Efficacy of radioiodine therapy for treating 20 patients with pulmonary metastases from differentiated thyroid cancer and a meta-analysis of the current literature.

BACKGROUND: Radioiodine therapy (RAI) after total or near-total thyroidectomy is a recommended treatment for patients with pulmonary metastasis from differentiated thyroid cancer (DTC). However, the total effective rate of iodine-131 therapy remains controversial. This study aimed to determine the efficacy of RAI for treating patients with pulmonary metastasis from DTC, and to identify independent predictors of its efficacy. METHODS: We conducted a retrospective study to evaluate 20 patients with pulmonary metastasis from DTC who underwent RAI at our center at first and performed a meta-analysis to evaluate relevant literature regarding the overall efficacy of RAI and subgroup-specific efficacies subsequently. RESULTS: The efficacy rate at our center was 40%, and no significant differences were observed according to sex, age, pathological type, metastasis state, or interval between the initial RAI and final surgery. The meta-analysis revealed that the pooled overall efficacy rate was 58%, and significant differences were observed when we compared pulmonary metastasis versus pulmonary and other distant metastasis, age of < 40 years versus age of ≥ 40 years, papillary thyroid cancer versus follicular thyroid cancer and male patients versus female patients. CONCLUSIONS: These results suggest that RAI is an effective treatment for patients with pulmonary metastasis from DTC after surgical treatment. The efficacy of RAI was significantly predicted by the presence of papillary thyroid cancer, age of < 40 years, the absence of non-lung distant metastasis and female patients.

Early weaning increases intestinal permeability, alters expression of cytokine and tight junction proteins, and activates mitogen-activated protein kinases in pigs.

Although weaning stress has been reported to impair intestinal barrier function, the mechanisms have not yet been elucidated. In the present study, the intestinal morphology and permeability and mRNA expressions of tight junction proteins and cytokines in the intestine of piglets during the 2 wk after weaning were assessed. The phosphorylated (activated) ratios of p38, c-Jun NH(2)-terminal kinase (JNK), and extracellular regulated kinases (ERK1/2) were determined to investigate whether mitogen-activated protein kinase (MAPK) signaling pathways are involved in the early weaning process. A shorter villus and deeper crypt were observed on d 3 and 7 postweaning. Although damaged intestinal morphology recovered to preweaning values on d 14 postweaning, the intestinal mucosal barrier, which was reflected by transepithelial electrical resistance (TER) and paracellular flux of dextran (4 kDa) in the Ussing chamber and tight junction protein expression, was not recovered. Compared with the preweaning stage (d 0), jejunal TER and mRNA expressions of occludin and claudin-1 on d 3, 7, and 14 postweaning and Zonula occludens-1 (ZO-1) mRNA on d 3 and 7 postweaning were reduced, and paracellular flux of dextran on d 3, 7, and 14 postweaning was increased. An increase (P < 0.05) of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) mRNA on d 3 and d 7 postweaning and an increase (P < 0.05) of interferon-γ (IFN-γ) mRNA on d 3 postweaning were observed compared with d 0. No significant increase of transforming growth factor ß1 (TGF-ß1) and interleukin-10 (IL-10) mRNA after weaning was observed. The phosphorylated (activated) ratios of JNK and p38 on d 3 and 7 postweaning and the phosphorylated ratio of ERK1/2 on d 3 postweaning were increased (P < 0.05) compared with d 0. The results indicated that early weaning induced sustained impairment in the intestinal barrier, decreased mRNA expression of tight junction proteins, and upregulated the expression of proinflammatory cytokines, but anti-inflammatory cytokines were not affected in the intestine of piglets. The recovery of the intestinal barrier function was slower than that of the intestinal mucosal morphology. The weaning stress activated MAPK signaling pathways in the intestine, which may be an important mechanism of weaning-associated enteric disorders of piglets.

Effects of zinc oxide-montmorillonite hybrid on growth performance, intestinal structure, and function of broiler chicken.

A total of 450 one-day-old Arbor Acres male chickens were used to investigate the effects of zinc oxide-montmorillonite hybrid (ZnO-MMT) on growth performance, intestinal structure, and function. The birds were allotted to 5 dietary treatments for 21 d, each of which was replicated 6 times with 15 chicks per replicate. The dietary treatments were 1) corn-soybean meal diet (basal, containing 42.35 mg of Zn/kg); 2) basal diet + 600 mg of MMT/kg (equivalent to the MMT in the ZnO-MMT treatment); 3) basal diet + 60 mg of Zn/kg as ZnO; 4) basal diet + 60 mg of Zn/kg as ZnO-MMT; and 5) basal diet + 60 mg of Zn/kg as ZnSO(4)•7H(2)O. The results showed that chicks fed ZnO-MMT had higher (P < 0.05) ADG and feed intake than those fed the basal diet, MMT, or ZnO. Compared with the control, MMT, ZnO, or ZnSO(4), supplementation with ZnO-MMT decreased (P < 0.05) viable counts of Clostridium in small intestinal and cecal contents, increased (P < 0.05) colonic transepithelial electrical resistance (TER) values, and reduced (P < 0.05) colonic probe mannitol permeability as well as ileal or colonic inulin permeability. Compared with the control, supplemental ZnO-MMT increased (P < 0.05) villus height, the ratio of villus height to crypt depth at the small intestinal mucosa, the trypsin activity in the pancreas, and the digestive enzyme activities in small intestinal contents. Compared with the control, supplementation with ZnO increased (P < 0.05) the villus height and the villus height to crypt depth ratio at the duodenum. Supplementation with ZnSO(4) increased the trypsin activity in pancreas and small intestinal contents. However, supplemental MMT, ZnO, or ZnSO(4) did not affect (P > 0.05) growth performance, ileal and colonic barrier function, and intestinal microflora. The results indicated that supplementing 60 mg of Zn/kg as ZnO-MMT in broiler chickens improved growth performance, intestinal microflora, intestinal morphology, and barrier function as well as the digestive enzyme activities.

Multicentre trial on the efficacy and toxicity of single-dose samarium-153-ethylene diamine tetramethylene phosphonate as a palliative treatment for painful skeletal metastases in China.

A multicentre trial was organized in China as part of an international coordinated research project to study the efficacy and toxicity of single-dose samarium-153 ethylene diamine tetramethylene phosphonate (EDTMP) as a palliative treatment for painful skeletal metastases. One hundred and five patients with painful bone metastases from various primaries were treated with 153Sm-EDTMP at a dose of 37 MBq/kg(group I) or 18.5 MBq/kg (group II). The effects were evaluated according to change in daily analgesic consumption, pain score, sum of effect product (SEP), Physician's Global Assessment (PGA), blood counts, and organ function tests conducted regularly for 16 weeks. Fifty-eight of 70 patients in group I and 30 of 35 in group II had a positive response, with SEPs of 22.29+/-14. 47 and 20.13+/-13.90 respectively. Of 72 patients who had been receiving analgesics, 63 reduced their consumption. PGA showed that the Karnofsky score (KS) increased from 58.54+/-25.90 to 71.67+/-26. 53, indicating improved general condition, but the difference was not significant. Among subgroups of patients, only those with breast cancer showed a significant change in the Karnofsky score after treatment. Inter-group differences were found for net change in KS between patients with lung and patients with breast cancer, and between patients with lung and patients with oesophageal cancer. Seventeen patients showed no response. No serious side-effects were noted, except for falls in the white blood cell (nadir 1.5x10(9)/l) and platelet (nadir 6.0x10(10)/l) counts in 44/105 and 34/105 cases, respectively. Ten patients had an abnormal liver function test. Response and side-effects were both independent of dose. In conclusion, 153Sm-EDTMP provided effective palliation in 83.8% of patients with painful bone metastases; the major toxicity was temporary myelosuppression. Further studies are needed to identify better ways of determining the appropriate dose in the individual case and the efficacy of treatment.