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Sample records for augmented radioiodine therapy

  1. Radioiodine therapy

    International Nuclear Information System (INIS)

    For over 40 years now, radioiodine (131I) has remained one of the most useful radionuclide for diagnosis and therapy in Nuclear Medicine. The wide application of radioiodine in the study of the thyroid gland and in the management of its disorders has been most rewarding. The medical literature is replete with reports of its efficacy, failures, and complications, but most of these studies have been conducted among Caucasian persons and in relatively affluent societies. Very few reports are available from the less developed and economically depressed areas of the world where thyroid disorders abound or and are even endemic. This chapter is an attempt to highlight the use of radioactive iodine therapy in the developing countries, particularly those in the Asian region

  2. Radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    A ten year study (1988-98) was done at the Veterans Memorial Medical Center on radioiodine (RAI) therapy for hyperthyroidism. A total of 162 patients received 131-I after careful selection hence was included in this study. A predominantly female population was seen (81%) compared to only (19%) males. The most frequent age group were in the third and fourth decades of life. Those included had clinical manifestations of thyrotoxicosis aside from the abnormal thyroid function tests and elevated RAI uptake. Almost all were given antithyroid drugs and beta-blockers prior to RAI ablation. Doses ranged from 7 to 12 mCi depending on gland size and degree of toxicity. Success rate of treatment was 92% which meant that the symptoms were abated and there was shrinkage of the thyroid gland after a single dose of iodine. The most common short term complications were sialitis and local neck tenderness while hypothyroidism was the commonest long term complication. (author)

  3. Teenage hyperthyroidism and radioiodine therapy

    International Nuclear Information System (INIS)

    Full text: Objective: To assess the efficacy of radioiodine therapy in teenage patients with hyperthyroidism. Method: The medical records of 28 patients (age range 16 -18 years) were purposely selected from a pool of 3637 hyperthyroid patients treated with radioiodine during the period January 1982 to December 2006. Data for analysis included the age, sex, clinical symptoms, type of hyperthyroidism, antithyroid medications received, doses of radioiodine therapy given and the outcome of the therapy after one and five years. Results: The mean age of the patients treated for hyperthyroidism was 17.60 ± 0.73 years and 82 % were females. The most common type of hyperthyroidism was Graves' disease (75%). All patients were pre-treated with antithyroid drugs for variable duration periods (6 months to 2 years). The mean administered dose of radioiodine was 10.69 ± 2.77 mCi. The dose of I-131 was calculated on the basis of gland size and morphology (assessment by palpation and scintigraphy) and percentage of radioactive iodine uptake. Effective control of hyperthyroidism after radioiodine treatment occurred in 60.72% patients with a single dose, 35.71% required a second dose and 3.57% required more than two doses. Frequency of early hypothyroidism within one year was 38.09 % in Graves' disease and 33.33% in toxic multinodular goiter. Most patients (66.66%) in the toxic nodule group remained euthyroid up to one year after I-131 therapy. Overall incidence rates of hypothyroidism after 1 year and 5 years of radioiodine therapy were 32.14% and 75%, respectively. Conclusion: Hyperthyroidism in the teen group of patients was effectively controlled with radioiodine. There were no early side effects. The only long-term effect was hypothyroidism. Appearance of early/late hypothyroidism showed a direct relationship with the type of hyperthyroidism and the dose of radioiodine administered. In general, patients with Graves' disease showed a greater tendency in the evolution of early

  4. Radioiodine therapy of thyroid autonomy

    International Nuclear Information System (INIS)

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  5. Radioactive Iodine (Radioiodine) Therapy

    Science.gov (United States)

    ... lymph nodes and other parts of the body. Radioactive iodine therapy improves the survival rate of patients with papillary ... and benefits of RAI therapy with your doctor. Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and ...

  6. Radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    The introduction of I-131 in 1946 for the treatment of hyperthyroidism marked a historic event. It ushered in the era of radionuclides in medicine and led to the birth of nuclear medicine. Today I-131 has become one of the most commonly used agents for the treatment of hyperthyroidism. Ninety percent (90%) of its effect is due to beta radiation and 10% is due to gamma radiation. The mechanism of action is production of radiation thyroiditis (3-10 days) and chronic gland atrophy (over a period of 3 years). To achieve the necessary dosage levels, four considerations are needed: maximum amount of I-131 taken by the thyroid gland, size of tissue to be irradiated, effective half life of the isotope in the thyroid and relative sensitivity of the thyroid to I-131. There are two kinds of dosing - the preferred dose where 160 μCi/gram of tissue of given (15-20μCi) or the usual dose 80 μCi/gram - (2 to 15 mCi). In giving these dosages, four basic approaches are utilized and two major principles are applied. However, precision in the calculation of I-131 dose makes very little difference in the outcome in any individual patients. The inherent sensitivity of the thyroid to radiation seems to vary widely for unknown reasons. The success in treatment is high with incidence of cure as follows: 70-86% in single dose; 10-20% using 2 doses and less than 5% required 3 doses or more. Adjunctive therapy in the forms of antithyroid drugs, beta blocker and steroids may be needed. There are short and long term complications where hypothyroidism is the most important complication. Long term follow-up is advocated by FT4 and TSH determinations. There is an unknown risk of malignancy and genetic damage. Finally, I-131 has been a choice of treatment for hyperthyroidism with some considerations in the U.S.A., Europe, and Asia. It is rapidly effective, predictable and inexpensive. Several studies on the experience will be discussed. (author)

  7. Results of radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Between 1971 and 1977, 102 hyperthyroidism patients were treated with 131I. The average age of the patients was 64 years. In 78 patients, hyperthyroidism was due to decompensated autonomous adenoma, 24 patients presented with diffuse hyperthyroidism. The patients were observed for 14 to 24 months. Until early 1976, diagnosis and therapy success assessment were based on thyroid scintiscanning, radioiodine two-phase tests, PBI131, T4 tests, and T3 tests. Since 1976, the radioiodine two-phase test has been replaced by the TRH test, the TRH-RIA, and the T4-RIA. The patients were given 3 to 25 mCi 131I. In 88 cases, euthyroidism was reached after a single therapy; in 8 cases, after two therapies; in 1 case, after three therapies; in 4 cases, after 4 therapies; in 1 case, after 5 therapies. Euthyroidism was thus reached in 96% of all cases after 131I therapy of hyperthyroidism. (orig./MG)

  8. Radioiodine therapy of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Radioiodine (I-131) therapy has been in use for the treatment of thyroid diseases for the past six decades. However its use in therapy for well-differentiated thyroid cancer is still controversial. This is because thyroid cancers are generally slow growing tumours, with low mortality and normal survival. Long term follow-up studies for two to three decades to record recurrence and mortality and to establish definite conclusions on the acceptable modes of treatment are recommended. As the incidence of the disease is very low, a large number of cases to establish good statistical data is required. Most published reports deal with a small series of cases and hence are not statistically significant. In order to overcome these deficiencies, reports are now being published on collated data obtained from several centres. Here again the problems encountered are the differing protocols for treatment with radioiodine, the indications for treatment which may include or exclude ablation of residual thyroid tissue, cervical nodal metastases and distal metastases. The administered doses of radioiodine for ablation of residual thyroid tissue and metastatic disease also vary from centre to centre. The most reliable conclusions regarding treatment protocol encountered in radioiodine treatment are obtained from studies reported on a large series of patients followed over a period of 3 decades or more from a single institute with a more or less unchanged protocol of treatment. Such studies are few. These reports from a handful of centres around the world are the most referred and cited studies. This paper portrays a comprehensive global practice of radioiodine therapy of differentiated thyroid carcinoma, along with some practical aspects of the treatment and a few pertinent information based on the local experience at the Radiation Medicine Centre, Mumbai, which probably has one of the largest experiences in this aspect of thyroid cancer management in the world. (author)

  9. Radioiodine therapy of benign non-toxic goitre. Potential role of recombinant human TSH

    DEFF Research Database (Denmark)

    Fast, S; Bonnema, S J; Hegedüs, L

    2011-01-01

    This review provides an update on recombinant human TSH (rh-TSH) augmented radioiodine (¹³¹I) therapy and outlines its potential role in the treatment of symptomatic benign multinodular non-toxic goitre. In some countries, ¹³¹I has been used for three decades to reduce the size of nodular goitres...

  10. Radioiodine therapy in benign thyroid diseases

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    Radioiodine ((131)I) therapy of benign thyroid diseases was introduced 70 yr ago, and the patients treated since then are probably numbered in the millions. Fifty to 90% of hyperthyroid patients are cured within 1 yr after (131)I therapy. With longer follow-up, permanent hypothyroidism seems...... of an exact thyroid dose is error-prone due to imprecise measurement of the (131)I biokinetics, and the importance of internal dosimetric factors, such as the thyroid follicle size, is probably underestimated. Besides these obstacles, several potential confounders interfere with the efficacy of (131...... predicts the outcome from (131)I therapy. The individual radiosensitivity, still poorly defined and impossible to quantify, may be a major determinant of the outcome from (131)I therapy. Above all, the impact of (131)I therapy relies on the iodine-concentrating ability of the thyroid gland. The thyroid...

  11. Long-term efficacy of modified-release recombinant human TSH (MRrhTSH) augmented radioiodine (131I) therapy for benign multinodular goiter. Results from a multicenter international, randomized, placebo-controlled dose-selection study

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedus, Laszlo; Pacini, Furio; Pinchera, Aldo; Leung, Angela M; Vaisman, Mário; Reiners, Christoph; Wemeau, Jean-Louis; Huysmans, Dyde; Harper, William; Rachinsky, Irina; De Souza, Hevelyn Noemberg; Castagna, Maria Grazia; Antonangeli, Lucia; Braverman, Lewis E; Corbo, Rossana; Düren, Christian; Proust-Lemoine, Emmanuelle; Marriott, Chris; Driedger, Al; Grupe, Peter; Watt, Torquil; Magner, James; Purvis, Annie; Graf, Hans

    2014-01-01

    Background: Enhanced reduction of multinodular goiter (MNG) can be achieved by stimulation with recombinant human thyrotropin (rhTSH) before radioiodine (131I) therapy. The objective was to compare the long-term efficacy and safety of two low doses of modified release rhTSH (MRrhTSH) in combinati...

  12. Thyrotoxicosis and radioiodine therapy: Does the dose matter?

    Directory of Open Access Journals (Sweden)

    Andrew Collier

    2012-01-01

    Full Text Available There are 3 treatment options for thyrotoxicosis: Antithyroid drugs, Surgery and radioiodine. The choice of treatment varies geographically. Radioiodine therapy is preferred in the United States. The aim of radioiodine is to destroy sufficient thyroid tissue to cure the hyperthyroidism. There is a lack of consensus towards what dose of radioiodine should be used. Several methods are used to determine the dose. In our practice we administer 400 MBq to patients with Graves and in patients with large multinodular goiter, we would administer 800 MBq.

  13. [Radioiodine therapy for Graves' disease: problems and new developments].

    Science.gov (United States)

    Reiners, Christoph

    2004-05-01

    In Germany, patients with Graves' disease are usually treated with radioiodine after unsuccessful antithyroid drug medication, occurrence of side effects from antithyroid drugs or an increased risk from surgery. In patients with normal or only slightly enlarged thyroid glands (volume TSH-receptor antibodies and cigarette smoking. Children are still rarely treated with radioiodine in Germany. In contrast, treatment with radioiodine should be more liberally applied in elderly patients with subclinical hyperthyroidism and cardiac symptoms. Individual dosimetry to determine the therapeutic activity is mandatory in Germany. Patients with large goitres obviously need higher organ doses than patients with smaller goitres or normal thyroid glands. Antithyroid drug treatment may interfere with radioiodine therapy. Therefore, it is recommendable to withdraw antithyroid drugs several days before treatment with radioiodine is initiated (and a preceding radioiodine uptake test is performed). In patients with Graves' orbitopathy prophylaxis with corticosteroids can prevent the worsening of symptoms that may be induced by radioiodine treatment. Currently, a risk adapted procedure is recommended according to which prophylactic medication with corticosteroids before applying radioiodine treatment is not necessary in patients with symptoms of orbitopathy and lack of other risk factors (cigarette smoking, in particular). Present results suggest that the risks of radioiodine treatment in Graves' disease patients are very low, while at the same time the cost-effectiveness of this treatment regimen is high. PMID:15255314

  14. Air monitoring in radioiodine therapy ward

    International Nuclear Information System (INIS)

    Full text: In Radioiodine therapy wards, in general the radiation exposure due to air borne activity from patients administered with 925MBq-7.4GBq (25-200mCi) of 131I has to be kept under regulatory limits. The purpose of conducting an air monitoring in our setup was to assess air borne activity levels. If the levels are high then it may lead to increased exposure to the occupational workers and patient's attendants. A total of 22.2GBq (600 mCi) 131I is administered every week to our patients in the isolation ward. After administered of 131I in the dose administration room, patients occupy their respective beds. The isolation beds are provided with attached toilet facility. Six air samples were collected from various regions (high dose room, low dose room, dose administration room, special room, corridor and entrance) in the vacuumized vials (9 ml) using 16 G needle at the breathing zone level. One control sample was also collected from the area with no possible 131I air-contamination. The vials were then counted in the pre-calibrated NaI well counter (known efficiency). The maximum air borne radioiodine concentration was found to be 1.999x10-6 ?Ci/cm3 in the high dose room (which keeps on decreasing with time, being maximum on second day and zero on third and subsequent days). We measured the thyroid counts of the staff and patient's attendants, routinely. The estimated thyroid activity never showed any significant increase in the thyroid uptake of the staff and patient's attendants. In our setup, air monitoring is strictly followed and performed periodically. We conclude that air monitoring program is only one element of the comprehensive radiation protection program and should be a made mandatory practice. (author)

  15. Strategies of radioiodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Several therapeutic options are available for the treatment of Graves' disease (GD), including long-term antithyroid drug medication (ATD), near-total resection (NTR) and radioiodine therapy (RIT). These treatments are used with different frequencies depending on geographical location, size of the goitre, age of the patient and experience of the physician. It should be noted that RIT is still being applied more frequently in the United States than in Europe. Despite the fact that RIT was introduced as long ago as 1941, several questions are still the subject of debate: Should a fixed dose or a calculated dose be used. If the dose is calculated, how many Grays (Gy) should be delivered to the thyroid? What is the goal of RIT in GD? Which factors, including ATD, influence the outcome of RIT? Is RIT appropriate in GD with Graves' ophthalmopathy (GO)? Although not all these questions have been answered yet, conclusions can be derived regarding a general strategy for use of RIT in GD. As with surgery, the goal of RIT in GD is euthyroidism with or without L-thyroxine medication. There is a clear advantage of dose calculation over use of a fixed dose because the only factor influencing the outcome is the dose delivered to a certain thyroid volume. To minimise recurrent hyperthyroidism, an ablative approach using a delivered dose of 250 Gy is widely accepted. Beside pretherapeutic T3 levels, thyroid volume and 24-h thyroid uptake, ATD may influence the outcome of RIT. Today it is accepted by most thyroidologists that, if ATD medication is necessary in overt hyperthyroidism, it should be withdrawn at least 2 days before RIT. In patients with GD and GO, RIT may worsen GO. If RIT is performed in GO it should be done under a 3-month steroid medication regimen. In conclusion, RIT can be considered an appropriate and cost-effective therapy in GD, although the decision regarding treatment should be taken on an individual basis, paying due respect to the course and severity of

  16. Results of radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    The goal of this work is the quantification of therapy results of a radioiodine therapy with Iodine 131 on 367 patients with the following benign thyroid diseases: euthyroidal struma, hyperthyroidism, hyperthyroidal struma and autonomous adenoma. 1. Euthyroidal struma - subjective improvement and objective diminution of the struma by 63%, subjective or objective improvement by 21% of the patients. Including the probable successful therapies the success rate was all together 90.1%. 2. Hyperthyroidism - after one-time/more-time (18.6%) radioiodine therapy the success rate was 71.5/85.7% including latent (8.6/10.0%) and manifest (7.1/8.5%) hypothroidism. 3. Hyperthyroidal struma - after one-time/more-time (16.9%) radioiodine therapy the success rate was 74.7/90.1% including latent (-/5.7%) and manifest (1.4/2.8%) hypothyroidism. 4. Autonomous adenoma - after one-time/two-time (5.2%) radioiodine therapy the success rate was 80.5/84.6% including 15.5% latent hypothyroidism. The results will be discussed in comparison to published data and to operation and thyrostatic treatment. (TRV)

  17. Experience and outcome of radioiodine therapy in hyperthyroidism

    International Nuclear Information System (INIS)

    Full text: Radioiodine is being increasingly used in the treatment of hyperthyroidism. The primary reasons for choosing radioiodine therapy are its effectiveness, ease of administration, relatively low cost and paucity of side effects. Here we presented our experiences and outcome of radioiodine therapy in hyperthyroidism in a divisional referral centre.We retrospectively analyzed 203 patients receiving radioiodine therapy for hyperthyroidism in Centre for Nuclear Medicine and Ultrasound, Khulna during the period from July 1994 to June 2004. All the patients had clinical signs and symptoms of hyperthyroidism as well as elevated triiodothyronine (T3), thyroxine (T4) and suppressed thyroid stimulating hormone (TSH). T3, T4 and TSH were done in all cases. Radionuclide scan and ultrasound of thyroid gland, radioactive iodine uptake (RAIU), thyroid microsomal antibody (TMAb) and fine needle aspiration cytology (FNAC) was done in selected cases. We assessed all patients prior to radioiodine therapy. Elderly patients and all those with cardiac complications and severe hyperthyroidism were pretreated with a short course of antithyroid drug in full dosages until they were clinically and biochemically euthyroid. Ninety five patients were on antithyroid medication (Neomercazole) prior to radioiodine therapy. Antithyroid medication were stopped 3 days before radioiodine therapy and restarted 3 days later and continued for 1 to 2 months depending on patient's symptoms. The rest of the patients received either no treatment or beta-blocker prior to radioiodine therapy. Menstrual history was taken in female patients and pregnancy was excluded by ultrasonography in doubtful cases before administering radioiodine. The likely consequences of the treatment were fully explained to the patients and attendants, the usual precautions for radiation protection of the public and the necessity of the follow-up were discussed and verbal consent was taken before administering radioiodine

  18. Radioiodine therapy for papillary and follicular thyroid carcinoma

    International Nuclear Information System (INIS)

    Radioiodine (131I) therapy is used in patients with papillary and follicular thyroid carcinoma for ablation of thyroid remnants and for treatment of persistent or recurrent disease. It should be used selectively, i.e. only in those patients for whom a clinical benefit may be expected. (orig.)

  19. The secondary hypothyroidism after radioiodine therapy and the replacement treatment

    International Nuclear Information System (INIS)

    The secondary hypothyroidism is the most important intercurrent disease after radioiodine therapy. The early hypothyroidism and the late hypothyroidism are incompletely different in pathogenesis. It needs researching further. there has not yet been an affirmable answer to choose the distillates from animal hypothyroid extract or complex preparation of levo-thyroxine in replacement treatment. (authors)

  20. Dosage assessment for radioiodine therapy in benign thyroid disorders

    NARCIS (Netherlands)

    Isselt, J.W. van

    2001-01-01

    The general aim of this thesis was to investigate the value and the shortcomings of the becquerel-per-gram method for radioiodine therapy in various benign thyroid disorders. The history of this treatment form, which goes back to the late 1940s, is described in Chapter 1. Almost fifty years after th

  1. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    International Nuclear Information System (INIS)

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version. (orig.)

  2. Radioiodine therapy and subsequent pregnancy; Gravidez apos radioiodoterapia

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Carmen Dolores G.; Miranda, Angelica E.; Corres, Nilson Duarte; Sieiro Neto, Lino; Corbo, Rossana; Vaisman, Mario [Hospital Universitario Clementino Fraga Filho (UFRJ), Rio de Janeiro, RJ (Brazil). Dept. of Endocrinology and Nuclear Medicine; Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil); Hospital dos Servidores do Estado do Rio de Janeiro, RJ (Brazil); E-mail: loloi@zaz.com.br

    2007-06-15

    Objectives: To evaluate abortion and fetal congenital anomaly rates in women previously submitted to radioiodine therapy for differentiated thyroid carcinoma. Study design: A case-control study of 108 pregnant women, 48 cases whose pregnancies were evaluated after they had undergone radioiodine therapy for differentiated thyroid carcinoma, and the control group consisted of 60 healthy pregnant women. Results: Of a total of 66 pregnancies, 14 conceived within the first year, 51 one or more years after the last administration of {sup 131}I, the medical record of one patient was not available. The interval between the last radioiodine therapy administration and conception ranged from 1 month to 10 years. There were a total of 4 miscarriages, 2 of them for unknown reasons. There was one case of congenital anomaly and two preterms birth. Nine women presented the following pregnancy events: placental insufficiency, hypertensive crisis, placental detachment, risk of miscarriage, preterm labour and four miscarriages. No statistical difference was observed between the studied and control groups. Conclusion: Radioiodine was followed by no significant increase in untoward effects in neither the pregnancy nor the offspring. (author)

  3. Radio-iodine therapy and Helicobacter pylori infection

    International Nuclear Information System (INIS)

    Helicobacter pylori is the most important cause of gastritis and related morbidities. Following consumption, radioactive iodine accumulates considerably in the stomach. On the basis of this observation, we decided to determine whether the high radiation induced by radio-iodine in the stomach is effective in the eradication of this infection. All consecutive patients with differentiated thyroid carcinoma, who were referred for radio-iodine therapy [dose 117.1±24.4 mCi (4.3±0.9 GBq), range 100-200 mCi (3.7-7.4 GBq)], were enrolled. To detect H. pylori infection, the urease breath test (UBT) was performed 1-2 h before radio-iodine consumption and the test was repeated 2 months later. Of 88 patients, 71 had pre-treatment positive UBT. Of these, 23 patients had negative post-treatment result, which means a significant reduction (26.1%, 95% confidence interval (CI) 16.8-35.5%) in the number of positive UBT results in our treated population (32.4% of UBT-positive cases became UBT-negative). Considering the high prevalence of reinfection in developing countries, the therapeutic benefit would have been more considerable if the second UBT had been done with a lag time of less than 2 months. Although radio-iodine therapy is not a logical method for the treatment of patients suffering from H. pylori, our finding provides indirect evidence about the radiosensitivity of bacteria, the future clinical applications of which need to be further evaluated. Also this finding can be useful for the food industry, where radiation is used widely to sterilize food. Regarding the possibility of H. pylori suppression, we recommend not using UBT for screening for the infection for at least within 2 months following radio-iodine therapy. (author)

  4. Radioiodine

    International Nuclear Information System (INIS)

    The physical, chemical radiochemical and radiometric properties of radioiodine significant for the radiochemical analysis are summarized. The occurrence of iodine, especially in the biosphere organic part, the calculation of the amount of iodine radioisotopes formed under different conditions, the spectrometric and integral methods of measuring the radioactivity of the most important iodine radioisotopes, the methods of separating iodine and its respective chemical forms are described. (M.K.)

  5. Radioiodine therapy within the German DRG-system 2005

    International Nuclear Information System (INIS)

    With introduction of a diagnosis-related groups system (DRG-system) in Germany the previous duration of stay based refunding is also replaced for the radioiodine therapies by a performance oriented reimbursement system. Since the at first optional start of the DRG-system in 2003 the adaptations which take place every year should lead, up to the planned end of the convergence phase in 2009, to a transparent, fair and economical financing system of the stationary hospital service. The physician is responsible for the right and complete coding of the diagnoses and procedures, which serve as essential parameters for the determination of the diagnosis related group (DRG) of a hospital case. In the actual version of the year 2005 the DRG-system still supplies for radioiodine therapy of thyroid carcinoma some unclarity in the coding of the diagnosis, as well as clear inadequacy with the fair mapping of the therapy costs. (orig.)

  6. Radioiodine therapy of benign thyroid diseases: Graves' disease - current aspects

    International Nuclear Information System (INIS)

    Radioiodine therapy is a reliable and cost-effective alternative to medical treatment of Graves' hyperthyroidism. Current recommendations favour a risk-adapted therapeutic procedure. Medical treatment is preferred in patients with a low risk of relapse which are characterised by the combination of female gender, age of onset above 40 years, thyroid volume below 40 ml and TSH-receptor antibodies below 10 U/l. Because of the poor remission rate with medical treatment in patients at less than 40 years of age, male gender, thyroid volume above 40 ml and TSH receptor antibodies above 10 U/l, it is suggested that definitive treatment with radioiodine or surgery should be considered soon after disease presentation. Analysis of cost-effectiveness clearly favour ablative radioiodine treatment. Ablative treatment is even more favourable in terms of early resumption of a normal life style of the hyperthyroid patient. Recent publications suggest further an adaptation of the tissue-absorbed dose to the pre-treatment thyroid volume using Marinelli's formula to achieve thyroid ablation with a single radioiodine treatment. (orig.)

  7. Recent advances in radioiodine therapy for thyroid cancer

    International Nuclear Information System (INIS)

    Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized

  8. Beyond radioiodine: novel therapies in advanced thyroid cancer

    International Nuclear Information System (INIS)

    Full text: Thyroid cancer is a relatively common endocrine malignancy. Fortunately, many patients do well with standard therapy including surgery and radioiodine. A minority of patients have poorly differentiated thyroid carcinoma that is unresponsive to radioiodine therapy. Redifferentiation agents that 'reprogram ' these tumors to concentrate radioiodine would be of great value in treating patients with advanced thyroid cancer. The retinoid isotretinoin is the most extensively studied of these agents. It appears that 20-40% of patients respond to isotretinoin treatment by concentration of radioiodine in metastatic tumors, but the clinical utility of this redifferentiation is still unclear. In vitro studies suggest that the retinoid receptors RARβ and RXRγ are required for this effect. Abnormal DNA methylation may be an early event in thyroid tumorigenesis and methylation of the sodium iodide symporter (NIS) may play a role in loss of iodine concentration in these tumors. Inhibitors of methylation (5-azacytidine, phenylacetate and sodium butyrate) have been shown to increase NIS expression and iodine uptake in cell culture models, but published trials in humans are not yet available. Histone acetylation is required for efficient transcription of genes necessary for differentiated function. Proteins that cause histone deacetylation inhibit gene transcription and differentiated function. Inhibitors of histone deacetylation (depsipeptide, trichostatin A) have been shown to increase NIS expression and iodine uptake in poorly differentiated and undifferentiated cell lines. Finally, commonly used agents such as thiazolidine diones (diabetes) and HMG-CoA reductase inhibitors (hypercholesterolemia) have shown promise in preliminary in vitro studies in advanced thyroid cancer cell lines. Our own work has focused on receptor-selective retinoids and thiazolidine diones as potential therapy in patients with advanced thyroid cancer based on nuclear hormone receptor

  9. Characterization of radioiodine therapy failures in Graves' disease

    International Nuclear Information System (INIS)

    Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves' disease without simultaneous carbimazole. Method: 226 patients with a confirmed diagnosis of Graves' disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), I-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ± 76.6 Gy vs. 285.2 ± 82.1 Gy, p 0.2). Of the 14 failures, n = 8 reached an absorbed dose 250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p 0.2) or gender (p = 0.13). Two-tailed Fisher's exact test showed no significant influence of gender on success rates (failures/successes: male 1/36, female 13/176, p = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves' disease without simultaneous carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy. (orig.)

  10. Pregnancy and high doses of radio-iodine therapy

    International Nuclear Information System (INIS)

    Therapy with high doses of radio-iodine means for both sexes a mutagenous risk for future pregnancies and a direct teratogeneous risk in the case of a prevalent pregnancy. The genetic risk is considered to be negligible, but high doses of radio-iodine will amost always cause radiation-induced athyreosis in the child, if given after the 12th week of gestation. Until the 10th week of gestation an abortion is only indicated when the administered activity of J-131 exceeded 4 GBq. Between the 10th and 12th week of gestation the decision depends on the amount of activity applied, later on abortion should be discussed in any case. (orig.)

  11. Therapy for non-toxic multinodular goiter. Radioiodine therapy as attractive alternative to surgery

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Dederichs, B.; Kobe, C.; Theissen, P.; Schmidt, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany)

    2006-07-01

    The need for therapy for nodular goiter results from the growth of thyroid nodules over decades and from the possibility of tracheal compression and worsening of respiratory function. Given the high prevalence of non-toxic goiter, the epidemiologically low incidence of clinically apparent thyroid cancer justifies non-surgical strategies. Randomised studies have shown that levothyroxine offers limited therapeutic effects and is inferior to radioiodine therapy regarding goiter shrinkage. When indication for a definitive therapy is given, the choice between resection and radioiodine therapy should consider volume of goiter, severity of clinical symptoms, thyroid uptake, patient's age, co-morbidity, previous resection of goiter, patient's profession and patient's wish. Even in large goiters between 100 and 300 ml radioiodine therapy showed consistent results with goiter size reduction from 35-40% one year and 40-60% two years after radioiodine therapy. Thyroid hormones to prevent recurrence of goiter are not necessary. Recurrent goiters were seldom observed after radioiodine therapy and resulted from initially very large goiters or uptake in dominante nodules or from low {sup 131}I activities. Recombinant human TSH (rhTSH) offers the opportunity to enhance the effect of radioiodine therapy. Observational studies have shown that rhTSH increases low {sup 131}I uptake in case of high alimentary iodine-supply by the factor 4, causes a more homogenous {sup 131}I distribution within the goiter and improves goiter reduction. A phase I study for dose finding is running in the USA. Conclusion: radioiodine therapy for shrinkage of large non-toxic goiter should not be restricted to elderly patients, or to patients with co-morbidity or high operative risk, but is an attractive alternative to surgery in patients with special professions (singer, teacher, speaker) or with the wish for a non-invasive treatment modality. (orig.)

  12. Primary hyperthyroidism - diagnosis and treatment. Indications and contraindications for radioiodine therapy

    International Nuclear Information System (INIS)

    Isotope therapy is one of the methods used in primary hyperthyroidism. The therapy is based on short-range beta radiation emitted from radioactive iodine. Radioiodine administration must always be preceded by pharmacological normalization of thyroid function. Otherwise, post-radiation thyrocyte destruction and thyroid hormones release may lead to hyperthyroidism exacerbation. Indications for radioiodine therapy in Graves-Basedow disease include recurrent hyperthyroidism after thyrostatic treatment or thyroidectomy and side-effects observed during thyrostatic treatment. In toxic nodule, isotope therapy is the first choice therapy. Radioiodine is absorbed only in autonomous nodule. Therefore, it destroys only this area and does not damage the remaining thyroid tissue. In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years. In patients with thyroid nodules suspected of malignancy, radioiodine treatment may be applied as a preparation for surgery, if thyrostatic drugs are ineffective or contraindicated. In children, radioiodine therapy should be considered in recurrent toxic goitre and when thyrostatic drugs are ineffective. In patients with Graves-Basedow disease and thyroid-associated orbitopathy, radioiodine treatment may increase the inflammatory process and exacerbate the ophthalmological symptoms. However, thyroid-associated orbitopathy cannot be considered as a contraindication for isotope therapy. The potential carcinogenic properties of radioiodine, especially associated with tissues with high iodine uptake (thyroid, salivary glands, stomach, intestine, urinary tract, breast), have not been confirmed. (authors)

  13. Radioiodine therapy for pediatric patients with thyroid cancer

    International Nuclear Information System (INIS)

    From 1986 to 1998, 753 patients under the age of 16 were operated on for thyroid cancer. A metastatic disease was diagnosed in 110 (14.6%) cases. In 108 patients (14.3%), there were lung metastases, and in 2 lung and bone metastatic lesions. In 22 of 110 patients (20%), metastases were detected by routine X-ray before therapy. Two patients died without treatment and 108 were selected for radioiodine therapy. Tumor histology was as follows: papillary carcinomas - 104, follicular - 3 and medullary - 1. Sex ratio was 1.2f/1m. Most of the patients had an extended disease. Neck lymph nodes were positive in 103 (95.4%) of cases and in 76 (70.4%) neck metastases were bilateral (pN1b). In 86 patients tumour involved the thyroid capsule and surrounding extrathyroid tissues (pT4). All the patients underwent thyroidectomy with either unilateral or bilateral radical neck dissection. Diffuse lung metastases were diagnosed in 88 cases. A single dose activity of sodium-iodine-131 varied from 3 to 5 GBq. In several advanced cases, the activity of radioiodine in following courses was enhanced up to 7 GBq. The total delivered activity for patients varied from 1.25 up to 43.7 GBq. Response was noted in 107 patients. There were 79 complete responders and in 28 patients partial response was reached. Cancer progression was seen only in one patient with medullary carcinoma, after three courses of radioiodine therapy. All the patients were alive from 6 to 56 months after surgery. (author)

  14. Thyroid emergencies following radioiodine therapy - Two case reports

    International Nuclear Information System (INIS)

    Thyrotoxicosis and well differentiated thyroid carcinomas are the two most common pathological conditions where radioiodine is used. Patients with well differentiated thyroid carcinomas are the candidates for post operative radio iodine therapy. It is currently the most popular and frequently used method of treatment. Its use is safe and cost effective. The results are usually eventless but in some exceptional cases emergencies that occurred after administration of I-131. One emergency occurred after I-131 administration for Graves' disease and the second case happened after therapeutic application of I-131 for treatment of local recurrences of thyroid cancer.(author)

  15. Dosage assessment for radioiodine therapy in benign thyroid disorders

    OpenAIRE

    van Isselt, J W

    2001-01-01

    The general aim of this thesis was to investigate the value and the shortcomings of the becquerel-per-gram method for radioiodine therapy in various benign thyroid disorders. The history of this treatment form, which goes back to the late 1940s, is described in Chapter 1. Almost fifty years after the discovery of radioactivity, the first clinical experiences with 131 I-treatment were reported in the United States. A simple and effective treatment form had emerged as an alternative to surgery ...

  16. Thyroid cancer radioiodine therapy: health service performance and radiation safety

    International Nuclear Information System (INIS)

    Greek Atomic Energy Commission collected data related to radioiodine I-131 therapy (RAIT) delivery to differentiated thyroid carcinoma patients, for the period 2003-13, corresponding to 100 % of hospitals at national level. Radiation safety and health service performance outcome indicators were assessed. The numbers of hospitals and nuclear medicine (NM) therapy wards, as well as RAIT annual frequencies, have increased. Geographical inhomogeneous distribution of existing infrastructure is recorded. In some cases, the observed inefficient use of NM therapy wards seems to be due to lack of human resources (e.g. nurses). Regular assessment of appropriate key indicators could serve as a useful tool for radiation safety monitoring and health service performance improvement. (authors)

  17. Thyroid cancer radioiodine therapy: health service performance and radiation safety.

    Science.gov (United States)

    Vogiatzi, S; Liossis, A; Lamprinakou, M

    2015-07-01

    Greek Atomic Energy Commission collected data related to radioiodine I-131 therapy (RAIT) delivery to differentiated thyroid carcinoma patients, for the period 2003-13, corresponding to 100 % of hospitals at national level. Radiation safety and health service performance outcome indicators were assessed. The numbers of hospitals and nuclear medicine (NM) therapy wards, as well as RAIT annual frequencies, have increased. Geographical inhomogeneous distribution of existing infrastructure is recorded. In some cases, the observed inefficient use of NM therapy wards seems to be due to lack of human resources (e.g. nurses). Regular assessment of appropriate key indicators could serve as a useful tool for radiation safety monitoring and health service performance improvement. PMID:25809109

  18. Anti-thyrotropin receptor antibody levels after radioiodine therapy in patients of childbearing age with Graves' disease

    International Nuclear Information System (INIS)

    Following radioiodine therapy for Graves' disease, transient elevation of anti-thyrotropin receptor antibody (TRAb) is observed. Elevation of TRAb causes neonatal hyperthyroidism. Serum TRAb levels before radioiodine therapy, 2 months to 1 year, 1 to 2 years, 2 to 3 years, and 3 to 4 years after radioiodine therapy were retrospectively analyzed in 25 women of childbearing age with Graves' disease. The normal range for TRAb is ≤15%. The one patient with serum TRAb levels <10% before radioiodine therapy did not have TRAb levels ≥50% after radioiodine therapy. However, in patients with serum TRAb levels of 10% to 30% before radioiodine therapy (n=8), TRAb were ≥50% in 75.0% 2 months to 1 year after radioiodine therapy, in 25.0% 1 to 2 years after, and in 37.5% 2 to 4 years after. In patients with serum TRAb levels of 30% to 50% before radioiodine therapy (n=3), TRAb levels were ≥50% in 33.3% 2 months to 1 year after radioiodine therapy and in 0.0% 1 to 4 years after. In patients with serum TRAb levels of 50% to 70% before radioiodine therapy (n=6), TRAb were ≥50% in 83.3% 2 months to 1 year after radioiodine therapy, in 66.6% 1 to 2 years after, and in 33.3% 2 to 4 years after. In patients with serum TRAb levels ≥70% before radioiodine therapy (n=7), TRAb levels were ≥50% in 100% 2 months to 1 year after radioiodine therapy, in 85.7% 1 to 2 years after, in 71.4% 2 to 3 years after, and in 57.1% 3 to 4 years after. Serum TRAb levels are more likely to be 50% after radioiodine therapy in patients with high serum TRAb levels before radioiodine therapy. (author)

  19. Radioiodine therapy of hyperthyroidism at 25 years experience in Vietnam

    International Nuclear Information System (INIS)

    prevalence of hypothyroidism according to the doses of I-131 received (p > 0.05). No occurring thyroid nodules was detected on thyroid scintigrams and echosonograms of all patients. Before and after (3 months - 3 years) I-131 therapy the mean thyroid volume reduction was 66.1%. TSH receptor antibodies (TRAb) are recognized as cause of organ-specific autoimmune disorder in Graves' disease. So the long-term effects of 131I treatment for Graves' disease on TRAb have been studied in Vietnam. The TRAb values decreased over a period of more than 2 years after 131I therapy for Graves' disease, and the TRAb values (negative or positive) before treatment may influence the long- term outcome of 1311 therapy. The overall success rate of therapy, recognized as the permanent resolution of hyperthyroidism was 98.7 % with 94.4% achieving resolution in not more than 2 dose.The main problem with radioiodine treatment is hypothyroidism and this is easily managed with L-thyroxine. In summary, radioiodine therapy for hyperthyroidism is safe, inexpensive and efficacious in Vietnam. (authors)

  20. Guideline for radioiodine therapy for benign thyroid diseases (version 4); Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen (Version 4)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany). Abteilung fuer Nuklearmedizin; Gruenwald, F. [Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Nuklearmedizinische Klinik der Henriettenstiftung des allgemeinen Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Nuklearmedizinische Klinik der Henriettenstiftung der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schober, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    Version 4 of the guideline for radioiodine therapy for benign thyroid diseases includes an interdisciplinary consensus ondecision making for antithyroid drugs, surgical treatment and radioiodine therapy. The quantitative description of a specific goiter volume for radioiodine therapy or operation was cancelled. For patients with nodular goiter with or without autonomy, manifold circumstances are in favor of surgery (suspicion on malignancy, large cystic nodules, mediastinal goiter, severe compression of the trachea) or in favor of radioiodine therapy (treatment of autonomy, age of patient, co-morbidity, history of prior subtotal thyroidectomy, profession like teacher, speaker or singer). For patients with Graves' disease, radioiodine therapy or surgery are recommended in the constellation of high risk of relapse (first-line therapy), persistence of hyperthyroidism or relapse of hyperthyroidism. After counseling, the patient gives informed consent to the preferred therapy. The period after radioiodine therapy of benign disorders until conception of at least four months was adapted to the European recommendation. (orig.)

  1. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    International Nuclear Information System (INIS)

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  2. Body weight gain after radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Aim: Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Methods: Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. Results: All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. Conclusions: An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas. (orig.)

  3. Amifostine is a potent radioprotector of salivary glands in radioiodine therapy. Structural and ultrastructural findings

    Energy Technology Data Exchange (ETDEWEB)

    Kutta, H. [Dept. of Anatomy, Christian Albrecht Univ. of Kiel (Germany); Dept. of Oto-Rhino-Laryngology, Head and Neck Surgery, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany); Kampen, U. [Clinic of Nuclear Medicine, Christian Albrecht Univ. of Kiel (Germany); Sagowski, C. [Dept. of Oto-Rhino-Laryngology, Head and Neck Surgery, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany); Brenner, W. [Clinic of Nuclear Medicine, Christian Albrecht Univ. of Kiel (Germany); Dept. of Nuclear Medicine, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany); Bohuslavizki, K.H. [Nuclear Medicine, Hamburg (Germany); Paulsen, F. [Dept. of Anatomy, Christian Albrecht Univ. of Kiel (Germany); Dept. of Anatomy and Cell Biology, Martin-Luther-Univ. of Halle-Wittenberg, Halle/Saale (Germany)

    2005-04-01

    Background and purpose: salivary gland impairment following high-dose radioiodine treatment is well recognized. Since differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigates the radioprotective effects of amifostine in salivary glands of rabbits receiving high-dose radioiodine therapy so as to obtain deeper insight in changes on the cellular and ultrastructural level. Material and methods: a total of 20 rabbits were investigated. High-dose radioiodine therapy applying 1 GBq {sup 131}I was performed in 16 animals. Eight of these 16 animals received 200 mg/m{sup 2} body surface amifostine prior to high-dose radioiodine therapy. Four additional rabbits served as controls, two receiving amifostine, the other two no treatment at all. Subsequently, salivary glands (submandibular and parotid glands, respectively) of all animals were examined by light and transmission electron microscopy. Results: parenchymal damage of both parotid and submandibular glands, specially acinar structures comprising cell organelles and nuclei, of animals pretreated with amifostine was much less pronounced than in animals without amifostine pretreatment. Conclusion: the results indicate that parenchymal damage in salivary glands induced by high-dose radioiodine therapy can significantly be reduced by amifostine. Therefore, amifostine therapy may increase quality of life in patients with differentiated thyroid cancer after radioiodine treatment. (orig.)

  4. Amifostine is a potent radioprotector of salivary glands in radioiodine therapy. Structural and ultrastructural findings

    International Nuclear Information System (INIS)

    Background and purpose: salivary gland impairment following high-dose radioiodine treatment is well recognized. Since differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigates the radioprotective effects of amifostine in salivary glands of rabbits receiving high-dose radioiodine therapy so as to obtain deeper insight in changes on the cellular and ultrastructural level. Material and methods: a total of 20 rabbits were investigated. High-dose radioiodine therapy applying 1 GBq 131I was performed in 16 animals. Eight of these 16 animals received 200 mg/m2 body surface amifostine prior to high-dose radioiodine therapy. Four additional rabbits served as controls, two receiving amifostine, the other two no treatment at all. Subsequently, salivary glands (submandibular and parotid glands, respectively) of all animals were examined by light and transmission electron microscopy. Results: parenchymal damage of both parotid and submandibular glands, specially acinar structures comprising cell organelles and nuclei, of animals pretreated with amifostine was much less pronounced than in animals without amifostine pretreatment. Conclusion: the results indicate that parenchymal damage in salivary glands induced by high-dose radioiodine therapy can significantly be reduced by amifostine. Therefore, amifostine therapy may increase quality of life in patients with differentiated thyroid cancer after radioiodine treatment. (orig.)

  5. Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit

    International Nuclear Information System (INIS)

    The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

  6. Stunning in radioiodine therapy of benign thyroid disease. Quantification and therapeutic relevance

    International Nuclear Information System (INIS)

    In radioiodine therapy of benign thyroid disease, a reduction of radioiodine uptake is known for consecutive administrations of 131I, which needs to be considered in therapy planning. Aim: Analysis of uptake reduction with regard on the time interval between radioiodine administration and the delivered dose to the thyroid tissue. Patients, methods: 200 patients were enrolled in the study and distributed into two groups (matched for diagnoses), each containing 32 patients with Graves' disease (target dose 250 Gy), 24 with focal (400 Gy), 44 with disseminated thyroid autonomy (150 Gy). In one group, a second fraction of radioiodine was given after 48 h (2d) due to an unexpected low radioiodine uptake or effective half-life, whereas in the other group the second fraction was given after 96 h (4d). Results: There was no significant difference between delivered doses due to the first fraction after four days: 2d: 86 ± 48 Gy (extrapolated) vs. 4d: 87 ± 41 Gy, p > 0.05. In 2d, delivered dose at time of second administration was significantly lower (51 μ 29 Gy) than in 4d (p < 0.01). The radioiodine uptake of the second fraction relative to the initial uptake was significantly lower in the 4d (4d: 63 ± 25% vs. 2d: 82 ± 24%, p < 0.01). In addition, a correlation between uptake reduction and delivered dose and an influence of the time interval between radioiodine administrations could be shown. Conclusions: Relative uptake of subsequent radioiodine fractions decreases with time after first administration and with increasing delivered dose to the thyroid. If a second fraction of 131I is given at an earlier time, the same therapeutic effect can be reached using lower amounts of activity, minimising radiation exposure and increasing efficiency of radioiodine therapy. (orig.)

  7. Symptomatic late-onset sialadenitis after radioiodine therapy in thyroid cancer

    International Nuclear Information System (INIS)

    The aim of this study was to document the subjective and objective findings of symptomatic late-onset sialadenitis after radioiodine therapy in patients with differentiated thyroid cancer. Subjective symptoms related to sialadenitis and Tc-99m pertechnetate salivary gland scintigram findings were assessed in 118 patients (26 males, 92 females) both before and during the late phase (mean 338 days) after the administration of radioiodine. Twelve of the 118 patients (10.2%) complained of symptomatic sialadenitis in the late phase without symptoms during the early phase (within 7 days of radioiodine administration). Significant associations were found between subjective symptoms and visual scintigram findings during the late phase (p=0.023). Furthermore, uptake and excretion by both parotid glands were significantly affected by radioiodine therapy. Symptomatic late-onset sialadenitis occurred at an incidence of 10.2%, and salivary gland function was affected in both parotids in most patients. (author)

  8. Radioiodine therapy in hyperthyroid disease: poorer outcome in patients with high 24 hours radioiodine uptake

    DEFF Research Database (Denmark)

    Kristoffersen, Ulrik Sloth; Hesse, Birger; Rasmussen, Ase Krogh; Kjaer, Andreas

    2006-01-01

    PURPOSE: To evaluate the importance of 24 h radioiodine uptake (24 h RIU) for the outcome of radioiodine treatment of hyperthyroidism. METHODS: Retrospective analysis of 72 patients who underwent radioiodine treatment for toxic goiter at our outpatient clinic [29 diffuse goiters (DG), 30 toxic...... multinodular goiters (TMG) and 13 toxic adenomas (TA)]. Thyroid status was determined by TSH, fT3 and fT4 levels, and outcome was rendered successful when hyperthyroidism was absent. Relation between low 24 h RIU (below median) or high 24 h RIU (above or equal to median) and outcome was evaluated. RESULTS: Of...... patients with DG and low 24 h RIU, 15% remained hyperthyroid, as opposed to 56% of patients with DG and high 24 h RIU (P<0.05). Of patients with TMG and low 24 h RIU, none remained hyperthyroid, as opposed to 44% of patients with TMG and high 24 h RIU (P<0.01). Of patients with TA and low 24 h RIU, none...

  9. Advances of radioiodine therapy of tumor induced by sodium iodide symporter gene

    International Nuclear Information System (INIS)

    As a kind of membrane protein that mainly mediates iodide transport into thyroid follicular cells, sodium iodide symporter (NIS) plays a key role in radioiodine therapy of both thyroid and other cancers. Studies show that decreased NIS expression level or intracellular localization in thyroid carcinomas lead to low iodine uptake. So NIS gene therapy is a new method to overcome this problem. To be therapeutically effective, radioiodine has to be remained in the tumor cells for sufficient long time; this is still a problem which reduces therapeutic effect. It should increase iodide retention and decrease iodide efflux in tumor cells to optimize therapeutic scheme. This article reviews the studies on advances of radioiodine therapy of tumor induced by sodium iodide symporter gene. (authors)

  10. Influence of preceding diagnostic and therapeutic procedures on the radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Before and until 3 weeks after application of nonionic CA iodine and the 20-min-technetium-thyroid-uptake was measured in serum and urine in 23 euthyroid patients, which were given intravenously nonionic CA during heart catheterization. Concerning the possible influence of iodine contamination on a subsequent radioiodine therapy the following aspects result from the study: the time interval between application of CA and therapy has to be at least 4-6 weeks to avoid dilution of the radioiodine by iodine being released from the contrast agents. The thyroid-uptake of Technetium or Iodine after administration of CA is not constant over time but reaches its original value only in a gradual way (60% of the initial value 3 weeks after the CA were given); that means, the iodine-uptake during, radioiodine therapy can be higher than it was at the time the dose was calculated. Concerning the possible influence of preceding therapeutic procedures on the therapy with radioiodine the pretreatment with antithyroid drugs plays the most important role. Antithyroid drugs of the thiourylene group have been shown by many study groups to have a radioprotective effect. Other large studies however could not demonstrate any effect of antithyroid medication on the results of radioiodine therapy. All studies so far existing have in common that they are not strongly randomized with regard to the patient groups, because generally only in severe cases of hyperthyroidism additional antithyroid drug treatment has been employed, therefore it might be the case that the radioprotective effect of antithyroid drugs may be caused only by selection artifacts. The contradictory results of the different studies justify the practical way in so far as there are no reasonable objections against the pretreatment with antithyroid drugs to restore euthyroidism before starting the therapy with radioiodine. (orig./MG)

  11. Radioiodine therapy in toxic multinodular goiter- the influence of carbimazole therapy and dietary iodine on relapse rates

    International Nuclear Information System (INIS)

    Full text: The relapse rate of radioiodine therapy in toxic multinodular goiter (TMNG) is reported to be around 34% at one year. The effect of antithyroid drugs on the response rate is controversial with studies reporting a higher relapse rate in patients pretreated with antithyroid drugs. Other studies report no influence of pretreatment with antithyroid drugs. The thyroid clinic at Tata Main Hospital is a referral center for thyroid disorders in Jamshedpur. 63 patients of TMNG (Group A) were treated with Radioiodine between 1995-2003. The demographic profile of these patients was as follows: M/F- 38%: 62%, 76% of patients were above 40 years, 85% had been on anti-thyroid drugs for more than 18 months. Fixed dose radioiodine in an oral dose varying from 5-10 mCi was given in all patients of Group A. 32.4 % of patients continued to be toxic or relapsed after a period of euthyroid status within 1 year of Radioiodine therapy. A change in protocol for radioiodine therapy was introduced in 2003. This included withdrawal of antithyroid drugs for one month before radioiodine therapy and the use of noniodized salt and abstinence from seafood in diet during this period. 33 TMN Goiter patients (Group B) followed this protocol before receiving Radioiodine. The dose of Radioiodine remained 5-10 mCi. The age and sex profile of Group A and B were comparable. However, Group B patients had been on antithyroid drugs for a shorter period (p< 0.001). The dose of Radioiodine in 94% of Group B patients was between 7-10mCi, whereas this was 63.4% in Group A. The rest of the patients had received a dose between 5-7 mCi. The relapse rate in Group B was 9.1% compared to 32.4% in Group A. Improvement in response rates with increase in Radioiodine dose remains controversial.P PThe better response rate in Group B patients may be attributed to the withdrawal of antithyroid drugs for one month before therapy and the reduction in dietary intake of Iodine for a month before therapy. However, a

  12. Radioiodine therapy in non-toxic multinodular goitre

    International Nuclear Information System (INIS)

    Full text: The effect of radioiodine in the treatment of non-toxic multinodular goitre has not been adequately evaluated. The aim of the study was to see the effect of radioiodine on thyroid size and function in patients with non-toxic multinodular goitre. We prospectively studied 55 non-toxic multinodular goitre patients treated with radioiodine of which 15 were males and 40 were females with age ranged from 25 years to 60 years (mean ± SD 40.45 ± 10.70 years) for a minimum of 12 months. Patients who were selected were those with local compression symptoms or for cosmetic reasons and the treatment was chosen because of a high operative risk or refusal to be operated on. Thyroid volume and T3, T4, TSH of all patients were determined before treatment and 6 months interval after treatment. Radioiodine was given in the dose ranged from 333 MBq (9 mCi) to 555 MBq (15 mCi) (mean ± SD 11.45 ± 2.04 mCi). The mean thyroid volume was reduced from 44.75 ± 37.44 ml to 28.76 ± 27.25 ml at 12 months (p < 0.001) i.e., reduced by 35.73%. Thyroid volume reduction at 6 months was 21.07%. Hypothyroidism occurred in 9.1% of the patients at 12 months. Side effects were few. Three cases developed radiation thyroiditis and two cases developed hyperthyroidism that was managed conservatively. It has been concluded that radioiodine is effective and well tolerated in the treatment of non-toxic multinodular goitre and may be the treatment of choice in elderly patients, in patients in whom surgery is contraindicated and in patients who are unwilling to undergo surgery. (author)

  13. Exhalation of {sup 131}I after radioiodine therapy: measurements in exhaled air

    Energy Technology Data Exchange (ETDEWEB)

    Schomaecker, Klaus; Sudbrock, Ferdinand; Fischer, Thomas; Dietlein, Markus; Kobe, Carsten; Gaidouk, Mark; Schicha, Harald [University of Cologne, Clinic of Nuclear Medicine, Cologne (Germany)

    2011-12-15

    A considerable amount of radioiodine is exhaled after radioiodine therapy leading to unwanted radiation exposure through inhalation. This study focused on the concentration of radioactivity exhaled and its chemical nature. Air exhaled by 47 patients receiving {sup 131}I-iodine for different thyroid diseases (toxic goitre n=26, Graves' disease n=13, thyroid cancer n=8) was investigated with a portable constant air-flow sampler. Different chemical iodine species were collected separately (organic, elemental and aerosolic) up to 26 h after administration of the radioiodine capsule. The data approximated to a monoexponential time-activity curve when integrated over 100 h. The radioactivity in the filters was measured with a well counter at defined time points after administration. The radioactivity of {sup 131}I in the exhaled air 1 h after administration ranged from 1 to 100 kBq/m{sup 3}. Two parameters (half-life of radioiodine exhalation and time-integrated activity over 100 h) were substantially higher in patients with cancer after near-total thyroidectomy (11.8 {+-} 2.1 h and 535 {+-} 140 kBq / m{sup 3}, respectively) than in patients with hyperfunctioning thyroid tissue due to toxic adenoma (7.6 {+-} 2.5 h and 115 {+-} 27 kBq/m{sup 3}, respectively) or Graves' disease (6.4 {+-} 3.6 h and 113 {+-} 38 kBq/m{sup 3}, respectively). The percentage of radioiodine in the exhaled air in relation to radioiodine administered to the patient was between 80 ppm and 150 ppm. The fraction of organically bound radioiodine (mean value) for all time points after administration was 94-99.9%. This percentage did not depend on the type of thyroid disease. The amount of exhaled radioiodine is small but by no means negligible on the first day after administration. This is the first study to provide experimental evidence on a systematic basis that radioiodine becomes exhalable in vivo, i.e. in the patient. The mechanism of organification of orally administered radioiodine

  14. Dynamics of circulating immune complexes in patients of different age with differentiated thyroid cancer in the process of radioiodine therapy

    International Nuclear Information System (INIS)

    Determining the influence of radioiodine on the amount of circulating immune complexes in the blood serum of patients of different ages demonstrated patients' age did nit have any significant effect on the degree of changes in circulating immune complexes content in patients who underwent radioiodine therapy, though in younger patients immunological disturbances were reported in earlier terms

  15. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    Energy Technology Data Exchange (ETDEWEB)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP); Monte, Osmar [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Physiology Department; Silva, Marta Assumpcao de Andrada e [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Speech Therapy School; Duprat, Andre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department; Marone, Marilia [Nuclimagem - Irmanity of the Sao Paulo Santa Casa de Misericordia, SP (Brazil). Nuclear Medicine Unit; Almeida, Renata de; Iglesias, Alexandre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department. Endocrinology and Metabology Unit

    2008-07-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  16. Radioiodine therapy effects on offspring of patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Radioiodine therapy has attained a significant role in the treatment of differentiated thyroid cancer. The literature addressing possible secondary effects of 131 I is limited, although there has been increasingly interest in this field. A more comprehensive understanding of the mutagenic effects of radiation on the offspring of women exposed to 131 I is mandatory in view of the possibility of occurrence of miscarriages, congenital abnormalities and malignancies in these children. In this review, we found that many reports on safety of this type of treatment in female patients in reproductive age recommend that pregnancy should be avoided for at least one year after therapeutic administration of radioiodine. (author)

  17. Recombinant human thyrotropin-stimulated radioiodine therapy of nodular goiter allows major reduction of the radiation burden with retained efficacy

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedüs, Laszlo; Grupe, Peter; Nielsen, Viveque Egsgaard; Bluhme, Christa; Bastholt, Lars; Bonnema, Steen Joop

    2010-01-01

    Context and Objective: Stimulation with recombinant human TSH (rhTSH) before radioiodine ((131)I) therapy augments goiter volume reduction (GVR). Observations indicate that rhTSH has a preconditioning effect beyond increasing thyroid (131)I uptake. We test the hypothesis that an equivalent GVR...... might be obtained by an absorbed thyroid dose well below what has been used previously. Patients and Design: In a double-blinded setup, 90 patients (78 women; median age, 52 yr; range, 22-83) with a nontoxic nodular goiter (median size, 63 ml; range, 25-379 ml) were randomized to either 0.1 mg rhTSH (n......-3530) in the placebo group (70% reduction, P < 0.0001). According to the official radiation regulation, hospitalization was required in 14 patients in the placebo group vs. one patient in the rhTSH group (P < 0.0001). In both groups, goiter-related symptoms were effectively relieved in the majority of...

  18. Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Jensen, Lars Thorbjoern; Vej-Hansen, Anders; Nygaard, Birte

    2015-01-01

    BACKGROUND AND OBJECTIVE: Hyperthyroid patients treated with radioiodine have increased morbidity and mortality from cerebrovascular events. This risk has until now has been attributed to the hyperthyroidism. However, radioiodine therapy of benign thyroid diseases exposes the carotid arteries to...... radiation and is capable of inducing atherosclerosis. The objective of the study was to elucidate whether ionizing radiation from radioiodine might contribute to cerebrovascular morbidity. METHODS: In a retrospective register cohort study, 4000 hyperthyroid and 1022 euthyroid goitre patients treated with...... cerebrovascular events among all treated patients, hazard ratio (HR) 1.18 (95% CI 1.09-1.29). The risk was increased among hyperthyroid (HR 1.17; 95% CI 1.07-1.28) as well as euthyroid patients (HR 1.21; 95% CI 1.02-1.44). CONCLUSIONS: We report an increased risk of cerebrovascular events in hyperthyroid as well...

  19. Unusual Fatal Effect of Radioiodine (I-131) Therapy : A Case Report

    International Nuclear Information System (INIS)

    The aim of radioiodine therapy following surgery for thyroid carcinoma is to ablate the remnant thyroid tissue in the neck by delivering a minimum dose of 300 gray to the residual thyroid tissue. Side-effects are usually minimal and transient, and use of rhTSH can reduce their incidence. In patients with functioning metastases, successive doses of radio iodine are administered until complete ablation of metastatic disease is achieved. A 54-year-old woman with diffuse pulmonary metastases from thyroid cancer died from a fatal sudden alveolar haemorrhage that occurred 3 weeks after radioiodine therapy. Post mortem biopsy of specimens taken from the sites of pulmonary metastasis revealed massive haemorrhage and apoptosis. It is known that in vitro, beta-irradiation can activate apoptosis pathways. This effect seems to depend on dose of radioiodine and time point. In humans, I-131 therapy can induce apoptosis in hyper-functioning thyroid tissue. This effect is dependent on iodine concentration which is dependent on NIS expression itself. A sudden wave of apoptosis occurring 3 weeks after radioiodine dose could be lethal. On the other hand in order to have favourable treatment response it is essential to have high I-131 uptake by pulmonary metastases. Although fatal effect of radioiodine therapy are rare, this particular case suggests that a high level of I-131 concentration in critical organs detected by post-therapy whole-body scan (WBS) should be an indication for imposing particular care in the management of such patients, and perhaps consideration for prolonged hospitalization and late discharge. (author)

  20. Outcome of radioiodine therapy without, on or 3 days off carbimazole: a prospective interventional three-group comparison

    International Nuclear Information System (INIS)

    Carbimazole ameliorates hyperthyroidism but reduces radioiodine uptake and adversely affects the outcome of simultaneous radioiodine therapy. We explored whether withdrawal of carbimazole for 3 days can restore the outcome of radioiodine treatment without concurrent exacerbation of hyperthyroidism. By generating three groups with comparable radioiodine uptake, we also investigated whether the effect of carbimazole depends on the radioiodine uptake. Stratified by a radioiodine uptake >30%, 227 consecutive adult patients were prospectively assigned to radioiodine therapy (target dose 200 Gy) without, on or 3 days off carbimazole. Patients were clinically (Crooks-Wayne score) and biochemically (T3, fT4, TSH) followed up after 3, 6 and 12 months. Primary endpoint was outcome 12 months after radioiodine therapy. A total of 207 patients completed follow-up (toxic nodular goitre, n=117; Graves' disease, n=90). The overall success rate was 71.5%. Patients without and 3 days off carbimazole had similar biochemical (81.4% and 83.3%, respectively; p=0.82) and clinical outcomes [median (range) Crooks-Wayne score 0 (0-16) and 1 (0-10), respectively; p=0.73], which were both higher than in patients on carbimazole [42.6%, p4, T3 and TSH. (orig.)

  1. Cost-effectiveness-analysis: radioiodine or antithyroid drugs as first-line therapy of hyperthyroidism due to Graves' disease

    International Nuclear Information System (INIS)

    Aim: As first-line therapy of hyperthyroidism caused by Graves' disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. Method: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq I-131 residual activity. Result: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. Conclusion: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake). (orig.)

  2. Radioiodine Therapy for Hyperthyroidism Changing Pattern of Management over Three Decades at INMAS

    OpenAIRE

    Ravi Shankar; Prakash, R.; S. K. Sharma; C.M. Khanna

    1990-01-01

    Iodine - 131 therapy is a relatively simple, effective and economical method of treating hyperthyroidism. Even fifty years after the introduction of radioactive iodine, there is no concensus on the approach for selection of the dose for treatment of hyperthyroidism. Since the last three decades, the approach for radioiodine therapy at this Institute has been to treat with low, fractionated doses to produce partial destruction of the thyroid gland leaving the patient sufficient function...

  3. Feasibility of a randomized trial on adjuvant radio-iodine therapy in differentiated thyroid cancer.

    OpenAIRE

    Dragoiescu, C.; Hoekstra, O S; Kuik, D J; Lips, P.T.A.M.; Plaizier, MA; Rodrigus, PT; Huijsmans, DA; Ribot, JG; Kuijpens, J; Coebergh, J. W.; Teule, G.J.J.

    2003-01-01

    BACKGROUND: Justification for adjuvant radio-iodine (I-131) therapy in differentiated thyroid cancer (DTC) is purely based on retrospective data. This is true for ablative therapy and even more so for high-dosage adjuvant schedules. Randomized trials on the latter application are considered impossible due to anticipated formidable sample sizes required in a disease with an overall excellent prognosis like DTC. OBJECTIVE: To develop and validate a model that could stratify for risk of recurren...

  4. Influence of low- and high-dose radioiodine therapy on oxidative modification of fibrinogen

    International Nuclear Information System (INIS)

    Fibrinogen plays a central role in the course of thrombosis and hemostasis. It is soluble in blood and tissue extracts and transformed into the insoluble fibrin network structure in the presence of thrombin. Fibrinogen in circulating blood consists of a population of slightly different molecules with a half-life of 3.5-4.5 days. Various environmental conditions may cause different types of modifications of the molecule leading to a different functional behavior. Introduction of carbonyl groups in amino acid side chains is known as a marker for protein oxidation. Radioiodine therapy, applied in patients suffering from hyperthyroidism or differentiated thyroid carcinoma, may cause an oxidative modification of fibrinogen by formation of free radicals in blood exposed to the radioactive agent 131I. The topic of my thesis was i. to develop a simple and not time consuming method for isolation of fibrinogen from small volumes of human plasma (∼ 6ml), ii. to assess, whether radioiodine therapy causes detectable introduction of carbonyl groups into the fibrinogen molecule, and iii. to analyze an association between thyroid hormone function, fibrinogen levels and protein oxidation by means of carbonyl content. Purification of fibrinogen from human plasma was possible by three different methods (ammonium sulphate/ethanol; glycine/ethanol; glycine). Plasma levels of fibrinogen (Clauss method) and protein carbonyl group content (2,4-DNPH - assay) were determined before and after radioiodine therapy. The results demonstrate a significant increase (p = 0.05) in carbonyl content of human fibrinogen in cancer patients treated with 131I. However, in patients with diagnosed hyperthyroidism values were not significantly altered. In carcinoma patients, baseline fT4 levels and the relative increase in carbonyl content of fibrinogen after radioiodine therapy were correlated (r = 0.83; p 0.005), whereas no such correlation was found in patients with hyperthyroidism. Plasma fibrinogen

  5. Radioiodine therapy in patients with hyperthyroid disorder: standard versus dosimetric activity application.

    Science.gov (United States)

    Reinartz, P; Zimny, M; Schaefer, W; Mueller, B; Buell, U; Sabri, O

    2003-12-01

    Due to its high success rate and non-invasive character, an increasing demand for radioiodine therapy can be seen. This study was conducted to determine whether standardized 131I activities can be used to facilitate management of patients with hyperthyroid disorder or whether a pre-therapeutic radioiodine test is advisable to determine an adequate therapeutic activity. The therapeutic uptake of 218 patients with benign thyroid disorders were determined and compared with 24 h and 48 h test uptake measurements as well as with calculated standard uptake values. Since there is a linear relationship between iodine uptake and delivered radiation dose, the effect of the different therapeutic approaches on the latter parameter was analysed. Special care was taken to assess possible differences between the various thyroid disorders. A mean deviation between pre-therapeutic test uptake and actual therapeutic uptake of 14.7% was observed in contrast to one of 29.1% when using disease specific standard values per millilitre of thyroid tissue. Furthermore, the proportion of patients with large deviations of more than 40% increased drastically when using standard uptake values (with radioiodine test, 4.1%; with standard values, 18.8%). In conclusion, the dosimetric approach with a pre-therapeutic radioiodine test proved to be the most accurate therapeutic procedure. Both the 24 h and 48 h test uptake measurements gave analogous results and yielded a correlation coefficient of 0.91 when compared with the therapeutic uptake. While it may be tempting to use standard activities to facilitate patient management, the findings of this study confirm that, for precise therapy planning, a pre-therapeutic radioiodine test is advised. Since no significant difference could be found between the 24 h and 48 h test uptake values, an early measurement 24 h after administration of the test activity is recommended. PMID:14627852

  6. Routine sensor-augmented pump therapy in type 1 diabetes

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten; Scaramuzza, Andrea; Bratina, Natasa;

    2013-01-01

    Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia.......Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia....

  7. Sensor-augmented pump therapy at 36 months

    DEFF Research Database (Denmark)

    Schmidt, Signe; Nørgaard, Kirsten

    2012-01-01

    This follow-up study investigates the metabolic and psychosocial effects of sensor-augmented pump (SAP) therapy in adults with type 1 diabetes 36 months after therapy start.......This follow-up study investigates the metabolic and psychosocial effects of sensor-augmented pump (SAP) therapy in adults with type 1 diabetes 36 months after therapy start....

  8. The Effect of High Dose Radioiodine Therapy on Formation of Radiation Retinopathy During Thyroid Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Tülay Kaçar Güvel

    2014-10-01

    Full Text Available Objective: Non-thyroidal complication of high-dose radioiodine therapy for thyroid carcinoma might cause salivary and lacrimal gland dysfunction, which may be transient or permanent in a dose-dependent manner. However, radiation retinopathy complicating 131I therapy, has not been previously well characterized. The aim of this study was to evaluate the extent of retinal damage among patients who had received high doses of radioiodine treatment. Methods: Forty eyes of 20 patients (3 male, 17 female who received 250-1000 mCi during 131I therapy and on ophthalmological follow up for a year after the last treatment were included in the study. Mean age of the study group was 50 years (range 25-70 years. In ophthalmologic examination, visual acuity was measured in order to determine visual loss. Intraocular pressure was measured in all the patients. Then lens examination was carried out with slit lamp biomicroscopy in order to investigate cataract or partial lens opacities. Fundus observation was carried out through the dilated pupil with slit lamp biomicroscopy using 90 D noncontact lens. Result: The best corrected visual aquity with Snellen chart was found as 1.0 in 36 eyes (90% and between 0.6 and 0.9 (10% in 4 eyes (10%. At the biomicroscopic fundus examination, retinal hemorrhage consistent with radiation retinopathy, microaneurysm, microinfarction, edema or exudation, vitreus hemorrhage, partial or total optical disc pallor indicating papillopathy in the optic disc were not observed in any of the eyes. Conclusion: This result indicates that there is not any significant correlation between repeated high-dose radioiodine therapy and radiation retinopathy in differentiated thyroid carcinomas. Even though there is not a significant restriction in use of higher doses of radioiodine therapy in differentiated thyroid carcinoma, more extensive studies are needed in order to obtain more accurate data on possible occurrence of retinopathy.

  9. Effect of radioiodine therapy on pulmonary metastases from well-differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Objective: To investigate effect of radioiodine therapy on pulmonary metastases from well-differentiated thyroid cancer. Methods: Fifty-eight cases of pulmonary metastases were studied utilizing chest X-ray, pulmonary function test and 99Tcm-DTPA aerosol clearance examination. Results: The data of pulmonary function test were of no difference between groups of various radiation doses cumulation (P > 0.05). The differences of vital capacity (VC), fast vital capacity (FVC) and forced expiratory volume in one second (FEV1) were not remarkable between the two groups of male or female patients (P > 0.05), but the difference of maximal volume ventilation (MVV) was P 99Tcm-DTPA aerosol clearance rates between various groups were of no difference (P > 0.05). Only for one female, 43 years old who had received an accumulative dose of 51.8 GBq radioiodine over an 8-yr period, her pulmonary function test showed evidence of restrictive lung disease, chest X-ray showed haziness and DTPA half-time clearance was 26.4 min, which is suggestive of interstitial fibrosis. Conclusion: The cumulative dose of radioiodine and gender of the patients had not statistically significant effects on the pulmonary function. Interstitial fibrosis must be carefully watched when the cumulative radioiodine dose is over 37 GBq

  10. Stunning effects in radioiodine therapy of thyroid carcinoma. Existence, clinical effects and ways out

    International Nuclear Information System (INIS)

    In radioiodine therapy for malignant thyroid disease, the pre-therapeutically administered iodine-131-dose can reduce the potential of thyroid or thyroid carcinoma cells to absorb the following therapeutic iodine-131-dose, possibly leading to its failure. This so called stunning effect is controversially discussed in the scientific community. Here we summarize and evaluate publications with regard to the existence and the effects of stunning as well as possible countermeasures. (orig.)

  11. Functional impairment of the salivary gland after high dose radioiodine therapy

    International Nuclear Information System (INIS)

    Radiation induced impairements of salivation, which are rather related to the more radio-sensitive parotides than to the submandibular glands according to our experience, occur in about 1/3 of the patients treated with 7,4-11,1 GBq (200-300 mCi) of I-131. Based on our results and experiences after percutaneous radiation therapy of the head and neck region, a total xerostomy (Sicca's syndrome) must already be expected at a focal dose of 40 Gy to the salivary gland parenchyma. Experience has shown that this cumulative radiation dose is reached at about 18,5 GBq (500 mCi) of I-131. The acute sialadenitis occuring a few days after therapeutic administration of radioiodine is mostly associated with minor complaints and therefore often escapes the patient's notice. During the onset of xerostomy, which is associated with a moderate reduction of salivation, the patients are surprisingly indolent. However, specific examinations including patient's history, palpation and functional scintigraphy enable early detection of radiation induced functional depression of the salivary glands, which should be accounted for in the assessment of indication for further radioiodine therapy. To prevent the severe consequences of xerostomy such as ageusia, dysphagia, epithelial lesion of the oral mucosa and loss of teeth, the patients under radioiodine therapy should be urged to see to sufficient fluid supply and to steadily stimulate salivation e.g. by sour drops, chewing gum or Emser pastilles. (orig.)

  12. Rh-TSH (Thyrogen) aided radioiodine therapy in children and adolescents with differentiated thyroid cancer

    International Nuclear Information System (INIS)

    -histaminic treatment. There were no signs of hyperthyrosis and in all patients fT3 was within normal range. There were no late side effects. Conclusions. rhTSH-aided radioiodine treatment in children/adolescents with DTC is safe and effective treatment. It allows to avoid hypothyroidism during L-thyroxin withdrawal, without any significant side effects. The so far observed results of the therapy suggest that the treatment is effective both as an adjuvant and radical treatment but longer follow up is necessary. (authors)

  13. Dosimetry in radioiodine therapy of benign thyroid diseases. Background and practice; Dosimetrie bei Radioiodtherapie benigner Schilddruesenerkrankungen. Hintergrund und Durchfuehrung

    Energy Technology Data Exchange (ETDEWEB)

    Bockisch, A.; Sonnenschein, W.; Jentzen, W.; Hartung, V.; Goerges, R. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2008-09-15

    Radioiodine therapy of benign thyroid diseases (focal = [toxic adenoma], multifocal, disseminated autonomy, Grave's disease or clinical relevant goitre) needs to be and can be performed individually for each patient. Most frequently a radioiodine test is performed applying a small activity of iodine-131 ({sup 131}I). The paper discusses some protocols for pre- or posttherapeutic dosimetry and discusses their advantages and disadvantages. All are based on the volumetry of the target tissue as well as the radioiodine kinetics in the target volume what may be represented by maximum uptake and half life of iodine retention in the thyroid. Possible disturbances and measuring uncertainties of these parameters are presented and discussed. In spite of the discussed uncertainties in dosimetry, due to its high therapeutic width radioiodine therapy is a very successful procedure to cure hyperthyroidism or to reduce goitre volume with only little side effects. (orig.)

  14. A mathematical model of optimized radioiodine-131 therapy of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    The current status of radioiodine-131 (RaI) dosimetry for Graves' hyperthyroidism is not clear. Recurrent hyperthyroidism and iatrogenic hypothyroidism are two problems which interact such that trying to solve one leads to exacerbation of the other. Optimized RaI therapy has therefore begun to be defined just in terms of early hypothyroidism (ablative therapy) as physicians have given up on reducing hypothyroidism. Optimized therapy is evaluated both in terms of the greatest separation of cure rate from hypothyroidism rate (non-ablative therapy) or in terms of early hypothyroidism (ablative therapy) by mathematical modeling of outcome after radioiodine and critically discussing the three common methods of RaI dosing for Graves' disease. Cure follows a logarithmic relationship to activity administered or absorbed dose, while hypothyroidism follows a linear relationship. The effect of including or omitting factors in the calculation of the administered I–131 activity such as the measured thyroid uptake and effective half-life of RaI or giving extra compensation for gland size is discussed. Very little benefit can be gained by employing complicated methods of RaI dose selection for non-ablative therapy since the standard activity model shows the best potential for cure and prolonged euthyroidism. For ablative therapy, a standard MBq/g dosing provides the best outcome in terms of cure and early hypothyroidism

  15. A-8 year review of radio-iodine therapy in the management of thyrotoxicosis

    International Nuclear Information System (INIS)

    Thyroid dysfunction is the commonest endocrine disease. In view of continuing debate regarding the best definitive treatment for management of thyrotoxicosis, we reviewed 86 cases of radio-iodine therapy in Nuclear Medicine Centre, Dinajpur over a period of 8 years from 1991-1998 and evaluated the results. There is no evidence that thyroid carcinoma or leukemia is induced by 131 I, or that its use results in an increased frequency of congenital malformation among subsequent offspring. A single dose successfully controlled thyrotosicosis in 87.21% and resulted in hypothyroidism in 16.28% cases up to December 2000. The rate of hypothyroidism was to be maximum within one year after radio-iodine treatment (5.81%). The female and male patients ratio was 2.19:1. It is premature to comment over the long term result of radio-iodine treatment for thyrotoxicosis, as the period of follow-up is only 8 years. Still the result is encouraging because of advantage of being a cheap and simple form of treatment. In our opinion radioactive iodine therapy should be given priority in the treatment of thyrotoxicosis. (author) 19 refs., 4 tabs

  16. Measurement and analysis of patient attenuation correction factor during radioiodine therapy

    International Nuclear Information System (INIS)

    The calculated dose rate from the radioiodine therapy patient should normally include a factor accounting for the attenuation and scatter of patient body tissues. The attenuation factor is currently neglected, and not applied in operational radiation protection. Realistic estimation of radiation dose rate levels from radioiodine therapy patients when properly performed will reduce operational cost and optimise institutional radiation protection practice. In this work, the existence of a patient body tissue attenuation factor is verified by comparing the dose rates measured from the radioiodine capsules immediately before administration with those measured from the patient immediately after administration. The correlation between the factors suspected to in- fluence the patient body tissue attenuation and the measured dose rates from the patient normalised per unit activity is statistically analysed. The calculated attenuation correction factor based on authors' measurements was (0.55±0.17). The measured dose rate per unit of radioactivity from the patient showed a negative correlation with their body mass index. (authors)

  17. Somatic risks of radioiodine therapy in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    We present own experiences with 67 patients who have been treated from January 1989 to June 1990. Gastric discomfort (9-31%), local cervical inflammation (23%), and acute sialadenitis (2%) were the main problems and side-effects during the first days after oral application of radioiodine. A reversible deterioration of the red blood cell count and decreasing leukocyte of platelet numbers often indicate temporary marrow depression. A persistent damage of the salivary glands causing dry mouth is also common especially after repeated radioiodine therapy. Complications as pneumonitis in the case of pulmonary metastasis, acute paresis of the recurrent nerve, thyroid storm, cerebral edema, or hemorrhage in metastatic tumor tissue are rarely described; none of our patients suffered from severe side-effects. (orig./MG)

  18. Frequency of glycophorin A (GPA) variant erythrocytes after therapy with radioiodine

    International Nuclear Information System (INIS)

    Persons with the blood group MN express on the surface of the red blood cells each form of the allelic GPA protein (GPAM and GPAN). Variant cells have lost one from of the protein. The measurement of variant cells with the BR6 assay was improved by our workgroup and applied to 24 children from Belarus treated with radioiodine for thyroid cancer. Treated children showed a significant increase in variant frequency compared to a group of 9 healthy children from Belarus. The increase of variant cells in patients was significantly dependent on the radiation dose in red bone marrow. In addition the increase of the variant frequency after one radioiodine therapy was measured for 6 patients. (orig.)

  19. Salivary function after radioiodine therapy: poor correlation between symptoms and salivary scintigraphy

    Directory of Open Access Journals (Sweden)

    Jacqueline eJonklaas

    2015-06-01

    Full Text Available The aim of this study was to determine whether there was a correlation between salivary symptoms and salivary functioning following radioiodine therapy. Fifteen patients receiving radioactive iodine therapy for differentiated thyroid cancer completed a questionnaire assessing their salivary and nasal symptoms and underwent salivary scanning prior to therapy and 3 and 12 months after therapy. Measures of salivary gland accumulation and secretion were correlated with scores of salivary and nasal symptomatology. The mean number of salivary, nasal, and total symptoms at 3 months increased significantly over the number of symptoms at baseline by 3.7, 2.7, and 6.3 symptoms respectively (p values 0.001, 0.0046, and <0.001. The mean right parotid gland accumulation and secretion of radioisotope declined significantly at 3 months, compared with baseline. There was no association between the increase in salivary, nasal, or total symptoms and the change in scintigraphy measures. The increases in nasal and total symptoms were significant in those with co-existent Hashimoto’s disease, compared with those without this condition (p values 0.01 and 0.04. Nasal symptoms decreased (p value 0.04 in those who used sour candies, compared with those who did not. Increasing body mass index was significantly associated with increasing nasal symptoms (p value 0.05. Greater decline in salivary parameters at 3 months compared with baseline was generally associated with heavier body weight, decreased thyroid cancer stage, absence of Hashimoto’s thyroiditis, and pre-menopausal status. Although salivary and nasal symptoms increased and salivary scintigraphy parameters decreased after radioiodine therapy, the variables associated with symptoms and changes in salivary scan parameters differed. A better understanding of the relationship between salivary gland symptoms and functioning, and the factors affecting susceptibility to salivary and nasal damage after radioiodine

  20. Pretreatment with betamethasone of patients with Graves' disease given radioiodine therapy: thyroid autoantibody responses and outcome of therapy

    International Nuclear Information System (INIS)

    The effects of betamethasone on thyroid autoantibody responses and outcome of radioiodine therapy were determined over a period of 1 yr in a prospective randomized study of 40 patients with Graves' disease. Twenty patients were given placebo tablets, and 20 patients were treated with betamethasone from 3 weeks before until 4 weeks after 131I therapy. At the time of inclusion in the study, the mean serum concentrations of TSH receptor antibodies, thyroid peroxidase antibodies, and thyroglobulin antibodies (TgAb) were increased in both groups. Three weeks of treatment with betamethasone reduced the thyroid peroxidase antibody and TgAb titers as well as the serum concentrations of thyroid hormones. A decrease in the TSH receptor antibody level was not statistically significant. After radioiodine therapy, transient increases in thyroid autoantibody levels were observed. The titers of the different antibodies generally changed in parallel. In some patients a detectable level of a given antibody was found only after the radioiodine treatment, and in two cases, TgAb did not appear at all, although the two other antibodies increased temporarily. Betamethasone delayed, but did not abolish, the 131I-induced antibody peaks. Betamethasone also caused a reduction in the total serum immunoglobulin G, a reduction which persisted throughout the study period. When the study ended, 17 patients given placebo and 9 patients given betamethasone were receiving replacement therapy due to the development of hypothyroidism. These patients at this point in time had lower antibody levels than those not requiring T4. The results of this study demonstrate that betamethasone reduces and modifies the thyroid autoantibody responses as well as the outcome of radioiodine therapy in patients with Graves' disease

  1. Pretreatment with betamethasone of patients with Graves' disease given radioiodine therapy: thyroid autoantibody responses and outcome of therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gamstedt, A.; Karlsson, A. (Department of Internal Medicine, Orebro Medical Center Hospital (Sweden))

    1991-07-01

    The effects of betamethasone on thyroid autoantibody responses and outcome of radioiodine therapy were determined over a period of 1 yr in a prospective randomized study of 40 patients with Graves' disease. Twenty patients were given placebo tablets, and 20 patients were treated with betamethasone from 3 weeks before until 4 weeks after {sup 131}I therapy. At the time of inclusion in the study, the mean serum concentrations of TSH receptor antibodies, thyroid peroxidase antibodies, and thyroglobulin antibodies (TgAb) were increased in both groups. Three weeks of treatment with betamethasone reduced the thyroid peroxidase antibody and TgAb titers as well as the serum concentrations of thyroid hormones. A decrease in the TSH receptor antibody level was not statistically significant. After radioiodine therapy, transient increases in thyroid autoantibody levels were observed. The titers of the different antibodies generally changed in parallel. In some patients a detectable level of a given antibody was found only after the radioiodine treatment, and in two cases, TgAb did not appear at all, although the two other antibodies increased temporarily. Betamethasone delayed, but did not abolish, the {sup 131}I-induced antibody peaks. Betamethasone also caused a reduction in the total serum immunoglobulin G, a reduction which persisted throughout the study period. When the study ended, 17 patients given placebo and 9 patients given betamethasone were receiving replacement therapy due to the development of hypothyroidism. These patients at this point in time had lower antibody levels than those not requiring T4. The results of this study demonstrate that betamethasone reduces and modifies the thyroid autoantibody responses as well as the outcome of radioiodine therapy in patients with Graves' disease.

  2. The role of radioiodine therapy in benign nodular goitre

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Fast, Søren; Hegedüs, Laszlo

    2014-01-01

    or if the goitre is large. Recombinant human TSH (rhTSH)-stimulated (131)I therapy significantly improves goitre reduction, as compared with conventional (131)I therapy without pre-stimulation, and adverse effects are few with rhTSH doses of 0.1 mg or lower. RhTSH-stimulated (131)I therapy reduces...... the need for additional therapy due to insufficient goitre reduction, but the price is a higher rate of hypothyroidism. Another approach with rhTSH-stimulation is to reduce the administered (131)I activity by a factor that equals the increase in the thyroid (131)I uptake. Using this approach...

  3. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  4. Radioiodine therapy for hyperthyroidism - changing pattern of management over three decades at INMAS

    International Nuclear Information System (INIS)

    Iodine-131 therapy is a relatively simple effective and economical method of treating hyperthyroidism. Even fifty years after the introduction of radioactive iodine, there is no concensus on the approach for selection of the dose for treatment of hyperthyroidism. Since the last three decades, the approach for radioiodine therapy at this Institute has been to treat with low, fractionated doses to produce partial destruction of the thyroid gland leaving the patient sufficient functioning gland for normal hormone production. New in vitro diagnostic techniques including free T3, T4 and sensitive TSH assay have been introduced over the past decade for the diagnosis of hyperthyroidism. Changes in the thyroid radioactive iodine uptake in the population due to introduction of iodized salt, and the high incidence of persistent hyperthyroidism after low dose radioiodine therapy have prompted to go for a proportionate increase in the 131I original dose schedules based on goitre grades. This has led to a nominal increase in the incidence of post therapy hypothyroidism. However the basic principle of low, fractionated dose therapy is still being followed at this Institute, which appears suitable for social and economic conditions in India. (author). 19 refs., 2 tabs

  5. Effect of radioiodine therapy on thyroid nodule size in patients with toxic adenomas

    International Nuclear Information System (INIS)

    Full text: Autonomously functioning toxic adenomas are a common cause of hyperthyroidism. Surgery, radioiodine and percutaneous ethanol injection into the nodule are effective therapies. Radioiodine therapy is increasingly used as first line therapy especially in elderly patients. Radioactive iodine I-131 seems to be a good therapeutic option with low incidence of post-therapy hypothyroidism. The important therapeutic effect has also been the regression in nodule size. The aim of this study was to investigate the effect of radioiodine therapy on the size of toxic adenomas. Forty-six patients with age range of 37-76 years (Mean age=60.9 years) were followed up for a period of 12 months after I-131 therapy for toxic adenomas. Thyroid hormone levels (T3, T4 and TSH) were determined. Each patient was subjected to ultrasound and radionuclide scanning of thyroid gland at 3,6 and 12 months following I-131 therapy. Successful treatment was defined as control of hyperthyroidism and reappearance of extra-glandular thyroid tissue on Thyroid scan, which were suppressed by the hyperactive nodule prior to therapy. The volumes of the thyroid pre and post-therapy were estimated by US using the formula of ellipsoid model (δ/2π6 x length x width x depth). The therapeutic dose of I-131 was calculated for each patient by the following formula: 12 mCi x 100/24 hrs RAIU. Patients received a single dose of I-131 and the range of administered I-131 dose was 825 1221 MBq. Results revealed that 42 patients (91%) became euthyroid in three months after I-131. All patients became euthyroid in 6 months. The adenomas were reduced in size from a mean of 18.23+11.21 ml to 7.38+3.48 ml during the 12 months follow up. This was highly significant (p<0.05, t=3.408). The extra-nodular thyroid volume did not change following therapy (12.2+7.4 ml pre-therapy vs. 11.8+7.1 ml post therapy at 12 months). The results of our study showed that I-131 can successfully treat not only the functional state of

  6. Mucoepidermoid carcinoma of the submandibular gland after high-dose radioiodine therapy: case report and review of the literature

    International Nuclear Information System (INIS)

    Case report of a 42 year old female, who recieved from 14th-20th year of life six radioiodine therapies with altogether 19,2 GBq 131I because of a papillary thyroid carcinoma. 17 years after the last therapy, she developed a histologicaly proven chronic radiogenic sialadenitis of the left submandibular gland. Further four years later, the right submandibular gland has been extirpated because of a mucoepidermoid carcinoma with infiltration of a regionary lymphatic node. Review of the previous published secondary-malignancies of the salivary glands after high-dose radioiodine therapies. (orig.)

  7. Intravenous alpha-1 antitrypsin augmentation therapy: systematic review

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Johansen, Helle Krogh

    2010-01-01

    We reviewed the benefits and harms of augmentation therapy with alpha-1 antitrypsin in patients with alpha-1 antitrypsin deficiency and lung disease. We searched for randomised trials comparing augmentation therapy with placebo or no treatment in PubMed and ClinicalTrials (7 January 2010). Two...

  8. A randomized trial evaluating a block-replacement regimen during radioiodine therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Grupe, Peter; Boel-Jørgensen, Henrik;

    2011-01-01

    Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...... (TNG, n = 49) were randomized to (131) I either 8 days following discontinuation of methimazole (-BRT, n = 52, median dose: 5 mg) or while on a continuous block-replacement regimen (+BRT, n = 48, median dose 15 mg methimazole and 100 μg levothyroxine). Results  Patients in the +BRT group required more...

  9. Radioiodine I-131 For The Therapy Of Graves’ Disease

    OpenAIRE

    Mumtaz, Malik; Lin, Lim Shueh; Hui, Khaw Chong; Mohd Khir, Amir Sharifuddin

    2009-01-01

    Graves’ disease is a common cause of hyperthyroidism. Treatment options for Graves’ disease include antithyroid medication, surgery or radioactive iodine (I-31) or RAI. This review will focus on the approach to RAI therapy; discussing dose selection, patient preparation, and consideration before and after administering RAI, examining aspects of pre-treatment with antithyroid medication as well as discussing possible adverse events including hypothyroidism and possible worsening of thyroid-ass...

  10. Patient management in radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Benign thyroid disease ranks by far as the most frequent therapy in nuclear medicine. In Germany approximately 25 000 cases of hyperthyreosis are being treated in association with autonomy or Graves' disease, but also for the reduction of goiters or the correction of latent functional disturbances. In such indications radiotherapy is virtually free of risk as opposed to surgery and ranks more favorable in regard to costs and curative effects versus pharmacological long term treatment. Still regional varying therapeutical concepts and intentions are being pursued and trials of improvements described. There is consent in therapy that quality of treatment is closely linked to a specialized out-door platient preparation, individual hospital activity dosage and lifelong follow up including continued evaluation of therapeutical results. In this paper minimal requirements of outpatient measures before and after therapy are summarized which in Germany is only permitted on an inhospital patient basis. Considering basics of radioactive preventive law, scientific evidence of available results of therapeutical studies and a survey of German therapeutic centers, suggestions for a quality maintaining management in view of the most effective utilization for the limited available number of beds is presented for discussion. (orig.)

  11. A case report of mucoepidermoid carcinoma of the parotid gland developing after radioiodine therapy for thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Cuevas, S.; Baena Ocampo, L. [Hospital de Oncologia (Mexico). Dept. of Head and Neck Surgery

    1995-12-01

    This a report on a 19-year-old female who developed a low grade T2 N0 M0 mucoepidermoid carcinoma of the right parotid gland 3 years and 5 months after the post-operative treatment of 100 mCi of radioactive iodine ({sup 131}I) for a papillary thyroid carcinoma. The parotid tumour appeared during the patient`s pregnancy. There are few reports of salivary gland cancer developing after radioiodine therapy for thyroid carcinoma and it is hoped that this report may stimulate others to investigate this association further in order to clarify the risk of secondary malignancies after radioiodine therapy. (author).

  12. A case report of mucoepidermoid carcinoma of the parotid gland developing after radioiodine therapy for thyroid carcinoma

    International Nuclear Information System (INIS)

    This a report on a 19-year-old female who developed a low grade T2 N0 M0 mucoepidermoid carcinoma of the right parotid gland 3 years and 5 months after the post-operative treatment of 100 mCi of radioactive iodine (131I) for a papillary thyroid carcinoma. The parotid tumour appeared during the patient's pregnancy. There are few reports of salivary gland cancer developing after radioiodine therapy for thyroid carcinoma and it is hoped that this report may stimulate others to investigate this association further in order to clarify the risk of secondary malignancies after radioiodine therapy. (author)

  13. Efficient multicistronic co-expression of hNIS and hTPO in prostate cancer cells for nonthyroidal tumor radioiodine therapy

    OpenAIRE

    Li, Guoquan; Xiang, Lei; Yang, Weidong; Wang, Zhe; Wang, Jing; Chen, Kai

    2012-01-01

    Radioiodine therapy has proven to be a safe and effective approach in the treatment of differentiated thyroid cancer. Similar treatment strategies have been exploited in nonthyroidal malignancies by transfecting hNIS gene into tumor cells or xenografts. However, rapid radioiodine efflux is often observed after radioiodine uptake, limiting the overall antitumor effects. In this study, we aimed at constructing multicistronic co-expression of hNIS and hTPO genes in tumor cells to enhance the rad...

  14. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    International Nuclear Information System (INIS)

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid 131I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 μg inactive potassium-iodide (127I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after 131I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective 131I half-life, thyroid dose, total T3, total T4, 131I-activity in the T3- and T4-RIAs. Results: In Group A, the effective 131I half-life M1 before iodine (3.81 ± 0.93 days) was significantly (p 131I half-life M2 (4.65 ± 0.79 days). Effective 131I half-life M1 correlated with the benefit from inactive 127I (r = -0.79): Administration of 127I was beneficial in patients with an effective 131I half-life M1 of 131I activity of T3 and T4 showed lower specific 131I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific 131I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for 131I T3 and y = 1.0827x - 0.4444 for 131I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for 131I T3 and y = 1.3191x - 0.2901 for 131I T4). Radioiodine therapy was successful in all 15 patients from Group A. Conclusion: The administration of 600 μg inactive iodide for three days during radioiodine therapy in patients with Graves' hyperthyroidism and an unexpectedly short half-life of <3 or 4 days was a safe and effective

  15. Radioiodine therapy in management of thyroid carcinoma - A review of 138 patients

    International Nuclear Information System (INIS)

    Differentiated thyroid carcinomas are being treated by using a widely accepted protocol of surgery and radioiodine therapy followed by supplementation of thyroid hormones in the Nuclear Medicine Centre (NMC), Dhaka Medical College Hospital (DMCH) since 1990. In the present study 138 patients(Male-54, Female-84) with differentiated thyroid cancers received radioiodine therapy for ablation of residual thyroid tissue with a dose of 2.77-3.7 GBq (75-100 mCi), for lymph node metastases 5.55-6.5 GBq(150-175mCi), for lung metastases 5.55 GBq(150 mCi) and for bony metastases 7.4 GBq (200 mCi). Among 138 patients papillary carcinoma was observed in 94 cases (68%; Male-42, Female-52), follicular type was found in 30 cases (22%; Male-8, Female-22) and mixed type in 14 patients (10%, Male-4, Female-10). Single dose of 2.77-3.7 GBq(75-100 mCi) of radioiodine was received by all 138 patients. Among the unablated patients 62 received double doses totalling 9.25 GBq (250 mCi), 44 received three doses 12.95 GBq (350 mCi) and one patient received 8 doses 33.3 GBq (900 mCi). Out of 138 patients single dose ablated 76 cases and 62 remain unablated. Multiple doses ablated 28 patients and 34 still remain unablated and is under follow up. The success and failure in management of patients with differentiated thyroid cancer over 8 years period have been discussed here revealing a satisfactory outcome. (author)

  16. In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    In-vivo diagnoses of thyroid diseases can be carried out using 123I, 131I, and 99sup(m)Tc-pertechnetate. For the thyroid scintiscan, 99sup(m)Tc-pertechnetate or 123I are used. Some functional parameters can be determined using 99sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with 123I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using 131I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited. (orig./MG)

  17. High-dose radioiodine therapy of Graves disease

    International Nuclear Information System (INIS)

    Full text of publication follows. Objectives: to estimate the effectiveness and safety of the disease treatment under different modes of applying RIT. Materials and methods: 67 patients with the thyrotoxicosis condition associated with Graves disease were researched. The patients were divided into 2 groups: a control group with 25 people (18 women and 7 men), who underwent a low-dose therapy of 150-500 MBq; and a main group of 42 people (32 women and 10 men), who underwent a high-dose therapy of 550 and 800 MBq. The volume of thyroid prior to the treatment made up 23.8 ± 20 ml in the main group and 30.2 ± 23 ml in the control one. The average age in the high-dose group was 44.6 ±23 years old and in the low-dose -47.2 ± 24 years old. In terms of the hormone level before the RIT, 52% of the main group patients experienced euthyroidism, while 48% - thyrotoxicosis. The corresponding indices in the control group were 42% and 58% respectively. The cessation of the thyreostatic therapy came on 5. to 21. day prior to the treatment, with the average of 14 ±7 days in both groups. The diagnosis of the disease was based on ultrasonography, planar scintigraphy, the hormone level and antibody titer. The performance was assessed through the attainment of hypo-thyrosis and the transition to a substitutive hormonal therapy with L-thyroxine in 6 months or more. The attainment of euthyroidism was seen as a partial effect due to a possibility of relapse. Results: in 6 months a positive result in the form of hypo-thyrosis was achieved for 39 patients in the main group, which accounted for 93%, and 3 patients (7%) experienced euthyroidism. No symptomatic thyrotoxicosis relapses were revealed. In the control group, hypo-thyrosis was achieved by 18 patients, which accounted for 72%; euthyroidism came up to 12%; 4 patients needed a refresher course of RIT, which made up 16% of the group. 93% of the main group patients tolerated the treatment favourably. 3 patients complained of the

  18. Measurement of incorporation in family members of patients with benign thyroid diseases after radioiodine therapy

    International Nuclear Information System (INIS)

    Aim: Patients exhale I-131 after radioiodine therapy. In this study we quantify the amount of radioactivity and resulting thyroid doses found in people living in close contact to patients treated with I-131 after their release from a therapy ward. Methods: For 31 relatives of 25 patients treated with I-131 the incorporation was monitored using the thyroid probe of a whole body counter. These values are used for a determination of thyroid doses. Results: 11 of the 31 monitored persons had a thyroid activity of less than the minimal detectable activity of 13 Bq. The mean value of the remaining 20 people was 104 Bq in the thyroid resulting in a mean thyroid dose of 0.2 mSv (Maximum: 2 mSv). Conclusion: the intake of I-131 for persons in close contact to patients after dismissal from a therapy ward is low. In no case an effective dose exceeding 1 mSv was observed. (orig.)

  19. Influence of radioiodine therapy on the immuno phenotype of peripheral blood lymphocytes of patients with thyroid cancer of different age

    International Nuclear Information System (INIS)

    The authors present the results of a study of the phenotypic composition of blood lymphocytes in patients with differentiated thyroid cancer of different all age before and on day 6 after radioiodine therapy. The phenotypic profile of peripheral blood cells was determined in patients of three age groups: patients aged under 18 years (group 1), patients whose age was within the range 19 to 40 years (group 2), and patients older than 41 years (group 3). The studies have shown that in patients with thyroid cancer, abnormalities developed in the composition of peripheral blood lymphocytes, which were more pronounced in elderly patients. Under the influence of radioiodine, disturbances in the immune system of patients are aggravated. The most significant after-effects of radioiodine therapy that had been identified in patients of all age groups, were represented by a significant decrease in the number of B-lymphocytes, an increase in natural killer cells and CD95+ lymphocytes. Furthermore, it was found that radioiodine has the most significant effect on the immune system of children and adolescents. In this age group, the content of lymphocyte subpopulations is changing: CD4+, CD8+, IRI, CD19+, CD16+CD56+, CD95+ and HLA-DR, which suggests the need for further dynamic studies in this age group of patients, which is the most sensitive to radioiodine effect in order to determine the extent of immunological disorders and the terms of their recovery

  20. Intravenous alpha-1 antitrypsin augmentation therapy: systematic review

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Johansen, Helle Krogh

    2010-01-01

    We reviewed the benefits and harms of augmentation therapy with alpha-1 antitrypsin in patients with alpha-1 antitrypsin deficiency and lung disease. We searched for randomised trials comparing augmentation therapy with placebo or no treatment in PubMed and ClinicalTrials (7 January 2010). Two...... (difference 1.14 g/l; 95% confidence interval 0.14 to 2.14; p = 0.03) over the total course of the trials. Augmentation therapy with alpha-1 antitrypsin cannot be recommended in view of the lack of evidence of clinical benefit and the cost of treatment....

  1. Influence of oral rinsing on the exposure of salivary glands during radioiodine therapy

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: the salivary glands (SG) constitute a risk organ during a radioiodine therapy of thyroid. A possible side effect is xerostomia. This study investigates whether repeated rinsing of the mouth with water during radioiodine therapy significantly extracts I-131 from the circuit between saliva and the gastrointestinal tract, and thus whether radiation exposure of the patient's SG is reduced. Methods: the control group consisted of 45 patients, ages 32 to 81 years, (mean 62 years, 8 male, 37 female), and received radioiodine therapy without rinsing their mouths. An intervention group of 42 patients, ages 36 to 88 years, (mean 61 years, 8 male, 34 female), with a benign or malignant thyroid disease, were asked 15-17 hours after capsule administration to rinse their mouths hourly with water for the next two days. The intervention group (n = 42) was divided into three groups. A low-risk group (n = 22) received between 0.4 and 1.0 GBq I-131 (mean 0.746), a medium risk group (n = 15) between 1.2 and 2.0 GBq (mean 1.783), and the high-risk group (n = 5) between 3.0 and 6.0 GBq (mean 3.600) respectively. To assess the function of the SG, scintigrams were performed prior to and 3 months after the radioiodine therapy. The estimation of the activity in the gastrointestinal tract was performed using whole-body scintigraphy on the day of release. Both, the SG and the whole body (WB) scintigraphies were evaluated using the region-of-interest technique. Furthermore, the activity of the collected saliva was quantified using a calibrated well-type detector. Results: the mean values of the activity extracted into the water-saliva mixture were 0.72% ± 0.3% and 0.14% ± 0.05% of the applied dose on the first and second day after capsule administration respectively. The analysis of the SG scintigrams of the low and medium risk groups showed no significant decrease in salivary gland function. Only in the high-risk group a significant loss of

  2. Study of immediate and long-term side effects on thyroid cancer patients caused by high-dose radioiodine therapy

    International Nuclear Information System (INIS)

    The well differentiated thyroid cancer patients had a better prognosis. High-dose radioiodine therapy may induce immediate and long-term side effects to patients. The aim of the author is to investigate the side effects after high-dose radioiodine therapy on thyroid cancer patients and the relation with cumulative therapy dosage. According to the common side effects of 131I therapy, 10 questions was chosen to set up a standard questionnaire. Patients were followed up by senior nuclear medicine physicians and the results were analyzed and compared. The results showed that the late symptom of sialadenitis and severe dry mouth were intensively related with cumulative therapy dosage. It is suggested that during the therapy certain necessary means should be adopted to reduce the potential side effects and improve the patients' life quality

  3. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?

    International Nuclear Information System (INIS)

    Aim: The impact of our dosimetry concept on radioiodine therapy success in Graves' disease (GD) was analysed. Three questions arised: Did individual estimation of pretherapeutic halflife improve therapeutic success? Did individual dosimetry result in accurate dose calculation? Did antithyroid medication have a measurable influence on therapeutic success under the prevailing conditions? Methods: 126 consecutive patients were treated with 200 Gy I-131 in our therapy ward for GD and followed-up six to nine months after therapy. Success quote was assessed using a standardized protocol and treatment was classified as successful when the patients was eu- or hypothyroid, or unsuccessful when he or she presented with a suppressed TSH-level or in hyperthyroid condition after antithyroid medication withdrawal. Antithyroid medication, activity I-131, dose, concentration of fT3 and fT4, specific delivered dose and halflife were put into a multiple regression model to assess their influence on therapeutic success. In order to assess possible factors disturbing the therapeutic outcome, relevant parameters were analyzed using Logit transformation. Results: Out of 126 patients 84 were classified as successfully treated and 42 (33,3%) as failures. A significant influence on the outcome only was found for thyroid mass. However, therapeutic success appeared to be more distinctly determined by the specific delivered dose using an estimated halflife of 5.5 days (Odds: 10.0, p <0.001). Accurate intratherapeutic dosimetry did not play a significant role to enhance therapeutic success. Neither did antihyroid medication during radioiodine therapy exert any significant impact. Conclusions: Measurement of individual intratherapeutic halflife as opposed to an estimate using a standard halflife did not provide improved results concerning the target dose. Retrospectively, the therapeutic outcome on the basis of a measured halflife as compared to a standard halflife did not significantly improve

  4. On the genetic risk after high dose radioiodine therapy with regard to the gonadal dose

    International Nuclear Information System (INIS)

    Aim: The genetic risk for the offspring of patients treated with high doses of radioiodine was to be assessed with special regard to the gonadal dose caused by diagnostic and therapeutic procedures. Methods: 41 young females (aged between 19 and 39 years) and four young males (aged 26 to 36 years) treated with radioiodine because of a thyroid carcinoma were interviewed by use of a questionnaire. The course of pregnancy and birth history could be documented as well as the congenital and developmental conditions of 56 children. Results: The amount of radioactivity applied for therapy and whole body scans ranged over 4,144 and 35,15 GBq I-131; the individual gonadal dose was calculated based on the MIRD model and ranged over 0,2 and 2,2 Sv (0,51 Sv at a mean). The period of time between the last radioiodine application and confinement was at least 9 months, not exceeding 14 years. As to the course of pregnancy and birth two early abortions, one extrauterine gravidity and one premature birth due to an insufficiency of the placenta were stated. In one case a chromosomal translocation 7/14 occured as a genetic defect which lead to an interruption. The children's development was unconspicuous except of two cases of neurodermatitis as well as multiple allergies and an early closure of the anterior fontanelle in one child each. Conclusion: Although the genetic risk is supposed to increase with the gonadal dose achieved (doubling dose 1 Sv) and the increased risk of any congenital anomaly was calculated as about 13% at a mean in our patients, the rate of genetic determined diseases was not elevated (1,8% or 1/57). Thus, no increase of genetic defects or congenital malformations was reported in a total of 408 children described in the literature and in our group. (orig.)

  5. Potential of radioiodine therapy in the treatment of medullary thyroid carcinoma

    International Nuclear Information System (INIS)

    Full text: The effect of I-131 ablation therapy as an adjunct to surgery in the management of patients with medullary thyroid carcinoma (MTC) was studied in our institute. The theme of the study was that among post surgical management of MTC, radioiodine therapy may be considered as a promising adjunct to surgery. No other therapeutic alternative is found to be practical and in recent years there have been several somewhat encouraging reports of treatment of medullary carcinoma of the thyroid with I-131. We have had the opportunity to address this notion on our group of patients. The patients underwent total thyroidectomy and hemithyroidectomy as a procedure. During the year 1988- 2007, 402 Ca thyroid patients were treated with radioiodine in our department of nuclear medicine for ablation of post thyroidectomy remnant tissue. Of these, 14 (3.48%) patients had been suffering from MTC; male to female ratio was 1:1 with mean age of 37.7 yrs ranging from 24-53 yrs. Among these 14 patients, 11(77%) had total thyroidectomy and 3 (23%) hemithyroidectomy. Hemithyroidectomy cases were accepted for ablation, where patients refused second surgery or the cases were inoperable according to the opinion of the concerned Surgeon. They were treated with a mean dose of 89 mCi of I-131 ranging from 75-100 mCi. The post therapy follow up was done at 6 months and 12 months following I- 131 treatments and imaged at 72 hrs. The following parameters were used as success indicator- i) Observation of reduced plasma calcitonin level; ii) Absence of any focal visible uptake in the anterior neck area of thyroid bed. iii) No physical complaints. High success rate and a set of good agreements were obtained from the study. Ablation was achieved in 11 (78%) cases out of 14 patients who were given RIT after thyroidectomy. Reduced/normal plasma calcitonin level was observed in almost in all patients. Out of 14 patients, only 1 patient died of his disease who had extensive metastasis during the

  6. Beneficial Effects of Lithium and Radioiodine Therapy in the Treatment of Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Wojciech Barud

    2014-09-01

    Full Text Available Intravenous contrast media used for coronary angiography are iodine-based and could induce thyroid gland dysfunction. We present the case of a 58-year-old woman with coronary artery disease who developed hyperthyroidism after percutaneus coronary intervention. Treatment with thiamazole induced agranulocytosis, complicated with severe tonsillitis. During recurrence of hyperthyroidism, after careful assessment of available methods of treatment, she was recommended to undergo radioiodine therapy (131I. The patient received lithium carbonate as pre-treatment. After 13 days of pre-treatment, patient received the therapeutic dose of 131I. Neither thyrotoxicosis progression nor acute coronary syndrome occurred. After 3 weeks, her thyroid hormones were found to be within normal ranges. Lithium therapy could be used as an effective treatment in patients who developed serious side-effects due to previous treatment with thionamides. Turk Jem 2014; 18: 92-94

  7. The influence of radioiodine therapy in 1470 patients with subclinical hyperthyroidism

    International Nuclear Information System (INIS)

    Full text of publication follows. The aim of our study was to assess the influence of radioiodine (131I) therapy on the achievement of euthyroidism, prevention of adverse effects on the cardiovascular and prevent evolvement to overt hyperthyroidism. Material and methods: we treated 1470 patients sent to our department during the last 7 years, aged 24-76 years; 88% of them were female and 12% male; 490 patients with multi-nodular goitre (MNG), and 980 patients with autonomous nodule (ATN). Some of the patients were treated with antithyroid drugs for 1 to 3 months before 131I therapy (140 patients). Malignant changes were excluded in all nodules by fine needle aspiration biopsy. All the patients had serum TSH levels <0.1 mU/l and effective T-half was more than 3 days at the time of treatment. The activity dose was calculated by the use of Marinelli's formula and ranged between 200 and 800 MBq. The absorbed dose (Gy) ranged between 180 and 300, and was proportional to thyroid volume. Follow up control was done every 6 weeks. Results: euthyroidism achieved in 99% of patient with ATN and 94% of MNG; 1% of patients with ATN and 5% of patients with MNG develop hypothyroidism. 1% of patients with MNG were in subclinical hyperthyroidism and received second dose of radioiodine therapy. In all of the patients, the symptoms and signs of subclinical hyperthyroidism disappeared (palpitation, tachycardia, atrial fibrillation, exercise tolerance improved, the blood pressure normalised and the quality of life improved). Conclusions: our result is good and is in the range of the existing literature. The achievement of euthyroidism and the remission of the symptoms and signs of subclinical hyperthyroidism, were due to good diagnosis, well preparation of the patients; accurate measurement of administered activity, effective half-life, and well-organised follow up. We recommend early treatment of subclinical hyperthyroidism, and long period of follow up visits in our department to

  8. Radiation risk by inhalation of iodine-131 during the handling of therapeutic capsules in radioiodine therapy

    International Nuclear Information System (INIS)

    The inhalation of small activities of Iodine-131 during radioiodine therapy seems to be unavoidable. According to radiation protection procedures measurement of radioiodine in air and regularly incorporation measurements have to be carried out. By routine incorporation measurements using a shadow shield whole body counter in the Donauspital Vienna, usually only few persons (30 %) with incorporated I-131 activities are detected. The measured activities are low (3 have been found. The activity in the atmosphere is the major reason for the positive scan results. After the improvement of the ventilation system the activities detected showed a remarkable reduction of the measured quantities, but the number of persons with positive scan results remained unchanged. Comparison with therapeutic capsules of other manufacturers showed an activity release reduced by a factor of 10 to 100 compared with the capsules used at the Donauspital. Radiation doses caused by inhalation of iodine-131 range from 0,1 mSv to 21 mSv depending on individual differences in handling procedures. According to the results of this work the capsules were withdrawn by the manufacturer. A new product with addition of sodium thiosulfate and a pH adjustment showed a dramatic reduction (from 71 kBq to 800 Bq) of the iodine diffusion through the gelatine shell. (author)

  9. Radioiodination and biological evaluation of Cladribine as potential agent for tumor imaging and therapy

    Energy Technology Data Exchange (ETDEWEB)

    Bayoumi, Noha Anwer; Amin, Abeer M.; El-Kolaly, Mohamed T. [Egyptian Atomic Energy Authority, Cairo (Egypt). Hot Lab Center; Ismail, Nasser S.M.; Abouzid, Khaled A.M. [Ain-Shams Univ., Cairo (Egypt). Pharmaceutical Chemistry Dept.

    2015-07-01

    Cladribine, a purine analogue antimetabolite, was radioiodinated with {sup 125}I via direct electrophilic substitution reaction. The maximum radiochemical yield (92.5 ± 0.8%) was obtained when the reaction was done at ambient temperature for 30 min using 100 μg of Cladribine and 10 μg N-chlorosuccinamide (NCS) in 150 μL of 0.2 M phosphate buffer, pH 7. In vitro stability studies of HPLC purified {sup 125}I-Cladribine sample dissolved in 0.5 ml of 0.2 M phosphate buffer pH 7 at ambient temperature showed that {sup 125}I-Cladribine is stable up to 12 h post labeling. Biodistribution results revealed excretion of {sup 125}I-Cladribine mainly by kidneys. The uptake of {sup 125}I-Cladribine in the induced Ehrlich Ascites Carcinoma was 2.8 ± 0.4%ID/g at 1 h post injection with maximum tumor/muscle ratio of 5.5. The good uptake of {sup 125}I-Cladribine confirms the molecular docking studies results which indicate that iodinated Cladribine binds with polymerase enzyme with a good-CDOCKER energy. As a result, radioiodinated Cladribine may be used as a valuable agent for tumor diagnosis and therapy.

  10. Radioiodination and biological evaluation of Cladribine as potential agent for tumor imaging and therapy

    International Nuclear Information System (INIS)

    Cladribine, a purine analogue antimetabolite, was radioiodinated with 125I via direct electrophilic substitution reaction. The maximum radiochemical yield (92.5 ± 0.8%) was obtained when the reaction was done at ambient temperature for 30 min using 100 μg of Cladribine and 10 μg N-chlorosuccinamide (NCS) in 150 μL of 0.2 M phosphate buffer, pH 7. In vitro stability studies of HPLC purified 125I-Cladribine sample dissolved in 0.5 ml of 0.2 M phosphate buffer pH 7 at ambient temperature showed that 125I-Cladribine is stable up to 12 h post labeling. Biodistribution results revealed excretion of 125I-Cladribine mainly by kidneys. The uptake of 125I-Cladribine in the induced Ehrlich Ascites Carcinoma was 2.8 ± 0.4%ID/g at 1 h post injection with maximum tumor/muscle ratio of 5.5. The good uptake of 125I-Cladribine confirms the molecular docking studies results which indicate that iodinated Cladribine binds with polymerase enzyme with a good-CDOCKER energy. As a result, radioiodinated Cladribine may be used as a valuable agent for tumor diagnosis and therapy.

  11. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Willegaignon, J., E-mail: j.willegaignon@gmail.com; Sapienza, M. T.; Coura-Filho, G. B.; Buchpiguel, C. A. [Cancer Institute of São Paulo State (ICESP), Clinical Hospital, School of Medicine, University of São Paulo, Sao Paulo 01246-000 (Brazil); Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, Sao Paulo 01246-000 (Brazil); Watanabe, T. [Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, Sao Paulo 01246-000 (Brazil); Traino, A. C. [Unit of Medical Physics, Azienda Ospedaliero-Universitaria Pisana, Pisa 56126 (Italy)

    2014-01-15

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurements were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG and A

  12. Repetitive use of recombinant human TSH in radioiodine therapy of follicular thyroid cancer with multiple skeletal metastasis

    International Nuclear Information System (INIS)

    Full text of publication follows. Follicular thyroid cancer constitutes 30% of our thyroid cancer population among which 10% patients present with lung and skeletal metastasis.The goal of the study for assessment of effectiveness and side effects of repeated use of rh TSH in radioiodine therapy in patients of follicular thyroid cancer with multiple skeletal metastasis. 9 patients of follicular cancer thyroid with multiple skeletal metastasis, 6 females and 3 males, age more than 45 years had undergone repeated radioiodine therapy at 6-9 months interval with intramuscular injection of two doses of 0.9 mg rhTSH on compassionate ground. Each patient have received at least twice rhTSH and maximum 4 times for radioiodine therapy and whole body radioiodine scan in same sitting. These patients did not reveal any obvious neurological deficit on clinical examination. Patients with compressive myelopathy were excluded from the study. Serum TSH were found to be mean of 46.75 (29.2-77.85 IU/l) following 24 hours of first intramuscular injection and 107.42 (77.87-150 IU/l) following 24 hours of second intramuscular injection. Serum thyroglobulin was found to be more than 300 ng/dl except one patient with 0.2 ng/dl in spite of demonstrable multiple skeletal metastasis on whole body radioiodine scan and anti-thyroglobulin antibodies were negative. Most of the patients did not develop any side effects besides mild nausea or fever except one patient who developed severe pain on both occasion following rhTSH administration at 6 month interval. First time the pain could be relieved with higher doses of analgesics and steroid. However,the second time,it required spinal decompression for relief of pain. Repeated administration of rh TSH in radioiodine therapy in follicular cancer thyroid with multiple skeletal metastasis could be possible because of rise of serum TSH >30 IU/l and no serious side effects or complications which lead to easy acceptability of this alternative procedure

  13. A Virtual Harp for Therapy in an Augmented Reality Environment

    OpenAIRE

    Taylor, Tanasha; Smith, Shana

    2010-01-01

    The use of the virtual harp therapy system had an impact on the participants in the program, most were very excited when they first arrived. While almost all of the participants have received some form of traditional therapy training, most have never experienced virtual or augmented reality before and were therefore, able to look at the therapy training that they have seen before in a different way. Part of the problem with traditional therapy training exercises is that patients get bored or ...

  14. Effects of Radioiodine Therapy on the Natural History of Graves' Ophtalmopathy

    Directory of Open Access Journals (Sweden)

    A Dreval

    2007-09-01

    Full Text Available 21 patients with Graves’ disease and Graves’ ophthalmopathy (GO received radioiodine treatment (RIT. Before 131-I therapy in all patients GO were non-active and no severe. Six patients not received any treatment before RIT; four patients received orbital radiotherapy and 11 patients received intravenous glucocorticoids. Thyreotoxicosis compensation were achieved by antithyroid medication before RIT. Antithyroid medication was stopped 10 days before RIT. Worsening of GO was seen on 47.7% patients 3 months after RIT, but only 9.5% of patients needed additional treatment GO. GO exacerbation take place in 90% of hypothyroid patients and its compensation reduced the symptoms of activity of GO for 3 months. 42.8% was without any symptoms of activity of GO by 9—12 months after RIT. Treatment of GO before RIT were improved the course of GO after RIT.

  15. Dose concepts and dosimetry for radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Dose planning prior to radioiodine therapy of benign thyroidal disease is usually based on macrodosimetry. The paper shows that this assumption is acceptable. The common concepts for dose planning are given. The following target doses are nowadays widely accepted: 150 Gy for euthyroid goiter, 400 Gy for toxic adenoma, 150 Gy for disserminated autonomy, 200 Gy for hyperthyroid Grave's disease if posttherapeutic euthyroidism is intended, and 250 (to 300) Gy if the risk of recurrency is to be minimized ('ablative' concept). Finally, a surveyfis given concerning the precision in which the parameters relevant for the dose calcultion can be determined. For realistic favourable conditions, the dose can be determined with an accuracy of better than ±25%. (orig.)

  16. Use of recombinant, human TSH radioiodine therapy in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    We describe the use of recombinant human TSH (rhTSH) in conjunction with ablative radioiodine therapy (RIT) in 11 patients (16 total treatments) with advanced and/or recurrent DTC (5 papillary, 6 follicular) for whom withdrawal of thyroid hormone suppressive therapy (THST) to increase serum TSH was not an option. Indications for rhTSH use in these patients included inability to tolerate withdrawal of thyroid hormones due to poor physical condition or inability to achieve sufficient serum TSH levels after THST withdrawal. All patients had undergone thyroidectomy and most (9/11) had received prior radioablative therapy after THST withdrawal. In 7 cases (5 patients), post-therapy Tg levels assessed at a mean of 4.3 months (range 2-10 months) after I-131 therapy were decreased by at least 30% compared to pre-therapy levels. In an additional 3 patients, whole body scans performed at follow-up indicated decreased or stabilized tumor burden compared to pre-therapy scans or marked clinical improvement was found. Three patients died of progressive disease within 2 months of therapy before follow-up assessments occurred. No adverse events were reported among the 8 surviving patients. The results suggest that rhTSH offers a promising alternative to THST withdrawal to allow radioablative therapy under maximal TSH stimulation in patients with advanced recurrent DTC who would not otherwise be able to receive this treatment. This therapeutic indication extends the clinical potential of the new agent, already demonstrated to be effective for use with I-131 for diagnostic purposes. However in some patients suffering from highly aggressive tumors the poor prognosis will not be improved. (orig.)

  17. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Moka, D.; Reinholz, U.; Schmidt, M.; Schomaecker, K.; Schicha, H.; Wellner, U. [Koeln Univ. (Germany). Dept. of Nuclear Medicine

    2007-07-01

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid {sup 131}I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 {mu}g inactive potassium-iodide ({sup 127}I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after {sup 131}I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective {sup 131}I half-life, thyroid dose, total T3, total T4, {sup 131}I-activity in the T3- and T4-RIAs. Results: In Group A, the effective {sup 131}I half-life M1 before iodine (3.81 {+-} 0.93 days) was significantly (p <0.01) shorter than the effective {sup 131}I half-life M2 (4.65 {+-} 0.79 days). Effective {sup 131}I half-life M1 correlated with the benefit from inactive {sup 127}I (r = -0.79): Administration of {sup 127}I was beneficial in patients with an effective {sup 131}I half-life M1 of <3 or 4 days. Patients from Group A with high initial specific {sup 131}I activity of T3 and T4 showed lower specific {sup 131}I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific {sup 131}I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for {sup 131}I T3 and y = 1.0827x - 0.4444 for {sup 131}I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for {sup 131}I T3 and y = 1.3191x - 0.2901 for {sup 131}I T4). Radioiodine therapy was successful in all 15 patients from Group A

  18. Whether antithyroid drugs influence on the outcome of radioiodine therapy of thyroid functional autonomy?

    International Nuclear Information System (INIS)

    Full text: The purpose of research was an estimation of the influence of antithyroid medication on efficiency of radioiodine therapy (RIT) in patients with thyroid functional autonomy (FA). 100 patients with various clinical variants of FA were included in research and received treatment with radioiodine. From them uni-focal autonomy (UFA) was diagnosed in 65 person, multifocal (MFA) in 14 and disseminated (DA) in 21. Among the patients included in research 8 had relapse of hyperthyroidism after initial operative treatment and 1 after RIT. The data in work are submitted as a median (1-st and 3-rd quartiles). The age of surveyed was 65.5 (54; 72.5), from them 63 persons were a female, 37 were a male. From surveyed 2 groups of patients were formed. The first group consisted from 50 person, initially accepting during 4 months (2.5; 6) antithyroid drugs (ATD) which cancellation had been made as a rule 2 day prior to RIT, and the second one included 50 person, not accepting ATD neither up to nor after RIT. 9 elderly and multi morbid patients from the first group continued to accept ATD within several months after RIT. Carbimazole (n=45) or methimazole (n=5) in a dose of 10 mg (5; 10) were used as ATD. Therapeutic activity of 131I was calculated by means of Marinelli's formula. The target dose for UFA has made 400 Gy, for MFA and DA - 150 Gy. For calculation of thyroid uptake 24-hour radioiodine test was carried 2-3 day prior to RIT. Used activity of I-131 have made from 4.08 up to 58.89 mCi. Duration of inpatient stay has made 3 days (2; 5). In 4 months (4; 5) after RIT the successful result (euthyroidism or hypothyroidism) has been achieved in 48 (96 %) patients accepting ATD, and in 47 (94 %) patients who were not accepting last. Conclusion: The conclusion that antithyroid medication does not influence on the efficiency of RIT of FA was made. It was revealed that frequency of hypothyroidism after RIT in patients of the first group was higher (36 %) than in patients of

  19. Efficiency of radioiodine therapy with a fix dose of I-131 in toxic thyroid adenoma

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to estimate the results obtained using a fix dose of I-131 in the treatment of the solitary toxic thyroid adenoma. Material and Methods: We have performed radioiodine therapy m 64 patients, 49 female (50+17 yrs) and 15 male (43+-15 yrs) with solitary toxic thyroid adenoma. 45 patients received fix dose I-131 of 850 MBq, while 19 patients were treated with calculated (MBq/gr) dose 555-1100 MBq Previously 39(64%) patients were clinically hyperthyreotic and received thyreostatic meditication which were interruptecf one week before the administration of I-131. Those patients who were euthyreotic, TSH was suppressed(<0.25 MU/m1). 61(95.3%) patients received a single dose, while 3(4, 7%) patients needed two doses. Resulting thyroid matabolism and volume of nodules were evaluated 6-48 months after treatment. Results: From 45 radioiodine treated patients with fix dose 6(9, 8%) became hypothyroidism, 36(85, 3%) euthyroidism and 3(4, 9%) recurrent hyperthyroidism, in comparison with 19 treated patients with calculated I-131 dose: 2(10, 5%) hypothyroidism, 16(84, 3%) euthyroidism and 1(5, 2%) recurrent hyperthyroidism. The size of the nodules became unpalpable m 17(26, 2%), decreased evidently in 33(52, 5%) and remained unchanged in 14(21, 3%) of the treated patients. Conclusion: A fix dose of I-131 is simple, safe and efficient in the treatment of solitary toxic thyroid adenoma. There was not significant different in incidence of late follow-up results of hypothyroidism and recurrent hyperthyroidism between fix dose and calculated MBq/gr dose. (authors)

  20. Predictive factors of failure in radioiodine therapy of Graves' disease

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: to retrospectively evaluate any factors that may limit the success rate of radioiodine therapy (RIT) in Graves' disease patients. Methods: 80 Graves' disease patients submitted for RIT in our department in a two years' period (2010-2011) were enrolled in the study. A fixed dose of 12 mCi (444 MBq) of 131I was administered to all patients after antithyroid drug administration, in order to achieve normal FT3 serum values. Thyroid function outcome were assessed 10-12 months after RIT. Patient's sex, age, evidence of ophthalmopathy, ultrasound measurement of the thyroid volume and 99mTc thyroid uptake % prior to RIT were considered as potential interference factors for success. Multiple logistic regression analysis was performed. Results: after RIT, 9 patients (11%) became euthyroid, 48 patients (61%) became hypothyroid and 23 (28%) remained hyperthyroid. No statistically significant association between treatment outcome and sex (p = 0.56), age (p=0.61) and ophthalmopathy (p = 0.72) was found. On the contrary, 99mTc thyroid uptake % and thyroid volume were associated with success rate (thyroid uptake<14%, p<0.001, odds ratio 3.9 and thyroid volume <58 ml, p < 0.001, odds ratio 7.9). Conclusions: A radioiodine fixed dose of 12 mCi (444 MBq) for treatment of Graves' disease seems to be a practical and effective approach. However, this administration is not recommended for patients with large goiters and a high pre-RIT thyroid uptake, due to high failure rates observed in patients with thyroid volume more than 58 ml and thyroid uptake higher than 14%. (authors)

  1. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

    International Nuclear Information System (INIS)

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131I ablation may be helpful in an individual constellation. Preparation for 131I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for 131I-therapy in patients with metastases, higher sensitivity of 131I whole-body scan) are discussed. In most centers standard activities are used for 131I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131I should not exceed 1-10MBq, alternative tracers are 123I or 124I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  2. Comments on 'Radioiodine therapy: care of the helpless patient and handling of the radioactive corpse'

    International Nuclear Information System (INIS)

    Dear Sir, I was most interested to read the article by C D Greaves and W B Tindale in the December 2001 issue (pages 381-92) regarding 'Radioiodine therapy: care of the helpless patient and handling of the radioactive corpse'. The sections on handling and disposal of the radioactive corpse by the funeral director and mortuary were most informative; however I was left wondering what was the current position regarding the rules and protocol required for use at crematoria when dealing with such corpses. Whilst recognising that radioiodine therapy was the topic of discussion, a wider range of radioisotopes are used in various therapies and may subsequently contaminate crematoria. The article by Mary G Aerts (Cremation of corpses containing bone-seeking radionuclides following medical treatment IRPA 2000 (P-5-296)) at IRPA 10 identified that Western Australia has undertaken an assessment of the radioactive content of the ashes of several crematoria undertaking such cremations, and established that most if not all strontium-89 remains in the bone fragments after cremation. This can give rise to contaminated furnaces, tools and working areas during the processing of cremated remains, and raises the question of how to deal with processed ashes, and what explanation and special requirements may be given to the relatives of the deceased. It is therefore questioned what, if any, role the Environment Agency (EA)/Scottish Environmental Protection Agency (SEPA) may play or regulate regarding emissions to the environment for cremation of corpses which had undergone various forms of radioisotope therapy prior to death, not just those of short-lived isotopes. Such a case was dealt with recently by SEPA, which recognised a need to include identification to relatives of any necessary precautions for the handling or internment or scattering of the ashes, whilst being 'content' that the cremation met conditions prescribed under Radioactive Substances Act 1993. SEPA further commented

  3. Radioiodine 131 therapy in hyperthyroidism evaluation of French nuclear medicine practices

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim Radioiodine 131I (RAI) is currently used routinely in the treatment of hyperthyroidism including Graves disease (GD), toxic multi-nodular goitre (TMNG) and toxic solitary nodule (TSN). It has proved to be safe, efficient and relatively inexpensive therapy. But after more than 60 years, many protocols are coexisting and no consensus exists on the most appropriate way to prescribe RAI dose: fixed dose regime or calculated doses based on gland size or turnover of RAI. This is the first nationwide French survey assessing the current practices about radioiodine treatment in thyrotoxicosis. Methods: we sent a questionnaire to French nuclear medicine hospital units and cancer treatment centres (n=69) about their practices in 2012. Questions were asked about RAI treatment: objectives, way to prescribe the therapeutic dose and its factors, radioisotope use to explore thyroid function and method of gland size measurement. Results: we received 40 responses. Euthyroidism was a successful treatment outcome for 33% of French respondents whereas hypothyroidism was the aim for 26%. Antithyroid drugs were stopped 7 days on average (range 3-21 days) before therapy. 68% of physicians used ultrasound for thyroid volume measurement. Calculated doses were used by 40% of clinicians (Marinelli's formula: 80%). Factors influencing prescription were thyroid uptake (100%) based on radiotracer iodine-131 (33%) or iodine-123 (67%), thyroid volume (93%) and disease (80%). Fixed activities represented 60% of the prescribed doses (72,5% for TMNG and TSN). The administered dose was chosen between 1 to 3 levels of standard doses, according to the patient characteristics. Factors influencing this choice were disease, with respectively a median of 370 MBq (range:185-740), 555 MBq (185-740), 555 MBq (296-925) for GD, TSN and TMNG, thyroid volume (59%) and thyroid uptake (52%) with the radiotracer iodine-123 (30%) or technetium-99m (70%). Even physicians using

  4. Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit; Benigne Schilddruesenerkrankungen, Radioiodtherapie und Diagnosis Related Groups (DRGs): Kosten-Nutzen-Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany)

    2005-06-01

    The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

  5. Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?

    Science.gov (United States)

    Hirosawa, Renata Midori; Marivo, Monica; Luengo, Juliana de Moura Leite; Tagliarini, Jose Vicente; Castilho, Emanuel Cellice; Marques, Mariangela de Alencar; Kiy, Yoshio; Marone, Marilia Martins Silveira; Silveira, Liciana Vaz de Arruda; Mazeto, Glaucia Maria Ferreira da Silva

    2011-01-01

    Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P = 0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P < 0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I. PMID:22084737

  6. Guidelines on radioiodine therapy for differentiated thyroid carcinoma. Impact on clinical practice

    International Nuclear Information System (INIS)

    Aim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing multicenter study differentiated thyroid carcinoma (MSDS) were analyzed. Patients, methods: patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pNO/1/x MO/x (UICC, 5th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4-6 weeks), in 33% and 84% with regard to 131I activity for RIT (1-3 vs. 1-4 GBq; ±10%), and in 16% and 60% with regard to 131I activity for WBS (100-300 vs. 100-400 MBq; ±10%). Conclusions: the 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes. (orig.)

  7. Radiation therapy after breast augmentation or reconstruction

    International Nuclear Information System (INIS)

    This paper evaluates the feasibility and cosmetic results of definitive breast irradiation in the presence of a silicone prosthesis. Fourteen patients who presented between 1984 and 1989 with a diagnosis of primary (four patients) or locally recurrent (ten patients) breast cancer and whose augmented or reconstructed breasts were treated with radiation were evaluated for acute and late complications. Silicone gel implants were used in 13 patients and free injected silicone in one patient. The total dose ranged from 4,400 to 6,200 cGy with use of tangential photon fields or an en face electron field by megavoltage equipment. In several cases, electron boost was added to the tumor bed

  8. Combined therapy with {sup 131}I and retinoic acid in Korean patients with radioiodine-refractory papillary thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Oh, So Won [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University Boramae Medical Center, Department of Nuclear Medicine, Seoul (Korea, Republic of); Moon, Seung-hwan; Chung, June-Key [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Park, Do Joon; Cho, Bo Youn [Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Jung, Kyeong Cheon [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Lee, Dong Soo [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University WCU Graduate School of Convergence Science and Technology, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul (Korea, Republic of)

    2011-10-15

    The aim of this study was to assess the clinical outcome of redifferentiation therapy using retinoic acid (RA) in combination with {sup 131}I therapy, and to identify biological parameters that predict therapeutic response in Korean patients with radioiodine-refractory papillary thyroid carcinoma (PTC). A total of 47 patients (13 men, 34 women; age 54.2 {+-} 13.6 years) with radioiodine-refractory PTC underwent therapy consisting of consecutive treatment with {sup 131}I and RA. Each {sup 131}I/RA treatment cycle involved the administration of oral isotretinoin for 6 weeks at 1-1.5 mg/kg daily followed by a single oral dose of {sup 131}I (range 5.5-16.7 GBq). Therapeutic responses were determined using serum thyroglobulin (Tg) levels and the change in tumour size 6 months after completing the {sup 131}I/RA therapy. Biological parameters and pathological parameters before and after combined therapy were compared. After completing {sup 131}I/RA therapy, 1 patient showed a complete response, 9 partial response, 9 stable disease, and 28 progressive disease, representing an overall response rate of 21.3%. Univariate analysis revealed that an age of <45 years and a persistently high serum Tg level were related to a good response. No clinical response was achieved when metastases showing no iodine uptake were present. Multivariate regression analysis showed that an age of <45 years was significantly associated with a good response. Of the 24 patients with well-differentiated carcinoma, 5 (20.8%) responded to {sup 131}I/RA therapy, whereas all 6 patients with poorly differentiated carcinoma failed to respond. {sup 131}I/RA therapy was found to elicit a response rate of 21.3% among patients with radioiodine-refractory PTC, and an age of <45 years was found to be significantly associated with a good response. (orig.)

  9. Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs

    International Nuclear Information System (INIS)

    Aim: Premedication with antithyroid drugs (ATD) compared to patients not pretreated with ATD causes a higher failure rate of radioiodine therapy (RITh) or demands higher therapeutical dosage of radioiodine (RI). For clinical reasons and because of accelerated iodine metabolism in hyperthyreosis a compensated thyroid metabolism is desirable. Aim of this study was to investigate the influence of ATD on the biokinetics of RI in case of Graves' disease in order to improve RITh of patients pre-treated with ATD. Methods: 385 consecutive patients who underwent RITh because of Graves' disease for the first time were included: Group A (n = 74): RITh under continuous medication with ATD; Group B (n = 111): Application of RI under continuous medication with ATD, in case of insufficient RI-uptake or shortened effective RI-half-life ATD were stopped 1-5 days after RITh; Group C (n = 200): ATD were stopped 2 days prior to RITh in all patients. We examined the influence of ATD on RI-uptake and effective RI-half-life as well as the absorbed dose achieved on the thyroid in dependence of thyroid volume and applied RI-dosage [TEQ - therapy efficiency quotient, (2)]. Results: In the RI-pretest (all patients under ATD) the RI-uptake was comparable in all three groups. During RITh-RI-uptake, effective RI-half-life and therefore the TEQ were significantly higher in Group C as compared to Groups A and B (p<0,001, respectively). In Group B the medication with ATD was stopped in 61 of 111 cases 1-5 days after RITh. In this subgroup the effective RI-half-life increased from 4,4 ± 1,7 d to 5,1 ± 1,6 d after stopping of ATD (p = 0,001). Conclusion: Stopping of ATD 2 days prior to RITh leads to an increased efficiency of about 50% compared to RITh carried out under ATD and therefore to a clear reduction of radiation exposure to the rest of the body with equal absorbed doses of the thyroid. Stopping of ATD shortly after RITh increases efficiency in case of short effective RI-half-life, but it

  10. Treatment results of radioiodine therapy in patients with pulmonary metastases of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Purpose: Radioiodine treatment is a popular treatment approach for patients with pulmonary metastases of differentiated thyroid cancer. In this study, we evaluated the survival of patients with pulmonary metastases of differentiated thyroid cancer receiving periodic 131I therapy and influence factors of prognosis. Methods: Ninety six patients with pulmonary metastases from well-differentiated thyroid carcinoma received initial 131I therapy in our department from 1976 to December 2001 were reviewed retrospectively. Follow-up data were recorded up to December 2003. Most of them underwent total or near total thyroidectomy before 1311 treatment. Sixty eight patients were PTC and 28 were FC. We had 49 males and 47 females with a mean age of 48.6 years. Thyroid hormone medications were withheld for two weeks for triiodothyronine (T3) and five weeks for thyroxine (T4). For postoperative ablation of thyroid bed remnants, activity in the range of 2.75-5.5 GBq (75-150 mCi) is administered. For treatment of pulmonary metastases, activity of 5.55-7.4 GBq (150-200 mCi) is given every six months. The range of accumulative dose of 131I was 100-1650 mCi. Survival was estimated by using the Kaplan-Meier method. Results: The overall 5-year and 10-year survivals for all patients were 95% and 85%, respectively. The post-lung-metastasis 5-year and 10-year survivals were 81% and 56%, respectively. Twenty-one of 59 (61.5%) of patients had a response after 131I treatment, with a complete response of 24.0% and a partial response of 37.5%, Papillary carcinoma, age less than 45 at diagnosis, treatment response (CR+PR), without other distant metastases, the radioiodine uptake in the lesions are favorite important facts affected prognosis. Conclusions: The results suggest that differentiated thyroid cancer patients with pulmonary metastases are indolent clinical course. 131I is an effective treatment for these patients with pulmonary metastases. (authors)

  11. Treatment of autonomously functioning thyroid nodules at a single institution. Radioiodine therapy, surgery, and ethanol injection therapy

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the efficacy of radioiodine (RI) therapy in Japanese patients with autonomously functioning thyroid nodules (AFTNs). We performed a retrospective analysis to assess the management of AFTN patients. Thyroid lobectomy was performed to treat toxic adenoma (TA) patients, and total thyroidectomy to treat toxic multinodular goiter (TMNG) patients. RI therapy was administered in the form of a single dose (500 MBq) of isotope in the outpatient clinic. Percutaneous ethanol injection therapy (PEIT) was performed under ultrasound guidance. Of the total 205 patients, consisting of 159 TA and 46 TMNG patients, 99 underwent surgery, 50 received RI therapy, and 56 received PEIT. Remission of thyrotoxicosis was achieved in all of the patients who were treated surgically. Hypothyroidism was documented in six of the 72 patients who were treated surgically other than by total thyroidectomy. Remission of thyrotoxicosis was observed in 43 of the 50 patients who were treated by RI therapy. Nine TA patients developed hypothyroidism during the follow-up period after RI therapy. Several PEIT sessions were required to achieve a remission of thyrotoxicosis. Remission of thyrotoxicosis was achieved in 29 of the 56 patients treated by PEIT, and thyrotoxicosis recurred in 17 these 56 patients. Surgery is the treatment of choice for large nodules and nodules that are resistant to other treatments, because it allows prompt control of thyrotoxicosis. RI therapy is a safe and effective means of controlling thyrotoxicosis in AFTN patients. We conclude that RI therapy is the treatment of choice for definitive treatment of AFTN patients who do not have local compression symptoms. (author)

  12. Preliminary study of attitude and knowledge of thyroid cancer patients to radioiodine therapy

    International Nuclear Information System (INIS)

    The purpose of this preliminary study is to survey the attitude and knowledge of radiation and radioiodine treatment in thyroid cancer patients. Fifty-two thyroid cancer patients who were prepared for radioactive iodine treatment at Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital were requested to fill the questionaires before and after receiving the information about radioiodine treatment. The questionaires consisted of 12 questions of which the first five were about the attitude to radiation and radioiodine treatment. The rest was about an information on radioiodine treatment. For data analysis, firstly the percentage of correct answer of each question was calculated and compared between pre- and post-test. Secondly all patients were categorized into 2 groups according to their education: upto high school, and undergraduate or higher. The attitude and the understanding about radioiodine treatment were analyzed in each group. The results show that post-test gives higher percentages of correct answers for all questions with an average of 29% improvement. For upto high school group, the attitude improves from 69.4% to 97.2% and the understanding about radioiodine treatment improves from 88.9% to 100%. Similarly, for the undergraduate or higher group,the attitude improves from 93.3% to 100% and the understanding about radioiodine treatment improves from 73.3% to 100%. It may be concluded that our education intervention is informative and the well-educated patients have better attitude to radiation

  13. {sup 18}F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Rosenbaum-Krumme, Sandra J.; Goerges, Rainer; Bockisch, Andreas; Binse, Ina [University Hospital Essen, Department of Nuclear Medicine, Essen (Germany)

    2012-09-15

    Advanced tumour stage and initial metastases are associated with reduced general and tumour-free survival in patients with differentiated thyroid carcinoma. Optimal initial therapy is mandatory for a positive patient outcome, but can only be performed if all non-iodine-avid tumour lesions are known before planning treatment. We analysed the benefit of {sup 18}F-FDG PET/CT at initial diagnosis in patients with high-risk differentiated thyroid carcinoma and determined whether the {sup 18}F-FDG PET/CT results led to a deviation from the standard procedure, which consists of two consecutive radioiodine treatments with thyroid hormone suppression in between and no additional imaging, with individual patient management. The study group comprised 90 consecutive patients with either extensive or metastasized high-risk differentiated thyroid carcinoma who received {sup 18}F-FDG PET/CT after the first radioiodine treatment approximately 4 weeks after thyroidectomy under endogenous TSH stimulation. We carried out PET/CT imaging with low-dose CT without contrast medium, which we only used for attenuation correction of PET images. {sup 18}F-FDG PET/CT was positive in 26 patients (29%) and negative in 64 patients (71%). Compared to the results of posttherapeutic {sup 131}I whole-body scintigraphy, the same lesions were PET-positive in 7 of the 26 patients, different lesions were PET-positive in 15 patients, and some PET-positive lesions were the same and some were different in 4 patients. TNM staging was changed due to the PET results in 8 patients. Management was changed in 19 of the 90 patients (21%), including all patients with only FDG-positive lesions and all patients with both FDG-positive and iodine-positive lesions. Age was not a predictive factor for the presence of FDG-positive lesions. FDG-positive and iodine-positive lesions were associated with high serum thyroglobulin. However, at low serum thyroglobulin values, tumour lesions (iodine- and/or FDG-avid) were also

  14. 18F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy

    International Nuclear Information System (INIS)

    Advanced tumour stage and initial metastases are associated with reduced general and tumour-free survival in patients with differentiated thyroid carcinoma. Optimal initial therapy is mandatory for a positive patient outcome, but can only be performed if all non-iodine-avid tumour lesions are known before planning treatment. We analysed the benefit of 18F-FDG PET/CT at initial diagnosis in patients with high-risk differentiated thyroid carcinoma and determined whether the 18F-FDG PET/CT results led to a deviation from the standard procedure, which consists of two consecutive radioiodine treatments with thyroid hormone suppression in between and no additional imaging, with individual patient management. The study group comprised 90 consecutive patients with either extensive or metastasized high-risk differentiated thyroid carcinoma who received 18F-FDG PET/CT after the first radioiodine treatment approximately 4 weeks after thyroidectomy under endogenous TSH stimulation. We carried out PET/CT imaging with low-dose CT without contrast medium, which we only used for attenuation correction of PET images. 18F-FDG PET/CT was positive in 26 patients (29%) and negative in 64 patients (71%). Compared to the results of posttherapeutic 131I whole-body scintigraphy, the same lesions were PET-positive in 7 of the 26 patients, different lesions were PET-positive in 15 patients, and some PET-positive lesions were the same and some were different in 4 patients. TNM staging was changed due to the PET results in 8 patients. Management was changed in 19 of the 90 patients (21%), including all patients with only FDG-positive lesions and all patients with both FDG-positive and iodine-positive lesions. Age was not a predictive factor for the presence of FDG-positive lesions. FDG-positive and iodine-positive lesions were associated with high serum thyroglobulin. However, at low serum thyroglobulin values, tumour lesions (iodine- and/or FDG-avid) were also diagnosed. Thus, the serum

  15. Development of parotitis after radioiodine therapy in a differentiated thyroid cancer patient: Case report

    Directory of Open Access Journals (Sweden)

    Zekiye Hasbek

    2016-03-01

    Full Text Available In this article, we report a 51 years old female patient treated with radioactive iodine (RAI-131I treatment for thyroid papillary carcinoma and developing parotitis on the 24 hour following treatment. Sialoadenitis after high dose ablative therapy with 131I is a relatively common complication with a low clinical impression. Taste altera-tion or loss, and nausea and vomiting due to radiation sickness are the other most frequent side effects. Xero-stomia is an important problem increasing morbidity of the patients. For this reason, it is important to prevent xerostamia by following serum amylase levels in symptomatic patients. By taking into account that not only bacterial and viral factors but also radiation may cause sialoadenitis, one has to rule out other parotisis possibili-ties by clinical and laboratory findings before claiming that salivary gland enlargement developing after radio-iodine is a complication of radiation. Moreover, history of RAI treatment should be given importance in patients applying either to emergency services or to Ear Nose Throat and Infectious Diseases Department with dry mouth.

  16. Salivary gland protection by amifostine in high-dose radioiodine therapy of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Quantitative salivary gland scintigraphy using 100 to 120 MBq Tc-99m-pertechnetate was performed in 17 patients with differentiated thyroid cancer prior to and 3 months after radioiodine treatment with 6 GBq I-131. Eight patients were treated with 500 mg/m2 amifostine prior to high-dose radioiodine treatment and compared retrospectively with 9 control patients. Xerostomia was graded according to WHO criteria. In 9 control patients high-dose radioiodine treatment significantly (p<0.01) reduced Tc-99m-pertechnetate uptake by 35.4±22.0% and 31.7±21.1% in parotid and submandibular glands, respectively. Of these 9 patients, 3 exhibited xerostomia Grade I (WHO). In contrast, in 8 amifostine-treated patients, there was no significant (p=0.878) decrease in parenchymal function following high-dose radioiodine treatment, and xerostomia did not occur in any of them. (orig.)

  17. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Gotthardt, M. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Nuclear Medicine; Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Rubner, C. [Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Bauhofer, A. [Philipps Univ., Marburg (DE). Inst. of Theoretical Surgery] (and others)

    2006-07-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76{+-}80.6 Gy versus 125.6{+-}46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2{+-}101.7 Gy versus 125.6{+-}46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  18. Results of radioiodine therapy of manifest hyperthyroidism and autonomous euthyroid goiter

    International Nuclear Information System (INIS)

    In 200 patients follow-up examinations were performed up to one year after radioiodine therapy (RITh) with individual dose calculation. The mean applied dose was significantly lower in patients with immunogenic hyperhyroidism (Graves' disease) as compared to patients with non-immunogenic hyperthyroidism (disseminated/multifocal autonomy, HYDA). In Graves' disease the rate of recurrent hyperthyroidism was significantly higher and that of posttreatment hypothyroidism lower. Considering the high recurrence rate in Graves' disease a higher dose, e.g. 150 Gy, seems to be appropriate. In patients with HYDA who received antithyroid drugs during RITh, recurrence of hyperthyroidism appeared slightly more, and posttreatment hypothyroidism slightly less, frequent. The efficiency of RITh was not significantly reduced by additional treatment with antithyroid drugs. Posttreatment hypothyroidism in patients with euthyroid goiter and disseminated/multifocal autonomy (EUDA) occurred significnatly more frequent if the basal TSH level was ≥ 0.5 μIE/ml before therapy. The goiter size was reduced independent of the basal TSH level. In HYDA patients after thyroid surgery recurrence appeared less, and in those with EUDA posttreatment hypothyroidism significantly more, frequent. A lower dose seems to be suitable in patients who underwent thyroid surgery before. In patients with focal autonomy after RITh no recurrence of hyperthyroidism was observed. In 9% a suppressed basal TSH level indicating persistent autonomy was seen. Posttreatment hypothyroidism in focal autonomy appeared only in patients without manifest hyperthyroidism before RITh and was significantly more frequent in this group. In patients with focal autonomy who developed hypothyroidism the dose calculation was based on a significantly higher volume of the adenoma. (orig./MG)

  19. Radioiodine therapy for Plummer's disease based on the thyroid uptake of technetium-99m pertechnetate

    International Nuclear Information System (INIS)

    The aim of this retrospective study was the evaluation of a TcTUs (global technetium-99m pertechnetate thyroid uptake under suppression)-based approach in 370 patients with thyroid autonomy (Plummer's disease) treated by radioiodine therapy (RIT) under standardised conditions. The analysis included 370 patients (309 females, 61 males; mean age 64±11.6 years) treated for thyroid autonomy [unifocal (UFA), 36.8%; multifocal (MFA), 55.7%; disseminated (DISA), 7.6%]. During RIT all patients were under thyroid suppression (TSH0.5 μU/l and/or TcTUs4 μU/ml). A dose of 350-450 Gy to the autonomous tissue resulted in a success rate of 97% in the UFA group and 81% in the MFA/DISA group. Decrease in total thyroid volume and TcTUs did not differ significantly between successfully treated patients and patients with persistent autonomy. Multivariate analysis of all 370 patients identified four independent factors that negatively influenced the therapeutic success: high pretherapeutic thyroid volume (P=0.0001; odds ratio: 1.017), high pretherapeutic TcTUs values (P=0.0001; odds ratio: 1.378), multifocal/disseminated autonomy (P=0.0056; odds ratio: 3.245) and low target dose (P=0.017; odds ratio: 0.997). It is concluded that the high success rate in the treatment of UFA indicates the concept of TcTUs-based RIT to be valid, but that in the therapy of MFA/DISA the target se has to be corrected if the total thyroid volume exceeds a critical threshold. (orig.)

  20. Prestimulation with Recombinant Human Thyrotropin (rhTSH) Improves the Long-Term Outcome of Radioiodine Therapy for Multinodular Nontoxic Goiter

    DEFF Research Database (Denmark)

    Fast, Søren; Nielsen, Viveque Egsgaard; Grupe, Peter; Boel-Jørgensen, Henrik; Bastholt, Lars; Andersen, Peter; Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    Objective: The objective of the study was to evaluate the long-term outcome of recombinant human TSH (rhTSH)-augmented radioiodine ((131)I) therapy for benign multinodular nontoxic goiter. Patients and Methods: Between 2002 and 2005, 86 patients with a multinodular nontoxic goiter were treated with...... (131)I in two randomized, double-blind, placebo-controlled trials. (131)I-therapy was preceded by 0.3 mg rhTSH (n = 42) or placebo (n = 44). In 2009, 80 patients completed a follow-up (FU) visit, including determination of thyroid volume, thyroid function, and patient satisfaction by a visual analog...... scale. Results: In both groups, thyroid volume was further reduced from 1 yr to final FU (71 months). The mean goiter volume reductions obtained at 1 yr and final FU [59.2 ± 2.4% (sem) and 69.7 ± 3.1%, respectively] in the rhTSH group were significantly greater than those obtained in the (131)I...

  1. Clinical Studies of Nonpharmacological Methods to Minimize Salivary Gland Damage after Radioiodine Therapy of Differentiated Thyroid Carcinoma: Systematic Review

    Directory of Open Access Journals (Sweden)

    Andri Christou

    2016-01-01

    Full Text Available Purpose. To systematically review clinical studies examining the effectiveness of nonpharmacological methods to prevent/minimize salivary gland damage due to radioiodine treatment of differentiated thyroid carcinoma (DTC. Methods. Reports on relevant trials were identified by searching the PubMed, CINHAL, Cochrane, and Scopus electronic databases covering the period 01/2000–10/2015. Inclusion/exclusion criteria were prespecified. Search yielded eight studies that were reviewed by four of the present authors. Results. Nonpharmacological methods used in trials may reduce salivary gland damage induced by radioiodine. Sialogogues such as lemon candy, vitamin E, lemon juice, and lemon slice reduced such damage significantly (p<0.0001, p<0.05, p<0.10, and p<0.05, resp.. Parotid gland massage also reduced the salivary damage significantly (p<0.001. Additionally, vitamin C had some limited effect (p=0.37, whereas no effect was present in the case of chewing gum (p=0.99. Conclusion. The review showed that, among nonpharmacological interventions, sialogogues and parotid gland massage had the greatest impact on reducing salivary damage induced by radioiodine therapy of DTC. However, the studies retrieved were limited in number, sample size, strength of evidence, and generalizability. More randomized controlled trials of these methods with multicenter scope and larger sample sizes will provide more systematic and reliable results allowing more definitive conclusions.

  2. Graves' disease and radioiodine therapy. Is success of ablation dependent on the choice of thyreostatic medication?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Weber, I.; Eschner, W.; Sudbrock, F.; Schmidt, M.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: a total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months offer RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: relief from hyperthyroidism was achieved in 96% of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p = 0.22). Conclusion: thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy. (orig.)

  3. Exogenous or endogenous TSH stimulation before radioiodine therapy of metastatic thyroid cancer patients? The answer from post-therapy whole-body scan

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: human thyroid-stimulating hormone (rhTSH) is a well establish preparation method for ablation therapy with 131I in patients with differentiated thyroid cancer (DTC). However, for residual or metastatic disease, the advantage of rhTSH-aided 131I compared with the conventional preparation with thyroid hormone withdrawal (THW) still is a subject of discussion. The aim of our study was to compare the efficacy of rhTSH versus THW preparation for 131I therapy of metastatic DTC, based on the post-therapeutic whole body scan (ptWBS) information. Material and methods: 10 DTC patients (4 female and 6 males; age: 53 ± 19 years) with iodine-avid metastasis (5 patients with lung, 2 with bone, 1 with lymph node, 1 with lung+bone+lymph node and 1 with lung+bone+hepatic), were submitted to several (mean per patient: 3.6) radioiodine therapeutic courses, between January 2004 and February 2013. Endogenous TSH stimulation was used in most treatments (n=28) but rhTSH was the choice in 12 therapies (once in 8 patients and twice in 2 patients). For every patient, the interval between two consecutive treatments with different stimulation methods was less than 11 months. Post-therapy WBS was performed one week after radioiodine administration. The radioiodine avidity for the metastatic lesions seen on the rhTSH-aided ptWBS was compared, on a within-patient comparison basis, to the radioiodine avidity for the metastatic lesions seen on the THW-aided ptWBS. Results: in patients with positive metastasis on ptWBS after THW, no visible radioiodine uptake was seen on rhTSH-aided ptWBS in 4 patients (2 cases of lung metastasis, 1 case of lymph node and 1 case of bone metastases). A significant reduction of 131I uptake was recorded in 4 cases (2 with pulmonary, 1 with lung+bone+lymph node and 1 with lung+bone+hepatic). No significant differences were detected between both TSH stimulation methods in the other 2 patients, 1 with pulmonary and the other with

  4. The superiority and benefits of whole body imaging after radioiodine -131 therapy over radioiodine 131 diagnostic imaging in management of thyroid carcinomas

    International Nuclear Information System (INIS)

    A comparison between diagnostic and post therapeutic radioiodine imaging methods utilized in detection of thyroid metastases in 34 patients with well differentiated thyroid cancer was performed. The study revealed that the differences in detection on neck activity only between the two methods for papillary and follicular thyroid cancer were 35% and 27% respectively. While the overall detection percentages in both papillary and follicular thyroid cancers cases were 23% in diagnostic and 76% in post therapy scintigrams and the detection difference between the methods was 53% when all lesions throughout the body were seen on scintigram for only follicular thyroid cancer cases were counted, the detection percentage was increased up to 109%. It is clear that post therapeutic scans visualize an additional site activity not shown in diagnostic scans. There fore, post therapeutic imaging method is far superior to diagnostic imaging method and highly sensitive in visualization of thyroid metastases. On the other hand, this research also achieves many scientific and financial benefits. Therefore. This method should be adopted in management and follow up of well differentiated malignancies. 2 figs., 2 tabs

  5. Radioiodine Therapy of Hyperthyroidism. Simplified patient-specific absorbed dose planning

    International Nuclear Information System (INIS)

    Radioiodine therapy of hyperthyroidism is the most frequently performed radiopharmaceutical therapy. To calculate the activity of 131I to be administered for giving a certain absorbed dose to the thyroid, the mass of the thyroid and the individual biokinetic data, normally in the form of uptake and biologic half-time, have to be determined. The biologic half-time is estimated from several uptake measurements and the first one is usually made 24 hours after the intake of the test activity. However, many hospitals consider it time-consuming since at least three visits of the patient to the hospital are required (administration of test activity, first uptake measurement, second uptake measurement plus treatment). Instead, many hospitals use a fixed effective half-time or even a fixed administered activity, only requiring two visits. However, none of these methods considers the absorbed dose to the thyroid of the individual patient. In this work a simplified patient-specific method for treating hyperthyroidism is proposed, based on one single uptake measurement, thus requiring only two visits to the hospital. The calculation is as accurate as using the individual biokinetic data. The simplified method is as patient-convenient and time effective as using a fixed effective half-time or a fixed administered activity. The simplified method is based upon a linear relation between the late uptake measurement 4-7 days after intake of the test activity and the product of the extrapolated initial uptake and the effective half-time. Treatments not considering individual biokinetics in the thyroid result in a distribution of administered absorbed dose to the thyroid, with a range of -50 % to +160 % compared to a protocol calculating the absorbed dose to the thyroid of the individual patient. Treatments with a fixed administered activity of 370 MBq will in general administer 250 % higher activity to the patient, with a range of -30 % to +770 %. The absorbed dose to other organs

  6. Encouraging results of radioiodine therapy in a 12-year-old boy with papillary carcinoma of the thyroid and pulmonary metastases

    International Nuclear Information System (INIS)

    The presented case report describes a 12-year-old boy with papillary thyroid carcinoma and lung metastases. Since the performance of primary therapy including surgery and double radioiodine therapy, up to now stable disease has been documented by negative iodine scans, decreasing TG values and normalizing chest X-rays, including CT. (orig.)

  7. Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

    Directory of Open Access Journals (Sweden)

    Laura Pratchett

    2010-12-01

    Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

  8. Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Bonnema, Steen Joop;

    2007-01-01

    OBJECTIVE: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules. DESIGN: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized to...... effects were seen. CONCLUSIONS: This first randomized study, comparing ILP with standard therapy, demonstrates that ILP and (131)I therapy approximately halves thyroid nodule volume within 6 months; but in contrast to (131)I, extranodular thyroid volume is unaffected by ILP and no patient developed...... hypothyroidism. Using the present design, ILP seems inferior to (131)I therapy in normalization of serum TSH. The potential value of ILP as a non-surgical alternative to (131)I needs further investigation...

  9. Influence of smoking associated with stress on the outcome of radioiodine therapy in patients with Graves' disease

    International Nuclear Information System (INIS)

    Full text of publication follows. Introduction: Graves' disease (GD) is characterized by activation of the immune system as a result of interactions between genetic predisposition and environmental factors such as iodine intake, stressful events or smoking. Currently, there are no sufficient data on influence of nicotine and other components of tobacco smoking on outcome of radioiodine therapy in GD. The aim of this study was to analyze a possible influence of cigarette smoking associated with stress on the outcome of radioiodine therapy (RIT) in the patients with Graves' disease. Patients and methods: the study included 29 patients (23 female) aged from 22 to 73 years, who were subjects of a follow-up within 12 months after RIT. The stressful events were presented in all patients prior to diagnosing the GD. Patients were divided into two groups: 1. smokers - 15 patients who smoked cigarettes before, at the moment and after RIT, and 2. non-smokers - 14 patients who were always non-smokers. Patients were treated using a sliding scale of fixed activity of radioiodine according to the goiter size. Antithyroid drugs were discontinued 7 days before radioiodine therapy. Therapy outcome was assessed by serum TSH and thyroid hormones levels, and clinical evaluation. A successful response (SR) to RIT was defined as euthyroidism and subclinical or clinical hypothyroidism, and unsuccessful response (UR) as persistent hyperthyroidism. Results: comparison of age (48.0±9.39 vs. 49.6±14.3 years, P=0.715), values of TRAb (2.25±0.91 vs. 2.75±1.32 U/l, P=0.560), administered activity of 131I-NaI (365±75.8 vs. 360±44.4 MBq, P=0.832), and duration of ATDs therapy before RIT (3.34±3.41 vs. 5.06±5.81 years, P=0.397) between smokers and non-smokers showed no significant difference. There was no significant influence of smoking on UR at 3., 6., 9. and 12. month compared with UR in patients who did not smoke (P=0.597, P=0.837, P=0.876, P=0.812, χ2 test). The cumulative

  10. Graves' disease and radioiodine therapy. Is success of ablation dependent on the achieved dose above 200 Gy?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Eschner, W.; Sudbrock, F.; Weber, I.; Marx, K.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to determine the results of ablative radioiodine therapy (RIT) when the achieved dose in the thyroid was above 200 Gy and to characterize predictive factors for treatment outcome. Patients, methods: a total of 571 consecutive patients were observed for 12 months between July 2001 and June 2004. Inclusion criteria were a confirmed diagnosis Groves' disease, compensation of hyperthyroidism and withdrawal of antithyroid drugs two days before preliminary radioiodine-testing and RIT. The intended dose was 250 Gy and the therapeutically achieved dose was calculated from serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The relation between success rate and the achieved dose, thyroid volume, age and sex of patients, TSH- and TRAb-values and presence of ophthalmopathy was analysed. Results: relief from hyperthyroidism was achieved in 96% of patients who received more than 200 Gy, even for thyroid volumes >40 ml. The success of ablative RIT was not influenced by age or sex of patients, or by TSH- or TRAb values or concomitant ophthalmopathy. The mean achieved dose in the thyroid was 298 Gy with a standard deviation of 74.6 Gy. Conclusion: to achieve a dose of over 200 Gy with the above standard deviation, we recommend calculating on intended dose of 250 Gy and using a dosimetric approach with early and late uptake values in the radioiodine test, to allow early therapeutic intervention should the posttherapeutic thyroid dose fall unexpectedly below 200 Gy. (orig.)

  11. Clinical Usefulness between High Dose Radioiodine Therapy and Helicobacter Pylori Infection after Total Thyroidectomy due to Well Differentiated Thyroid Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Kuk No; Lim, Seok Tae; Moon, Eun Ha; Kim, Jin Suk; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-12-15

    Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. One hundred ninety nine patients (M:F=33:166, age 46.7{+-}12.3 years) who had HD-RIT (dose 159.1{+-}25.9 mCi, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive ({>=}50 dpm) or negative (<50 dpm), and analyzed its values. Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were 62{+-}66.1 dpm in increased one of follow-up UBT, and 153.3{+-}157.1 dpm in decreased one of follow-up UBT. We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection.

  12. Clinical Usefulness between High Dose Radioiodine Therapy and Helicobacter Pylori Infection after Total Thyroidectomy due to Well Differentiated Thyroid Cancer

    International Nuclear Information System (INIS)

    Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. One hundred ninety nine patients (M:F=33:166, age 46.7±12.3 years) who had HD-RIT (dose 159.1±25.9 mCi, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive (≥50 dpm) or negative (<50 dpm), and analyzed its values. Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were 62±66.1 dpm in increased one of follow-up UBT, and 153.3±157.1 dpm in decreased one of follow-up UBT. We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection

  13. Graves' disease and radioiodine therapy. Is success of ablation dependent on the achieved dose above 200 Gy?

    International Nuclear Information System (INIS)

    Aim: this study was performed to determine the results of ablative radioiodine therapy (RIT) when the achieved dose in the thyroid was above 200 Gy and to characterize predictive factors for treatment outcome. Patients, methods: a total of 571 consecutive patients were observed for 12 months between July 2001 and June 2004. Inclusion criteria were a confirmed diagnosis Groves' disease, compensation of hyperthyroidism and withdrawal of antithyroid drugs two days before preliminary radioiodine-testing and RIT. The intended dose was 250 Gy and the therapeutically achieved dose was calculated from serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The relation between success rate and the achieved dose, thyroid volume, age and sex of patients, TSH- and TRAb-values and presence of ophthalmopathy was analysed. Results: relief from hyperthyroidism was achieved in 96% of patients who received more than 200 Gy, even for thyroid volumes >40 ml. The success of ablative RIT was not influenced by age or sex of patients, or by TSH- or TRAb values or concomitant ophthalmopathy. The mean achieved dose in the thyroid was 298 Gy with a standard deviation of 74.6 Gy. Conclusion: to achieve a dose of over 200 Gy with the above standard deviation, we recommend calculating on intended dose of 250 Gy and using a dosimetric approach with early and late uptake values in the radioiodine test, to allow early therapeutic intervention should the posttherapeutic thyroid dose fall unexpectedly below 200 Gy. (orig.)

  14. Potential of radioiodinated anticancer compounds of traditional Chinese medicine for cancer therapy

    International Nuclear Information System (INIS)

    23-Hydroxybetulinic acid (23-HBA) is the efficient antitumor compound extracted from the roots of a Chinese Medicinal Herb, Pulsatilla chinensis (Bge) Regel. To evaluate the effect of radioiodination on cytotoxicity, 23-HBA was radioiodinated with 125I. 125I-23-HBA could be prepared in high yields and good radiochemical purity and was characterized using reverse phase HPLC. In ICR mice bearing Liver Cancer HepA tumor, 125I-23-HBA showed a tumor uptake of 2.1% ID/g at 2 h p.i. and 0.15% ID/g at 48 h p.i on i.v. injection. When injected intratumorally, greater tumor uptake and retention was observed (20% ID/g at 2 h p.i. and 4.6% ID/g at 48 h p.i. respectively). (author)

  15. Potential of radioiodinated anti cancer compounds of natural origin for cancer therapy

    International Nuclear Information System (INIS)

    Plumbagin and Quercetin are naturally occurring compounds which exhibit anti-cancerous activity. To evaluate the effect of radioiodination on cytotoxicity, both Plumbagin and Quercetin were radioiodinated with 125I. 125I-Plumbagin and 125I-Quercetin could be prepared in moderate yields and good radiochemical purity and were characterized using reverse phase HPLC. In Swiss mice bearing fibrosarcoma, 125I-Plumbagin showed a tumor uptake of ∼2.5%ID/g at 3 h p.i. and ∼0.5%ID/g at 24 h p.i on i.v. injection. When injected intratumorally, greater tumor uptake and retention was observed (∼20%ID/g at 3 h p.i. and ∼14%ID/g at 24 h p.i. respectively). (author)

  16. Interest of a multidisciplinary and two-step consultation in radioiodine therapy to improve patient's support

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: the surgery of differentiated thyroid cancer may be followed by radioiodine therapy (I131). This therapy requires a 3-day hospital stay in an isolation room without family visits, but also many precautions before, during and after the hospital stay. This clinical environment can give rise to increased anxiety for a number of patients. This is why we have set up a dedicated consultation, aimed at improving preparation of the hospital stay. The aim of our work was to assess the efficiency of such consultation for patient's understanding of their disease, related apprehensions, and coordination between the nuclear medicine (NM) unit and inpatient ward. Material and methods: we followed the recommendations of the first French Cancer Plan regarding the diagnosis or treatment announcement and the project was reviewed in the frame of Professional Practices Evaluation. Consultations were carried out according to a 2-step procedure in the NM unit. First, patients were informed by the NM physician about disease and treatment. Then, a technologist evaluated social and psychological conditions, and checked proper understanding of disease and treatment. He/she paid a special attention to radiation protection measures, especially for the discharge period. Patients received a guidance manual document, and when necessary were oriented towards the supportive care staff. A dedicated computerized form was used to share patient information between the NM unit and inpatient ward. These consultations ran every day (2 per day). To evaluate procedure efficiency, patients were asked to fulfill a satisfaction questionnaire. Inpatient ward nurses were also surveyed for patient's understanding of their disease, level of anxiety, and quality of care. Results: at Montpellier Cancer Institute, a total of 30 thyroid cancer patients and 15 nurses were surveyed about their perceptions about the consultation before radioiodine therapy from April to

  17. Radioiodine therapy effects on offspring of patients with differentiated thyroid carcinoma; Efeitos da radioiodoterapia nas geracoes futuras de mulheres com carcinoma diferenciado de tireoide

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Carmen Dolores Goncalves [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia]. E-mail: loloi@zaz.com.br; Antonucci, Jane [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil). Hospital das Clinicas. Servico de Medicina Nuclear; Correa, Nilson Duarte [Hospital dos Servidores do Estado, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Corbo, Rossana; Vaisman, Mario [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    2004-02-01

    Radioiodine therapy has attained a significant role in the treatment of differentiated thyroid cancer. The literature addressing possible secondary effects of {sup 131} I is limited, although there has been increasingly interest in this field. A more comprehensive understanding of the mutagenic effects of radiation on the offspring of women exposed to {sup 131} I is mandatory in view of the possibility of occurrence of miscarriages, congenital abnormalities and malignancies in these children. In this review, we found that many reports on safety of this type of treatment in female patients in reproductive age recommend that pregnancy should be avoided for at least one year after therapeutic administration of radioiodine. (author)

  18. Salivary gland protection by amifostine in high-dose radioiodine therapy of differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bohuslavizki, K.H.; Klutmann, S.; Bleckmann, C.; Mester, J.; Clausen, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Dept. of Nuclear Medicine; Brenner, W.; Lassmann, S.; Henze, E. [Kiel Univ. (Germany). Clinic of Nuclear Medicine

    1999-02-01

    Quantitative salivary gland scintigraphy using 100 to 120 MBq Tc-99m-pertechnetate was performed in 17 patients with differentiated thyroid cancer prior to and 3 months after radioiodine treatment with 6 GBq I-131. Eight patients were treated with 500 mg/m{sup 2} amifostine prior to high-dose radioiodine treatment and compared retrospectively with 9 control patients. Xerostomia was graded according to WHO criteria. In 9 control patients high-dose radioiodine treatment significantly (p<0.01) reduced Tc-99m-pertechnetate uptake by 35.4{+-}22.0% and 31.7{+-}21.1% in parotid and submandibular glands, respectively. Of these 9 patients, 3 exhibited xerostomia Grade I (WHO). In contrast, in 8 amifostine-treated patients, there was no significant (p=0.878) decrease in parenchymal function following high-dose radioiodine treatment, and xerostomia did not occur in any of them. (orig.) [Deutsch] Im Rahmen eines Heilversuchs wurde eine limitierte Anzahl von Patienten untersucht. Vor und drei Monate nach Gabe von 6 GBq I-131 wurde eine quantitative Speicheldruesenszintigraphie mit 100 bis 120 MBq Tc-99m-Pertechnetat an 17 Patienten mit differenzierten Schilddruesenkarzinomen durchgefuehrt. Acht Patienten erhielten vor Radiojodtherapie 500 mg/m{sup 2} Amifostin und wurden mit einer historischen Kontrollgruppe aus neun Patienten verglichen. Eine Xerostomie wurde nach WHO-Kriterien beurteilt. Die Patienten der Kontrollgruppe wiesen sowohl fuer die Glandulae parotides als auch fuer die Glandulae submandibulares eine signifikante Verminderung der Tc-99m-Pertechnetat-Aufnahme um 35,4{+-}22,0% bzw. 31,7{+-}21,1% als Zeichen einer Parenchymschaedigung auf. Bei drei dieser neuen Patienten fand sich eine Xerostomie Grad I (WHO). Im Gegensatz dazu konnte bei den mit Amifostin behandelten Patienten keine signifikante Verminderung der Parechymfunktion festgestellt werden (p=0,878). Dementsprechend wies keiner dieser Patienten eine Xerostomie auf. (orig.)

  19. Outcome of radioiodine therapy in primary thyrotoxicosis in young (21-40 years) Bangladeshi population - A 10 year study with 482 patients

    International Nuclear Information System (INIS)

    Full text: Introduction: Among the current available radio iodine therapy for thyrotoxicosis, choice of administered dose for each patient must be made individually. The purpose of the study is to evaluate the outcome of I-131 therapy (single/double/multiple) doses in thyrotoxic young (21-40 yrs) adults. Materials and Methods: 482 patients were studied for 10 years (1993-2003), of them, 290 were female and 192 were male. The age range was 21-40 years (mean 27.3± 4.2 years). All of them were having primary thyrotoxicosis as diagnosed clinically and confirmed by laboratory investigations. Patients with thyroiditis and patients noncompliant to regular treatment were excluded. Patients unresponsive to at least six months of drug therapy or patients with disease recurrence after a three- month remission period were treated with 8-15 mCi of radioiodine and antithyroid therapy was continued until reaching a euthyroid state. All patients were followed-up periodically; mean follow up was 3±0.3 years. Results: Out of 482, 398 patients (82.57 %) achieved remission by single doses of radio iodine (I131), 70 patients (14.53 %) achieved remission by double doses. A total of 468 patients (97%) achieved complete remission by radioiodine either in single or by double doses. In relation with the whole study element, 92.73% (447 patients) eventually became hypothyroid as judged by clinical criteria, 4.36% (21 patients) remain euthyroid without any supplement after radioiodine ablation. 14 patients (3%) required multiple doses for remission and recurrence occurred. No drug reaction or recurrence was observed during the follow- up period. Conclusion: Radioiodine has been used for over 40 years to treat primary thyrotoxicosis. In young adults also, remission by radioiodine therapy is quite encouraging as our data suggests. (author)

  20. Outcome after radioiodine therapy in 107 patients with differentiated thyroid carcinoma and initial bone metastases: side-effects and influence of age

    International Nuclear Information System (INIS)

    Initial bone metastases in patients with differentiated thyroid carcinoma are rare, especially in younger patients. Long duration of therapy and high activities of radioiodine are often necessary to induce remission of metastatic disease. The curative potential of radioiodine therapy, in particular in younger patients, has not yet been determined. In this retrospective study we evaluated the therapeutic outcome, total radioiodine activities and associated side-effects in 107 patients with initial bone metastases. Eight of the 107 patients were younger than 45 (37.5±7.3) years, and were classified as group 1 (stage II, ''low risk'', WHO classification). The remaining 99 patients were older than 45 (64.1±9.5) years, and formed group 2 (stage IV, ''high risk'', WHO classification). Total or partial remission was more frequently achieved in group 1 than in group 2 (62.5% vs 49.5%). Lower activities were needed in group 1 (18.89±15.08 GBq vs 41.97±31.25 GBq), and there were less marked alterations in the blood count in this group. In group 1, blood count alterations reached only grade I or II (WHO classification), whereas grade III and grade IV alterations as well as acute leukaemia were observed in group 2. In group 1, complete remission was achieved with radioiodine therapy (11.1 GBq) in three out of four patients with ≤3 bone metastases. Additional pulmonary metastases (present in 44 out of 107 patients) did not influence prognosis. We conclude that initial bone metastases in differentiated thyroid carcinoma can be treated with curative intent by means of radioiodine therapy, and that this approach has a particularly realistic chance of success in younger patients and those with a small number of metastases. (orig.)

  1. Outcome after radioiodine therapy in 107 patients with differentiated thyroid carcinoma and initial bone metastases: side-effects and influence of age

    Energy Technology Data Exchange (ETDEWEB)

    Petrich, T.; Hofmann, M.; Brunkhorst, T.; Ehrenheim, C.; Oetting, G.; Knapp, W.H. [Dept. of Nuclear Medicine, Hannover University Medical School (Germany); Widjaja, A. [Dept. of Endocrinology, Hannover University Medical School (Germany); Musholt, T.J. [Dept. of Visceral and Transplantation Surgery, Hannover University Medical School (Germany)

    2001-02-01

    Initial bone metastases in patients with differentiated thyroid carcinoma are rare, especially in younger patients. Long duration of therapy and high activities of radioiodine are often necessary to induce remission of metastatic disease. The curative potential of radioiodine therapy, in particular in younger patients, has not yet been determined. In this retrospective study we evaluated the therapeutic outcome, total radioiodine activities and associated side-effects in 107 patients with initial bone metastases. Eight of the 107 patients were younger than 45 (37.5{+-}7.3) years, and were classified as group 1 (stage II, ''low risk'', WHO classification). The remaining 99 patients were older than 45 (64.1{+-}9.5) years, and formed group 2 (stage IV, ''high risk'', WHO classification). Total or partial remission was more frequently achieved in group 1 than in group 2 (62.5% vs 49.5%). Lower activities were needed in group 1 (18.89{+-}15.08 GBq vs 41.97{+-}31.25 GBq), and there were less marked alterations in the blood count in this group. In group 1, blood count alterations reached only grade I or II (WHO classification), whereas grade III and grade IV alterations as well as acute leukaemia were observed in group 2. In group 1, complete remission was achieved with radioiodine therapy (11.1 GBq) in three out of four patients with {<=}3 bone metastases. Additional pulmonary metastases (present in 44 out of 107 patients) did not influence prognosis. We conclude that initial bone metastases in differentiated thyroid carcinoma can be treated with curative intent by means of radioiodine therapy, and that this approach has a particularly realistic chance of success in younger patients and those with a small number of metastases. (orig.)

  2. Atypical Antipsychotics as Augmentation Therapy in Anorexia Nervosa

    Science.gov (United States)

    Marzola, Enrica; Desedime, Nadia; Giovannone, Cristina; Amianto, Federico; Fassino, Secondo; Abbate-Daga, Giovanni

    2015-01-01

    Anorexia nervosa (AN) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings. PMID:25922939

  3. Atypical antipsychotics as augmentation therapy in anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Enrica Marzola

    Full Text Available Anorexia nervosa (AN is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

  4. Results of radioiodine therapy using different radiation doses in patients suffering from immunogenic and non-immunogenic hyperthyroidism

    International Nuclear Information System (INIS)

    During the past few years high rates of recidivation have increasingly been reported following drug treatment for hyperthyroidism. In view of these unsatisfactory results it is only natural that the use of surgery and ratioiodine treatment is now more often considered in order to achieve complete elimination of the metabolic disorders caused by hyperactivity of the thyroid gland. The aim of this study was to investigate into the effectiveness of radioiodine therapy in a large cohort of patients (n = 925). Particular attention was given to the influence of the dose applied to the thyroid tissue on the rates of success achieved in immunogenic hyperthyroidism (IH) and autonomous disorders (non-immunogenic hyperthyroidism = NIH). (orig./GDG)

  5. The effects of radioiodine therapy on peripheral blood lymphocyte subpopulations in patients with Graves' disease. Preliminary report

    International Nuclear Information System (INIS)

    Treatment of Graves' disease patients with radioactive iodide (131I) is becoming the standard therapy in an increasing group of cases but can induce alterations in immune response, like increasing levels of thyroid autoantibodies, and, in part, exacerbation of ophthalmopathy. The aim of this study was to assess the changes in peripheral blood (PB) lymphocyte subpopulations after 131I treatment of patients with Graves' disease. The study was carried out in a group of 30 patients with Graves' disease (23 f; 7 m) 49.5±10.0 years of age, 26 with different subjective ocular signs like gritty sensation, increased lacrimation, orbital pain, and exophthalmos. PB lymphocyte subsets were analysed by cytofluorometry, serum concentration of TSH and fT4 were evaluated before and 6 weeks after radioiodine treatment. After 131I treatment a significant increase in CD3+, CD4+, CD3+HLA-DR+ and a decrease in CD19+ percentages of lymphocyte subsets were found in comparison with the initial evaluation. No significant changes in percentage of CD8+ and NK (CD3-CD16+ CD56+) cells were observed during this study. A significant increase in TSH and a slight decrease in fT4 concentration concentration took place in the 6th week after 131I application. The patients without subjective improvement of ocular signs during the therapy initially had a percentage of CD3+, CD8+ lymphocytes which was significantly lower compared with those with regression of ocular signs observed after 131I treatment. The changes in PB lymphocyte subsets caused by 131I treatment of Graves' disease confirm the involvement of acquired cellular immunity after radiation damage of the thyroid gland. The decreased initial percentage of CD8+ and CD3+ lymphocytes could help make a prediction of ocular symptoms persisting after radioiodine treatment in some patients with ophthalmopathy. (author)

  6. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3); Verfahrensanweisung zur Radioiodtherapie (RIT) beim differenzierten Schilddruesenkarzinom (Version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Nuklearmedizinsiche Klinik der Henriettenstiftung, Hannover (Germany); Eschner, W. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Gruenwald, F. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Lassmann, M. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany); Luster, M.; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Moser, E. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Radiologische Universitaetsklinik Freiburg (Germany); Schober, O. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for {sup 131}I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative {sup 131}I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC {<=}1 cm {sup 131}I ablation may be helpful in an individual constellation. Preparation for {sup 131}I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for {sup 131}I-therapy in patients with metastases, higher sensitivity of {sup 131}I whole-body scan) are discussed. In most centers standard activities are used for {sup 131}I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of {sup 131}I should not exceed 1-10MBq, alternative tracers are {sup 123}I or {sup 124}I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  7. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: a quality improvement project

    International Nuclear Information System (INIS)

    Radioiodine (131I) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after 131I therapy. The present study was undertaken to reduce treatment failure rate of 131I therapy in TMNG patients. Multiple causes may have lead to treatment failure of 131I in TMNG patients making it difficult to establish a direct cause-effect relationship and take corrective action. Therefore, the JURAN methodology of quality improvement was applied. The treatment failure rate in 80 TMNG patients treated with 131I in the period 2003-06 was 29%. The root cause analysis identified delay in decision to radioablate and concomitant antithyroid drugs (ATD) with 131I therapy as factors leading to relapse. In 2007, a change in management was introduced with decision to radioablate all TMNG patients not remitting at 1 year of ATD and to withdraw ATD for 2 weeks prior to 131I therapy. A total of 63 patients of TMNG followed the changed protocol between 2007 and 2009. Further analysis showed that one of the factors identified in the initial brainstorming (high iodide pool in the patient) had not been addressed in the protocol currently followed. The protocol was modified to include patient preparation and implemented after standardization. The post-131I relapse rate in patients treated after implementation of the new protocol from 2007 to 2009 was 18% which further reduced to 16% in 2011 after modification of the protocol. The failure rate of 131I therapy in TMNG reduced from 29% to 16% through standardization of the treatment procedure achieved by the use of Juran Methodology that helped to identify process-related defects. (author)

  8. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

    International Nuclear Information System (INIS)

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15±9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256±80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses. (orig.)

  9. Radioiodine Therapy: Care of the Helpless Patient and Handling of the Radioactive Corpse

    International Nuclear Information System (INIS)

    Nurses caring for a helpless patient following a nominal 800 MBq administration of radioiodine were concerned about their radiation dose. Using published data, a nurse could receive an estimated 650 micro Sv per shift. A regime to restrict their dose was planned using a 500 micro Sv dose constraint. Thermoluminescent dosimeters indicated a maximum whole body effective dose of 250 micro Sv. Three days post 131I administration the patient died (estimated activity in the body 400 MBq). A minimum delay of two weeks was advised prior to a post-mortem. Special precautions were issued to minimise contamination. Dose rates (micro Sv h-1), measured one day after the patient died, at the level of the thyroid, chest and bladder at 0.01 m from the corpse were 1800, 290 and 73 respectively. At 1.0 m the dose rate was 26 micro Sv h-1 at all levels. The pathologist was estimated to have received a maximum whole-body dose of 400 micro Sv during the postmortem. Contamination measurements (Bq cm-2) made following the postmortem were as follows: pathologist's hands 5, clothes 0, towels 1.8, saw 5, instruments 0.5, plastic sheet 0.8, scales 0.4 and floors/walls 1.1. These data indicate that with appropriate radiation protection guidelines, staff can be reassured that their doses in these circumstances are very low. (author)

  10. Radioiodine therapy: care of the helpless patient and handling of the radioactive corpse

    International Nuclear Information System (INIS)

    Nurses caring for a helpless patient following a nominal 800 MBq administration of radioiodine were concerned about their radiation dose. Using published data, a nurse could receive an estimated 650 μSv per shift. A regime to restrict their dose was planned using a 500 μSv dose constraint. Thermoluminescent dosimeters indicated a maximum whole-body effective dose of 250 μSv. Three days post 131I administration the patient died (estimated activity in the body 400 MBq). A minimum delay of two weeks was advised prior to a post-mortem. Special precautions were issued to minimise contamination. Dose rates (μSv h-1), measured one day after the patient died, at the level of the thyroid, chest and bladder at 0.01 m from the corpse were 1800, 290 and 73 respectively. At 1.0 m the dose rate was 26 μSv h-1 at all levels. The pathologist was estimated to have received a maximum whole-body dose of 400 μSv during the post-mortem. Contamination measurements (Bq cm-2) made following the post-mortem were as follows: pathologist's hands 5, clothes 0, towels 1.8, saw 5, instruments 0.5, plastic sheet 0.8, scales 0.4 and floors/walls 1.1. These data indicate that with appropriate radiation protection guidelines, staff can be reassured that their doses in these circumstances are very low. (author)

  11. The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using 124I PET(/CT) imaging

    International Nuclear Information System (INIS)

    A serious side effect of high-activity radioiodine therapy in the treatment of differentiated thyroid cancer is radiogenic salivary gland damage. This damage may be diminished by lemon-juice-induced saliva flow immediately after 131I administration. The aim of this study was to assess the effect of chewing lemon slices on the absorbed (radiation) doses to the salivary glands. Ten patients received (pretherapy) 124I PET(/CT) dosimetry before their first radioiodine therapy. The patients underwent a series of six PET scans at 0.5, 1, 2, 4, 48 and ≥96 h and one PET/CT scan at 24 h after administration of 27 MBq 124I. Blood samples were also collected at about 2, 4, 24, 48, and 96 h. Contrary to the standard radioiodine therapy protocol, the patients were not stimulated with lemon juice. Specifically, the patients chewed no lemon slices during the pretherapy procedure and neither ate food nor drank fluids until after completion of the last PET scan on the first day. Organ absorbed doses per administered 131I activity (ODpAs) as well as gland and blood uptake curves were determined and compared with published data from a control patient group, i.e. stimulated per the standard radioiodine therapy protocol. The calculations for both groups used the same methodology. A within-group comparison showed that the mean ODpA for the submandibular glands was not significantly different from that for the parotid glands. An intergroup comparison showed that the mean ODpA in the nonstimulation group averaged over both gland types was reduced by 28% compared to the mean ODpA in the stimulation group (p=0.01). Within each gland type, the mean ODpA reductions in the nonstimulation group were statistically significant for the parotid glands (p=0.03) but not for the submandibular glands (p=0.23). The observed ODpAs were higher in the stimulation group because of increased initial gland uptake rather than group differences in blood kinetics. The 124I PET(/CT) salivary gland dosimetry

  12. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99mTc-pertechnetate thyroid uptake under suppression (TcTUs) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTUs, which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTUs of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTUs>3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.)

  13. Another case of metastatic malignant struma ovarii? A case report of good response to radioiodine therapy

    International Nuclear Information System (INIS)

    . Thyroglobulin value 3 months after RI ablation, both while on L-thyroxine suppression and under endogenous TSH stimulation, preceding second (therapeutic) 131-I application, were 0.2 ng/mL, however with high anti-TG antibody titres (507.63 and 277.8 respectively). A post-therapeutic WBS, 48 hrs post 5.5 GBq 131-I and 4 months after ablation, has again shown faint uptake in the thyroid tissue remnants, but demonstrated a complete regression of the intraabdominal lesions. The patient is now, during a 16 months follow-up period after the last radioiodine application, euthyroid. She is clinically and biochemically with no evidence of the disease. The case demonstrates the necessity of combined surgical and radioiodine treatment in malignant struma ovarii and the importance of long-term follow-up after the initial surgery. (author)

  14. A 30-year perspective on radioiodine therapy of benign nontoxic multinodular goiter

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Hegedüs, Laszlo

    2009-01-01

    PURPOSE OF REVIEW: There is no consensus on the ideal treatment of patients with a benign nontoxic multinodular goiter. In some European countries, (131)I therapy has replaced surgery as the treatment of choice in these patients. Recombinant human thyrotropin (rhTSH) is a very potent stimulator of...... the thyroid gland and this review focuses on rhTSH-stimulated (131)I therapy. RECENT FINDINGS: The concept of rhTSH-stimulated (131)I therapy has been tested in several trials during the last 8 years. With this treatment, the goiter reduction is improved by 35-55%, compared with (131)I therapy without...... rhTSH stimulation. RhTSH prestimulation is particularly beneficial in patients with very large goiters and in those with a low baseline thyroid (131)I uptake. In addition, this therapy facilitates tracheal decompression leading to improved respiratory function. RhTSH-stimulated (131)I therapy results...

  15. Synergistic tumor-cidal effect of combination of hMUC1 vaccination and hNIS radioiodine gene therapy

    International Nuclear Information System (INIS)

    We developed the combination therapy of hMUC1 vaccination and hNlS radioiodine gene therapy in tumor bearing mice and visualized the anti-tumor effect using molecular imaging. A stable colon cancer cell line (CT26/hMUC1-hNlS-Fluc: CMNF) expressing the hMUC1, hNlS, and Flue genes was established. The in vitro survival rates of CMNF were determined using clonogenic assay after I-131 treatment. Five groups of 28 Balb/c (7mice/group) mice were made after subcutaneously injection of CMNF cells according to treatments (pcDNA3.1+PBS, phMUC1+PBS, pcDNA3.1+I-131, and phMUC1+I-131 groups). After development of xenografted tumor, PBS, MUC1 vaccine, I-131, and MUC1 vaccine + I-131 were administered to the mice. Tumor progression was monitored by using a bioluminescent image and caliper. Thirty-two days after tumor transplantation, we re-challenged CMNF to pcDNA3.1+I-131, and phMUC1 +I-131 groups. We investigated the number of hMUC1-associated CD8+IFN-+ T cells and of cytotoxic T cells (CTLs) activity using splenocytes in treated mice. The in vitro survival rate of CMNF was significantly reduced to 15.31.1 % after I-131 treatment compared with the survival rates of parental cells (p<0.001). Complete tumor growth inhibition was shown in phMUC1+ I-131 group at 48 days post challenge, but not in any monotherapy group (p<0.05). In cases of tumor rechallenging, complete rejection of the tumor occurred in phMUC1 + I-131 group, but not in pcDNA3.1 + I-131 group. The number of hMUC1-associated CD8+ IFN-+ T cells was significantly more increased in phMUC1 +I-131 group compared mono-therapy group (P<0.001). The activity of hMUC1-associated CTLs in was higher than those of monotherapy groups (P<0.005). We found that this combination therapy induced the complete remission, and rejected rechallenged tumor cells in murine colon cancer model. This novel combination therapy strategy has a possibility to be applied in clinical oncology

  16. Relationships between properties of {sup 131}I-therapy capsules and the radioiodine kinetics; Zusammenhaenge zwischen Eigenschaften von {sup 131}I-Therapiekapseln und der Radioiodkinetik

    Energy Technology Data Exchange (ETDEWEB)

    Schomaecker, K. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Wellner, U. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Scheidhauer, K. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Gabruk-Szostak, B. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Fischer, T. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Steinbach, J. [Inst. fuer Bioanorganische und Radiopharmazeutische Chemie, Forschungszentrum Rossendorf (Germany); Fuechtner, F. [Inst. fuer Bioanorganische und Radiopharmazeutische Chemie, Forschungszentrum Rossendorf (Germany); Schicha, H. [Inst. fuer Bioanorganische und Radiopharmazeutische Chemie, Forschungszentrum Rossendorf (Germany)

    1996-10-01

    Aim: The reason of unreproducible data under diagnosis and therapy with radioiodine should be elucidated. Methods: The iodine content of the capsules was tested by a colorimetric method and by activation analysis. Radiochemical purity was determined by HPLC and by electrophoresis. Solubility of the capsules was investigated under different conditions. Results: The iodine content of the capsules varied between 0,8 and appr. 100 {mu}g/capsule. The radiochemical purity of the capsule iodine varied between 75% and 99.5% (main contamination: Iodate). The solubility of the capsules differed. Conclusion: Additional non-radioactive iodine in the therapy capsules could be one reason of the reduced radioiodine-uptake under therapy. (orig.) [Deutsch] Ziel: Es sollte das Auftreten nichtreproduzierbarer Messwerte bei Radioiodtest und Radioiodkinetik unter {sup 131}I-Therapie geklaert werden. Methoden: Der Iodgehalt der Kapseln wurde kolorimetrisch und mit der Aktivierungsanalyse bestimmt. Die Messung der radiochemischen Reinheit erfolgte mittels HPLC und Elektrophorese. Das Loeseverhalten der Kapseln wurde unter unterschiedlichen Bedingungen ueberprueft. Ergebnisse: Der Iodgehalt der Kapseln schwankte zwischen 0,8 und ca. 100 {mu}g/Kapsel. Die radiochemische Reinheit der Kapseln differierte ebenfalls (75%-99,5%). Hauptverunreinigung war Iodat. Das Loeseverhalten war ebenfalls unterschiedlich. Schlussfolgerung: Zusaetzliches nichtradioaktives Iod in den Therapiekapseln koennte eine Ursache verminderter Radioiodaufnahme unter Therapie sein. (orig.)

  17. Combined 2-deoxy glucose and metformin improves therapeutic efficacy of sodium-iodide symporter-mediated targeted radioiodine therapy in breast cancer cells.

    Science.gov (United States)

    Chatterjee, Sushmita; Thaker, Nirmal; De, Abhijit

    2015-01-01

    Radiosensitization using either metformin or 2-deoxy-d-glucose (2-DG) in various cancer cells has been reported. The present study reveals novel information on combining these drugs to enhance radiosensitization effect in breast cancer (BC) cells. Responses to low-dose Cobalt60 radiation, as well as a newly emerged radioiodine therapy target for BC, that is, sodium-iodide symporter (NIS or SLC5A5) protein, are tested. As therapeutic potential of NIS in BC is often limited due to low uptake and fast efflux rate of iodine, the scope of these two radiosensitizers to further improve NIS-mediated (131)I therapeutic efficacy is explored. Two BC cell lines, MCF-7, and MDA MB231 are tested to optimize minimal drug doses required for radiosensitization. A combination of 2 mM metformin and 20 mM 2-DG with 2 grey (Gy) Cobalt60 radiation shows significant radiosensitization effect (P=0.0002). In cells treated with the combination therapy, increased γH2A.X foci formation was noted. Further, MCF-7 BC cells overexpressing NIS (MCF-7 NIS) was established, and using the optimized drug concentrations, significant radiosensitization (P=0.0019) by 50 μ Ci (131)I usage was found to be the case as well. Apoptosis data corroborates with the result of clonogenic assay showing significant increase in apoptotic population upon dual drug-mediated radiosensitization. In case of metformin treatment, lowered adenosine triphosphate (ATP) content of the cell has been observed. The encouraging radiosensitization effect observed using combined 2-DG and metformin may aid in reducing Cobalt60 radiation exposure or for targeted radioiodine therapy in BC cells with NIS expression. This study indicates high potential of this drug combination in sensitizing BC cells for NIS-mediated-targeted radioiodine therapy, which otherwise may have lacked efficacy. PMID:26355636

  18. Radioiodine therapy for treatment of benign and malignant thyroid diseases; Radiojodtherapie bei benignen und malignen Schilddruesenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Bell, E. [Herz-Jesu-Krankenhaus, Dernbach (Germany). Radiolog.- Nuklearmed. Abt.; Gruenwald, F. [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin

    1999-07-01

    This book closes a gap. It presents a condensed review of benefits and risks of the radioactive iodine therapy which still has to struggle with old prejudices. The long-term results demonstrate the excellent capabilities of this therapy. The book is intended to serve as a source of concise and competent information for doctors wishing to rapidly deepen their knowledge of the specific therapy and the treatment modalities in Germany. Readers will find a comprehensive list of therapy centers in Germany, so that patients may be routed to treatment centers offering capacities for treatment with least possible delay. (orig./CB) [German] Der vorliegende Band fuellt eine Luecke. Er gibt einen komprimierten Ueberblick ueber Chancen und Risiken der immer noch mit Vorurteilen belegten Therapieform. Die Langzeitergebnisse belegen die hervorragenden Moeglichkeiten der Radiojodtherapie. Das Buch enthaelt auch eine komplette Uebersicht der deutschen Therapiezentren, damit die Patienten trotz relativ knapper Kapazitaeten moeglichst rasch einer Radiojodtherapie zugefuehrt werden koennen. (orig./MG)

  19. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism

    International Nuclear Information System (INIS)

    Serum levels of thyroid stimulating hormone (TSH) receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism. (author)

  20. Results of radioiodine therapy of patients with immunogenic and non-immunogenic hyperthyroidism using different radiation doses

    International Nuclear Information System (INIS)

    The aim of this study was to check the efficacy of radioiodine (131I) therapy (RIT) in a large number of patients (n = 506) suffering from immunogenic or non-immunogenic hyperthyroidism (Graves' disease, Plummer's disease). Since there is no causal cure for immunogenic hyperthyroidism RIT provides, like all other modalities, only a moderate rate of success which is clearly dose-related. Applying 60 Gy, normal thyroid function can be achieved is only 54% of the cases. A dose of 150 Gy succeeds in 86% of the cases. The solitary decompensated autonomous adenoma (DAA) can be eliminated surgically as well as by RIT with a high degree of success (95%). Contrary to surgery, RIT does not have any noticeable early or late morbidity. The high rate of success of RIT in patients with DAA could be confirmed in two groups with different follow-up periods (16 and 65 months). As expected, the rate of hypothyroidism increased from 11% in the early group to 23% in the late group. Multinodular autonomous adenomas can be eliminated successfully using RIT as well. The concept to apply a dose of 400 Gy to the total functional autonomous tissue as determined by ultrasound yields better results (95%) than 150 Gy to the whole thyroid gland as measured by ultrasound (88%). The rate of hypothyroidism as shown by these results (up to a maximum of 62% after RIT of Graves' disease using 150 Gy) is the lesser evil compared to remaining or recurrent hyperthyroidism since these patients can be treated with thyroid hormones without problems. (orig.)

  1. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake

    International Nuclear Information System (INIS)

    The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTUs). The TcTUs value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70±9 years, and the mean thyroid volume was 54±26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTUs: 150 Gy for a TcTUs of 1.5%-2.49%, 200 Gy for a TcTUs of 2.5%-3.49%, 250 Gy for a TcTUs of 3.5%-4.49% and 300 Gy for a TcTUs of ≥4.5%. Normalisation of TcTUs and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTUs in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54±26 before treatment to 34±20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTUs can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

  2. Follow-up on thyroidal uptake after radioiodine therapy. How robust is the peri-therapeutic dosimetry?

    Energy Technology Data Exchange (ETDEWEB)

    Eschner, Wolfgang; Kobe, Carsten; Schicha, Harald [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2011-07-01

    Radioiodine therapy (RIT) for benign thyroid diseases in Germany requires the patient to stay in a nuclear medicine therapy ward for at least 48 hours and the dose to the thyroid to be computed from activity measurements performed during that stay. A major part of the total dose will be delivered after the patient's discharge from the hospital and thus has to be predicted through extrapolation with the effective half-life measured peri-therapeutically. We performed repeated thyroid uptake measurements on patients up to five months post therapy to investigate post-therapeutic changes in their effective half-lives and examine the dosimetric consequences. 12 patients (4 m, 8 f; age 36 - 76 y; 4 Graves' disease, 4 toxic adenoma, 3 toxic goitre, 1 non-toxic goitre) underwent late uptake measurements (1 - 7 meas., 13 - 154 d post administration, median 54 d, performed with thyroid probe resp. whole body counter at lower activities). Doses calculated from late measurements were compared to those predicted at discharge; half-lives calculated from the late measurement closest to the median delay (54 d) were compared to those determined at time of discharge. A cross-calibration between activity calibrator, thyroid probe, and whole body counter over an activity range from 52 MBq down to 45 Bq revealed linearity to within 6%, which was considered sufficient. In 9 out of 12 patients the achieved dose was within the range predicted at discharge. Averaged deviation between achieved and predicted dose was 3.1 {+-} 2.2% (median 2.5%, range 0.7% - 7.2%). Averaged deviation between post- and peri-therapeutic half-lives was 5.1 {+-} 3.9% (median 3.5%, range 1.3% - 12.5%). For n=5 patients discharged after 3 days, averaged deviations were greater (dose 4.0%, half-life 5.6%) than for those patients (n = 7) who stayed in the hospital for a minimum of 4 days (dose 2.5%, half-life 4.8%). Excretion of iodine from the thyroid remains practically unchanged for at least two months

  3. Follow-up on thyroidal uptake after radioiodine therapy. How robust is the peri-therapeutic dosimetry?

    International Nuclear Information System (INIS)

    Radioiodine therapy (RIT) for benign thyroid diseases in Germany requires the patient to stay in a nuclear medicine therapy ward for at least 48 hours and the dose to the thyroid to be computed from activity measurements performed during that stay. A major part of the total dose will be delivered after the patient's discharge from the hospital and thus has to be predicted through extrapolation with the effective half-life measured peri-therapeutically. We performed repeated thyroid uptake measurements on patients up to five months post therapy to investigate post-therapeutic changes in their effective half-lives and examine the dosimetric consequences. 12 patients (4 m, 8 f; age 36 - 76 y; 4 Graves' disease, 4 toxic adenoma, 3 toxic goitre, 1 non-toxic goitre) underwent late uptake measurements (1 - 7 meas., 13 - 154 d post administration, median 54 d, performed with thyroid probe resp. whole body counter at lower activities). Doses calculated from late measurements were compared to those predicted at discharge; half-lives calculated from the late measurement closest to the median delay (54 d) were compared to those determined at time of discharge. A cross-calibration between activity calibrator, thyroid probe, and whole body counter over an activity range from 52 MBq down to 45 Bq revealed linearity to within 6%, which was considered sufficient. In 9 out of 12 patients the achieved dose was within the range predicted at discharge. Averaged deviation between achieved and predicted dose was 3.1 ± 2.2% (median 2.5%, range 0.7% - 7.2%). Averaged deviation between post- and peri-therapeutic half-lives was 5.1 ± 3.9% (median 3.5%, range 1.3% - 12.5%). For n=5 patients discharged after 3 days, averaged deviations were greater (dose 4.0%, half-life 5.6%) than for those patients (n = 7) who stayed in the hospital for a minimum of 4 days (dose 2.5%, half-life 4.8%). Excretion of iodine from the thyroid remains practically unchanged for at least two months after RIT. The

  4. Separation of autonomous function from cell density in non-immunogenic hyperthyroidism. Pt. 2. Quantified comparison before and after radioiodine therapy

    International Nuclear Information System (INIS)

    Regional autonomous cell mass (Q: cell density ratio) and function (T: toxicity index) were compared by double isotope parametric thyroid scintigraphy (Als et al., Nucl. Med. 1995; 34) in 53 patients with non-immunogenic hyperthyroidism before and after radioiodine therapy (aRIT) and showed a break-down (medians) of Q: 4.3→1.0 (toxic adenomas: TA), 2→1.1 (multifocal functional autonomies: MFA) (p1 may represent a clinically sub-critical mass of residual autonomous tissue. This new technique facilitates individual pretherapeutic evaluations and aRIT quality control. (orig.)

  5. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger [Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Brink, Ingo [Department of Nuclear Medicine, University Hospital of Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

    2002-09-01

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15{+-}9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256{+-}80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses

  6. Predictive estimate of blood dose from external counting data preceding radioiodine therapy for thyroid cancer

    International Nuclear Information System (INIS)

    Bone marrow depression following 131I therapy for metastatic thyroid cancer can occur in up to one-quarter of all patients so treated. An analysis was made of the 131I whole body (WB) retention and its relationship to activity in blood for 46 patients (45 adult, 1 adolescent in 49 total studies) to define the accuracy of utilizing WB external counting data as a predictor of blood dose in comparison to the more classical method which requires data from sequential blood samples. The mean percentage differences between blood dose estimates based on external WB counting and those calculated by the classical method lie within ± 10%. The WB methodology provides a useful first-order approximation for hematopietic dose estimates in adult patients undergoing 131I therapy for thyroid cancer. (author)

  7. Radioiodine therapy for Plummer's disease based on the thyroid uptake of technetium-99m pertechnetate

    Energy Technology Data Exchange (ETDEWEB)

    Meller, J.; Wisheu, S.; Behe, M.; Gratz, S.; Becker, W. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin; Munzel, U. [Dept. of Medical Statistics, Georg August Univ., Goettingen (Germany)

    2000-09-01

    The aim of this retrospective study was the evaluation of a TcTUs (global technetium-99m pertechnetate thyroid uptake under suppression)-based approach in 370 patients with thyroid autonomy (Plummer's disease) treated by radioiodine therapy (RIT) under standardised conditions. The analysis included 370 patients (309 females, 61 males; mean age 64{+-}11.6 years) treated for thyroid autonomy [unifocal (UFA), 36.8%; multifocal (MFA), 55.7%; disseminated (DISA), 7.6%]. During RIT all patients were under thyroid suppression (TSH<0.1 {mu}U/ml) and without thionamide treatment. Of the 370 patients, 73% (n=271) were manifestly hyperthyroid and 27% (n=99) subclinically hyperthyroid. A dosimetric study included uptake measurements 24, 48, and 96 h p.i. For dose estimation the Marinelli algorithm was used. For retrospective definition of the target volume we used the equation: autonomous volume = TcTUs x 5. The spectrum of doses given in our patients ranged from 81 to 1933 Gy. After 18 months of follow-up, RIT was successful (TSH>0.5 {mu}U/l and/or TcTUs<1.6%) in 310 patients (84%). Of these patients, 291 (94%) were euthyroid (with or without L-thyroxine) and 19 (6%) subclinically hypothyroid (TSH>4 {mu}U/ml). A dose of 350-450 Gy to the autonomous tissue resulted in a success rate of 97% in the UFA group and 81% in the MFA/DISA group. Decrease in total thyroid volume and TcTUs did not differ significantly between successfully treated patients and patients with persistent autonomy. Multivariate analysis of all 370 patients identified four independent factors that negatively influenced the therapeutic success: high pretherapeutic thyroid volume (P=0.0001; odds ratio: 1.017), high pretherapeutic TcTUs values (P=0.0001; odds ratio: 1.378), multifocal/disseminated autonomy (P=0.0056; odds ratio: 3.245) and low target dose (P=0.017; odds ratio: 0.997). It is concluded that the high success rate in the treatment of UFA indicates the concept of TcTUs-based RIT to be valid, but

  8. Noninferior response in BRAFV600E mutant nonmetastatic papillary thyroid carcinoma to radioiodine therapy

    International Nuclear Information System (INIS)

    As the most frequent and specific genetic alteration in papillary thyroid carcinoma (PTC), BRAFV600E has an intimate relationship with more invasive tumour and higher postoperative recurrence risk in PTC patients. We investigate the effect of radioactive iodine (RAI) therapy on the clinical outcome in PTC patients with the BRAFV600E mutation without distant metastases. This retrospective study included PTC 228 patients without distant metastases who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2011 to July 2014. The BRAFV600E status of the primary lesions was determined and the patients were divided into two groups according to the presence of the mutation. Serological and imaging data were collected at a median follow-up of 2.34 years after RAI administration. Suppressed and stimulated thyroglobulin (Tg), Tg antibody, diagnostic whole-body scintigraphy, and other imaging examinations were used to assess clinical outcome, which was defined as excellent response, indeterminate response, biochemical incomplete response and structural incomplete response. The BRAFV600E mutation was observed in 153 of the 228 patients (67.1 %). The clinicopathological features did not differ between the BRAFV600E mutatation and wild-type groups except age at diagnosis (P = 0.000), tumour size (P = 0.023) and TNM stage (P = 0.003). Older age and more advanced TNM stage were prevalent in the BRAFV600E mutatation group, whereas tumours were slightly larger in the BRAFV600E wild-type group. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk, and no significant difference in response was found between the BRAFV600E mutatation and the wild-type groups (P = 0.881 and P = 0.851, respectively). The clinical response to timely postsurgical RAI therapy is not inferior in BRAFV600E mutation PTC patients without distant metastases, which suggests that RAI therapy might improve the general

  9. Fetus dose estimation in thyroid cancer post-surgical radioiodine therapy

    International Nuclear Information System (INIS)

    Unrecognised pregnancy during radioisotope therapy of thyroid cancer results in hardly definable embryo/fetus exposures, particularly when the thyroid gland is already removed. Sources of such difficulty include uncertainty in data like pregnancy commencing time, amount and distribution of metastasized thyroid cells in body, effect of the thyroidectomy on the fetus dose coefficient etc. Despite all these uncertainties, estimation of the order of the fetus dose in most cases is enough for medical and legal decision-making purposes. A model for adapting the dose coefficients recommended by the well-known methods to the problem of fetus dose assessment in athyrotic patients is proposed. The model defines a correction factor for the problem and ensures that the fetus dose in athyrotic pregnant patients is less than the normal patients. A case of pregnant patient undergone post-surgical therapy by I-131 is then studied for quantitative comparison of the methods. The results draw a range for the fetus dose in athyrotic patients using the derived factor. This reduces the concerns on under- or over-estimation of the embryo/fetus dose and is helpful for personal and/or legal decision-making on abortion. (authors)

  10. Dose-response study on thyrotoxic patients undergoing positron emission tomography and radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Flower, M.A. (Thyroid Unit, Royal Marsden Hospital, Sutton (United Kingdom)); Al-Saadi, A. (Thyroid Unit, Royal Marsden Hospital, Sutton (United Kingdom)); Harmer, C.L. (Thyroid Unit, Royal Marsden Hospital, Sutton (United Kingdom)); McCready, V.R. (Thyroid Unit, Royal Marsden Hospital, Sutton (United Kingdom)); Ott, R.J. (Thyroid Unit, Royal Marsden Hospital, Sutton (United Kingdom))

    1994-06-01

    Our policy had been to give 75 MBq iodine-131 at 6-monthly intervals to patients with Graves' disease until they became euthyroid. Since PET has been available at this hospital, the radiation dose to the thyroid has been calculated with an accuracy of -20%, the thyroid mass being determined from an iodine-124 PET scan. A dose-response study has been carried out on 65 patients who have received single or cumulative radiation doses of < 80 Gy. The results show that patients who receive a low radiation dose (< 20 Gy) at their first treatment have a high probability of remaining toxic at 12 months. In contrast, patients who receive higher radiation doses (> 40 Gy) at their first treatment have a high probability of control. The probability of becoming euthyroid increases more rapidly with increasing radiation dose than the probability of becoming hypothyroid. Following this dose-response study, a new treatment protocol has been introduced. A [sup 124]I PET tracer study prior to [sup 131]I therapy will be performed to enable a prescribed thyroid dose of 50 Gy to be delivered to patients with Graves' disease. Further [sup 131]I therapy will be considered if patients are still toxic at 12 months. (orig./MG)

  11. D-Cycloserine as an augmentation strategy for cognitive behavioral therapy of anxiety disorders.

    Science.gov (United States)

    Hofmann, Stefan G; Wu, Jade Q; Boettcher, Hannah

    2013-01-01

    The goal of this review is to examine the clinical studies on d-cycloserine, a partial glutamatergic N-methyl-D-aspartate agonist, as an augmentation strategy for exposure procedures during cognitive behavioral therapy for anxiety disorders. Although cognitive behavioral therapy and anxiolytic medications are more effective than placebo for treating anxiety disorders, there is still considerable room for further improvement. Traditional combination strategies typically yield disappointing results. However, recent studies based on translational research have shown promise to augment the neural circuitry underlying fear extinction with pharmacological means. We discuss the current state of the literature, including inconsistencies of findings and issues concerning the drug mechanism, dosing, and dose timing. D-cycloserine is a promising combination strategy for cognitive behavioral therapy of anxiety disorders by augmenting extinction learning. However, there is also evidence to suggest that d-cycloserine can facilitate reconsolidation of fear memory when exposure procedures are unsuccessful. PMID:23768232

  12. Radioiodine and thyroid gland

    Directory of Open Access Journals (Sweden)

    Takavar A

    1994-05-01

    Full Text Available Administration of a precise amount of activity in thyroid gland radioiodine (¹³¹I therapy is of prime importance. Several methods for this purpose have been suggested and used over many years. In this paper, a method for required ¹³¹I activity calculation for each case has been proposed. Major factors affecting ¹³¹I calculation such as gland volume, integral dose, and prescription index have been described. Using the method, ¹³¹I activity or any other radioisotope activity required for a certain case can be determined with a good estimate.

  13. Undetected latrogenic hypothyroidism: a late complication of radio-iodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Smidt, K.P.

    1975-04-09

    The thyroid status of 317 patients treated with radioactive iodine between 1951 and December 1971 was investigated. Information was obtained on 236 patients and hypothyroidism, either treated or untreated, was present in 48 percent of women and 37 percent of men at mean follow-up intervals of 5.5 and 4.4 years respectively. Ninety-four of the 241 patients still alive were assessed personally by clinical examination and serum thyroxine assay, and 10 were found to have previously undiagnosed hypothyroidism. Seven of these patients had symptoms and in five these symptoms were the cause of significant distress. The importance of undertaking a long term review program following radioactive iodine therapy is emphasized. (auth)

  14. Myopathy Associated with Acute Hypothyroidism following Radioiodine Therapy for Graves Disease in an Adolescent

    Directory of Open Access Journals (Sweden)

    Rivkees ScottA

    2010-08-01

    Full Text Available We describe acute myopathy following I-131 treatment for hyperthyroidism due to Graves Disease (GD in an adolescent. A 15 year-old diagnosed with GD required treatment with radioactive iodine (I-131 therapy. Six weeks post I-131, he developed generalized muscle cramps. The CK was 19.800 U/L, the total thyroxine was 2.3 mcg/dL (29.6 nmol/L SI and the estimated free thyroxine (EFT was 0.5 ng/dL (6.4 pmol/L SI. The ALT was 112 U/L and AST was 364 U/L (normal

  15. Radioiodine therapy in skeletal metastases from well-differentiated thyroid cancer: a Johannesburg experience

    Directory of Open Access Journals (Sweden)

    Nalini Sindy Perumal

    2010-03-01

    Full Text Available Aim.The purpose of this study was to examine the outcome of patients with skeletal metastases from well-differentiated thyroid carcinoma and analyse the effect of variables that influence the prognosis of this disease. Method. We retrospectively reviewed 352 patients treated and followed-up at the Charlotte Maxeke Johannesburg Academic Hospital’s thyroid cancer clinic from 1982 - 1999. Findings. Skeletal metastases were diagnosed in 24 (6.8%, 17 at presentation to the thyroid clinic, and 7 at follow-up. Patients’ ages ranged from 30 - 77 years (mean 53.9 years and the female:male ratio was 3.8:1. Based on the original pathology reports from resected tumours, 9 were papillary and 15 were follicular cancers. Twenty-three of the 24 patients underwent thyroid surgery as the initial management – total thyroidectomy in 18, subtotal thyroidectomy in 3, and lobectomy plus neck dissection in one. The diagnosis of thyroid cancer was based on lobectomy in a single subject. Radioactive iodine (RAI was used as part of the original treatment; external radiation therapy (XRT was mainly used to alleviate severe symptoms. Twenty-one patients (87.5% were treated with RAI; 11 (45.8% received radiotherapy. Seven patients died – 4 from neurological disease directly associated with bone metastases. Of the 17 surviving patients, 2 appeared to be disease-free, 8 were asymptomatic despite overt bony disease, and 7 had persistent symptoms which much improved in 5. Bone metastases were uncommon, and follicular cancer predominated in this survey. Conclusion. RAI therapy improves quality of life in most patients. There is a place for XRT.

  16. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley [Santa Casa de Belo Horizonte, MG (Brazil). Endocrinology Service

    2013-05-01

    Objective: To evaluate {sup 131}I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. Subjects and methods: Thirty-six patients with TSH {<=} 0.1mIU/L and non-voluminous goiter (< 60 cm{sup 3} were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. Results: Mean 24-h {sup 131}I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. Conclusions: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia. (author)

  17. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

    Directory of Open Access Journals (Sweden)

    Pedro Weslley Rosario

    2013-03-01

    Full Text Available OBJECTIVE: To evaluate 131I therapy in elderly patients with subclinical hyperthyroidism (SCH due to nodular disease and who did not receive antithyroid drugs (ATDs, and the effect of the treatment on bone metabolism. SUBJECTS AND METHODS: Thirty-six patients with TSH ≤ 0.1 mIU/L and non-voluminous goiter (< 60 cm³ were studied. Bone mineral density (BMD was assessed in 17 women with osteopenia. RESULTS: Mean 24-h 131I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5% patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3% patients, and hypothyroidism was detected in one (2.7%. In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. CONCLUSIONS: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia.

  18. Sialoscintigraphy with Tc-99m pertechnetate in the evaluation of salivary gland function in patients with differentiated thyroid cancer after radioiodine therapy

    International Nuclear Information System (INIS)

    The aim of this study was an evaluation of salivary gland function after radioiodine therapy (RIT) in patients with differentiated thyroid cancer (DTC) using sialoscintigraphy with Tc-99m pertechnetate. We investigated 97 patients with thyroid cancer aged from 35 to 65 years. The patients were divided into two groups. First group consisted of 30 patients after total or subtotal thyroidectomy without RIT and symptoms of functional activity changes of salivary glands. Second group included 67 patients after thyroidectomy and following RIT. Administered therapeutic activities varied ranging from 1100 to 4720 MBq. We performed sialoscintigraphy in dynamic mode over a period of 30 minutes (1 frame per 20 sec) with stimulation of gland function at 20 min of study using lemon juice. For evaluation of salivary gland function we used wide spectrum of indices and activity-time curves obtained from zones of interest 'salivary glands'. From among the large number of indices determined in the study we could identify three most informative indices. These are 1. Coefficient of concentration (Cc), coefficient of excretion (Ce) and T-max. The mean values of all of these indices were significantly decreased in the patients belonging to the second group in comparison with first group. These are presented. Overall significant decrease in salivary gland function was detected (P < 0.05) following radioiodine therapy as compared to the control group

  19. Iodine kinetics and dosimetry in the salivary glands during repeated courses of radioiodine therapy for thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B.; Huang, R.; Kuang, A.; Zhao, Z.; Zeng, Y.; Wang, J.; Tian, R. [Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041 (China)

    2011-10-15

    Purpose: The present study was conducted to investigate salivary iodine kinetics and dosimetry during repeated courses of radioiodine ({sup 131}I) therapy for differentiated thyroid cancer (DTC). Such data could provide a better understanding of the mechanisms of {sup 131}I induced salivary toxicity and help to develop appropriate methods to reduce this injury. Methods: Seventy-eight consecutive DTC patients (mean age 45 {+-} 17 years, 60%, female) undergoing {sup 131}I therapy for remnant ablation or metastatic tumors were prospectively recruited. Planar quantitative scintigraphy of head-neck images was serially acquired after administration of 2.9-7.4 GBq of {sup 131}I to assess kinetics in the salivary glands of patients. Salivary absorbed doses were calculated based on the schema of Medical Internal Radiation Dosimetry. Results: The maximum uptakes in percentage of administered {sup 131}I activity per kilogram of gland tissue (%/kg) were 12.9% {+-} 6.5%/kg (range, 0.4%-37.3%/kg) and 12.3% {+-} 6.2%/kg (range, 0.4%-35.1%/kg) for the parotid and submandibular glands, respectively. Statistically significant correlations of maximum uptake versus cumulative activity (r = -0.74, P < 0.01, for the parotid glands; r = -0.71, P < 0.01, for the submandibular glands) and treatment cycle (P < 0.001, for both gland types) were found. The effective half-lives of {sup 131}I in the parotid and submandibular glands were 9.3 {+-} 3.5 h (range, 1.5-19.8 h) and 8.6 {+-} 3.2 h (range, 0.8-18.0 h), respectively. A statistically significant correlation was observed between effective half-life with cumulative activity (r = 0.37, P < 0.01) and treatment cycle (P = 0.03) only for the parotid glands. The calculated absorbed doses were 0.20 {+-} 0.10 mGy/MBq (range, 0.01-0.92 mGy/MBq) and 0.25 {+-} 0.09 mGy/MBq (range, 0.01-1.52 mGy/MBq) for the parotid and submandibular glands, respectively. The photon contribution to the salivary absorbed dose was minimal in relation to the beta dose

  20. Occupational exposure of nursing staff working with radioiodine therapy during 11 years

    International Nuclear Information System (INIS)

    Objective: The present study was aimed at evaluating the occupational exposure of nursing staff in charge of inpatients undergoing 131I therapy during 11 years. Materials and methods: The exposure situations were classified according to a questionnaire answered by three nursing attendants, correlating the procedures with activities, distances and amount of time in the iodotherapy room. Records of received doses by two types of dosimeters were evaluated over two subsequent periods. In both periods the nursing attendants received instructions about radiological protection. Results: In usual situations, their amount of time in the iodotherapy room was in compliance with the standard time established by the service. In unusual situations, where the patient needed assistance for mobility, the exposure period was above the standard. However, this exposure occurs casually (only one or two times a year). During the period between 1993 and 1999 (dosimetric films) there were ten dose records, all of them at record level. From 2000 to 2003 (thermoluminescent dosimeters) ten dose records were also obtained, with only one of them at the investigation level. During this study period, the mean 131I activity was doubled. Conclusion: Despite the increased levels of activity there was no significant increase in dose to nursing attendants. (author)

  1. Escitalopram tolerability as mono- versus augmentative therapy in patients with affective disorders: a naturalistic study

    Directory of Open Access Journals (Sweden)

    Dell'Osso B

    2013-02-01

    Full Text Available Bernardo Dell’Osso, Chiara Arici, Cristina Dobrea, Giulia Camuri, Beatrice Benatti, A Carlo AltamuraUniversity of Milan, Department of Psychiatry, Fondazione IRCSS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, ItalyBackground: Escitalopram is a selective serotonin reuptake inhibitor, widely used in the treatment of affective disorders. The purpose of this study was to examine its safety and tolerability, as mono- versus augmentative therapy, in a group of patients with affective disorders.Materials and methods: The sample consisted of 131 patients suffering from different affective disorders, including major depressive disorder, bipolar disorder, and generalized anxiety disorder, who received escitalopram for at least 4 weeks. Data were analyzed on the basis of mono- versus augmentative therapy, as well as age, gender, mean daily dosage, and patterns of combination therapy.Results: Sixty-seven (51.1% patients were treated with monotherapy (mean dose of 11.76 mg/day and 64 (48.9% with augmentative escitalopram (mean dose of 12.81 mg/day. The mean duration of escitalopram treatment was 14 months. The most frequently combined compounds were: other antidepressants (36.5%, mood stabilizers (33.4%, and atypical antipsychotics (30.1%. Side effects were reported in 5.3% of the total sample and the most common were insomnia (2.3%, nausea (2.3%, and dizziness (0.8%. No significant difference, in terms of tolerability, in mono- versus augmentative therapy groups was found. In addition, neither age nor gender was significantly correlated with a greater presence of side effects. Finally, no significant correlation between dosage and side effects was observed.Conclusion: Over a 14-month observation period, escitalopram, either as monotherapy or an augmentative treatment, was found to be well tolerated in a large sample of patients with affective disorders, with an overall low rate of side effects.Keywords: affective disorders, escitalopram

  2. Results of radioiodine therapy in patients with pulmonary metastases of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Factors affecting the effect of 131I treatment and survival after pulmonary metastases in patients with differentiated thyroid cancer, were studied. Between 1984-1999, pulmonary metastases was observed in 51 out of 153 patients with differentiated thyroid cancer at our institution. Of these 41 patients had papillary and 10 follicular thyroid cancer. There were 37 females and 14 males with mean age (±S.D.) of 50.5±19.0 years. These 51 patients were subjected to 131I therapy. The effect of 131I treatment and the prognostic values of the following variables were examined: sex, age at the time of 131I treatment, histologic type of cancer, size of pulmonary metastases on CT, total-body scintigraphy with 201Tl and 131I, serum thyroglobulin levels and presence of metastases in distant sites other than lung. The effect of 131I treatment was evaluated by means of changes in the number and size of metastatic shadows on chest CT and by serum thyroglobulin levels. The minimum duration of follow-up was 12 months. Therapeutic 131I dose scans revealed detectable uptake in 25 of 51 patients. Therapeutic 131I dose uptake was achieved more frequently in patients under 40 years of age and in those with follicular cancers. Of the 51 patients, 13 were evaluated to be treated successfully. Those under 40 years of age, with 131I up-take in the lung and presence of other metastases showed a good response to treatment than others. Follicular cancer showed a more significant association with coarse type of lung metastases (>5 mm in diameter on chest CT) and good 131I uptake than papillary cancer. Of all the variables studied, the best prognosis for survival was demonstrated by increased 131I uptake in pulmonary metastases. These results indicate that age, 131I uptake and presence of other metastases are important factors in predicting the effect of 131I treatment for pulmonary metastases of differentiated thyroid cancer. (author)

  3. Approxination errors in physical treatment planning of radioiodine therapy of the thyroid. Naeherungsfehler bei der physikalischen Planung der Radiojodtherapie der Schilddruese

    Energy Technology Data Exchange (ETDEWEB)

    Bogner, L. (Klinik und Poliklinik fuer Strahlentherapie und Radio-Onkologie, Univ. Regensburg (Germany)); Czempiel, H. (Inst. fuer Medizinische Physik und Strahlenschutz, Krankenhaus Schwabing, Muenchen (Germany))

    1993-10-01

    The approximations in the equations used for the calculation of the radioiodine therapy are reviewed and compared with a reference formula, based on ICRP Publication 30. Applying these equations to two clinical cases, we find pronounced differences compared to the reference method. Investigations of a collective of 314 patients yield in a relatively high fraction delayed maxima in the uptake curves. Simulations prove that serious errors occur when the ascending slope of the uptake curve is neglected. An equation taking care of this effect is presented. Pronounced individual differences are found between uptake curves recorded before and after therapy. The effects on the difference between planned and actually applied dose to the thyroid are shown. The difficulties of the determination of the thyroid mass are discussed and a combined method using scinti- and sonographic data presented. (orig.)

  4. Radioiodine therapy in veterinary medicine: treatment of hyperthyroidism in a cat; Die Radioiodtherapie in der Veterinaermedizin: Behandlung der Schilddruesenueberfunktion bei einer Katze

    Energy Technology Data Exchange (ETDEWEB)

    Reinartz, P.; Sabri, O.; Zimny, M.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Kinzel, S.; Kuepper, W. [Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde; Bachmann, T. [Tierarztpraxis Dr. med. vet. Thomas Bachmann, Glashhuetten (Germany)

    1999-06-01

    A nine-year-old cat with symptoms of a distinct hyperthyroidism was presented at the University Hospital of the RWTH Aachen. The clinical symptoms as well as the diagnostic procedures performed at the hospital confirmed the diagnosis. After five weeks of thyreostatic medication a regular metabolism of the thyroid gland was established, followed by a radioiodine therapy with 70.3 MBq 131-iodine. Subsequently, the cat was hospitalized for two days before it could be released in good condition. Six weeks after treatment the former drastically reduced weight of the cat recovered to near normal. Even though the chemical analysis detected a discrete hyperthyroidism, clinical symptoms were no longer prominent. Three months after treatment, the final examination showed a regular metabolism of the thyroid gland without a specific thyroidal medication. The presented case illustrates that radioiodine therapy is a safe and efficient treatment of thyroidal dysfunctions in veterinary medicine. (orig.) [Deutsch] Eine neun Jahre alte, europaeische Langhaarkatze wurde mit Symptomen einer ausgepraegten Schilddruesenueberfunktion im Universitaetsklinikum der RWTH Aachen vorgestellt. Sowohl die klinische Symptomatik als auch die Labordiagnostik und die apparativ erhobenen Befunde belegten das Vorliegen einer Hyperthyreose. Im Anschluss an eine fuenfwoechige thyreostatische Therapie, mit der eine euthyreote Stoffwechsellage erreicht werden konnte, wurde eine Radioiodtherapie mit 70,3 MBq 131-Iod durchgefuehrt. Nach einer nur zweitaegigen komplikationslosen Hospitalisierung konnte die Katze in gutem Allgemeinzustand entlassen werden. Sechs Wochen nach der Therapie hatte sich das zuvor deutlich reduzierte Koerpergewicht auf nahezu normgerechte Werte erhoeht; klinische Symptome der Schilddruesenueberfunktion liessen sich trotz einer laborchemisch diagnostizierten diskreten Gesamtthyroxiderhoehung nicht mehr nachweisen. Bei einer abschliessenden Kontrolle drei Monate nach Entlassung wies

  5. Combined 2-deoxy glucose and metformin improves therapeutic efficacy of sodium-iodide symporter-mediated targeted radioiodine therapy in breast cancer cells

    Directory of Open Access Journals (Sweden)

    Chatterjee S

    2015-08-01

    Full Text Available Sushmita Chatterjee, Nirmal Thaker, Abhijit DeMolecular Functional Imaging Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai, IndiaAbstract: Radiosensitization using either metformin or 2-deoxy-d-glucose (2-DG in various cancer cells has been reported. The present study reveals novel information on combining these drugs to enhance radiosensitization effect in breast cancer (BC cells. Responses to low-dose Cobalt60 radiation, as well as a newly emerged radioiodine therapy target for BC, that is, sodium-iodide symporter (NIS or SLC5A5 protein, are tested. As therapeutic potential of NIS in BC is often limited due to low uptake and fast efflux rate of iodine, the scope of these two radiosensitizers to further improve NIS-mediated 131I therapeutic efficacy is explored. Two BC cell lines, MCF-7, and MDA MB231 are tested to optimize minimal drug doses required for radiosensitization. A combination of 2 mM metformin and 20 mM 2-DG with 2 grey (Gy Cobalt60 radiation shows significant radiosensitization effect (P=0.0002. In cells treated with the combination therapy, increased γH2A.X foci formation was noted. Further, MCF-7 BC cells overexpressing NIS (MCF-7 NIS was established, and using the optimized drug concentrations, significant radiosensitization (P=0.0019 by 50 µ Ci 131I usage was found to be the case as well. Apoptosis data corroborates with the result of clonogenic assay showing significant increase in apoptotic population upon dual drug-mediated radiosensitization. In case of metformin treatment, lowered adenosine triphosphate (ATP content of the cell has been observed. The encouraging radiosensitization effect observed using combined 2-DG and metformin may aid in reducing Cobalt60 radiation exposure or for targeted radioiodine therapy in BC cells with NIS expression. This study indicates high potential of this drug combination in sensitizing BC cells for NIS

  6. Use of recombinant human thyrotropin (rh TSH) as a method of preparation for radioiodine therapy in thyroid disorders; Utilisation de la thyreostimuline humaine recombinante dans la preparation au traitement par iode-131 des pathologies thyroidiennes

    Energy Technology Data Exchange (ETDEWEB)

    Taieb, D.; Guillet, B.A.; Tessonnier, L.; Mundler, O. [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, 13 - Marseille (France)

    2008-02-15

    The introduction of recombinant human TSH (rh TSH) as a method of preparation for radioiodine therapy of follicular-derived thyroid tumors (benign and malignant) is a significant medical advance. Rh TSH has been approved for use in remnants ablation after total thyroidectomy for carcinoma. There are other potential uses for rh TSH that have not yet been licensed. The use of rh TSH allows to reduce administrated doses in goiters through an increase of iodine uptake and a more homogeneous distribution of radioiodine in the gland. Rh TSH also improves thyroid cancer patients quality of life by avoiding hypothyroidism. (authors)

  7. Efficacy of alpha1-antitrypsin augmentation therapy in conditions other than pulmonary emphysema

    Directory of Open Access Journals (Sweden)

    de Serres Frederick

    2011-04-01

    Full Text Available Abstract Up to now alpha 1-antitrypsin (AAT augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null alleles expressing AAT serum concentrations

  8. Efficacy of alpha1-antitrypsin augmentation therapy in conditions other than pulmonary emphysema

    OpenAIRE

    de Serres Frederick; Lara Beatriz; Blanco Ignacio

    2011-01-01

    Abstract Up to now alpha 1-antitrypsin (AAT) augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null alleles expressing AAT serum concentrations

  9. Radioiodination of monoclonal antibodies, proteins and peptides for diagnosis and therapy. A review of standardized, reliable and safe procedures for clinical grade levels kBq to GBq in the Goettingen/Marburg experience

    Energy Technology Data Exchange (ETDEWEB)

    Behr, Th.M.; Gotthardt, M.; Behe, M. [Marburg Univ. (Germany). Dept. of Nuclear Medicine; Becker, W. [Goettingen Univ. (Germany). Dept. of Nuclear Medicine

    2002-04-01

    Simple and reliable methodologies for radioiodination of proteins and peptides are described. The labeling systems are easy to assemble, capable of radioiodinating any protein or, with slight modifications, also peptide (molecular mass 1000-300,000) from kBq to GBq levels of activity for use in diagnosis and/or therapy. Furthermore, the procedures are feasible in any nuclear medicine department. Gigabecquerel amounts of activity can be handled safely. The most favored iodination methodology relies on the lodogen system, a mild oxidating agent without reducing agents. Thus, protein degradation is minimized. Labeling yields are between 60 and 90%, and immunoreactivities remain {>=}85%. Other radioiodination methods (chloramine-T, Bolton-Hunter) are described and briefly discussed. (orig.)

  10. Radioiodination of monoclonal antibodies, proteins and peptides for diagnosis and therapy. A review of standardized, reliable and safe procedures for clinical grade levels kBq to GBq in the Goettingen/Marburg experience

    International Nuclear Information System (INIS)

    Simple and reliable methodologies for radioiodination of proteins and peptides are described. The labeling systems are easy to assemble, capable of radioiodinating any protein or, with slight modifications, also peptide (molecular mass 1000-300,000) from kBq to GBq levels of activity for use in diagnosis and/or therapy. Furthermore, the procedures are feasible in any nuclear medicine department. Gigabecquerel amounts of activity can be handled safely. The most favored iodination methodology relies on the lodogen system, a mild oxidating agent without reducing agents. Thus, protein degradation is minimized. Labeling yields are between 60 and 90%, and immunoreactivities remain ≥85%. Other radioiodination methods (chloramine-T, Bolton-Hunter) are described and briefly discussed. (orig.)

  11. Radiation therapy after breast augmentation or reconstruction in early or recurrent breast cancer

    International Nuclear Information System (INIS)

    Fourteen patients whose augmented or reconstructed breasts were treated with radiation therapy were analyzed. Silicone gel implants were used in 13 patients and free-injected silicone in one patient. The total radiation dose ranged from 4400 to 6200 cGy using tangential photon fields or an en face electron field by megavoltage equipment. In several cases, electron boost radiation was added to the tumor bed. The majority of the patients tolerated therapy well with minimal transient skin reactions; only three patients required a treatment break secondary to moist desquamation. Three patients developed documented implant encapsulation, although the majority retained good to excellent cosmesis. In summary, when breast carcinoma arises in the augmented or reconstructed breast, conservative management (i.e., limited surgery and definitive irradiation) is feasible without compromising the therapy or the cosmetic result. Thus, conservative management should be offered as an option to patients who are interested in breast prosthesis conservation

  12. GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

    International Nuclear Information System (INIS)

    The recommended target dose in radioiodine therapy of solitary hyperfunctioning thyroid nodules is 300-400 Gy and therefore higher than in other radiotherapies. This is due to the fact that an unknown, yet significant portion of the activity is stored in extranodular areas but is neglected in the calculatory dosimetry. We investigate the feasibility of determining the ratio of nodular and extranodular activity concentrations (uptakes) from post-therapeutically acquired planar scintigrams with Monte Carlo simulations in GATE. The geometry of a gamma camera with a high energy collimator was emulated in GATE (Version 5). A geometrical thyroid-neck phantom (GP) and the ICRP reference voxel phantoms 'Adult Female' (AF, 16 ml thyroid) and 'Adult Male' (AM, 19 ml thyroid) were used as source regions. Nodules of 1 ml and 3 ml volume were placed in the phantoms. For each phantom and each nodule 200 scintigraphic acquisitions were simulated. Uptake ratios of nodule and rest of thyroid ranging from 1 to 20 could be created by summation. Quantitative image analysis was performed by investigating the number of simulated counts in regions of interest (ROIs). ROIs were created by perpendicular projection of the phantom onto the camera plane to avoid a user dependant bias. The ratio of count densities in ROIs over the nodule and over the contralateral lobe, which should be least affected by nodular activity, was taken to be the best available measure for the uptake ratios. However, the predefined uptake ratios are underestimated by these count density ratios: For an uptake ratio of 20 the count ratios range from 4.5 (AF, 1 ml nodule) to 15.3 (AM, 3 ml nodule). Furthermore, the contralateral ROI is more strongly affected by nodular activity than expected: For an uptake ratio of 20 between nodule and rest of thyroid up to 29% of total counts in the ROI over the contralateral lobe are caused by decays in the nodule (AF 3 ml). In the case of the 1 ml nodules this effect is smaller: 9

  13. GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Hammes, Jochen; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Pietrzyk, Uwe [Forschungszentrum Juelich GmbH (Germany). Inst. fuer Neurowissenschaften und Medizin (INM-4); Wuppertal Univ. (Germany). Fachbereich C - Physik

    2011-07-01

    The recommended target dose in radioiodine therapy of solitary hyperfunctioning thyroid nodules is 300-400 Gy and therefore higher than in other radiotherapies. This is due to the fact that an unknown, yet significant portion of the activity is stored in extranodular areas but is neglected in the calculatory dosimetry. We investigate the feasibility of determining the ratio of nodular and extranodular activity concentrations (uptakes) from post-therapeutically acquired planar scintigrams with Monte Carlo simulations in GATE. The geometry of a gamma camera with a high energy collimator was emulated in GATE (Version 5). A geometrical thyroid-neck phantom (GP) and the ICRP reference voxel phantoms 'Adult Female' (AF, 16 ml thyroid) and 'Adult Male' (AM, 19 ml thyroid) were used as source regions. Nodules of 1 ml and 3 ml volume were placed in the phantoms. For each phantom and each nodule 200 scintigraphic acquisitions were simulated. Uptake ratios of nodule and rest of thyroid ranging from 1 to 20 could be created by summation. Quantitative image analysis was performed by investigating the number of simulated counts in regions of interest (ROIs). ROIs were created by perpendicular projection of the phantom onto the camera plane to avoid a user dependant bias. The ratio of count densities in ROIs over the nodule and over the contralateral lobe, which should be least affected by nodular activity, was taken to be the best available measure for the uptake ratios. However, the predefined uptake ratios are underestimated by these count density ratios: For an uptake ratio of 20 the count ratios range from 4.5 (AF, 1 ml nodule) to 15.3 (AM, 3 ml nodule). Furthermore, the contralateral ROI is more strongly affected by nodular activity than expected: For an uptake ratio of 20 between nodule and rest of thyroid up to 29% of total counts in the ROI over the contralateral lobe are caused by decays in the nodule (AF 3 ml). In the case of the 1 ml nodules this

  14. D-cycloserine augmentation in behavioral therapy for obsessive-compulsive disorder: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Xia J

    2015-04-01

    Full Text Available Jing Xia,1 Yanqiu Du,2 Jiyang Han,1 Guo Liu,1 Xumei Wang11Department of Psychiatry, Shengjing Hospital of China Medical University, Heping District Shenyang, Liaoning, People’s Republic of China; 2Department of Medicine, Shenyang Ninth People’s Hospital, Tiexi District, Shenyang, Liaoning, People’s Republic of ChinaObjective: To evaluate the overall effect of D-cycloserine (DCS augmentation on exposure and response prevention (ERP therapy for obsessive-compulsive disorder (OCD.Methods: Clinical studies on the effect of DCS augmentation on ERP therapy for OCD compared to placebo were included for meta analysis. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS. Meta-analyses were performed with a random-effect model or a fixed-effect model using the Cochrane Review Manager (RevMan, version 5.2 to calculate the odds ratio and the mean difference, with their corresponding 95% confidence intervals.Results: A total of six studies was included in the current meta-analyses, and their data were extracted. Among them, four were for analyses of DCS and Y-BOCS at midtreatment, six for analysis at posttreatment, and four at 3-month follow-up. Besides, three of the six eligible studies were included in the meta-analysis of the DCS and Clinical Global Impression – Severity Scale at posttreatment, and three in the meta-analysis of DCS and proportions of treatment responders and of subjects attaining clinical remission status criteria at posttreatment. Our meta-analyses do not reveal a significant effect of DCS augmentation in ERP therapy for OCD patients, except when measured at midtreatment. Compared to the placebo group, DCS augmentation did show a trend toward significantly lower/decreased Y-BOCS; when measured at posttreatment and in the subpopulation of DCS taken before some of the ERP sessions, DCS augmentation showed a trend toward significantly lower/decreased Y-BOCS.Conclusion: Our result suggested that with the careful

  15. The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency

    Directory of Open Access Journals (Sweden)

    Schmid ST

    2012-09-01

    Full Text Available ST Schmid,1 J Koepke,1 M Dresel,1 A Hattesohl,1 E Frenzel,2 J Perez,3 DA Lomas,4 E Miranda,5 T Greulich,1 S Noeske,1 M Wencker,6 H Teschler,6 C Vogelmeier,1 S Janciauskiene,2,* AR Koczulla1,*1Department of Internal Medicine, Division for Pulmonary Diseases, University Hospital Marburg, Marburg, Germany; 2Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; 3Department of Cellular Biology, University of Malaga, Malaga, Spain; 4Department of Medicine, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom; 5Department of Biology and Biotechnology, Istituto Pasteur – Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy; 6Department of Pneumology, West German Lung Clinic, Essen University Hospital, Essen, Germany*These authors contributed equally to this workBackground: The major concept behind augmentation therapy with human α1-antitrypsin (AAT is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema.Objective: To evaluate the short-term effects of augmentation therapy (Prolastin® on plasma levels of AAT, C-reactive protein, and chemokines/cytokines.Materials and methods: Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12 on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL.Results: There were significant fluctuations in serum (but not in exhaled breath condensate levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL

  16. Clinical significance of thyroglobulin autoantibodies enhancement in patients with differentiated thyroid cancer after thyroidectomy and radioiodine therapy

    Directory of Open Access Journals (Sweden)

    N V Severskaya

    2013-09-01

    Full Text Available Purpose: to evaluate the clinical utility of antithyroglobulin antibodies (TgAb as a tumor marker in patients with differentiated thyroid cancer (DTC after thyroidectomy and radioiodine ablation. Patients and methods. From 345 consecutive DTC patients after thyroidectomy and radioiodine ablation we select ed 148 patients with elevated TgAb level (with distant metastasis n = 93, without distant metastasis n = 55. Serum TgAb concentration was measured before radioiodine ablation and then every time before 131I treatment (RIT or diagnostic 131I whole body scanning (WBS. Results were compared with serum thyroglobulin (Tg concentration, neck echography, lung and bone roentgenography and 131I WBS findings. Results. TgAb level was elevated in 21% DTC patients before 131I ablation. The other 22% with initially normal TgAb displayed their rising during followup. In absence of distant metastasis TgAb declined after 1 st–2 nd cycle of RIT (an average 8.9 months after 131I ablation. Persistance or rising of TgAb in the longer term was associated with detectable thyroid remnant, residual tumor or metastatic lymph nodes. In case of negative TgAb status after sugery an increase of TgAb during first 3–6 months after ablation indicated mostly a response to the rise of Tg antigen secondary to 131I ablation. A rise TgAb in the longer term (after 3rd–5th cycles of RIT indicated to residual or recurrent disease in 86% cases. In patients with distant metastasis there were no correlation between change in TgAb concentration and clinical sta tus, including the rate of regression of metastatic disease. But in case of low or undetectable Tg and permanent high TgAb level only TgAb indicated the presence of disease. Conclusion: persistence or rising TgAb in longer term after 131I ablation can serve as surrogate tumor marker of per sistent or recurrent disease. It is critical to measure TgAb concentration, especially in patients with low or unde tectable Tg, because

  17. Radioiodine Therapy of Liver Cancer Cell Following Tissue Specific Sodium Iodide Symporter Gene Transfer and Assessment of Therapeutic Efficacy with Optical Imaging

    International Nuclear Information System (INIS)

    Cancer specific killing can be achieved by therapeutic gene activated by cancer specific promotor. Expression of sodium iodide symporter (NIS) gene causes transportation and concentration of iodide into the cell, therefore radioiodine treatment after NIS gene transfer to cancer cell could be a form of radionuclide gene therapy. luciferase (Luc) gene transfected cancer cell can be monitored by in vivo optical imaging after D-luciferin injection. Aims of the study are to make vector with both therapeutic NIS gene driven by AFP promoter and reporter Luc gene driven by CMV promoter, to perform hepatocellular carcinoma specific radiodiodine gene therapy by the vector, and assessment of the therapy effect by optical imaging using luciferase expression. A Vector with AFP promoter driven NIS gene and CMV promoter driven Luc gene (AFP-NIS-CMV-Luc) was constructed. Liver cancer cell (HepG2, Huh-7) and non liver cancer cell (HCT-15) were transfected with the vector using liposome. Expression of the NIS gene at mRNA level was elucidated by RT-PCR. Radioiodide uptake, perchlorate blockade, and washout tests were performed and bioluminescence also measured by luminometer in these cells. In vitro clonogenic assay with I-131 was performed. In vivo nuclear imaging was obtained with gamma camera after I-131 intraperitoneal injection. A Vector with AFP-NIS-CMV-Luc was constructed and successfully transfected into HepG2, Huh-7 and HCT-15 cells. HepG2 and Huh-7 cells with AFP-NIS-CMV-Luc gene showed higher iodide uptake than non transfected cells and the higher iodide uptake was totally blocked by addition of perchlorate. HCT-15 cell did not showed any change of iodide uptake by the gene transfection. Transfected cells had higher light output than control cells. In vitro clonogenic assay, transfected HepG2 and Huh-7 cells showed lower colony count than non transfected HepG2 and Huh-7 cells, but transfected HCT-15 cell did not showed any difference than non transfected HCT-15 cell

  18. The imunocytochemical advances in prognosis of metastasis radioiodine resistant of papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    The topical issues is the problem of prognosis of metastasis radioiodine resistant metastasis. We offered the methods of prognosis of metastasis radioiodine resistant of papillary thyroid carcinoma with the help of immunocytochemical detection of the cytokeratin 17 and thyroid peroxidase. With the purpose of prognosis of metastasis radioiodine resistibility the cytokeratin 17 is taped in punctates of primary papillary carcinomas. This approach allows predict response of metastases on radioiodine therapy to choose proper therapeutic approach

  19. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, H.; Happel, C.; Koch, D.A.; Gruenwald, F. [Frankfurt University Hospital (Germany). Dept. of Nuclear Medicine

    2016-01-15

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  20. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    International Nuclear Information System (INIS)

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  1. Chewing-gum stimulation did not reduce the absorbed dose to salivary glands during radioiodine treatment of thyroid cancer as inferred from pre-therapy 124I PET/CT imaging

    OpenAIRE

    Jentzen, Walter; Richter, Marion; Nagarajah, James; Poeppel, Thorsten Dirk; Brandau, Wolfgang; Dawes, Colin; Bockisch, Andreas; Binse, Ina

    2014-01-01

    Background The goal of this prospective study was to estimate the absorbed (radiation) doses to salivary glands in radioiodine therapy of thyroid cancer under chewing-gum stimulation using 124I positron emission tomography (PET)/computed tomography (CT) imaging. Methods Duplex ultrasonography was conducted in three test persons for visual comparison of the glandular blood flow with three different stimulation types (no stimulation, chewing tasteless gum base, sucking on lemon slices). Ten pat...

  2. Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

    DEFF Research Database (Denmark)

    Hermanides, J; Nørgaard, K; Bruttomesso, D;

    2011-01-01

    To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes.......To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes....

  3. Diagnostic 123I and 131I activities and radioiodine therapy. Effects on urinary iodine excretion in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Aim: urinary iodine excretion (UIE) provides information about iodine supply and release. In the present study we investigated effects of the application of different radioiodine isotopes on UIE in patients with differentiated thyroid carcinoma (DTC). Patients, methods: in 91 consecutive patients with DTC UIE, measured as iodine/creatinine ratio, was determined before and after application of 123I and 131I for diagnostic or therapeutic purposes. Additionally, remnant volume (V) was determined prior to therapy. Group A consisted of 33 patients with supposed successful ablation of DTC. These patients received 370 MBq 131I for diagnostic use and served as controls. 58 patients (group B) with remnants, relapses and metastases received 370 MBq 123I for diagnostics prior to therapy with 1.5-22.2 GBq 131I. Factors influencing individual changes in urinary iodine excretion (ΔUIE) were investigated by using non-parametric tests. Results: in group A UIE did not change significantly after application of 131I. As well, UIE remained unchanged after diagnostic application of 123I in group B. In contrast, UIE increased significantly already 24 h after therapeutic application of 131I in this group. In patients with small remnants (V 131I. (orig.)

  4. Radioiodine therapy of differentiated thyroid cancer: radiologic impact of out-patient treatment with 100 to 150 mCi Iodine-131 activities

    International Nuclear Information System (INIS)

    Purpose: To evaluate exposure and dosimetry to family members and environment due to outpatient radioiodine therapy of differentiated thyroid carcinoma. Methods: Twenty patients were treated with 100-150 mCi of iodine-131 on an out-patient basis. Family members dosimetry (n = 27) and potential doses inside the house were measured with thermoluminescent dosimeters. Surface contamination and radioactive wastes were also monitored. Results: Less than 1.0 mSv doses were found in 26 co-habitants and 2.8 mSv in a single case (inferior to the acceptable value of 5.0 mSv/procedure). Potential doses in the houses were inferior to 0.25 mSv, excluding the patients bedroom (mean value = 0.69 mSv). Surface contamination (mean = 4.2 Bq.cm-2) were below clearance levels. Radioactive wastes generated had a volume of 2.5 liters and a total activity estimated in 90 μCi, with a calculated exposure close to the background radiation levels. Conclusions: No radiological impact was detected after iodine therapy with 100-150 mCi on an out-patient basis followed by experienced professionals. (author)

  5. Alpha-1 Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    DD Marciniuk

    2012-01-01

    Full Text Available Alpha-1 antitrypsin (A1AT functions primarily to inhibit neutrophil elastase, and deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD. Severe A1AT deficiency occurs in one in 5000 to one in 5500 of the North American population. While the exact prevalence of A1AT deficiency in patients with diagnosed COPD is not known, results from small studies provide estimates of 1% to 5%. The present document updates a previous Canadian Thoracic Society position statement from 2001, and was initiated because of lack of consensus and understanding of appropriate patients suitable for targeted testing for A1AT deficiency, and for the use of A1AT augmentation therapy. Using revised guideline development methodology, the present clinical practice guideline document systematically reviews the published literature and provides an evidence-based update. The evidence supports the practice that targeted testing for A1AT deficiency be considered in individuals with COPD diagnosed before 65 years of age or with a smoking history of <20 pack years. The evidence also supports consideration of A1AT augmentation therapy in nonsmoking or exsmoking patients with COPD (forced expiratory volume in 1 s of 25% to 80% predicted attributable to emphysema and documented A1AT deficiency (level ≤11 μmol/L who are receiving optimal pharmacological and nonpharmacological therapies (including comprehensive case management and pulmonary rehabilitation because of benefits in computed tomography scan lung density and mortality.

  6. Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression

    DEFF Research Database (Denmark)

    Straasø, Birgit; Lauritzen, Lise; Lunde, Marianne;

    2014-01-01

    OBJECTIVE: To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields (T-PEMF) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after 8 weeks of augmentation therapy. METHODS: A self-treatment set-up of...... (active dose in the morning and sham in the afternoon) or two T-PEMF doses (active dose both morning and afternoon) in a double-blind procedure. A score of 7 or less on the Hamilton Depression Scale (HAM-D17) was the criterion of remission. RESULTS: In total 34 patients received active T-PEMF once a day...

  7. D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel A.; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.

    2010-01-01

    This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine (DCS), to augment cognitive-behavioral therapy (CBT) for anxiety disorders. The literature on behavioral theory of exposure-based therapies is provided, followed by a discussion of the role of DCS in enhancing extinction…

  8. Immunogenic hyperthyroidism following radioiodine ablation of focal autonomy

    International Nuclear Information System (INIS)

    Immunogenic hyperthyroidism rarely develops after radioiodine elimination of focal autonomous thyroid tissue. We observed this phenomenon in 8 patients between 1989 and 1992. The occurrence of immunogenic hyperthyroidism shortly after elimination of autonomous nodules has not been studied nor is it properly understood. Most studies known today describe the development of autonomous nodules in the course of immunogenic hyperthyroidism or ignore the chronologic order of occurrence. The possibility that immunogenic hyperthyroidism may occur after radioiodine therapy of autonomous nodules, makes a consequent follow-up within the first year following radioiodine therapy mandatory. (orig.)

  9. Long-term experience in the treatment of α1-antitrypsin deficiency: 25 years of augmentation therapy

    Directory of Open Access Journals (Sweden)

    Helmut Teschler

    2015-03-01

    Full Text Available Although it is often under-recognised, α1-antitrypsin deficiency (AATD represents one of the most common genetic respiratory disorders worldwide. Since the publication of studies in the late 1980s, which demonstrated that plasma-derived augmentation therapy with intravenous α1-antitrypsin (AAT can reverse the biochemical deficiencies in serum and lung fluid that characterise emphysema, augmentation therapy has become the cornerstone of patient management. This article, with a focus on experience gained in clinical practice in Germany, provides an overview of some of the research highlights and clinical experience gained in the use of augmentation therapy for AATD during the past 25 years, and briefly discusses the potential role of AAT augmentation therapy in lung transplant recipients. Additionally, the goals of AAT augmentation therapy will be discussed, namely to delay the progression of emphysema, reduce the frequency of exacerbations and improve health-related quality of life. Beyond pulmonary disease, there is recent growing evidence to indicate that AATD could also play a role in rare disorders such as panniculitis, granulomatosis with polyangiitis and ulcerative colitis.

  10. Characterization of radioiodine therapy failures in Graves' disease; Charakterisierung von Therapieversagern bei der Radioiodtherapie des Morbus Basedow ohne simultane Thyreostase

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, O.; Zimny, M.; Schreckenberger, M.; Reinartz, P.; Nowak, B.; Ostwald, E.; Schaefer, W.; Block, S.; Setani, K.; Buell, U. [Klinik fuer Nuklearmedizin der RWTH Aachen (Germany)

    2001-02-01

    Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves' disease without simultaneous carbimazole. Method: 226 patients with a confirmed diagnosis of Graves' disease received 686.8 {+-} 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), I-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 {+-} 76.6 Gy vs. 285.2 {+-} 82.1 Gy, p <0.005), but with no significant differences regarding age, thyroid volume, function or TRAb (all p >0.2). Of the 14 failures, n = 8 reached an absorbed dose <200 Gy and n = 1 a dose <250 Gy, although 5 of the failures reached an absorbed dose of >250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p <0.005), but not influence of initial thyroid volume, function, TRAb value, age (all p >0.2) or gender (p = 0.13). Two-tailed Fisher's exact test showed no significant influence of gender on success rates (failures/successes: male 1/36, female 13/176, p = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves' disease without simultaneous carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy. (orig.) [German] Ziel der Studie war eine

  11. Radioiodine ( sup 131 I) therapy of Graves' disease; Use of the new high resolutional ultrasonic scanner for the determination of the accurate weight of the thyroid gland

    Energy Technology Data Exchange (ETDEWEB)

    Nagayama, Yuji; Ashizawa, Kiyoto; Matsuo, Keiichi; Inoue, Shuji; Harakawa, Seijiro; Hirayu, Hideshi; Yamashita, Shunichi; Izumi, Motomori; Nagataki, Shigenobu (Nagasaki Univ. (Japan). School of Medicine)

    1989-06-01

    In this series, eighteen patients with Graves' disease were treated with 8000 rads (80 Gy) of radioiodine ({sup 131}I), using the new high resolutional ultrasonic scanner for the determination of the accurate weight of the thyroid gland. The mean dose of radioiodine administered orally was 4.6 {plus minus} 3.0 mCi (170.2 {plus minus} 110.0 MBq) and 133.7 {plus minus} 44.6 muCi/g (4.95 {plus minus} 1.65 MBq). At one year after treatment, twelve of eighteen patients (66.7%) became euthyroid, five (27.8%) remained hyperthyroid and one (5.6%) became hypothyroid. Analysis of various factors which may be related to the effect of radioiodine therapy revealed that the weight of the thyroid gland in the hyperthyroid and euthyroid groups was significantly different (61.7 {plus minus} 33.5 g vs. 25.1 {plus minus} 9.1 g, p<0.05). Furthermore, all patients with larger glands (more than sixty grams) remained hyperthyroid, while the incidence of euthyroidism was as high as 80% in patients with smaller glands (less that forty grams). Although the number of patients studied was small, these results indicate that a larger thyroid gland requires a larger radioiodine dose per gram of tissue than a smaller gland, suggesting that the therapeutic radiation dose should be graded according to the gland size even when the gland size is accurately estimated by ultrasound. Further study is required to determine the appropriate radiation dose graded according to the gland size. (author).

  12. Recombinant human thyrotropin-stimulated radioiodine therapy of large nodular goiters facilitates tracheal decompression and improves inspiration

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Nielsen, Viveque E; Boel-Jørgensen, Henrik; Grupe, Peter; Andersen, Peter B; Bastholt, Lars; Hegedüs, Laszlo

    2008-01-01

    INTRODUCTION: The impact on tracheal anatomy and respiratory function of recombinant human (rh)TSH-stimulated (131)I therapy in patients with goiter is not clarified. METHODS: In a double-blinded design, patients (age 37-87 yr) with a large multinodular goiter (range, 99-440 ml) were randomized to...... placebo (n = 15) or 0.3 mg rhTSH (n = 14) 24 h before (131)I therapy. The smallest cross-sectional area of the trachea (SCAT; assessed by magnetic resonance imaging) and the pulmonary function were determined before, 1 wk, and 12 months after therapy. RESULTS: Data on goiter reduction have been reported...... previously. In the placebo group, no significant changes in the lung function or SCAT were found throughout the study. In the rhTSH group, a slight decrease was observed in the forced vital capacity 1 wk after therapy, whereas the mean individual change in SCAT was significantly increased by 10.5% (95...

  13. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Bin Long

    2015-01-01

    Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

  14. Thyrotropin receptor antibody activities significantly correlate with the outcome of radioiodine (131I) therapy for hyperthyroid Graves' disease

    International Nuclear Information System (INIS)

    The outcome of 131I therapy for 109 patients with Graves' disease was analysed according to pretreatment laboratory data including thyrotropin receptor antibody (TRAb) activities. Forty-five percent of patients became euthyroid, and 13% of patients became hypothyroid within one year after 131I therapy. Forty-two percent of patients remained hyperthyroid one year after 131I therapy. Pretreatment values for serum T4, T3, and the estimated weight of the thyroid were significantly higher in the hyperthyroid group. The mean for the TRAb index of the hyperthyroid group was significantly higher than that of the euthyroid group. Life table analysis revealed a significant effect of the TRAb index on the rate of hyperthyroidism after 3 months or later. These results appear to suggest that the TRAb index is one of the factors which influence the outcome of 131I therapy for Graves' disease. (author)

  15. Radioiodine therapy in a patient with papillary thyroid carcinoma associated with breast uptake; hyperprolactinemia due to empty sella syndrome

    International Nuclear Information System (INIS)

    We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was was due to the decreased secretion of PIF induced by empty sella

  16. Radioiodine therapy in a patient with papillary thyroid carcinoma associated with breast uptake; hyperprolactinemia due to empty sella syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Seo, Jung Ho [College of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Kyoung Rae [Yungdong Sevrance Hospital, Seoul (Korea, Republic of)

    1998-01-01

    We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was was due to the decreased secretion of PIF induced by empty sella.

  17. STAR: Speech Therapy with Augmented Reality for children with autism spectrum disorders

    OpenAIRE

    Silva,Camilla Almeida da; Fernandes, António Ramires; Grohmann, Ana Paula

    2015-01-01

    Graphics based systems of Augmented and Alternative Communication are widely used to promote communication in people with Autism Spectrum Disorders. This study discusses an integration of Augmented Reality in communication interventions, by relating elements of Augmented and Alternative Communication and Applied Behaviour Analysis strategies. An architecture for an Augmented Reality based interactive system to assist interventions is proposed. STAR provides an Augmented Reality tool to assi...

  18. Prognostic implication of thyroglobulin and quantified whole body scan after initial radioiodine therapy on early prediction of ablation and clinical response for the patients with differentiated thyroid cancer

    International Nuclear Information System (INIS)

    The objective of this study was to investigate predictors for successful ablation and disease-free status after high-dose radioiodine therapy in patients with differentiated thyroid cancer. We enrolled 173 consecutive patients with differentiated thyroid cancer between November 2001 and December 2004 retrospectively (female 145, 46±12 years). All patients underwent total thyroidectomy and I-131 ablative therapy (IAT) (3.7-5.4 GBq). The success or failure of ablation was assessed 6-9 months after the IAT with reference to undetectable thyroglobulin (Tg) and negative I-131 whole body scan (WBS). Afterward, the decision for disease-free status was evaluated using Tg and WBS (follow-up period after 1st IAT 7-81 months, median 43 months, criteria of disease-free: less than 10 ng/ml thyroid stimulating hormone (TSH)-stimulated Tg or less than 2 ng/ml TSH-unstimulated Tg and/or negative WBS). Clinical and tumoral factors such as sex, age, pathologic type, the size of tumor, quantified cervical uptake in WBS1, pattern in WBS1, ablative therapy dose, American Joint Committee on cancer (AJCC) stage, lymph node (LN) stage, Tg just before IAT (Tg1), and ablation status were assessed using logistic regression analyses. There were 93 successful ablations (54%). Significant predictors for the ablation failure were Tg1 (odd raito (OR)=8.42; 95% confidence interval (CI)=2.76-25.69; p<0.0001), LN metastasis (OR=3.05; 95% CI=1.11-8.37; p=0.031), and quantified cervical uptake in WBS1 (OR=4.95; 95% CI=1.07-22.88; p=0.041). One hundred fifty-five patients were determined as disease-free after follow-up. All the eighteen patients with persistent disease were identified as ablation failure after first IAT. Significant predictors for the disease-free status were Tg1 (OR=0.98; 95% CI=0.97-0.99; p=0.028), tumor size (OR=0.53; 95% CI=0.28-0.96; p=0.044), and quantified cervical uptake in WBS1 (OR=0.87; 95% CI=0.76-0.98; p=0.024). The thyroglobulin and quantified cervical uptake in whole

  19. Determination of factors influencing the outcome of radioiodine therapy in patients with Graves` disease; Bestimmung von Einflussgroessen fuer den Therapieerfolg der Radioiodtherapie bei Patienten mit Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, O.; Schulz, G.; Zimny, M.; Schreckenberger, M.; Zimny, D.; Wagenknecht, G.; Kaiser, H.J.; Dohmen, B.M.; Bares, R.; Buell, U. [Rheinisch-Westfaelische Technische Hochschule (RWTH), Aachen (Germany). Klinik fuer Nuklearmedizin

    1998-05-01

    Aim of this study was to determine whether success of radioiodine therapy (RIT) in Graves` disease depends on thyroid volume, function, thyroideal receptor antibodies (TRAK), thyresotasis, therapeutic dosage, {sup 131}I uptake, or effective half-life. Method: 78 patients received an average of 626{+-}251 MBq of iodine-131 orally for tyroid ablation. 60 were assessed for successful therapy 3 months after RIT. Results: In patients showing hyperthyreosis or a TRAK value >11 U/l at the beginning of RIT, a significantly lower therapeutic doseage and effective iodine half-life were found than in non-hyperthyreotic patients or patients with TRAK{<=}11 U/l. Patients with a thyroid volume {<=}25 ml showed a significantly lower {sup 131}I uptake, but a significantly higher relative uptake ({sup 131}I uptake/volume) than patients with a tyroid volume >25 ml. All failures were treated thyreostatically during RIT and showed a signifiantly lower therapeutic iodine dosage and relative uptake, as well as a significantly higher thyroid volume than patients with a successful therapy. RIT caused a thyroid volume reduction of 44%, with therapy failures showing a significantly lower volume reduction. Patients who received a therapeutic doseage of {<=}250 Gy showed significantly worse results than did those who had received >250 Gy. Only one case of therapy failure received a dosage >250 Gy, while 50% of failures received dosages >200 Gy but <250 Gy. Multivariate analyses (MANOVA, factor analyses) showed thyreostasis as the decisive negative factor for a successful course of therapy. Conclusions: Since most treatment failures occurred in patients under thyreostatic medication, we recommend raising the target dosage to 250 Gy for these cases. (orig.) [Deutsch] Ziel der Studie war es, zu pruefen, inwieweit der Erfolg einer Radioiodtherapie (RIT) des Morbus Basedow (MB) von verschiedenen Parametern (Schilddruesenvolumen [SDVol], Funktion, TRAK, Thyreostase, Therapiedosis, {sup 131}I

  20. Augmenting Antidepressant Medication Treatment of Depressed Women with Emotionally Focused Therapy for Couples: A Randomized Pilot Study

    Science.gov (United States)

    Denton, Wayne H.; Wittenborn, Andrea K.; Golden, Robert N.

    2012-01-01

    This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM +…

  1. The incidence of ophthalmopathy after radioiodine therapy for Graves' disease: Prognostic factors and the role of methimazole

    OpenAIRE

    Kung, AWC; Yau, CC; Cheng, A

    1994-01-01

    Radioactive iodine-131 (RAI) has been reported to be associated with a high incidence of development or exacerbation of Graves' ophthalmopathy (GO). This is thought to be associated with a surge of autoantibodies after RAI therapy. The role of methimazole (MMI), which possesses immunomodulatory action, in the prevention of GO was explored by studying 114 patients with Graves' disease. They were assigned randomly to receive either RAI alone or adjunctive antithyroid drugs, which consisted of M...

  2. Mucoepidermoid carcinoma of the submandibular gland after high-dose radioiodine therapy: case report and review of the literature; Mukoepidermoid-Karzinom der Glandula Submandibularis nach hochdosierter Radioiodtherapie: Fallpraesentation und Literaturuebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Henze, M.; Elser, H. [Radiologische Universitaetsklinik Heidelberg (Germany). Abt. fuer Nuklearmedizin; Hittel, J.P. [Heidelberg Univ. (Germany). HNO-Klinik

    1998-01-01

    Case report of a 42 year old female, who recieved from 14th-20th year of life six radioiodine therapies with altogether 19,2 GBq {sup 131}I because of a papillary thyroid carcinoma. 17 years after the last therapy, she developed a histologicaly proven chronic radiogenic sialadenitis of the left submandibular gland. Further four years later, the right submandibular gland has been extirpated because of a mucoepidermoid carcinoma with infiltration of a regionary lymphatic node. Review of the previous published secondary-malignancies of the salivary glands after high-dose radioiodine therapies. (orig.) [Deutsch] Fallpraesentation einer 42jaehrigen Patientin, die aufgrund eines papillaeren Schilddruesenkarzinoms vom 14. bis 20. Lebensjahr sechsmalig mit insgesamt 19,2 GBq {sup 131}I therapiert wurde. 17 Jahre nach Abschluss der Radioiodtherapien zeigte sich eine histologisch gesicherte chronische Strahlensialadenitis der linken Glandula submandibularis. Vier weitere Jahre spaeter wurde die rechte Glandula submandibularis aufgrund eines Mukoepidermoidkarzinoms mit Infiltration eines lokoregionaeren Lymphknotens extirpiert. Literaturuebersicht und kritische Wertung der bislang publizierten Faelle von Speicheldruesen-Zweitkarzinomen nach hochdosierten Radioiodtherapien. (orig.)

  3. Systemic oxidative stress to nucleic acids is unaltered following radioiodine therapy of patients with benign nodular goiter

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Stovgaard, Elisabeth S; Fast, Søren; Broedbaek, Kasper; Andersen, J T; Weimann, Allan; Grupe, Peter; Hegedüs, Laszlo; Poulsen, Henrik E

    2015-01-01

    .1 mg of recombinant human TSH (rhTSH). In 6 patients, the applied thyroid dose was 100 Gy without rhTSH prestimulation. Well-established biomarkers of oxidative stress to RNA (8-oxo-7,8-dihydroguanosine; 8-oxoGuo) and DNA (8-oxo-7,8-dihydro-2'-deoxyguanosine; 8-oxodG) were measured in freshly voided......BACKGROUND: Little is known about the whole body oxidative stress burden following radioactive iodine ((131)I) therapy of thyroid diseases. METHODS: We studied 17 patients with benign nodular goiter treated with (131)I therapy. The targeted thyroid dose was 50 Gy in 11 patients pretreated with 0...... MBq; 8-oxoGuo: p = 0.66, 8-oxodG: p = 0.71). CONCLUSION: Systemic oxidative stress, as detected by nucleic acids metabolites in the urine, is not increased after thyroid stimulation with 0.1 mg of rhTSH, or after (131)I therapy. Our method cannot quantify the oxidative stress induced locally in the...

  4. Comparison of the Influence on the Liver Function Between Thyroid Hormone Withdrawal and rh-TSH Before High-Dose Radioiodine Therapy in Patients with Well-Differentiated Thyroid Cancer

    International Nuclear Information System (INIS)

    An elevated thyroid stimulating hormone level (TSH) is essential to stimulate the uptake of radioiodine into thyroid remnants and metastases and metastases of thyroid cancer when a patient under-goes high-dose radioiodine therapy. Nowadays, recombinant human thyroid stimulating hormone (rh-TSH) is increasingly used instead of the classic method of thyroid hormone withdrawal (THW). However, beyond the therapeutic effects, clinical differences between the two methods have not yet been clearly demonstrated. The aim of this work was to investigate the effects of the two methods, especially on liver function. We identified 143 evaluable patients who were further divided into two groups: THW and rh-TSH. We first reviewed the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, which were measured during the admission period for total thyroidectomy. We called these liver enzyme levels 'base AST' and 'base ALT.' We also assessed other chemistry profiles, including AST, ALT, total cholesterol, LDL cholesterol, alkaline phosphatase (ALP), total bilirubin (TB), and triglyceride (TG), which were measured on admission day for high-dose radioiodine therapy. We called these liver enzyme levels 'follow-up AST'and 'follow-up ALT.' We compared the changes in base and follow-up liver enzyme levels and the other chemistry profiles between the two groups. The base AST and base ALT levels of the two groups were within normal range, and there was no significant difference between the two groups. In contrast to these base liver enzyme levels, follow-up AST and ALT levels than did the rh-TSH group. Patients in the THW group. Patients in the THW group also had higher levels of total cholesterol and LDL cholesterol than did the patients in the rh-TSH group. However there were no statistically significant differences in ALP, total bilirubin, and triglyceride levels between the two groups. In this retrospective analysis of liver function, the use of rh-TSH for high

  5. Comparison of the Influence on the Liver Function Between Thyroid Hormone Withdrawal and rh-TSH Before High-Dose Radioiodine Therapy in Patients with Well-Differentiated Thyroid Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yeon-Hee; Lim, Seok Tae; Yun, Kuk-No; Yim, Sung Kyun; Kim, Dong Wook; Jeong, Hwan-Jeong; Sohn, Myung-Hee [Chonbuk National Univ. Medical School and Hospital, Jeonju (Korea, Republic of)

    2012-06-15

    An elevated thyroid stimulating hormone level (TSH) is essential to stimulate the uptake of radioiodine into thyroid remnants and metastases and metastases of thyroid cancer when a patient under-goes high-dose radioiodine therapy. Nowadays, recombinant human thyroid stimulating hormone (rh-TSH) is increasingly used instead of the classic method of thyroid hormone withdrawal (THW). However, beyond the therapeutic effects, clinical differences between the two methods have not yet been clearly demonstrated. The aim of this work was to investigate the effects of the two methods, especially on liver function. We identified 143 evaluable patients who were further divided into two groups: THW and rh-TSH. We first reviewed the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, which were measured during the admission period for total thyroidectomy. We called these liver enzyme levels 'base AST' and 'base ALT.' We also assessed other chemistry profiles, including AST, ALT, total cholesterol, LDL cholesterol, alkaline phosphatase (ALP), total bilirubin (TB), and triglyceride (TG), which were measured on admission day for high-dose radioiodine therapy. We called these liver enzyme levels 'follow-up AST'and 'follow-up ALT.' We compared the changes in base and follow-up liver enzyme levels and the other chemistry profiles between the two groups. The base AST and base ALT levels of the two groups were within normal range, and there was no significant difference between the two groups. In contrast to these base liver enzyme levels, follow-up AST and ALT levels than did the rh-TSH group. Patients in the THW group. Patients in the THW group also had higher levels of total cholesterol and LDL cholesterol than did the patients in the rh-TSH group. However there were no statistically significant differences in ALP, total bilirubin, and triglyceride levels between the two groups. In this retrospective analysis of liver

  6. Noninferior response in BRAF{sup V600E} mutant nonmetastatic papillary thyroid carcinoma to radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Jiao; Zhao, Teng; Lin, Yansong [Peking Union Medical College Hospital, Department of Nuclear Medicine, Beijing (China); Liang, Jun [Peking University International Hospital, Department of Oncology, Beijing (China)

    2016-06-15

    As the most frequent and specific genetic alteration in papillary thyroid carcinoma (PTC), BRAF{sup V600E} has an intimate relationship with more invasive tumour and higher postoperative recurrence risk in PTC patients. We investigate the effect of radioactive iodine (RAI) therapy on the clinical outcome in PTC patients with the BRAF{sup V600E} mutation without distant metastases. This retrospective study included PTC 228 patients without distant metastases who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2011 to July 2014. The BRAF{sup V600E} status of the primary lesions was determined and the patients were divided into two groups according to the presence of the mutation. Serological and imaging data were collected at a median follow-up of 2.34 years after RAI administration. Suppressed and stimulated thyroglobulin (Tg), Tg antibody, diagnostic whole-body scintigraphy, and other imaging examinations were used to assess clinical outcome, which was defined as excellent response, indeterminate response, biochemical incomplete response and structural incomplete response. The BRAF{sup V600E} mutation was observed in 153 of the 228 patients (67.1 %). The clinicopathological features did not differ between the BRAF{sup V600E} mutatation and wild-type groups except age at diagnosis (P = 0.000), tumour size (P = 0.023) and TNM stage (P = 0.003). Older age and more advanced TNM stage were prevalent in the BRAF{sup V600E} mutatation group, whereas tumours were slightly larger in the BRAF{sup V600E} wild-type group. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk, and no significant difference in response was found between the BRAF{sup V600E} mutatation and the wild-type groups (P = 0.881 and P = 0.851, respectively). The clinical response to timely postsurgical RAI therapy is not inferior in BRAF{sup V600E} mutation PTC patients without distant metastases, which

  7. APOBEC3G-Augmented Stem Cell Therapy to Modulate HIV Replication: A Computational Study.

    Directory of Open Access Journals (Sweden)

    Iraj Hosseini

    Full Text Available The interplay between the innate immune system restriction factor APOBEC3G and the HIV protein Vif is a key host-retrovirus interaction. APOBEC3G can counteract HIV infection in at least two ways: by inducing lethal mutations on the viral cDNA; and by blocking steps in reverse transcription and viral integration into the host genome. HIV-Vif blocks these antiviral functions of APOBEC3G by impeding its encapsulation. Nonetheless, it has been shown that overexpression of APOBEC3G, or interfering with APOBEC3G-Vif binding, can efficiently block in vitro HIV replication. Some clinical studies have also suggested that high levels of APOBEC3G expression in HIV patients are correlated with increased CD4+ T cell count and low levels of viral load; however, other studies have reported contradictory results and challenged this observation. Stem cell therapy to replace a patient's immune cells with cells that are more HIV-resistant is a promising approach. Pre-implantation gene transfection of these stem cells can augment the HIV-resistance of progeny CD4+ T cells. As a protein, APOBEC3G has the advantage that it can be genetically encoded, while small molecules cannot. We have developed a mathematical model to quantitatively study the effects on in vivo HIV replication of therapeutic delivery of CD34+ stem cells transfected to overexpress APOBEC3G. Our model suggests that stem cell therapy resulting in a high fraction of APOBEC3G-overexpressing CD4+ T cells can effectively inhibit in vivo HIV replication. We extended our model to simulate the combination of APOBEC3G therapy with other biological activities, to estimate the likelihood of improved outcomes.

  8. The incidence of ophthalmopathy after radioiodine therapy for Graves` disease: Prognostic factors and the role of methimazole

    Energy Technology Data Exchange (ETDEWEB)

    Kung, A.W.C. [Univ. of Hong Kong, Pokfulam (Hong Kong); Cheng, A. [Queen Mary Hospital, Pokfulam (Hong Kong)

    1994-08-01

    Radioactive iodine-131 (RAI) has been reported to be associated with a high incidence of development or exacerbation of Graves` ophthalmopathy (GO). This is thought to be associated with a surge of autoantibodies after RAI therapy. The role of methimazole (MMI), which possesses immunomodulatory action, in the prevention of GO was explored by studying 114 patients with Graves` disease. They were assigned randomly to receive either RAI alone or adjunctive antithyroid drugs, which consisted of MMI and L-T{sub 4} as a block-replacement therapy for 12 months and were followed for 2 yr. Thirty-five patients (30.7%) had GO at presentation. Twenty-one (18%) patients developed new GO, and six had worsening of preexisting GO. The development of hypothyroidism (P < 0.01) and an elevation of TSH (P < 0.05) were associated with increased risk of development or exacerbation of GO. The chance of development or exacerbation of GO is higher in those with no ophthalmopathy than in those with preexisting GO at presentation (P = 0.002). The incidence of development or exacerbation of GO was similar in the two treatment groups (RAI, 22.8%; adjunctive antithyroid drugs, 23.7%; P = NS). MMI was able to suppress the surge of TSH receptor antibody (TRAB) after RAI, but a surge in TRAB was not of prognostic significance for the development of GO after RAI. Patients who developed or had exacerbation of GO actually had lower TRAB at presentation (P = 0.02). The authors conclude that hypothyroidism with elevated TSH is an important adverse factor for the development or exacerbation of GO, and MMI was unable to prevent the development or exacerbation of GO after RAI. 35 refs., 4 tabs.

  9. Added value of SPECT/CT in addition to whole-body scintigraphy augmented with prone lateral views in patients with well-differentiated thyroid carcinoma

    OpenAIRE

    ATASAYAR N.

    2014-01-01

    Purpose: We aimed to determine the impact of SPECT/CT performed in addition to whole-­‐body scintigraphy augmented with prone lateral views in patients with well-­‐differentiated thyroid carcinoma. Methods and Materials: This retrospective study included 141 patients (87 female, 54 male, mean age 47 years) with well-­‐differentiated thyroid carcinoma (105 papillary, 31 follicular, 1 Hürthle cell and 4 poorly differentiated) treated with radioiodine therapy (1000-7400 MBq). P...

  10. Evaluation of radioiodine therapy with fixed doses of 10 and 15 mCi in patients with Graves disease; Avaliacao da radioiodoterapia com doses fixas de 10 e 15 mCi em pacientes com doenca de Graves

    Energy Technology Data Exchange (ETDEWEB)

    Canadas, Viviane; Vilar, Lucio; Moura, Eliane; Brito, Ana; Castellar, Enio [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Hospital das Clinicas. Servico de Endocrinologia]. E-mail: vivi2207@ig.com.br

    2007-10-15

    The treatment options for the hyperthyroidism of Graves' disease are antithyroid drugs, surgery and radioiodine, none of which is considered ideal, as they do not act directly on the etiopathogenesis of the disease. Radioiodine has been increasingly used as the treatment of choice because it is a safe and definitive therapy whose administration is very easy. Some authors prefer to administer higher doses in order to deliberately induce hypothyroidism, while others recommend lower doses that result in a lower incidence of hypothyroidism and a greater incidence of euthyroidism. There is no consensus for the optimal regimen of fixed doses to be used and this is the main focus of the present study, where doses of 10 and 15 mCi of {sup 131}I were compared. Among the 164 patients analyzed, 61 (37.2%) were submitted to 10 mCi and 103 (62.8%) to 15 mCi. In the longitudinal analysis it was observed that remission of the hyperthyroidism was statistically different in the sixth month (p < 0.001), being higher in the group that used the dose of 15 mCi, but similar in both groups at 12 and 24 months. It may be concluded that the administration of fixed doses of 10 and 15 mCi of {sup 131}I brought about a similar remission of the hyperthyroidism after 12 months of treatment. Moreover, the remission rate of the hyperthyroidism had no association with age, sex or previous therapy with antithyroid drugs. (author)

  11. Separation of autonomous function from cell density in non-immunogenic hyperthyroidism. Pt. 2. Quantified comparison before and after radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Als, C. [Dept. of Nuclear Medicine, Inselspital, Univ. Bern (Switzerland); Roesler, H. [Dept. of Nuclear Medicine, Inselspital, Univ. Bern (Switzerland); Listewnik, M. [Dept. of Nuclear Medicine, Inselspital, Univ. Bern (Switzerland)

    1996-02-01

    Regional autonomous cell mass (Q: cell density ratio) and function (T: toxicity index) were compared by double isotope parametric thyroid scintigraphy (Als et al., Nucl. Med. 1995; 34) in 53 patients with non-immunogenic hyperthyroidism before and after radioiodine therapy (aRIT) and showed a break-down (medians) of Q: 4.3{yields}1.0 (toxic adenomas: TA), 2{yields}1.1 (multifocal functional autonomies: MFA) (p<0.0001) as of T: 96{yields}1.7 (TA), 15{yields}1.1 (MFA) (p<0.001). Five functional aRIT patterns resulted: euthyroidism (n=37, 70%), at half with scarred/non-scarred autonomous areas (low/higher T, respectively), primary hypothyroidism (n=4), residual hyperthyroidism (n=7), secondary hyperthyroidism (n=5). The last two groups with persistent subnormal TSH values were clearly separated by divergent T, thyroxine and triiodothyronine levels. A resulting T>1 may represent a clinically sub-critical mass of residual autonomous tissue. This new technique facilitates individual pretherapeutic evaluations and aRIT quality control. (orig.) [Deutsch] Regionale autonome Zellmasse (Q: Zelldichtequotient) und Funktion (T: Toxizitaetsindex) wurden bei 53 Patienten mit nichtimmunogener Hyperthyreose vor und nach Radiojodtherapie (nRJT) mittels einer parametrischen Doppelisotopen-Schilddruesenszintigraphie (Als et al., Nucl. Med. 1995; 34) untersucht, und ergaben einen Zusammenbruch (Medianen) von Q: 4,3{yields}1,0 (toxische Adenome: TA), 2{yields}1,1 (multifokale funktionelle Autonomien: MFA) (p<0,0001) sowie von T: 96{yields}1,7 (TA), 15{yields}1,1 (MFA) (p<0,001). Fuenf funktionelle Muster wurden nRJT unterscheidbar: Euthyreose (n=37, 70%), zur Haelfte mit vernarbten/nichtvernarbten autonomen Arealen (respektive niedrige/hoehere T); primaere Hypothyreose (n=4), Rest-Hyperthyreose (n=7), sekundaere Hyperthyreose (n=5). Die beiden letzten Gruppen mit persistierend subnormalen TSH-Werten wurden eindeutig anhand divergierender T-, Trijodthyronin- und Thyroxin

  12. Subjective perception of radioactivity. No change post successful treatment with radioiodine

    International Nuclear Information System (INIS)

    We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35-79 years) were included in this study. All patients were interviewed prior to and 22-27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. The personal perception of radioactivity as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy. (orig.)

  13. Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, Steen J.; Nielsen, Viveque E.; Hegedues, Laszlo [Odense Univ. Hospital (Denmark). Dept. of Endocrinology and Metabolism

    2006-12-15

    There is no consensus regarding the optimum treatment of benign non-toxic goitre. L-thyroxine suppressive therapy is widely used, but there is poor evidence of its efficacy, and it may have serious adverse effects on health. Surgery is first choice in large goitres or if malignancy is suspected. {sup 131}I therapy results in a one-year goitre reduction of around 40% in multinodular goitres, usually with a high degree of patient satisfaction and improvement of the inspiratory capacity. The effect is attenuated with increasing goitre size. The risk of hypothyroidism is 22-58% within 5-8 years. A sufficient thyroid {sup 131}I uptake is mandatory for {sup 131}I therapy to be feasible and pre-stimulation with recombinant human TSH (rhTSH) increases this considerably. This leads to an increased absorbed thyroid dose by approx.75%, mainly in those patients with the lowest thyroid {sup 131}I uptake, and a more homogeneous intrathyroidal isotope distribution. Pre-stimulation with even a small dose of rhTSH seems to allow a reduction of the {sup 131}I activity while still achieving a mean goitre reduction of approximately 40% within a year. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged {sup 131}I activity, rhTSH pre-stimulation improves the goitre reduction by 30-50%. However, this is at the expense of a higher rate of hypothyroidism, cervical pain and transient thyrotoxicosis. Of particular concern is the observation made in healthy persons, that rhTSH results in a transient average thyroid volume increase of 35%. A similar goitre swelling may cause problems in susceptible patients during rhTSH-augmented {sup 131}I therapy. Thus, this concept still needs a closer evaluation before routine use.

  14. A retrospective study of predictive factors for effective aripiprazole augmentation of antidepressant therapy in treatment-resistant depression

    Directory of Open Access Journals (Sweden)

    Sugawara H

    2016-05-01

    Full Text Available Hiroko Sugawara,1,2 Kaoru Sakamoto,1 Tsuyoto Harada,3 Satoru Shimizu,4 Jun Ishigooka1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Support Center for Women Health Care Professionals and Researchers, Tokyo Women’s Medical University, Shinjuku-ku, 3Department of Psychiatry, Tokyo Women’s Medical University Medical Center East, Arakawa-ku, 4Department of Research, Medical Research Institute, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan Background: Several studies have evaluated the efficacy and tolerability of aripiprazole for augmentation of antidepressant therapy for treatment-resistant depression (TRD. Here, we investigated the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and bipolar disorder and the clinical predictors of treatment efficacy in a Japanese population.  Methods: Eighty-five depressed Japanese patients who underwent aripiprazole augmentation therapy after failing to respond satisfactorily to antidepressant monotherapy were included in the study. Treatment responses were evaluated based on Clinical Global Impression Improvement scores assessed 8 weeks after initiation of aripiprazole administration. We compared demographic and diagnostic variables, psychiatric medication variables, and clinical variables between remission and nonremission groups.  Results: The aripiprazole augmentation remission rate was 36.5%. Multiple logistic regression analysis indicated that aripiprazole augmentation was significantly more effective for bipolar depression than for major depressive disorder, and both absence of comorbid anxiety disorders and current episode duration >3 months were significantly associated with the efficacy of aripiprazole augmentation.  Conclusion: Polarity of depression, comorbidity of anxiety disorders, and current episode duration may predict the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and

  15. Augmented exercise biking with virtual environments for elderly users:A preliminary study for retirement home physical therapy

    OpenAIRE

    Bruun-Pedersen, Jon Ram; Pedersen, Kasper Søndergaard; Serafin, Stefania; Kofoed, Lise B.

    2014-01-01

    Virtual reality (VR) has been shown to function well as an assistive technology to physical therapy for elderly users. Elderly users are a unique user group in this field, due to their characteristics and demands. They are also a user group that can definitely benefit from VR technology, which is unfortunately a perspective that seems elude the VR community. This study explores how augmenting a manuped exercise (chair-based exercise bike), using an interactive screen-based virtual environment...

  16. Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study

    OpenAIRE

    Denton, Wayne H.; Wittenborn, Andrea K; Golden, Robert N.

    2012-01-01

    This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to six months of medication management alone (MM) or medication management augmented with EFT (MM+EFT). Medication management followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were...

  17. Alpha-1-antitrypsin augmentation therapy in deficient individuals enrolled in the Alpha-1 Foundation DNA and Tissue Bank

    OpenAIRE

    Tonelli, Adriano

    2009-01-01

    Adriano R Tonelli1, Farshid Rouhani1, Ning Li2, Pam Schreck1, Mark L Brantly11Alpha-1 Research Program, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, 2Department of Epidemiology and Biostatistics, University of Florida, Gainesville, Florida, USAIntroduction: Intravenous augmentation therapy with purified intravenous alpha-1 antitrypsin replaces the deficient protein and is the only currently approved treatment for alpha-1 antitrypsin deficiency (AAT...

  18. Investigation of early DNA damage after radioiodine therapy in patients with thyroid cancer using the gamma-H2AX focus assay

    International Nuclear Information System (INIS)

    Full text of publication follows. Objectives: the Aim of the study is to investigate the DNA damage formation in blood lymphocytes and the correlation to the absorbed dose to the blood in patients with differentiated thyroid carcinoma (DTC) after their first radionuclide therapy with I-131 as measured by the induction, persistence and decay behaviour of γ-H2AX and 53BP1 DNA damage-induced foci. Radiation-induced DNA double strand breaks (DSBs) cause in their vicinity the formation of microscopically visible foci of the phospho-histone H2AX (γ-H2AX) and the 53BP1 protein that binds to and signals damaged chromatin at the DSB site. Nuclear foci containing both markers thus represent radiation-induced DSBs. Methods: we investigated 19 patients with DTC during the first treatment with 3.5±0.3 GBq I-131. Between 7 and 10 sequential peripheral blood samples (at least four within the first 5 hours) were taken before and between 0.5 h and 144 h post administration. The physical dosimetry procedures were performed according to the EANM DTC SOP. White blood cells were recovered by density centrifugation in CPT tubes (BD Biosciences) and subjected to two-colour immunofluorescence staining. The average frequencies of the radiation-induced γ-H2AX foci/nucleus that co localized with 53BP1 foci were derived from immuno-stained mononuclear peripheral blood lymphocyte samples. The number of foci was counted manually using a red/green double band pass filter (Chroma) in a Zeiss microscope by an experienced observer. Results: The mean I-131 absorbed dose to the blood was (0.04±0.01) Gy at t=2 h, (0.07±0.02) Gy at t=4 h, and (0.21±0.05) Gy at t=24 h, respectively. The mean value of the total absorbed dose to the blood was (0.36±0.08) Gy. The highest number of radiation-induced foci per nucleus (RIF) and per absorbed dose (median: 8.8 RIF/Gy, range 3.1-10.9 RIF/Gy) was observed in the first three hours post administration. Four hours after radioiodine administration the number

  19. Radioiodine treatment of feline hyperthyroidism in Germany

    International Nuclear Information System (INIS)

    Aim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with 131I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German ''Strahlenschutzverordnung''. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT3 and FT4 were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 ± 10%, effective halflife 2.5 ± 0.7 days. Whole body activity 131I. Radiation exposure of cat owners was estimated as 1.97 μSv/MBq for adults. Conclusion: Radioiodine therapy of feline hyperthyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are highly desirable. (orig.)

  20. Unbounded 131I elimination by means of hemodialysis after papillary thyroid cancer radioiodine therapy in patients with terminal renal failure: 3 case reports

    International Nuclear Information System (INIS)

    Full text of publication follows. Background and objectives: after its administration for therapeutic purposes, unbounded and circulating 131I should be eliminated from the body, as it can cause adverse effects to non-thyroid/tumor tissue. If a patient is anuric or severely oliguric, the only way for unbound radioiodine to get eliminated is via hemodialysis. However, the effectiveness of this process is questionable, and furthermore, the patient is not allowed to leave the controlled radiation zone until the radioactivity in their body drops below 400 MBq. Methods: 3 patients (two males and one female, 35, 53 and 66 years of age) with terminal renal failure accompanied by anuria/severe oliguria, who had previously undergone papillary thyroid cancer surgery (pT1NxMx/CSI), received therapeutic doses of 1915, 1880 and 1850 MBq of 131I, respectively. Prior to this, the patients had received chronic hemodialysis (4 hours every other day) over a 6-month period. Twenty-four hours after the oral administration of radioiodine, each patient was hemo-dialysed in the controlled zone (veno-venous hemo-dia-filtration for 4 hours, via MultiFILTRATE device, Fresenius Medical Care). Upon the completion of dialysis, venous blood was sampled from the patients every hour for 4 hours. Moreover, the dialysis effluent was collected hourly, its value was measured and it was sampled. The radioactivity of blood and dialysis effluent samples was measured by means of gamma-counter using peak of 131I energy. Results: the total radioactivity measured in the dialysis effluent after 4 hours amounted to 31.61% of the administered dose. Within the first hour following the dialysis, the radioactivity decreased by 8.31%, whereas after the 2., 3. and 4. hour it decreased by 7.23%, 7.77% and 8.30%, respectively. In other words, one hour after the dialysis the radioactivity of blood samples was 91.33% of the pre-dialysis value. After 2, 3 and 4 hours it was 83.34%, 75.23% and 69.88 % respectively

  1. The BLT1 Inhibitory Function of α-1 Antitrypsin Augmentation Therapy Disrupts Leukotriene B4 Neutrophil Signaling.

    Science.gov (United States)

    O'Dwyer, Ciara A; O'Brien, M Emmet; Wormald, Mark R; White, Michelle M; Banville, Nessa; Hurley, Killian; McCarthy, Cormac; McElvaney, Noel G; Reeves, Emer P

    2015-10-15

    Leukotriene B4 (LTB4) contributes to many inflammatory diseases, including genetic and nongenetic forms of chronic obstructive pulmonary disease. α-1 Antitrypsin (AAT) deficiency (AATD) is characterized by destruction of lung parenchyma and development of emphysema, caused by low AAT levels and a high neutrophil burden in the airways of affected individuals. In this study we assessed whether AATD is an LTB4-related disease and investigated the ability of serum AAT to control LTB4 signaling in neutrophils. In vitro studies demonstrate that neutrophil elastase is a key player in the LTB4 inflammatory cycle in AATD, causing increased LTB4 production, and associated BLT1 membrane receptor expression. AATD patients homozygous for the Z allele were characterized by increased neutrophil adhesion and degranulation responses to LTB4. We demonstrate that AAT can bind LTB4 and that AAT/LTB4 complex formation modulates BLT1 engagement and downstream signaling events, including 1,4,5-triphosphate production and Ca(2+) flux. Additionally, treatment of ZZ-AATD individuals with AAT augmentation therapy decreased plasma LTB4 concentrations and reduced levels of membrane-bound neutrophil elastase. Collectively, these results provide a mechanism by which AAT augmentation therapy impacts on LTB4 signaling in vivo, and not only reinforces the utility of this therapy for resolving inflammation in AATD, but supports useful future clinical applications in treatment of other LTB4-related diseases. PMID:26371243

  2. Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

    OpenAIRE

    Ash Gargya; Elizabeth Chua

    2012-01-01

    Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions. Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an und...

  3. Efeitos da radioiodoterapia nas gerações futuras de mulheres com carcinoma diferenciado de tireóide Radioiodine therapy effects on offspring of patients with differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Carmen Dolores Gonçalves Brandão

    2004-02-01

    Full Text Available A radioiodoterapia tem conseguido desempenhar um papel significante no tratamento do carcinoma diferenciado de tireóide. A literatura é limitada em relação a possíveis efeitos secundários do 131I, embora o interesse tenha aumentado nesse campo. A importância de se saber mais sobre os efeitos mutagênicos da radiação em filhos de mães expostas ao 131I para tratamento do carcinoma diferenciado de tireóide é devida à possibilidade de ocorrência de abortos, anormalidades genéticas e aparecimento de malignidades nas crianças. Nesta revisão da literatura vários estudos têm demonstrado a segurança desse tipo de tratamento em mulheres na idade fértil, sendo apenas aconselhadas a evitar gravidez pelo período de, pelo menos, um ano após a administração da radioiodoterapia.Radioiodine therapy has attained a significant role in the treatment of differentiated thyroid cancer. The literature addressing possible secondary effects of 131I is limited, although there has been increasingly interest in this field. A more comprehensive understanding of the mutagenic effects of radiation on the offspring of women exposed to 131I is mandatory in view of the possibility of occurrence of miscarriages, congenital abnormalities and malignancies in these children. In this review, we found that many reports on safety of this type of treatment in female patients in reproductive age recommend that pregnancy should be avoided for at least one year after therapeutic administration of radioiodine.

  4. E-selectin, L-selectin, ICAM-1 and IL-6 concentrations changes in the serum of patients with hyperthyroidism in the early period of radioiodine I-131 therapy

    International Nuclear Information System (INIS)

    Among cytokines- interleukins: -6 and -8 (IL-6, IL-8) and E-selectin (E-sel.), L-selectin (L-sel.) and intercellular cell adhesion molecule-1 (ICAM-1) are the most important links in the initiation of the inflammatory process. Taking into account that the inflammatory process is the basic stage of effective radioiodine therapy, we tried to compare the behaviour of the initial inflammatory factors in the early period of I-131 therapy (RAI) of hyperthyroidism. The aim of the study was to estimate the behaviour of IL-6, ICAM-1, E-selectin and L-selectin concentrations in the serum of patients with hyperthyroidism before and during I-131 therapy. The groups of 26 patients with Graves' disease (GD) and 18 patients with toxic nodular goiter (TNG), aged 34-77, were studied. Control group (C) consisted of 10 healthy volunteers. For estimation of thyroid function serum concentrations of TSH, free T4 and free T3 were measured by IRMA or RIA kits (Polatom, Poland). IL-6, ICAM-1, E-selectin and L-selectin serum concentrations were determined using ELISA method by Bender kits (USA). Blood samples for all estimations were taken 10-12 days before and in 6th week after I-131 administration. Treatment dose of radioiodine was calculated, basing on modified equation for absorbed dose compared to. control, no statistical differences in the levels of E-selectin (C - 44.4 ± 11 ng/ml) and L-selectin (C - 842 ± 168.9 ng/ml) were observed before treatment in the patients with GD (E-sel. - 59.8 ± 19.6 ng/ml; L-sel. - 1288.2 ± 273.5 ng/ml) and with TNG (E-sel. - 61.5 ± 18.4 ng/ml, L-sel. - 1247.0 ± 273.5 ng/ml) as well as in the 6th week after I-131 administration; values in GD group were: E-sel. - 57.3 ± 19.5 ng/ml, L-sel. - 1142.4 ± 193.4 ng/ml; in TNG group: E-sel. - 62.1 ± 20.6 ng/ml, L-sel. - 1113.5 ± 236.3 ng/ml. In comparison to control there was no difference in initial IL-6 levels either in GD or in TNG group, but a statistically important decrease was observed in the 6th

  5. Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-131 therapy for differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    This study was performed to clarify factors that might influence short-term side effects occurring within 96 hours after administration of 131I for patients with thyroid carcinoma. In 71 patients with differentiated thyroid carcinoma, short-term side effects including gastrointestinal complaints, salivary gland swelling with pain, change in taste and headache were retrospectively analyzed. All patients were given domperidone for prevention of gastrointestinal complaints and advised to consume sour foods to promote discharge of radioiodine from the salivary glands. Selected factors possibly affecting the incidence of side effects were dose per body weight, thyroid stimulating hormone (TSH), effective half-life of 131I, sex, age, 131I accumulation into the stomach and salivary glands, and edema prior to radioiodine administration. The factors were evaluated by multivariate analyses. Incidence of gastrointestinal complaints, salivary gland swelling with pain, change in taste and headache was 65.2%, 50.0%, 9.8% and 4.4%, respectively. In gastrointestinal complaints, the incidence of appetite loss, nausea and vomiting was 60.9%, 40.2% and 7.6%, respectively. The gastrointestinal complaints increased significantly in the patients dosed above 55.5 MBq/kg and with TSH elevation. For salivary gland swelling with pain, female patients displayed a significantly higher incidence than males. No statistically significant factors were detected for change in taste or headache. Significant factors influencing short-term side effects were dose per body weight and TSH values for gastrointestinal complaints, and female sex for salivary gland swelling with pain. Our preliminary experience suggests that the most frequent gastrointestinal complaints can be prevented with ramosetron. (author)

  6. CpG Oligodeoxynucleotides Enhance the Activities of CD8+Cytotoxic T-Lymphocytes Generated by Combined hMUC1 Vaccination and hNIS Radioiodine Gene Therapy

    International Nuclear Information System (INIS)

    The authors evaluated whether the cytotoxicity of CD8+CTLs generated by combined hMUC1 vaccination and hNIS radioiodine gene therapy was enhanced in the presence of CpG in an established tumor model. CMNF cells (CT26 cells expressing hMUC1, hNIS and Firefly luciferase) were transplanted into BALB/c mice. Four and 10 days later, tumor-bearing mice were immunized intramuscularly with pcDNA3.1 or pcDNA-hMUC1 or pcDNA-hMUC1+CpG, and subsequently administered PBS or 131I [five groups (seven mice/group): referred to as the pcDNA3.1+PBS, phMUC1+PBS, pcDNA3.1+131I, phMUC1+131I, and phMUC1+131I+CpG groups]. The number of CD8+IFNr+ T cells of splenocytes as well as the number of CD8+IFNr+ T cells of splenocytes re-stimulated with CD11c+ cells was determined using FACS analysis. The activities of cytotoxic T cells (CTLs) from splenocytes were investigated. Marked tumor growth inhibition was observed in the phMUC1+131I and phMUC1+131I+CpG groups, but not in the other three single therapy groups. Particularly the number of CD8+IFN-γ+ T cells of splenocytes was more increased in the phMUC1+131I+CpG group than in the phMUC1+131I group. The number of CD8+IFN-γ+ T cells of splenocytes stimulated with CD11c+ cells was the most enhanced in the phMUC1+131I+CpG group among the five groups. Concurrently, the activities of hMUC1-associated CTLs obtained from splenocytes in the phMUC1+131I+CpG group were significantly greater than in the other four groups(pcDNA+PBS, phMUC1+PBS, pcDNA+131I, phMUC1+131I, and phMUC1+131I+CpG, 16±2%, 20±1%, 30±2%, 60±2%, and 87±2%, respectively, P<0.01). Our data suggest that adjuvant CpG ODNs can increase the killing activities of CTLs generated by combined hMUC1 DNA vaccination and hNIS radioiodine gene therapy.

  7. CpG Oligodeoxynucleotides Enhance the Activities of CD8+Cytotoxic T-Lymphocytes Generated by Combined hMUC1 Vaccination and hNIS Radioiodine Gene Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Yong Hyun; Choi, Yun; Kim, Chul Woo; Chung, June Key [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Jaetae [Kyungpook National University, Daegu (Korea, Republic of)

    2010-09-15

    The authors evaluated whether the cytotoxicity of CD8+CTLs generated by combined hMUC1 vaccination and hNIS radioiodine gene therapy was enhanced in the presence of CpG in an established tumor model. CMNF cells (CT26 cells expressing hMUC1, hNIS and Firefly luciferase) were transplanted into BALB/c mice. Four and 10 days later, tumor-bearing mice were immunized intramuscularly with pcDNA3.1 or pcDNA-hMUC1 or pcDNA-hMUC1+CpG, and subsequently administered PBS or {sup 131}I [five groups (seven mice/group): referred to as the pcDNA3.1+PBS, phMUC1+PBS, pcDNA3.1+{sup 131}I, phMUC1+{sup 131}I, and phMUC1+{sup 131}I+CpG groups]. The number of CD8+IFNr+ T cells of splenocytes as well as the number of CD8+IFNr+ T cells of splenocytes re-stimulated with CD11c+ cells was determined using FACS analysis. The activities of cytotoxic T cells (CTLs) from splenocytes were investigated. Marked tumor growth inhibition was observed in the phMUC1+{sup 131}I and phMUC1+{sup 131}I+CpG groups, but not in the other three single therapy groups. Particularly the number of CD8+IFN-{gamma}+ T cells of splenocytes was more increased in the phMUC1+{sup 131}I+CpG group than in the phMUC1+{sup 131}I group. The number of CD8+IFN-{gamma}+ T cells of splenocytes stimulated with CD11c+ cells was the most enhanced in the phMUC1+{sup 131}I+CpG group among the five groups. Concurrently, the activities of hMUC1-associated CTLs obtained from splenocytes in the phMUC1+{sup 131}I+CpG group were significantly greater than in the other four groups(pcDNA+PBS, phMUC1+PBS, pcDNA+{sup 131}I, phMUC1+{sup 131}I, and phMUC1+{sup 131}I+CpG, 16{+-}2%, 20{+-}1%, 30{+-}2%, 60{+-}2%, and 87{+-}2%, respectively, P<0.01). Our data suggest that adjuvant CpG ODNs can increase the killing activities of CTLs generated by combined hMUC1 DNA vaccination and hNIS radioiodine gene therapy.

  8. Experimental Transport Benchmarks for Physical Dosimetry to Support Development of Fast-Neutron Therapy with Neutron Capture Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    D. W. Nigg; J. K. Hartwell; J. R. Venhuizen; C. A. Wemple; R. Risler; G. E. Laramore; W. Sauerwein; G. Hudepohl; A. Lennox

    2006-06-01

    The Idaho National Laboratory (INL), the University of Washington (UW) Neutron Therapy Center, the University of Essen (Germany) Neutron Therapy Clinic, and the Northern Illinois University(NIU) Institute for Neutron Therapy at Fermilab have been collaborating in the development of fast-neutron therapy (FNT) with concurrent neutron capture (NCT) augmentation [1,2]. As part of this effort, we have conducted measurements to produce suitable benchmark data as an aid in validation of advanced three-dimensional treatment planning methodologies required for successful administration of FNT/NCT. Free-beam spectral measurements as well as phantom measurements with Lucite{trademark} cylinders using thermal, resonance, and threshold activation foil techniques have now been completed at all three clinical accelerator facilities. The same protocol was used for all measurements to facilitate intercomparison of data. The results will be useful for further detailed characterization of the neutron beams of interest as well as for validation of various charged particle and neutron transport codes and methodologies for FNT/NCT computational dosimetry, such as MCNP [3], LAHET [4], and MINERVA [5].

  9. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Chen PH

    2015-02-01

    Full Text Available Pao-Huan Chen, Yu-Jui Huang Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan Abstract: The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age of 31 years during lithium therapy. After levothyroxine augmentation therapy was introduced, the patient had remission from the rapid cycling illness course along with normalization of serum levels of free T4 and thyroid stimulating hormone in the subsequent year. This observation suggested that investigation of both levothyroxine pharmacology and thyroid pathology in male patients with rapid cycling bipolar disorder might be of much value. Keywords: mood disorder, therapy, thyroid hormone

  10. Radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Hyperthyroidism is a clinical symptom complex caused by elevated thyroid hormone levels. Of the disorders in which it appears, the most common is Graves' disease; toxic nodular goiter (Plummer's disease) is considerably less frequent. Recent studies suggest that Graves' disease is autoimmune in origin and is probably caused by a genetic defect in immunoserveillance in which thyroid-stimulating antibodies interact with thyroid-stimulating hormone (TSH) receptor sites on thyroid follicular cell membranes to increase synthesis and secretion of thyroid hormones. Toxic nodular goiter is characterized by the secretion of increased amounts of thyroid hormone by localized autonomous areas of increased function within the thyroid gland. Other forms of hyperthyroidism are discussed. Radioiodine treatment of hyperthyroidism is described

  11. The combination of ANT2 shRNA and hNIS radioiodine gene therapy increases CTL cytotoxic activity through the phenotypic modulation of cancer cells: combination treatment with ANT2 shRNA and I-131

    International Nuclear Information System (INIS)

    It is important to simultaneously induce strong cell death and antitumor immunity in cancer patients for successful cancer treatment. Here, we investigated the cytotoxic and phenotypic modulation effects of the combination of ANT2 shRNA and human sodium iodide symporter (hNIS) radioiodine gene therapy in vitro and in vivo and visualized the antitumor effects in an immunocompromised mouse colon cancer model. A mouse colon cancer cell line co-expressing hNIS and the luciferase gene (CT26/hNIS-Fluc, named CT26/NF) was established. CT26/NF cells and tumor-bearing mice were treated with HBSS, scramble, ANT2 shRNA, I-131, and ANT2 shRNA + I-131. The apoptotic rates (%) and MHC class I and Fas gene expression levels were determined in treated CT26/NF cells using flow cytometry. Concurrently, the level of caspase-3 activation was determined in treated cells in vitro. For in vivo therapy, tumor-bearing mice were treated with scramble, ANT2 shRNA, I-131, and the combination therapy, and the anti-tumor effects were monitored using bioluminescence. The killing activity of cytotoxic T cells (CTLs) was measured with a lactate dehydrogenase (LDH) assay. For the in vitro experiments, the combination of ANT2 shRNA and I-131 resulted in a higher apoptotic cell death rate compared with ANT2 shRNA or I-131 alone, and the levels of MHC class I and Fas-expressing cancer cells were highest in the cells receiving combination treatment, while single treatment modestly increased the level of MHC class I and Fas gene expression. The combination of ANT2 shRNA and I-131 resulted in a higher caspase-3 activation than single treatments. Interestingly, in vivo combination treatment led to increased gene expression of MHC class I and Fas than the respective mono-therapies; furthermore, bioluminescence showed increased antitumor effects after combination treatment than monotherapies. The LDH assay revealed that the CTL killing activity against CT26/NF cells was most effective after combination

  12. Aripiprazole as augmentation therapy in bipolar patients with current minor or subsyndromal mood symptoms

    OpenAIRE

    Schweitzer, Isaac; Sarris, Jerome; Tuckwell, Virginia; Maguire, Kay; Smith, Deidre; Ng, Chee

    2013-01-01

    Background This study aims to evaluate the effectiveness of aripiprazole augmentation of maintenance treatment for bipolar disorder in patients with minor or subsyndromal mood episodes while on a stable dose of a mood stabiliser and/or antidepressant. Methods All subjects had a diagnosis of bipolar I or II disorder (Diagnostic and Statistical Manual of Mental Disorders-4th Edition, Text Revision). Open-label aripiprazole was given over 8 weeks initially. The starting dose was 5 to 15 mg/day w...

  13. Dose timing of D-cycloserine to augment cognitive behavioral therapy for social anxiety: Study design and rationale.

    Science.gov (United States)

    Hofmann, Stefan G; Carpenter, Joseph K; Otto, Michael W; Rosenfield, David; Smits, Jasper A J; Pollack, Mark H

    2015-07-01

    The use of D-cycloserine (DCS) as a cognitive enhancer to augment exposure-based cognitive-behavioral therapy (CBT) represents a promising new translational research direction with the goal to accelerate and optimize treatment response for anxiety disorders. Some studies suggest that DCS may not only augment extinction learning but could also facilitate fear memory reconsolidation. Therefore, the effect of DCS may depend on fear levels reported at the end of exposure sessions. This paper presents the rationale and design for a randomized controlled trial examining the relative efficacy of tailoring DCS administration based on exposure success (i.e. end fear levels) during a 5-session group CBT protocol for social anxiety disorder (n = 156). Specifically, tailored post-session DCS administration will be compared against untailored post-session DCS, untailored pre-session DCS, and pill placebo in terms of reduction in social anxiety symptoms and responder status. In addition, a subset of participants (n = 96) will undergo a fear extinction retention experiment prior to the clinical trial in which they will be randomly assigned to receive either DCS or placebo prior to extinguishing a conditioned fear. The results from this experimental paradigm will clarify the mechanism of the effects of DCS on exposure procedures. This study aims to serve as the first step toward developing an algorithm for the personalized use of DCS during CBT for social anxiety disorder, with the ultimate goal of optimizing treatment outcome for anxiety disorders. PMID:26111923

  14. Kinetic behaviour of radioiodines accumulating in recurrent thyroid carcinomas and their metastases and the role of substituted thyroid hormones during radioiodine treatment

    International Nuclear Information System (INIS)

    The relationship between the kinetic behaviour of radioiodines accumulating in recurrent thyroid tumours or their metastases and the role of substituted thyroid hormones was examined in 2 groups of patients undergoing radioiodine treatment, one of which additionally received thyroid hormones, while no such treatment was carried out in the other one. Two computer-assisted, whole body scintiscan studies (days 2 and 4) were performed so as to permit quantitative evaluation of the region of interest. The effective half-lives derived from this this procedure were longer for the patients receiving no thyroid hormones, pointing to a more beneficial effect of radioiodine treatment in this group. This leads to the conclusion that in patients receiving radioiodine therapy in order to control the spread of thyroid carcinomas, thyroid hormones should not be substituted until the cessation of this treatment. (TRV)

  15. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?; Verbessert die individuelle Bestimmung der effektiven Halbwertszeit die Ergebnisse der Radioiodtherapie des Morbus Basedow?

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, P.; Koerber, C.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, Chr. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany)

    2002-12-01

    Aim: The impact of our dosimetry concept on radioiodine therapy success in Graves' disease (GD) was analysed. Three questions arised: Did individual estimation of pretherapeutic halflife improve therapeutic success? Did individual dosimetry result in accurate dose calculation? Did antithyroid medication have a measurable influence on therapeutic success under the prevailing conditions? Methods: 126 consecutive patients were treated with 200 Gy I-131 in our therapy ward for GD and followed-up six to nine months after therapy. Success quote was assessed using a standardized protocol and treatment was classified as successful when the patients was eu- or hypothyroid, or unsuccessful when he or she presented with a suppressed TSH-level or in hyperthyroid condition after antithyroid medication withdrawal. Antithyroid medication, activity I-131, dose, concentration of fT{sub 3} and fT{sub 4}, specific delivered dose and halflife were put into a multiple regression model to assess their influence on therapeutic success. In order to assess possible factors disturbing the therapeutic outcome, relevant parameters were analyzed using Logit transformation. Results: Out of 126 patients 84 were classified as successfully treated and 42 (33,3%) as failures. A significant influence on the outcome only was found for thyroid mass. However, therapeutic success appeared to be more distinctly determined by the specific delivered dose using an estimated halflife of 5.5 days (Odds: 10.0, p <0.001). Accurate intratherapeutic dosimetry did not play a significant role to enhance therapeutic success. Neither did antihyroid medication during radioiodine therapy exert any significant impact. Conclusions: Measurement of individual intratherapeutic halflife as opposed to an estimate using a standard halflife did not provide improved results concerning the target dose. Retrospectively, the therapeutic outcome on the basis of a measured halflife as compared to a standard halflife did not

  16. A method for retrospectively estimating the dose to the bone marrow after radioiodine therapy of children and young adolescents; Eine Methode zur retrospektiven Bestimmung der Knochenmarksdosis bei Radiotherapie von Kindern und Jugendlichen

    Energy Technology Data Exchange (ETDEWEB)

    Schelper, L.F.; Lassmann, M.; Haenscheid, H.; Biko, J.; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1998-12-31

    Aim of the study is the development of a simple method for the determination of the bone marrow dose to children after radioiodine therapy using only the whole body retention function as input. For nine juvenile patients we determined the specific activity of 4-5 blood samples after oral application of 2 to 6 GBq {sup 131}I and the whole body retention function. Assuming 70 ml blood per kilogram body mass the mean fraction f of blood activity to whole body activity was calculated (f=19{+-}6%). Knowing the fraction of blood activity compared to whole body activity for children allows easily the additional determination of the dose to the red bone marrow. (orig.) [Deutsch] Ziel der Studie ist es, ein einfaches Verfahren zu entwickeln, mit dem die Knochenmarksdosis nach Radioiodtherapie bei Kindern ohne Blutabnahmen ausschliesslich durch Messung der Ganzkoerperretention ermittelt werden kann. Dazu wurden bei neun jugendlichen Patienten innerhalb der ersten 90 Stunden nach oraler Verabreichung von 2 bis 6 GBq {sup 131}I 4-5 Blutproben entnommen und deren spezifische Aktivitaet sowie die {sup 131}I-Aktivitaet im Ganzkoerper gemessen. Unter der Annahme einer Blutmenge von 70 ml pro Kilogramm Koerpergewicht ergibt sich aus den Messdaten der mittlere Anteil f des Blutes an der Ganzkoerperaktivitaet zu f=19{+-}6%. Aus der Kenntnis des Blutanteils an der Ganzkoerperaktivitaet laesst sich die Dosis des roten Knochenmarks bestimmen. (orig.)

  17. Peptide receptor radionuclide therapy of treatment-refractory metastatic thyroid cancer using 90Yttrium and 177Lutetium labeled somatostatin analogs: toxicity, response and survival analysis

    OpenAIRE

    Budiawan, Hendra; Salavati, Ali; Kulkarni, Harshad R.; Baum, Richard P.

    2013-01-01

    The overall survival rate of non-radioiodine avid differentiated (follicular, papillary, medullary) thyroid carcinoma is significantly lower than for patients with iodine-avid lesions. The purpose of this study was to evaluate toxicity and efficacy (response and survival) of peptide receptor radionuclide therapy (PRRT) in non-radioiodine-avid or radioiodine therapy refractory thyroid cancer patients. Sixteen non-radioiodine-avid and/or radioiodine therapy refractory thyroid cancer patients, i...

  18. The use of virtual reality-based therapy to augment poststroke upper limb recovery

    Science.gov (United States)

    Samuel, Geoffrey S; Choo, Min; Chan, Wai Yin; Kok, Stanley; Ng, Yee Sien

    2015-01-01

    Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient’s disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts. PMID:26243983

  19. Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults

    OpenAIRE

    Canto, Abigail U.; Dominguez, Paulette N.; Jimeno, Cecilia A.; Obaldo, Jerry M.; Ogbac, Ruben V.

    2016-01-01

    Background Radioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease. Methods A hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those ra...

  20. Social Skills Training Augments the Effectiveness of Cognitive Behavioral Group Therapy for Social Anxiety Disorder

    Science.gov (United States)

    Herbert, James D.; Gaudiano, Brandon A.; Rheingold, Alyssa A.; Myers, Valerie H.; Dalrymple, Kristy; Nolan, Elizabeth M.

    2005-01-01

    Cognitive Behavioral Group Therapy (CBGT) is the most widely researched intervention program for social anxiety disorder (SAD, also known as social phobia), with a number of studies demonstrating its effectiveness. Another common treatment, social skills training (SST), has also been shown to be efficacious for SAD. The present study compared the…

  1. Electroporation: a novel approach to enhance the radioiodine uptake in a human thyroid cancer cell line

    International Nuclear Information System (INIS)

    Radioiodine has been the best choice of treatment for differentiated thyroid cancer. Loss of the ability to concentrate iodide makes thyroid cancer cells refractory to radioiodine therapy. Therefore, the methods that enhance the uptake of radioiodine may have significant therapeutic effect. Electroporation involves the application of short high-voltage electric pulses which transiently permeabilize the plasma membrane, allowing entry of the otherwise impermeable molecules. The aim of our study was to use electroporation for incorporating radioiodine into a non-iodine concentrating thyroid cell line. Cultured WRO thyroid cancer cells that do not incorporate iodine due to the lack of the specific transporter protein incorporated significant amounts of radioiodine after electroporation. The uptake of radioiodine by electroporation showed dependence on the electric field, external concentration of the iodine, time and the temperature of incubation. The incorporated radioiodine was retained over a period of 24 h. The retainability of the incorporated iodine may have a significant effect on the tumoricidal properties if validated in vivo

  2. Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.

    Science.gov (United States)

    Lorincz, B B; Lichtenberger, G; Bihari, A; Falvai, J

    2005-01-01

    Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven. PMID:14986020

  3. Can pill placebo augment cognitive-behavior therapy for panic disorder?

    OpenAIRE

    Churchill Rachel; Omori Ichiro M; Watanabe Norio; Furukawa Toshi A

    2007-01-01

    Abstract Background In a number of drug and psychotherapy comparative trials, psychotherapy-placebo combination has been assumed to represent psychotherapy. Whether psychotherapy plus pill placebo is the same as psychotherapy alone is an empirical question which however has to date never been examined systematically. Methods We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) that directly compared cognitive-behavior therapy (CBT) alone against CBT plus p...

  4. Substrate reduction augments the efficacy of enzyme therapy in a mouse model of Fabry disease.

    Directory of Open Access Journals (Sweden)

    John Marshall

    Full Text Available Fabry disease is an X-linked glycosphingolipid storage disorder caused by a deficiency in the activity of the lysosomal hydrolase α-galactosidase A (α-gal. This deficiency results in accumulation of the glycosphingolipid globotriaosylceramide (GL-3 in lysosomes. Endothelial cell storage of GL-3 frequently leads to kidney dysfunction, cardiac and cerebrovascular disease. The current treatment for Fabry disease is through infusions of recombinant α-gal (enzyme-replacement therapy; ERT. Although ERT can markedly reduce the lysosomal burden of GL-3 in endothelial cells, variability is seen in the clearance from several other cell types. This suggests that alternative and adjuvant therapies may be desirable. Use of glucosylceramide synthase inhibitors to abate the biosynthesis of glycosphingolipids (substrate reduction therapy, SRT has been shown to be effective at reducing substrate levels in the related glycosphingolipidosis, Gaucher disease. Here, we show that such an inhibitor (eliglustat tartrate, Genz-112638 was effective at lowering GL-3 accumulation in a mouse model of Fabry disease. Relative efficacy of SRT and ERT at reducing GL-3 levels in Fabry mouse tissues differed with SRT being more effective in the kidney, and ERT more efficacious in the heart and liver. Combination therapy with ERT and SRT provided the most complete clearance of GL-3 from all the tissues. Furthermore, treatment normalized urine volume and uromodulin levels and significantly delayed the loss of a nociceptive response. The differential efficacies of SRT and ERT in the different tissues indicate that the combination approach is both additive and complementary suggesting the possibility of an improved therapeutic paradigm in the management of Fabry disease.

  5. Approaches to augment CAR T-cell therapy by targeting the apoptotic machinery.

    Science.gov (United States)

    Karlsson, Hannah

    2016-04-15

    Chimaeric antigen receptor (CAR) T-cells have shown impressive results in patients with B-cell leukaemia. Yet, in patients with lymphoma durable responses are still rare and heavy preconditioning required. Apoptosis resistance is considered a hallmark of cancer, often conveyed by a halted apoptosis signalling. Tumours regularly skew the balance of the components of the apoptotic machinery either through up-regulating anti-apoptotic proteins or silencing pro-apoptotic ones. Malignant B-cells frequently up-regulate anti-apoptotic B-cell lymphoma 2 (Bcl-2) family proteins leading to therapy resistance. CAR T-cells kill tumour cells via apoptosis induction and their efficacy may be affected by the level of Bcl-2 family proteins. Hence, there is an interesting possibility to increase the effect of CAR T-cell therapy by combining it with apoptosis inhibitor blockade agents. Compounds that inhibit Bcl-2, B-cell lymphoma extra large (Bcl-xL) and Bcl-2-like protein 2 (Bcl-w), can restore execution of apoptosis in tumour cells or sensitize them to other apoptosis-dependent treatments. Hence, there is a great interest to combine such agents with CAR T-cell therapy to potentiate the effect of CAR T-cell killing. This review will focus on the potential of targeting the apoptotic machinery to sensitize tumour cells to CAR T-cell killing. PMID:27068942

  6. Efficacy of 131I SPECT/CT in the initial nodal staging in patients with differentiated thyroid carcinoma at the first ablative radioiodine therapy

    International Nuclear Information System (INIS)

    Full text of publication follows. Background: after the first radioiodine ablative dose, planar Whole-Body Scanning (WBS) offers the possibility for detecting thyroid remnant, loco-regional node involvement and distant metastases. Nevertheless, available anatomic information is scarce and the high activity of thyroid remnants can interfere with the detection of cervical lymphatic nodes. Objective: to determine the additional value of the SPECT-CT over planar WBS, performed seven days after ablative treatment with 131I, in patients who were operated on for Differentiated Thyroid Cancer (DTC). Methods: from January 2009 to December 2012, 132 patients with DTC were admitted for radio-ablation with 131I after thyroidectomy. All of them underwent WBS seven days after ablation, and 91 had an additional SPECT-CT, 71 women and 20 men, with ages ranged from 15 to 89 years (mean, age 54 years). All patients had histological confirmed DTC (73 papillary, 17 follicular -2 cases with double tumour, papillary and follicular-, and 1 insular type). In addition to the thyroidectomy, lymph node dissection was performed in 54 patients (59%): 20 patients were classified as N0 and 29 as N1. The remaining 42 patients were classified as Nx. Planar and tomographic images were independently evaluated by two experienced nuclear medicine physicians. Results: 195 cervical focal uptake were observed in the 91 planar WBSs. No additional foci were observed in SPECT-CT. Findings: Planar WBS........... SPECT-CT........... Number of Foci Thyroid remnant...... Thyroid remnant..........51........... LNM...........0 Indeterminate.......... Thyroid remnant..........84............. LNM............5 LNM............ Thyroid remnant.........12............ Indeterminate.............0............ LNM..........43. Total Number of Foci............. 195. Compared to the nodal staging prior to ablation based on the histopathological diagnosis, we had an upstaging from N0 to N1 in 4 of 20 patients and from Nx to N

  7. Radioiodine removal in nuclear facilities

    International Nuclear Information System (INIS)

    Technical means are reviewed available for the retention of radioiodine in nuclear power plants and fuel reprocessing plants, its immobilization, storage, and disposal. The removal of iodine species from gaseous effluents of nuclear power plants using impregnated activated charcoal is dealt with. Various scrubbing techniques for trapping iodine from the head-end and dissolver off-gases are discussed as well as solid adsorbents for iodine which may be used to clean up other gaseous streams. Current practices and activities for radioiodine treatment and management in Belgian, Dutch, Swedish, USSR and UK nuclear installations are presented

  8. Radioiodine in the environment

    International Nuclear Information System (INIS)

    An experimental procedure was developed in order to follow the pathways of radioiodine, 129I especially, through the various compartments of nuclear plant environment: atmosphere, soil, plants, precipitations, ... A partial evaluation of the results is made. Data are supplied on iodine transfer into soil, iodine distribution one year later, release of iodine at the level of soil and plants. The intake of various forms of iodine in a soil and the evaluation of availability to plants by chemical tests showed that radioactive iodine (125I) reached equilibrium with stable iodine after 120 - 140 days of incubation. During this time, there was a large amount of iodine exchangeable against a KI solution N/10. Equilibrium was reached progressively by iodine transfer on soil organic molecules. According to the origin of contamination, the transfer was more or less fast and differences were especially noticed in volatile iodine release and on chemical mobility. During intake, potential hazard of soil, groundwater, plant and atmospheric contaminations was greater. Iodine-129 is presently one of the chief contributors to air pollution around nuclear installations because of its radioactive half-life (1.72 x 107 yr) rather than on account of the amounts released. Just as with iodine-131, it is released into the atmosphere under many chemical forms. However, 129I reaches man through several food chains and not only through the air-grass-cow-milk food chain. The values of its deposition rate on soil and plants are fairly dispersed because of its changing reactivity due to its chemical instability. On account of this chemical complexity, the transfer of iodine along the air-soil-plant system was studied using 125I. (author)

  9. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  10. Thyrotropin receptor antibody activities significantly correlate with the outcome of radioiodine ( sup 131 I) therapy for hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Kaise, Kazuro; Kaise, Nobuko; Yoshida, Katsumi; Fukazawa, Hiroshi; Mori, Koki; Yamamoto, Makiko; Sakurada, Toshiro; Saito, Shintaro; Yoshinaga, Kaoru (Tohoku Univ., Sendai (Japan). School of Medicine)

    1991-08-01

    The outcome of {sup 131}I therapy for 109 patients with Graves' disease was analysed according to pretreatment laboratory data including thyrotropin receptor antibody (TRAb) activities. Forty-five percent of patients became euthyroid, and 13% of patients became hypothyroid within one year after {sup 131}I therapy. Forty-two percent of patients remained hyperthyroid one year after {sup 131}I therapy. Pretreatment values for serum T{sub 4}, T{sub 3}, and the estimated weight of the thyroid were significantly higher in the hyperthyroid group. The mean for the TRAb index of the hyperthyroid group was significantly higher than that of the euthyroid group. Life table analysis revealed a significant effect of the TRAb index on the rate of hyperthyroidism after 3 months or later. These results appear to suggest that the TRAb index is one of the factors which influence the outcome of {sup 131}I therapy for Graves' disease. (author).

  11. Negative correlation between therapeutic success in radioiodine therapy and TcTUs: are TcTUs-adapted dose concepts the only possible answer?

    Energy Technology Data Exchange (ETDEWEB)

    Gotthardt, Martin; Nowack, Miriam; Behe, Martin P.; Schipper, Meike L.; Schlieck, Anja; Hoeffken, Helmut; Behr, Thomas M. [Department of Nuclear Medicine, Philipps-University of Marburg, 35043, Marburg (Germany)

    2003-08-01

    Calculation of iodine-131 activities for radioiodine treatment (RIT) in patients with disseminated thyroid autonomy may be difficult because of uncertainties in the determination of the autonomous volume (vol{sub aut}). The algorithm established by Emrich is used for calculation of the vol{sub aut} based on the TcTUs (technetium thyroid uptake under TSH suppression) (vol{sub aut}= 5 x TcTUs+0.6). Clinical experience using this approach has shown that there is a negative correlation between increasing TcTUs and the results of RIT. Our aim was to identify the reasons for this observation as well as to assess the relation between TcTUs and sonographic vol{sub aut}. Furthermore, we intended to find an alternative algorithm for the TcTUs-based calculation of the vol{sub aut}. Data from 100 patients with unifocal autonomy who met strict inclusion criteria were used to evaluate the correlation between TcTUs and sonographic vol{sub aut}. Using Marinelli's algorithm, we calculated the therapeutic activities for a standardised patient at a target dose of 300 Gy. The vol{sub aut} was determined based on the TcTUs using the four published algorithms [Emrich 1993 (vol{sub aut}= 5 x TcTUs+0.6), Kreisig 1992 (vol{sub aut}=10 x TcTUs-9.3), Joseph 1977 (vol{sub aut}=8.33 x TcTUs-6.67) and 1994 (vol{sub aut}=2.88 x TcTUs+0.09)]. We then compared the results of the calculation of therapeutic activities obtained using Emrich's algorithm (with known success rates) with those obtained by the other algorithms in order to determine which algorithm would lead to better results in RIT. Only a weak correlation was found between the TcTUs and the sonographic vol{sub aut} (r{sup 2}=0.39). The calculated therapeutic activities of {sup 131}I were similar for all algorithms at a TcTUs of around 2% but Joseph's (1977) and Kreisig's (1992) algorithms resulted in clearly higher activities than Emrich's algorithm at a TcTUs above 2%. The need for target doses to increase with

  12. Augmented Feedback System to Support Physical Therapy of Non-specific Low Back Pain

    Science.gov (United States)

    Brodbeck, Dominique; Degen, Markus; Stanimirov, Michael; Kool, Jan; Scheermesser, Mandy; Oesch, Peter; Neuhaus, Cornelia

    Low back pain is an important problem in industrialized countries. Two key factors limit the effectiveness of physiotherapy: low compliance of patients with repetitive movement exercises, and inadequate awareness of patients of their own posture. The Backtrainer system addresses these problems by real-time monitoring of the spine position, by providing a framework for most common physiotherapy exercises for the low back, and by providing feedback to patients in a motivating way. A minimal sensor configuration was identified as two inertial sensors that measure the orientation of the lower back at two points with three degrees of freedom. The software was designed as a flexible platform to experiment with different hardware, and with various feedback modalities. Basic exercises for two types of movements are provided: mobilizing and stabilizing. We developed visual feedback - abstract as well as in the form of a virtual reality game - and complemented the on-screen graphics with an ambient feedback device. The system was evaluated during five weeks in a rehabilitation clinic with 26 patients and 15 physiotherapists. Subjective satisfaction of subjects was good, and we interpret the results as encouraging indication for the adoption of such a therapy support system by both patients and therapists.

  13. Can pill placebo augment cognitive-behavior therapy for panic disorder?

    Directory of Open Access Journals (Sweden)

    Churchill Rachel

    2007-12-01

    Full Text Available Abstract Background In a number of drug and psychotherapy comparative trials, psychotherapy-placebo combination has been assumed to represent psychotherapy. Whether psychotherapy plus pill placebo is the same as psychotherapy alone is an empirical question which however has to date never been examined systematically. Methods We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs that directly compared cognitive-behavior therapy (CBT alone against CBT plus pill placebo in the treatment of panic disorder. Results Extensive literature search was able to identify three relevant RCTs. At the end of the acute phase treatment, patients who received CBT plus placebo had 26% (95%CI: 2 to 55% increased chances of responding than those who received CBT alone. At follow-up the difference was no longer statistically significant (22%, 95%CI: -10% to 64%. Conclusion The act of taking a pill placebo may enhance the placebo effect already contained in the effective psychotherapeutic intervention during the acute phase treatment. Theoretically this is an argument against the recently claimed null hypothesis of placebo effect in general and clinically it may point to some further room for enhancing the psychotherapeutic approach for panic disorder.

  14. Microsponge based drug delivery system for augmented gastroparesis therapy: Formulation development and evaluation

    Directory of Open Access Journals (Sweden)

    Riyaz Ali M. Osmani

    2015-10-01

    Full Text Available The intention behind the present work was to develop a microsponge based novel dosage form for sustained delivery of domperidone. Quasi-emulsion solvent diffusion method was employed using Eudragit RS-100 with various drug–polymer ratios for the preparation of microsponges. For optimization purposes, several factors which affect microparticles' physical properties were investigated. Characterization techniques followed for the formed microsponges were DSC, FTIR, SEM, XRD and particle size analysis, along with morphology, drug loading and in vitro drug release. It was found that there were no chemical interactions between drugs and polymers used as per DSC and FTIR results. The drug–polymer ratio showed remarkable impact on drug content, encapsulation efficiency and particle size. SEM micrographs revealed that microsponges were spherical in shape with porous surface, and had 104 ± 0.22 µm mean particle size. The microsponges were then loaded in capsules followed by in vitro drug release study; which depicted that microsponges with drug–polymer ratio of 1:2 were more proficient to give extended drug release of 76.38% at the end of 8 h, superior in contrast to conventional marketed formulation Domstal®, which got exhausted incredibly earlier by releasing 82.57% drug at the end of ½ h only. Hence, the developed microsponge based formulation of domperidone would be an expectant, promising substitute to conventional therapy of gastroparesis, emesis and alike gastric ailments.

  15. Nicotinamide augments the survival and incidence of apoptosis in glioma cells following photodynamic therapy in vitro

    Science.gov (United States)

    Bisland, Stuart K.; Modi, Nayan; Wilson, Brian C.

    2004-10-01

    The ability to customize photodynamic therapy (PDT) parameters with regards to timing and dosing of administered drug and light can be beneficial in determining target specificity and mode of cell death. Sustained, low level PDT or metronomic PDT (mPDT) may afford enhanced apoptotic cell death. This is of particular importance when considering PDT for the treatment of brain tumors as unlike apoptosis, necrotic cell death often leads to inflammation with increased intracranial pressure. The ability, therefore, to 'fine tune' PDT in favour of apoptosis is paramount. We have studied both acute (one time treatment) PDT (aPDT) and mPDT delivery strategies in combination with nicotinamide (NA) in an attempt to maximize the number of tumor cells dieing by apoptosis. Using several different glioma cell lines (9L, U87-MG and CNS-1) we now confirm that NA provides a dose-dependent (0.1-0.5 mM) increase in apoptotic cells following d-aminolevulinic acid-mediated aPDT or mPDT. Furthermore, using the 9L cell line stably transfected with the luciferase gene, NA was shown to delay the depletion of bioluminscence signal in aPDT and mPDT treated cells, inferring that adenosine triphosphate levels are maintained for longer following NA treatment. NA has previously been reported as promoting neuronal and vascular cell survival in normal brain following a number of neurological insults in which reactive oxygen species are implicated including, stroke, Alzheimer's disease and toxin-induced lesions. It is likely that the effects of NA reflect its capacity as an antioxidant as well as its ability to inhibit poly (adenosine diphosphate-ribose) polymerase-mediated depletion of ATP. Our results indicate that NA may prove therapeutically advantageous when used in combination with PDT treatment of brain tumors.

  16. Outcome of radioiodine (I-131) therapy in primary thyrotoxicosis in young (21-40 years) Bangladeshi population - A 10 years study in 482 patients

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the outcome of I- 131 therapy (single/ double/multiple doses) in young adults suffering from thyrotoxicosis. A total of 482 patients, 290 females and 192 males, were evaluated over a period of 10 years (1993-2003). The age range was 21-40 years (mean 27.3 ±4.2 years). All patients were diagnosed to have primary thyrotoxicosis clinically, and confirmed biochemically by laboratory investigations. Patients with thyroiditis and those, who were non-compliant to regular treatment, were excluded from this study. Patients unresponsive to at least six months of anti-thyroid drug therapy or patients with disease recurrence after a three months remission period were treated with 8-15 mCi of radio iodine. All patients were followed up at regular intervals over several years following I-131 therapy, with a mean follow up period of 3±0.3 years. All patients who became either euthyroid or hypothyroid following I-131 therapy and showed no evidence of recurrence of thyrotoxicosis for at least three years were considered disease free. Out of 482, 398 patients (82.57 %) achieved remission by single doses of radio iodine (I-131), 70 patients (14.53 %) achieved remission by two doses. A total of 468 patients (97%) achieved complete remission by either one or two doses of radio iodine. Subsequently 92.73% (N=447) of patients became hypothyroid, and only 4.36% (N=21 patients) remained euthyroid without any supplement after radio iodine therapy. A total number of 14 patients (3%) required multiple (more than two) doses of I- 131. No drug reaction or disease recurrence observed in our patients during the follow up period. (author)

  17. Three basic patterns of changes in serum thyroid hormone levels in Graves' disease during the one-year period after radioiodine therapy

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the characteristic patterns of the thyroid hormonal changes in Graves' disease during the one-year period after 131I therapy considering that few serial hormonal data during this period are available in the literature. The levels of serum triiodothyronine (T3), thyroxine (T4) and free T4 (FT4) before and during one year were plotted as a function of time in 70 therapy courses of 58 patients without subsequent antithyroid or steroid therapy. 35 euthyroid, 6 hypothyroid and 29 hyperthyroid states were obtained during one year after therapy. Although individual patients had individual hormonal changing patterns, 3 common basic patterns were observed from baseline to one month (early) and thereafter (late), respectively. The early patterns were a decrease in 54 (77%), a minimum change in 8 (11.5%) and an increase in 8 (11.5%). The late patterns were a stable state after an initial decrease with a bottom followed by an increase (valley pattern) in 47 (67%), a stable state after an initial increase with a peak followed by a decrease with a bottom and a subsequent re-increase (mountain pattern) in 12 (17%) and a late stable state after a gradual slow decrease without an obvious bottom near or till one year (downhill pattern) in 11 (16%). The bottom level and the degree of hormonal recovery from the bottom determined the stable euthyroid, hypothyroid or hyperthyroid state in 49 (86%) of 57 with the valley or mountain pattern. Most of the bottom levels (81%) and transient abnormal changes including transient hypothyroidism (93%, 13/14), peak or hyperthyroidism (85%, 11/13) and euthyroidism (67%, 10/15) appeared within 6 months. The post-therapeutic stable euthyroid, hypothyroid or hyperthyroid state could be judged from the hormonal patterns in 57% (39/68) from 2.5 to 6 months, in 18% (12/68) from 6 to 9 months and in 25% (17/68) thereafter. Although the changes in thyroid hormones are not constant in Graves' disease during one year

  18. Diffuse pulmonary metastases with negative 18FDG positron emission tomography/computed tomography and positive post-radioiodine therapy scan of papillary thyroid cancer

    Institute of Scientific and Technical Information of China (English)

    LIN Yan-song; LIANG Zhi-yong; QIU Li-heng; CHENG Xin

    2012-01-01

    A female papillary thyroid cancer patient with diffuse micronodular pulmonary metastases was confirmed only by post radioactive iodine (RAI) therapy whole body scan (RxWBS).Her diagnostic iodine-131 whole body scan (DxWBS),chestCT and 18FDG PET/CT scan were all negative.Attention and pitfalls of this case concerning surgical and RAI dosemanagement are against current international guidelines on thyroid cancer.

  19. Radioiodine-treatment (RIT) of functional thyroidal autonomy

    International Nuclear Information System (INIS)

    Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

  20. Molecularly Targeted Therapy of Human Hepatocellular Carcinoma Xenografts with Radio-iodinated Anti-VEGFR2 Murine-Human Chimeric Fab

    OpenAIRE

    Jianfei Huang; Qi Tang; Changjun Wang; Huixin Yu; Zhenqing Feng; Jin Zhu

    2015-01-01

    Vascular endothelial growth factor receptor 2 (VEGFR2) is traditionally regarded as an important therapeutic target in a wide variety of malignancies, such as hepatocellular carcinoma (HCC). We previously generated a murine-human anti-VEGFR2 chimeric Fab (cFab), named FA8H1, which has the potential to treat VEGFR2-overexpressing solid tumors. Here, we investigated whether FA8H1 can be used as a carrier in molecularly targeted therapy in HCC xenograft models. FA8H1 was labeled with 131I, and t...

  1. Abnormal radioiodine uptake on post-therapy whole body scan and sodium/iodine symporter expression in a dermoid cyst of the ovary: report of a case and review of the literature

    International Nuclear Information System (INIS)

    In patients affected by differentiated thyroid cancer, the whole-body scan (WBS) with 131-radioiodine, especially when performed after a therapeutic activity of 131I, represents a sensitive procedure for detecting thyroid remnant and/or metastatic disease. Nevertheless, a wide spectrum of potentially pitfalls has been reported. Herein we describe a 63-year-old woman affected by follicular thyroid cancer, who was accidentally found to have an abdominal mass at post-dose WBS (pWBS). pWBS showed abnormal radioiodine uptake in the upper mediastinum, consistent with lymph-node metastases, and a slight radioiodine uptake in an abdominal focal area. Computed tomography revealed an inhomogeneous mass in the pelvis, previously unrecognized. The lesion, surgically removed, was found to be a typical dermoid cyst of the ovary, without any evidence of thyroid tissue. By immunohistochemistry, a moderate expression of the sodium-iodine symporter (NIS) was demonstrated in the epithelial cells, suggesting a NIS-dependent uptake of radioiodine by the cyst. (author)

  2. Abnormal radioiodine uptake on post-therapy whole body scan and sodium/iodine symporter expression in a dermoid cyst of the ovary: report of a case and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Campenni, Alfredo; Baldari, Sergio, E-mail: acampenni@unime.ittalia [Dipartimento di Scienze Biomediche e delle Immagini Morfologiche e Funzionali, Unità di Medicina Nucleare, Università degli Studi di Messina, Messina (Italy); Giovinazzo, Salvatore; Ruggeri, Rosaria M. [Dipartimento di Medicina Clinica e Sperimentale, Unità di Endocrinologia, Università degli Studi di Messina (Italy); Tuccari, Giovanni [Dipartimento di Patologia Umana, Università degli Studi di Messina (Italy); Fogliani, Simone [Unità di Scienze Radiologiche, Ospedale di Milazzo, Messina (Italy)

    2015-08-15

    In patients affected by differentiated thyroid cancer, the whole-body scan (WBS) with 131-radioiodine, especially when performed after a therapeutic activity of {sup 131}I, represents a sensitive procedure for detecting thyroid remnant and/or metastatic disease. Nevertheless, a wide spectrum of potentially pitfalls has been reported. Herein we describe a 63-year-old woman affected by follicular thyroid cancer, who was accidentally found to have an abdominal mass at post-dose WBS (pWBS). pWBS showed abnormal radioiodine uptake in the upper mediastinum, consistent with lymph-node metastases, and a slight radioiodine uptake in an abdominal focal area. Computed tomography revealed an inhomogeneous mass in the pelvis, previously unrecognized. The lesion, surgically removed, was found to be a typical dermoid cyst of the ovary, without any evidence of thyroid tissue. By immunohistochemistry, a moderate expression of the sodium-iodine symporter (NIS) was demonstrated in the epithelial cells, suggesting a NIS-dependent uptake of radioiodine by the cyst. (author)

  3. Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Nielsen, Viveque E; Hegedüs, Laszlo

    2006-01-01

    sufficient thyroid 131I uptake is mandatory for 131I therapy to be feasible and pre-stimulation with recombinant human TSH (rhTSH) increases this considerably. This leads to an increased absorbed thyroid dose by approx.75%, mainly in those patients with the lowest thyroid 131I uptake, and a more homogeneous...... intrathyroidal isotope distribution. Pre-stimulation with even a small dose of rhTSH seems to allow a reduction of the 131I activity while still achieving a mean goitre reduction of approximately 40% within a year. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged 131......I activity, rhTSH pre-stimulation improves the goitre reduction by 30-50%. However, this is at the expense of a higher rate of hypothyroidism, cervical pain and transient thyrotoxicosis. Of particular concern is the observation made in healthy persons, that rhTSH results in a transient average...

  4. Augmented postcard

    OpenAIRE

    Bernik , Aleš

    2012-01-01

    The aim of this thesis is the examination of augmented reality technology, which allows us mixing real and virtual elements. Augmented reality is a relatively new technology which is becoming more widespread, thanks to a fairly reasonable price of smart phones. Here we presents the types of augmented reality, the necessary technology and their advantages and disadvantages, its current use in applications, and software for building augmented reality applications. The thesis is mainly focuse...

  5. Radioiodine Contamination Artifacts and Unusual Patterns of Accumulation in Whole-body I-131 Imaging: A Case Series

    OpenAIRE

    Ozcan Kara, Pelin; Gunay, Emel Ceylan; Erdogan, Alihan

    2014-01-01

    Introduction: Radioactive iodine has been used for more than 50 years for the treatment of thyroid diseases. Differentiated thyroid cancers have the ability to trap iodine. Therefore, radioiodine can be used both diagnostically and therapeutically. In the follow-up of patients, it is critical to interpret radioiodine scans correctly. Case Presentation: Non-physiological Iodine-131 (I-131) extra-thyroidal uptake detected on post-therapy or diagnostic I-131 scanning are not always interpreted a...

  6. Radioiodine: The atomic cocktail

    International Nuclear Information System (INIS)

    The use of artificial radionuclides in medicine has continued to increase in importance resulting in the growth of a new medical specialty, Nuclear Medicine. The availability of very low cost radionuclides from Oak Ridge beginning in 1946 initiated a revolution that led to widespread use of 131I in the understanding and management of thyroid disease and to extensive use of 131I-labeled dyes, fats, drugs, proteins and other substances in diverse areas of medicine. While the role of the 'atomic cocktail' in cancer therapy has diminished greatly, in vivo and in vitro radionuclide procedures in medical diagnosis are employed in over one-third of hospital admissions

  7. The treatment of multinodular large non-toxic goiter using repeated doses of radioiodine (preliminary report)

    International Nuclear Information System (INIS)

    Introduction: The aim of study was to establish the effectiveness of radioiodine therapy using 131I in the group of patients with multinodular large non-toxic goiter. Material and methods: Therapy was undertaken in female patients disqualified from surgery due to high risk and these patients who didn't agree to surgery. Studies were performed in 7 women (age range: 62.82 yrs) with large goiters (2nd degree according to WHO classification and goiter volume assessed by USG over 100 cm3). Serum TSH, fT4, fT3, antithyroid antibodies (TPOAb, TgAb, TRAb) levels, urinary iodine concentration (UIE) were estimated in all patients parallel with radioiodine uptake test (after 5 and 24 hours), 131I thyroid scintigraphy and fine needle biopsy to exclude neoplasmatic transformation. These studies and therapy with 22 mCi 131I were repeated every 3 months. Results: Before therapy median thyroid volume was approximately 145 cm3 and during therapy gradually decreased to 76 cm3 after 6 months and to 65 cm3 after 12 months. Increase of TRAb can be a inhibiting factor of thyroid volume reduction. Other antithyroid antibodies showed marked tendency to rise but without significant correlation with radioiodine uptake and goiter reduction. After 12 months we found 2 patients with clinical and laboratory hypothyroidism. Conclusions: In some cases of multinodular large non-toxic goiter, the radioiodine therapy can be the best alternative way for L-thyroxine treatment or surgery therapy. The fractionated radioiodine therapy of multinodular large non-toxic goiter is safe and effective method but continuation of nodules observation is necessary. (author)

  8. Optimization of Inpatient Management of Radioiodine Treatment in Korea

    International Nuclear Information System (INIS)

    We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after long term retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer

  9. Dry Distillation of Radioiodine from TeO2 Targets

    Directory of Open Access Journals (Sweden)

    Jacek Koziorowski

    2013-10-01

    Full Text Available As medical cyclotrons are becoming more abundant, 123I and 124I are getting more attention as alternatives to 131I for diagnostics of thyroid disease. Both 123I and 124I provide better diagnostics, deliver less dose to patients and both reduce the risk of thyroid stunning, facilitating subsequent therapy. Dry distillation of radioiodine from tellurium dioxide targets has become the standard approach to producing these radioiodines. Setting up such a production of radioiodine is associated with a lengthy optimization of the process and for this purpose natural tellurium is often used for economical reasons. In this paper, the distillation parameters are scrutinized to ensure optimal distillation temperature, in order to minimize time spent and prevent loss of expensive target material. It is further demonstrated how the individual iodine isotopes, produced from proton bombardment of natTe, will diffuse out of the target in a time dependent ratio. We believe the effect is due to the isotopes having their maximum cross section at different energies. The individual isotopes produced will thus have their highest concentration at different depths in the target. This results in individual mean diffusion lengths and diffusion times for the different isotopes.

  10. Radioiodine thyroid ablation in graves' hyperthyroidism: merits and pitfalls.

    Science.gov (United States)

    Nwatsock, J F; Taieb, D; Tessonnier, L; Mancini, J; Dong-A-Zok, F; Mundler, O

    2012-01-01

    Ablative approaches using radioiodine are increasingly proposed for the treatment of Graves' disease (GD) but their ophthalmologic and biological autoimmune responses remain controversial and data concerning clinical and biochemical outcomes are limited. The aim of this study was to evaluate thyroid function, TSH-receptor antibodies (TRAb) and Graves' ophthalmopathy (GO) occurrence after radioiodine thyroid ablation in GD. We reviewed 162 patients treated for GD by iodine-131 ((131)I) with doses ranging from 370 to 740 MBq, adjusted to thyroid uptake and sex, over a 6-year period in a tertiary referral center. Collected data were compared for outcomes, including effectiveness of radioiodine therapy (RIT) as primary endpoint, evolution of TRAb, and occurrence of GO as secondary endpoints. The success rate was 88.3% within the first 6 months after the treatment. The RIT failure was increased in the presence of goiter (adjusted odds ratio = 4.1, 95% confidence interval 1.4-12.0, P = 0.010). The TRAb values regressed with time (r = -0.147; P = 0.042) and patients with a favorable outcome had a lower TRAb value (6.5 ± 16.4 U/L) than those with treatment failure (23.7 ± 24.2 U/L, P hyperthyroidism but developed early and prolonged period of hypothyroidism in the context of antithyroid drugs (ATD) intolerance (P = 0.003) and high TRAb level (P = 0.012). On the basis the results of this study we conclude that ablative RIT is effective in eradicating Graves' hyperthyroidism but may be accompanied by GO occurrence, particularly in patients with early hypothyroidism and high pretreatment TRAb and/or ATD intolerance. In these patients, we recommend an early introduction of LT4 to reduce the duration and the degree of the radioiodine-induced hypothyroidism. PMID:22942775

  11. A Logical levothyroxine dose Individualization: Optimization Approach at discharge from Radioiodine therapy ward and during follow-up in patients of Differentiated Thyroid Carcinoma: Balancing the Risk based strategy and the practical issues and challenges: Experience and Views of a large volume referral centre in India

    International Nuclear Information System (INIS)

    In this communication, the authors discuss the issue of individualization of thyrotropin suppressive therapy in differentiated thyroid carcinoma (DTC) patients and share their views with respect to optimizing the dose of levothyroxine (LT) prescription both during discharge from radioiodine therapy ward and during follow-up. The changing management paradigm at our Institute during post-thyroidectomy period and during the preparation for radioiodine scan is also briefly highlighted. Five factors can be identified as important determinants for the dose individualization approach: (1) Persistence or absence of metastatic disease, (2) the risk characteristics of the patient and the tumor (3) patient's clinical profile, symptomatology, and contraindications (4) the feasibility to ensure a proper thyroid stimulating hormone TSH suppression level (depends on patient's socio-economic and educational background, the connectivity with the local physician and his expertise) (5) time period elapsed since initial diagnosis. While discussing each individual case scenario, the authors, based upon their experience in one of the busiest thyroid cancer referral centers in the country, discuss certain unaddressed points in the current guideline recommendations, deviations made and some challenges toward employing them into practice, which could be situation and center specific. In addition to these, the value of clinical examination, patient profile and detailed enquiry about clinical symptomatology by the attending physician in each follow-up visit cannot be overemphasized. According to the authors, this aspect, quite important for dose determination in an individual, is relatively underrepresented in the present guidelines. It would also be worthwhile to follow a conservative approach (till clear data emerges) in patients who have characteristics of “high-risk” disease, but are clinically and biochemically disease free, if no medical contraindications exist and

  12. Comparison of diagnostic and post-theraphy radioiodine scan in well-differentiated thyroid cancer and the clinical outcome

    International Nuclear Information System (INIS)

    We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. The first postoperative diagnostic and post-therapy radioiodine scans of the hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of 3.7-9.3 GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10ng/ml) during serum TSH elevation. Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/43) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.=20

  13. Radioiodine uptake in inactive pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.)

  14. Nationwide trends in surgery and radioiodine treatment for benign thyroid disease during iodization of salt

    DEFF Research Database (Denmark)

    Cerqueira, C.; Knudsen, N.; Ovesen, L.;

    2010-01-01

    Objective: Iodization of salt was introduced in Denmark in 1998 because of mild-to-moderate iodine deficiency (ID). The aim of this study was to analyze the utilization rate of surgery and radioiodine therapy for benign thyroid disorders before and after the introduction of iodization, and to study...

  15. Long-Term Cognitive and Behavioral Therapies, Combined with Augmentative Communication, Are Related to Uncinate Fasciculus Integrity in Autism

    Science.gov (United States)

    Pardini, Matteo; Elia, Maurizio; Garaci, Francesco G.; Guida, Silvia; Coniglione, Filadelfo; Krueger, Frank; Benassi, Francesca; Gialloreti, Leonardo Emberti

    2012-01-01

    Recent evidence points to white-matter abnormalities as a key factor in autism physiopathology. Using Diffusion Tensor Imaging, we studied white-matter structural properties in a convenience sample of twenty-two subjects with low-functioning autism exposed to long-term augmentative and alternative communication, combined with sessions of cognitive…

  16. A pilot study for augmenting atomoxetine with methylphenidate: safety of concomitant therapy in children with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Ball Susan

    2007-09-01

    Full Text Available Abstract Background This study examined augmenting atomoxetine with extended-release methylphenidate in children whose attention-deficit/hyperactivity disorder (ADHD previously failed to respond adequately to stimulant medication. Methods Children with ADHD and prior stimulant treatment (N = 25 received atomoxetine (1.2 mg/kg/day plus placebo. After 4 weeks, patients who were responders (n = 4 were continued on atomoxetine/placebo while remaining patients were randomly assigned to either methylphenidate (ATX/MPH (1.1 mg/kg/day or placebo augmentation (ATX/PB for another 6 weeks. Patients and sites were blind to timing of active augmentation. Safety measures included vital signs, weight, and adverse events. Efficacy was assessed by ADHD rating scales. Results Categorical increases in vital signs occurred for 5 patients (3 patients in ATX/MPH, 2 patients in ATX/PBO. Sixteen percent discontinued the study due to AE, but no difference between augmentation groups. Atomoxetine treatment was efficacious on outcome measures (P ≤ .001, but methylphenidate did not enhance response. Conclusion Methylphenidate appears to be safely combined with atomoxetine, but conclusions limited by small sample. With atomoxetine treatment, 43% of patients achieved normalization on ADHD ratings.

  17. Radioiodine in the Savannah River Site environment

    Energy Technology Data Exchange (ETDEWEB)

    Kantelo, M.V.; Bauer, L.R.; Marter, W.L.; Murphy, C.E. Jr.; Zeigler, C.C.

    1993-01-15

    Radioiodine, which is the collective term for all radioactive isotopes of the element iodine, is formed at the Savannah River Site (SRS) principally as a by-product of nuclear reactor operations. Part of the radioiodine is released to the environment during reactor and reprocessing operations at the site. The purpose of this report is to provide an introduction to radioiodine production and disposition, its status in the environment, and the radiation dose and health risks as a consequence of its release to the environment around the Savannah River Plant. A rigorous dose reconstruction study is to be completed by thee Center for Disease Control during the 1990s.

  18. Radioiodine in the Savannah River Site environment

    International Nuclear Information System (INIS)

    Radioiodine, which is the collective term for all radioactive isotopes of the element iodine, is formed at the Savannah River Site (SRS) principally as a by-product of nuclear reactor operations. Part of the radioiodine is released to the environment during reactor and reprocessing operations at the site. The purpose of this report is to provide an introduction to radioiodine production and disposition, its status in the environment, and the radiation dose and health risks as a consequence of its release to the environment around the Savannah River Plant. A rigorous dose reconstruction study is to be completed by thee Center for Disease Control during the 1990s

  19. Detection of radioiodine-induced cytogenetic alterations in circulating lymphocytes of thyroid patients

    International Nuclear Information System (INIS)

    Radioiodines are often used for experimental purposes and for diagnosis and therapy in clinical practice. Human population might also be exposed to radioiodines in nuclear accidents. The ionizing energy of radioiodine affects not only the thyroid where it concentrates but also other tissues, especially the lymphocytes during their circulation through and around the gland containing the radioisotopes. Therefore, it seemed to be of interest to carry out investigations concerning the cytogenetic alterations in blood lymphocytes of patients treated with iodine-131. The method of choice was the relatively easily performable micronucleus assay in cytokinesis-blocked cultures of human peripheral lymphocytes. The test was performed on blood samples of 30 patients before the radioisotope treatment and one, two and four days after, one as well as 6 and - in a few cases - 12 weeks later. The amounts of iodine-131 injected were dependent on the clinical practices to reach the therapeutic radiation doses for hyperthyroidism and adenomas and were in the range of 220 and 5180 MBq. it was observed that the micronucleus frequency increased in the treated hyperthyroid patients while in patients with toxic adenomas the radioiodine did not result in an increase or even as compared to the pretreatment values in a few cases decreased values were seen. The results suggest individual differences in radiosensitivity as well as that the frequency of cytogenetic alterations depend on the physiological or pathological conditions of the thyroid. The significance of this observation will be discussed for dose assessments by cytogenetic techniques due to internal radioiodine. (author)

  20. Inhibition of Src and forkhead box O1 signaling by induced pluripotent stem-cell therapy attenuates hyperoxia-augmented ventilator-induced diaphragm dysfunction.

    Science.gov (United States)

    Li, Li-Fu; Chang, Yuh-Lih; Chen, Ning-Hung; Wang, Chien-Ying; Chang, Gwo-Jyh; Lin, Meng-Chih; Chang, Chih-Hao; Huang, Chung-Chi; Chuang, Jen-Hua; Yang, Yi-Pin; Chiou, Shih-Hwa; Liu, Yung-Yang

    2016-07-01

    Mechanical ventilation (MV) with hyperoxia is required for providing life support to patients with acute lung injury (ALI). However, MV may cause diaphragm weakness through muscle injury and atrophy, an effect termed ventilator-induced diaphragm dysfunction (VIDD). Src protein tyrosine kinase and class O of forkhead box 1 (FoxO1) mediate acute inflammatory responses and muscle protein degradation induced by oxidative stress. Induced pluripotent stem cells (iPSCs) have been reported to improve hyperoxia-augmented ALI; however, the mechanisms regulating the interactions among VIDD, hyperoxia, and iPSCs are unclear. In this study, we hypothesized that iPSC therapy can ameliorate hyperoxia-augmented VIDD by suppressing the Src-FoxO1 pathway. Male C57BL/6 mice, either wild-type or Src-deficient, aged between 6 and 8 weeks were exposed to MV (6 or 10 mL/kg) with or without hyperoxia for 2-8 h after the administration of 5 × 10(7) cells/kg Oct4/Sox2/Parp1 mouse iPSCs or iPSC-derived conditioned medium (iPSC-CM). Nonventilated mice were used as controls. MV during hyperoxia aggravated VIDD, as demonstrated by the increases in Src activation, FoxO1 dephosphorylation, malondialdehyde, caspase-3, atrogin-1 and muscle ring finger-1 production, microtubule-associated protein light chain 3-II, disorganized myofibrils, disrupted mitochondria, autophagy, and myonuclear apoptosis; however, MV with hyperoxia reduced mitochondrial cytochrome C, diaphragm muscle fiber size, and contractility (P < 0.05). Hyperoxia-exacerbated VIDD was attenuated in Src-deficient mice and by iPSCs and iPSC-CM (P < 0.05). Our data indicate that iPSC therapy attenuates MV-induced diaphragmatic injury that occurs during hyperoxia-augmented VIDD by inhibiting the Src-FoxO1 signaling pathway. PMID:27055225

  1. Second malignancies following the treatment of differentiated thyroid carcinoma with radioiodine

    International Nuclear Information System (INIS)

    Full text: To see the incidence of second cancers in patients with well differentiated thyroid carcinoma after being treated with radioiodine. Medical records of 814 (417 males, 397 females) patients with differentiated thyroid cancer treated at Institute of Nuclear Medicine and Ultrasound, Dhaka were reviewed. The purpose was to investigate the incidence of second cancer in these patients after radioiodine therapy. The age range of the patient population treated with radioiodine was 9 to 69 years. Doses of radioiodine given were in the range of 30 to 100mCi for ablation and 150 to 250mCi for treatment of metastasis. The median follow-up period was 93.7± 15 months. Eleven (1.35 %) of the 814 patients developed a second malignancy. Two patients (0.25%) developed chronic myelogenous leukemia within a latency period of 5 years and after receiving a cumulative dose of 600- 670mCi. The over all incidence of second malignancy in the form of solid tumors was 1.10%. Of the nine patients with solid tumors, there were two patients with renal cell carcinoma, three patients with parotid gland tumor, one patient with pancreatic cancer, one with adenocarcinoma of the stomach, one with carcinoid tumor and one with small cell carcinoma of the lungs. The mean latency period for development of these tumors was 6.92 ± 3.934 years and the mean cumulative dose received by all these patients was 537.25±120.55 mCi. Follow-up of a fairly large cohort of patients treated with radioiodine showed a low incidence of second neoplasm. No relation was observed between the cumulative dose received and the development of a second malignancy. Thyroid carcinoma is a polygenic disease, which may be associated with other malignancies. Common environmental or genetic factors as well as long-term carcinogenic effects of radioiodine therapy should be considered. (author)

  2. Application of lithium carbonate on radioiodine treatment of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Effectiveness of radioiodine for Graves' hyperthyroidism depends on retention time of 131I in the thyroid, and may be effected by several factors, including previous treatment with antithyroid drugs,goiter volume, 24 h thyroidal radioactive iodine uptake and so on. A short course of therapy with low dose of lithium carbonate increased retention of 131I in the thyroid and prolong the intrathyroidal effective half-life of 131I before and after 131I therapy in patients with Graves' disease, because of the actions that lithium blocks the release of organic iodine and thyroid hormone from the thyroid gland without affecting thyroidal radioactive iodine uptake. Therefore, using lithium as adjunct to radioiodine therapy increases the radiation dose delivered to the thyroid, to result in reduced the activity required and whole-body radiation dose in patients with very short effective half-life, and so improve the cure rate of hyperthyroidism. A short course of lithium carbonate therapy can be considered a useful adjunct to 131I therapy for obtaining a more rapid control of thyrotoxicosis and avoiding its transient exacerbation because of methimazole withdrawal prior to 131I administration or in patients who cannot tolerate or do not respond to antithyroid drugs, and for helping to prevent the radioiodine-associated increase in serum free thyroid hormone concentrations. In addition, lithium carbonate enhances the effectiveness of 131I therapy, in terms of prompter control of hyperthyroidism in patients with small or large goiters. At the same time, lithium also may increases the rate of permanent control of hyperthyroidism in patients with large goiters. In summary, in the short-term lithium plays an important role as an adjunct to 131I, since it helps to prevent the 131I-associated increase in serum free thyroid hormone concentrations and allows a more prompt control of thyrotoxicosis. This is of particular importance in high risk patients, such as the elderly,those with

  3. Radiostatine and radioiodine uptake characterization in sodium iodine symporter-expressing cell lines

    International Nuclear Information System (INIS)

    Full text: The sodium iodide symporter (NIS) has been recognized as an attractive target for cancer gene therapy. Here we investigated NIS-mediated transport of the high LET α-emitter astatine, 211At, in comparison to radioiodine. A constitutive expression vector harbouring the human NIS cDNA was used in combination with reporter gene vectors for transient transfection of 13 different human cancer cell lines. Radioiodine uptake was measured as well as transfection efficiencies. Six stable NIS-expressing cell lines (3 derived from thyroid carcinomas, 2 colon carcinoma, 1 glioblastoma) were generated by antibiotic selection. NIS expression was monitored by immunohistochemistry and RT-PCR. Subsequently the radioastatine and radioiodine uptake characteristics of genetically modified cells were studied in comparison to the respective control cells. After xenotransplantation in nude mice in vivo tumor imaging by scintigraphy and biodistribution studies following organ removal were performed. Transient transfection of NIS cDNA led to high specific sodium perchlorate-sensitive radioiodine uptake in NIS-expressing cells that roughly correlates to transfection efficiencies. Similarly, stable NIS-expressing cell lines were able to concentrate high levels of radioiodine and in addition showed comparable transport capacity for radioastatine. Accumulation of 211At was inhibited by sodium perchlorate like iodide uptake and displayed dependency an extracellular Na+- and I--ions as well. Compared to wash-out experiments in cell culture the effective half life of radioiodine and radioastatine in vivo was significantly prolonged. Preliminary dose calculations by MIRD concepts indicated higher tumor radiation doses for 211At compared to 131I. Tumor cells of different origins transfected with the NIS-expression vector specifically and significantly take-up radioiodine and radioastatine in vitro and in vivo. The data provide direct evidence that the NIS efficiently transports the high

  4. Radioiodine Treatment of Well-Differentiated thyroid cancer in children

    International Nuclear Information System (INIS)

    Full text: Well-differentiated thyroid cancer (DTCA) in children is quite different from the adult- onset disease in that they are more aggressive at the time of diagnosis and with metastases and has a higher risk for recurrence. Some studies claim it to be less lethal and hence treatment protocols may be different from that of the adult. This study was made to analyze the need for RAI therapy as one of the cornerstone of treatment aside from surgery and thyroid hormone suppression as well as to determine the behavior of WDTCA in children. Results: The incidence of DTCA is varied and ranges from 1-10% in several published series. In the Philippines where thyroid cancer in adults ranks 5th in mortality for both sexes, the incidence is likewise very low, around 0.5-1% for ages 18 years and below in a ten year study. It was predominantly a female population (74%) as compared to the males (26%). Fifteen cases were reviewed and included as most were given RAI (87%). Most presented as a solitary nodule and with lymph node metastases. Thirteen cases were papillary in nature and only two cases were follicular. The incidence of nodal metastases was 53% while lung metastases were seen in 20% of cases. Of the 13 cases that underwent RAI therapy, three cases of lung metastases needed repeat therapy. In the cases with lymph node metastases, 2 cases also had recurrence and which necessitated repeat RAI therapy. The two cases that did not get RAI therapy had progressive disease on follow- up after 5 and 7 years respectively from surgery. Discussion: Primary treatment for DTC should consist of surgery, radioiodine ablation and thyroid hormone suppression. We must rely on pediatric outcome studies and the high frequency of multifocal intrathyroidal disease, loco- regional spread and extra cervical metastases often seen as initial presentations of this particular group. The more advanced disease at diagnosis for children, propensity for recurrence as well as the greater radioiodine

  5. Changing trends in the treatment of Graves' disease with radioiodine: a 12-year experience in a university hospital; Mudancas evolutivas no tratamento da doenca de Graves com iodo radioativo: 12 anos de experiencia em um hospital universitario

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Marcus Vinicius Leitao de [Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ (Brazil)], e-mail: marcusleitao@gmail.com; Souza, Honomar Ferreira de [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia; Buescu, Alexandru; Vaisman, Mario [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia

    2009-03-15

    Objective: To evaluate the changes in clinical parameters and in the approach to patients submitted to radioiodine therapy for Graves' disease. Materials and methods: Dossiers of 226 patients submitted to radioiodine therapy for Graves' disease in the period between January 1990 and December 2001 were retrospectively evaluated. For the purposes of statistical analysis, the 12-year period was subdivided into three periods of 4 years, with a comparison of clinical and laboratory variables in these periods. Results: The authors have observed that the total number of patients referred for radioiodine therapy as well as the percentage of female patients presented a significant increase (from 62% to 86%; p = 0.005). The percentage of patients pretreated with methimazole before radioiodine therapy increased significantly (from 9.1% to 35.6%; p = 0.03). The mean radioiodine dose delivered has also presented a significant increase (from 7.6 mCi to 12.7 mCi; p = 0.000003) with a direct reflection on a higher percentage of patients cured one year after the radioiodine therapy (from 55.6% to 83.7%; p = 0.004). Conclusion: Radioiodine therapy has increasingly been accepted for treatment of patients with Graves' disease and the doses delivered have increased to achieve a permanent cure as well as a reduction of the chances of recurrence. (author)

  6. Induction of Graves' disease in patients with non-autoimmune hyperthyroidism or nontoxic goiter after radioiodine treatment

    International Nuclear Information System (INIS)

    Thyrotropin receptors antibodies may occur and induce Graves' disease (GD) several months after radioiodine therapy in a small number of patients with non-autoimmune hyperthyroidism or nontoxic goiter. The prevalence of radiation-induced GD is between 0.05% and 5%. The hypothesis of this disease includes induction by autoimmune reaction and others. Detection of the thyroid autoantibodise or of 99mTc pertechnetate scan can forecast the appearance of GD. Antithyroid drugs, again radioiodine therapy and surgery are the treatments. (authors)

  7. Peripheral blood T cell activation after radioiodine treatment for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Teng; Stark, R.; Borysiewicz, L.K.; Weetman, A.P. (Department of Medicine, University of Cambridge Clinical School, Level 5, Addenbrooke' s Hospital, Cambridge (UK)); Munro, A.J. (Department of Clinical Oncology, Hammersmith Hospital, London (UK)); McHardy Young, S. (Department of Medicine, Central Middlesex Hospital, London (UK))

    1990-01-01

    Radioiodine therapy for Graves' thyrotoxicosis produces a rise in thyroid autoantibodies in the first three months after treatment, but little is known of its effects on T cells. We have therefore followed the changes in T cell subsets in sequential samples from 23 patients with Graves' disease treated with radioiodine, using dualcolour flow cytometry. In the first month after treatment there was a significant rise in activated T cells, identified by the markers HLA-DR(la) and CDw26/Tal (p<0.025 in both cases). CD45RO-positive T cells, which are the primed population containing memory cells, also increased (p<0.025), but there was no change in CD45R-positive, resting T cells or in the CD4 to CD8 (helper to cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the contrasuppressor population, showed a more variable response, but the trend was to an overall increase from pre-treatment values (p<0.025). The changes did not appear to be related to antithyroid drug treatment, since they were seen irrespective of whether patients continued such therapy. These results suggest that T cell activation and enhanced contrasuppressor activity may in part be responsible for the rise in autoantibodies after radioiodine. The T cell changes could also contribute to the worsening of ophthalmopathy seen in some radioiodine-treated patients. (author).

  8. Exploring the optimum approach to the use of CT densitometry in a randomised placebo-controlled study of augmentation therapy in alpha 1-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Parr, David G; Dirksen, Asger; Piitulainen, Eeva; Deng, Chunqin; Wencker, Marion; Stockley, Robert A

    2009-01-01

    lung assessment. The EXAcerbations and CT scan as Lung Endpoints (EXACTLE) trial aimed to clarify the optimum approach to the use of CT densitometry data for the assessment of alpha 1-antitrypsin (AAT) augmentation therapy on the progression of emphysema in AAT deficiency (AATD). METHODS: Patients with...... AATD (n = 77) were randomised to weekly infusions of 60 mg/kg human AAT (Prolastin) or placebo over 2 to 2.5 years. Lung volume was included as a covariate in an endpoint analysis and a comparison was made of different CT densitometric indices (15th percentile lung density [PD15], mean lung density...... analysis. TRIAL REGISTRATION: Registered in ClinicalTrials.gov as 'Antitrypsin (AAT) to Treat Emphysema in AAT-Deficient Patients'; ClinicalTrials.gov Identifier: NCT00263887....

  9. Therapeutic efficacy of alpha-1 antitrypsin augmentation therapy on the loss of lung tissue: an integrated analysis of 2 randomised clinical trials using computed tomography densitometry

    Directory of Open Access Journals (Sweden)

    Stolk Jan

    2010-10-01

    Full Text Available Abstract Background Two randomised, double-blind, placebo-controlled trials have investigated the efficacy of IV alpha-1 antitrypsin (AAT augmentation therapy on emphysema progression using CT densitometry. Methods Data from these similar trials, a 2-center Danish-Dutch study (n = 54 and the 3-center EXAcerbations and CT scan as Lung Endpoints (EXACTLE study (n = 65, were pooled to increase the statistical power. The change in 15th percentile of lung density (PD15 measured by CT scan was obtained from both trials. All subjects had 1 CT scan at baseline and at least 1 CT scan after treatment. Densitometric data from 119 patients (AAT [Alfalastin® or Prolastin®], n = 60; placebo, n = 59 were analysed by a statistical/endpoint analysis method. To adjust for lung volume, volume correction was made by including the change in log-transformed total lung volume as a covariate in the statistical model. Results Mean follow-up was approximately 2.5 years. The mean change in lung density from baseline to last CT scan was -4.082 g/L for AAT and -6.379 g/L for placebo with a treatment difference of 2.297 (95% CI, 0.669 to 3.926; p = 0.006. The corresponding annual declines were -1.73 and -2.74 g/L/yr, respectively. Conclusions The overall results of the combined analysis of 2 separate trials of comparable design, and the only 2 controlled clinical trials completed to date, has confirmed that IV AAT augmentation therapy significantly reduces the decline in lung density and may therefore reduce the future risk of mortality in patients with AAT deficiency-related emphysema. Trial registration The EXACTLE study was registered in ClinicalTrials.gov as 'Antitrypsin (AAT to Treat Emphysema in AAT-Deficient Patients'; ClinicalTrials.gov Identifier: NCT00263887.

  10. Effectiveness of methylphenidate as augmentation therapy after failure of adjunctive neuromodulation for patients with treatment-refractory bipolar depression: a case report

    Directory of Open Access Journals (Sweden)

    Adida M

    2014-04-01

    Full Text Available Marc Adida,1,2 Jean-Michel Azorin1,21Sainte-Marguerite Hospital, Department of Psychiatry, Mediterranean University, 2Timone Health Campus, National Research Scientific Centre, Marseille, FranceAbstract: Adjunctive use of methylphenidate, a central stimulant, has been considered as a potential therapeutic choice for patients with refractory unipolar, geriatric, or bipolar depression, and depression secondary to medical illness. We present a case of bipolar depression in which the patient responded significantly to augmentation with methylphenidate, without any side effects, after failure of adjunctive repetitive transcranial magnetic stimulation and electroconvulsive therapy. Mr U, a 56-year-old man with bipolar I disorder, had melancholic symptoms during his sixth episode of bipolar depression. After failure of repetitive transcranial magnetic stimulation and electroconvulsive therapy, he was treated with fluoxetine 80 mg/day, duloxetine 360 mg/day, mirtazapine 60 mg/day, and sodium valproate 1,000 mg/day, with no improvement. We added methylphenidate at a dose of 10 mg/day for one week, which resulted in mild clinical improvement, and then methylphenidate extended-release 20 mg/day for one week, with significant clinical improvement. He tolerated his medications well. His clinical recovery was stable over one year. The patient's antidepressants and methylphenidate were gradually tapered and finally discontinued after one year with no withdrawal syndrome. To date, he remains well on sodium valproate as monotherapy and is being followed up at our bipolar department. This case suggests that methylphenidate augmentation might be a therapeutic option when treating highly treatment-resistant patients with bipolar depression, even if they had not responded to adjunctive neuromodulation. In these clinical situations, physicians might be interested in prescribing methylphenidate because of its efficacy and safety.Keywords: bipolar disorder, treatment

  11. Effectiveness of methylphenidate as augmentation therapy after failure of adjunctive neuromodulation for patients with treatment-refractory bipolar depression: a case report.

    Science.gov (United States)

    Adida, Marc; Azorin, Jean-Michel

    2014-01-01

    Adjunctive use of methylphenidate, a central stimulant, has been considered as a potential therapeutic choice for patients with refractory unipolar, geriatric, or bipolar depression, and depression secondary to medical illness. We present a case of bipolar depression in which the patient responded significantly to augmentation with methylphenidate, without any side effects, after failure of adjunctive repetitive transcranial magnetic stimulation and electroconvulsive therapy. Mr U, a 56-year-old man with bipolar I disorder, had melancholic symptoms during his sixth episode of bipolar depression. After failure of repetitive transcranial magnetic stimulation and electroconvulsive therapy, he was treated with fluoxetine 80 mg/day, duloxetine 360 mg/day, mirtazapine 60 mg/day, and sodium valproate 1,000 mg/day, with no improvement. We added methylphenidate at a dose of 10 mg/day for one week, which resulted in mild clinical improvement, and then methylphenidate extended-release 20 mg/day for one week, with significant clinical improvement. He tolerated his medications well. His clinical recovery was stable over one year. The patient's antidepressants and methylphenidate were gradually tapered and finally discontinued after one year with no withdrawal syndrome. To date, he remains well on sodium valproate as monotherapy and is being followed up at our bipolar department. This case suggests that methylphenidate augmentation might be a therapeutic option when treating highly treatment-resistant patients with bipolar depression, even if they had not responded to adjunctive neuromodulation. In these clinical situations, physicians might be interested in prescribing methylphenidate because of its efficacy and safety. PMID:24729710

  12. Study of the radiopharmaceutical potential of radioiodinated phenolphtalein

    Energy Technology Data Exchange (ETDEWEB)

    Uenak, T.; Avcibasi, U.; Yildirim, Y. [Ege Univ., Bornova, Izmir (Turkey). Faculty of Science, Dept. of Chemistry, Div. of Nuclear Chemistry; Duman, Y. [Ege Univ., Bornova, Izmir (Turkey). Faculty of Medicine, Div. of Nuclear Medicine

    2004-07-01

    Starting from this pharmaceutical property of phenolphthalein, in this study we examined the radiopharmaceutical potential of radioiodinated phenolphthalein. Phenolphthalein was radioiodinated with iodine-131 using the iodogen method which was earlier applied at our laboratory for radioiodination of different kinds of chemical compounds having at least one phenyl ring in their structures. (orig.)

  13. A rare case of isolate pericardial effusion detected by SPECT/CT on a post-therapeutic radioiodine whole-body scan

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Teik Hin [Dept. of Nuclear Medicine, National Cancer Institute, Putrajaya (Malaysia); Hassan, Siti Zarina Amir [Dept. of Nuclear Medicine, Kuala Lumpur Hospital, Kuala Lumpur (Malaysia)

    2015-09-15

    We reported a rare finding of isolated pericardial uptake detected by SPECT/CT on posttherapeutic radioiodine whole body scan. This case highlights the usefulness of hybrid SPECT/CT, with subsequent correlation with biochemical results, in ruling out metastatic pericardial effusion in the postsurgical radioiodine remnant ablation setting. The effusion was resolved after reinstituted thyroid replacement therapy. Recombinant thyrotropin is recommended to avoid such rare but life-threatening complication.

  14. A rare case of isolate pericardial effusion detected by SPECT/CT on a post-therapeutic radioiodine whole-body scan

    International Nuclear Information System (INIS)

    We reported a rare finding of isolated pericardial uptake detected by SPECT/CT on posttherapeutic radioiodine whole body scan. This case highlights the usefulness of hybrid SPECT/CT, with subsequent correlation with biochemical results, in ruling out metastatic pericardial effusion in the postsurgical radioiodine remnant ablation setting. The effusion was resolved after reinstituted thyroid replacement therapy. Recombinant thyrotropin is recommended to avoid such rare but life-threatening complication

  15. Radioiodinated ligands for dopamine receptors

    International Nuclear Information System (INIS)

    The dopamine receptor system is important for normal brain function; it is also the apparent action site for various neuroleptic drugs for the treatment of schizophrenia and other metal disorders. In the past few years radioiodinated ligands for single photon emission tomography (SPECT) have been successfully developed and tested in humans: [123I]TISCH for D1 dopamine receptors; [123I]IBZM, epidepride, IBF and FIDA2, four iodobenzamide derivatives, for D2/D3 dopamine receptors. In addition, [123I]β-CIT (RTI-55) and IPT, cocaine derivatives, for the dopamine reuptake site are potentially useful for diagnosis of loss of dopamine neurons. The first iodinated ligand, (R)trans-7-OH-PIPAT, for D3 dopamine receptors, was synthesized and characterized with cloned cell lines (Spodoptera frugiperda, Sf9) expressing the D2 and D3 dopamine receptors and with rat basal forebrain membrane preparations. Most of the known iodobenzamides displayed similar potency in binding to both D2 and D3 dopamine receptors expressed in the cell lines. Initial studies appear to suggest that by fine tuning the structures it may be possible to develop agents specific for D2 and D3 dopamine receptors. It is important to investigate D2/D3 selectivity for this series of potent ligands

  16. Lip augmentation.

    Science.gov (United States)

    Byrne, Patrick J; Hilger, Peter A

    2004-02-01

    Lip augmentation has become increasingly popular in recent years as a reflection of cultural trends emphasizing youth and beauty. Techniques to enhance the appearance of the lips have evolved with advances in biotechnology. An understanding of lip anatomy and aesthetics forms the basis for successful results. We outline the pertinent anatomy and aesthetics of the preoperative evaluation. A summary of various filler materials available is provided. Augmentation options include both injectable and open surgical techniques. The procedures and materials currently favored by the authors are described in greater detail. PMID:15034811

  17. Procedure guideline for radioiodine test. Version

    International Nuclear Information System (INIS)

    The version 2 of the procedure guideline for radioiodine test is an update of the guideline published in 1999. The following statements were added or modified: The procedure guideline discusses the pros and cons of a single measurement or of repeated measurements of the iodine-131 uptake and their optimal timing. Different formulas are described when one, two or three values of the radioiodine kinetic are available. The probe with a sodium iodide crystal, alternative or additionally the gamma-camera using the ROI-technique are instrumentations for the measurement of iodine-131 uptake. A possible source of error is an inappropriate measurement (sonography) of the target volume. The patients' preparation includes the withdrawal of antithyroid drugs 2-3 days before radioiodine administration. The patient has to avoid iodine-containing medication and the possibility of additives of iodide in vitamin- or electrolyte-supplementation has to be considered. (orig.)

  18. Procedure guideline for radioiodine test (version 3)

    International Nuclear Information System (INIS)

    The version 3 of the procedure guideline for radioiodine test is an update of the guideline previously published in 2003. The procedure guideline discusses the pros and cons of a single measurement or of repeated measurements of the iodine-131 uptake and their optimal timing. Different formulas are described when one, two or three values of the radioiodine kinetic are available. The probe with a sodium-iodine crystal, alternatively or additionally the gamma camera using the ROI-technique are instrumentations for the measurement of iodine-131 uptake. A possible source of error is an inappropriate measurement (sonography) of the target volume. The patients' preparation includes the withdrawal of antithyroid drugs 2-3 days before radioiodine administration. The patient has to avoid iodine-containing medication and the possibility of additives of iodine in vitamin- and electrolyte-supplementation has to be considered. (orig.)

  19. Labelling of some amino acids with radioiodine

    International Nuclear Information System (INIS)

    Some radioiodine labelled compounds which have application in nuclear medicine have been prepared. Two common techniques were employed. A comparative study on the radioiodination of the amino acids, L - tyrosine, L - a - methyl tyrosine and L-tyrosine methyl ester has been carried out by the electrophilic radioiodination technique. The blood flow reagent, antipyrine, also has been prepared by this technique using chloramine - T, iodogen and H2 O2 as oxidizing agents to generate electrophilic iodine. Radio chromatograms revealed side product impurities at long reaction times and high oxidizing agent concentrations. Comparison between the different oxidizing agents was done. Optimization of the radioiodination conditions, such as Ph of the medium, reaction time, oxidizing agent and substrate concentrations and carrier KI concentration was performed resulting in high radiochemical yields of 97% L - 3 -(131) iodotyrosine, 95% L -3-(131) iodo-a-methyl tyrosine, 88% L-3-(131) iodotyrosine methyl ester and 96% 4-(131) iodoantipyrine within short reaction times at room temperature when chloramine - T was used as oxidizing agent. Purification by high pressure liquid chromatography resulted in high radiochemically pure products suitable for medical application. Radioiodinated 3- iodotyrosine and 4- iodophenyl alanine have been prepared by the isotopic exchange technique using cuprous chloride as catalyst for the exchange reaction. The effect of solvents and the different parameters affecting the labelling yield were investigated to optimize the conditions for labelling of these compounds. Kinetic study indicated a second order reaction with an activation energy of 9.6 and 12.20 Kcal/mole for 3- iodotyrosine and 4-iodophenyl alanine respectively. Reducing agents were added to the Cu CI catalyzed reactions to improve the yield and decrease side products formation. Applying the results obtained to the radioiodination of the phenyl fatty acid 15(p-iodophenyl) pentadecanoic acid

  20. Compartment models of radioiodine in man

    International Nuclear Information System (INIS)

    The differential equations governing the flow of iodine through a three-compartment model of iodine metabolism in man have been solved and the solutions compared to those obtained from two-compartment models. The boundary conditions used were those appropriate for a single acute exposure to radioiodine. The urinary excretion equation derived from the solutions to the three-compartment model exhibits a minimum at four days after the exposure time. This minimum can be used to calculate a maximum value for thyroid burden using a single urinary excretion rate measurement, and in conjunction with this value, an optimum urinary sampling frequency for the different radioiodines can be calculated. (author)

  1. Research on removal of radioiodine by charcoal

    International Nuclear Information System (INIS)

    The major R and D work carried out in the CIRP laboratory on removal of radioiodine is introduced, which involves the adsorption performances of various kinds of fruit shell base and coal base charcoal impregnated with chemicals, the influence of various parameters, the technique of non-destructive test for commercial scale iodine adsorber, and the iodine samplers for both gross iodine and iodine in different forms. The experimental results have been applied to the design and test of iodine adsorber and the monitoring of airborne radioiodine

  2. Augmented Reality

    DEFF Research Database (Denmark)

    Kjærgaard, Hanne Wacher; Kjeldsen, Lars Peter Bech; Rahn, Annette

    2015-01-01

    This chapter describes the use of iPad-facilitated application of augmented reality in the teaching of highly complex anatomical and physiological subjects in the training of nurses at undergraduate level. The general aim of the project is to investigate the potentials of this application in term...

  3. Integrin αvβ3-targeted gold nanoshells augment tumor vasculature-specific imaging and therapy

    Directory of Open Access Journals (Sweden)

    Huan Xie

    2011-01-01

    Full Text Available Huan Xie1, Parmeswaran Diagaradjane2, Amit A Deorukhkar2, Beth Goins3, Ande Bao3, William T Phillips3, Zheng Wang4, Jon Schwartz5, Sunil Krishnan21Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA; 2Department of Radiation Oncology, Division of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Department of Radiology, the University of Texas Health Science Center at San Antonio (UTHSC-San Antonio, San Antonio, TX, USA; 4MPI Research, Inc., Mattawan, MI, USA; 5Nanospectra Biosciences, Inc., Houston, TX, USAPurpose: Gold nanoshells (NSs have already shown great promise as photothermal actuators for cancer therapy. Integrin αvβ3 is a marker that is specifically and preferentially overexpressed on multiple tumor types and on angiogenic tumor neovasculature. Active targeting of NSs to integrin αvβ3 offers the potential to increase accumulation preferentially in tumors and thereby enhance therapy efficacy.Methods: Enzyme-linked immunosorbent assay (ELISA and cell binding assay were used to study the in vitro binding affinities of the targeted nanoconjugate NS–RGDfK. In vivo biodistribution and tumor specificity were analyzed using 64Cu-radiolabeled untargeted and targeted NSs in live nude rats bearing head and neck squamous cell carcinoma (HNSCC xenografts. The potential thermal therapy applications of NS–RGDfK were evaluated by subablative thermal therapy of tumor xenografts using untargeted and targeted NSs.Results: ELISA and cell binding assay confirmed the binding affinity of NS–RGDfK to integrin αvβ3. Positron emission tomography/computed tomography imaging suggested that tumor targeting is improved by conjugation of NSs to cyclo(RGDfK and peaks at ~20 hours postinjection. In the subablative thermal therapy study, greater biological effectiveness of targeted NSs was implied by the greater degree of tumor necrosis

  4. Neurally augmented sexual function.

    Science.gov (United States)

    Meloy, S

    2007-01-01

    Neurally Augmented Sexual Function (NASF) is a technique utilizing epidural electrodes to restore and improve sexual function. Orgasmic dysfunction is common in adult women, affecting roughly one quarter of populations studied. Many male patients suffering from erectile dysfunction are not candidates for phosphdiesterase therapy due to concomitant nitrate therapy. Positioning the electrodes at roughly the level of the cauda equina allows for stimulation of somatic efferents and afferents as well as modifying sympathetic and parasympathetic activity. Our series of women treated by NASF is described. Our experience shows that the evaluation of potential candidates for both correctable causes and psychological screening are important considerations. PMID:17691397

  5. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    OpenAIRE

    Chen, Pao-Huan; Huang, Yu-Jui

    2015-01-01

    The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age...

  6. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    OpenAIRE

    Chen, Pao-Huan

    2015-01-01

    Pao-Huan Chen, Yu-Jui Huang Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan Abstract: The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipola...

  7. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    OpenAIRE

    Chen PH; Huang YJ

    2015-01-01

    Pao-Huan Chen, Yu-Jui Huang Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan Abstract: The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 ...

  8. Radioiodine-induced kidney damage and protective effect of amifostine: An experimental study

    OpenAIRE

    Aktoz, T; Durmus-Altun, G; Usta, U; Torun, N; Ergulen, A; Atakan, I H

    2012-01-01

    Background: Ablative radioiodine-131 (131I) therapy is used in the standart treatment procedure of thyroid carcinoma and procedures using 131I represent the majority of Nuclear Medicine therapeutic procedures. The principal route of 131I excretion after the administration of 131I is the urine. Amifostine is an organic thiophosphate ester prodrug and the kidney concentrations of the active metabolite WR-1065 are about 100 times higher than tumour concentrations. To our knowledge, there is no p...

  9. Radioiodine prediction model for nuclear tests

    International Nuclear Information System (INIS)

    Over a 5-year period, 14 major experiments were conducted to investigate the air-forage-cow-milk system for transfer of radioiodine. The experiments included controlled releases using prepared aerosols, planned releases during Plowshare cratering tests, and releases due to accidental venting of underground nuclear tests. Two or more groups of dairy cows, three to six cows per group, were used in each experiment to study the effect on radioiodine transfer of such factors as: the mode of exposure, the type and state of forage fed, the type of aerosol, and variations in feeding practices. In each experiment, measurements were made of the total radioiodine intake and output in milk of the cows, the concentrations in forage and milk, the gaseous and particulate air concentrations, the open-field gamma exposure rate, and the deposition per unit area. The mean values of the experimental data are assembled in this report and are used to develop the parameters for a standard milk excretion pattern for dairy cows and to develop predictive equations for radioiodine. The resultant equations, for predicting the infinite dose to a 2-gram human thyroid caused by ingestion of 131I, are presented

  10. Psychotherapy Augmentation through Preconscious Priming

    OpenAIRE

    Borgeat, François; O’Connor, Kieron; Amado, Danielle; St-Pierre-Delorme, Marie-Ève

    2013-01-01

    Objective: To test the hypothesis that repeated preconscious (masked) priming of personalized positive cognitions could augment cognitive change and facilitate achievement of patients’ goals following a therapy. Methods: Twenty social phobic patients (13 women) completed a 36-weeks study beginning by 12 weeks of group behavioral therapy. After the therapy, they received 6 weeks of preconscious priming and 6 weeks of a control procedure in a randomized cross-over design. The Priming conditi...

  11. Psychotherapy augmentation through preconscious priming

    OpenAIRE

    Francois eBorgeat; Kieron eO'Connor; Danielle eAmado; Marie-Eve eSt-Pierre-Delorme

    2013-01-01

    Objective: To test the hypothesis that repeated preconscious (masked) priming of personalized positive cognitions could augment cognitive change and facilitate achievement of patients’ goals following a therapy.Methods: Twenty social phobic patients (13 women) completed a 36 weeks study beginning by 12 weeks of group behavioural therapy. After the therapy, they received 6 weeks of preconscious priming and 6 weeks of a control procedure in a randomized cross-over design. The Priming condition ...

  12. Ablative radioactive iodine therapy for apparently localized thyroid carcinoma. A decision analytic perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wong, J.B.; Kaplan, M.M.; Meyer, K.B.; Pauker, S.G. (Tufts Univ. School of Medicine, Boston, MA (USA))

    1990-09-01

    Adjuvant therapy with ablative radioiodine after surgical resection of apparently localized thyroid carcinoma remains controversial because of the favorable prognosis of thyroid carcinoma and the risk of leukemia from the radioiodine. No controlled trials have been performed to examine this issue. We constructed a decision analytic model to examine whether patients with apparently localized thyroid carcinoma should receive radioiodine. Our analysis suggests that radioiodine modestly improves life expectancy by 2 to 15 months, depending on the patient's age and sex. This model predicts that the benefit of a reduction in the likelihood of recurrence outweighs the risk of leukemia from radioiodine.

  13. Peripheral blood T cell activation after radioiodine treatment for graves' disease

    International Nuclear Information System (INIS)

    Radioiodine therapy for Graves' thyrotoxicosis produces a rise in thyroid autoantibodies in the first three months after treatment, but little is known of its effects on T cells. We have therefore followed the changes in T cells subsets in sequential samples from 23 patients with Graves' disease treated with radioiodine, using dual-colour flow cytometry. In the first month after treatment there was a significant rise in activated T cells, identified by the markers HLA-DR (Ia) and CDW 26/Ta1 (P<0.025 in both case). CD45RO-positive T cells, which are the prime population containing memory cells, also increased (P<0.025), but there was no change in CD45R-positive, resting cells or in the CD4/CD8 (helper to cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the contra-suppressor population, showed a more variable response, but the trend was to an overall increase from pre-treatment values (P<0.025). The change did not appear to be related to antithyroid drugs treatment, since they were seen irrespective of whether patients convinced such therapy. These results suggest that T cell activation and enhanced contra-suppressor activity may in part be responsible for the rise in autoantibodies after radioiodine therapy

  14. Radioiodine concentrated in a wetland

    International Nuclear Information System (INIS)

    Most subsurface environmental radioactivity contamination is expected to eventually resurface in riparian zones, or wetlands. There are a number of extremely sharp biogeochemical interfaces in wetlands that could alter radionuclide speciation and promote accumulation. The objective of this study was to determine if a wetland concentrated 129I emanating from a former waste disposal basin located on the Savannah River Site (SRS) in South Carolina, USA. Additionally, studies were conducted to evaluate the role of sediment organic matter in immobilizing the radioiodine. Groundwater samples were collected along a 0.7-km transect away from the seepage basin and in the downstream wetlands. The samples were analyzed for 129I speciation (iodide (I−), iodate (IO3−), and organo-I). Groundwater 129I concentrations in many locations in the wetlands (as high as 59.9 Bq L−1129I) were greatly elevated with respect to the source term (5.9 Bq L−1129I). 129I concentration profiles in sediment cores were closely correlated to organic matter concentrations (r2 = 0.992; n = 5). While the sediment organic matter promoted the uptake of 129I to the wetland sediment, it also promoted the formation of a soluble organic fraction: 74% of the wetland groundwater 129I could pass through a 1 kDa (<1 nm) membrane and only 26% of the 129I was colloidal. Of that fraction that could pass through a 1 kDa membrane, 39% of the 129I was organo-I. Therefore, while wetlands may be highly effective at immobilizing aqueous 129I, they may also promote the formation of a low-molecular-weight organic species that does not partition to sediments. This study provides a rare example of radioactivity concentrations increasing rather than decreasing as it migrates from a point source and brings into question assumptions in risk models regarding continuous dilution of released contaminants. - Highlights: • 129I emanating from a former waste disposal basin is concentrating in a wetland located ∼700 m

  15. Exploring the role of CT densitometry: a randomised study of augmentation therapy in alpha1-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dirksen, A; Piitulainen, E; Parr, D G;

    2009-01-01

    than other measures of emphysema progression, and the changes in CT and forced expiratory volume in 1 s were correlated. All methods of densitometric analysis concordantly showed a trend suggestive of treatment benefit (p-values for Prolastin versus placebo ranged 0.049-0.084). Exacerbation frequency......Assessment of emphysema-modifying therapy is difficult, but newer outcome measures offer advantages over traditional methods. The EXAcerbations and Computed Tomography scan as Lung End-points (EXACTLE) trial explored the use of computed tomography (CT) densitometry and exacerbations for the......-point was change in CT lung density, and an exploratory approach was adopted to identify optimal methodology, including two methods of adjustment for lung volume variability and two statistical approaches. Other end-points were exacerbations, health status and physiological indices. CT was more sensitive...

  16. Augmentation mammoplasty

    International Nuclear Information System (INIS)

    Seventy-five cases of breast implants have been reviewed. Two categories of abnormalities were identified: those involving the implant itself and those within the breast parenchyma. Complications of the implant itself include leakage, fibrous capsular contraction, traumatic rupture, displacement, and collapse. Concomitant breast parenchymal abnormalities include breast carcinoma, cysts, solid masses, and clusters of microcalcifications. Mammographic technique is critical and often involves manual settings and special views. Mammography and US in conjunction with physical examination play an important role in detecting breast pathology in the augmented breast

  17. Effects of treatment with radioiodine (131 I) on the gonadal function of the hyperthyroid patients

    International Nuclear Information System (INIS)

    Introduction: hyperthyroidism is a relatively common disorder caused by different etiologies, Graves' disease and toxic-nodular goiter(Plummer's disease) are among the most common causes. Treatment with radioiodine is considered to be the treatment of choices in many of the patients. Higher biological half-life of 13I in hyperthyroid patients as compared with patients with differentiated thyroid carcinoma who have undergone thyroidectomy, may lead to a higher frequency of complications with radioiodine at similar dosage. Therefore gonadal dysfunction in hyperthyroid patients treated with radioactive iodine is not likely. Materials and methods: hyperthyroid patients with the clinical diagnosis of Graves' disease , toxic multi nodular goiter and toxic adenoma were entered the study. Their age distribution was 16-40 years in women and 17-70 years in men (reproductive years). Patients were euthyroid at the time of radioiodine treatment. FSH, LH, testosterone and semen analysis in men; and FSH, LH, estrogen and progesterone in women were measured before and 3 months after radioiodine therapy. All patients with previous history of radioiodine treatment, those with known sexual hormone abnormalities, women with a history of tube ligation and men with a history of vasectomy, as well as those women who were receiving OCP contraception were excluded from the study. results: From 104 enrolled patients, 40(38.5%) were men and 64(61.5%) were women. The case of hyperthyroidism was Graves' disease in 66 cases(63.5%), toxic multi nodular goiter in 28 cases (26.9%), and toxic adenoma in 10 others (9.6%). Hormonal status was normal in all patients before therapy while this became abnormal in 20(19.2%) of patients after treatment. Semen analysis became abnormal in 8/20(40%) of the patients after treatment. Conclusion: among different variables which were analyzed during study, meaningful correlation was found in the following situations: FSH values in men and women were found to be

  18. Analysis on the childhood and adolescent differentiated thyroid cancer: clinical features and radioiodine treatment

    International Nuclear Information System (INIS)

    Objective: Children with differentiated thyroid cancer (DTC) frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of child-hood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods: The records of 38 childhood and adolescent DTC cases, with 28 females and 10 males (mean age: 16.4 years) were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results: At the time of follow-up, all were survive (with a median follow-up of 5.13 years). Four-teen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions: DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Post-thyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes. (authors)

  19. Radioiodine treatment for malignant thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-12-15

    Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

  20. Transmission of radioiodine through sampling lines

    International Nuclear Information System (INIS)

    An experimental program to measure radioiodine transmission through sampling lines is described. The transmission depends upon both deposition on and resuspension from the walls of the line. The deposition and resuspension processes are themselves controlled by the length, diameter, and material of the line and the conditions under which it is operated. The operating conditions under study are sampling flow rate, temperature and relative humidity. Measurement results have been interpreted in terms of a four-compartment model of radioiodine deposition and resuspension. The model is applied to each of twenty or more segments of the line. Experimental measurements of short-term transmission fractions and the deposition velocities derived from them are presented for six lines. Data on resuspension rates for the same lines were obtained and are also discussed

  1. An improved method for hyaluronic acid radioiodination

    Energy Technology Data Exchange (ETDEWEB)

    Orlando, P.; De Feo, A.; Orlando, M.; Trenta, R.; Trevisi, R. [Universita Cattolica del Sacro Cuore, Rome (Italy). Centro Radioisotopi; Binaglia, L. [Perugia Univ. (Italy). Ist. di Biochimica e Chimica Medica

    1995-09-01

    A simple procedure is described for preparing {sup 125}I-labelling hyluronan of high molecular weight. The reducing terminal group of hyaluronic acid was derivatized with tyramine through the formation of a Schiff base which was subsequently reduced with sodium cyanoborohydride. By radioiodination of the aromatic ring, {sup 125}I-labelled hyaluronic acid was obtained in high yield (40%) and high specific activity, 555 GBq/mmol (15 Ci/mmol). (Author).

  2. An improved method for hyaluronic acid radioiodination

    International Nuclear Information System (INIS)

    A simple procedure is described for preparing 125I-labelling hyluronan of high molecular weight. The reducing terminal group of hyaluronic acid was derivatized with tyramine through the formation of a Schiff base which was subsequently reduced with sodium cyanoborohydride. By radioiodination of the aromatic ring, 125I-labelled hyaluronic acid was obtained in high yield (40%) and high specific activity, 555 GBq/mmol (15 Ci/mmol). (Author)

  3. Radioiodine Remnant Ablation: A Critical Review

    OpenAIRE

    Bal, Chandra Sekhar; Padhy, Ajit Kumar

    2015-01-01

    Radioiodine remnant ablation (RRA) is considered a safe and effective method for eliminating residual thyroid tissue, as well as microscopic disease if at all present in thyroid bed following thyroidectomy. The rationale of RRA is that in the absence of thyroid tissue, serum thyroglobulin (Tg) measurement can be used as an excellent tumor marker. Other considerations are like the presence of significant remnant thyroid tissue makes detection and treatment of nodal or distant metastases diffic...

  4. Indirect labeling of proteins with radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Elaine Bortoleti de; Lavinas, Tatiana; Muramoto, Emiko; Pereira, Nilda P.S. de; Silva, Constancia P.G. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil); Tavares, Leoberto C. [Sao Paulo Univ., SP (Brazil). Faculdade de Ciencias Farmaceuticas. Departamento de Tecnologia Bioquimico-Farmaceutica

    2000-07-01

    A procedure is described for the radioiodination of proteins using an iodinated derivative of N succinimidyl 3-(tri-n-butylstannyl)benzoate (ATE), previously described by Zalutsky. ATE was obtained in a high pure form and the iodination has been performed with 131-Iodine in 70-80% yield. Protein labeling studies performed with human IgG indicate that the ATE intermediate is an important alternative to conventional labeling methods. (author)

  5. Radioiodine (I-131) treatment for uncomplicated hyperthyroidism: An assessment of optimal dose and cost-effectiveness

    International Nuclear Information System (INIS)

    Aim: Radioiodine (I-131) is increasingly being considered for the treatment of hyperthyroidism but there is no general agreement for the initial dose. To determine the cost-effectiveness and optimal dose of I-131 to cure disease, we prospectively studied the outcome of radioiodine therapy of 423 patients. Material and Methods: Any of the fixed doses of 6, 8, 10, 12 or 15 mCi of I-131 was administered to the patients relating to thyroid gland size. The individual was excluded from this study who had multinodular goitre and autonomous toxic nodule. Patients were classified as cured if the clinical and biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. The costs were assessed by analyzing the total cost of care including office visit, laboratory testing, radioiodine treatment, average conveyance and income loss of patient and attendant and thyroxine replacement for a period of 2 years from the day of I-131 administration. Results: The results showed a progressive increase of cure rate from the doses of 6, 8 and 10 mCi by 67%, 76.5% and 85.7% respectively but the cure rate for the doses of 12 and 15 mCi was 87.9% and 88.8% respectively. Cure was directly related to the dose between 6 and 10 mCi but at higher doses the cure rate was increased marginally at the expense of increased total body radiation. There was little variation in total costs, but was higher for low dose-therapy and the cost proportion between the 6 mCi regimen and 10 mCi regimen was 1.04:1. Conclusion: We could conclude that an initial 10 mCi of I-131 may be the optimal dose for curing hyperthyroidism and will also limit the total costs

  6. Radioiodine treatment effects of lacrimal glands function in patients with thyroid cancer

    International Nuclear Information System (INIS)

    There is a limited number of case reports published in the past decade confirming the radio-iodine presence in the tear. These observations as well as reported cases of salivary and lacrimal gland dysfunction after radioiodine therapy stimulated investigators to clarify whether lacrimal gland function can be affected post-radioiodine therapy. Hence we planned a historical cohort study to evaluate this effect. Methods: we studied 100 eyes of 50 patients who were referred to the nuclear medicine department of Dr. Shariati hospital from 01.1383 to 02.1384 and had received high doses (accumulative dose: 100-450mCi) of 1-131 treatment of differentiated thyroid carcinoma with their latest admission at least 3 months previously. Dry eye symptoms (obtained via a standard questionnaire) and Schirmer I test results (mm/5min) of this group were compared with those of an unexposed group (1 00 eyes of 50 individuals) matched by sex and age. Cases with another known cause(s) of dry eye were not included in either group. Results: 51% of the exposed eyes and 50% of the unexposed ones revealed at least one of the dry eye symptoms in the questionnaire. Data analysis showed no significant difference between the number of symptoms of two groups, but 2 symptoms (burning, unrelated to light and rythema) were significantly higher in the exposed eyes. From 9 exposed eyes complaining of erythema, Schirmer test result was abnormal only in 2 (one patient). Also among the 10 eyes with burning symptom (unrelated to light) one patient (2 eyes) revealed abnormal Schirmer test result. The study also demonstrated a significantly lower wetting amount of the Schirmer paper in exposed group compared to others. In the patients undergone radio-iodine therapy, results were 0-4 mm in 21%, 5-9 mm in 20% and 10 mm or more in 59%. These results were seen in the unexposed group in 6%, 17% and 77%, respectively. File review of the 21 exposed eyes with 0-4 mm Schirmer test results revealed presence of the

  7. Effects of Performing Morning Versus Afternoon Exercise on Glycemic Control and Hypoglycemia Frequency in Type 1 Diabetes Patients on Sensor-Augmented Insulin Pump Therapy

    Science.gov (United States)

    Gomez, Ana Maria; Gomez, Claudia; Aschner, Pablo; Veloza, Angelica; Muñoz, Oscar; Rubio, Claudia; Vallejo, Santiago

    2015-01-01

    Background: Although physical exercise (PE) is recommended for individuals with type 1 diabetes (DM1), participation in exercise is challenging because it increases the risk of severe hypoglycemia and the available therapeutic options to prevent it frequently result in hyperglycemia. There is no clear recommendation about the best timing for exercise. The aim of this study was to compare the risk of hypoglycemia after morning or afternoon exercise sessions up to 36 hours postworkout. Methods: This randomized crossover study enrolled subjects with DM1, older than 18 years of age, on sensor-augmented insulin pump (SAP) therapy. Participants underwent 2 moderate-intensity exercise sessions; 1 in the morning and 1 in the afternoon, separated by a 7 to 14 day wash-out period. Continuous glucose monitoring (CGM) data were collected 24 hours before, during and 36 hours after each session. Results: Thirty-five subjects (mean age 30.31 ± 12.66 years) participated in the study. The rate of hypoglycemia was significantly lower following morning versus afternoon exercise sessions (5.6 vs 10.7 events per patient, incidence rate ratio, 0.52; 95% CI, 0.43-0.63; P < .0001). Most hypoglycemic events occurred 15-24 hours after the session. On days following morning exercise sessions, there were 20% more CGM readings in near-euglycemic range (70-200 mg/dL) than on days prior to morning exercise (P = .003). Conclusions: Morning exercise confers a lower risk of late-onset hypoglycemia than afternoon exercise and improves metabolic control on the subsequent day. PMID:25555390

  8. ARLearn: augmented reality meets augmented virtuality

    NARCIS (Netherlands)

    Ternier, Stefaan; Klemke, Roland; Kalz, Marco; Van Ulzen, Patricia; Specht, Marcus

    2012-01-01

    Ternier, S., Klemke, R., Kalz, M., Van Ulzen, P., & Specht, M. (2012). ARLearn: augmented reality meets augmented virtuality [Special issue]. Journal of Universal Computer Science - Technology for learning across physical and virtual spaces, 18(15), 2143-2164.

  9. Microbial copper reduction method to scavenge anthropogenic radioiodine

    Science.gov (United States)

    Lee, Seung Yeop; Lee, Ji Young; Min, Je Ho; Kim, Seung Soo; Baik, Min Hoon; Chung, Sang Yong; Lee, Minhee; Lee, Yongjae

    2016-06-01

    Unexpected reactor accidents and radioisotope production and consumption have led to a continuous increase in the global-scale contamination of radionuclides. In particular, anthropogenic radioiodine has become critical due to its highly volatile mobilization and recycling in global environments, resulting in widespread, negative impact on nature. We report a novel biostimulant method to effectively scavenge radioiodine that exhibits remarkable selectivity for the highly difficult-to-capture radioiodine of >500-fold over other anions, even under circumneutral pH. We discovered a useful mechanism by which microbially reducible copper (i.e., Cu2+ to Cu+) acts as a strong binder for iodide-iodide anions to form a crystalline halide salt of CuI that is highly insoluble in wastewater. The biocatalytic crystallization of radioiodine is a promising way to remove radioiodine in a great capacity with robust growth momentum, further ensuring its long-term stability through nuclear I‑ fixation via microcrystal formation.

  10. Microbial copper reduction method to scavenge anthropogenic radioiodine

    Science.gov (United States)

    Lee, Seung Yeop; Lee, Ji Young; Min, Je Ho; Kim, Seung Soo; Baik, Min Hoon; Chung, Sang Yong; Lee, Minhee; Lee, Yongjae

    2016-01-01

    Unexpected reactor accidents and radioisotope production and consumption have led to a continuous increase in the global-scale contamination of radionuclides. In particular, anthropogenic radioiodine has become critical due to its highly volatile mobilization and recycling in global environments, resulting in widespread, negative impact on nature. We report a novel biostimulant method to effectively scavenge radioiodine that exhibits remarkable selectivity for the highly difficult-to-capture radioiodine of >500-fold over other anions, even under circumneutral pH. We discovered a useful mechanism by which microbially reducible copper (i.e., Cu2+ to Cu+) acts as a strong binder for iodide-iodide anions to form a crystalline halide salt of CuI that is highly insoluble in wastewater. The biocatalytic crystallization of radioiodine is a promising way to remove radioiodine in a great capacity with robust growth momentum, further ensuring its long-term stability through nuclear I− fixation via microcrystal formation. PMID:27311370

  11. Internal contamination in nurses attending patients, that received therapeutic amounts of radioiodine-131

    International Nuclear Information System (INIS)

    The most frequent and often very successful used unsealed source in Nuclear Medicine and Radiotherapy is the radioiodine-131 for the treatment of thyroid carcinoma and hyperthyroidism. Always there is a great concern about the health physics of radioiodine and possible internal contamination involved in high level 131-I thyroid therapy cases, in particular to the thyroid as target and limiting organ. This report deals with 131-I air concentrations and internal contamination in nurses attending these patients under two different conditions. During the past three years a change took place from the old building, where we had an unventilated two-bed nursing room, to a new building were we have rooms with forced ventilation and air-conditioning (refreshment five times per hour). From both external exposure caused by radioiodine treated patients and internal contamination due to ingestion and inhalation of 131-I, we calculated the dose-equivalent to the thyroid and the effective dose-equivalent to our health care personnel

  12. Recent advances in radioiodine use for the management of thyroid carcinoma

    International Nuclear Information System (INIS)

    Full text: It has been well accepted that radioiodine is useful in the management of patients with recurrent or metastatic differentiated thyroid cancer. Although radioiodine has been used for more than 60 years in diagnosis and treatment, some improvements still appear continuously. Serum Thyroglobulin (Tg) and radioiodine whole body scans (WBS) are used to detect recurrent thyroid caner. Tg has been known to be more sensitive than WBS, and false negative WBS with elevated Tg are frequently found. However, the clinical importance of Tg negative cases with positive WBS has not been clarified. We found that 34 among 960 patients who showed negative Tg with positive post-therapy I-131 WBS had functioning metastases to extrathyroidal organs. Complementary use of radioiodine WBS is recommended to exclude Tg false negative cases. The retinoic acid (RA) is well known to induce the cellular re-differentiation and increase the expression of sodium/iodide symporter (NIS) in de-differentiated tumor cell. We performed RA treatment with I-131 in 40 patients with elevated serum Tg level but no focal iodine uptake in WBS. In 14 patients (35%), improved I-131 uptake was seen. Focal iodine uptakes were seen in 4 patients, and diffuse hepatic visualization without localized lesions were found in 10 patients. Maximal safe dose (MSD) administration based on bone marrow radiation allows the delivery of a large amount of I-131 to thyroid cancer tissue within the safety margin. We performed MSD therapy in 46 patients with differentiated thyroid cancers, which had persisted even after conventional fixed dose therapy. MSD was calculated according to the Memorial Sloan Kettering Cancer Center protocol using blood samples. Mean calculated MSD was 12.5±2.1 GBq (337.3±37.5 mCi). Of the 46 patients, 6 (13.0%) showed complete remission, 15 (32.6%) partial response, 19 stable disease, and 6 disease progression. Twenty-nine patients (63%) had a transient cytopenia after therapy. MSD therapy of

  13. Sparse location radioactive counts/radioactive counts in thyroid area in predicting hypothyroidism after radioiodine therapy in patients with Graves disease%甲状腺显像疏/甲比预测131I治疗Graves病后甲状腺功能减退症

    Institute of Scientific and Technical Information of China (English)

    李俊红; 韦智晓; 李亚范

    2011-01-01

    Objective To explore the relationship between the specific value of sparse location radioactive counts/radioactive counts in thyroid area (S/T) of 99mTcO4 - thyroid imaging and hypothyroidism following 131 I treatment in patients with Graves disease (GD). Methods 99mTcO4- thyroid imaging were performed for all of 172 patients with GD before radioiodine therapy, and the value of S/T of each imaging was measured. The patients were divided into recovery group, hypothyroidism group and non-recovery group according to curative effect after 1 year's following up. The diagnostic cut-off value of S/T was confirmed with ROC curve, then the relationship between S/T and hypothyroidism after treatment was assessed.Results ROC curve analysis showed the best diagnostic cut-off value of S/T was 0. 92, and the responding sensitivity and specificity was 0.86 and 0. 65, respectively. The difference of S/T was statistically significant between hypothyroidism group and recovery group, as well as between hypothyroidism group and non-recovery group (P<0. 05). S/T<0. 92 was associated with high incidence rate of hypothyroidism after radioiodine therapy. Conclusion There are some relativities between the S/T and hypothyroidism after 131I treatment in patients with GD. The incidence of hypothyroidism increases when S/T<0. 92.%目的 探讨99mTcO4-甲状腺显像中甲状腺内稀疏部位平均放射性计数与整个甲状腺内平均放射性计数的比值(疏/甲比)与Graves病(GD)131I治疗后甲状腺功能减退症(简称甲减)的关系.方法 对172例经131I治疗的GD患者于治疗前进行99mTcO4-甲状腺显像,并计算其疏/甲比.根据治疗效果将患者分为痊愈组、甲减组和未愈组.用ROC曲线确定疏/甲比的诊断阈值,分析疏/甲比与治疗后甲减的关系.结果 取疏/甲比0.92为诊断甲状腺内存在稀疏部位的临界值,其灵敏度为0.86,特异度为0.65.甲减组与痊愈组、未愈组的疏/甲比

  14. Radio-iodine treatment of hyperthyroid cats

    International Nuclear Information System (INIS)

    Thirty-two elderly domestic shorthaired cats (mean age 12.9 years) were treated with radioiodine (131I). The dose of 131I administered ranged from 39 mBq to 134 mBq. Twenty-eight cats became euthyroid after treatment, one became hypothyroid and three remained hyperthyroxaemic. Two of the hyperthyroxaemic cats were successfully re-treated with 131I. Five cats died from concurrent diseases within one year of treatment. The administration of a dose of 131I selected by assessing the severity of the clinical signs, the size of the thyroid gland(s) and the serum level of thyroxine was an effective treatment for hyperthyroidism

  15. Guidelines for radioiodinated MIBG scintigraphy in children.

    Science.gov (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations. PMID:12658506

  16. Is it worth to calculate the dose of radioiodine?

    International Nuclear Information System (INIS)

    Full text: Administration of empirical doses of radioiodine (RAI) has been preferred to calculated doses in many hospitals, because the need to measure the size and the iodine uptake in the thyroid involves considerable inconvenience to the patient and additional costs. The preparation of RAI of varying activities also means extra work. Today there is no general consensus on whether radioiodine should be given as a fixed dose or should be calculated. There is also no consensus regarding the question of which radiation burden should be administered to a given volume of thyroid if the activity is calculated. However, while it is possible to deliver a relatively precise dose of radiation to the thyroid gland, maybe it is worth doing this?The aim of this study was to investigate the results of different uptake and volume dependent target doses on clinical outcome of patients with hyperthyroidism in Graves' disease, multi-nodular toxic goiter or toxic adenoma after radioiodine therapy. We reviewed the records of 428 patients (389 women and 39 men, mean age 56.8±12.9 years) who had received radioiodine treatment for Graves' disease and multinodular toxic goiter (n=312) or toxic adenoma (n=116) during the period of 2000-2004 in Kaunas Medical University Hospital. Most patients were given antithyroid drug therapy in order to achieve euthyroidism before treatment with RAI. Radioiodine uptake test with repeated measurements at 2, 6, 24, 48 and/or 72 and/or 96 hr to define the effective half-life was performed. In addition, all the patients underwent thyroid ultrasonography and scintigraphy to define the volume of the thyroid. The 131I activities were calculated according to the formula of Marinelli. In addition to the normal calculation individual target doses were adjusted to the thyroid volumes of each patient before therapy. For statistical evaluation, the patients were divided into four groups: group I included those with a thyroid volume 51 ml. Statistical analysis was

  17. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ross, D.S.; Nussbaum, S.R.

    1989-06-01

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status.

  18. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status

  19. Augmented Reality in Astrophysics

    OpenAIRE

    Vogt, Frédéric P. A.; Shingles, Luke J.

    2013-01-01

    Augmented Reality consists of merging live images with virtual layers of information. The rapid growth in the popularity of smartphones and tablets over recent years has provided a large base of potential users of Augmented Reality technology, and virtual layers of information can now be attached to a wide variety of physical objects. In this article, we explore the potential of Augmented Reality for astrophysical research with two distinct experiments: (1) Augmented Posters and (2) Augmented...

  20. Usefulness of recombinant human TSH aided radioiodine doses administered in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    The published studies confirming the safety and efficacy of rh TSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI) dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC). In order to establish the efficacy of RI therapy after rh TSH, we have reviewed 39 rh TSH-aided radioiodine treatments in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17), with previous thyroid bed uptake and undetectable thyroglobulin (Tg) levels under levothyroxine treatment and GII (n=11), with proven metastatic local or distant disease. Median follow-up after the first rh TSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months). Sixteen patients (94%) in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rh TSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer) and five out of the remaining patients have persistent disease. In conclusion, rh TSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94%) patients (GI). rh TSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rh TSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels. (author)

  1. Heath-related quality of life in thyroid cancer patients following radioiodine ablation

    Directory of Open Access Journals (Sweden)

    Henry Jean-françois

    2011-05-01

    Full Text Available Abstract Background There is limited information about the medium to long-term health-related quality of life (QOL in thyroid cancer patients after initial therapy and the existing studies suffer from limitations. The aim of the study was to assess the determinants of medium-term QOL after the initial therapy. Methods Following a total thyroidectomy, 88 thyroid cancer patients received either rhTSH or hypothyroid-assisted radioiodine ablation (RRA using 3.7 GBq (100 mCi of radioiodine. QOL evaluation of the patients using the validated Functional Assessment of Chronic Illness & Therapy (FACIT was performed at the time of inclusion (t0 and later at the 9-month post-RRA (t1. Results 83 patients were eligible for the final evaluation. Medium-term FACIT scores were not statistically different between t0 and t1 patients. All but one domain of the QOL score was similar between t0 and t1. Using a multivariate analysis, only age and immediate postoperative QOL scores were found to be determinants of the overall medium term 9-month QOL scores. Analysis showed that 'high QOL levels' (baseline and 9-month and 'no depression', 'low anxiety levels', were associated with ' Conclusions The use of radioiodine ablation does not seem to affect the medium term QOL scores of patients. Medium-term QOL is mainly determined by pre-ablation QOL. The assessment of baseline QOL might be interesting to evaluate in order to adapt the treatment protocols, the preventive strategies, and medical information to patients for potentially improving their outcomes.

  2. Follow-up of patients treated with retinoic acid for the control of radioiodine non-responsive advanced thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    S.M. Coelho

    2011-01-01

    Full Text Available During thyroid tumor progression, cellular de-differentiation may occur and it is commonly accompanied by metastatic spread and loss of iodine uptake. Retinoic acid (RA administration might increase iodine uptake in about 40% of patients, suggesting that RA could be a promising therapeutic option for radioiodine non-responsive thyroid carcinoma, although a prospective study with a long-term follow-up has not been reported. This was a clinical prospective study assessing the value of 13-cis-RA in patients with advanced thyroid carcinoma and its impact on major outcomes such as tumor regression and cancer-related death with a long-term follow-up of patients submitted to radioiodine (131I therapy after RA administration. Sixteen patients with inoperable disease and no significant radioiodine uptake on post-therapy scan were selected. Patients were treated orally with 13-cis-RA at a dose of 1.0 to 1.5 mg·kg-1·day-1 for 5 weeks and then submitted to radioiodine therapy (150 mCi after thyroxine withdrawal. A whole body scan was obtained 5 to 7 days after the radioactive iodine therapy. RECIST criteria were used to evaluate the response. An objective partial response rate was observed in 18.8%, a stable disease rate in 25% and a progression disease rate in 56.2%. Five patients died (62.5% in the group classified as progression of disease. Progression-free survival rate (PFS ranged from 72 to 12 months, with a median PFS of 26.5 months. RA may be an option for advanced de-differentiated thyroid cancer, due to the low rate of side effects.

  3. Radioiodination of vasoactive intestinal peptide (VIP)

    International Nuclear Information System (INIS)

    In recent years, increasing biochemical and radiochemical research has been performed to develop radiolabelled peptides as specific ligands for tumour associated receptors. VIP, a 28-amino acid peptide containing two tyrosines and three lysines, has demonstrated that various tumour cells express significantly higher amounts of VIP-receptors and could be applied to the clinic diagnosis. For these purposes, radiohalogenation of VIP by direct and indirect method was studied. Direct labelling works well for radioiodine but is limited to dehalogenation of labelling products in vivo. Conjugate labelling methods including Boltonhunter and wood reagents were developed but introduction of such a molecule to peptides may lead to the decrease of biological activity in vivo. In order to resolve these problems, N-Succinimidyl-3-(tri-nbutylstannyl) benzoate (ATE) was elected for the radioiodination of VIP and already employed to radioiodination of IgG successfully. The in vitro stability and biological activity would be compared in these two methods. Vasoactive intestinal peptide (VIP) and human immunoglobulin (IgG) were radioiodinated by direct and indirect methods. Iodogen was employed in direct method and N-Succinimidyl-3-(tri-n-butylstannyl) benzoate (ATE) was applied as a prosthetic group in the conjugation labelling. The subject of our study was optimizing the radiohalogenation of IgG and VIP followed by separation and analysis of reaction products. The advantages and disadvantages were illustrated by comparing the in vitro stability and biological activity in these two methods. Na123I was prepared by nuclear reaction of 124Te(p, 2n)123I using cyclone-30. More than 95% of radiochemical purity, more than 95% of radionuclide purity and about 100 mCi/mL of radioactivity concentration were obtained. ATE was supplied by Dr. Pozzi and radioiodinated with iodogen and 96% of labelling efficiency was obtained. The stability of radioactive S125IB kept well in dark at 4 . Human Ig

  4. Myocardial uptake of radioiodinated fatty acids under influence of beta-adrenoceptor antagonists in the dog

    International Nuclear Information System (INIS)

    The metabolic effects of Pindolol and Metoprolol on myocardial uptake and distribution of radioiodinated free fatty acids (131I-heptadecanoic acid) in the normal and acutely ischemic dog heart, are investigated. The study shows a decrease in uptake of 131I-heptadecanoic acid in the myocardium after administration of beta-blocking agents, which could have major implications: 1) for the administration of beta-blocking agents in the acute stage of myocardial infarction in clinical practice and 2) for the use of 131I-heptadecanoic acid as cardiac imaging agent in patients with or suspect for coronary artery disease whom are on beta-blocker therapy

  5. 乳腺癌组织中碘化钠同向转运蛋白的表达及其诱导与乳腺癌放射碘治疗%The sodium iodide symporter:expression and induction in breast cancer and breast cancer radioiodine ther-apy

    Institute of Scientific and Technical Information of China (English)

    李婧(综述); 张清媛(审校)

    2015-01-01

    The sodium iodide symporter( NIS) is a transmembrane glycoprotein that mediates active iodide uptake into thyroid follicular cells. NIS⁃mediated iodide uptake in thyroid cells is the basis for treatment of differentiated thyroid carcinomas and their me⁃tastases. Furthermore, NIS is expressed in many human breast tumors, suggesting that NIS⁃mediated radionuclide uptake may be used for the targeted therapy of breast cancer. However, functional cell surface NIS expression is often low in breast cancer, making it impor⁃tant to uncover signaling pathways that modulate NIS expression at multiple levels, from gene transcription to posttranslational process⁃ing and cell surface trafficking. In this review, we summarized the research progress of the presence, relevance and regulation of NIS in breast cancer. The clinical significance of NIS in breast cancer radioiodine therapy will also be discussed.%碘化钠同向转运蛋白( NIS)是一种调控甲状腺滤泡细胞碘吸收的跨膜糖蛋白。 NIS调控甲状腺细胞碘吸收是甲状腺及其转移癌放射碘治疗的基础。然而研究证实,NIS除表达于哺乳期乳腺细胞上外,还表达于多数乳腺癌细胞,提示放射碘治疗也可能成为乳腺癌一种可行的治疗方法,尤其是对三阴性乳腺癌及乳腺癌脑转移患者。然而,乳腺癌细胞表面NIS蛋白表达通常都较低,且只有表达于细胞表面的NIS方具备放射碘吸收能力。因此揭示不同水平上NIS表达的调控机制就显得格外重要。本文就NIS在乳腺癌中的表达及其诱导与乳腺癌放射碘治疗的研究进展作一综述。

  6. Radioiodine uptake in a renal cyst mimicking a metastasis in a patient affected by differentiated thyroid cancer. Case report and review of the literature

    International Nuclear Information System (INIS)

    We report a 55-year-old man affected by differentiated thyroid carcinoma with lymph nodes metastases. After conventional levothyroxine withdrawal, the patient underwent thyroid remnant ablation by oral administration of radioiodine-131 ablative activity (3700 MBq). 7 days later, post-therapy whole body scan (pWBS) demonstrated thyroid remnant and showed a large area of abnormal radioiodine uptake located in the posterior left upper abdomen. Ultrasonography of the abdominal region revealed a cyst in left kidney corresponding to the focal radioiodine uptake. On the same day, 131I static images of the posterior upper abdomen obtained before and after administration of furosemide, showed that radioiodine uptake in the lesion was markedly lower after diuretic administration, indicating that radioiodine accumulation in the renal cyst is linked to an active secretory process by the renal tubule. Due to its non-negligible frequency, renal cyst should be taken into account in DTC patients as a potential pitfall at 131I pWBS. (author)

  7. Psychotherapy augmentation through preconscious priming

    Directory of Open Access Journals (Sweden)

    Francois eBorgeat

    2013-03-01

    Full Text Available Objective: To test the hypothesis that repeated preconscious (masked priming of personalized positive cognitions could augment cognitive change and facilitate achievement of patients’ goals following a therapy.Methods: Twenty social phobic patients (13 women completed a 36 weeks study beginning by 12 weeks of group behavioural therapy. After the therapy, they received 6 weeks of preconscious priming and 6 weeks of a control procedure in a randomized cross-over design. The Priming condition involved listening twice daily with a passive attitude to a recording of individualized formulations of appropriate cognitions and attitudes masked by music. The Control condition involved listening to an indistinguishable recording where the formulations had been replaced by random numbers. Changes in social cognitions were measured by the Social Interaction Self Statements Test (SISST.Results: Patients improved following therapy. The Priming procedure was associated with increased positive cognitions and decreased negative cognitions on the SISST while the Control procedure was not. The Priming procedure induced more cognitive change when applied immediately after the group therapy. Conclusion: An effect of priming was observed on social phobia related cognitions in the expected direction. This self administered addition to a therapy could be seen as an augmentation strategy.

  8. Improvement of goiter volume reduction after 0.3 mg recombinant human thyrotropin-stimulated radioiodine therapy in patients with a very large goiter: a double-blinded, randomized trial

    DEFF Research Database (Denmark)

    Bonnema, Steen; Nielsen, Viveque E; Boel-Jørgensen, Henrik; Grupe, Peter; Andersen, Peter B; Bastholt, Lars; Hegedüs, Laszlo

    2007-01-01

    INTRODUCTION: The effect of (131)I therapy amplification by recombinant human (rh) TSH prestimulation in very large goiters has not been evaluated in a double-blinded, placebo-controlled study. METHODS: Twenty-nine patients (22 females; age range 37-87 yr) with a large multinodular goiter (median...... 160 ml, range 99-440 ml) were randomized to receive placebo (n = 15) or 0.3 mg rhTSH (n = 14) 24 h before (131)I administration. Goiter volume was monitored by magnetic resonance imaging. RESULTS: On average, the goiter volume was unchanged 1 wk after therapy in both groups, but the largest deviations...... from baseline were observed in the rhTSH group. After 12 months the median goiter volume was reduced from 170 to 121 ml in the placebo group and from 151 to 72 ml in the rhTSH group, respectively (within group: P = 0.001; between group: P = 0.019). This corresponds to reductions of 34.1 +/- 3.2 and 53...

  9. The diagnostic and therapeutic utility of radioiodinated metaiodobenzylguanidine (MIBG)

    International Nuclear Information System (INIS)

    The authors' experience of more than 5 years in the diagnostic and therapeutic use of radioiodinated MIBG in neural crest tumor is reported. 123I/131I-MIBG scintigraphy was performed in 158 patients: 75 suspected (24 proven) pheochromocytomas (pheos), 43 neurablastomas (NB), 20 medullary thyroid carcinomas (MTC), 6 ganglioneuromas, 5 carcinoids and 1 insulinoma. Eight cases of tumors not originating from the neural crest were also investigated. The diagnostic sensitivity of the method was above 90% both in pheos and NB (primary tumors and bone metastases). The examination was less effective in localizing MTC (sensitivity=64.4% in primary or residual/recurrent tumors). The scintigraphic outcome was negative in ganglioneuromas, carcinoids and insulinoma. Specificity was very high (>95%), and no false positive results were found in tumors not deriving from the neural crest. 131I-MIBG treatment was administered to four patients with malignant pheo, nine with NB and four with MTC. Therapy resulted in a complete response in one pheo, two NB and one MTC treated after surgery or at diagnosis (one NB); it gave partial response and prolonged remission in five advanced cases (one pheo, two NB and two MTC); it resulted in temporary stabilization of the disease in one pheo and two NBs; it was ineffective in four cases. (orig.)

  10. Radioiodine treatment for complicated hyperthyroidism using a fixed dose regime

    International Nuclear Information System (INIS)

    Full text: Hyperthyroidism in the elderly and all those with cardiovascular and psychiatric problem has increased mortality and morbidity rate. These patients need special care to cure the disease promptly and permanently for avoidance of complications. Radioactive I-131 is one of the accepted forms of treatment for hyperthyroidism and increasingly being considered for the patients in whom rapid and permanent control of disease is desirable. To evaluate the success of I-131 to cure disease in-patients with complicated hyperthyroidism, we prospectively studied the outcome of radioiodine therapy using a fixed dose regime. Ninety-three patients with toxic diffuse goitre (65 female, 28 male) age ranging from 29-67 years (mean ? SD 41.35 ? 11.02 years) were evaluated. The subjects included 71 cases with cardiovascular problem, 13 elderly patients, 5 with poor drug compliance and 4 with associated psychiatric disease. The individual was excluded from the study who had autonomous toxic nodule. Every patient was pre-treated with antithyroid drugs for 4 weeks and the drug was discontinued for 3 days before administering I-131. No patients had post-treatment antithyroid drugs. All the patients were treated with a fixed oral dose of 15 mCi I-131 sodium iodide. Post-treatment follow-up examinations were done at 6 weeks without biochemical tests, at 3 months, 6 months, 9 months and 1 year and then annually with biochemical tests. Patients were classified as cured if the biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. Of the 93 cases, 82 patients became euthyroid or hypothyroid requiring no further treatment for hyperthyroidism with an overall cure of 88.17%. Hypothyroidism was developed in 49 (52.69%) patients at one year of whom 39 became hypothyroid within 6 months and another 10 patients within 1 year. 4 patients were subclinical hyperthyroid at 6 months and still hyperthyroid at 9 months. 7

  11. Potential of the drug-regulation iodide uptake in patients for prevention of radioiodine-refractory papillary thyroid cancer

    Directory of Open Access Journals (Sweden)

    Dmitriy Kirillovich Fomin

    2014-11-01

    Full Text Available ObjectiveTo evaluate the efficacy and feasibility of retinoic acid derivatives and lithium salts for radioiodine-refractory prevention in patients with differentiated thyroid cancer during multistage radioiodine therapy.Materials and methodsThe retrospective analysis was performed using the diagnostic and treatment results of 40 patients with differentiated thyroid cancer that underwent 131I therapy, which on the basis of posttherapy whole-body scan had direct indications for subsequent course of radioiodine therapy. The patients were divided into two groups:the control group (20 patients, which conducted a second course of radioiodine therapy on the standard template and without special training$the main group (20 patients, who were administered Sedalia (900 mg per day for 8 days, p.o. and isotretinoin (1.2 mg/kg body weight for 60 days, p.o. to prevention of the 131I resistance.To evaluate the effectiveness of a repeated course of radioiodine therapy following parameters were used: the thyroglobulin (Tg and antibodies to thyroglobulin (Tg-Ab level in the serum, the posttherapy whole body scan in combination with SPECT-CT.ResultsWe have found, that radioactive iodine treatment was effective in 75% of the main group and 90% of patients in the control group. The remission was observed in 10% and 40% in the main and control group, respectively. The partial regression was considered as Tg and TG-Ab reduction, and was observed more in the study group. The resistance to 131I therapy was found in 20% and 10% in the main and control group, respectively, which was based on the fact of permanent Tg/Tg-Ab serum level and absence of the pathological foci iodine uptake on the whole-body scans. The disease progress was found in one patient in the main group.ConclusionThe use of retinoic acid derivatives and lithium salts, in an effort to prevent the resistance to 131I-theraphy pretend to be unjustified, because it does not lead to significant

  12. The indirect radioiodination of vasoactive intestinal peptide

    International Nuclear Information System (INIS)

    Objective: To seek for an effective way to acquire radiolabeled vasoactive intestinal peptide (VIP) with excellent in vivo stability. N-succinimidyl-3-iodo-125-benzoate (S125IB) came from radioiodination of N-succinimidyl-3-(tri-n-butylstannyl) benzoate (ATE) precursor and then conjugated with VIP to form 125IBA-VIP. The labelling procedure was optimized; the in vitro stability and biological activity were evaluated. Methods: 1) Radiolabeling of ATE precursor was achieved with iodogen oxidant and the influential factors were considered in this procedure. The labeling efficiency was determined by thin layer chromatography (TLC) and the purification was carried out by Sep-pak silica gel cartridge. The stability was detected by TLC after 2 h storage in dark at 4 degree C. 2) Conjugation of S125 IB and VIP. The labelling efficiency was determined with RP TLC and the purification was carried out with high performance liquid chromatography (HPLC, RP C18 column). Trichloroacetic acid (TCA) precipitation method was applied to evaluate the in vitro stability while the biological activity was determined by cell binding experiments with SGC7901 cell lines. Results: 1) S125IB experiments. The radioiodination of ATE was performed well for 5 min at 25 degree C with 10 micrograms of iodogen at suitable mole ratio (3-8:1) of ATE/Na 125I, the labelling efficiency was about 96%. The stability was kept well at 4 degree C in dark, no significant decrease of S125IB was observed. 2) The conjugation efficiency of S125IB and VIP was above 75% with TLC. HPLC showed the different retention time (tR) as follows, 125IBA-VIP: 13.3 min, S125IB: 19.6 min, VIP: 8.32 min. The stability of 125IBA-VIP was better than 125I-VIP from direct radioiodination of VIP with iodogen oxidant, only 2.85% decrease was found after 7 d at 4 degree C. The biological activity of 125IBA-VIP was kept as well as 125I-VIP under the condition of 37 degree C 60 min. Conclusions: The indirect radiolabelling procedure with

  13. Aggregation of encephalomyocarditis virus induced by radio-iodination

    International Nuclear Information System (INIS)

    Radio-iodination causes encephalomyocarditis virus to behave aberrantly when examined by affinity chromatography and to sediment rapidly during analysis on sucrose density gradients suggesting that aggregation had taken place. The change in physical properties of the virus occurred whether iodination was carried out with 125I or 131I, with radio-iodine from two different sources, or using two different iodination procedures. The changes were not observed in virus subjected to an iodination procedure in the absence of radio-iodine suggesting that modification of tyrosine residues was involved rather than a side reaction such as amino acid oxidation. It is recommended that caution be exercised when following the fate of radio-iodinated virus in any particular study because its behaviour may not reflect that of normal, non-iodinated virus present. (Auth.)

  14. Radioiodination of melagenine-II with I-125 (preliminary study)

    International Nuclear Information System (INIS)

    Radioiodination of Melagenine-II with I-125 farmacokinetic studies was made, using Chloramine-T method. Radiochemical purity and stability of the labelled product were determined by radiochromatography. The labelled Melagenine-II showed two radioactive fractions

  15. Can previous thyroid scan induce cytogenetic radio adaptive response in patients treated by radioiodine for hyperthyroidism?

    International Nuclear Information System (INIS)

    Background: Induction of radio adaptive responses in cells pretreated with a low dose radiation before exposure to a high dose is well documented by many in investigators. The aim of this study is to determine the frequency of chromosomal aberration in peripheral blood lymphocytes of patients treated by radioiodine (131 I) for hyperthyroidism, with or without previous thyroid scan with 99m Tc. Materials and methods: venous blood samples were obtained from 35 patients one month after radioiodine therapy and cytogenetic ally evaluated using analysis of metaphase in two groups. The first group (n=15, 13 females and 2 males, mean age=44.7±11.5 years and mean weight 74.4±7.9 Kg) received 5 mCi 99m Tc for thyroid scanning 38.6±19.9 days before radioiodine therapy with 10.4±3.4 mCi 131I. The second group (n=20, 14 females and 6 males, mean age=41.0±10.8 years and mean weight=68.1±9.2 Kg) didn't have history of thyroid scanning. We also studied a control group (n=29, 11 females and 8 males age=33.7±7.4 and mean weight=70.0±8.8 Kg) who didn't have any history of diagnostic or therapeutic and also occupational exposure. Results: The mean frequency of total chromosomal aberrations in the first and second groups and controls were 1.46±1.55, 1.65±1.62 and 0.93±0.92 respectively. Results also showed that the mean frequency of total chromosome aberration in two groups were higher than controls and significantly higher in patients who had not received 99m Tc compared those who had undertaken thyroid scan before radioiodine therapy (p=0.03). Conclusion: These findings may indicate the fact that the radiation dose received from 99m Tc could induce resistance to subsequent higher radiation dose of 131 I in peripheral blood lymphocytes and it might be due to cytogenetic radio adaptive response

  16. Radioiodine Thyroid Ablation in Graves’ Hyperthyroidism: Merits and Pitfalls

    OpenAIRE

    Nwatsock, J. F.; Taieb, D.; Tessonnier, L.; Mancini, J; Dong-A-Zok, F.; Mundler, O.

    2012-01-01

    Ablative approaches using radioiodine are increasingly proposed for the treatment of Graves′ disease (GD) but their ophthalmologic and biological autoimmune responses remain controversial and data concerning clinical and biochemical outcomes are limited. The aim of this study was to evaluate thyroid function, TSH-receptor antibodies (TRAb) and Graves′ ophthalmopathy (GO) occurrence after radioiodine thyroid ablation in GD. We reviewed 162 patients treated for GD by iodine-131 (131I) with dose...

  17. A Mathematical Model for Assaying Gaseous Radioiodine in Charcoal Cartridges

    International Nuclear Information System (INIS)

    Sampling radioiodine in ambient air or gaseous effluent streams is accomplished by passing an air sample through a charcoal cartridge. Since gaseous radioiodine may be presented in various chemical forms including elemental and organic species, the charcoal is impregnated with 5% TEDA (TetraEthylenDiAmine) to convert organic iodide species to forms that can be collected on charcoal. Charcoal cartridges' producers test their cartridges against nonradioactive iodine at concentrations that are about 9-10 orders of magnitude higher than radioiodine concentrations that could be encountered in nuclear industry. Thus, the suitability of their reported adsorption efficiencies to the radioiodine concentration range is doubtful. The analysis of a cartridge containing radioiodine is generally performed by germanium gamma ray spectrometer. The cartridge is counted with the inlet side facing the detector and assuming most of the activity is concentrated in the front side of the cartridge. When sampling is performed for long periods (over several days), radioiodine can be found in deeper parts of the cartridge. In such cases the analysis may lead to major discrepancies between the measured value and the true value. Another problem rises in very long sampling periods (around one month) where breakthrough of the cartridge may occur. In such a case, the measured value does not account for the radioiodine that crossed the cartridge. In the present study, a numerical model was developed, to estimate the total amount of radioiodine that is adsorbed in the cartridge and the amount that breaks-through the cartridge. In order to use the model, the cartridge was divided into 14 layers and calibration was performed for the counting of each layer from the front and rear sides of the cartridge. Such a calibration has to be performed for each radionuclide and for each detector

  18. Molten Hydroxide Trapping Process for Radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Trowbridge, L.D.

    2003-01-28

    A molten hydroxide trapping process has been considered for removing radioiodine species from off-gas streams whereby iodine is reacted directly with molten hydroxides such as NaOH or KOH. The resulting product is the corresponding iodide, which can be separated by simple cooling of the molten mixture to grow the iodide primary phase once the mixture reaches 70-80 mol% in the iodide component. Thermodynamic analysis indicates that such a chemical process is highly favorable. Experimental testing of the trapping process using molecular iodine showed trapping of up to 96% of the volatile iodine. The trapping efficiency was dependent on operational parameters such as temperature and gas-melt contact efficiency, and higher efficiencies are expected as the process is further developed. While an iodide phase could be effectively isolated by slow cooling of a molten iodide-hydroxide mixture, the persistent appearance of hydroxide indicated that an appreciable solubility of hydroxide occurred in the iodide phase.

  19. Radioiodine in kelp from western Australia

    Energy Technology Data Exchange (ETDEWEB)

    Marsh, K.V.; Buddemeier, R.W.; Wood, W.; Smith, C.

    1987-03-25

    As part of a program to survey low levels of radioactivity in the marine environment of the southern hemisphere, we have studied the distribution and uptake of /sup 131/I found in the subtidal kelp Ecklonia radiata, on the west coast of Australia. Concentrations of 5 to 75 fCi/g of /sup 131/I exist in this species over a considerable distance along the coast. We have characterized the principal source of the /sup 131/I and found a general temporal correlation between the amount of radioiodine discharged from sewer outfalls and its concentration in kelp. Transplant experiments have enabled us to estimate uptake and depuration rates, and our results are consistent with laboratory measurements made by others.

  20. Exercise lowers thyroid radioiodine uptake: concise communication

    International Nuclear Information System (INIS)

    The effect of exercise upon the uptake of radioiodine by the thyroid was examined in both rats and humans. Rats that exercised intermittently on a mechanical wheel for a period of 20 days had singificantly lower uptake values (p < 0.0001) than sedentary controls. Human volunteers that ran at least ten miles/week had a lower mean 24-h uptake value (8.0 +- 2.8%) than nonexercisign subjects (14.3 +- 5.1%, p < 0.01). Other thyroid function studies (thyroxine, triiodothyronine, triiodothyronine resin uptake, thyroid-stimulating hormone) did not differ significantly between the exercisign and nonexercising groups. These studies suggest that exercise significantly alters thyroid iodine economy

  1. Radioiodine in kelp from western Australia

    International Nuclear Information System (INIS)

    As part of a program to survey low levels of radioactivity in the marine environment of the southern hemisphere, we have studied the distribution and uptake of 131I found in the subtidal kelp Ecklonia radiata, on the west coast of Australia. Concentrations of 5 to 75 fCi/g of 131I exist in this species over a considerable distance along the coast. We have characterized the principal source of the 131I and found a general temporal correlation between the amount of radioiodine discharged from sewer outfalls and its concentration in kelp. Transplant experiments have enabled us to estimate uptake and depuration rates, and our results are consistent with laboratory measurements made by others

  2. The efficacy and safety of recombinant human TSH-aided radioiodine treatment of differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    62 patients of differentiated thyroid cancer were performed total or near total thyroidectomy. 31 cases received rh TSH-aided radioiodine treatment of 3.7 GBq (Group euthyroid). Another 31 were given radioiodine ablation treatment of 3.7 GBq after 4 weeks thyroxine withdrawal (Group hypothyroidism). After about 5 to 6 months, the effect of radioiodine treatment was evaluated by whole body scan with diagnostic radioiodine. The complete ablation rate was 77.4% in group euthyroid, and 71.0% in group hypothyroidism (P>0.05). In a word, rh TSH-aided radioiodine treatment can acquire satisfactory radioiodine ablation efficacy. (authors)

  3. Radioiodine 131I metabolism in human

    International Nuclear Information System (INIS)

    Metabolic fate of orally administered 131I in human was studied. Chronological observations of whole body radioactivity distribution and thyroid 131I uptake curve revealed that 131I metabolism was greatly affected by the amount of dietary iodine intake. Under the high iodine intake exceeding 1 mg per day, uptake curve showed biphasic descending type, that is, rapid accumulation during 3 to 6 hours and rapid fall up to 48 hours and gradual decrease afterwards. While, ascending type, monophasic and maximal at 24 hours, was found universary under low iodine intake less than 500 μg per day. Thyroid function should not be affected by the amount of iodine intake, and we analysed 131I metabolism using a new four compartments which included intrathyroidal inorganic iodine pool. The results, especially hormone production rate, were found quite useful even under high iodine intake. Thyroidal organic iodine contents were calculated as approximately 2.5 mg and this value was much less than previously reported values from other countries. Administered radioiodine were mixed up with stable body iodine and reached equilibration by around 10 days. From seroimmunological, histological (microscopic and electron microscopic) studies, and irradiation studies to the cultured human thyroid cells, we concluded that this unexpected phenomenon was derived from chromosomal damage which induced gradual decrease in cell population because of inability to reproduce. Carcinogenic and genetic effects were not serious, and only three leukemic patients were reported in this country and 484 normal babies were born from 7,500 treated parents. Thus, therapeutic dose of 131I was proved rather safe, and even when exposed to radioiodine, administration of perchlorate or thiocyanate, excessive iodine and TSH seemed effective to avoid radiation injuries. (auth.)

  4. Patterns of radioiodine uptake by the lactating breast

    Energy Technology Data Exchange (ETDEWEB)

    Bakheet, S.M. (Dept. of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)); Hammami, M.M. (Dept. of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia))

    1994-07-01

    Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: ''full'', ''focal'', ''crescent'' and ''irregular''. The uptake was asymmetric in 60% (left>right in 45%, right>left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis. (orig.)

  5. Patterns of radioiodine uptake by the lactating breast.

    Science.gov (United States)

    Bakheet, S M; Hammami, M M

    1994-07-01

    Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: "full", "focal", "crescent" and "irregular". The uptake was asymmetric in 60% (left > right in 45%, right > left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis. PMID:7957345

  6. The principles of radioiodine dosimetry following a nuclear accident

    International Nuclear Information System (INIS)

    Based upon the experience of radioiodine dosimetry after the Chernobyl accident main principals of radioiodine measurements and dosimetry in thyroid glands of population in case of a radiation accident are discussed in the report. For the correct dose estimation following the radioiodine measurement in the thyroid one should know the ''history'' of radionuclide intake into the body of a contaminated person. So a measurement of radioiodine thyroid content should be accompanied by asking questions of investigated persons about, their life style and feeding after a nuclear incident. These data coincidently with data of radionuclides dynamic in the air and food (especially in milk products) are used for the development of radioiodine intake model and then for thyroid dose estimation. The influence of stable iodine prophylaxis and other countermeasures on values are discussed in dependence on the time of its using. Some methods of thyroid dose reconstruction used after the Chernobyl accident in Russia for a situation of thyroid radioiodine measurements lacking in a contaminated settlement are presented in the report. (author). 16 refs, 5 figs, 3 tabs

  7. Patterns of radioiodine uptake by the lactating breast

    International Nuclear Information System (INIS)

    Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: ''full'', ''focal'', ''crescent'' and ''irregular''. The uptake was asymmetric in 60% (left>right in 45%, right>left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis. (orig.)

  8. Conditionally replicative adenovirus under the control of glial fibrillary acidic protein and human telomerase reverse transcriptase dual-promoters direct sodium iodide symporter expression for malignant glioma radioiodine therapy

    International Nuclear Information System (INIS)

    Objective: To explore the possibility of using 131I as a targeted therapy method for malignant glioma by infecting U87 and U251 cells with conditionally replicative adenovirus Ad-Tp-E1a-Gp-NIS. Methods: Human telomerase reverse transcriptase (hTERT) promoter and glial fibrillary acidic protein (GFAP) promoter were cloned and their transcriptional activities were detected by luciferase assay. The conditionally replicative adenovirus Ad-Tp-E1 a-Gp-NIS was constructed,purified,and transfected into U87 and U251 glioma cells. For these transfected cells, the selective replication ability was evaluated by plaque forming assay, and protein expression was detected by Western blot assay. 125I-iodide uptake and exflux, the clone formation of 131I-iodide treated cells were also measured. Results: Transcriptions activity of the GFAP and hTERT promoters was 59.75%-62.10% (F = 11.89, P < 0.01) in U87 cells and 37.31%-49.00% (F = 5.87, P < 0.05) in U251 cells. The Ad-Tp-E1a-Gp-NIS could be selectively replicated and the hNIS gene was successfully expressed in the hTERT-positive and GFAP-positive glioma cells which showed two protein bands with relative molecular mass of 120 × 103 and 49 × 103 in Western blot assay. After infection with Ad-Tp-E1a-Gp-NIS, the cell ability of 125I uptake was increased by 78.80 (F = 2 914.58, P <0.01) and 92.48 (F = 2 275.91, P <0.01) times in U87 and U251 cells, respectively. The GFAP-negative MRC-5 cells could not take in 125I. The in vitro clonogenic assay indicated that, after 131I treatment, more than 90% of the transfected cells were killed, while only about 65% (t = 11.73-78.33, P < 0.01) of control cells were killed. Conclusions: The Ad-Tp-E1a-Gp-NIS has a good ability in selective replication and the enhancement of antitumor therapy effect by increasing tumor-specific iodide uptake in malignant glioma cells. (authors)

  9. Augmented Reality in Astrophysics

    CERN Document Server

    Vogt, Frédéric P A

    2013-01-01

    Augmented Reality consists of merging live images with virtual layers of information. The rapid growth in the popularity of smartphones and tablets over recent years has provided a large base of potential users of Augmented Reality technology, and virtual layers of information can now be attached to a wide variety of physical objects. In this article, we explore the potential of Augmented Reality for astrophysical research with two distinct experiments: (1) Augmented Posters and (2) Augmented Articles. We demonstrate that the emerging technology of Augmented Reality can already be used and implemented without expert knowledge using currently available apps. Our experiments highlight the potential of Augmented Reality to improve the communication of scientific results in the field of astrophysics. We also present feedback gathered from the Australian astrophysics community that reveals evidence of some interest in this technology by astronomers who experimented with Augmented Posters. In addition, we discuss p...

  10. A long-term follow-up study of late-onset hypothyroidism and prognosis of hyperthyroid patients treated with radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Hideki (Tottori Univ., Yonago (Japan). School of Medicine)

    1991-09-01

    We performed a follow-up study of 7,325 cases of hyperthyroidism treated with radioiodine in Japan from 1953 to 1967. Of these cases, there were 1,892 which clearly had or had not received thyroid hormone substitution therapy. Based on this, the frequency, period of onset and background of patients with hypothyroidism were investigated. There was a high incidence of cases among women in their thirties who had received large doses of radioiodine. Also, consistent with previous reports, a continuous, long-term increase in hypothyroidism was recognized. There is a need to investigate the course of the disease more throughly. The outbreak of thyroid tumors was also investigated. No clear increase in the incidence of tumors was seen in cases that had received radioiodine therapy. An evaluation of prognosis was made to establish the anticipated mortality rate using the mortality rate of the population at large as a base for comparison. In the 2,379 cases in which there was an effective response, no significant increase in either mortality or cancer mortality was recognized in the group that received radioiodine therapy. Nor was there an increase in the mortality rate among the younger patients in the treated group. Although there was a tendency for the overall mortality to increase when large quantities of radioiodine were prescribed. There is, however, some uncertainty as to whether or not there is a direct relationship to hypothyroidism. From this standpoint, rigorous observation during the course of treatment is important as well as commencement of appropriate substitution therapy. (author).

  11. A long-term follow-up study of late-onset hypothyroidism and prognosis of hyperthyroid patients treated with radioiodine

    International Nuclear Information System (INIS)

    We performed a follow-up study of 7,325 cases of hyperthyroidism treated with radioiodine in Japan from 1953 to 1967. Of these cases, there were 1,892 which clearly had or had not received thyroid hormone substitution therapy. Based on this, the frequency, period of onset and background of patients with hypothyroidism were investigated. There was a high incidence of cases among women in their thirties who had received large doses of radioiodine. Also, consistent with previous reports, a continuous, long-term increase in hypothyroidism was recognized. There is a need to investigate the course of the disease more throughly. The outbreak of thyroid tumors was also investigated. No clear increase in the incidence of tumors was seen in cases that had received radioiodine therapy. An evaluation of prognosis was made to establish the anticipated mortality rate using the mortality rate of the population at large as a base for comparison. In the 2,379 cases in which there was an effective response, no significant increase in either mortality or cancer mortality was recognized in the group that received radioiodine therapy. Nor was there an increase in the mortality rate among the younger patients in the treated group. Although there was a tendency for the overall mortality to increase when large quantities of radioiodine were prescribed. There is, however, some uncertainty as to whether or not there is a direct relationship to hypothyroidism. From this standpoint, rigorous observation during the course of treatment is important as well as commencement of appropriate substitution therapy. (author)

  12. Diet low in iodine as well as goitrogens (LILGD) enhanced radioiodine (I-131) uptake in treatment of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Full text: Low iodine diet (LID) is accepted as an adjuvant to post-thyroidectomy radioiodine therapy of differentiated thyroid cancer since it is held to enhance radioiodine uptake in thyroid remnants and thyroid cancer tissue. However, in the few clinical investigations performed only an indirect and weak evidence of a positive effect of the LID has been demonstrated. Also we had discouraging experience in the application of a strict LID using the same design as in the present study. We therefore decided to investigate the effect of a diet low in iodine as well as in goitrogens (LILGD). Methods: Six patients with differentiated thyroid cancer entered the study and they were their own control. After thyroid hormone withdrawal (TSH > 30 m U/L) and on regular diet a diagnostic whole body scan was performed 24 h after administration of 50 MBq (1,4 mCi) 123I. The day following diagnostic scan the patients were put on LILGD for 4 days prior and two days after radioiodine therapy. In LILGD beverages, fruits and vegetables containing flavonoids, glucosinolates, cyanides and thiocyanates were avoided and spices and smoking prohibited. Therapeutic radioiodine was administered one week after diagnostic procedures and in the morning after over-night fasting with an activity range of 3,7-5,4 GBq (100 -150 mCi) 131I. A 24-h therapeutic whole body scan and calculations of percentage uptake U(24) were performed. Diagnostic (basal) D U(24)% and subsequent therapeutic T U(24)% uptake were compared and expressed as therapeutic/diagnostic uptake ratios T/D U(24). Results: A significant increase in therapeutic versus diagnostic uptake T/D U(24) was observed (mean 2,53, median 2,30, range 1,40 - 4,46, p131I uptake in radio-ablation of normal and thyroid cancer tissue. (author)

  13. Attitude and Knowledge of Hyperthyroid Patients to Radioiodine Treatment

    International Nuclear Information System (INIS)

    The purpose of this study is to survey the attitude and knowledge of radiation and radioiodine treatment in hyperthyroid patients. One-hundred-eighty-seven hyperthyroid patients who were sent for radioactive iodine treatment at Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital were requested to fill the questionnaires before and after receiving the information about radioiodine treatment. The questionnaires consisted of 15 questions of which the first five were about the attitude to radiation and radioiodine treatment. The rest was about an information on hyperthyroidism and radioiodine treatment. For data analysis, firstly the percentage of correct answer of each question was calculated and compared between pre-and post-test. Secondly all patients were categorized into 2 groups according to their education: up to high school, and undergraduate or higher. The attitude and the understanding about radioiodine treatment were analyzed in each group. If the average percentage was greater than 80, patients has positive attitude of good understanding. The results showed that post-test gives higher percentages of correct answers for all questions with an average of 24.6% improvement. For up to high school group, the attitude improved from 81.6% to 98.6% and the understanding about radioiodine treatment improved from 92.2% to 100%. Similarly, for the undergraduate or higher group, the attitude improved from 87% to 97.8% and the understanding about radioiodine treatment was 100% for both pre- and post-intervention. It may be concluded that our education intervention is informative and improves the patients, attitude and understanding about radiation

  14. GFAP启动子介导放射性131Ⅰ靶向性治疗胶质瘤的实验研究%Glial fibrillary acidic protein promoters directed sodium iodide symporter expression in malignant gioma radioiodine therapy

    Institute of Scientific and Technical Information of China (English)

    李玮; 谭建; 王澎

    2013-01-01

    -GFAP-hNIS transfection increased 69.5 and 70.8 times; the 125I effective half-life was shortened.The cloning efficiency of U87 cells being transfected with Ad-GFAP-hNIS was (9.31±0.50)% and (9.33±1.15)%,respectively,which was significantly higher than that of U87 cells being transfected with Ad-CMV-EGFP and Ad-CMV-hNIS (P<0.05).After treatment with 131I and injection of Ad-GFAP-hNIS,the survival of U87 tumor loading nude mice were prolonged most (44.00±0.58 d).Cells in the Ad-GFAP-hNIS group could uptake the radionuclide,while those in the Ad-CMV-EGFP could not.Conclusion The gliomas after Ad-GFAP-hNIS transfection can uptake iodine and also effectively direct radioactive iodine therapy.

  15. Radioiodine Biogeochemistry and Prevalence in Groundwater

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, Daniel I.; Denham, Miles E.; Zhang, Saijin; Yeager, Chris; Xu, Chen; Schwehr, Kathy; Li, Hsiu-Ping; Ho, Yi-Fang; Wellman, Dawn M.; Santschi, Peter H.

    2014-08-03

    129I is commonly either the top or among the top risk drivers, along with 99Tc, at radiological waste disposal sites and contaminated groundwater sites where nuclear material fabrication or reprocessing has occurred. The risk stems largely from 129I having a high toxicity, a high bioaccumulation factor (90% of all the body’s iodine concentrates in the thyroid), a high inventory at source terms (due to its high fission yield), an extremely long half-life (16M yr), and rapid mobility in the subsurface environment. Another important reason that 129I is a key risk driver is that there is the uncertainty regarding its biogeochemical fate and transport in the environment. We typically can define 129I mass balance and flux at sites, but cannot predict accurately its response to changes in the environment. As a consequence of some of these characteristics, 129I has a very low Drinking Water Standard, DWS, which is set at 1 pCi/L, the lowest of all radionuclides in the Federal Register. Recently, significant advancements have been made in detecting iodine species at ambient groundwater concentrations, defining the nature of the organic matter and iodine bond, and quantifying the role of naturally occurring sediment microbes to promote iodine oxidation and reduction. These recent studies have led to a more mechanistic understanding of radioiodine biogeochemistry. The objective of this review is to describe these advances and to provide a state of the science of radioiodine biogeochemistry relevant to its fate and transport in the terrestrial environment and provide information useful for making decisions regarding the stewardship and remediation of 129I contaminated sites. As part of this review, knowledge gaps were identified that would significantly advance the goals of basic and applied research programs for accelerating 129I environmental remediation and reducing uncertainty associated with disposal of 129I waste. Together the information gained from addressing these

  16. Graves' ophthalmopathy and 131I therapy

    International Nuclear Information System (INIS)

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; i i) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between progression of

  17. Radioiodination of chicken luteinizing hormone without affecting receptor binding potency

    International Nuclear Information System (INIS)

    By improving the currently used lactoperoxidase method, we were able to obtain radioiodinated chicken luteinizing hormone (LH) that shows high specific binding and low nonspecific binding to a crude plasma membrane fraction of testicular cells of the domestic fowl and the Japanese quail, and to the ovarian granulosa cells of the Japanese quail. The change we made from the original method consisted of (1) using chicken LH for radioiodination that was not only highly purified but also retained a high receptor binding potency; (2) controlling the level of incorporation of radioiodine into chicken LH molecules by employing a short reaction time and low temperature; and (3) fractionating radioiodinated chicken LH further by gel filtration using high-performance liquid chromatography. Specific radioactivity of the final 125I-labeled chicken LH preparation was 14 microCi/micrograms. When specific binding was 12-16%, nonspecific binding was as low as 2-4% in the gonadal receptors. 125I-Labeled chicken LH was displaced by chicken LH and ovine LH but not by chicken follicle-stimulating hormone. The equilibrium association constant of quail testicular receptor was 3.6 x 10(9) M-1. We concluded that chicken LH radioiodinated by the present method is useful for studies of avian LH receptors

  18. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2003-12-01

    Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainty and debate. Early side effects are uncommon and readily manageable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

  19. Effect of reserpine on salivary gland radioiodine uptake in thyroid cancer

    International Nuclear Information System (INIS)

    Nine patients with thyroid cancer were treated with reserpine in an attempt to reduce radiation exposure to the salivary glands from 100-150 mCi doses of I-131 therapy to thyroid remnants or metastases. Three control patients were not treated with reserpine but did receive 100-150 mCi of I-131. Parotid/background ratios of activity after radioablative doses of I-131 in patients not treated with reserpine were significantly higher than the patients treated with reserpine, and this was also true seven days after the radioablative dose. Combined therapy with reserpine, chewing gum, lemon candies, and hydration is suggested for the prevention of sialadenitis and xerostomia due to large doses of radioiodine

  20. Novel Insulin Delivery Profiles for Mixed Meals for Sensor-Augmented Pump and Closed-Loop Artificial Pancreas Therapy for Type 1 Diabetes Mellitus

    OpenAIRE

    Srinivasan, Asavari; Lee, Joon Bok; Dassau, Eyal; Doyle, Francis J.

    2014-01-01

    Maintaining euglycemia for people with type 1 diabetes is highly challenging, and variations in glucose absorption rates with meal composition require meal type specific insulin delivery profiles for optimal blood glucose control. Traditional basal/bolus therapy is not fully optimized for meals of varied fat contents. Thus, regimens for low- and high-fat meals were developed to improve current insulin pump therapy. Simulations of meals with varied fat content demonstrably replicated published...

  1. Introdução da comunicação suplementar e alternativa na terapia com afásicos Introduction of augmentative and alternative communication in aphasia therapy

    Directory of Open Access Journals (Sweden)

    Juliana Ferreira Marcolino Galli

    2009-01-01

    Full Text Available Sabe-se que o tratamento fonoaudiológico de pacientes com afasia severa é limitado. A ausência de fala articulada, algumas vezes, impede o diagnóstico da afasia. O paciente "grave" pode não falar devido à inabilidade de articulação, como ocorre na disartria e/ou apraxia. Essa ausência de fala não permite afirmar se a linguagem está comprometida. O uso da comunicação suplementar e alternativa tem sido um método eficaz na reabilitação desses pacientes. Esse estudo visou descrever o uso da comunicação suplementar e alternativa associada a outras modalidades de linguagem (escrita, gestos, a partir do relato de dois casos de afasia. A análise dos dados foi composta por dois blocos: a introdução da comunicação suplementar e alternativa no diálogo; e o uso da leitura e escrita associado aos símbolos. A comunicação suplementar e alternativa foi um apoio para a oralidade, leitura e escrita dos pacientes.It is known that the speech-language treatment of patients with severe aphasia is limited. Sometimes the absence of articulated speech is an obstacle to diagnose the aphasia. The patient with severe aphasia might not speak due to articulation inability, as it occurs in dysarthria and/or apraxia, and the absence of speech makes it difficult for speech-language pathologists to determine whether language is also impaired. The use of augmentative and alternative communication techniques has been an effective method for the rehabilitation of these patients. The aim of this study was to describe the use of the augmentative and alternative communication in therapy associated with other modalities of language (written language, gestures, based on the report of two cases of aphasia. Data analysis had two parts: introduction of augmentative and alternative communication in dialogue; and use of reading and writing associated with symbols. The augmentative and alternative communication supported oral language, reading and writing of the

  2. Radioiodinated PHIPA's; metabolically trapped fatty acids

    International Nuclear Information System (INIS)

    Radioiodinated PHIPA 3-10 [13-(4'-iodophenyl)-3-(p-phenylene)tridecanoic acid] has been developed for nuclear-cardiological investigation of coronary artery disease or cardiomyopathies of various origin. The compound features a phenylene group located within the backbone of a long-chain fatty acid. In spite of its bulky structure [123I]PHIPA 3-10 is extracted by the myocardium in a manner similar to that for the unmodified fatty acid analogue, [123I]IPPA. The retention of PHIPA 3-10 in heart muscle results from the presence of the p-phenylene group which prevents more than one β-oxidation cycle. Only one single, rapidly formed metabolite was found in rat-heart extracts. According to comparative HPLC with synthetic metabolites and mass spectrometric analysis this metabolite was identified as [123I]PHIPA 1-10, a by two methylene groups shortened PHIPA derivative. Formation of this metabolite could be suppressed by Etomoxir, a carnitine palmitoyl fransferase I inhibitor, indicating β-oxidation of [123I]PHIPA 3-10 in mitochondria. Final evidence for the involvement of mitochondria in the degradation of [123I]PHIPA 3-10 was obtained performing density-gradient centrifugation with homogenized rat heart tissue. Labeled free PHIPA 3-10 and free metabolite peaked with the fraction containing mitochondria. With respect to its biochemical characteristics, [123I]PHIPA 3-10 may be considered as a useful tool for nuclear cardiological investigations. (orig.)

  3. Radiation dosimetry of radioiodinated thyroid hormones

    International Nuclear Information System (INIS)

    A physiologically based compartmental model for T4 and T3 metabolism in man was used to generate time-activity curves for residence of radioiodine in key organs. T4 and T3 labeled with 123I, 124I, 125I, and 131I were studied. Conditions modeled included radioactive iodine uptake (RAIU) values of 0%, 1%, 5%, 15% and 25%, and RAIU of 15% combined with various degrees of pharmacologic block of thyroidal RAIU. Using the MIRD S tables, rad doses were generated for each condition. While the shapes of the time-activity curves varied widely with alterations in physical and biological turnover and with changes in steady-state due to iodine administration, it was possible to calculate overall effective half-lives for each organ of interest from the integral of the time-activity curve projected by solution of the model. This overall effective half-life of the hormone for the body's exchangeable hormone compartments correlated well with calculated radiation dose to the thyroid in the unblocked state. With progressive degrees of iodine block, this correlation persisted, though with proportionately reduced thyroid radiation doses. Use and manipulation of a compartmental model, rather than the usual multiexponential model, for radiation dosimetry facilitates conceptualization and the projection of the effects of interventions such as iodide block

  4. Outpatient management of patients with large multinodular goitres treated with fractionated radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.M.; Thomas, P.A.; Allen, L.W.; Akerman, R.; Lan, L. [Department of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW (Australia); Epstein, M.T. [Department of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia)

    1997-12-01

    The efficacy of fractionated out-patient radioiodine therapy in 38 patients with compressive symptoms due to long-standing large multinodular goitres was assessed. The diagnosis was established by clinical assessment in addition to technetium-99m pertechnetate thyroid scan or computed tomography scan of the thyroid and mediastinum. Oral iodine-131 therapy was administered as a 2.22 GBq (60 mCi) cumulative dose over 4 months (555 MBq per month). All patients were monitored with serum thyroid-stimulating hormone and free thyroxine ({+-} free tri-iodothyronine) assays before the treatment and after each dose fraction. Clinical and biochemical follow-up was performed on all patients and ranged from 6 to 45 months after therapy. The patients consisted of 35 female and three male patients with a median age of 59 years (range 37-87 years). Prior to treatment 20 patients were biochemically hyperthyroid and 18 were euthyroid. Overall, 71% of patients reported a subjective improvement in compressive symptoms and 29% reported no change. Clinically assessed reduction in goitre size occurred in 92% of patients while there was no change in 8%. At 3 months of follow-up, 31% of patients had become hypothyroid and at 18 months 66% were hypothyroid. Seven hyperthyroid patients (35%) became euthyroid and 13 hyperthyroid patients (65%) became hypothyroid. Three patients who became hypothyroid experienced neck soreness (transient in one patient, persistent in two patients). There were no differences in outcome between patients who were hyperthyroid and those who were euthyroid prior to treatment. Fractionated out-patient radioiodine therapy showed excellent short- and medium-term safety, was very well tolerated and offered a satisfactory alternative treatment to surgery. (orig.) With 1 fig., 3 tabs., 23 refs.

  5. Outpatient management of patients with large multinodular goitres treated with fractionated radioiodine

    International Nuclear Information System (INIS)

    The efficacy of fractionated out-patient radioiodine therapy in 38 patients with compressive symptoms due to long-standing large multinodular goitres was assessed. The diagnosis was established by clinical assessment in addition to technetium-99m pertechnetate thyroid scan or computed tomography scan of the thyroid and mediastinum. Oral iodine-131 therapy was administered as a 2.22 GBq (60 mCi) cumulative dose over 4 months (555 MBq per month). All patients were monitored with serum thyroid-stimulating hormone and free thyroxine (± free tri-iodothyronine) assays before the treatment and after each dose fraction. Clinical and biochemical follow-up was performed on all patients and ranged from 6 to 45 months after therapy. The patients consisted of 35 female and three male patients with a median age of 59 years (range 37-87 years). Prior to treatment 20 patients were biochemically hyperthyroid and 18 were euthyroid. Overall, 71% of patients reported a subjective improvement in compressive symptoms and 29% reported no change. Clinically assessed reduction in goitre size occurred in 92% of patients while there was no change in 8%. At 3 months of follow-up, 31% of patients had become hypothyroid and at 18 months 66% were hypothyroid. Seven hyperthyroid patients (35%) became euthyroid and 13 hyperthyroid patients (65%) became hypothyroid. Three patients who became hypothyroid experienced neck soreness (transient in one patient, persistent in two patients). There were no differences in outcome between patients who were hyperthyroid and those who were euthyroid prior to treatment. Fractionated out-patient radioiodine therapy showed excellent short- and medium-term safety, was very well tolerated and offered a satisfactory alternative treatment to surgery. (orig.)

  6. Confronting an augmented reality

    OpenAIRE

    Munnerley, Danny; Bacon, Matt; Wilson, Anna,; Steele, James; Hedberg, John; Fitzgerald, Robert

    2012-01-01

    How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself ? In this article, we seek to initiate a discussion that focuses on these questions, and suggest that they be used as drivers for research into effective educational applications of augmented reality. We discuss how multi-modal, sensorial...

  7. Mobile Augmented Reality Applications

    OpenAIRE

    Prochazka, David; Stencl, Michael; Popelka, Ondrej; Stastny, Jiri

    2011-01-01

    Augmented reality have undergone considerable improvement in past years. Many special techniques and hardware devices were developed, but the crucial breakthrough came with the spread of intelligent mobile phones. This enabled mass spread of augmented reality applications. However mobile devices have limited hardware capabilities, which narrows down the methods usable for scene analysis. In this article we propose an augmented reality application which is using cloud computing to enable using...

  8. Mobile Augmented Reality Applications

    CERN Document Server

    Prochazka, David; Popelka, Ondrej; Stastny, Jiri

    2011-01-01

    Augmented reality have undergone considerable improvement in past years. Many special techniques and hardware devices were developed, but the crucial breakthrough came with the spread of intelligent mobile phones. This enabled mass spread of augmented reality applications. However mobile devices have limited hardware capabilities, which narrows down the methods usable for scene analysis. In this article we propose an augmented reality application which is using cloud computing to enable using of more complex computational methods such as neural networks. Our goal is to create an affordable augmented reality application suitable which will help car designers in by 'virtualizing' car modifications.

  9. Effect of temperature on the radioiodination of human growth hormone

    International Nuclear Information System (INIS)

    Studies have been undertaken to assess the effect of altering the temperature at which human growth hormone is radioiodinated on the incorporation of 125I and the immunoreactivity and stability of the labelled hormone. Employing highly purified monomeric hormone it proved possible, by the iodogen procedure, to prepare a labelled product of high specific activity irrespective of temperature. However, in radioiodinations performed at ambient temperature (20 to 25 degrees) significant amounts of the labelled hormone were in an aggregated form which was less immunoreactive than the 125I-labelled monomeric hormone. Such aggregation was largely prevented by radioiodinating at low temperature (0 to 4 degrees) and even the large monomeric peak was more immunoreactive (about 95% bound in antibody excess) than the monomeric peak from iodinations performed at room temperature

  10. Radioiodine therapy for pulmonary metastasis of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Factors affecting the effect of radioiodide treatment for pulmonary metastasis of 26 patients with differentiated thyroid cancer were studied. The first treatments on the patients at Tokyo Women's Medical College were performed during 1973 and 1981, and the successive treatments were repeated until August, 1985. The X-ray findings of pulmonary metastasis were divided into three groups, ''Fine type'', ''Coarse type'', and ''Occult type''. Occult type was defined as the cases with diffuse I-131 uptake in the lung while the chest X-ray finding was normal. we evaluated the effect of I-131 treatment by means of changes in the number and size of metastatic shadows on chest X-ray or the degree of the I-131 accumulation in the lung on scintigram. Fourteen cases of 26 (53.8 %) were estimated to be treated successfully. Those under 40 years of age, with ''Fine type'' and with high I-131 uptake showed the best response to the treatment than others. The degree of I-131 uptake in the pulmonary metastasis had close relation with age and type of pulmonary metastasis defind by X-ray films and scintigrams, but little relationship with histology. Complete disappearance or decrease in number and size of metastatic shadows were shown in the majority of cases with good I-131 uptake and also ''Occult'' or ''Fine'' type. These results indicate that not only the degree of I-131 but age and type of pulmonary metastasis are important factors in predicting the effect of radioiodide treatment for pulmonary metastasis from differentiated thyroid cancer. (author)

  11. A Case of Plummer Disease Treated With Radioiodine Therapy

    OpenAIRE

    池田, 新; 横川, 正樹; 川口, 篤哉; 森山, 正浩; 守田, 美和; 山内, 美香; 杉本, 利嗣; 内田, 伸恵

    2012-01-01

    A case of Plummer disease treated with radioactive iodine was described. A 74-year-old woman was examined for her thyroid mass, which had been unattended for 7 years, and was diagnosed as having Plummer disease. Laboratory tests showed high and low levels of thyroid hormones and TSH, respectively, but no clinical manifestation of hyperthyroidism was observed. Technetium 99m scintigraphy showed strong accumulation to the mass and suppressed accumulation to the normal part of the thyroid....

  12. Synthesis, evaluation and application of radioiodine labeled compounds in nuclear medicine

    International Nuclear Information System (INIS)

    This study reviews synthesis, evaluation,diagnostic and therapeutic applications of iodine radiopharmaceutical especially with 13II and 123I in contemporary nuclear medicine. It is well Known that iodine is used in thyroid diagnostic and therapy with sodium iodide and played an important role in diagnostic procedures using single photon emission tomography (SPECT). The study covers the general chemistry of iodine, physical properties, biological role of iodine, general uses of iodine compounds , production and decay schemes of 131I, 125I and 123I in the first chapter. Preparation of radioiodine labeled compounds, quality control of radiopharmaceuticals and safety of radioiodination are dealt with in detail in two chapters. These were followed by chapters dealing in length with the chemistry, preparation, quality control, pharmacokinetics and radiation dosimetry of some iodine radiopharmaceuticals, and then current trends in diagnostic and therapeutic applications of iodine radiopharmaceuticals particularly 131/123I-MIBG and 123I-IMP. We found that the iodine radiopharmaceuticals are considered amongst principal indicators in single photon emission tomography (SPECT), and 131/123I-MIBG and 123I-IMP appear to be appropriate diagnostic and therapeutic agents for variety of diseases.(Author)

  13. Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

    Energy Technology Data Exchange (ETDEWEB)

    Li, Luchuan; Lv, Bin; Chen, Bo [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Guan, Ming [Department of General Surgery, Qihe People' s Hospital, Qihe, Shandong 251100 (China); Sun, Yongfeng [Department of General Surgery, Licheng District People' s Hospital, Jinan, Shandong 250115 (China); Li, Haipeng [Department of General Surgery, Caoxian People' s Hospital, Caoxian, Shandong 274400 (China); Zhang, Binbin; Ding, Changyuan; He, Shan [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Zeng, Qingdong, E-mail: qingdz0201@163.com [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China)

    2015-07-10

    Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na{sup +}/I{sup −} symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells.

  14. Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

    International Nuclear Information System (INIS)

    Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na+/I− symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells

  15. Labeling of the peptide DOTA-tyr3-octreotate with radioiodine and biodistribution and AR42J neuroendocrine tumor affinity study in mice

    International Nuclear Information System (INIS)

    Neuroendocrine tumors are rare and affect mainly the gastrointestinal tract but other systems are also affected like the skin, lungs and the nervous system. They are rich in type 2 somatostatin (SM) receptors (SSTR2) and may secrete hormones in excess. Synthetic SM derivative peptides are of great utility because presented bigger half life when compared to SM and can be used to clinical improvement of these patients due to its tumoral inhibitory action. The labeling of these peptides with radioisotopes allowed the acquisition of images with favourable cost-efficiency relationship and use in therapy. The peptide, DOTATyr3- octreotate (DOTATATE), has much more affinity for the SSTR2 receptor than the peptide commercially used nowadays, is easily radioiodinated and has a favourable biodistribution for diagnosis and treatment due to the presence of the chelator DOTA. We have studied the influence of various factors on the radiochemical purity of the labeled compound as labeling stability, absorbed dose estimation and biodistribution in normal and AR42J cell tumor-bearing Swiss and Nude mice. We observed easy and stable peptide radioiodination at peptide/radioiodine (131I) ratio of 2.73 that produced a radiochemical species with retention time of 22.7 minutes at high performance liquid chromatography and presented a favourable biodistribution and dosimetry for imaging and therapy of patients with neuroendocrine tumors, just the opposite result observed the radioiodinated compounds without a chelator as described in the literature. Other molar peptide/radioiodine ratios did not showed good results, with various radiochemical species and unfavourable biodistribution. A possible dosimetric study in patients with neuroendocrine tumors may be carried out in the near future. (author)

  16. Environmental radioiodine monitoring to control exposure expected from containment release accidents. Final report

    International Nuclear Information System (INIS)

    Reactor accidents may cause releases of radionuclides from containment. The active material would cause exposure to man through inhalation of gases or aerosols or through consumption of food products containing deposited radioactive particles. Certain aspects of internal exposure are considered. They are field assessment of the exposure potential of milk, and predictions of human thyroid dose commitment based on direct measurements of radioiodine incorporated within the human thyroid. Radioiodine in milk may be inferred by measurements of radioiodine in cow thyroids, and by measuring deposited radioiodine on pasture grasses consumed by cows. Direct radioiodine measurements on milk were also considered

  17. Adaptive Augmented Reality: Plasticity of Augmentations

    OpenAIRE

    Ghouaiel, Nehla; Cieutat, Jean-Marc; Jessel, Jean-Pierre

    2014-01-01

    International audience An augmented reality system is used to complete the real world with virtual objects (computer generated) so they seem to coexist in the same space as the real world. The concept of plasticity [4][5] was first introduced for Human Computer Interaction (HCI). It denotes the ability of an HCI interface to fit the context of use defined by the user, the environment and the platform. We believe that plasticity is a very important notion in the domain of augmented reality....

  18. Radioiodination of low potency human growth hormone and its characterisation

    International Nuclear Information System (INIS)

    Radioimmunoassay (RIA) of human growth hormone (hGH) using 125I-labelled tracer prepared from low purity (low potency) hGH and characterisation of the tracer are described. The radioiodination of low potency hGH resulted in low yield of immunoreactive fraction of the tracer. The major quantity of non-immunoreactive fraction could be removed by purification by gel filtration. However, the quality of radioiodinated tracer of low potency hGH has been found to be as that of the tracer prepared from high potency hGH with respect to assay sensitivity and RIA standard curve parameters. (author)

  19. Radioiodine treatment in children with thyroid cancer from Belarus

    International Nuclear Information System (INIS)

    Between 1st of April 1993 and 15th of November 1995, 95 children from Belarus with most advanced stages of thyroid cancer have been treated totally 305 times with radioiodine in Germany. In spite of a high frequency of advanced tumor stages pT4 (82%), lymph node metastases (95%) and distant metastases (55%) in those selected children, the preliminary results of radioiodine treatment are promising. In 55% of the children complete remission and in 44% partial remission of thyroid cancer could be achieved. In no case progressive disease under treatment has been observed

  20. Radionuclide therapy for thyroid cancer with nervous system metastasis

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer is 85% of all thyroid cancer, and is known to have good prognosis with proper surgery and radioiodine therapy. But 4% of papillary carcinoma and 36% of follicular carcinoma present with distant metastasis. Even if the patient had distant metastasis, total thyroidectomy and radioiodine therapy show good response. Forty seven percent of bone metastases are found in the initial diagnosis, in which vertebral metastases is 29%, pelvic metastases 22%. The metastases to vertebrae often combine spinal cord compression, making it difficult to deliver enough radiation dose to the lesion with radioiodine or external beam irradiation. Brain metastases is found in less than 1% of thyroid cancer, and is also difficult to cure. In Korea Cancer Center Hospital, from 1997 to 2002, we analyzed 437 patients with thyroid cancer who were treated with radioiodine after total thyroidectomy. There were four patients with brain metastases, and 32 patients with vertebral metastases. In four patients with brain metastases, one patient, who also had bone metastases, received high dose radioiodine therapy after total thyroidectomy, and is alive for more than 15 months. Another patients received total thyroidectomy, radioiodine therapy and external irradiation therapy, and survived 22 months. Two patients refused further treatment and died in one month. I-131 uptake in the metastatic lesion in brain is reported to be 17%, and multimodality therapy with surgery, radioiodine therapy, external irradiation and chemotherapy may improve the prognosis. In 32 patients with vertebral metastases, 19 patients (59.4%) showed I-131 uptake after high dose radioiodine therapy, and 5 year survival rate was 65.8%. 13 patients without I-131 uptake after radioiodine therapy had 26.9% of 5 year survival rate. In 11 patients with spinal cord compression, 7 patients received high dose radioiodine therapy and external irradiation after total thyroidectomy and spinal surgery, and six

  1. Radioiodine (I-131) application in the management of differentiated thyroid cancer (DTC) audit

    International Nuclear Information System (INIS)

    Full text: Differentiated thyroid cancer (DTC) remains one of the curable of all cancers. All literature reviews and clinical experiences regarding I131 use in DTC conclude the beneficial effects, better prognosis, longer survival time and an assurance for cure. The Overall prognosis of patients with DTC is excellent if treat scientifically, adequately and timely. The management of thyroid cancer depends on the resources available in different institutions. Nuclear Medicine unit (NMU), Faculty of Medicine Peradeniya, Sri Lanka is in the process of uplifting the services for thyroid cancer management. Clinical audit was carried out in NMU on patients who utilized the Nuclear Medicine facilities in the management of DTC. It is important to identify deficiencies in current practice to improve our services. During January 2004 to March 2005, 126 DTC patients were referred for radioiodine Whole body scan (WBS) and therapy. Their age, sex, histology, extent of surgery, adequacy of thyroxine suppression treatment, monitoring with serum thyroglobulin levels (Tg), WBS results and radioiodine therapy were analyzed. There were 104(82.5%) females and 22(17.5%) males giving sex ratio of 4.7: 1. The Mean age was 35.5 years (range 9-58 years). The commonest histological types were papillary carcinoma 55.5% (n=70), follicular carcinoma 35% (n=44) and follicular variant of papillary carcinoma 9.5% (n=12). Seventy five percent (n=95) had total thyroidectomy (TT), 17 %(n=21) had near total thyroidectomy (NTT) and 8%(n=10) had subtotal thyroidectomy (STT). Sixty-nine patients (54.8%) were on thyroid suppression therapy. Thirty-six patients (28.6%) were referred to the WBS soon after surgery without initiation of thyroxine treatment. Another twenty-one patients (16.6%) were not on thyroxine therapy since surgery. Serum thyroglobulin was assessed on 20.6% (n=26). WBS done using 3-4 mCi liquid radioiodine showed residual functioning thyroid tissues in 41% (n=52). Lymph nodes or bone

  2. Environmental radioiodine in thyroids of grazing animals

    International Nuclear Information System (INIS)

    Animal thyroids are excellent indicators of environmental contamination from radioiodine, a fact largely unappreciated before 1954. From continuous monitoring of excised thyroids in Nal well-detectors, we know that high-altitude releases of mixed fission products caused increases of 103 to 105 times the minimal detectable level of 131I (3.7 mBq/g) in sheep thyroids from the United States, Europe, Asia, Australia, and New Zealand. Within 6 weeks after high-altitude releases, sheep thyroids from different continents of the same hemisphere contained comparable concentrations of 131I: more than 104 times greater concentrations than cow's milk and 5 x 103 times greater concentrations than human thyroids from similar areas. In contrast, during the low-altitude Chernobyl release, average 131I concentrations in animal thyroids, at distances greater than 1,200 km from Chernobyl, were distributed as the inverse square of the distance from the source. 129I concentrations measured since 1984 with a germanium well-detector in thyroids of sheep slaughtered in Birmingham, England, ranged from 3 to 50 mBq/g organ weight. Similar quantities of 125I were present intermittently in thyroids of sheep slaughtered in Birmingham since 1986. The source of the 125I, which is not a fission product, is not clear. For comparison, deer thyroids from the Savannah River Reservation, USA, contained 10 to 7 x 105 mBq 129I/g. Although this isotope is not a biological hazard, it is a long-lived tracer of fission products

  3. Low-activity radioiodine for remnant ablation after surgery for differentiated thyroid cancer - Initial experience

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: residual thyroid tissue ablation with radioiodine after total thyroidectomy is one of the key elements in differentiated thyroid carcinoma (DTC) therapy. Clinicians worldwide have been trying to address what is the lowest effective radioiodine activity to successful ablation. This study intends to show our initial results using a low 131I activity -1850 MBq (50 mCi) - for that purpose in patients (pts) with low-risk DTC. Material and methods: 13 patients (12 female, 1 male; mean age 43.7 years; range 23-66 years), with histologically confirmed DTC (12 cases of papillary thyroid carcinoma- 3 pT1a N0, 1 pT1a N1, 4 pT1b N0, 2 pT2 N0 and 2 pT3 N0 and 1 case of follicular thyroid carcinoma - pT3 N0), underwent total thyroidectomy followed by an ablative 131I activity of 1850 MBq. An 131I whole body scan (WBS) was performed 6 months after the ablative activity as well as thyroglobulin (Tg) level determination. Ablative therapy, WBS and Tg measurements were performed at least 4 weeks after thyroid hormone withdrawal. Six months after ablative therapy, patients with negative WBS and stimulated Tg levels < 2 ng/ml were considered to have successful ablation. Results: complete thyroid tissue ablation was obtained in 9/13 pts with a success rate of 69.2%. Of the four remaining pts: one (pT1bN0) presented positive WBS; one (pT1aN0) showed both positive WBS and elevated Tg levels and the other two (pT2N0; pT3N0) presented Tg levels above the considered limit despite negative WBS. 3 of those patients who did not achieve a successful complete ablation presented high Tg levels (> 30 ng/ml) at the time of radioiodine treatment. Conclusion: although several studies have demonstrated good rates of ablation using low 131I activities, each center must assess whether the same results are found in its particular context. Our preliminary data reveals a successful ablation rate for post-thyroidectomy remnant thyroid tissue, in patients with low

  4. Equating of Augmented Subscores

    Science.gov (United States)

    Sinharay, Sandip; Haberman, Shelby J.

    2011-01-01

    Recently, there has been an increasing level of interest in subscores for their potential diagnostic value. Haberman (2008b) suggested reporting an augmented subscore that is a linear combination of a subscore and the total score. Sinharay and Haberman (2008) and Sinharay (2010) showed that augmented subscores often lead to more accurate…

  5. Confronting an Augmented Reality

    Science.gov (United States)

    Munnerley, Danny; Bacon, Matt; Wilson, Anna; Steele, James; Hedberg, John; Fitzgerald, Robert

    2012-01-01

    How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself ? In this article, we seek to initiate a discussion that focuses on these questions, and…

  6. Changes in conjunctival cytology and tear function tests with radioiodine treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Radioiodine (RAI) is used in the treatment of hyperthyroidism and differentiated thyroid cancer. Radioiodine therapy is associated with dry eyes and some side effects are seen especially due to beta rays. In this study, the functional and cytological status of lacrimal glands after RAI therapy was evaluated. Twenty-five patients with a mean age of 55.16 years with planned low-dose RAI therapy were evaluated. Just before and 6 months after the treatment, the lacrimal glands were evaluated with tear break-up time (BUT), Schirmer's test, impression cytology and ''Ocular Surface Disease Index (OSDI)'' questionnaire. The mean value of Schirmer's test was 16.20±3.61 pre-treatment and 11.28±4.39 post-treatment for the right eye, and 15.76±3.27 and 10.60±4.42 for the left eye, respectively. The mean value of Schirmer's test decreased significantly post-treatment in both eyes (p=0.0001). The BUT score also decreased significantly post-treatment (p=0.001). The mean value of OSDI score was 27.5±8.02 pre-treatment and 46.36±10.27 post-treatment. The mean value of OSDI score increased post-treatment (p=0.0001). The impression scores also increased post-treatment in both eyes (p=0.0001). Even low-dose (≤30 mci) RAI treatment affects lacrimal gland functions. Low-dose RAI causes a decrease in the value of Schirmer's test and the BUT test, and an increase in the value of OSDI score and impression scores. (author)

  7. C16-Ceramide Analog Combined with Pc 4 Photodynamic Therapy Evokes Enhanced Total Ceramide Accumulation, Promotion of DEVDase Activation in the Absence of Apoptosis, and Augmented Overall Cell Killing

    Directory of Open Access Journals (Sweden)

    Duska Separovic

    2011-01-01

    Full Text Available Because of the failure of single modality approaches, combination therapy for cancer treatment is a promising alternative. Sphingolipid analogs, with or without anticancer drugs, can improve tumor response. C16-pyridinium ceramide analog LCL30, was used in combination with photodynamic therapy (PDT, an anticancer treatment modality, to test the hypothesis that the combined treatment will trigger changes in the sphingolipid profile and promote cell death. Using SCCVII mouse squamous carcinoma cells, and the silicone phthalocyanine Pc 4 for PDT, we showed that combining PDT with LCL30 (PDT/LCL30 was more effective than individual treatments in raising global ceramide levels, as well as in reducing dihydrosphingosine levels. Unlike LCL30, PDT, alone or combined, increased total dihydroceramide levels. Sphingosine levels were unaffected by LCL30, but were abolished after PDT or the combination. LCL30-triggered rise in sphingosine-1-phosphate was reversed post-PDT or the combination. DEVDase activation was evoked after PDT or LCL30, and was promoted post- PDT/LCL30. Neither mitochondrial depolarization nor apoptosis were observed after any of the treatments. Notably, treatment with the combination resulted in augmented overall cell killing. Our data demonstrate that treatment with PDT/LCL30 leads to enhanced global ceramide levels and DEVDase activation in the absence of apoptosis, and promotion of total cell killing.

  8. Radioiodine: a boon and a bane emergency preparedness during accidental release of radioiodine

    International Nuclear Information System (INIS)

    Radioiodine, can be a double edged sword and can be dangerous and lethal. It will turn out to be a bane rather than a boon, exposing millions of individuals in and far away from the side of accident across geographical borders depending upon the weather conditions. Iodine is an indispensable element because of its being a constituent of the thyroid hormones, biosynthesized and released from the thyroid gland for the growth and over all metabolic functions. This gland weighing 20-30 g in a normal human adult, is comparatively very vascular organ with 5 lit. of blood flowing through it every hour. It contains 90% of the body iodine amounting to 5000-7000 μg, in the form of iodo aminoacids

  9. Synthesis of N-(2-diethylamino-ethyl)-4-(4-fluoro-benzamido)-2-methoxybenzamide (desiodo-MIP-1145) by coupling technique and its radioiodination: a potential melanoma imaging agent.

    Science.gov (United States)

    Aglan, H; Kandil, S A; El-Kafrawy, A F; Seddik, U

    2016-07-01

    Radioiodinated MIP-1145, which specifically targets melanin, is an ideal candidate for targeted therapy of melanoma. An analogue of MIP-1145 lacking the iodo-substituent (desiodo-MIP-1145) was synthesized as a labeling precursor in three simple steps. The radioiodination of desiodo-MIP-1145 by iodine-125 was carried out via an electrophilic substitution reaction. An optimization study for the iodination reaction was carried out. The labeled compound was isolated and purified by means of electrophoresis and HPLC. The maximum radiochemical yield, 76%, was obtained with radiochemical purity greater than 99%. The log P value for [(125) I]MIP-1145 was measured as 4.5. PMID:27313146

  10. Inadvertent 131I therapy for hyperthyroidism in the first trimester of pregnancy

    International Nuclear Information System (INIS)

    Of 963 physicians surveyed to determine therapeutic attitudes toward, and experience with inadvertent radioiodine therapy for hyperthyroidism during the first trimester of pregnancy, 116 physicians (of 517 responding) reported 237 cases. Therapeutic abortion was advised for 55 patients by 22 physicans. From the 182 remaining pregnancies there were two spontaneous abortions, two stillborn, one neonate with biliary atresia, and one with respiratory distress. This complication rate was not greater than might be expected in a similar number of random pregnancies. On the other hand, six infants were hypothyroid (transient for one) and four of these were mentally deficient. Three mothers of hypothyroid infants had received radioiodine therapy in the second trimester. None of the six mothers of hypothyroid infants had had pregnancy tests prior to radioiodine therapy. Survey responses indicate that routine pregnancy testing prior to radioiodine therapy for patients in the child-bearing age is not yet a standard procedure. It should be

  11. Intratumoral but not systemic delivery of CpG oligodeoxynucleotide augments the efficacy of anti-CD20 monoclonal antibody therapy against B cell lymphoma.

    Science.gov (United States)

    Betting, David J; Yamada, Reiko E; Kafi, Kamran; Said, Jonathan; van Rooijen, Nico; Timmerman, John M

    2009-01-01

    The anti-CD20 monoclonal antibody rituximab (Rituxan) has become a mainstay in the treatment of B cell non-Hodgkin lymphomas. The mechanisms of action for rituximab include antibody-dependent cellular cytotoxicity (ADCC), complement-dependent cytotoxicity, and apoptosis induction. Combination of anti-CD20 antibodies with immunostimulatory agents may improve their efficacy via enhancement of one or more of these mechanisms. Toll-like receptor 9 agonist CpG oligodeoxynucleotides administered systemically have been studied in clinical trials with and without rituximab. However, recent data suggest that intratumoral (IT) delivery of CpG has advantages in the treatment of tumors. Using a syngeneic murine B cell lymphoma line expressing human CD20, we found that IT, but not systemically administered CpG significantly improved the efficacy of rituximab against 7-day established tumors. Rituximab plus IT CpG could eradicate tumors from 42% of mice, whereas systemically administered CpG, with or without rituximab, did not achieve tumor eradication. Both natural killer cells and complement participated in the cure of tumors by rituximab plus IT CpG, apparently by increasing tumor cell sensitivity to complement and ADCC lysis, and by augmenting the cytotoxicity of ADCC effectors. No role for T cells in mediating tumor eradication was demonstrated in this model. These results suggest that previous clinical trials in B cell lymphoma combining systemic administration of CpG with rituximab may have employed suboptimal routes of CpG delivery. Future trials combining IT CpG with anti-CD20 antibodies or the antibody-mediated targeting of CpG directly to the sites of B cell lymphoma may thus be warranted. PMID:19483647

  12. Radioiodination and quality control of human thyrotropin for radioimmunoassay

    International Nuclear Information System (INIS)

    This work reports the radioiodination of human thyrotropin (hTSH) in our laboratory (IPEN) and evaluates its quality in comparison with a commercial product. The radioiodination yield obtained in 20 experiments ranged from 18.5 to 56.3%, while the purification recovery ranged from 75.5 to 124.0% and the specific activity ranged from 1.01 to 3.10 MBq μg-1. The values for the distribution coefficient revealed in the purification of radioiodinated hTSH ranged from 0.232 to 0.371. When tested concomitantly in the same radioimmunoassay system, the IPEN and the commercial tracer presented parallel standard curves. A highly significant correlation ion was observed between the quality control samples estimated through both curves (p < 0.001). These results confirm the quality of the hTSH radioiodinated at IPEN and suggest the acquirement of self-sufficiency in this 'in vitro' nuclear technology. (author) 26 refs.; 5 figs.; 2 tabs

  13. Turbulent transfer characteristics of radioiodine effluents from air to grass

    International Nuclear Information System (INIS)

    A total of 20 controlled field releases of radioiodine have been performed at the National Reactor Testing Station in Idaho as a portion of a program to study the transmission of gaseous radioiodine through the air-vegetation-cow-milk-human chain. Most of the releases were conducted over typical pasture grasses during different wind and stability conditions. Radioiodine adherence to grass and carbon plates was measured during most of the tests. Vertical air concentration profiles and turbulence parameters were measured to determine flux characteristics. Analysis of the data reveals the complex interdisciplinary nature of transfer of radioiodine from air to a natural surface. The data are in reasonable agreement with the deposition models of Sheppard and Chamberlain when corrections for the physical and biological receptiveness of the grass and grass density are made. The average ratios of momentum to mass flux were found to be 0.9 in stable conditions and 1.4 in unstable conditions. These ratios demonstrate the effect on mass flux in the lowest 4m by a surface that acts as a partial sink for gaseous effluents. This series of releases indicates the need for further research on the biological receptiveness of grass and turbulent transfer within a grass canopy. (author)

  14. Augmented reality: a review.

    Science.gov (United States)

    Berryman, Donna R

    2012-01-01

    Augmented reality is a technology that overlays digital information on objects or places in the real world for the purpose of enhancing the user experience. It is not virtual reality, that is, the technology that creates a totally digital or computer created environment. Augmented reality, with its ability to combine reality and digital information, is being studied and implemented in medicine, marketing, museums, fashion, and numerous other areas. This article presents an overview of augmented reality, discussing what it is, how it works, its current implementations, and its potential impact on libraries. PMID:22559183

  15. Decreased radioiodine uptake of FRTL-5 cells after 131I incubation in vitro: molecular biological investigations indicate a cell cycle-dependent pathway

    International Nuclear Information System (INIS)

    In radioiodine therapy the ''stunning phenomenon'' is defined as a reduction of radioiodine uptake after diagnostic application of 131I. In the current study, we established an in vitro model based on the ''Fisher rat thyrocyte cell line no. 5'' (FRTL-5) to investigate the stunning. TSH-stimulated FRTL-5 cells were incubated with 131I. Time-dependent 131I uptake and the viability of FRTL-5 cells were evaluated at 4-144 h after radioiodine application. All data was corrected for number of viable cells, half life and 131I concentration. Sodium iodide symporter (NIS) and the housekeeping gene (β-actin, GAPDH) levels were quantified by quantitative polymerase chain reaction (qPCR). Additionally, immunohistochemical staining (IHC) of NIS on the cell membrane was carried out. FRTL-5 monolayer cell cultures showed a specific maximum uptake of 131I 24-48 h after application. Significantly decreased 131I uptake values were observed after 72-144 h. The decrease in radioiodine uptake was correlated with decreasing mRNA levels of NIS and housekeeping genes. In parallel, unlike in controls, IHC staining of NIS on FRTL-5 cells declined significantly after 131I long-term incubation. It could be demonstrated that during 131I incubation of FRTL-5 cells, radioiodine uptake decreased significantly. Simultaneously decreasing levels of NIS mRNA and protein expression suggest a NIS-associated mechanism. Since mRNA levels of housekeeping genes decreased, too, the reduced NIS expression might be provoked by a cell cycle arrest. Our investigations recommend the FRTL-5 model as a valuable tool for further molecular biological investigations of the stunning phenomenon. (orig.)

  16. Impact of long-term use of eHealth systems in adolescents with type 1 diabetes treated with sensor-augmented pump therapy.

    Science.gov (United States)

    Schiaffini, R; Tagliente, I; Carducci, C; Ullmann, N; Ciampalini, P; Lorubbio, A; Cappa, M

    2016-07-01

    Telemedicine in diabetes includes telemonitoring and transmission of important data (self monitoring of blood glucose data, insulin therapy, pump setting, etc.) from the patient s home to the diabetic unit, with a real-time health feedback. Moreover, an eHealth approach is thought to facilitate diabetes management and to improve compliance to CSII/SAP treatment in adolescents, but to date, limited literature related to this topic is available and long-term studies are still lacking. The main aim of this study was to compare the long-term effect on glycometabolic control of eHealth intervention and traditional care in T1DM SAP-treated adolescents. In our study we demonstrated a favorable impact of monthly teleassistance on treatment compliance. Adolescents receiving frequent feedback provided by the medicalmultidisciplinary team, due to the telemonitoring, resulted more compliant in self-management of diabetes. In particular, the medical team feedback resulted in interventions on behavioral errors and insulin therapy adjustments, leading to an improved glycometabolic control. PMID:26289613

  17. Metastatic Follicular Thyroid Carcinoma Secreting Thyroid Hormone and Radioiodine Avid without Stimulation: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Syed A. Abid

    2014-01-01

    Full Text Available Introduction. This is an extremely rare case of a patient with metastatic follicular thyroid cancer who continued to produce thyroid hormone and was iodine scan positive without stimulation after thyroidectomy and radioiodine (I-131 therapy. Patient Findings. A 76-year-old Caucasian male was diagnosed with metastatic follicular thyroid carcinoma on lung nodule biopsy. Total thyroidectomy was performed and he was ablated with 160 mCi of I-131 after recombinant human thyrotropin (rhTSH stimulation. Whole body scan (WBS after treatment showed uptake in bilateral lungs, right sacrum, and pelvis. The thyroglobulin decreased from 2,063 to 965 four months after treatment but rapidly increased to 2,506 eleven months after I-131. Thyroid stimulating hormone (TSH remained suppressed and free T4 remained elevated after I-131 therapy without thyroid hormone supplementation. He was treated with an additional 209 mCi with WBS findings positive in lung and pelvis. Despite I-131, new metastatic lesions were noted in the left thyroid bed and large destructive lesion to the first cervical vertebrae four months after the second I-131 dose. Conclusions. This case is exceptional because of its rarity and also due to the dissociation between tumor differentiation and aggressiveness. The metastatic lesions continued to secrete thyroid hormone and remained radioiodine avid with rapid progression after I-131 therapy.

  18. Differentiated thyroid cancer. New concept of radioiodine ablation; Differenziertes Schilddruesenkarzinom. Fortschritte bei der Radioiodablation

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Kobe, C. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Universitaetsklinikum Koeln (Germany), Zentrum fuer Integrierte Onkologie Koeln-Bonn; Luster, M. [Universitaetsklinikum Ulm (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    Ablative radioiodine therapy is the treatment of choice in patients with differentiated thyroid cancer, the only exception being the unifocal, very small papillary thyroid cancer. The TSH-stimulation can be achieved by a waiting period for 2-3 weeks after thyroidectomy without medication or by the use of recombinant human TSH (rhTSH). Both options lead to high success rates. 'Single dose cure' using activities between 1.85 and 3.7 GBq {sup 131}I is standard. Since 2010 rhTSH is approved by the EMA for the indications pT1-4, N0-1, cM0. Survey studies did not find any inferiority of ablation with rhTSH or iatrogenic hypothyroidism in the high-risk patient group. Renal clearance is not reduced after rhTSH administration, thus the {sup 131}I blood dose and the whole body doses are lower in patients under rhTSH. Comparing identical {sup 131}I activities after endogeneous or exogeneous stimulation, rhTSH will minimize the acute adverse effects of {sup 131}I. A short-term withdrawal of levothyroxine some days before rhTSH-injection lowers the iodine plasma level, which may be advantageous for the ablation success if lower 131I activities are used. A rhTSH-based diagnostic {sup 131}I whole-body scintigraphy 3-6 months after ablation is standard for therapy control. At this time, the rhTSH-stimulated thyroglobulin-level is essential for a personalized risk stratification. Tg-measurements by a second generation assay should be used for follow-up care. Metaanalyses have shown that radioiodine ablation lowers the mortality rate, the risk of locoregional recurrences and the risk of late metastasizing. Therefore, ablation has shown a clear benefit. (orig.)

  19. Postreduction Breast Augmentation

    OpenAIRE

    Hidalgo, David A.; Doft, Melissa A.

    2015-01-01

    Background: Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume chiefly associated with weight loss and postpartum changes. Breast shape and overall aesthetics are often revised at the same time. Methods: A retrospective review was performed of 2 surgeons’ experiences with post-reduction breast augmentation. Twenty patients were identified between 2002 and 2014. An in-depth chart...

  20. Transaxillary Endoscopic Breast Augmentation

    OpenAIRE

    Sim, Hyung-Bo

    2014-01-01

    The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants d...

  1. Marketing and Augmented Reality

    OpenAIRE

    Zelený, Martin

    2010-01-01

    The main goal of this diploma thesis is to identify the usage of augmented reality in contemporary marketing practice and the expectations of marketers for the future use. This will be achieved by conducting a quantitative and qualitative research among existing creative and advertising companies. Secondary goal is introducing the concept of augmented reality from the theoretical point of view and also description of potential utilization based on known examples. The tools for the practical p...

  2. Augmented Reality im Techniktraining

    OpenAIRE

    Schack, Thomas; Heinen, Thomas; Hermann, Thomas

    2007-01-01

    In den letzten Jahren wurden in Bereichen wie Robotik, Telemanipulation und Militär neue Technologien entwickelt, die als Augmented Reality (Erweiterte Realität) (Milgram et al., 1994) bezeichnet werden. Durch Augmented Reality wird die Leistungs fähigkeit der beteiligten Menschen nachweisbar unterstützt. Dabei wird die Realität eines Agenten computergestützt mit virtueller Information - auf visueller, akustischer oder taktiler Basis - in Echtzeit überlagert (erweitert). Die wesentliche Eig...

  3. The effect of short-chain fatty acids butyrate, propionate, and acetate on urothelial cell kinetics in vitro: potential therapy in augmentation cystoplasty.

    Science.gov (United States)

    Dyer, J P; Featherstone, J M; Solomon, L Z; Crook, T J; Cooper, A J; Malone, P S

    2005-07-01

    The intestinal element of enterocystoplasty is affected by chronic inflammatory changes, which lead to excess mucus production, urinary tract infections, and stone formation. There is also an increased risk of malignancy. These inflammatory changes may be due to diversion colitis, which affects colonic segments excluded from the faecal stream and likewise may respond to intraluminal short-chain fatty acid (SCFA) therapy. The SCFAs have interesting antiproliferative, differentiating, and pro-apoptotic effects, which are protective against colorectal cancer and may influence the risk of malignancy in enterocystoplasty. Before intravesical therapy can be considered, the effect on normal urothelium must be investigated. Primary urothelial cells cultured from biopsy specimens and transformed urothelial (RT112 and MGH-U1) and intestinal cell lines (HT29 and CaCo-2) were incubated with SCFAs. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to measure the residual viable biomass to assess cell proliferation. Proliferation of primary and transformed urothelial cells in culture was inhibited by all SCFAs in a similar time- and dose-dependent manner. The concentration of SCFA required to inhibit growth of primary cells by 50% (IC50) was 20 mM of butyrate, 120 mM of propionate, and 240 mM of acetate after incubation for 1 h. After 72 h the IC50 was 2 mM of butyrate, 4 mM of propionate, and 20 mM of acetate. Transformed urothelial and colon cancer cell lines demonstrated similar growth inhibition. Butyrate was the most potent inhibitor of cell proliferation, followed by propionate and then acetate. Growth inhibition is not an immediate cytotoxic effect, and urothelial cells show a degree of adaptation to butyrate and growth recovery after incubation with butyrate. In conclusion, butyrate- and propionate-induced growth inhibition is potentially clinically significant and may have therapeutically beneficial implications in vivo. PMID:15864601

  4. Confronting an augmented reality

    Directory of Open Access Journals (Sweden)

    John Hedberg

    2012-08-01

    Full Text Available How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself? In this article, we seek to initiate a discussion that focuses on these questions, and suggest that they be used as drivers for research into effective educational applications of augmented reality. We discuss how multi-modal, sensorial augmentation of reality links to existing theories of education and learning, focusing on ideas of cognitive dissonance and the confrontation of new realities implied by exposure to new and varied perspectives. We also discuss connections with broader debates brought on by the social and cultural changes wrought by the increased digitalisation of our lives, especially the concept of the extended mind. Rather than offer a prescription for augmentation, our intention is to throw open debate and to provoke deep thinking about what interacting with and creating an augmented reality might mean for both teacher and learner.

  5. Comparison between thyroid hormone withdrawal and recombinant human TSH administration before radioiodine treatment for advanced thyroid cancer

    International Nuclear Information System (INIS)

    Full text: Radioiodine treatment is traditionally performed after thyroid hormone withdrawal. However, induction of hypothyroidism is associated with physical and psychological symptoms and a possible induction of tumor growth. This is particularly harmful in patients with advanced thyroid cancer (ATC). The objective of this study was to compare the thyroxine withdrawal and the recombinant human TSH (rh TSH) administration in patients with non-radioiodine responsive ATC after retinoic acid (RA) therapy for induction of iodine uptake. Patients were treated with isotretinoin (1.0 to 1.5 mg/kg/d) for 5 weeks, then, thyroxine (LT4) was discontinued 4 weeks before therapeutic dose (150 mCi). Based on the presence of a satisfactory response to RA (increased iodine uptake, reduction of serum thyroglobulin and tumor regression), another cycle of RA was offered, then rh TSH was used (0.9 mg in two consecutive days). A total of 8 patients (1 follicular, 1 poorly differentiated and 6 papillary carcinomas) were treated. In a patient with pituitary adenoma the endogenous TSH did not rise after T4 withdrawal, and rh TSH was administered before radioiodine therapy. Although an increase in iodine uptake was observed after RA therapy in the patient with poorly differentiated cancer, the tumor continued to progress and patient died of respiratory insufficiency. Four out of 7 patients had at least a partial response and were selected for re-treatment. Post-therapeutic whole body scan was similar using both protocols, but patients had fewer side effects with rh TSH. One patient who had no compressive symptoms during LT4 withdrawal did present dysphagia and dysphonia secondary to tumor swelling, 6 hours after the last rh TSH injection. Glucocorticoid was administered and symptoms were reversed after 10 days. Conclusion: Radioiodine uptake using rh TSH was comparable to T4 withdrawal and is particularly useful when endogenous TSH cannot rise. However, the possibility of compressive

  6. Determination of the optimal minimum radioiodine dose in patients with Graves' disease: a clinical outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.; Tan, P.; Booker, J. [Pacific Medical Imaging, Newcastle, NSW (Australia); Epstein, M. [Dept. of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia); Lan, L. [High-Dependency Unit, St. George Hospital, Sydney, NSW (Australia)

    2001-10-01

    The study was performed under the auspices of the International Atomic Energy Commission, Vienna, Austria, with the aim of determining the optimal minimum therapeutic dose of iodine-131 for Graves' disease. The study was designed as a single-blinded randomised prospective outcome trial. Fifty-eight patients were enrolled, consisting of 50 females and 8 males aged from 17 to 75 years. Each patient was investigated by clinical assessment, biochemical and immunological assessment, thyroid ultrasound, technetium-99m thyroid scintigraphy and 24-h thyroid {sup 131}I uptake. Patients were then randomised into two treatment groups, one receiving 60 Gy and the other receiving 90 Gy thyroid tissue absorbed dose of radioiodine. The end-point markers were clinical and biochemical response to treatment. The median follow-up period was 37.5 months (range, 24-48 months). Among the 57 patients who completed final follow-up, a euthyroid state was achieved in 26 patients (46%), 27 patients (47%) were rendered hypothyroid and four patients (7%) remained hyperthyroid. Thirty-four patients (60%) remained hyperthyroid at 6 months after the initial radioiodine dose (median dose 126 MBq), and a total of 21 patients required additional radioiodine therapy (median total dose 640 MBq; range 370-1,485 MBq). At 6-month follow-up, of the 29 patients who received a thyroid tissue dose of 90 Gy, 17 (59%) remained hyperthyroid. By comparison, of the 28 patients who received a thyroid tissue dose of 60 Gy, 17 (61%) remained hyperthyroid. No significant difference in treatment response was found (P=0.881). At 6 months, five patients in the 90-Gy group were hypothyroid, compared to two patients in the 60-Gy group (P=0.246). Overall at 6 months, non-responders to low-dose therapy had a significantly larger thyroid gland mass (respective means: 35.9 ml vs 21.9 ml) and significantly higher levels of serum thyroglobulin (respective means: 597.6 {mu}g/l vs 96.9 {mu}g/l). Where low-dose radioiodine

  7. Radiation exposure and familial aggregation of cancers as risk factors for colorectal cancer after radioiodine treatment for thyroid carcinoma

    International Nuclear Information System (INIS)

    Purpose: In thyroid cancer patients, radioiodine treatment has been shown to be associated with an increased risk of colon carcinoma. The aim of this study in thyroid cancer patients was to evaluate the role of familial factors in the risk of colorectal cancer and their potential interaction with radioiodine exposure. Methods and Materials: We performed a case-control study on 15 colorectal cancer patients and 76 matched control subjects, nested in a cohort of 3708 thyroid cancer patients treated between 1933 and 1998. For each patient, the radiation dose delivered to the colon by radioiodine was estimated by use of standard tables. In those who received external radiation therapy, the average radiation doses delivered to the colon and rectum were estimated by use of DOSEg software. A complete familial history was obtained by face-to-face interviews, and a familial index was defined to evaluate the degree of familial aggregation. Results: The risk of colorectal cancer increased with familial aggregation of colorectal cancer (p = 0.02). After adjustment for the radiation dose delivered to the colon and rectum, the risk of colorectal cancer was 2.8-fold higher (95% CI, 1.0-8.0) for patients with at least one relative affected by colorectal cancer than for patients without such a family history (p = 0.05). The radiation dose delivered to the colon and rectum by 131I and external radiation therapy was associated with an increase of risk near the significance threshold (p = 0.1). No significant interaction was found between radiation dose and having an affected relative (p = 0.9). Conclusions: The role of familial background in the risk of colorectal cancer following a differentiated thyroid carcinoma appears to increase with the radiation dose delivered to the colon and rectum. However, the study population was small and no interaction was found between these two factors

  8. Treatment of medulloblastoma using an oncolytic measles virus encoding the thyroidal sodium iodide symporter shows enhanced efficacy with radioiodine

    Directory of Open Access Journals (Sweden)

    Hutzen Brian

    2012-11-01

    Full Text Available Abstract Background Medulloblastoma is the most common malignant brain tumor of childhood. Although the clinical outcome for medulloblastoma patients has improved significantly, children afflicted with the disease frequently suffer from debilitating side effects related to the aggressive nature of currently available therapy. Alternative means for treating medulloblastoma are desperately needed. We have previously shown that oncolytic measles virus (MV can selectively target and destroy medulloblastoma tumor cells in localized and disseminated models of the disease. MV-NIS, an oncolytic measles virus that encodes the human thyroidal sodium iodide symporter (NIS, has the potential to deliver targeted radiotherapy to the tumor site and promote a localized bystander effect above and beyond that achieved by MV alone. Methods We evaluated the efficacy of MV-NIS against medulloblastoma cells in vitro and examined their ability to incorporate radioiodine at various timepoints, finding peak uptake at 48 hours post infection. The effects of MV-NIS were also evaluated in mouse xenograft models of localized and disseminated medulloblastoma. Athymic nude mice were injected with D283med-Luc medulloblastoma cells in the caudate putamen (localized disease or right lateral ventricle (disseminated disease and subsequently treated with MV-NIS. Subsets of these mice were given a dose of 131I at 24, 48 or 72 hours later. Results MV-NIS treatment, both by itself and in combination with 131I, elicited tumor stabilization and regression in the treated mice and significantly extended their survival times. Mice given 131I were found to concentrate radioiodine at the site of their tumor implantations. In addition, mice with localized tumors that were given 131I either 24 or 48 hours after MV-NIS treatment exhibited a significant survival advantage over mice given MV-NIS alone. Conclusions These data suggest MV-NIS plus radioiodine may be a potentially useful therapy for

  9. Treatment of medulloblastoma using an oncolytic measles virus encoding the thyroidal sodium iodide symporter shows enhanced efficacy with radioiodine

    International Nuclear Information System (INIS)

    Medulloblastoma is the most common malignant brain tumor of childhood. Although the clinical outcome for medulloblastoma patients has improved significantly, children afflicted with the disease frequently suffer from debilitating side effects related to the aggressive nature of currently available therapy. Alternative means for treating medulloblastoma are desperately needed. We have previously shown that oncolytic measles virus (MV) can selectively target and destroy medulloblastoma tumor cells in localized and disseminated models of the disease. MV-NIS, an oncolytic measles virus that encodes the human thyroidal sodium iodide symporter (NIS), has the potential to deliver targeted radiotherapy to the tumor site and promote a localized bystander effect above and beyond that achieved by MV alone. We evaluated the efficacy of MV-NIS against medulloblastoma cells in vitro and examined their ability to incorporate radioiodine at various timepoints, finding peak uptake at 48 hours post infection. The effects of MV-NIS were also evaluated in mouse xenograft models of localized and disseminated medulloblastoma. Athymic nude mice were injected with D283med-Luc medulloblastoma cells in the caudate putamen (localized disease) or right lateral ventricle (disseminated disease) and subsequently treated with MV-NIS. Subsets of these mice were given a dose of 131I at 24, 48 or 72 hours later. MV-NIS treatment, both by itself and in combination with 131I, elicited tumor stabilization and regression in the treated mice and significantly extended their survival times. Mice given 131I were found to concentrate radioiodine at the site of their tumor implantations. In addition, mice with localized tumors that were given 131I either 24 or 48 hours after MV-NIS treatment exhibited a significant survival advantage over mice given MV-NIS alone. These data suggest MV-NIS plus radioiodine may be a potentially useful therapy for the treatment of medulloblastoma

  10. Late onset radioiodine-induced hypothyroidism presenting with psychosis 14 years after treatment: a rare case

    Science.gov (United States)

    Er, Chaozer; Sule, Ashish Anil

    2016-01-01

    Radioiodine treatment-induced hypothyroid psychosis is uncommon. Our literature search shows only three cases of hypothyroid psychosis developed within 3 months after the radioiodine treatment. Our case represents the first case of radioiodine-induced hypothyroidism presenting as psychosis much later (14 years) after the radioiodine treatment. A 60-year-old Chinese lady, with long-standing primary hypothyroidism due to the radioiodine treatment performed 14 years ago, presented with a 1-week history of hallucination, delusion and agitation. She was not on thyroid replacement. Thyroid function test done 14 years ago and again upon her admission to our facility was consistent with primary hypothyroidism. General blood tests and brain imaging were unremarkable. Her psychotic features resolved within 1 week with thyroid replacement and 9 days of antipsychotics. No further relapse of psychosis was noted. This emphasizes that radioiodine-induced hypothyroidism can go unnoticed for many years and present much later solely as psychosis. PMID:27099771

  11. Late onset radioiodine-induced hypothyroidism presenting with psychosis 14 years after treatment: a rare case.

    Science.gov (United States)

    Er, Chaozer; Sule, Ashish Anil

    2016-04-01

    Radioiodine treatment-induced hypothyroid psychosis is uncommon. Our literature search shows only three cases of hypothyroid psychosis developed within 3 months after the radioiodine treatment. Our case represents the first case of radioiodine-induced hypothyroidism presenting as psychosis much later (14 years) after the radioiodine treatment. A 60-year-old Chinese lady, with long-standing primary hypothyroidism due to the radioiodine treatment performed 14 years ago, presented with a 1-week history of hallucination, delusion and agitation. She was not on thyroid replacement. Thyroid function test done 14 years ago and again upon her admission to our facility was consistent with primary hypothyroidism. General blood tests and brain imaging were unremarkable. Her psychotic features resolved within 1 week with thyroid replacement and 9 days of antipsychotics. No further relapse of psychosis was noted. This emphasizes that radioiodine-induced hypothyroidism can go unnoticed for many years and present much later solely as psychosis. PMID:27099771

  12. RADIOIODINE GEOCHEMISTRY IN THE SRS SUBSURFACE ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, D.; Emerson, H.; Powell, B.; Roberts, K.; Zhang, S.; Xu, C.; Schwer, K.; Li, H.; Ho, Y.; Denham, M.; Yeager, C.; Santschi, P.

    2013-05-16

    Iodine-129 is one of the key risk drivers for several Savannah River Site (SRS) performance assessments (PA), including that for the Low-Level Waste Disposal Facility in E-Area. In an effort to reduce the uncertainty associated with the conceptual model and the input values used in PA, several studies have recently been conducted dealing with radioiodine geochemistry at the SRS. The objective of this report was to review these recent studies and evaluate their implications on SRS PA calculations. For the first time, these studies measured iodine speciation in SRS groundwater and provided technical justification for assuming the presence of more strongly sorbing species (iodate and organo-iodine), and measured greater iodine sediment sorption when experiments included these newly identified species; specifically they measured greater sorption coefficients (K{sub d} values: the concentration ratio of iodine on the solid phase divided by the concentration in the aqueous phase). Based on these recent studies, new best estimates were proposed for future PA calculations. The new K{sub d} values are greater than previous recommended values. These proposed K{sub d} values reflect a better understanding of iodine geochemistry in the SRS subsurface environment, which permits reducing the associated conservatism included in the original estimates to account for uncertainty. Among the key contributing discoveries supporting the contention that the K{sub d} values should be increased are that: 1) not only iodide (I{sup -}), but also the more strongly sorbing iodate (IO{sub 3}{sup -}) species exists in SRS groundwater (average total iodine = 15% iodide, 42% iodate, and 43% organoiodine), 2) when iodine was added as iodate, the measured K{sub d} values were 2 to 6 times greater than when the iodine was added as iodide, and perhaps most importantly, 3) higher desorption (10 to 20 mL/g) than (ad)sorption (all previous studies) K{sub d} values were measured. The implications of this

  13. Resonance frequency analysis of implant stability in augmented and non-augmented sinus sites

    Directory of Open Access Journals (Sweden)

    Amir Moeintaghavi

    2015-12-01

    Full Text Available Background and aim:  Although there have been substantial developments in dental implant therapies, achieving good implant stability (ISQ >60 for implants inserted in augmented sinus sites appears to be challenging in comparison with non-augmented sites due to the high prevalence of bone resorption in posterior regions of maxilla. This study aimed to evaluate and compare the time required to achieve good implant stability between implants inserted in sites that had undergone a sinus augmentation procedure with implants inserted in non-augmented similar regions of maxilla. Methods: Thirty Stroman ITI Dental Implants were inserted in 14 patients (8 females and 6 males with average age of 55 ± 10 years. Fourteen implants were inserted in sinus augmented sites (open sinus elevation and Demineralized Freezed Bone Allograft  or DFDBA 6 months after healing (test group, and 16 implants were inserted into non-augmented  posterior areas of maxilla (control group. The implant stability quotient (ISQ for each implant was measured at the time of insertion (baseline, ISQ0 and at 1, 2 and 3 months later (ISQ1, ISQ2, ISQ3. Residual and augmented bone heights were also recorded. Results: The average residual bone height was 2.92 ± 0.63mm and 10.41 ± 1.46mm for the augmented bone height. The difference between ISQ values in the test and control groups was only significant at the baseline (p=0.023. No significant correlation was found between ISQ and bone height (residual and augmented, and there was no significant correlation between ISQ values and the implant diameter and length. In the test group, the differences between ISQ0 and ISQ1, ISQ1 and ISQ3 and ISQ2 and ISQ3 were all statistically significant (p=0.006, p=0.032, p=0.046. In the control group, the difference was only significant between ISQ0 and ISQ1 (p=0.002. Conclusion:  ISQ values were not statistically significant between implants inserted in natural and augmented bone six months after sinus

  14. Radioiodination of interleukin 2 to high specific activities by the vapor-phase chloramine T method

    International Nuclear Information System (INIS)

    Recombinant human interleukin 2 (IL-2) was radioiodinated utilizing the vapor phase chloramine T method of iodination. The method is rapid, reproducible, and allows the efficient radioiodination of IL-2 to specific activities higher than those previously attained with full retention of biological activity. IL-2 radioiodinated by this method binds with high affinity to receptors present on phytohemagglutinin-stimulated peripheral blood lymphocytes and should be useful for the study of receptor structure and function

  15. Efficacy analysis of first radioiodine ablation of residual thyroid tissue in postoperative patients with thyroid cancer

    International Nuclear Information System (INIS)

    Objective: To study the influence of age, sex, type of surgery, pathologic type of the tumor, postoperative time to the administration and the dose of radioiodine, TSH level and the existence of radioiodine uptake beyond thyroid to first radioiodine ablation of residual thyroid tissue (RTT) in well-differentiated thyroid cancer after surgery. Methods: Eighty-five well-differentiated thyroid cancer patients after surgery were ablated of RTT with radioiodine from 1975 to 1998 and were followed up for 3 - 6 months after ablation. Using the absence of visible uptake compared with background as the criterion for successful ablation. Results: Fifty-eight of 85 patients (68.2%) had successful ablation of RTT after the first administration of radioiodine. The results were statistically related to the type of surgery, the time after surgery to the ablation and the dosage of radioiodine, TSH level and the simultaneous existence of radioiodine uptake in metastatic site in the patients gained successfully ablation (P < 0.05), there were no statistically significant relation with age, sex and pathologic type of tumor. Conclusions: In well-differentiated thyroid cancer, there would be better effect of first ablation of RTT with suitable dosage of radioiodine, total thyroidectomy, above 50 mU/L TSH level,ablation conducted within 3 months after surgery and radioiodine uptake found only in RTT. The effectiveness of first ablation of RTT possesses no relationship with the age, sex and the pathologic type of the tumor

  16. Augmenting computer networks

    Science.gov (United States)

    Bokhari, S. H.; Raza, A. D.

    1984-01-01

    Three methods of augmenting computer networks by adding at most one link per processor are discussed: (1) A tree of N nodes may be augmented such that the resulting graph has diameter no greater than 4log sub 2((N+2)/3)-2. Thi O(N(3)) algorithm can be applied to any spanning tree of a connected graph to reduce the diameter of that graph to O(log N); (2) Given a binary tree T and a chain C of N nodes each, C may be augmented to produce C so that T is a subgraph of C. This algorithm is O(N) and may be used to produce augmented chains or rings that have diameter no greater than 2log sub 2((N+2)/3) and are planar; (3) Any rectangular two-dimensional 4 (8) nearest neighbor array of size N = 2(k) may be augmented so that it can emulate a single step shuffle-exchange network of size N/2 in 3(t) time steps.

  17. Predictive value of thyrotropin receptor antibodies using the second generation TRAb human assay after radioiodine treatment in Graves' disease

    International Nuclear Information System (INIS)

    The detection of TSH-receptor antibodies (TRAb) in patients with Graves' disease is routinely used in nuclear medicine laboratories. This determination has been possible for approximately 3 years with a second generation human TRAb assay. Studies showed that this TRAb determination is diagnostically more sensitive compared to established, porcine TRAb assays. Objective: The aim of our study was to investigate, based on a ROC analysis, whether TRAb determination with the new, second generation assay allows a dependable statement about probability of occurence of relapse after radioiodine therapy in patient suffering from Graves' disease. Methods: 57 patients were examined with the DYNOtest trademark TRAKhuman (BRAHMS Diagnostica AG, Hennigsdorf) directly before and six months after therapy with radioiodine (dose: 150 Gy). A ROC-analysis was performed to determine positive/negative predictive values depending on different cut-off values. Results: Whereas 21/57 patients became eu- or hypothyroid after six months, 36/57 patients relapsed. Non-relapsed patients showed a significant lower median TRAb titer (4.2 IU/I vs. 19.2 IU/I; ptrademark TRAKhuman in the diagnostic of Graves' disease. It is not held over the established radioreceptorassay concerning the positive predictive value for relapsing patients. (orig.)

  18. Ocular melanoma imaging with 99m Tc (V)Dimercapto succinic acid in Thyrotoxic (Grave's) patients pretreated with radioiodine

    International Nuclear Information System (INIS)

    Ocular melanoma in Thyrotoxic patients is a very rare type of cancer, where its exact cause or link between the radiation exposure due to radioiodine therapy or other external radiation exposure on its development is still an unsolved puzzle. In the recent years the ectopic production of melanin and presence of somatostatin receptors in medullary thyroid carcinoma demonstrated its neuroendocrine origin. Thereafter the accumulation of 99mTc (V) Dimercapto succinic acid in medullary thyroid carcinoma cells were also reported. In 1991, Feggi et al demonstrated the scintigraphic uptake of radiolabelled monoclonal antibodies directed against melanoma in follicular thyroid adenoma. On this basis we conducted studies with 99m Tc (V) DMSA, in two thyrotoxic patients, received radioiodine therapy in 1985 and 1986 respectively and developed choroidal melanoma (in one case lacrimal gland was also involved), however the exact etiology was not established. The DMSA cold kits were prepared locally and labeled at five-valent state of 99m Technetium. Proper quality control methods were applied and the dose of 10 mCi was injected in each patient. The whole body images as well as brain SPECT images were taken after two hrs. and analyzed for further evaluation. The 99mTc(V) DMSA accumulation in melanoma site was seen in SPECT images .Our findings were further confirmed by CT and histochemistry. It further corroborates the neuroendocrine origin of melanoma having originated from the neural crest during development as mentioned in literature

  19. Microelectrochemical radioiodination of monoclonal antibody: a preliminary study

    International Nuclear Information System (INIS)

    The optimal reaction conditions for the microelectrochemical iodination of immunoglobulins were determined with non-specific human serum immunoglobulins. These conditions were used for the efficient radioiodination of a monoclonal antibody, 140.240, in submilligram quantities. An approximately five-fold decrease in the titre of the antibody against melanoma cells, as determined by the miniaturized mixed hemadsorption assay, was observed after iodination with an average of 0.85 atoms of iodine per molecule of antibody. (author)

  20. Does radioiodine cause the ophthalmopathy of Graves' disease?

    International Nuclear Information System (INIS)

    This editorial briefly reviews studies which might answer the question as to whether radioiodine treatment causes the ophthalmopathy of Graves' disease. However, the data do not allow any conclusion one way or the other. Other possible causal factors are discussed. Further studies are required to define whether treatment of hyperthyroidism aggravates the ophthalmopathy and whether one thereby is worse than the others and by how much. (UK)

  1. Medical and legal implications of a large release of radioiodine

    International Nuclear Information System (INIS)

    Data from NCRP Report No. 55 by the National Council on radiation Protection and Measurements are used in a hypothetical release situation to delineate the potential medical and legal problems that may arise from such a release. An analysis of these problems indicates that the effects of radioiodine release are the most important and that guidelines for countermeasures and follow-up action must be developed and promulgated. Model guidelines based on the hypothetical release are presented and discussed

  2. Prototyping Augmented Reality

    CERN Document Server

    Mullen, Tony

    2011-01-01

    Learn to create augmented reality apps using Processing open-source programming language Augmented reality (AR) is used all over, and you may not even realize it. Smartphones overlay data onto live camera views to show homes for sale, restaurants, or historical sites. American football broadcasts use AR to show the invisible first-down line on the field to TV viewers. Nike and Budweiser, among others, have used AR in ads. Now, you can learn to create AR prototypes using 3D data, Processing open-source programming language, and other languages. This unique book is an easy-to-follow guide on how

  3. Augmented reality som wearable

    DEFF Research Database (Denmark)

    Buhl, Mie; Rahn, Annette

    2015-01-01

    Artiklen omhandler design og implementering af Augmented Reality (AR) i form af en wearable i sygeplejerskeuddannelsens anatomiundervisning, mere specifikt undervisning i lungeanatomi og respiration, med fokus på potentialer for visuel læring. Projektet undersøger, hvordan en udviklet AR-applikat......Artiklen omhandler design og implementering af Augmented Reality (AR) i form af en wearable i sygeplejerskeuddannelsens anatomiundervisning, mere specifikt undervisning i lungeanatomi og respiration, med fokus på potentialer for visuel læring. Projektet undersøger, hvordan en udviklet AR...

  4. Recent advances in targeted radionuclide therapy in treatment of metastatic cancers

    International Nuclear Information System (INIS)

    Since the early forties, Nuclear Medicine uses 'targeted radionuclide therapy' for treatment, when it was discovered that 131I (radioiodine) is accumulated in thyroid tumours and their metastases. The examples of nuclear medicine viz. radioiodine therapy for thyroid cancer, for bone metastases in prostrate and breast cancer, in neuroendocrine tumors, selective internal radio therapy, antibody therapy of lymphoma, indicates its benefits. In the near future, some other ways of tumour treatment using PSMA and RGD have to prove their utility for targeted radionuclide therapy

  5. Collaborative augmented reality environments

    DEFF Research Database (Denmark)

    Büscher, Monika; Christensen, Michael; Grønbæk, Kaj;

    2000-01-01

    This paper describes Manufaktur, a prototype of a concept and infrastructure that goes beyond the classical CVE systems toward a collaborative augmented reality environment, where users? documents and objects appear as live representations in a 3D workspace. Manufaktur supports collaborative...

  6. Augmented Reality og kulturarv

    DEFF Research Database (Denmark)

    Nielsen, Mikkel Kirkedahl Lysholm

    2013-01-01

    Museerne står overfor at skulle omfavne den digitale kultur i håndteringen af den store mængde viden, institutionerne repræsenterer. Augmented Reality-systemer forbinder ved hjælp af moderne teknologi det virtuelle med det virkelige, og kan derfor synes som en oplagt anvendelsesmulighed i...

  7. The false-positive radioiodine I-131 uptake in the foreign body granuloma located in gluteal adipose tissue

    International Nuclear Information System (INIS)

    The purpose of using a whole-body scanning after the radioactive I-131 treatment is to screen functional residual or metastatic thyroid tissues. In whole-body scanning of some patients, false positive radioiodine I-131 uptakes may be seen in physiological uptake regions or atypical localizations. A 54 year-old woman underwent total thyroidectomy for papillary thyroid carcinoma. A positive appearance seen in the upper postero-lateral part of the right gluteal region was determined by a post-therapy I-131 whole body scan. The colour Doppler ultrasonography, magnetic resonance imaging features and histopathological characteristics of the excised lesion were presented. The lesion was demonstrated to be a foreign body granuloma. Unexpected positive findings in the post-therapy I-131 whole body scan should be confirmed with other imaging modalities in order to avoid unnecessary treatments. In uncertain situations, the diagnosis should be established histopathologically

  8. Protein radioiodination in a radioassay laboratory: evaluation of commercial Na125I reagents and related biohazards

    International Nuclear Information System (INIS)

    Three commercial Na125I solutions (Amersham, New England Nuclear, and Union Carbide) have been examined with respect to multiple parameters affecting their use in the radioiodination of three representative peptides (insulin, growth hormone, and gastrin): % of radioiodine incorporation in protein; immunoreactivity and non-specific binding properties of the radiolabeled proteins; pH, volatility, and radionuclidic purity of radioiodine solutions; and vial construction with respect to multidose use. All three commercial Na125I produced radioiodinated proteins of good quality for use in radioligand assays. The radioiodines differed with respect to the amount of iodine released during initial vial opening as a consequence of different pH levels. Two of the three products were shipped in vials with poor construction with respect to multidose use. Selection of a radioiodine was therefore reduced to the secondary considerations of iodine volatility and vial construction. The volatilized radioiodine observed during the spill of millicuries quantities of unbuffered pH 7.5 Na125I was 14 microcuries per millicurie within the first 30 minutes. One thickness of rubber gloves reduced potential skin contamination from an accidental spill to insignificant levels: 20-30 picocuries per microcurie. Common good housekeeping procedures: i.e. rubber gloves, laboratory coat and a fume hood were found to be sufficient protection to eliminate most radioiodine volatility and contamination hazards associated with protein radiolabeling procedures

  9. Exposure / Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD

    Science.gov (United States)

    ... NIMH (99 items) Exposure / Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD CBT Trumps Antipsychotic for Augmentation, ... Update A form of behavioral therapy can augment antidepressant treatment of obsessive compulsive disorder (OCD) better than ...

  10. Augmentation Mammaplasty in Asian Women

    OpenAIRE

    Cheng, Ming-Huei; Huang, Jung-Ju

    2009-01-01

    With the rapid economic development of Southeast Asia, the demand for cosmetic surgery has increased rapidly. Breast augmentation is among the most frequently performed cosmetic procedures. However, breast augmentation still has “bad press” in Southeast Asia because of not so distant catastrophes caused by direct liquid silicone injection and “Amazing Gel” augmentations. Asian patients have special characteristics that need to be taken into consideration when performing breast augmentation. T...

  11. Augmentation therapy for alpha-1 antitrypsin deficiency

    DEFF Research Database (Denmark)

    Stockley, Robert A; Miravitlles, Marc; Vogelmeier, Claus

    2013-01-01

    combination of age, physiological impairment, exacerbation history and rate of decline in spirometry and other measures of emphysema may be used to improve therapeutic decision making, until a reliable predictive biomarker of the evolution of lung impairment can be identified. In addition, individual...

  12. METASTATIC RADIOIODINE AVID STRUMA OVARII ASSOCIATED WITH PSEUDO-MEIGS' SYNDROME.

    Science.gov (United States)

    Riaz, Saima; Bashir, Humayun; Hassan, Aamna; Syed, Aamir Ali; Hussain, Mudassar; Imtiaz, Saba

    2015-01-01

    We report a case of 21 years old lady who presented with ascites, left adnexal mass and elevated CA-125. With suspicion of ovarian malignancy, she underwent left salpingo-oophorectomy with omental biopsy. Histopathology revealed: 'follicular variant of papillary thyroid carcinoma arising in struma ovarii' with metastatic papillary thyroid carcinoma in omental and peritoneal nodules. Patient underwent total thyroidectomy followed by radioactive iodine therapy for metastatic omental and peritoneal disease. Post-therapy whole body scan, revealed extensive I-131 avid disease metastatic disease involving the chest, abdomen, pelvis and the musculoskeletal system. Patient was treated with multiple doses of high dose radioactive iodine. She became symptom free on supra-physiologic doses of oral thyroxin however her high thyroglobulin levels and residual radioiodine avid metastatic disease required further treatment. In literature a few cases of struma ovarii have been reported with elevated CA-125 and associated pseudo-Meigs' syndrome. The treatment for this rare disease is still not standardized and poses a therapeutic challenge. Our case emphasizes the need for a multidisciplinary approach for managing struma ovarii. PMID:26721055

  13. Comparison of radioiodine biokinetics following the administration of recombinant human thyroid stimulating hormone and after thyroid hormone withdrawal in thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Luster, Markus; Lassmann, Michael; Haenscheid, Heribert; Reiners, Christoph [Department of Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg (Germany); Sherman, Steven I. [Section of Endocrine Neoplasia and Hormonal Disorders, University of Texas M.D. Anderson Cancer Center, Houston, Texas (United States); Skarulis, Monica C. [Division of Intramural Research, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (United States); Reynolds, James R. [Department of Nuclear Medicine, Warren Grant Magnusen Clinical Center, NIH, Bethesda, Maryland (United States)

    2003-10-01

    Iodine kinetics were studied in patients with differentiated thyroid cancer while euthyroid under exogenous thyroid stimulating hormone (TSH) and while hypothyroid to detect differences in radioiodine uptake, distribution and elimination. Nine patients with total or near-total thyroidectomy on thyroid hormone suppressive therapy received two or three daily doses of 0.9 mg recombinant human TSH (rhTSH) followed by administration of a diagnostic activity of 2 mCi (74 MBq) iodine-131. After the biokinetics assessments had been performed, patients stopped taking thyroid hormones to become hypothyroid. A second 2 mCi (74 MBq) diagnostic activity of {sup 131}I was administered, followed by a second set of biokinetics assessments. One week later the patients underwent remnant ablation with a therapeutic activity of {sup 131}I. A comparison of the {sup 131}I kinetics in the patients while euthyroid and while hypothyroid showed major differences in the doses to the remnant as well as in residence times and radiation exposure to the blood. In the first diagnostic assessment the remnant dose was higher in eight of the nine patients and clearance of the activity from the blood was faster in all of them. The data from this study suggest that radioiodine administration is potent and safe when administered to euthyroid patients following rhTSH administration. Enhanced residence time in the remnant and decreased radiation exposure to the blood were noted when patients were euthyroid compared to when they were rendered hypothyroid. However, all patients received diagnostic activities in the same order: first while euthyroid, followed by hypothyroidism. It is quite possible that ''stunning'' from the radioiodine administered in the initial uptake study inhibited the subsequent uptake of radioiodine by the remnant lesions in the second uptake study. (orig.)

  14. Augmenting Clozapine With Sertindole

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Emborg, Charlotte; Gydesen, Susanne;

    2012-01-01

    study design was a 12-week, double-blind, randomized, placebo-controlled study including patients with International Statistical Classification of Diseases, 10th Revision schizophrenia (F20.0-F20.3) and treated with clozapine for at least 6 months who had not achieved sufficient response. Patients were...... Inventory, fasting glucose, lipids, and elect