Efforts in the Formation and Development of Nuclear Medicine in Vietnam.

The foundations of nuclear medicine in Vietnam were established from 1970. Until now, after 48 years of development, in Vietnam, we have some basic equipment including 31 SPECT, 4 SPECT/CT machines, 11 PET/CT scanners, five cyclotrons, and one nuclear reactor. Many nuclear medicine techniques in diagnosis and treatment have been routinely performed at provincial and central level health facilities such as tumor scintigraphy, thyroid scintigraphy, bone scintigraphy, kidney scintigraphy, cardiac scintigraphy, and radio-isotope therapy with I-131 and P-32. Selective internal radiation therapy with Y-90 microsphere and I-125 radioactive seed implantation has been also successfully applied in some big hospitals. However, there are still many difficulties for Vietnam as the lack of new widely used radioisotopes such as Ga-67, Cu-64, Samarium-153, and Lutetium-177 and the lack of nuclear medicine specialists. In the future, we are putting our efforts on the applications of new isotopes in diagnosis and treatment of cancers (theranostic) like Ga-68-DOTATATE, Lutetium-177-DOTATATE, Ga-68-PSMA, and Lutetium-177-PSMA, equipping modern nuclear medicine diagnostic tools, strengthening the human resources training in nuclear medicine. At the same time, we are trying our best to strengthen the cooperation with international nuclear medicine societies in over the world.

Household Financial Burden and Poverty Impacts of Cancer Treatment in Vietnam.

PURPOSE: This paper aims to analyze the household financial burden and poverty impacts of cancer treatment in Vietnam. METHODS: Under the "ASEAN CosTs in ONcology" study design, three major specialized cancer hospitals were employed to assemble the Vietnamese data. Factors of socioeconomic, direct, and indirect costs of healthcare were collected prospectively through both individual interviews and hospital financial records. RESULTS: The rates of catastrophic expenditure based on the cut-off points of 20%, 30%, 40%, and 50% of household's income were 82.6%, 73.7%, 64.7%, and 56.9%, respectively. 37.4% of the households with patient were impoverished by the treatment costs for cancer. The statistically significant correlates of the impoverishment problem were higher among older patients (40-60 years: 1.77, 95% CI 1.14-2.73; above 60 years: 1.75, 95% CI 1.03-2.98); poorer patients (less than 100% national income: 29, 95% CI 18.6-45.24; less than 200% national income: 2.89, 95% CI 1.69-4.93); patients who underwent surgery alone (receiving nonsurgery treatment: 2.46, 95% CI 1.32-4.59; receiving multiple treatments: 2.4, 95% CI 1.38-4.17). CONCLUSIONS: Lots of households were pushed into poverty due to their expenditure on cancer care; more actions are urgently needed to improve financial protection to the vulnerable groups.

Applying of radioactive immune quantitative method in evaluation result of treatment I-131 in patients with Basedow’s disease

175 Basedow’s disease patients (45 males and 170 females; mean age: 44.48 ± 8.89) were treated by I-131 at Bach Mai hospital and Military Hospital 103. Total T3 level in serum was 6.45 ± 2.81 nmol/l (n=146) and total T4 level was 243.58 ± 72.34 nmol/l (n=143). Before treatment T3 and T4 level increased abnormaly comparing with healthy people. By 4 months of treatment, T3 level was 2.15 ± 0.78 nmol/l and T4 level was 120.35 ± 36.81nmol/l, FT4 level was 15.67 ± 6.51pmol/l. With average dose of 6.52 ± 1.64 mCi I-131, most of patients had normalized total T3, T4 level

Some clinical, paraclinical characteristics of differentiated thyroid metastasis cancer patients after surgery and before using I-13

A study on 70 thyroid cancer patients at the K Hospital and Bach Mai Hospital got the results: thyroid cancer in females was 3.37 times more than in males. Mean age was 38.813.3 years. Incidence of distance metastases was 5/70 (7.1%). Histology type: Papillary cell carcinoma was 68.6%, follicular cell carcinoma is 12.8% and mixed papillary-follicular was 18.6%. Incidence of hypothyroidism was 100% (70/70) after 4 – 6 weeks total thyroidectomy. Thyroid remnants after total thyroidectomy was 5.253.01ml. Thyroid uptake of I-131 before treatment was 6.85.2%. The median serum concentration of thymoglobulin was 105.289.3 mg/ml

Study on the change of T3, T4, TSH concentrations in the blood of pregnant women

RIA and IRMA irradiation quantification technique was applicated for determining the concentration of triiodothyrosin (T3), thyroxin (T4), thyroid stimulating hormon (TSH) in blood of normal woman and pregnant woman. Results showed the significantly higher level of TSH and FT4 has not considerable difference in comparing with normal woman (no pregnancy). For verifying the thyroid disease in pregnant woman, TSH and FT4 should be quantified

Quantification of blood level of calcitonine, thyroglobulin in healthy subjects and menopausal patients with osteoporosis

Healthy normal adult volunteers without endocrinological diseases, aged 18-45 and menopausal subjects (>45 years old of age) diagnosed definitly as osteoporosis, Results showed: blood level of calcitonin in healthy adults, male subjects with n=30, median 75, min.30, max 125pg/ml female subjects n=30, median 30, min 10, max 50pg/ml respectively. Calcitonin in male is higher than in female (p<0,05). In female subjects: menopausal patients with osteoporosis, calcitonin level is lower than normal woman in reproductive age (p<0,01). Thyroglobuline level in healthy adult is 13,58 4,2 ng/ml, with no cosiderable difference between male and female

To study the change of the concentration of hypophysial-thyroid axis hormones on pubertal children

The change of thyroide function was investigated in monitoring the change of total T3, T4 and TSH levels on 33 healthy children (20 male, 13 female of 9-15 years old of age), without thyroid diseases, living in Ha Noi. Results showed that on studied subjects, total T3 account for 2.09 +/- 0.43 mol/l, T4 111.26 +/- 24.70 nmol/l and TSH 2.28 +/- 0.73. There was no difference in T3, T4 and TSH levels in male and female subjects. Their T3, T4 and TSH levels were approximate to the ones of healthy adult subjects

Blood level of cortisol change in healthy subject, according to age, gender, day-night rhythm, and geographic location

Children and healthy volunteers aged 1-60 years old. In the morning, blood cortisol in female subject aged 9-12 is higher than in male and the blood level of cortisol is highest at the age group of 21-40. In aldult volunteer, blood level is highest in morning and lowest in evening (only 50% vessus morning value). In the morning there is no difference between male – female in the same locality and the difference of value is no significant between 3 various location

Fundamental principle of radiotherapy with radio active-isotopes

Radiotherapy with radioactive-isotopes was used in the treating of some thyroidal diseases, malignant diseases of blood, and cancer… The efficacy of this method is depended on radiation, radiating energy, destiny of in vivo transformation of radioactive-isotopes, half-life disintegration time, and characteristics of treated cells and tissues. Author introduces some diseases treated by radiotherapy such as Basedow’s disease, simple goiter, polycythemia, and chronic disease of white blood cell… In addition author introduces some methods such as treating by radioactive colloid and radioimmunotherapy

Study on the concentration of blood TRAb in the healthy people and patients with basedow before and after treatment with the I-131

TRAb concentration in the blood of healthy adults and Basedow patients before and after I-131 treatment was measured by RIA (Radioimmunoassay) method. The results were as follow: RIA method for measuring TRAb was standardized. TRAb concentration in the blood of healthy adults was in the very low level (undetectable). TRAb concentrations in the Basedow patients before I-131 treatment were 426.98+/-206.21 mU/ml and by many times higher than that of healthy adults. After I-131 treatment: TRAb concentrations in the 5/12 Basedow patients could not be measured (undetectable) and in 7/12 patients were 127.67+/-59.21 mU/ml.