Physiological Uptake of Radioactive Iodine Around an ArtificialEyeball Observed with Single-Photon Emission ComputedTomography/Computed Tomography After RadioactiveIodine Treatment / 대한핵의학회잡지

Radioactive iodine treatment is useful for ablating remnant thyroid tissue and metastasis ofwell-differentiated thyroid cancer withlong-lasting effects. A scintigraphy after radioactive iodine treatment is a major imaging modality for detecting metastasis andassessing the management of metastasis. However, caution is required when reading the scan due to potential false-positivefindings. In this study, scintigraphy and single-photon emission computed tomography/computed tomography images afterradioactive iodine treatment revealed a physiological uptake of radioactive iodine due to lacrimal secretion around an artificialeyeball; such findings have not been reported previously.

Radiation recall dermatitis triggered by sorafenib after radiation therapy for hepatocellular carcinoma

Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.

Radiation recall dermatitis triggered by sorafenib after radiation therapy for hepatocellular carcinoma

Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.

The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

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 Effect of Aging on Intervals, Axis, Heart Position, and Transitional Zone of Electrocardiogram

Author analysed ECG records of conventional 12 leads of 240 healthy persons (120 males and 120 females of 15-90 years of age) to evaluate the cardiac changes with advancing age and following results were obtained; 1. P-R intervals were not changed significantly with advancing age. The QT, Q-aT, Q-aU, and Q-U intervals were prolonged with advancing age and they were marked in male than female. 2. Mean QRS axis were shifted to the left with advancing age and these were more distinct in male than female. Mean P axis and mean T axis were not changed appreciably with advancing age. 3. The incidences of ECG position of vertical and semivertical heart position were decrease with advancing age and intermediate, horizontal and semihorizontal heart position were increased with advancing age. 4. The transitional zone of precordial leads were not changed with advancing age.

The Evaluation of Minnesota Code in Electrocardioraphic Diagnosis of Ventricular Hypertrophy

Authors evaluated the electrocardiographic criteria of Minnesota Code (III-1, III-2) for the diagnosis of left and right ventricular hypertrophy in 93 cases of healthy peoples, 74 cases of left ventricular hypertrophy and 4 cases of right ventricular hypertrophy and following results were obtained. 1. By left ventricular hypertropy criteria (III-1), there were 5.4% of false positive and 14.9% of false negative cases. 2. By right ventricular hypertrophy criteria III-2), there were 24.7% of false positive and 20.0% of false negative cases. 3. Electrocardiographic diagnosis of ventricular hypertrophy by Minnesota Code (III-1, III-2) were more reliable criteria than many other criteria of ventricular hypertrophy.

Epidemiological Study of Heart Disease in Korea: 5 Year Interval Change

In order to investigate the trend of prevalence of heart disease in Korea, statistical observation was made on 19,239 cases of medical in-patients who were treated in 3 general hospitals, Korea University Hospital, Seoul Red Cross Hospital and Seoul Adeventist Hospital, on 73,484 cases of medical out-patients who were seen at Korea University Hospital and Seoul Adventist Hospital during the period of 5 years, from 1972 through 1976, on 7,746 cases of medical in-patients during the period of 10 years (1967 through 1976), and on 50,083 cases of medical out-patients during the period of 15 years (1962 through 1976) who were treated in Korea University Hospital. The results obtained were as follows. 1. Heart disease was 5.5% (male 5.4%, female 5.7%) of medical out-patients and 16.1% (male 16.7%, female 15.5%) of medical in-patients. 2. The incidence of heart disease was increased with the increase of age in both out-patients and in-patients. The incidences of heart disease in out-patients by age group to the total out-patients of each age group were 1.8% in 15~40 year group, 10.2% in 41~60 year group and 18.4% in over 61 year group, and those in in-patients were 5.0% in 15~40 year group, 24.4% in 41~60 year group and 30.8% in over 61 year group. 3. The incidences of individual heart disease to 4,074 cases with heart disease (male 1,986, female 2,088) of out-patients were as follows. Rheumatic myocarditis was 0.5% (male 0.6%, female 0.5%), mitral valvular disease 8.3% (male 5.8%, female 10.6%), aortic valvular disease 3.1% (male 3.9%, female 2.2%), mitral and aortic valvular disease 0.7% (male 1.3%, female 0.7%), hyper tension 72.0% (male 72.8%, female 71.0%), myocardial infarction 0.7% (male 1.2%, female 0.2%), angina pectoris 2.2% (male 3.1%, female 1.4%), atherosclerotic heart failure 4.5% (male 4.8%, female 4.1%), pericarditis 0.4% (male 0.6%, female 0.3%), idiopathic myocardiopathy 0.5% (male 0.5%, female 0.6%), postpartum myocardiopathy 0.3% in female, cor pulmonale 0.3%(male 0.2%, female 0.4%) and congenital heart disease 1.4% (male 1.8%, female 1.1%). 4. Incidences of individual heart disease to total 3,091 cases with heart disease (male 1,573, female, 1,518) of in-patients were as follows. Rheumatic myocarditis was 0.4% (male 0.5%, female 0.3%), mitral valvular disease 8.1% (male 5.1%, female 11.2%), aortic valvular disease 1.1% (male 1.3%, female 0.8%), mitral and arotic valvular disease 0.3% (male 0.3% female 0.4%), hypertension 69.6% (male 71.3%, female 68.5%), myocardial infarction 2.8% (male 4.3%, female 1.4%), angina pectoris 1.7% (male 2.0%, female 1.3%), atherosclerotic heart failure 7.5%(male 7.7%, female 6.8%), pericarditis 0.8% (male 0.9%, female 0.8%), idiopathic myocardiopathy 1.3% (male 1.3%, female 1.3%), postpartum myocardiopathy 0.7% in female, cor pulmonale 1.5% (male 1.5%, female 1.6%) and congenital heart disease 0.5% (male 0.4%, female 0.5%). 5. There was no significant seasonal variation of the incidences of individual heart diseases. 6. The incidences of rheumatic valvular heart disease, coronary heart disease and congenital heart disease of medical out-putients of Korea University hospital by 5-year-period for 3 consecutive periods (1962 through 1976) were increased and those of hypertension and cor pulmonale were decreased. 7. The incidneces of coronary heart disease and idiopathic myocardiopathy of medical in-patients of Korea University Hospital by 5-year-period for 2 consecutive periods (1967 through 1976) were increased and those of rheumatic myocarditis, hypertension and postpartum myocardiopathy were decreased. There was no change in incidence of rheumatic heart disease including rheumatic myocarditis, and congenital heart disease. 8. The trend of increasing prevalence of coronary heart disease, especially angina pectoris, was noted. Although hypertension was decreased in relative incidence, the total number of patients with hypertension was increased. This seems to suggest that hypertension tends to increase.

Electrocardiographic Findings in Korean Students: Electrocardiographic Findings in Cardiomegaly by Chest X-Ray

Mass screening of cardiomegaly by chest X-ray in 144,021 (male 55,491, female 88,530) students of primary, middle and high school (6~17 years of age) in Seoul was performed and electrocardiograms of 217 cases of cardiomegaly were studied. The results were as follows; 1) Cardiomegaly (cardiothoracic ratio over 0.5) was seen in 0.19% of each sex and it was higher in middle and high school ages (12~17 years) than primary school ages (6~11 years). 2) Incidences of abnormal electrocardiogram in cardiomegaly were 59.5% in male and 54.7% of female students. Major abnormal electrocardiograms in cardiomegaly were right ventricular hypertrophy (24.8%), left ventricular hypertrophy (11.6%), biventricular hypertrophy(4.8%), complete right bundle branch block (7.7%), incomplete right bundle branch block (8.7%), first degree A-V block (5.8%) and premature beat (4.3%). 3) Left ventficular hypertrophy was seen most frequently in high school ages (15~17 years) and decreased with decreasing age. Right ventricular hypertropy was seen most frequently in primary school ages (9~11 years) and decreased with increasing age. Biventricular hypertrophy was seen most frequently in primary school ages (6~8 years) and decreased with increasing age. 4) Complete and incomplete right vundle branch block were seen commonly in 12~17 years of age and first degree A-V block in 9~11 years of age.

Clinical Experience of Etafenone (Baxacor(R)) in the Treatment of Angina Pectoris

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.

Clinical Experience of Etafenone (Baxacor(R)) in the Treatment of Angina Pectoris

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.

Antihypertensive Effect of Debrisoquin Sulfate in the Treatment of Hypertension

Authors observed the antihypertensive effect of debrisoquin sulfate in 35 cases of essential hypertension and following results were obtained. 1) Results of short term control of blood pressure with debrisquin in 35 hypertensive patients revealed good control in 74.3%, fair in 14.3%, poor in 5.7% and failure in 5.7% of cases. Significant reduction of blood pressure was achieved in 7 of 9 cases of hypertension with addition of hydrochlorthiazide to debrisoquin. 2) During long term therapy with debrisoquin (duration of average 3.9 months), good control cases were slightly reduced(good in 58.6%, fair in 24.1%, poor in 6.9%, failure in 10.3%). But average effective dose of debriioquin was not increased significantly. 3) Antihypertensive effect of debrisoquin was slightly reduced in the cases of severe hypertension, hypertension of over 10 years duration and complication of cerebrovascular accident. 4) The side effects during treatment with debrisoquin were dizziness in 31.4%, headache in 11.4%, dry mouth, blurred vision, general weakness, insomnia in 8.6% respectively. There were no side effects in 48.6% of cases.

Clinical Studies on Idiopathic Myocardiopathy

Twenty-two cases of idiopathic myocardiopathy were observed during the period of 1962 to 1971 and follow up clinical study was made in 5 cases. The criteria of diagnosis was based mainly on exclusive diagnosis in etiology unknown marked cardiomegaly. 1) Male and female ratio of idiopathic myocardiopathy was 1.1:1 and age of onset were distributed from first decade to fifth decade with similar number of cases. 2) Cardinal symptoms were dyspnea, palpitation, chest pain and cough. Common physical findings were protodiastolic gallop (in 2 cases), moist rales (in 3 cases) and hepatomegaly(in 3 cases). 3) Laboratory findings were normal except elevated T.T.T. in one case. 4) Electrocardiogram were abnormal in all cases. There were 3 cases of left ventricular hypertrophy, 3 cases of non-specific ST-T changes and one case of first degree A-V block, intraventricular conduction defect, abnormal Q wave and low valtage, respectively. 5) After medical treatment, symptoms were improved in 4 cases but heart size was reduced in only one case and E.C.G. abnormalities were unchanged in all cases.

Treatment of Cardiac Neurosis with Propranolol (Inderal(R))

Thirty-seven cases of cardiac neurosis were treated with propranolol (Inderal(R)) and following results were obtained. 1) Symptoms, such as palpitation, dyspnea, chest tightness and chest pain were disappeared or improved in all cases. 2) Heart rate reduced significantly after treatment from 99.8 per minutes to 74.8 per minutes. 3) Systolic blood pressure reduced significantly after treatment from 147.6 mmHg to 131.4 mmHg. but diastolic blood pressure were not reduced significantly. These results indicated that propranolol is recommendable medicine for improving cardiac symptoms and tachycardia in cardiac neurosis.

Study on the Electrocardiographic Exercise Test: 2. Comparative Analysis of Electrocardiographic Exercise Test in Normal and Diseases

Authers analysed the electrocardiographic exercise test of 196 cases of normal and 150 cases of various diseases according to the Minnesota Code, Master's criteria and Lepeschkin's criteria and following results were obtained. 1. In normal cases, Lepeschkin's method of analysis of single Master's exercise test revealed less frequent false positive case (7.7%) than those of Master's (12.1%) and Minnesota Code (12.6%). 2. ST-segment changes by the Minnesota Code in the postexercise electrocardiogram were obtained 12.6% of nomal cases, 63.9% of the cases of anginal symptoms, 31.5% of hypertension and 15.4% of diabetes mellitus. 3. Positive exercise test by the Master's criteria in the postexercise electrocardiogram were obtained 12.1% of normal cases, 63.9% of the cases of anginal symptoms, 31.5% of hypertension and 15.4% of diabetes mellitus. 4. Positive exercise test by the Lepeschkin's criteria in the postexercise electorcardiogram were obtained 7.7% of normal cases, 50% of the cases of anginal symptoms, 18.4% of hypertension and 15.4% of diabetes mellitus.