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Objective To investigate the influence of different time discontinuation of compound iodine solution on 131Ⅰ uptake and curative effect of 131Ⅰ therapy in patients with Graves disease (GD).Methods A total of 1 585 patients (415 males,1 170 females;age range:17-62 years) treated with 131Ⅰ therapy for the first time between January 2012 and November 2016 were enrolled in this retrospective study.All patients were divided into preliminary treatment group (n =85) and control group (no iodine solution taking,n =1 500).Preliminary treatment group including 4-7 d discontinuation subgroup (group A,n=35),8-14 d discontinuation subgroup (group B,n=28) and 15-30 d discontinuation subgroup (group C,n=22).The high-est radioactive iodine uptake (RAIU),effective half-life,free triiodothyronine (FT3) and free thyroxine (FT4) levels before 131Ⅰ therapy were compared,and curative effects were evaluated.One-way analysis of variance,Ridit analysis and x2 test were used to analyze the data.Results The highest RAIU in group A,group B,group C and control group was (64.86 ± 13.20) ％,(67.40 ± 9.10) ％,(73.46 ± 4.65) ％ and (74.14±9.87) ％,respectively (F =1.658,P＞ 0.05).No significant difference was found in the effective half-life among 4 groups (F=0.651,P＞0.05).FT3 level in group A and group B ((11.90±4.85) and (15.51±2.95) pmol/L) was significantly lower than that in control group ((23.98±4.98) pmoL/L) and group C ((22.08±2.31) pmol/L;F=13.972,t values:6.57-12.08,all P＜0.05).FT4 level in group A and group B ((25.65±11.95) and (32.33±6.25) pmol/L) was obviously lower than that in control group ((73.65±21.55) pmol/L) and group C ((68.41±13.94) pmo]/L;F=21.238,t values:36.09-48.00,all P＜0.01).The overall curative effect of preliminary treatment group and that of control group were not statistically significant (u=0.397,P＞0.05),and no significant difference was found in the complete remission rates among 4 groups (x2 =1.169,P＞0.05).Conclusions If pretreatment with compound iodine solution is used before 131Ⅰ therapy in GD,it is feasible to carry out 131Ⅰ therapy within 2 weeks after withdrawal.In order to avoid the possibility of severe hyperthyroidism after 131Ⅰ therapy,it is recommended that radioiodine treatment should be carried out after discontinuation for 4-7 d.
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ABSTRACT BACKGROUND The diagnosis of corrosion cancer should be suspected in patients with corrosive ingestion if after a latent period of negligible symptoms there is development of dysphagia, or poor response to dilatation, or if respiratory symptoms develop in an otherwise stable patient of esophageal stenosis. Narrow Band Imaging detects superficial squamous cell carcinoma more frequently than white-light imaging, and has significantly higher sensitivity and accuracy compared with white-light. OBJECTIVE To determinate the clinical applicability of Narrow Band Imaging versus Lugol´s solution chromendoscopy for detection of early esophageal cancer in patients with caustic/corrosive agent stenosis. METHODS Thirty-eight patients, aged between 28-84 were enrolled and examined by both Narrow Band Imaging and Lugol´s solution chromendoscopy. A 4.9mm diameter endoscope was used facilitating examination of a stenotic area without dilation. Narrow Band Imaging was performed and any lesion detected was marked for later biopsy. Then, Lugol´s solution chromoendoscopy was performed and biopsies were taken at suspicious areas. Patients who had abnormal findings at the routine, Narrow Band Imaging or Lugol´s solution chromoscopy exam had their stenotic ring biopsied. RESULTS We detected nine suspicious lesions with Narrow Band Imaging and 14 with Lugol´s solution chromendoscopy. The sensitivity and specificity of the Narrow Band Imaging was 100% and 80.6%, and with Lugol´s chromoscopy 100% and 66.67%, respectively. Five (13%) suspicious lesions were detected both with Narrow Band Imaging and Lugol's chromoscopy, two (40%) of these lesions were confirmed carcinoma on histopathological examination. CONCLUSION Narrow Band Imaging is an applicable option to detect and evaluate cancer in patients with caustic /corrosive stenosis compared to the Lugol´s solution chromoscopy.
RESUMO CONTEXTO A suspeita do câncer de esôfago na lesão cáustica ocorre quando os pacientes com estenoses previamente estáveis, após um período latente sem sintomas, apresentam disfagia, baixa resposta as dilatações ou sintomas respiratórios. A cromoscopia com luz de banda estreita detecta o câncer superficial de esôfago mais frequentemente que a luz branca, com alta sensibilidade e acurácia. OBJETIVO Determinar a aplicabilidade clínica da luz de banda estreita versus a cromoscopia vital com Lugol na detecção do câncer precoce de esôfago em pacientes com lesões cáusticas. MÉTODOS Um total de 38 pacientes, entre 28 e 84 anos, foram alocados seguidamente e submetidos à cromoscopia com luz de banda estreita e com Lugol. Um gastroscópio de 4,9 mm de diâmetro foi usado para facilitar o exame da área estenosada, sem necessidade de dilatação. A cromoscopia com luz de banda estreita era realizada primeiro e as áreas suspeitas anotadas. Depois, a cromoscopia com Lugol era realizada e as áreas suspeitas biopsiadas. RESULTADOS Detectamos nove lesões suspeitas com a luz de banda estreita e 14 com o Lugol. A sensibilidade e especificidade da cromoscopia com luz de banda estreita foi de 100% e 80,6%, e a do Lugol foi de 100% e 66,67% respectivamente. Cinco (13%) lesões suspeitas foram detectadas coincidentemente pelos dois métodos, sendo duas (40%) com diagnóstico anatomopatológico de câncer de esôfago. CONCLUSÃO A cromoscopia com luz de banda estreita é opção concreta para o diagnóstico de câncer em pacientes com estenoses esofágicas por corrosões cáusticas, comparado a cromoscopia com Lugol.
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Humans , Male , Female , Adult , Aged , Aged, 80 and over , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/chemically induced , Caustics/adverse effects , Esophagoscopy/methods , Coloring Agents , Narrow Band Imaging/methods , Iodides , Cross-Sectional Studies , Sensitivity and Specificity , Cross-Over Studies , Constriction, Pathologic , Middle AgedABSTRACT
BACKGROUND: Increased oxidative stress has been suggested as one of the underlying mechanisms in iodide excess-induced thyroid disease. Metallothioneins (MTs) are regarded as scavengers of reactive oxygen species (ROS) in oxidative stress. Our aim is to investigate the effects of propylthiouracil (PTU), a thyroid peroxidase inhibitor, perchlorate (KClO4), a competitive inhibitor of iodide transport, and thyroid stimulating hormone (TSH) on mitochondrial superoxide production instigated by high concentrations of iodide in the thyroids of MT-I/II knockout (MT-I/II KO) mice. METHODS: Eight-week-old 129S7/SvEvBrd-Mt1(tm1Bri) Mt2(tm1Bri)/J (MT-I/II KO) mice and background-matched wild type (WT) mice were used. RESULTS: By using a mitochondrial superoxide indicator (MitoSOX Red), lactate dehydrogenase (LDH) release, and methyl thiazolyl tetrazolium (MTT) assay, we demonstrated that the decreased relative viability and increased LDH release and mitochondrial superoxide production induced by potassium iodide (100 µM) can be relieved by 300 µM PTU, 30 µM KClO4, or 10 U/L TSH in the thyroid cell suspensions of both MT-I/II KO and WT mice (P<0.05). Compared to the WT mice, a significant decrease in the relative viability along with a significant increase in LDH release and mitochondrial superoxide production were detected in MT-I/II KO mice(P<0.05). CONCLUSION: We concluded that PTU, KClO4, or TSH relieved the mitochondrial oxidative stress induced by high concentrations of iodide in the thyroids of both MT-I/II KO and WT mice. MT-I/II showed antioxidant effects against high concentrations of iodide-induced mitochondrial superoxide production in the thyroid.
Subject(s)
Animals , Mice , Antioxidants , Iodide Peroxidase , Iodides , L-Lactate Dehydrogenase , Metallothionein , Mice, Knockout , Oxidative Stress , Potassium Iodide , Propylthiouracil , Reactive Oxygen Species , Superoxides , Suspensions , Thyroid Diseases , Thyroid Gland , ThyrotropinABSTRACT
Objective We set up an uncertainty assessment method for determination of iodides in water by As3+-Ce4+ catalytic spectrophotometry, in order to assess the accuracy of the method and the major influencing factors, and to build up an equation to assess the uncertainty in the mobility of working curve and an uncertainty assessment method for pipettors.Methods According to Methods for Water Iodine Detection Suitable for Iodine Deficiency and Iodine Excess Areas, the uncertainty items of the two standard materials (GBW09114c and GBW09113c) in different concentrations, such as repeatability of measurement, the mobility of working curve, the uncertainty of standard solution and sample solution, etc, were analyzed.Results The contents of iodide in GBW09114c and GBW09113c were (61.3 ± 1.4) and (8.1 ± 0.3)μg/L;relative expanded uncertainty RU1 and RU2 were 2.25％ and 3.46％, both of them were in the range of acceptable deviation in the standard material certification (10.0％ and 14.8％).Major influencing factors were repeatability of measurement, the uncertainty of standard solution (including the uncertainty of potassium iodide reference reagent and glass equipment), and the uncertainty of sample solution (including the uncertainty of pipettors).A more adaptable equation for the mobility of working curve had been proposed;the factors involved in environment temperature and operation repeatability were used as the items of the pipettors' uncertainty.Conclusion This method can be used to assess the uncertainty in determination of water iodides by As3+-Ce4+ catalytic spectrophotometry.
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BACKGROUND: A diagnostic whole-body scan (WBS) is recommended 6 to 12 months after total thyroidectomy and radioactive iodide ablation in intermediate- or high-risk patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate the necessity of a diagnostic WBS after radioactive iodide ablation in intermediate-risk patients with DTC. METHODS: A total of 438 subjects were included in the study: 183 low-risk subjects and 255 intermediate-risk subjects according to the American Thyroid Association guideline. All subjects diagnosed with DTC received 1,100 MBq (30 mCi) activity of radioiodine (I-131) following total thyroidectomy. On follow-up, all subjects underwent a diagnostic I-131 WBS after thyroid hormone withdrawal. RESULTS: After initial radioactive iodide ablation, 95.1% of low-risk patients and 91.4% of intermediate-risk patients showed no uptake on diagnostic WBS (P=0.135). Intermediate-risk patients with stimulated thyroglobulin (Tg) levels higher than 2.0 ng/mL showed a greater rate of radioactive iodine uptake on diagnostic WBS. Four intermediate-risk patients showed recurrence during the 16 to 80 months follow-up period. Three of the four patients with recurrence showed no uptake on diagnostic WBS and had a stimulated Tg level less than 2.0 ng/mL. CONCLUSION: A diagnostic I-131 WBS after radioactive iodide ablation in intermediate-risk patients with DTC may not be necessary. A large prospective study is necessary to determine the necessity of diagnostic WBS in intermediate-risk patients with DTC.
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Humans , Follow-Up Studies , Iodides , Iodine , Radioactivity , Recurrence , Thyroglobulin , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A "Tianjin Medical psychomotor test battery" (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD.