treated between January 1986 and December 1999 were followed-up for a median 137(84-238) months. During the follow-up period, 129(7.4%) recipients were identified as having posttransplant malignancies. Of those, 12(0.7%) had PTCs, and these comprised six male and six female patients with a median age of 41(23-57) years. Results：Nine cases(incidentalomas) were diagnosed based on ultrasonography(US) screening. Eight of those nine were TNM stage I, and two of the three clinical carcinomas were TNM stage IVa. During a median follow-up of 94(18-159) months, two(16.7%) PTC patients developed loco-regional recurrence, but no patients showed distant metastasis. Posttransplant PTC showed no gender bias, and was often associated with aggressive lymphatic metastasis. However, most incidentalomas showed a favorable treatment outcome. Conclusion：In conclusion, routine surveillance of the thyroid gland using US screening is recommended to ensure early detection, treatment and favorable prognosis in RA patients with PTC.