[131]I percentage neck uptake as a determining factor for post-operative [131]I ablative dose quantification: validity and efficacy

This prospective study was executed to validate and evaluate the efficacy of the [131]I% neck uptake as a determining factor for postoperative [131]I ablative dose quantification for local thyroid remnant. 144 patients with well-differentiated thyroid carcinoma were the subject of this work. All of them were submitted to near-total or subtotal thyroidectomy, neck iiltrasonography, 48 hours[131]I whole body scan and%neck uptake prior to [131]I therapy dose. They were grouped into two groups according to the method of [131]I ablative dose quantification. Group 1: Included 65 patients receiving empirical [subjective] [131]I ablative dose. Group 2: included 79 patients receiving [131]I ablative dose according to the following protocol based on the 48 hours% neck uptake. Patients with% neck uptake <2%, 2-4%and >4% received 1.07 GBq 1.85 GBq and 3.7 GBq respectively. Follow-up [131]I scan and% neck uptake were done at least 3 months after [131]I therapy. Successful ablation was defined as the absence of visible uptake in the neck background. There were statistically significant correlations between% neck uptake and both thyroid residual volume and surface area[r=0.7 and 0.5 respectively, p <0.05]. The overall ablation rate in group 2 cases treated according to the proposed protocol was significantly higher than that of the empiric group [79.7%and 35.4% respectively, p<0.0001]. Also ablation rates per given dose of [131]I were significantly higher in group 2 than those of group I [p< 0.006]. Thirty [37.97%] out of 79 group 2 patients received 1.07 GBq as outpatients saving about 90 hospitalization days with 86.7% ablation rate. We concluded that [131]I% neck uptake is a simple, accurate, objective and effective method for [131]I dose quantification required for postoperative ablation of local thyroid remnant, allowing for a significant proportion of these cases to be treated on an outpatient basis while maintaining a high ablation rate

Gastric emptying in insulin treated diabetics, a new equation for insulin meal interval

Gastric emptying time was studied in 25 insulin-treated diabetics, compared with 12 matched healthy volunteers. Both liquid and solid meals labeled by technetium sulfur-colloid [99m Tc] as the isotopic marker were used. The results showed delayed gastric emptying time in the diabetic group for liquid [0: 45 +/- 14 min.] and solids [1: 20 +/- 38 min.] compared with [0: 31 +/- 10 and 0: 49 +/- 0: 15 min.] in the control group [P = 0.04 and 0.008, respectively]. The delay in the diabetic group was apparent in males, older age and with longer duration of diabetes, and also in those who had gastrointestinal symptoms, peripheral or autonomic neuropathy. Adjusting the time of insulin injection in relation to the times of meals according to the solid-lag time by applying the equation [the onset of insulin action-solid lag time] caused significant reduction in fasting and post-prandial blood glucose level resulting in a better glycemic control