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이재태,조일 대한갑상선학회 2019 International Journal of Thyroidology Vol.12 No.2
Radioiodine has been known as an important and safe armamentarium in the diagnosis and treatment of differentiated thyroid cancer (DTC) for more than 70 years. The 2015 guidelines from the American Thyroid Association (ATA) for adults with thyroid nodules and DTC seem to be the most comprehensive guidelines in the thyroid cancer field. The 2015 ATA guidelines provided an advance in evidence-based management of DTC, and resulted in a significant change in the patterns of practice regarding the application of the radioiodine. However, the 2015 ATA guidelines also provoked much controversy because a substantial portion of the recommendations announced were not based on sufficiently strong evidence. While the number of radioiodine administrations in Korea in the year of 2018 has decreased to a level less than 50% of that in 2013, in this review, we address some of the current issues and controversies regarding the application of radioiodine for the diagnosis, ablation and treatment of DTC, especially related to the 2015 ATA guidelines. Possible strategies for the achievement of better quality in radioiodine imaging and improvement in treatment efficiency that can be used in the near future are also discussed here.
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李載胎,鄭憲瑩,琴坰樹,朴炅 한국전통의학연구소 1999 한국전통의학지 Vol.9 No.1
This fasciale, a remainder of So Moon(素問) with Bon Byung Ron(本病論), is a part of the theory of the Five Circuit Phases and the Six Atmospheric Influences(五運六氣學) that studied and discussed the rules of the weather change in ancient oriental medicine. The change in weather is one of the most important factors which influence man's health therefore the theory is worth while to study further. This fascicle explains the cause of diseases occured by irregular and exceptional change of weather and acupunctural treatment methods to prevent and cure those kinds of disease as its title -Ja Bup Ron(刺法論)-suggests. During Tang Dynasty(唐) when Wang Ping(王氷) commentated the So Moon(素問) only the title of this fascicle was kept but the contents of it was lost differing from Seven volumes of the Five Circuit Phases and the Six Atmospheric Influences(運氣七篇). However in the times of the North Song Dynasty(北宋) when Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books this fasciale and another lost fasciale-Bon Byung Ron(本病論) appeared with theirs notes. So these two fascicles called Lost Volumes of So Moon(素問遺篇). But we can infer these two fascicles were written by a certain Taoist during the ninth and tenth century A.D. - the former times of Kao Pao-Heng(高保衡), Lin I(林億) and the other scholars studied and compared medical books during the North Song Dynasty(北宋) since Wang Ping(王氷) because this fascicle connots the Taoism training methods such as Pe Gi(閉氣), Jon Sang Bup(存想法) and Oi Dan Bup(外丹法) and so on. This thesis runs as follows; Chapter 1 deals with acupuncture treatment to prevent and cure UI(鬱) disease occuerd by Sung Gi Bu Jun(升之不前) of the Six Atmospheric Influence(六氣). Chapter 2 deals with acupuncture treatment to prevent and cure diseases due to Bul Chun Jung(不遷正) and Bul Toi Wui(不退位) of the Six Atmospheric Influence(六氣). Chapter 3 deals with acupuncture treatment of an epidermic(疫癘) due to the deviation of the Five Ciecuit Phases from the regularity(五運失守). Chapter 4 deals with the symptomes of an epidemi and the preventive treatments such as Jon Sang Bup(存想法), Vomitory treatment(吐法), respiratory treatment(汗法) and So Kum Dan Bang(小金丹方). Chapter 5 deals with the interaction among the five viscera and the six bowels as well as the principle of the acupuncture.
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이재태,안병철 대한핵의학회 2004 핵의학 분자영상 Vol.38 No.2
다약제내성이 발현된 암세포에서 세포내의 항암제를 세포외로 배출시키는 기전을 체내에서 비침습적인 방법으로 영상화 할 수 있는 SPECT와 PET는 악성종양의 진단과 평가에 중요한 역할을 할 것으로 판단되나, 아직까지도 Pgp와 MRP의 운반능력을 적절하게 평가하는 핵의학적 영상방법을 정립하는데는 극복해야할 문제점들이 많다.16) 지금까지의 MDR영상에 관한 연구들은 대부분이 ^(99m)Tc-표지 방사성의약품을 이용한 연구였으나, PET의 임상 응용이 증가함에 따라 보다 특이적이고 쉽게 응용될 수 있는 PET용 방사성 추적자의 개발도 이루어져야 할 것이다. ^(99m)Tc-MIBI의 암 세포내 일방향(unidirectional) 섭취는 음성인 세포막 전하와 세포내 소립체 기질 전하에 의하여 결정되므로, MIBI의 섭취는 다른 지용성 양전하를 띤 막전위 추적자들과 유사하게 작용한다. ^(99m)Tc-표지 방사성의약품은 암조직의 혈류 증가나 소립체 용적이나 활성도가 증가하면 섭취가 증가할 수 있어 보다 특이적인 MDR추적제의 개발이 필요한 것이다. 최근 Lorke 등60)은 약제감수성 및 내성 인체대장암세포인 HT-29par 세포와 HT-29mdr1 세포를 이용한 연구에서, 두세포 모두에서 18F-FDG의 섭취가 있었고, MDR이 발현된 세포와 종양에서 18F-FDG 섭취가 훨씬 낮았고, MIBI는 MDR이 없는 모세포에서도 매우 낮았음을 보고한 바 있다. 이 세포는 전자현미경 검사에서 사립체가 풍부하지 않은 세포였다. 그러므로 이러한 결과로 보아 ^(99m)Tc-MIBI 영상에서 종양이 보이지 않거나 섭취가 미약하다고 해도 MDR이 발현되었다고 단정할 수는 없게 된다. 즉 MDR의 발현유무를 정확하게 감별할 수 있기 위하여는 저항이 없는 세포에 MIBI가 충분하게 섭취되어야 한다는 것이 필수적인 요건이며, 종양세포 종류에 따라서는 FDG가 MDR의 marker가 될 수 있다는 것이다. Pgp 수송체는 ATP의존성 약제배출 펌프이므로 MDR세포는 에너지가 많이 필요하여, MDR세포는 당분해율(rate of glycolysis)이 증가되어 있고 HT-29mdr1 종양세포에서는 포도당 이동과정의 변화로 FDG 섭취가 감소되었다. 또한 Pgp가 점차 증가됨과 함께 plasmam embrane transporter인 GLUT-1 level이 감소된다. 이러한 결과는 다약제내성의 영상화가 지금까지의 예상보다 보다 복합적이고 다양하므로 보다 많은 연구가 필요할 것이라는 점을 시사한다. 최근 시도되고 있는 생체광학 영상을 이용한 다약제내성 유전자 및 Pgp 발현 연구는 아직 시작단계이나, 분자 생물학적 영상법의 발전과 함께 MRI 기술등에도 이용될 수 있으므로 향후 많은 연구가 있을 것으로 기대된다. Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. ^(99m)Tc-MIBI and other ^(99m)Tc-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of Pgp-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with ^(11)C have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and N-[11C]acetyl-leukotriene E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo. (Korean J Nucl Med 38(2):180-189, 2004)
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李載胎,鄭憲瑩,琴坰樹,朴炅 대한한의진단학회 1998 大韓韓醫診斷學會誌 Vol.2 No.2
Young Chou O Sa(靈樞 五邪) described the symptoms of a disease when injurious factors permeated the five viscera and the location of a meridian point and the acupuncture in curing them according to the five viscera. When there are injurious factors within the lungs, you ought to acupuncture Woon Moon Hul(雲門穴), Joong Bu Hul(中府혈穴), Pae Soo HuI(肺輸穴 B13), and Geol Boon Hul(缺盆穴 S12), when there are injurious factors within the liver, acupuncture Hang Gan HuI(行間穴 LIV2) and Jok Sam Ri HuI(尺三里穴 S36), within the spleen, do acupuncture Yong Chul HuI(湧泉穴 K1) and Gon Ryun HuI(崑崙穴 B60), and when there are injurious factors within the heart, do so in the place of Shin Moon Hul(神門穴 H7).
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