[The role of iodine in various thyroid disorders]. / Rola jodu w róznych chorobach tarczycy.

Mechanisms regulating thyroid hormone synthesis in conditions of proper iodine supply, iodine excess and iodine deficit in subjects with normal thyroid function and in patients with various thyroid gland disorders are presented.

A patient homozygous for a mutation in the prothrombin gene 3'-untranslated region associated with massive thrombosis.

We describe the first reported case of a thrombophilia patient genetically homozygous for a recently described polymorphism in the 3'-UTR (untranslated region) of the prothrombin gene. It has previously been demonstrated that this genetic variant due to a G to A transition at nucleotide 20210 is common and associated with an almost threefold increased risk of venous thrombosis. This polymorphism was also shown to be associated with elevated plasma prothrombin (factor II) levels, which in itself was found to be a risk factor for venous thrombosis. The patient was a healthy young Mexican male who presented with a myocardial infarction and subsequent ileofemoral venous thrombosis and massive saddle pulmonary embolus. Testing done during his initial hospitalization suggested a congenital protein C deficiency. The patient was found to be homozygous for the prothrombin gene polymorphism as well as a carrier for factor V Leiden. This case strongly implies a clinically significant role for the factor II gene mutation in both arterial and venous thrombosis and demonstrates the need to perform diagnostic clotting based assays after resolution of acute thrombotic events. These findings further support the 'double hit' theory for thrombophilia in young patients.

[Evaluation of the efficacy of treatment with exogenous thyroxin in patients after thyroidectomy]. / Ocena skutecznosci leczenia egzogenna tyroksyna u chorych po tyreoidektomii.

The study was performed in 228 patients after thyroidectomy, including 101 individuals permanently treated with thyroxin and 127 ones in whom treatment with thyroxin was started on the average 5 years after surgery. Control group consisted of 35 patients after thyroidectomy, average 2 years after surgery, not treated with thyroxin. Stump volumes and serum TSH concentrations were significantly higher in the patients who began treatment a long time after surgery (mean after 5 years) when compared with the control group (mean after 2 years). It was proven that treatment with thyroxin led to significant decrease of the stump volume and to serum TSH normalisation. Treatment with thyroxin was successive in not all patients with nodular regrowth; in some of them despite using suppressive doses of thyroxin, progression of the lesions occurred, what claimed for different regrowth etiology. In spite of high serum TSH concentrations in 132 patients, only in 60 of them clinical manifestation of hyperthyroidism was observed. Treatment with thyroxin should be recognised as reasonable in prophylaxis and therapy of patients after thyroidectomy.