Sample records for goiter volume reduction

  1. 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

    Bonnema, Steen; Nielsen, Viveque E; Boel-Jørgensen, Henrik;


    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...... the reduction of very large goiters by more than 50%, compared with (131)I therapy alone, but at the expense of more adverse effects after therapy. Our data suggest that rhTSH stimulation may work through mechanisms that go beyond the increase in thyroid (131)I uptake...

  2. Goiter

    ... if the goiter is due to an underactive thyroid Small doses of Lugol's iodine or potassium iodine solution if the goiter is due to a lack of iodine Radioactive iodine to shrink the gland, especially if the thyroid is producing too much thyroid hormone Surgery ( thyroidectomy ) ...

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

    Fast, Søren; Hegedüs, Laszlo; Grupe, Peter;


    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...

  4. Bocio Goiter

    Judith Parlá Sardiñas


    Full Text Available Bocio es todo aumento de volumen de la glándula tiroidea. Su patogenia está dada fundamentalmente por una disminución en los niveles circulantes de hormonas tiroideas, con el consiguiente aumento de los niveles de hormona tirotropa que provocan hipertrofia e hiperplasia de las células foliculares y dan lugar al aumento de volumen de la glándula. Se clasifica en bocio simple, nodular y puberal. Según la OMS se clasifica por grados desde el 0 al III, y de acuerdo con la etiología en endémico y esporádico. El diagnóstico se realiza por el interrogatorio, el examen físico y se apoya en estudios complementarios: los niveles de TSH y el ultrasonido. El tratamiento depende de la etiología, la edad y el momento fisiológico de aparición. Consta de 5 pilares: preventivo, conservador o expectante, medicamentoso, quirúrgico y el uso de radioyodo. El seguimiento es clínico, apoyado en la ecografía y estudios de la función tiroidea, durante el primer año cada 6 meses, y que, si no hay modificación, se repiten anualmente.Goiter is any increase of volume of the thyroid gland. The pathogenesis is mainly due to a reduction of the circulating levels of thyroid hormones, with the resulting rise of thyrotropin hormone levels that cause hypertrophy and hyperplasia of the follicular cells and give rise to the increased volume of the gland. It is classified as simple, nodular and pubertal goiter. According to the WHO, the degree-based classification goes from 0 to III, and according to etiology, it may be endemic and sporadic. The diagnosis of goiter is based on the questioning of the patient, the physical exam and supplementary studies as TSH levels and ultrasonography. The treatment depends on the etiology, the age of the patient, and the time of onset and has five pillars: preventive, preservative or expectant, pharmacological, surgical and the use of radioiodine. The clinical follow-up supports on echography and thyroid function studies every

  5. Stimulation with 0.3-mg recombinant human thyrotropin prior to iodine 131 therapy to improve the size reduction of benign nontoxic nodular goiter

    Nielsen, Viveque Egsgaard; Bonnema, Steen Joop; Boel-Jørgensen, Henrik;


    ) were randomized to receive either 0.3 mg of recombinant human thyrotropin (n = 28) or placebo (n = 29) 24 hours before (131)I therapy. The (131)I dose was calculated based on thyroid size (measured by ultrasound), thyroid (131)I uptake, and (131)I half-life. The follow-up period was 1 year and included......BACKGROUND: Use of recombinant human thyrotropin increases the thyroid radioiodine (iodine 131 [(131)I]) uptake and may have a role in the context of (131)I therapy of benign goiter. METHODS: In a double-blind, placebo-controlled trial, 57 patients with nodular nontoxic goiter (51 women and 6 men...... measurements of thyroid size and function and patient satisfaction. RESULTS: Baseline median goiter volume was 51 mL (range, 20-99 mL) in the placebo group and 59 mL (range, 25-92 mL) in the thyrotropin group (P = .75). At 12 months, the mean +/- SEM relative goiter reduction was 46.1% +/- 4.0% in the placebo...

  6. Smoking as a risk factor for thyroid volume progression and incident goiter in a region with improved iodine supply.

    Ittermann, Till; Schmidt, Carsten Oliver; Kramer, Axel; Below, Harald; John, Ulrich; Thamm, Michael; Wallaschofski, Henri; Völzke, Henry


    The role of smoking in the pathogenesis of thyroid enlargement is currently under debate. It has been hypothesized that the effect of smoking on increased thyroid volume is larger in regions with than in regions without iodine deficiency. The aim of this paper was to investigate the association of smoking with thyroid volume progression and incident goiter for different age-strata in a region with improved iodine supply. The population-based Study of Health in Pomerania compromised 3300 subjects with complete 5-year examination follow-up. Data from 2484 participants without known history of thyroid disorder or thyroid medication were analyzed. Thyroid size was evaluated by ultrasound. Determinants of thyroid volume progression and incident goiter, i.e., newly occurred goiter between baseline and follow-up, were analyzed by linear and logistic regression respectively. Participants aged 20-39 years who were current smokers at baseline and at follow-up had a lower risk of incident goiter (odds ratio: 0.33; 95% confidence interval (CI): 0.15; 0.71; P=0.005). In this subpopulation, age was inversely related to thyroid volume progression. In subjects aged 60-79 years, smoking at baseline and follow-up was a risk factor for thyroid volume progression (beta: 3.37; 95% CI: 0.84; 5.89; P=0.009). After exclusion of individuals who had actual goiter in ultrasound at baseline, this association disappeared. We conclude that the inverse association between smoking and goiter in young adults and the lacking association of smoking with goiter and thyroid volume progression in adult non-goitrous subjects indicate that smoking has a declining impact on thyroid growth in the study region. Our findings mirror the improved iodine supply of Northeast Germany.

  7. Serum thyroxine and age - rather than thyroid volume and serum TSH - are determinants of the thyroid radioiodine uptake in patients with nodular goiter

    Bonnema, S J; Fast, S; Nielsen, V E;


    patients (146 females; age range: 22-87 yrs.) with nodular goiter (median 64 ml, range: 20-464 ml) selected for 131I therapy. Serum TSH was sub-normal in 42.4%. None were treated with anti-thyroid drugs. The thyroid RAIU was determined at 24h and 96h. The goiter volume was measured by ultrasound (n=127......Background: 131I therapy is widely used for treatment of non-toxic goiters. A limitation for this treatment is a low thyroid radioiodine uptake (RAIU), often encountered in these patients. Aim: To estimate the impact of various factors on the thyroid RAIU. Methods: We examined prospectively 170...

  8. Combination therapy of temporary tracheal stenting and radiofrequency ablation for multinodular thyroid goiter with airway compression

    Shin, Ji Hoon; Beak, Jung Hwan; Oh, Yeon Mok; Ha, Eun Ju; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)


    We report a case of multinodular thyroid goiter in an 80-year-old man who successfully underwent tracheal stent placement for respiratory distress caused by the thyroid goiter and following two radiofrequency (RF) ablation sessions performed for thyroid volume reduction. This sequential treatment allowed elective stent removals four weeks after the second RF ablation session because the thyroid volume had been progressively reduced. Combination therapy of temporary airway stenting and RF ablation for the treatment of thyroid goiter has two advantages, i.e., immediate reliefs of dyspnea with airway stenting and reductions of the thyroid volume with RF ablation, and thus, allowing symptom reliefs even after the stent removals.

  9. Bronchoscopic lung volume reduction

    M. I. Polkey


    Full Text Available Surgical lung volume reduction can improve exercise performance and forced expiratory volume in one second in patients with emphysema. However, the procedure is associated with a 5% mortality rate and a nonresponse rate of 25%. Accordingly, interest has focused on alternative ways of reducing lung volume. Two principle approaches are used: collapse of the diseased area using blockers placed endobronchially and the creation of extrapulmonary pathways. Preliminary data from the former approach suggest that it can be successful and that the magnitude of success is related to reduction in dynamic hyperinflation.

  10. Design for volume reduction

    Wever, R.; Boks, C.; Stevels, A.


    Traditionally packaging design-for-sustainability (DfS) strongly focuses on resource conservation and material recycling. The type and amount of materials used has been the driver in design. For consumer electronics (CE) products this weight-based approach is too limited; a volume-based approach is

  11. Insular volume reduction in schizophrenia.

    Saze, Teruyasu; Hirao, Kazuyuki; Namiki, Chihiro; Fukuyama, Hidenao; Hayashi, Takuji; Murai, Toshiya


    Structural and functional abnormalities of the insular cortex have been reported in patients with schizophrenia. Most studies have shown that the insular volumes in schizophrenia patients are smaller than those of healthy people. As the insular cortex is functio-anatomically divided into anterior and posterior subdivisons, recent research is focused on uncovering a specific subdivisional abnormality of the insula in patients with schizophrenia. A recent ROI-based volumetric MRI study demonstrated specific left anterior insular volume reduction in chronic schizophrenia patients (Makris N, Goldstein J, Kennedy D, Hodge S, Caviness V, Faraone S, Tsuang M, Seidman L (2006) Decreased volume of left and total anterior insular lobule in schizophrenia. Schizophr Res 83:155-171). On the other hand, our VBM-based volumetric study revealed a reduction in right posterior insular volume (Yamada M, Hirao K, Namiki C, Hanakawa T, Fukuyama H, Hayashi T, Murai T (2007) Social cognition and frontal lobe pathology in schizophrenia: a voxel-based morphometric study. NeuroImage 35:292-298). In order to address these controversial results, ROI-based subdivisional volumetry was performed using the MRI images from the same population we analyzed in our previous VBM-study. The sample group comprised 20 schizophrenia patients and 20 matched healthy controls. Patients with schizophrenia showed a global reduction in insular gray matter volumes relative to healthy comparison subjects. In a simple comparison of the volumes of each subdivision between the groups, a statistically significant volume reduction in patients with schizophrenia was demonstrated only in the right posterior insula. This study suggests that insular abnormalities in schizophrenia would include anterior as well as posterior parts. Each subdivisional abnormality may impact on different aspects of the pathophysiology and psychopathology of schizophrenia; these relationships should be the focus of future research.

  12. Simple goiter in children and juveniles

    Wiebel, J.


    Non-toxic, simple goiter is the most common cause of thyroid enlargement in adolescents and children. Although initially there are hardly any complaints it should be treated with l-thyroxine to prevent further enlargement, degenerative alterations, development of nodules, possible hyper- or hypothyroidism occurring with increasing age. Anamnesis and clinical features are as important for establishing the diagnosis as laboratory parameters, which are not always necessary. Thyroid nodules in children or adolescents are more likely to be malignant than in later life; their nature has to be clarified by sonography, scintigraphy, fine needle biopsy or even operation. After l-thyroxine therapy has normalized thyroid size (60-90%), goiter prophylaxis with iodine supplementation can be tried, since iodine deficiency exists throughout Germany. If the goiter reappears continuous l-thyroxine treatment is recommended. Following the general introduction of iodine prophylaxis using iodinized salt there has been a significant reduction in goiter incidence in Switzerland, Austria and other areas with iodine deficiency. New legislation in the FRG now allows for the general use of e.g., Bad Reichenhaller Jodsalz, Duera Vollsalz or Bayerisches Vollsalz to prevent the development of the majority of goiters in children and adolescents.

  13. Fetal goiter and bilateral ovarian cysts

    Lassen, Pernille; Sundberg, Karin; Juul, Anders


    by each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10...

  14. Two cases of fetal goiter

    Ashish Saini


    Full Text Available Introduction: Anterior fetal neck masses are rarely encountered. Careful routine ultrasound screening can reveal intrauterine fetal goiters (FGs. The incidence of goitrous hypothyroidism is 1 in 30,000-50,000 live births. The consequences of both FG and impaired thyroid function are serious. Aims and Objectives: To emphasize role of ultrasound in both invasive and non-invasive management of FG. Materials and Methods: Two pregnant patients, during second trimester, underwent routine antenatal ultrasound revealing FG, were investigated and managed. Results: Case 1: Revealed FG with fetal hypothyroidism. Intra-amniotic injection l-thyroxine given. Follow-up ultrasound confirmed the reduction of the goiter size. At birth, thyroid dyshormogenesis was suspected and neonate discharged on 50 mcg levothyroxine/day with normal growth and development so far. Case 2: Hypothyroid mother with twin pregnancy revealed FG, in twin 1, confirmed on magnetic resonance imaging (1.5 × 1.63 cm. The other twin had no thyroid swelling. Cordocentesis confirmed hypothyroidism in twin 1. Maternal thyroxine dose increased as per biochemical parameters leading to reduction in FG size. Mother delivered preterm and none of the twins had thyroid swelling. Fetal euthyroidism was confirmed on biochemical screening. Conclusion: FG during pregnancy should be thoroughly evaluated, diagnosed and immediately treated; although in utero options for fetal hypothyroidism management are available, emphasis should be laid on non-invasive procedures. Newer and better resolution techniques in ultrasonography are more specific and at the same time are less harmful.

  15. Ultrasound diagnosis on the goiter

    Igl, W.; Fink, V.; Leisner, B.; Gebauer, A.


    Sonography of the thyroid means facilitation to the differential diagnosis of the goiter, and if combined with the nuclear-medical methods, its accuracy is even increased. Cysts, thyreoditis de Quervain, morbus Basedow, and autonomous adenoma can be assumed due to the areals with low echo in the sonogram and they can be differentiated by the scintigram. In the case of iodine-free areals which can be manifested by fluorescence scintiscanning and normal echo pattern of the thyroid below a malignoma has to be suspected. The volume can be determined with an accuracy of +-10% by ultrasound, without needing long time. Knowing the thickness of the thyroid at places of increased storage in the scintigram, an impulse-thickness-quotient can be calculated which permits, in most cases, to diagnose an autonomous adenoma at a regional increased storage without suppression test.

  16. Ultrasonographic determination of goiter prevalence in southern Brazilian schoolchildren

    Lisbôa H.R.K.


    Full Text Available The aim of the present study was to estimate the prevalence of goiter in schoolchildren in a formerly iodine-deficient region in southern Brazil by assessing the relationship between body surface area (m² and thyroid volume (ml measured by ultrasonography. A population-based sample of 1,094 randomly selected schoolchildren (6 to 14 years; 556 boys and 538 girls underwent clinical evaluation. A total of 119 (10.9% children were diagnosed with goiter upon clinical examination according to WHO criteria (grade Ia: 65, grade Ib: 24, grade II: 29, grade III: 1. Of these, 85 underwent ultrasonography. In order to ascertain the absence of goiter in the 975 schoolchildren with a negative result upon clinical examination, one of ten children was randomly selected for ultrasonography. Sixty-two children agreed to be submitted to the exam. Thus, 147 schoolchildren were evaluated by ultrasonography (7.5-MHz transducer. Goiter was considered to be present when the thyroid volume:body surface area index was >6.2 ml/m². The estimated prevalence of goiter if all schoolchildren had been submitted to thyroid volume measurement by ultrasound was 7.2%; it was higher in the lower socioeconomic class (8.2% than in the upper (7.8% and middle classes (6.5%. In conclusion, the prevalence of goiter in schoolchildren of this region was higher than in other iodine-sufficient areas, especially in lower socioeconomic classes. Goiter in this region may be associated with naturally occurring goitrogens that operate more intensively among less privileged individuals.

  17. Evaluation of Children with Goiter and Treatment Outcomes

    Ömer Tarım


    Full Text Available Aim: Goiter is defined as the enlargement of thyroid gland independent of the etiology. It is common in childhood, especially in adolescence. The prevalence of goiter in children aged 6 to 12 years of age was found as 24.9 to 92% in different studies performed in different regions of Turkey. The most common cause in endemic regions is iodine deficiency and it is chronic lymphocytic thyroiditis in non-endemic areas. The aim of this study was to evaluate the demographic and diagnostic characteristics; and physical, laboratory and radiological findings of the children who were presented and followed-up with goiter, and the efficacy of the treatments applied was also assessed.Materials and Methods: A total of 116 children diagnosed as having goiter by physical and ultrasonographic examination in the outpatient clinic of Pediatric Endocrinology Division of Uludag University Faculty of Medicine, between January 2000 and December 2005. Data of the patient were collected retrospectively from the files/records of the patients. Goiter grades of the patients were determined according to that recommended by WHO. Thyroid volumes were calculated from the ultrasonographic measurement of thyroid dimensions. Patients with euthyroid or hypothyroid goiter had L-thyroxine therapy and those with hyperthyroidism had propiltiourasil and/or propranolol. Results: Of all children, 80 (69% were girls and the remaining 36 were boys (31%. At the time of initial diagnosis, the mean ages of the girls and the boys were 10.1±2.9 years and 9.02± years, respectively. The mean follow-up period was 3.18±1.83 years. Most children (76.7% had grade Ib (38.8% or II (37.9% goiter at the time of diagnosis. Of all children with goiter, 62 (53.4% were euthyroid, 47 (40.5% were hypothyroid and 7 (6.0% were hyperthyroid. Seventy nine (68.1% patients had history of thyroid disease in their families. There were additional endocrinological disturbances, epilepsy and other systemic diseases

  18. Brain volume reductions in adolescent heavy drinkers.

    Squeglia, Lindsay M; Rinker, Daniel A; Bartsch, Hauke; Castro, Norma; Chung, Yoonho; Dale, Anders M; Jernigan, Terry L; Tapert, Susan F


    Brain abnormalities in adolescent heavy drinkers may result from alcohol exposure, or stem from pre-existing neural features. This longitudinal morphometric study investigated 40 healthy adolescents, ages 12-17 at study entry, half of whom (n=20) initiated heavy drinking over the 3-year follow-up. Both assessments included high-resolution magnetic resonance imaging. FreeSurfer was used to segment brain volumes, which were measured longitudinally using the newly developed quantitative anatomic regional change analysis (QUARC) tool. At baseline, participants who later transitioned into heavy drinking showed smaller left cingulate, pars triangularis, and rostral anterior cingulate volume, and less right cerebellar white matter volumes (pteens. Over time, participants who initiated heavy drinking showed significantly greater volume reduction in the left ventral diencephalon, left inferior and middle temporal gyrus, and left caudate and brain stem, compared to substance-naïve youth (pbrain regions in future drinkers and greater brain volume reduction in subcortical and temporal regions after alcohol use was initiated. This is consistent with literature showing pre-existing cognitive deficits on tasks recruited by frontal regions, as well as post-drinking consequences on brain regions involved in language and spatial tasks. Published by Elsevier Ltd.

  19. Exponential reduction of finite volume effects with twisted boundary conditions

    Cherman, Aleksey; Wagman, Michael L; Yaffe, Laurence G


    Flavor-twisted boundary conditions can be used for exponential reduction of finite volume artifacts in flavor-averaged observables in lattice QCD calculations with $SU(N_f)$ light quark flavor symmetry. Finite volume artifact reduction arises from destructive interference effects in a manner closely related to the phase averaging which leads to large $N_c$ volume independence. With a particular choice of flavor-twisted boundary conditions, finite volume artifacts for flavor-singlet observables in a hypercubic spacetime volume are reduced to the size of finite volume artifacts in a spacetime volume with periodic boundary conditions that is four times larger.

  20. Update on Nonsurgical Lung Volume Reduction Procedures

    J. Alberto Neder


    Full Text Available There has been a surge of interest in endoscopic lung volume reduction (ELVR strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR, bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC 225% predicted and thoracic hyperinflation (TLC > 150% predicted have the greatest potential to derive benefit from ELVR procedures. Pre-LVRS or ELVR assessment should ideally include cardiological evaluation, high resolution CT scan, ventilation and perfusion scintigraphy, full pulmonary function tests, and cardiopulmonary exercise testing. ELVR procedures are currently available in selected Canadian research centers as part of ethically approved clinical trials. If a decision is made to offer an ELVR procedure, one-way valves are the first option in the presence of complete lobar exclusion and no significant collateral ventilation. When the fissure is not complete, when collateral ventilation is evident in heterogeneous emphysema or when emphysema is homogeneous, coil implants or BioLVR (in that order are the next logical alternatives.

  1. Sequential unilateral lung volume reduction for emphysema - Stretching the benefit.

    Khorramnia, Sadie; Holsworth, Lynda; Mestitz, Hugh; Westall, Glen P; Williams, Trevor J; Gooi, Julian H; Snell, Gregory I


    Bronchoscopic Lung Volume Reduction (BLVR) and Surgical Lung Volume Reduction (SLVR) and are two different approaches used to remodel severely emphysematous lungs to improve lung function and quality-of-life. We present a case initially referred for lung transplantation, where sequential left upper lobe BLVR and 7 years later right upper lobe SLVR, providing enduring physiological and functional improvement. The potential for sustained benefit via sequential unilateral lung volume reduction is under-appreciated.

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

    Fast, Søren; Nielsen, Viveque Egsgaard; Grupe, Peter;


    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...... 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......-alone group (43.2 ± 3.7 and 56.2 ± 3.6%, respectively, P = 0.001 and P = 0.006), corresponding to a gain of 24% at final FU. At last FU the mean reduction in compression visual analog scale score was significantly greater in patients receiving rhTSH (P = 0.049). Additional therapy (thyroid surgery or (131)I...

  3. October 2015 Phoenix pulmonary journal club: lung volume reduction

    Mathew M


    Full Text Available No abstract available. Article truncated at 150 words. The October 2015 pulmonary journal club focused on the review of older studies evaluating lung volume reduction surgery and how this has transitioned toward the development of non-surgical modes of lung volume reduction. The physiology behind dyspnea in chronic obstructive pulmonary disease (COPD is a complex process. One of the proposed mechanisms has been hyperinflation associated with air trapping. In the mid 1990s studies by Cooper and Peterson (1 offered a promising approach in which lung volume reduction (LVR could improve ventilatory mechanics and improve dyspnea. As the procedure gained more popularity, additional larger scale trials were performed to support its validity. We reviewed 2 studies looking at lung volume reduction. The first was "The Effect of Lung Volume Reduction Surgery In Patients With Severe Emphysema” (2 . This was a smaller, randomized controlled trial (RCT that looked at 2 groups of 24 patients. Once group received LVR while the ...

  4. Bocio endotorácico Endothoracic goiter

    Gabriel González Sosa


    Full Text Available Se informa el caso de una paciente de 71 años de edad, con antecedentes de hipertensión arterial, que acude a consulta externa pues hace unos 5 años presenta aumento de volumen de la región inferior y lateral del cuello que se acompaña de decaimientos, palpitaciones y disfagia ocasional. Se realizaron los estudios de laboratorio para la valoración preoperatoria, además de los estudios de la función tiroidea, radiografías de tórax (vista anteroposterior, tomografía de tórax, ecografía de la tiroides y biopsia de aspiración con aguja fina. Se encontró un bocio endotorácico eutiroideo y se realizó tratamiento quirúrgico que consistió en hemitiroidectomía izquierda con istmectomía. El transoperatorio y el posoperatorio transcurrieron sin complicaciones, y el informe anatomopatológico reveló la presencia de un bocio coloide nodular.This is the case of a female patient aged 71 with a history of high blood pressure seen in external consultation since five years ago she presents a volume increase of lower and lateral region of the neck accompanied of weakness, palpitations and occasional dysphagia. Laboratory studies were conducted to preoperative assessment in addition to thyroid function studies, thorax X-rays (anteroposterior view, thorax tomography, thyroid gland echography and fine needle aspiration biopsy (FNAB. A euthyroid endothoracic goiter was present; surgical treatment was done consisting of left hemithyroidectomy with isthmectomy. In transoperative and postoperative periods there were not complications and the anatomic and pathologic report revealed the presence of nodular colloid goiter.

  5. [Multinodular diving goiters: 100 cases in Morocco].

    Tajdine, Med Tariq; Lamrani, Mohamed; Serhane, Khalid; Achour, Abdessamad; Benariba, Farid; Daali, Mustapha


    To assess 100 cases of multinodular diving goiters, the authors review the literature to compare the epidemiology, clinical pictures, additional required work-up, treatments, complications, and sequelae. Records of 100 cases of multinodular diving goiters were collected in the surgical department of the Military Hospital of Marrakesh in Morocco from 1991 through 2004. They accounted for 6% of all goiters. The sex ratio was clearly female, and the mean age 50 years. The clinical symptoms of diving goiters involves mainly signs of compression, with dyspnea seen in 50% of cases. Thyroid dysfunction was found in only 25% of our patients. A diagnosis of diving goiter must be suspected when there are signs of mediastinal compression and a palpable cervical goiter, as seen in all our patients. The diagnosis can often be confirmed with thoracic radiography and thyroid scintigraphy. Treatment is mainly surgical and depends on disease course. Cervicotomy was performed in 97% of our patients and was sufficient to extract even most voluminous goiters and those deepest in the mediastinum. Immediate operative results were satisfactory. More long-term results were also generally satisfactory, except for 4 cases of recurrent paralysis and 5 cases of hypoparathyroidism. Both have been reported by several authors. Surgical management of multinodular diving goiters is necessary. In general, cervicotomy is sufficient, and the results generally satisfactory, except some complications and neoplasms.

  6. Predictors of prostate volume reduction following neoadjuvant cytoreductive androgen suppression

    Krishan R. Jethwa


    Full Text Available Purpose: Limited duration cytoreductive neoadjuvant hormonal therapy (NHT is used prior to definitive radiotherapeutic management of prostate cancer to decrease prostate volume. The purpose of this study is to examine the effect of NHT on prostate volume before permanent prostate brachytherapy (PPB, and determine associated predictive factors. Material and methods : Between June 1998 and April 2012, a total of 1,110 patients underwent PPB and 207 patients underwent NHT. Of these, 189 (91.3% underwent detailed planimetric transrectal ultrasound before and after NHT prior to PPB. Regression analysis was used to assess predictors of absolute and percentage change in prostate volume after NHT. Results: The median duration of NHT was 4.9 months with inter quartile range (IQR, 4.2-6.6 months. Prostate-specific antigen (PSA reduced by a median of 97% following NHT. The mean prostate volume before NHT was 62.5 ± 22.1 cm 3 (IQR: 46-76 cm 3 , and after NHT, it was 37.0 ± 14.5 cm 3 (IQR: 29-47 cm 3 . The mean prostate volume reduction was 23.4 cm 3 (35.9%. Absolute prostate volume reduction was positively correlated with initial volume and inversely correlated with T-stage, Gleason score, and NCCN risk group. In multivariate regression analyses, initial prostate volume (p < 0.001 remained as a significant predictor of absolute and percent prostate volume reduction. Total androgen suppression was associated with greater percent prostate volume reduction than luteinizing hormone releasing hormone agonist (LHRHa alone (p = 0.001. Conclusions : Prostate volume decreased by approximately one third after 4.9 months of NHT, with total androgen suppression found to be more efficacious in maximizing cytoreduction than LHRHa alone. Initial prostate volume is the greatest predictor for prostate volume reduction.

  7. Volume reduction through perturbative Wilson loops

    Perez, Margarita Garcia; Okawa, Masanori


    We derive the perturbative expansion of Wilson loops to order g^4 in a SU(N) lattice gauge theory with twisted boundary conditions. Our expressions show that the thermodynamic limit is attained at infinite N for any number of lattice sites and allow to quantify the deviations from volume independence at finite large N as a function of the twist.

  8. Disc volume reduction with percutaneous nucleoplasty in an animal model.

    Richard Kasch

    Full Text Available STUDY DESIGN: We assessed volume following nucleoplasty disc decompression in lower lumbar spines from cadaveric pigs using 7.1Tesla magnetic resonance imaging (MRI. PURPOSE: To investigate coblation-induced volume reductions as a possible mechanism underlying nucleoplasty. METHODS: We assessed volume following nucleoplastic disc decompression in pig spines using 7.1-Tesla MRI. Volumetry was performed in lumbar discs of 21 postmortem pigs. A preoperative image data set was obtained, volume was determined, and either disc decompression or placebo therapy was performed in a randomized manner. Group 1 (nucleoplasty group was treated according to the usual nucleoplasty protocol with coblation current applied to 6 channels for 10 seconds each in an application field of 360°; in group 2 (placebo group the same procedure was performed but without coblation current. After the procedure, a second data set was generated and volumes calculated and matched with the preoperative measurements in a blinded manner. To analyze the effectiveness of nucleoplasty, volumes between treatment and placebo groups were compared. RESULTS: The average preoperative nucleus volume was 0.994 ml (SD: 0.298 ml. In the nucleoplasty group (n = 21 volume was reduced by an average of 0.087 ml (SD: 0.110 ml or 7.14%. In the placebo group (n = 21 volume was increased by an average of 0.075 ml (SD: 0.075 ml or 8.94%. The average nucleoplasty-induced volume reduction was 0.162 ml (SD: 0.124 ml or 16.08%. Volume reduction in lumbar discs was significant in favor of the nucleoplasty group (p<0.0001. CONCLUSIONS: Our study demonstrates that nucleoplasty has a volume-reducing effect on the lumbar nucleus pulposus in an animal model. Furthermore, we show the volume reduction to be a coblation effect of nucleoplasty in porcine discs.

  9. Reduction of residual limb volume in people with transtibial amputation

    Audrey T. Tantua, MD


    Full Text Available The early postoperative phase after transtibial amputation is characterized by rapid residual limb volume reduction. Accurate measurement of residual limb volume is important for the timing of fitting a prosthesis. The aim of this study was to analyze the reduction of residual limb volume in people with transtibial amputation and to correlate residual limb volume with residual limb circumference. In a longitudinal cohort study of 21 people who had a transtibial amputation, residual limb volume was measured using a laser scanner and circumference was measured using a tape measure 1 wk postamputation and every 3 wk thereafter until 24 wk postamputation. A linear mixed model analysis was performed with weeks postamputation transformed according to the natural logarithm as predictor. Residual limb volume decreased significantly over time, with a large variation between patients. Residual limb volume did not correlate well with circumference. On average, residual limb volume decreased 200.5 mL (9.7% of the initial volume per natural logarithm of the weeks postamputation. The decrease in residual limb volume following a transtibial amputation was substantial in the early postamputation phase, followed by a leveling off. It was not possible to determine the specific moment at which the residual limb volume stabilized.

  10. The "forgotten" goiter after total thyroidectomy.

    Sahbaz, Alper; Aksakal, Nihat; Ozcinar, Beyza; Onuray, Feyyaz; Caglayan, Kasim; Erbil, Yesim


    "Forgotten" goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. We report two cases with forgotten goiter. One underwent total thyroidectomy due to thyroid papillary cancer and TSH level was in normal range one month after surgery. The thyroid scintigraphy scan revealed mediastinal thyroid mass. The second case underwent total thyroidectomy due to Graves' disease and TSH level was low after surgery. At postoperative seventh year, patients were admitted to our Endocrinology Division due to persistent hyperthyroidism and CT scan revealed forgotten thyroid at mediastinum. Both patients underwent median sternotomy and mass excision, there was no morbidity detected after second surgical procedures. In the majority of cases forgotten goiter is the consequence of the incomplete removal of a plunging goiter. Although in some cases, it may be attributed to a concomitant, unrecognized mediastinal goiter which is not connected to the thyroid with a thin fibrous band or vessels. Absence of signs like mediastinal mass or tracheal deviation in preoperative chest X-ray do not excluded the substernal goiter. Retrosternal goiter should be suspected if the lower poles could not be palpated on physical examination and when postoperative TSH levels remained unchanged. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Surgical considerations about amyloid goiter.

    García Villanueva, Augusto; García Villanueva, María Jesús; García Villanueva, Mercedes; Rojo Blanco, Roberto; Collado Guirao, María Vicenta; Cabañas Montero, Jacobo; Beni Pérez, Rafael; Moreno Montes, Irene


    Amyloidosis is an uncommon syndrome consisting of a number of disorders having in common an extracellular deposit of fibrillary proteins. This results in functional and structural changes in the affected organs, depending on deposit location and severity. Amyloid infiltration of the thyroid gland may occur in 50% and up to 80% of patients with primary and secondary amyloidosis respectively. Amyloid goiter (AG) is a true rarity, usually found associated to secondary amyloidosis. AG may require surgical excision, usually because of compressive symptoms. We report the case of a patient with a big AG occurring in the course of a secondary amyloidosis associated to polyarticular onset juvenile idiopathic arthritis who underwent total thyroidectomy. Current literature is reviewed, an attempt is made to provide action guidelines, and some surgical considerations on this rare condition are given.

  12. Amyloid Goiter Secondary to Ulcerative Colitis

    Bunyamin Aydin


    Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.

  13. Prophylaxis and treatment of endemic goiter with iodized oil in rural Ecuador and Peru.

    Kevany, J; Fierro-Benitez, R; Pretell, E A; Stanbury, J B


    Endemic goiter is a health problem in many areas of the world; in some areas the disease is so severe that cretinism and other defects are found. In many areas geographic, economic, and other factors prevent the use of iodized salt as a preventive measure. Field studies were begun in 1966 to determine the feasibility and effectiveness of parenteral administration of iodized oil in goiter prevention. Studies were carried out in Ecuador and Peru. In Ecuador 2 villages were chosen in which the prevalence of goiter was about 60%; in Peru 3 villages were chosen where incidence was about 50%. Prevalence of goiter decreased for 20 months during the study but then began to rise again with the maximum reduction seen up to age 18 and minimal reduction after 40 years of age. The control groups in the study experienced only slight decreases in rate of incidence. Cretinism has not yet appeared among the progeny of the population injected with iodized oil but several instances have appeared in control groups. The use of iodized oil as a public health procedure for the prevention of endemic goiter and its associated defects is an acceptable measure in regions where salt iodization cannot be done.


    O. S. Rogova


    Full Text Available For today the question of early diagnosis of nosological variants, the method of treatment and prevention of nodular goiter in children is still not fully resolved. There is a few available literature data about study of this problem in children. Objective: to study morphofunctional structure of thyroid nodules in children.The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A. Bashlyaeva Children’sCityClinicalHospital(Moscow from 2003 to May 2015. The examination included an evaluation of the functional status of the pituitary-thyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hor-mone, also was performed thyroid scintigraphy 99mТc. In the postoperative period, there was carried out a final verification of the diagnosis according to the results of the histological conclusion. The histologi-cal type of nodal disease was defined by the WHO classification of 2004. It was established that in the structure of a single-node goiter in children prevail nodular colloid goiter with equal frequency in boys and girls, with the same frequency occurs thyroid adenoma, but more often in girls than in boys. The multinodular goiter equally often detected in girls and boys both nodular goiter colloidal with varying degree of proliferation and colloid in combination with follicular thyroid adenoma. "Hot" nodes in the multinodular goiter are more common than in the single-node goiter and more fre-quently in girls than in boys. The half of children with nodular pathology have "hot" nodes and one out of every three – decompensated form of functional autonomy. Decompensated form of functional autonomy of the thyroid gland in children with "hot" nodes detects regardless of the number of nodes. Papillary thyroid cancer occurs not only in patients with a single-node, but with a multinodular goiter. The results allow to

  15. Volume reduction philosophy and techniques in use or planned

    Row, T.H.


    Siting and development of nuclear waste disposal facilities is an expensive task. In the private sector, such developments face siting and licensing issues, public intervention, and technology challenges. The United States Department of Energy (DOE) faces similar challenges in the management of waste generated by the research and production facilities. Volume reduction can be used to lengthen the service life of existing facilities. A wide variety of volume reduction techniques are applied to different waste forms. Compressible waste is compacted into drums, cardboard and metal boxes, and the loaded drums are supercompacted into smaller units. Large metallic items are size-reduced and melted for recycle or sent to shallow land burial. Anaerobic digestion is a process that can reduce cellulosic and animal wastes by 80%. Incinerators of all types have been investigated for application to nuclear wastes and a number of installations operate or are constructing units for low-level and transuranic solid and liquid combustibles. Technology may help solve many of the problems in volume reduction, but the human element also has an important part in solving the puzzle. Aggressive educational campaigns at two sites have proved very successful in reducing waste generation. This overview of volume reduction is intended to transfer the current information from many DOE facilities. 44 references, 85 figures, 5 tables.

  16. Stabilization and volume reduction of radioactive spent ionexchange resins


    Stabilization and volume reduction of spent radioactive ion-exchange resins (IERs)were studied. Stabilization technology includes volume reduction with wet chemicaloxidation process and immobilization of the residue into cement. Undersuitable conditions, the exhaustedradioactive ion-exchange resins were dissolved successfully in aH2O2-Fe2+/Cu2+ catalytic oxidationsystem (Fenton reagent). The analytical results indicated that the radioactive nuclides loaded in the resins were concentrated in decomposed solution and solid residues. The process parameters ofwet chemical oxidation and solidification were also obtained. Thedecomposition ratios were 100%and more than 90% for cation and anion IERs respectively. The waste volume was decreased by40% compared with that of original spent resins.

  17. Compendium of Practical Astronomy. Volume 1: Instrumentation and Reduction Techniques.

    Augensen, H. J.; Heintz, W. D.; Roth, Günter D.

    The Compendium of Practical Astronomy is a revised and enlarged English version of the fourth edition of G. Roth's famous handbook for stargazers. In three volumes 28 carefully edited articles, aimed especially at amateur astronomers and students and teachers of astronomy in high schools and colleges, cover the length and breadth of practical astronomy. Volume 1 contains information on modern instrumentation and reduction techniques, including spherical astronomy, error estimations, telescope mountings, astrophotography, and more. Volume 2 covers the planetary system, with contributions on artificial satellites, comets, the polar aurorae, and the effects of the atmosphere on observational data. Volume 3 is devoted to stellar objects, variable stars and binary stars in particular. An introduction to the astronomical literature and a comprehensive chapter on astronomy education and instructional aids make the Compendium a useful complement to any college library, in addition to its being essential reading for all practical astronomers.

  18. Endobronchial Valves for Endoscopic Lung Volume Reduction : Best Practice Recommendations from Expert Panel on Endoscopic Lung Volume Reduction

    Slebos, Dirk-Jan; Herth, Felix J F; Valipour, Arschang


    Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patie

  19. Postoperative recurrent nontoxic nodular (multinodular goiter

    Tolstokorov A.S.


    Full Text Available The extensive use of modern methods of examination (ultrasound investigation with Doppler mapping, aspiration (needle biopsy, radiodiagnostics cannot resolve the problem of verification of nodular mass in case of multinodular goiter before operation. Operative intervention is the method of choice in this case, which gives rise to the problem of surgery extent. The present study is useful in improvement of remote results of surgical treatment of multinodular goiter through statistical estimation of recurrent goiter development. The study was retrospective and included 102 consecutively admitted and operated patients with recurrent goiter and 102 patients of control group with first diagnosed and operated goiter. Patients of both groups were in euthyroid state. Patients were admitted to the Clinic of Surgery and Oncology of Raising Skills Faculty of Saratov State Medical University n.a. V. I. Razumovsky from 2000 till 2004. Statistical analyses included calculation of average mean, standard deviation and mean error. Student's ratio was used as the test of validity of average mean. Chi-square test was used for assessment of qualitative characteristics.

  20. Volume Reduction of Decommissioning Radioactive Burnable and Metal Wastes

    Min, B. Y.; Lee, Y. J.; Yun, G. S.; Lee, K. W.; Moon, J. K. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Choi, Y. K.; Cho, J. H. [SunKwang Atomic Energy Safety Co., Seoul (Korea, Republic of)


    A large quantity of radioactive waste was generated during the decommissioning projects. For the purpose of the volume reduction and clearance for decommissioning wastes from decommissioning projects, the incineration and high melting technology has been selected for the decommissioning wastes treatment. The volume reduction of the combustible wastes through the incineration technologies has merits from the view point of a decrease in the amount of waste to be disposed of resulting in a reduction of the disposal cost. Incineration is generally accepted as a method of reducing the volume of radioactive waste. The incineration technology is an effective treatment method that contains hazardous chemicals as well as radioactive contamination. Incinerator burns waste at high temperature. Incineration of a mixture of chemically hazardous and radioactive materials, known as 'mixed waste,' has two principal goals: to reduce the volume and total chemical toxicity of the waste. Incineration itself does not destroy the metals or reduce the radioactivity of the waste. A proven melting technology is currently used for low-level waste (LLW) at several facilities worldwide. These facilities use melting as a means of processing LLW for unrestricted release of the metal or for recycling within the nuclear sector. About 16.4 tons of decommissioning combustible waste has been treated using Oxygen Enriched incineration. The incineration facility operated quite smoothly through the analysis major critical parameters of off-gas.

  1. Accurate monitoring of intravascular fluid volume: A novel application of intrathoracic impedance measures for the guidance of volume reduction therapy

    Barbara A. Lara


    Conclusion: Impedance vectors derived from a multivector monitoring system reflect changes in intravascular plasma volume. Two of these vectors most closely track changes in plasma volume and may be used to more accurately guide and optimize volume reduction therapy.

  2. Musculoskeletal System Symptoms in Goiter

    Sevim Akin


    Full Text Available Aim: The aim of this study was to investigate the prevalence of musculoskeletal manifestations in patients with thyroid dysfunction. Methods: One hundred and twenty-three patients (100 female, 23 male who visited the nuclear medicine department for thyroid gland scintigraphy were included in our study. According to thyroid hormone levels, patients were allocated into five categories: hyperthyroidism, subclinical hyperthyroidism, euthyroid, subclinical hypothyroidism, and hypothyroidism. Before neurological and musculoskeletal examinations, a standardized symptom questionnaire was completed including questions about sensory symptoms, muscle weakness, restricted joint mobility, musculoskeletal pain. Neurological examination, range of motion of joints, effusion or swelling of joints was assessed. Diagnosis of osteoarthritis was done by the clinical and radiological characteristics. The diagnosis of FMS was made according to criteria of American College of Rheumatology. According to the World Health Organization (WHO, a T-score ≤ -2.5 was classified as osteoporosis, whereas a T-score between -2.5 and -1.0 was classified as osteopenia. Thyroid status was determined by serum TSH levels. Results: Eighty-one percent of the patients were female (100 and 19% were male (23. Mean age of female patients was 49.99±15.27 years (range 20-87 and mean age of male patients was 61.8±12.33 years (range 34-88. When divided according to thyroid status, 21.1% (n=26 had hyperthyroidism, 21.1% (n=26 had subclinical hyperthyroidism, 49.6% (n=61 were euthyroid, 4.9% (n=6 had subclinical hypothyroidism and 3.3% (n=4 were hypothyroid. None of 59% of patients had any musculoskeletal diagnosis. Osteoporosis was the most common problem, affecting 23.7% of patients Conclusion: The presence of musculoskeletal symptoms in patients with goiter should be considered and investigated. [Cukurova Med J 2013; 38(2.000: 261-269

  3. Risk factors for goiter and thyroid nodules

    Knudsen, N.; Laurberg, P.; Perrild, H.


    is probably dependent on iodine status, because it seems that the zenith of goiter prevalence appears earlier in life the more severe iodine deficiency the population is exposed to. The association with individual risk factors has been investigated in some studies, especially the association with tobacco......The occurrence of thyroid diseases is determined by interplay between genetic and environmental factors. The major environmental factor that determines goiter prevalence is iodine status, but other environmental factors influencing entire populations have been identified such as goitrogens in food...... smoking. In iodine-deficient areas, a strong association between tobacco smoking and goiter prevalence is found, whereas the association is less pronounced in iodine-replete areas. This was predictable from experimental studies showing thiocyanate to be the mediator of the goitrogenic effect of tobacco...

  4. Particle size separation via soil washing to obtain volume reduction.

    Anderson, R; Rasor, E; Van Ryn, F


    A pilot-plant study was performed using a soil washing pilot plant originally designed by the Environmental Protection Agency (EPA) to demonstrate scale-up and potential full-scale remediation. This pilot plant named VORCE (Volume Reduction/Chemical Extraction) was modified to meet the specific requirements for treatment of the Formerly Utilized Sites Remedial Action Program (FUSRAP) and a Department of Energy site soils. After a series of tests on clean soils to develop operating parameters and system performance, the machine was used to treat soils, one contaminated with Thorium-232 and the other with Cesium-137. All indicate that soil washing is very promising for volume reduction treatment. In addition, cost data was generated and is given herein.

  5. Endothoracic goiter. Presentation of two cases

    José Alberto Puerto Lorenzo


    Full Text Available A goiter is considered thoracic when more than 50% of the thyroid gland is in the mediastinum, under the level of the upper thoracic inlet. It is an infrequent disease, which represents about 10% of the mediastinal masses. Two cases are presented of patients who underwent endothoracic goiter surgery in the Hospital Dr. Gustavo Aldereguía Lima of Cienfuegos. The surgical treatment applied was right hemithyroidectomy, with isthmectomy and resection of the mediastinic tumor extension. It is an infrequent entity, reason for which it is considered a publication of interest.

  6. C-cells in colloid goiter

    Lima Marcus A.


    Full Text Available PURPOSE: The aim of this investigation was to quantitatively evaluate C-cells in colloid goiters, analyzing 36 thyroids that were obtained through thyroidectomy from 24 patients with goiter and 12 normal glands from adult patients without thyroid disease, which were used as the control group. MATERIAL AND METHODS: On average, 6 different thyroid areas were sampled and labeled by immunohistochemistry with a monoclonal anticalcitonin antibody, utilizing the avidin-biotin-peroxidase complex. C-cells were counted in fields measuring 1 square centimeter, and the mean number of cells per field was then calculated. Data were statistically analyzed using the Mann-Whitney test. RESULTS: In the colloid goiter group, the number of C-cells ranged from 0 to 23 per field, while in normal controls they ranged from 20 to 148 per field. CONCLUSIONS: These results demonstrate a significant decrease of C-cell number in the colloid goiter group compared with control group, indicating that the hyperplastic process is restricted to follicular cells, to the detriment of C-cells, which probably cease to receive trophic stimuli.

  7. Harmonic focus in thyroidectomy for substernal goiter

    Hahn, Christoffer Holst; Trolle, Waldemar; Sørensen, Christian Hjort


    , hospital stay and complications. MATERIALS AND METHODS: Prospective non-randomised study of 242 consecutive patients with substernal goiter out of 2258 patients (11%) who underwent thyroidectomy. A total of 121 patients had thyroidectomy performed with bipolar electrocoagulation and knot-tying techniques...

  8. Fetal goiter and bilateral ovarian cysts

    Lassen, Pernille; Sundberg, Karin; Juul, Anders


    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations o...

  9. An unusual cause of hematemesis: Goiter

    Astrid AM van der Veldt; Mohammed Hadithi; Marinus A Paul; Fred G van den Berg; Chris JJ Mulder; Mikael E Craanen


    Downhill varices are located in the upper part of the esophagus and are usually related to superior vena cava obstruction. Bleeding from these varices is extremely rare. We describe a 77-year-old patient with hematemesis due to downhill varices as a result of recurrent goiter. A right lobe thyroidectomy was carried out with disappearance of the varices.

  10. Forgotten goiter. Our experience and a review of the literature.

    Calò, Pietro Giorgio; Tatti, Alberto; Medas, Fabio; Petruzzo, Palmina; Pisano, Giuseppe; Nicolosi, Angelo


    "Forgotten" goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. The authors report their experience of 7 cases of residual mediastinal goiter after total thyroidectomy for substernal goiter. Six patients were female and one male with a median age of 56 years (range: 25-70 years). Four patients were asymptomatic, 2 patients showed signs of mediastinal compression, and one patient had persistent hyperthyroidism. A sternal splitting incision associated with a cervical incision was required in 3 patients while an exclusively cervical incision was sufficient in 4 patients. Histology did not show neoplasia. Postoperative outcome was uncomplicated in 6 patients and in one patient a transient recurrent laryngeal nerve paralysis occurred. In the majority of cases forgotten goiter is the consequence of the incomplete removal of a plunging goiter, although sometimes it may be attributed to a concomitant, unrecognized mediastinal goiter which is not connected to the thyroid. The residual goiter has the same clinical presentation as an ordinary intrathoracic goiter. Our experience confirms that surgical treatment of forgotten goiter is associated with only minimal morbidity although a sternal split is sometimes required. Forgotten goiter is a rare pathology which can be prevented if particular attention is paid to preoperative imaging and intraoperative management during the first operation. However surgical treatment for forgotten goiter, when performed in specialized centers, is associated with low morbidity.

  11. The onset of goiter in several species of sharks following the addition of ozone to a touch pool.

    Morris, Alexis L; Stremme, Donald W; Sheppard, Barbara J; Walsh, Michael T; Farina, Lisa L; Francis-Floyd, Ruth


    This report describes the onset of goiter in several species of shark following the addition of ozone to a touch pool. A detailed description of a female brown-banded bamboo shark (Chiloscyllium punctatum) that was presented with multinodular goiter is provided. Four other brown-banded bamboo sharks and 11 white-spotted bamboo sharks (Chiloscyllium plagiosum) housed in the same system developed clinical disease consistent with goiter, but two zebra bullhead sharks (Heterodontus zebra) did not. Plasma thyroxine (T4) concentration was 4.64 ng/ml before euthanasia, consistent with a diagnosis of hypothyroidism. The sharks had been chronically exposed to mean (+/- standard error) NO3-N concentrations of 35 +/- 5.12 mg/L before ozonation of the system. Ozonation of aquarium water causes a reduction in environmental iodide, which is required for thyroid hormone synthesis. Nitrate is goitrogenic and would further decrease I- absorption by competitive inhibition. Multinodular goiter is consistent with goiter caused by chronic iodide deficiency. Understanding the interaction between water chemistry and goiter development is critical to development of elasmobranch health management systems.

  12. Large Nc volume reduction and chiral random matrix theory

    Lee, Jong-Wan; Yamada, Norikazu


    Motivated by recent progress on the understanding of the Eguchi-Kawai (EK) volume equivalence and growing interest in conformal window, we simultaneously use the large-Nc volume reduction and Chiral Random Matrix Theory (chRMT) to study the chiral symmetry breaking of four dimensional SU(Nc) gauge theory with adjoint fermions in the large Nc limit. Although some cares are required because the chRMT limit and 't Hooft limit are not compatible in general, we show that the breakdown of the chiral symmetry can be detected in large-Nc gauge theories. As a first step, we mainly focus on the quenched approximation to establish the methodology. We first confirm that heavy adjoint fermions, introduced as the center symmetry preserver, work as expected and thanks to them the volume reduction holds. Using massless overlap fermion as a probe, we then calculate the low-lying Dirac spectrum for fermion in the adjoint representation to compare to that of chRMT, and find that chiral symmetry is indeed broken in the quenched ...

  13. Hippocampal volume reduction in congenital central hypoventilation syndrome.

    Paul M Macey

    Full Text Available Children with congenital central hypoventilation syndrome (CCHS, a genetic disorder characterized by diminished drive to breathe during sleep and impaired CO(2 sensitivity, show brain structural and functional changes on magnetic resonance imaging (MRI scans, with impaired responses in specific hippocampal regions, suggesting localized injury.We assessed total volume and regional variation in hippocampal surface morphology to identify areas affected in the syndrome. We studied 18 CCHS (mean age+/-std: 15.1+/-2.2 years; 8 female and 32 healthy control (age 15.2+/-2.4 years; 14 female children, and traced hippocampi on 1 mm(3 resolution T1-weighted scans, collected with a 3.0 Tesla MRI scanner. Regional hippocampal volume variations, adjusted for cranial volume, were compared between groups based on t-tests of surface distances to the structure midline, with correction for multiple comparisons. Significant tissue losses emerged in CCHS patients on the left side, with a trend for loss on the right; however, most areas affected on the left also showed equivalent right-sided volume reductions. Reduced regional volumes appeared in the left rostral hippocampus, bilateral areas in mid and mid-to-caudal regions, and a dorsal-caudal region, adjacent to the fimbria.The volume losses may result from hypoxic exposure following hypoventilation during sleep-disordered breathing, or from developmental or vascular consequences of genetic mutations in the syndrome. The sites of change overlap regions of abnormal functional responses to respiratory and autonomic challenges. Affected hippocampal areas have roles associated with memory, mood, and indirectly, autonomic regulation; impairments in these behavioral and physiological functions appear in CCHS.


    Ivan N. Dimitrov


    Full Text Available The development of sophisticated magnetic resonance imaging techniques and software for medical imaging processing and analysis has led to a significant progress in multiple sclerosis research and clinical care. The measurement of brain volumes provides a quantitative representation of damage, thus facilitating the objective follow-up process. The parameters obtained, though not being used routinely in clinical practice, are more and more often applied in clinical studies. The amount of whole brain and regional atrophy, estimated from serial scans, is considered important not only for disease progression, but also for cognitive dysfunction which is common in multiple sclerosis. In this paper we describe a volumetric study of two magnetic resonance scans of a patient with relapsing-remitting multiple sclerosis, performed 16 months one after the other, and analyzed using FSL SIENA software. Analysis demonstrated brain volume reduction of 1.7% between the two scans. We discuss the advantages of the method and its possible clinical applications.

  15. Low cost biological lung volume reduction therapy for advanced emphysema

    Bakeer M


    Full Text Available Mostafa Bakeer,1 Taha Taha Abdelgawad,1 Raed El-Metwaly,1 Ahmed El-Morsi,1 Mohammad Khairy El-Badrawy,1 Solafa El-Sharawy2 1Chest Medicine Department, 2Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt Background: Bronchoscopic lung volume reduction (BLVR, using biological agents, is one of the new alternatives to lung volume reduction surgery.Objectives: To evaluate efficacy and safety of biological BLVR using low cost agents including autologous blood and fibrin glue.Methods: Enrolled patients were divided into two groups: group A (seven patients in which autologous blood was used and group B (eight patients in which fibrin glue was used. The agents were injected through a triple lumen balloon catheter via fiberoptic bronchoscope. Changes in high resolution computerized tomography (HRCT volumetry, pulmonary function tests, symptoms, and exercise capacity were evaluated at 12 weeks postprocedure as well as for complications.Results: In group A, at 12 weeks postprocedure, there was significant improvement in the mean value of HRCT volumetry and residual volume/total lung capacity (% predicted (P-value: <0.001 and 0.038, respectively. In group B, there was significant improvement in the mean value of HRCT volumetry and (residual volume/total lung capacity % predicted (P-value: 0.005 and 0.004, respectively. All patients tolerated the procedure with no mortality.Conclusion: BLVR using autologous blood and locally prepared fibrin glue is a promising method for therapy of advanced emphysema in term of efficacy, safety as well as cost effectiveness. Keywords: BLVR, bronchoscopy, COPD, interventional pulmonology

  16. Correlation between thyroid function and nodular goiter accompanied with gallstone

    Shihong Ma; Qinjiang Liu; Xiaofeng Hou



  17. Time for the Global Rollout of Endoscopic Lung Volume Reduction.

    Koegelenberg, Coenraad F N; Slebos, Dirk-Jan; Shah, Pallav L; Theron, Johan; Dheda, Keertan; Allwood, Brian W; Herth, Felix J F


    Chronic obstructive pulmonary disease remains one of the most common causes of morbidity and mortality globally. The disease is generally managed with pharmacotherapy, as well as guidance about smoking cessation and pulmonary rehabilitation. Endoscopic lung volume reduction (ELVR) has been proposed for the treatment of advanced emphysema, with the aim of obtaining the same clinical and functional advantages of surgical lung volume reduction whilst potentially reducing risks and costs. There is a growing body of evidence that certain well-defined sub-groups of patients with advanced emphysema may benefit from ELVR, provided the selection criteria are met and a systematic approach is followed. ELVR devices, particularly unidirectional valves and coils, are currently being rolled out to many countries outside of the U.S.A. and Europe, although very few centres currently have the capacity to correctly evaluate and provide ELVR to prospective candidates. The high cost of these interventions underpins the need for careful patient selection to best identify those who may or may not benefit from ELVR-related procedures. The aim of this review is to provide the practicing pulmonologist with an overview of the practical aspects and current evidence for the use of the various techniques available, and to suggest an evidence-based approach for the appropriate use of these devices, particularly in emerging markets, where there should be a drive to develop and equip key specialised ELVR units.

  18. Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency.

    Rendina, D; De Filippo, G; Mossetti, G; Zampa, G; Muscariello, R; Benvenuto, G; Vivona, C L; Ippolito, S; Galante, F; Lombardi, G; Biondi, B; Strazzullo, P


    Obesity and insulin resistance predispose individuals to the development of both metabolic syndrome and non-toxic nodular thyroid diseases. The aim of this observational, cross-sectional study is to evaluate the relationship between metabolic syndrome and multinodular nontoxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. We examined 1422 Caucasian euthyroid inpatients. Thyroid volume was determined by ultrasound of the neck. A fine-needle aspiration biopsy was performed to evaluate single thyroid nodules and dominant nodules ≥15 mm in euthyroid multinodular goiter. The diagnosis of metabolic syndrome was made according to the criteria of the American Heart Association/ National Heart, Lung, and Blood Institute. Of the sample, 277 patients had clinical evidence of multinodular nontoxic goiter, 461 met the criteria for the diagnosis of metabolic syndrome, and 132 were found to have both conditions. After adjusting for age, gender, body mass index, nicotinism, parity, alcohol intake, thyroid function, and metabolic syndrome- related pharmacological treatment, metabolic syndrome was found to be an independent risk factor for the occurrence of multinodular non-toxic goiter. The relationship between metabolic syndrome and multi nodular non-toxic goiter was apparent in both men and women. In this study of euthyroid inpatients, we demonstrate that metabolic syndrome is an independent risk factor for the occurrence of multinodular non-toxic goiter in a geographic area with moderate iodine deficiency. We propose that patients meeting the criteria for metabolic syndrome should be screened for the presence of multinodular non-toxic goiter.

  19. Retrosternal Goiter: Analysis of 42 Cases

    Alkýn Yazýcýoðlu


    Full Text Available Aim: Cases that were operated due to diagnosis of retrosternal goiter were examined in terms of age, gender, complaints, diagnosis methods, surgical methods and postoperative complications. Material and Metod: The records of 42 cases operated due to retrosternal goiter between January 2006 and April 2012 were retrospectively evaluated. Results: Of the 42 cases, 16 (38.1% were male and 26 (61.9% were female; mean age was 56.4 years (range 31 – 79. 10 patients (23.8% were asymptomatic and the most frequent complaint was dyspnea (n = 18, 42.9%. A collar-incision was used in 22 patients (52.4%, collar + sternotomy to 5 patients (11.9%, and right thoracotomy to 8 patients (19.0%. The most frequently observed thyroid pathology was nodular hyperplasia (n = 32, 76.2% and 5 patients (11.9% were diagnosed with thyroid carcinoma. The average duration of hospital stay was 5.6 days (2 – 16 and hypoparathyroidic hypocalcemia was determined in 2 patients (4.8%; no mortality was observed. Discussion: Collar incision is adequate for excision in most cases of retrosternal goiter. Sternotomy or thoracotomy can be safely applied with low morbidity rate to cases with suspected adjacency to mediastinal structures.  

  20. Pathogenesis of nodular goiter and its implications for surgical management

    Teuscher, J.; Peter, H.J.; Gerber, H.; Berchtold, R.; Studer, H.


    Despite sufficient iodine supply, goiter continues to be of considerable surgical significance in formerly endemic countries. It now appears that iodine deficiency and increased thyrotropin stimulation are not the only causes of goiter. Xenotransplantation of human thyroid tissue onto nude mice allowed study of the regulation of growth and function in human goiter tissue. Grafts of human thyroid tissue growing in nude mice could be shown to react to endogenous mouse thyrotropic stimulation and suppression. /sup 131/I autoradiographs of xenotransplanted goiter tissue showed as marked a heterogeneity as did the original goitrous tissue prior to transplantation. There was no firm correlation between the morphologic appearance of a follicle and its iodine metabolism. Scintigraphically cold and hot goiter tissue differed from each other quantitatively but not qualitatively; i.e., both hot and cold tissue were composed of metabolically active and nonactive follicles. Iodine organification was not completely suppressible by thyroxine treatment; this indicates autonomous functional activity. The distribution of proliferating tissue labeled by /sup 3/H-thymidine did not parallel the distribution of functionally active tissue labelled by /sup 131/I. Thyroxine treatment did not completely inhibit /sup 3/H-thymidine incorporation, indicating autonomous growth. Thus, our pathogenetic concept of goiter formation is based on three mainstays: (1) goiter heterogeneity, (2) autonomy of growth and function, and (3) dissociation of growth and function in human goiter tissue. Thus, the surgeon dealing with goiter ought to remove all pathologically altered tissue, i.e., nodular tissue, irrespective of its appearance on scintiscans.

  1. Current prevalence of goiter determined by ultrasonography and associated risk factors in a formerly iodine-deficient area of Turkey.

    Kocak, Mustafa; Erem, Cihangir; Deger, Orhan; Topbas, Murat; Ersoz, Halil Onder; Can, Emine


    The aim of this study was to determine the prevalence of goiter and related risk factors in an adult population in a formerly iodine-deficient area of Turkey. In this cross-sectional study, we enrolled 2,500 subjects (1,270 women and 1,230 men, aged over 20 years) by multistage sampling. Blood and urine specimens were collected for the assessment of thyroid function. Thyroid ultrasonography (USG) was performed to measure thyroid volume and evaluate nodules. The overall goiter prevalence was 26.5 % (28.4 % in women, 24.5 % in men, P iodine was 122.79 μg/L. USG revealed thyroid nodules in 35.2 % of the subjects (38.4 % in women, 31.8 % in men, P iodine excretion levels, prevalence of goiter in this adult population in a formerly iodine-deficient province of Turkey remained high, even about 10 years after salt iodine supplementation program introduction. In addition, the goiter prevalence was higher for female gender, advanced age, positive family history of goiter, low education level, and high BMI.

  2. Normal values for thyroid ultrasonography, goiter prevalence and urinary iodine concentration in schoolchildren of the Veneto Region, Italy.

    Busnardo, B; Nacamulli, D; Frigato, F; Vianello-Dri, A; De Vido, D; Mian, C; Candiani, F; Tomasella, G; Zambonin, L; Piccolo, M; Girelli, M E


    Goiter prevalence in school-age children and median urinary iodine concentration (UIC) are the main indicators of iodine deficiency in a population. In areas of mild iodine deficiency, where goiters are small, ultrasound is preferable to physical examination to estimate goiter prevalence. The World Health Organization (WHO) has adopted thyroid volume ultrasonography results from a survey of European schoolchildren as an international reference, but these values have recently been questioned. The aims of the study were: a) to determine regional normal echographic reference values of thyroid volume in children aged between 11 and 14 yr in the Veneto Region, in North-East Italy; b) to determine goiter prevalence by physical and ultrasonographic examination; c) to determine UIC in this section of the population. A cross-sectional study was carried out on 1730 schoolchildren, aged between 11 and 14, living in towns in low-lying areas, in the valleys of the pre-Alps and in the mountains between 600 and 1200 m. Thyroid volume was evaluated by inspection and palpation using the WHO criteria. In 560 children thyroid volume was determined by ultrasound. UIC was measured in 1368 children. On physical examination a grade I goiter was found in 7.5% of children. No goiter grade II or grade III was found. The regional thyroid volume reference values by ultrasonography were similar, or slightly lower (5-20%), to the corresponding WHO reference values. Mean UIC was 148 +/- 110 microg/l, with no difference between lowlands and uplands; UIC values less than 100 microg/l were found in about 30-35% of the children. UIC was higher in children using iodized salt than in non-users. No correlation was found between thyroid volume by ultrasonography and UIC. Thyroid volume was found to be bigger in upland children than in those in low-lying areas, probably because of low iodine intake in people living in the mountains in previous generations. This data show that Veneto is not a iodine

  3. Lung volume reduction surgery: an overview Cirurgia redutora de volume pulmonar: uma revisão

    Rodrigo Afonso da Silva Sardenberg


    Full Text Available This study intends to review the literature on the efficacy, safety and feasibility of lung volume reduction surgery (LVRS in patients with advanced emphysema. Studies on LVRS from January 1995 to December 2009 were included by using Pubmed (MEDLINE and Cochrane Library literature in English. Search words such as lung volume reduction surgery or lung reduction surgery, pneumoplasty or reduction pneumoplasty, COPD or chronic obstructive pulmonary disease and surgery, were used. We also compared medical therapy and surgical technique. Studies consisting of randomized controlled trials, controlled clinical trials (randomized and nonrandomized, reviews and case series were analyzed. Questions regarding validity of the early clinical reports, incomplete follow-up bias, selection criteria and survival, confounded the interpretation of clinical data on LVRS. Patients with upper, lower and diffuse distribution of emphysema were included; we also analyzed as key points perioperative morbidity and mortality and lung function measurement as FEV1. Bullous emphysema was excluded from this review. Surgical approach included median sternotomy, unilateral or bilateral thoracotomy, and videothoracoscopy with stapled or laser ablation. Results of prospective randomized trials between medical management and LVRS are essential before final assessment can be established.O objetivo deste estudo é revisar a literatura acerca da eficácia, segurança e viabilidade da cirurgia redutora de volume pulmonar (CRVP em pacientes com enfisema pulmonar avançado. Estudos de CRVP de janeiro de 1995 a dezembro de 2009 foram incluídos através de pesquisa na Pubmed (MEDLINE e Cochrane Library, na literatura inglesa. Palavras de busca tais como lung volume reduction surgery ou lung reduction surgery, pneumoplasty ou reduction pneumoplasty, COPD ou chronic obstructive pulmonary disease e surgery foram utilizadas. Também realizamos comparação entre terapia médica e cir

  4. Clinicopathological profile, airway management, and outcome in huge multinodular goiters: an institutional experience from an endemic goiter region.

    Agarwal, Amit; Agarwal, Sudhi; Tewari, Prabhat; Gupta, Sushil; Chand, Gyan; Mishra, Anjali; Agarwal, Gaurav; Verma, A K; Mishra, S K


    Huge goiters are common in iodine-deficient endemic regions. They are of concern to the surgeons because of the anticipated risk of difficult dissection and increased chances of surgical complications. Similarly, they are of concern to the anesthesiologists because of anticipated intubation-related difficulties and post-thyroidectomy tracheomalacia. In the present study we aimed to present our experience of managing goiters based on their gross weight, highlighting their clinicopathological profile, perioperative airway-related difficulties, and management of surgical morbidity. Retrospective analysis of patients who underwent total thyroidectomy in the primary setting at our institute from 1995 to 2009 was carried out based on the gross gland weight. The patients were thus grouped into group A: ≤200 g; group B: 201 to ≤400 g; group C: 401 to ≤600 g; group D: >600 g. Group A (660 cases); group B (108 cases); group C (36 cases); and group D (9 cases) were included. As the goiter size increased, the mean duration of goiter, compressive symptoms, retrosternal extension (RSE), airway deformity, intubation difficulty, and tracheomalacia increased. The rate of tracheostomy, sternotomy, hemorrhage, visceral injury, and hospital stay was high with huge goiters. These features were more marked in malignant goiters compared to benign goiters. However, the postoperative complications were comparable in both of those groups. Long-standing huge goiters are common in iodine-deficient endemic areas. The majority of patients have symptomatic or clinicoradiological evidence of airway involvement. The incidence of RSE, airway deformity, intubation difficulty, and tracheomalacia is high with huge goiters. The surgery is technically demanding with greater associated chances of injury to native structures. Malignancy influences the presentation and outcome in smaller goiters. In centers with experienced endocrine surgeons and dedicated anesthetists, huge goiters can be

  5. Dyshormonogenic Goiter within Ectopic Thyroid: A Case Report

    Lee, Woong Hee; Han, Jong Kyu; Kim, Young Tong; Jou, Sung Shick; Kim, Sang Won; Kim, Sung Yong; Cho, Hyun Deuk [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)


    A dyshormonogenetic goiter is a congenital hyperplasia of the thyroid parenchyma caused by a defect in the normal hormongenetic pathway. Here, we report on a case involving the simultaneous occurrence of a thyroid and an ectopic thyroid dyshormonogenetic goiter. We describe the ultrasound and CT findings along with a brief literature review

  6. Safe Reduction of Blood Volume in the Blood Gas Laboratory.

    Jensen, Phillip R; Markewitz, Boaz A


    Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes. This study was conducted in 1 of the adult ICUs at the University of Utah Hospital. Over a baseline period a standard adult 3 mL blood gas syringe was utilized. Subsequently the standard adult syringe was replaced by a 1 mL syringe produced by the same manufacturer with the same heparin concentration. The change to the 1 mL syringe had no effect on specimen integrity in regards to laboratory's ability to process the specimen. With use of the 1 mL syringe there was a 60% reduction in the volume of blood drawn compared with the baseline period. Standardizing the 1 mL syringe for Blood Gas Laboratory tests will reduce patient blood loss without appreciably affecting specimen rejection relative to current rates. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail:

  7. Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage

    Schlader, Zachary J; Seifert, Thomas; Wilson, Thad E


    Hyperthermia reduces the capacity to withstand a simulated hemorrhagic challenge, but volume loading preserves this capacity. This study tested the hypotheses that acute volume expansion during hyperthermia increases cerebral perfusion and attenuates reductions in cerebral perfusion during a simu...

  8. Fetal Goiter was Resolved with Decreasing Maternal Propylthiouracil Dose

    And Yavuz


    Full Text Available We report a case of fetal goiter diagnosed by detailed ultrasonography. A 33-year-old woman at twenty weeks of gestation was referred to our hospital for detailed ultrasonography. A fetal goiter was identified. She was receiving propylthiouracil (PTU 100 mg daily for Graves’ disease. Amniocentesis was performed and fetal thyroid function was evaluated as normal. Her recent thyroid function tests were normal, but anti-thyroid antibodies were positive. The dose of PTU was reduced to 50 mg. However, at twenty six weeks of gestation, maternal thyroid-related autoantibodies became undetectable. A fetal magnetic resonance imaging demonstrated a slight shrinkage of the fetal goiter at 30 weeks. The fetus was delivered vaginally. Thyroid function tests of the neonate were normal, and neonatal goiter was nonpalpable. Fetal goiter is a rare disease. It can be spontaneously resolved by decreasing the maternal dose of PTU.

  9. [Endemic goiter in the extreme North of West Siberia].

    Luzina, I G; Suplotova, L A; Osadchenko, G A


    Random examinations covering 8-60-year-old 4345 citizens of 12 settlements of the Yamal-Nenets Autonomic Territory discovered goiter endemia throughout the territory but most evident the endemy manifested in the Far North. The prevalence of endemic goiter among schoolchildren made up 52.8% (enlargement of the goiter of the 1st and 2nd degree), among adults-49.2%. By ultrasound investigation, the above percentages were 29 and 26.4%, respectively. This corresponds to moderate endemia. The median of urinary iodine excretion averaged in the territory 5.1 micrograms%, while overall iodine insufficiency (number of children with urinary iodine < 10 micrograms%) was 81.9%. In the Far North iodine excretion was less but goiter incidence was higher than normal. Thus, in the Far North goiter endemia is rather serious.

  10. [Endemic goiter in Latium: environmental and genetic factors].

    Paggi, A


    Most studies on the pathogenesis of endemic goiter focus above all on iodine deficiency. In some endemic goiter areas (i.e. Nigeria) there is no evidence of iodine deficiency; therefore, we suggest the taking into account of various factors, both environmental and non-environmental. We report the results of two studies carried out in three different areas in Latium: one of them (Cerveteri, RM) could be classified as high prevalence of goiter area, while the two others (Roccasecca dei Volsci, LT and Castel San Pietro Romano, RM) are true endemic goiter areas. The role of environmental factors, radioactivity and electromagnetism, foodstuff, the hydrogeological and chemical composition of natural water and the importance of genetics are here discussed, assuming that the endemic goiter could have a multifactorial pathogenesis.

  11. Evaluation of a goiter epidemic degree among pregnant women in natural iodine deficiency region

    V Petrova


    Full Text Available Objectives: the aim of the study was to investigate clinical features of thyroid function in pregnant woman in the region of natural iodine deficiency. Methods: serum thyroid stimulating hormone (TSH, free thyroxin (fT4 concentrations, urine excretion of iodine were measured. The structure and volume of thyroid gland were defined by palpation and ultrasonography. The 150 pregnant women (50 in every trimester were included in study. Results: median of urine iodine excretion was 72.5 mkg/l, that confirm mild iodine deficiency in the region. During pregnancy median of urine excretion of iodine is significantly lower in third trimester (51.0 mkg/l, than in first (93.0 mkg/l and in second (86.1 mkg/l. The goiter was registered more often in third trimester of pregnancy. The level of fT4 was decreased in third trimester of pregnancy. Key words: iodine deficiency, goiter, hypothyroidism pregnancy.

  12. Efficacy of bronchoscopic lung volume reduction: a meta-analysis

    Iftikhar IH


    Full Text Available Imran H Iftikhar,1 Franklin R McGuire,1 Ali I Musani21Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of South Carolina, Columbia, SC, USA; 2Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USABackground: Over the last several years, the morbidity, mortality, and high costs associated with lung volume reduction (LVR surgery has fuelled the development of different methods for bronchoscopic LVR (BLVR in patients with emphysema. In this meta-analysis, we sought to study and compare the efficacy of most of these methods.Methods: Eligible studies were retrieved from PubMed and Embase for the following BLVR methods: one-way valves, sealants (BioLVR, LVR coils, airway bypass stents, and bronchial thermal vapor ablation. Primary study outcomes included the mean change post-intervention in the lung function tests, the 6-minute walk distance, and the St George's Respiratory Questionnaire. Secondary outcomes included treatment-related complications.Results: Except for the airway bypass stents, all other methods of BLVR showed efficacy in primary outcomes. However, in comparison, the BioLVR method showed the most significant findings and was the least associated with major treatment-related complications. For the BioLVR method, the mean change in forced expiratory volume (in first second was 0.18 L (95% confidence interval [CI]: 0.09 to 0.26; P<0.001; in 6-minute walk distance was 23.98 m (95% CI: 12.08 to 35.88; P<0.01; and in St George's Respiratory Questionnaire was −8.88 points (95% CI: −12.12 to −5.64; P<0.001.Conclusion: The preliminary findings of our meta-analysis signify the importance of most methods of BLVR. The magnitude of the effect on selected primary outcomes shows noninferiority, if not equivalence, when compared to what is known for surgical LVR.Keyword: emphysema, endobronchial valves, sealants, stents, coils

  13. The “forgotten” goiter after total thyroidectomy

    Sahbaz, Alper; Aksakal, Nihat; Ozcinar, Beyza; Onuray, Feyyaz; Caglayan, Kasim; Erbil, Yesim


    INTRODUCTION “Forgotten” goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. PRESENTATION OF CASE We report two cases with forgotten goiter. One underwent total thyroidectomy due to thyroid papillary cancer and TSH level was in normal range one month after surgery. The thyroid scintigraphy scan revealed mediastinal thyroid mass. The second case underwent total thyroidectomy due to Graves’ disease and TSH level was low after surgery. At postoperative seventh year, patients were admitted to our Endocrinology Division due to persistent hyperthyroidism and CT scan revealed forgotten thyroid at mediastinum. Both patients underwent median sternotomy and mass excision, there was no morbidity detected after second surgical procedures. DISCUSSION In the majority of cases forgotten goiter is the consequence of the incomplete removal of a plunging goiter. Although in some cases, it may be attributed to a concomitant, unrecognized mediastinal goiter which is not connected to the thyroid with a thin fibrous band or vessels. Absence of signs like mediastinal mass or tracheal deviation in preoperative chest X-ray do not excluded the substernal goiter. CONCLUSION Retrosternal goiter should be suspected if the lower poles could not be palpated on physical examination and when postoperative TSH levels remained unchanged. PMID:23336990

  14. Decreased Expression of GPER1 Gene and Protein in Goiter

    Raquel Weber


    Full Text Available Goiter is more common in women, suggesting that estrogen could be involved in its physiopathology. The presence of classical estrogen receptors (ERα and ERβ has been described in thyroid tissue, suggesting a direct effect of estrogen on the gland. A nonclassic estrogen receptor, the G-protein-coupled estrogen receptor (GPER1, has been described recently in several tissues. However, in goiter, the presence of this receptor has not been studied yet. We investigated GPER1 gene and protein expressions in normal thyroid and goiter using reverse transcription quantitative polymerase chain reaction (RT-qPCR and Western blot, respectively. In normal thyroid (n=16 and goiter (n=19, GPER1 gene was expressed in all samples, while GPER1 protein was expressed in all samples of normal thyroid (n=15 but in only 72% of goiter samples (n=13. When comparing GPER1 gene and protein levels in both conditions, gene expression and protein levels were higher in normal thyroid than in goiter, suggesting a role of this receptor in this condition. Further studies are needed to elucidate the role of GPER1 in normal thyroid and goiter.

  15. 76 FR 58543 - Draft Policy Statement on Volume Reduction and Low-Level Radioactive Waste Management


    ... COMMISSION Draft Policy Statement on Volume Reduction and Low-Level Radioactive Waste Management AGENCY... Statement on Volume Reduction and Low-Level Radioactive Waste Management that updates the 1981 Policy... are also needed to safely manage Low-Level Radioactive Waste. The public comment period closed on...

  16. 77 FR 25760 - Low-Level Radioactive Waste Management and Volume Reduction


    ... COMMISSION Low-Level Radioactive Waste Management and Volume Reduction AGENCY: Nuclear Regulatory Commission... Commission) is revising its 1981 Policy Statement on Low-Level Radioactive Waste (LLRW) Volume Reduction..., ``Blending of Low-Level Radioactive Waste'' (ADAMS Accession No. ML090410531), and referenced the Policy...

  17. Bronchoscopic Lung Volume Reduction Coil Treatment of Patients With Severe Heterogeneous Emphysema

    Slebos, Dirk-Jan; Klooster, Karin; Ernst, Armin; Herth, Felix J. F.; Kerstjens, Huib A. M.


    Background: The lung volume reduction coil (LVR-coil), a new experimental device to achieve lung volume reduction by bronchoscopy in patients with severe emphysema, works in a manner unaffected by collateral airflow. We investigated the safety and efficacy of LVR-coil treatment in patients with hete

  18. Reduction of Volume-preserving Flows on an n-dimensional Manifold

    Yong-ai Zheng; De-bin Huang; Zeng-rong Liu


    A geometric reduction procedure for volume-preserving flows with a volume-preserving symmetry on an n-dimensional manifold is obtained. Instead of the coordinate-dependent theory and the concrete coordinate transformation, we show that a volume-preserving flow with a one-parameter volume-preserving symmetry on an n-dimensional manifold can be reduced to a volume-preserving flow on the corresponding (n - 1)-dimensional quotient space. More generally, if it admits an r-parameter volume-preserving commutable symmetry, then the reduced flow preserves the corresponding (n - r)-dimensional volume form.

  19. Advanced Age and Mild Thyrotoxicosis are Associated with Nodular Goiter in Graves Disease

    Serkan Yener


    Full Text Available Objective: The primary goal of this study is to evaluate predictors of nodular goiter in Graves Disease (GD.Materials and Methods: A total of 202 consecutive patients (mean age: 45; 145 female, 57 male were enrolled. All patients were treated with antithyroid drugs as initial therapy. TSH, FT3, FT4, TRAb, ATPO, and ATG were measured. Radioactive iodine uptake and thyroid ultrasonography were performed, and thyroid volume and nodule diameter were assessed. Ultrasound-guided fine needle aspiration was performed on thyroid nodules ≥8mm. Results: Diffuse goiter was detected in 51% of patients. Solitary nodules were detected in 16%, and multi-nodular disease in 33%. Mean nodule diameter was 8.82 mm. Nodular disease was slightly more common in women (p=0.063. Patients with nodular GD were older (p=0.004, had lower levels of FT3 (p=0.016 and TRAB (p=0.002 when compared with subjects with diffuse GD. Age (OR:6.867 was the independent variable predicting nodular GD. Conclusion: Increased prevalence of nodules was associated with advanced age and milder thyrotoxicosis. Apoptosis of thyroid follicular cells due to excess iodine might interfere with nodule formation, and lead to diffuse goiter in severe thyrotoxicosis. Because of increased rate if malignancy in GD, comprehensive evaluation of thyroid nodules of any size is mandatory. Turk Jem 2009; 13: 1-4

  20. Lung Volume Reduction After Stereotactic Ablative Radiation Therapy of Lung Tumors: Potential Application to Emphysema

    Binkley, Michael S. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Shrager, Joseph B. [Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Leung, Ann N. [Department of Radiology, Stanford University School of Medicine, Stanford, California (United States); Popat, Rita [Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California (United States); Trakul, Nicholas [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California (United States); Atwood, Todd F.; Chaudhuri, Aadel [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Maxim, Peter G. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian, E-mail: [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W., E-mail: [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States)


    Purpose: Lung volume reduction surgery (LVRS) improves dyspnea and other outcomes in selected patients with severe emphysema, but many have excessive surgical risk for LVRS. We analyzed the dose-volume relationship for lobar volume reduction after stereotactic ablative radiation therapy (SABR) of lung tumors, hypothesizing that SABR could achieve therapeutic volume reduction if applied in emphysema. Methods and Materials: We retrospectively identified patients treated from 2007 to 2011 who had SABR for 1 lung tumor, pre-SABR pulmonary function testing, and ≥6 months computed tomographic (CT) imaging follow-up. We contoured the treated lobe and untreated adjacent lobe(s) on CT before and after SABR and calculated their volume changes relative to the contoured total (bilateral) lung volume (TLV). We correlated lobar volume reduction with the volume receiving high biologically effective doses (BED, α/β = 3). Results: 27 patients met the inclusion criteria, with a median CT follow-up time of 14 months. There was no grade ≥3 toxicity. The median volume reduction of the treated lobe was 4.4% of TLV (range, −0.4%-10.8%); the median expansion of the untreated adjacent lobe was 2.6% of TLV (range, −3.9%-11.6%). The volume reduction of the treated lobe was positively correlated with the volume receiving BED ≥60 Gy (r{sup 2}=0.45, P=.0001). This persisted in subgroups determined by high versus low pre-SABR forced expiratory volume in 1 second, treated lobe CT emphysema score, number of fractions, follow-up CT time, central versus peripheral location, and upper versus lower lobe location, with no significant differences in effect size between subgroups. Volume expansion of the untreated adjacent lobe(s) was positively correlated with volume reduction of the treated lobe (r{sup 2}=0.47, P<.0001). Conclusions: We identified a dose-volume response for treated lobe volume reduction and adjacent lobe compensatory expansion after lung tumor SABR, consistent across

  1. Nodular goiter after occupational accidental exposure to radiation

    Pisarev, M.A. [Radiobiology, National Atomic Energy Commission, Buenos Aires (Argentina); Human Biochemistry, Uninversity of Buenos Aires, School of Medicine, Buenos Aires (Argentina); Schnitman, M. [Center of Endocrinology and Metabolism, French Hospital C.Milstein, Buenos Aires (Argentina)


    In the present paper we present the consequences of an accidental occupational radiation exposure at a local hospital in Buenos Aires. Control at a local radiology service showed the lack of correct shielding in the X-ray equipment. The physicians and technicians (14 persons) exposed to radiation during 12 months were examined. The survey shows that: a) In 11 out of 14 radiation-exposed patients nodular goiter developed and an additional patient had diffuse goiter which means a goiter incidence of 85.7%; b) In 5 of the nodular goiter patients an increase in the size or the appearance of new nodules was observed along the follow-up period. No cancer was detected by FNA; c) Hypothyroidism was observed in 3/14 patients, and an additional patient had an abnormal TRH-TSH test, suggesting subclinical hypothyroidism; and d) Increased circulating antithyroid antibodies were found in one of the hypothyroid patients

  2. The Mystery of Michelangelo Buonarroti’s Goiter

    Davide Lazzeri


    Full Text Available Whilst painting the vault of the Sistine Chapel, Michelangelo Buonarroti left an autographical sketch that revealed a prominence at the front of his hyper-extended neck. This image was recently diagnosed as goiter. The poet Michelangelo in a sonnet dated 1509 described himself as being afflicted by goiter similarly to the cats in the northern Italian Lombardy, a region with endemic goiter. Several narratives extended this sonnet into a pathological theory. The analyses of Michelangelo’s works, however, his portraits and self-portraits, of poems and major biographies, have not indicated the likelihood of goiter. This investigation makes an attempt to assess the diagnosis on clinical as well as iconographical grounds.

  3. Thyroid hemiagenesis associated with retrosternal nodular goiter: a case report.

    Turkay Kirdak


    Full Text Available Thyroid hemiagenesis can be associated with various thyroid pathologies such as papillary thyroid cancer or nodular goiter. However, we did not encounter any publication in the literature in which hemiagenesis could be observed together with retrosternal goiter. In this report, a thyroid hemiagenesis associated with a benign nodular goiter extending retrosternally is reported. A 59-year-old male patient presented to the surgery clinic because of swelling in the neck. A mass was observed in the right thyroid lobe extending to the retrosternal region. On ultrasonography, a nodule in the right thyroid lobe measuring 63 mm was determined, which was extended retrosternally. However, the left lobe of the thyroid could not be visualized. Scintigraphy and Computerized Tomography confirmed hemiagenesis. Total thyroidectomy was performed without sternotomy. In conclusion, thyroid hemiagenesis can be associated with a retrosternally located nodular goiter.

  4. Iodine Excess is a Risk Factor for Goiter Formation

    mandatory iodine fortification of salt, goiter rates reduced to 14% ... studies have suggested that excess iodine may be the cause of ... change, which depends upon the amount of iodine present .... medicine with too much iodine causes thyroid.

  5. The Condition of Thyroid and Fetoplacental Systems in Pregnant Women with Clinically Euthyroid Goiter

    V N Petrova


    Full Text Available The aim is to study a condition of thyroid and fetoplacental systems at pregnant women with clinically euthyroid goiter. Materials and methods: 116 pregnant women have been included in the basic group with clinically euthyroid goiter. The control group was made by 60 pregnant women with physiologically proceeding pregnancy, not having anamnestic and the clinical data on diseases of the thyroid. Inspection included: definition of concentration thyroid-stimulating hormone (TSH and free thyroxine (fT4 by a radio-immunologic method, sets “RIA-gnost” (France and the maintenance of antibodies to thyroid peroxydase (anti-TPO by a method hard phase immune-enzyme analysis; ultrasonic assessment of a thyroid with the help of device SONOACE 8800 “GAIA MT”; ultrasonic fetometry, placentography, measurement of amniotic fluid volume, doppler ultrasound examination of the blood flow, an estimation of a functional condition of a fetus on parameters of its biophysical profile (BP and cardiotocography (CTG, carried out on device “Oxford Sonicaid Team S8000”. Results: At studying hormonal function thyroid systems at 25 pregnant (21.6% with euthyroid goiter in the third trimester of pregnancy a level fT4 norms were lower and had values from 4.5 up to 6.9 ng/ml, therefore an average level fT4 at pregnant women of the basic group was authentically lower, than in control (8.26 ± 0.30 and 10.71 ± 0.52 ng/ml, accordingly. At the retrospective analysis it is established, that only at 5 of 116 (4.3% pregnant women with a goiter were not complications pregnancy, at the others — 111 (95.7% took place a combination various obstetric complications: an anemia — at 72 (62.0%, threat noncarrying of pregnancy — at 75 (64.6 %, an early toxicosis — at 45 (38.6%, a gestosis — at 47 (40.5% which frequency authentically is higher, than in control group: 20.0%, 25.0%, 16.6%. 20.0%, accordingly, р < 0.05. Average Estimation CTG at patients of the basic group is

  6. State of the art review of radioactive waste volume reduction techniques for commercial nuclear power plants


    A review is made of the state of the art of volume reduction techniques for low level liquid and solid radioactive wastes produced as a result of: (1) operation of commercial nuclear power plants, (2) storage of spent fuel in away-from-reactor facilities, and (3) decontamination/decommissioning of commercial nuclear power plants. The types of wastes and their chemical, physical, and radiological characteristics are identified. Methods used by industry for processing radioactive wastes are reviewed and compared to the new techniques for processing and reducing the volume of radioactive wastes. A detailed system description and report on operating experiences follow for each of the new volume reduction techniques. In addition, descriptions of volume reduction methods presently under development are provided. The Appendix records data collected during site surveys of vendor facilities and operating power plants. A Bibliography is provided for each of the various volume reduction techniques discussed in the report.

  7. Iodine Status and Goiter Prevalence in Nizhegorodsky Region

    Yu I Tarasov


    Full Text Available The undertaken study was to evaluate the severity of iodine deficiency and to establish the prevalence of goiter in the city of Nizhny Novgorod and in 35 districts of Nizhegorodsky region. 1868 children aged 8—11 years were examined. The median of urinary iodine concentration was measured, and the size of the thyroid was determined by palpation and by ultrasound study. Among all the examinees, the detection rate of the goiter was 19.4% (as evidenced by palpation and the median of urinary iodine concentration was 45.05 μg/l. The findings indicate natural iodine deficiency on the whole territory studied with severity variations from mild to moderate, and the disparity in goiter rate and iodine excretion level in some districts of Nizhegorodsky region. Cluster analysis and automatic classification of the districts based on goiter prevalence and urinary iodine parameters may be useful for a comprehensive assessment of iodine status in the whole region. Analyzing the pattern of the spread of goiter has demonstrated the role of geochemical, social and medical factors existing in the region. Key words: iodine deficiency, goiter, population based stady, thyroid.

  8. Reduction in mean platelet volume in children with acute bronchiolitis.

    Ergül, Ayşe Betül; Torun, Yasemin Altuner; Uytun, Salih; Aslaner, Hümeyra; Kısaaslan, Ayşenur Paç; Şerbetçi, Mahmut Can


    Platelets which are known to play a role in inflamation change their shapes when they are activated and this change is reflected in mean platelet volume and platelet distribution width values. Therefore, the mean platelet volume and platelet distribution width values are considered to be beneficial parameters for the diagnosis and treatment of many inflammatory diseases. The aim of the study was to evaluate platelet volume indices in children with acute bronchiolitis. A total of 514 infants who were below the age of 2 years old were evaluated in this study. Three hundred thirteen of these infants were diagnosed with acute bronchiolitis patients and 201 were healthy children. The patients were separated into four groups as mild, moderate, severe bronchiolitis and the control patient group. The groups were evaluated in terms of significant differences in the values of mean platelet volume and platelet distribution width. A p value of <0.05 was considered statistically significant for all results. The mean platelet volume was found to be 6.8±0.6 fL in the patients with mild bronchiolitis attack, 6.7±0.6 fL in the patients with moderate bronchiolitis attack, 6.5±0.5 fL in the patients with severe bronchiolitis attack and 7.3±1.1 fL in the control group. The mean platalet volume was statistically significantly lower in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). The platelet distribution width was found to be 17.2%±0.83 in the mild bronchiolitis attack group, 17.1%±0.96 in the moderate bronchiolitis attack group, 17.3%±0.87 in the severe bronchiolitis attack group and 16.9±1.6% in the control patient group. This difference was not statistically significant (p=0.159). The platelet count was statistically significantly higher in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). The mean platalet volume is decreased in patients with acute bronchiolitis. It is not

  9. Physiological Modeling of Responses to Upper vs Lower Lobe Lung Volume Reduction in Homogeneous Emphysema

    Arschang eValipour


    Full Text Available Rationale: In clinical trials, homogeneous emphysema patients have responded well to upper lobe volume reduction but not lower lobe volume reduction. Materials/Methods: To understand the physiological basis for this observation, a computer model was developed to simulate the effects of upper and lower lobe lung volume reduction on RV/TLC and lung recoil in homogeneous emphysema.Results: Patients with homogeneous emphysema received either upper or lower lobe volume reduction therapy based on findings of radionucleotide scintigraphy scanning. CT analysis of lobar volumes showed that patients undergoing upper (n=18; -265 mL/site and lower lobe treatment (n=11; -217 mL/site experienced similar reductions in lung volume. However, only upper lobe treatment improved FEV1 (+11.1±14.7% vs -4.4±15.8% and RV/TLC (-5.4± 8.1% vs -2.4±8.6%. Model simulations provided an unexpected explanation for this response. Increases in transpulmonary pressure subsequent to volume reduction increased RV/TLC in upper lobe alveoli, while caudal shifts in airway closure decreased RV/TLC in lower lobe alveoli. Upper lobe treatment, which eliminates apical alveoli with high RV/TLC values, lowers the average RV/TLC of the lung. Conversely, lower lobe treatment, which eliminates caudal alveoli with low RV/TLC values, has less effect. Conclusions: Lower lobe treatment in homogeneous emphysema is uniformly less effective than upper lobe treatment.

  10. Non-surgical approach to the benign nodular goiter: new opportunities by recombinant human TSH-stimulated (131)I-therapy

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


    nodule. If thyroid hyperfunction due to nodular autonomy is the dominant problem, life-long anti-thyroid drug treatment may be relevant in elderly individuals. With the advent of recombinant human TSH (rhTSH) stimulation the goiter reduction following (131)I-therapy is significantly enhanced...... and this treatment is of particular benefit, as compared with conventional (131)I-therapy, in patients with a low baseline thyroid (131)I uptake and a large goiter. If the rhTSH dose does not exceed 0.1 mg the risk of temporary hyperthyroidism and acute thyroid swelling is low. Since patient satisfaction seemingly...... is not improved by the greater goiter reduction obtained by rhTSH-stimulated (131)I-therapy, and permanent hypothyroidism is more frequent, it may be more relevant to reduce the administered radioactivity equivalent to the rhTSH-induced increase in the thyroid (131)I uptake. Future large-scale well...

  11. Biotreatment of produced waters for volume reduction and contaminant removal

    Negri, M.C.; Hinchman, R.R. [Argonne National Lab., IL (United States); Mollock, J. [Devon Energy Corp., Oklahoma City, OK (United States)


    Produced water is wastewater that is brought to the surface from natural gas wells during natural gas production. Its constituents, mostly salt, with traces of hydrocarbons and heavy metals, are a significant disposal problem. Argonne National Laboratory (ANL), in partnership with the Gas Research Institute (GRI), has developed a low-cost, low-tech method, in which green plants are used to reduce the volume of produced water. The authors have designed an engineered bioreactor system, which is modeled after natural saline wetland ecosystems. The plant bioreactor system maximizes plant evapotranspiration to reduce wastewater volume and, concurrently, may function as a biological filter to enhance contaminant degradation and immobilization in the root/rhizosphere zone. Halophyte plant species having high salt tolerance and high transpiration rates were selected after they tested them in greenhouse experiments. Models obtained by using their greenhouse findings reduced the volume of the wastewater (up to 6% salt) by 75% in about 8 days. A field demonstration of the bioreactor, designed on the basis of the results from the greenhouse study, is successfully under way at a natural gas well site in Oklahoma. The process could offer the petroleum industry a low-cost biological alternative to existing expensive options.

  12. Waste volume reduction factors for potential 242-A evaporator feed

    Sederburg, J.P.


    Double-shell tank (DST) storage space requirements have been shown to be highly dependent on the end point of 242-A operations. Consequences to the DST of various waste volumes, and concentrations, are evaluated. Only waste streams that are currently planned to be stored in the DST system before the year 2004 are discussed. As of January 1, 1995, approximately 27-million L (7.2-million gal) of dilute wastes are stored in the DSTs available for evaporator processing. Waste streams planned to be transferred to the DSTs before December 31, 2004, are identified. The DST volume for storing slurry from these wastes is presented in this document. At a final slurry specific gravity of -1.35, 22.5-million L (5.93-million gal) of DST space would be needed on December 31, 2004, to store the product from evaporator processing of these feedstocks. The expected volume needed if the resultant slurry were concentrated to the traditional double-shell slurry feed (DSSF) phase boundary (a specific gravity of {approximately}1.5) would be 17.7-million L (4.67-million gal). An additional 4.8-million L (1.26-million gal) is therefore needed if these wastes are concentrated to a specific gravity of 1.35 instead of the DSSF limit.

  13. The lung volume reduction coil for the treatment of emphysema : a new therapy in development

    Klooster, Karin; ten Hacken, Nick H. T.; Slebos, Dirk-Jan


    Lung volume reduction (LVR) coil treatment is a novel therapy for patients with severe emphysema. In this bilateral bronchoscopic treatment, approximately 10 LVR coils per lobe are delivered under fluoroscopic guidance in two sequential procedures. The LVR coil reduces lung volume by compressing the

  14. Reduced astrocyte density underlying brain volume reduction in activity-based anorexia rats

    Frintrop, Linda; Liesbrock, Johanna; Paulukat, Lisa; Johann, Sonja; Kas, Martien J; Tolba, Rene; Heussen, Nicole; Neulen, Joseph; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Beyer, Cordian; Seitz, Jochen


    OBJECTIVES: Severe grey and white matter volume reductions were found in patients with anorexia nervosa (AN) that were linked to neuropsychological deficits while their underlying pathophysiology remains unclear. For the first time, we analysed the cellular basis of brain volume changes in an animal

  15. New Approach for Error Reduction in the Volume Penalization Method

    Iwakami-Nakano, Wakana; Hatakeyama, Nozomu; Hattori, Yuji


    The volume penalization method offers an efficient way to numerically simulate flows around complex-shaped bodies which move and/or deform in general. In this method a penalization term which has permeability eta and a mask function is added to a governing equation as a forcing term in order to impose different dynamics in solid and fluid regions. In this paper we investigate the accuracy of the volume penalization method in detail. We choose the one-dimensional Burgers' equation as a governing equation since it enables us extensive study and it has a nonlinear term similar to the Navier-Stokes equations. It is confirmed that the error which consists of the discretization/truncation error, the penalization error, the round-off error, and others has the same features as those in previous results when we use the standard definition of the mask function. As the number of grid points increases, the error converges to a non-zero constant which is equal to the penalization error. We propose a new approach for reduc...

  16. Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction

    Ikander, Peder; Drejøe, Jennifer Berg; Lumholt, Pavia


    -off values for breast volume were calculated based on whether or not the patients were offered reduction surgery. Most patients (93%) with a breast volume below 800 cc were not offered surgery, while most with a volume exceeding 900 cc were offered surgery (94%). In the grey zone between 800 and 900 cc...... with breast hypertrophy as a tool which facilitates their decision-making and patients' acceptance of the decisions made. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  17. Tumor Volume Reduction Rate After Preoperative Chemoradiotherapy as a Prognostic Factor in Locally Advanced Rectal Cancer

    Yeo, Seung-Gu [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of); Kim, Dae Yong, E-mail: [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Park, Ji Won; Oh, Jae Hwan; Kim, Sun Young; Chang, Hee Jin; Kim, Tae Hyun; Kim, Byung Chang; Sohn, Dae Kyung; Kim, Min Ju [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)


    Purpose: To investigate the prognostic significance of tumor volume reduction rate (TVRR) after preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). Methods and Materials: In total, 430 primary LARC (cT3-4) patients who were treated with preoperative CRT and curative radical surgery between May 2002 and March 2008 were analyzed retrospectively. Pre- and post-CRT tumor volumes were measured using three-dimensional region-of-interest MR volumetry. Tumor volume reduction rate was determined using the equation TVRR (%) = (pre-CRT tumor volume - post-CRT tumor volume) Multiplication-Sign 100/pre-CRT tumor volume. The median follow-up period was 64 months (range, 27-99 months) for survivors. Endpoints were disease-free survival (DFS) and overall survival (OS). Results: The median TVRR was 70.2% (mean, 64.7% {+-} 22.6%; range, 0-100%). Downstaging (ypT0-2N0M0) occurred in 183 patients (42.6%). The 5-year DFS and OS rates were 77.7% and 86.3%, respectively. In the analysis that included pre-CRT and post-CRT tumor volumes and TVRR as continuous variables, only TVRR was an independent prognostic factor. Tumor volume reduction rate was categorized according to a cutoff value of 45% and included with clinicopathologic factors in the multivariate analysis; ypN status, circumferential resection margin, and TVRR were significant prognostic factors for both DFS and OS. Conclusions: Tumor volume reduction rate was a significant prognostic factor in LARC patients receiving preoperative CRT. Tumor volume reduction rate data may be useful for tailoring surgery and postoperative adjuvant therapy after preoperative CRT.

  18. Volume reductions in frontopolar and left perisylvian cortices in methamphetamine induced psychosis.

    Aoki, Yuta; Orikabe, Lina; Takayanagi, Yoichiro; Yahata, Noriaki; Mozue, Yuriko; Sudo, Yasuhiko; Ishii, Tatsuji; Itokawa, Masanari; Suzuki, Michio; Kurachi, Masayoshi; Okazaki, Yuji; Kasai, Kiyoto; Yamasue, Hidenori


    Consumption of methamphetamine disturbs dopaminergic transmission and sometimes provokes schizophrenia-like-psychosis, named methamphetamine-associated psychosis (MAP). While previous studies have repeatedly reported regional volume reductions in the frontal and temporal areas as neuroanatomical substrates for psychotic symptoms, no study has examined whether such neuroanatomical substrates exist or not in patients with MAP. Magnetic resonance images obtained from twenty patients with MAP and 20 demographically-matched healthy controls (HC) were processed for voxel-based morphometry (VBM) using Diffeomorphic Anatomical Registration using Exponentiated Lie Algebra. An analysis of covariance model was adopted to identify volume differences between subjects with MAP and HC, treating intracranial volume as a confounding covariate. The VBM analyses showed significant gray matter volume reductions in the left perisylvian structures, such as the posterior inferior frontal gyrus and the anterior superior temporal gyrus, and the frontopolar cortices, including its dorsomedial, ventromedial, dorsolateral, and ventrolateral portions, and white matter volume reduction in the orbitofrontal area in the patients with MAP compared with the HC subjects. The smaller regional gray matter volume in the medial portion of the frontopolar cortex was significantly correlated with the severe positive symptoms in the individuals with MAP. The volume reductions in the left perisylvian structure suggest that patients with MAP have a similar pathophysiology to schizophrenia, whereas those in the frontopolar cortices and orbitofrontal area suggest an association with antisocial traits or vulnerability to substance dependence. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Changes in superior mesenteric artery Doppler waveform during reduction of cardiac stroke volume and hypotension

    Perko, M J; Perko, Grazyna; Just, S


    Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity, pulsati......Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity...... of the study indicate that alterations in stroke volume induce consequential changes in the SMA Doppler waveform. These changes originate from both direct influence of stroke volume and/or pressure on blood flow velocity, and alterations in SMA peripheral resistance that follow variations in stroke volume....... Presented interdependencies should be taken into consideration while studying mesenteric physiology with the use of Doppler technique and while interpreting the duplex results in patients suffering from diseases that may influence flow velocity and mimic or obscure Doppler effects of the SMA stenosis....

  20. Cortical grey matter volume reduction in people with schizophrenia is associated with neuro-inflammation.

    Zhang, Y; Catts, V S; Sheedy, D; McCrossin, T; Kril, J J; Shannon Weickert, C


    Cortical grey matter volume deficits and neuro-inflammation exist in patients with schizophrenia, although it is not clear whether elevated cytokines contribute to the cortical volume reduction. We quantified cortical and regional brain volumes in fixed postmortem brains from people with schizophrenia and matched controls using stereology. Interleukin (IL)-6, IL-1β, IL-8 and SERPINA3 messenger RNAs (mRNAs) were quantified in the contralateral fresh frozen orbitofrontal cortex. We found a small, but significant reduction in cortical grey matter (1.3%; F(1,85)=4.478, P=0.037) and superior frontal gyrus (6.5%; F(1,80)=5.700, P=0.019) volumes in individuals with schizophrenia compared with controls. Significantly reduced cortical grey matter (9.2%; F(1,24)=8.272, P=0.008) and superior frontal gyrus (13.9%; F(1,20)=5.374, P=0.031) volumes were found in cases with schizophrenia and 'high inflammation' status relative to schizophrenia cases with 'low inflammation' status in the prefrontal cortex. The expression of inflammatory mRNAs in the orbitofrontal cortex was significantly correlated with those in dorsolateral prefrontal cortex (all r>0.417, all Pgrey matter and superior frontal gyrus volumes (all rgrey matter volume in people with schizophrenia is exaggerated in those who have high expression of inflammatory cytokines. Further, antipsychotic medication intake does not appear to ameliorate the reduction in brain volume.

  1. Transuranic (Tru) waste volume reduction operations at a plutonium facility

    Cournoyer, Michael E [Los Alamos National Laboratory; Nixon, Archie E [Los Alamos National Laboratory; Dodge, Robert L [Los Alamos National Laboratory; Fife, Keith W [Los Alamos National Laboratory; Sandoval, Arnold M [Los Alamos National Laboratory; Garcia, Vincent E [Los Alamos National Laboratory


    Programmatic operations at the Los Alamos National Laboratory Plutonium Facility (TA 55) involve working with various amounts of plutonium and other highly toxic, alpha-emitting materials. The spread of radiological contamination on surfaces, airborne contamination, and excursions of contaminants into the operator's breathing zone are prevented through use of a variety of gloveboxes (the glovebox, coupled with an adequate negative pressure gradient, provides primary confinement). Size-reduction operations on glovebox equipment are a common activity when a process has been discontinued and the room is being modified to support a new customer. The Actin ide Processing Group at TA-55 uses one-meter-long glass columns to process plutonium. Disposal of used columns is a challenge, since they must be size-reduced to get them out of the glovebox. The task is a high-risk operation because the glass shards that are generated can puncture the bag-out bags, leather protectors, glovebox gloves, and the worker's skin when completing the task. One of the Lessons Learned from these operations is that Laboratory management should critically evaluate each hazard and provide more effective measures to prevent personnel injury. A bag made of puncture-resistant material was one of these enhanced controls. We have investigated the effectiveness of these bags and have found that they safely and effectively permit glass objects to be reduced to small pieces with a plastic or rubber mallet; the waste can then be easily poured into a container for removal from the glove box as non-compactable transuranic (TRU) waste. This size-reduction operation reduces solid TRU waste generation by almost 2% times. Replacing one-time-use bag-out bags with multiple-use glass crushing bags also contributes to reducing generated waste. In addition, significant costs from contamination, cleanup, and preparation of incident documentation are avoided. This effort contributes to the Los Alamos

  2. Fluorescence enhancement and focal volume reduction observed in c-shaped nano-apertures

    Yuen, Yin; Fore, Samantha; Huser, Thomas; Hesselink, Lambertus


    We evaluate the potential ability of c-shaped apertures milled in aluminum thin films to reduce the effective measurement volume and to enhance the fluorescence signal for fluorescence correlation spectroscopy of ATTO655 dye dissolved in a HEPES buffer solution. Previous studies have shown that by morphing a square aperture into a rectangular aperture while holding the cross-sectional area constant will yield strong polarization dependence in the reduction of the effective volume and about a factor of 2-3 enhancement in the fluorescence count rate per molecule. By morphing the rectangular aperture into a c-shaped aperture we gain further reduction in focal volume while maintaining the count rate enhancements. In particular, we compare c-shaped apertures to squares with the same cross-sectional area and show that one can achieve one molecule per focal volume at ~3µM (about a 1000 times reduction in effective volume compared to confocal FCS) while maintaining a fluorescence count rate per molecule of about an order of magnitude higher than for bulk diffusing dyes. Two orthogonal polarizations for the incident field have been studied to explore the effects on the focal volume reduction and fluorescence count rate enhancements.

  3. Relationship between intra thyroid calcifications and thyroglobulin in endemic goiter

    Zaccheroni, V.; Iagulli, M.P.; Vescini, F.; Bianchi, G.P.; Menini, S.; Vacirca, A.; Vallese, M.; Lodi, A. [Bologna Univ., Bologna (Italy). Dipt. di medicina interna, cardioangiologia e epatologia


    The authors have been looking for the presence of parameters associated with thyroid calcifications in patients affected by simple or nodular goiter, either sporadic or endemic. A multistep discriminant analysis taking the presence-absence of calcifications as dependent variant was applied and a new variable (TG1) was created to differentiate normal from supra physiologic concentrations of hTG. In conclusion, as far as a follicular hyperstimulation can be assumed, especially if long-lasting, the presence intra thyroid calcifications should rise clinical suspect toward an old goiter rather than a neoplastic lesion.

  4. Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction

    Ikander, Peder; Drejøe, Jennifer Berg; Lumholt, Pavia


    for breast reduction surgery, thus establishing a standard decision basis that can be shared by surgeons and departments to secure patients fair and equal treatment opportunities. MATERIAL AND METHODS: A total of 427 patients who were referred to three Danish public hospitals with breast hypertrophy...... in the period from January 2007 to March 2011 were included prospectively in the study. The patients' subjective complaints, height, weight and standard breast measurements were registered as well as the decision for or against surgery. Breast volume was measured using transparent plastic cups. RESULTS: Cut......-off values for breast volume were calculated based on whether or not the patients were offered reduction surgery. Most patients (93%) with a breast volume below 800 cc were not offered surgery, while most with a volume exceeding 900 cc were offered surgery (94%). In the grey zone between 800 and 900 cc...

  5. Relation between trunk fat volume and reduction of total lung capacity in obese men.

    Watson, R A; Pride, N B; Thomas, E Louise; Ind, P W; Bell, J D


    Reduction in total lung capacity (TLC) in obese men is associated with restricted expansion of the thoracic cavity at full inflation. We hypothesized that thoracic expansion was reduced by the load imposed by increased total trunk fat volume or its distribution. Using MRI, we measured internal and subcutaneous trunk fat and total abdominal and thoracic volumes at full inflation in 14 obese men [mean age: 52.4 yr, body mass index (BMI): 38.8 (range: 36-44) kg/m(2)] and 7 control men [mean age: 50.1 yr, BMI: 25.0 (range: 22-27.5) kg/m(2)]. TLC was measured by multibreath helium dilution and was restricted (fat volume was 16.65 (range: 12.6-21.8) liters in obese men and 6.98 (range: 3.0-10.8) liters in control men. Anthropometry and mean total trunk fat volumes were similar in OR men and obese men without restriction (the ON subgroup). Mean total intraabdominal volume was 9.41 liters in OR men and 11.15 liters in ON men. In obese men, reduced thoracic expansion at full inflation and restriction of TLC were not inversely related to a large volume of 1) intra-abdominal or total abdominal fat, 2) subcutaneous fat volume around the thorax, or 3) total trunk fat volume. In addition, trunk fat volumes in obese men were not inversely related to gas volume or estimated intrathoracic volume at supine functional residual capacity. In conclusion, this study failed to support the hypotheses that restriction of TLC or impaired expansion of the thorax at full inflation in middle-aged obese men was simply a consequence of a large abdominal volume or total trunk fat volume or its distribution.

  6. Surgical treatment of benign nodular goiter; report of 72 patients



    Full Text Available Surgical resection is usually prefered for the treatment of benign nodular goiter. But the extention of thyroidectomy in the surgical management of benign nodular goiter still remains controversial. Seventytwo patients underwent thyroid surgery between April 2002- July2007 in Kızıltepe State Hospital Otorhinolaryngology Service. Of the patients 63 were women (%87.5, 9 were man (%12.5. The range of age was between 15-62 years and mean age was 36,5. Thirtynine patients had unilateral total lobectomy+ istmusectomy (%54.2, 11 patients had unilateral lobectomy+ isthmusectomy+contralateral subtotal lobectomy (Dunhill Procedure (%15.3, 20 patients had nearly total thyroidectomy (%27.8, 2 patients had total thyroidectomy (% 2.7. Three patients had seroma (%4.1, 2 patients had hemorrhage requiring operative hemostasis (%2.7, 1 patient had suture reaction(%1.3. Patients have not had permanent or temporary nervus laryngeus recurrens injury, hypoparathyroidism and infection.As a result more extent surgical resections must be preferred by the surgeon for the treatment of benign nodular goiter. The preferable surgical treatment of solitary nodules is lobectomy+isthmusectomy. The multinodular goiter must be treated with unilateral lobectomy+ isthmusectomy+contralateral subtotal lobectomy (Dunhill procedure when the remnant thyroid tissue is normal; otherwise nearly total or total thyroidectomy is preferable.

  7. Quality of life in patients with benign nontoxic goiter

    Cramon, Per; Bonnema, Steen Joop; Bjørner, Jakob


    BACKGROUND: While health-related quality of life (HRQoL) issues often prompt treatment of benign nontoxic goiter (NTG), few clinical studies have systematically assessed HRQoL in patients with this condition. The purpose of the present study was to evaluate thyroid-related and generic HRQo...

  8. Amyloid goiter in a child - US, CT and MR evaluation

    Perez Fontan, F.J.; Mosquera Oses, J.; Pombo Felipe, F. (Hospital Juan Canalejo, La Coruna (Spain). Dept. of Radiology); Rodriguez Sanchez, I.; Arnaiz Pena, S. (Hospital Juan Canalejo, La Coruna (Spain). Dept. of Pediatric Oncology)


    There are few radiological descriptions of amyloid goiter, basically in adult patients or oriental origin. We present a ten-year-old boy with Still's disease and secondary thyroid amyloidosis, describing the US, CT and MR findings. (orig.).

  9. Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT

    Hein, Patrick A.; May, Juliane; Rogalla, Patrik; Hamm, Bernd; Lembcke, Alexander [Charite-University Hospital, Department of Radiology, Berlin (Germany); Butler, Craig [Charite-University Hospital, Department of Radiology, Berlin (Germany); University of Alberta, Department of Cardiology, Edmonton, Alberta (Canada)


    To assess reduced volumes of contrast agent on image quality for coronary computed tomography angiography (CCTA) by using single-beat cardiac imaging with 320-slice CT. Forty consecutive male patients (mean age: 55.8 years) undergoing CCTA with body weight {<=}85 kg, heart rate {<=}65 bpm, and ejection fraction {>=}55% were included. Image acquisition protocol was standardized (120 kV, 400 mA, and prospective ECG-triggered single-beat nonspiral CCTA). Patients were randomly assigned to one of four groups (G1: received 40 ml, G2: 50 ml, G3: 60 ml, G4: 70 ml). Groups were compared with respect to aortic attenuation, image noise, and image quality. CT values (mean {+-} standard deviation) in the aortic root were measured as 423 {+-} 38 HU in G1, and 471 {+-} 68, 463 {+-} 60, and 476 {+-} 78 HU in G2-4, respectively. There were no statistically significant differences in attenuation among the groups (P > 0.068). All 40 CT datasets were rated diagnostic, and image noise and image quality were not statistically different among groups. Using 320-slice volume CT, diagnostic image quality can be achieved with 40 ml of contrast material in CCTA in patients with normal body weight, cardiac function, and low heart rate. (orig.)

  10. Treatment of nodular goiter; Der Schilddruesenknoten. Medikamentoese Therapie der benignen Knotenstruma

    Quadbeck, B. [Praxis fuer Endokrinologie, Duesseldorf (Germany)


    Benign thyroid nodules are common in iodine deficient countries like Germany. Current standard treatment of iodine deficient goiter is oral iodine and or levothyroxine but solid evidence on which to base dosage and duration of treatment is still missing. Recent studies have addressed a new pathogenic concept of a true neoplasia in thyroid nodules. Based on the pathogenesis, the effectiveness of thyroid hormone suppressive therapy in reducing volume of benign thyroid nodules is a matter of controversy since many years. It is necessary to clarify this therapeutic effect, because its use needs to be carefully weight against its potential deleterious effects in the skeletal and cardiovascular system e.g. in elderly patients. Iodine deficient goiter is the best option for medical treatment. Benign thyroid nodules displayed a slow but continous growth during long-term follow up. Treatment with levothyroxine and/or iodide did not significantly influence growth of nodules. From a therapeutic point of view, prevention of thyroid nodules in iodine deficient countries needs an early and different strategy than the therapy of existing nodules. (orig.)

  11. Treatment of emphysema using bronchoscopic lung volume reduction coil technology : an update on efficacy and safety

    Hartman, Jorine E.; Klooster, Karin; ten Hacken, Nick H. T.; Slebos, Dirk-Jan


    In the last decade several promising bronchoscopic lung volume reduction (BLVR) treatments were developed and investigated. One of these treatments is BLVR treatment with coils. The advantage of this specific treatment is that it works independently of collateral flow, and also shows promise for pat

  12. Ossified materialism: introduction to the special volume on absolute reductions in materials throughput and emissions

    Akenji, L.; Bengtsson, M.; Bleiswitaz, R.; Tukker, A.


    Drawing from papers in this special volume (SV), this introductory paper on absolute reductions argues that the magnitude, scope and urgency of the sustainability challenge require a drastic change in global civilisation, including a radical transformation of the institutional arrangements and socio

  13. Lung volume reduction coil treatment for patients with severe emphysema : a European multicentre trial

    Deslee, Gaetan; Klooster, Karin; Hetzel, Martin; Stanzel, Franz; Kessler, Romain; Marquette, Charles-Hugo; Witt, Christian; Blaas, Stefan; Gesierich, Wolfgang; Herth, Felix J. F.; Hetzel, Juergen; van Rikxoort, Eva M.; Slebos, Dirk-Jan


    Background The lung volume reduction (LVR) coil is a minimally invasive bronchoscopic nitinol device designed to reduce hyperinflation and improve elastic recoil in severe emphysema. We investigated the feasibility, safety and efficacy of LVR coil treatment in a prospective multicentre cohort trial

  14. Lung volume reduction for severe emphysema: do we need a scalpel or a scope?

    D. Van Raemdonck


    Full Text Available Resectional lung volume reduction has proven to be superior to medical treatment in reducing dyspnoea and in increasing lung function, survival and quality of life in a very well selected, low risk group of hyperinflated patients with heterogeneous emphysema predominantly in the upper lobe. Nevertheless, this intervention is hampered by an important pulmonary (30% and cardiovascular (20% morbidity, mainly as a result of prolonged (>7 days air leak, and a 5% risk of death as a result of the surgical intervention. Results from ongoing randomised trials are awaited in order to determine whether less invasive, non-resectional lung volume treatment of emphysema via the bronchoscope using endobronchial valves, airway bypass stents or biological adhesives/heated water vapour will yield similar improvement with less morbidity and reduced mortality, compared with surgical resection. Furthermore, it is hoped that endoscopic lung volume reduction techniques may help patients with homogeneous emphysema currently excluded by most teams for the resectional procedure.

  15. Effect of volume loading on the Frank-Starling relation during reductions in central blood volume in heat-stressed humans

    Bundgaard-Nielsen, Morten; Wilson, T E; Seifert, Thomas


    During reductions in central blood volume while heat stressed, a greater decrease in stroke volume (SV) for a similar decrease in ventricular filling pressure, compared to normothermia, suggests that the heart is operating on a steeper portion of a Frank-Starling curve. If so, volume loading of h...

  16. Development of volume reduction method of cesium contaminated soil with magnetic separation

    Yukumatsu, Kazuki; Nomura, Naoki; Mishima, Fumihito; Akiyama, Yoko; Nishijima, Shigehiro [Osaka University, Osaka (Japan)


    In this study, we developed a new volume reduction technique for cesium contaminated soil by magnetic separation. Cs in soil is mainly adsorbed on clay which is the smallest particle constituent in the soil, especially on paramagnetic 2:1 type clay minerals which strongly adsorb and fix Cs. Thus selective separation of 2:1 type clay with a superconducting magnet could enable to reduce the volume of Cs contaminated soil. The 2:1 type clay particles exist in various particle sizes in the soil, which leads that magnetic force and Cs adsorption quantity depend on their particle size. Accordingly, we examined magnetic separation conditions for efficient separation of 2:1 type clay considering their particle size distribution. First, the separation rate of 2:1 type clay for each particle size was calculated by particle trajectory simulation, because magnetic separation rate largely depends on the objective size. According to the calculation, 73 and 89 % of 2:1 type clay could be separated at 2 and 7 T, respectively. Moreover we calculated dose reduction rate on the basis of the result of particle trajectory simulation. It was indicated that 17 and 51 % of dose reduction would be possible at 2 and 7 T, respectively. The difference of dose reduction rate at 2 T and 7 T was found to be separated a fine particle. It was shown that magnetic separation considering particle size distribution would contribute to the volume reduction of contaminated soil.

  17. Adjuvant radiotherapy in stage I seminoma: Is there a role for further reduction of treatment volume?

    Bruns, Frank; Bremer, Michael; Meyer, Andreas; Karstens, Johann H. [Hannover Medical School (Germany). Dept. of Radiation Oncology


    An analysis was performed to determine whether a cranial reduction of the portals to the T11/T12 junction instead of the common T10/T11 junction would alter the outcome of patients with stage I seminoma. Of 163 consecutive patients with newly diagnosed testicular seminoma referred to the authors' institution between April 1992 and April 1999, 80 patients with stage I seminoma were treated with cranially reduced para-aortic treatment fields reaching from the top of T12 to the bottom of L4. Median total dose was 20.0 Gy (range, 19.8-27.2 Gy). Patients were followed-up by the use of CT in regular intervals. After a median follow-up of 7.1 years (range, 4.1-11.1 years), four patients (5%) had relapsed resulting in an actuarial 5-year relapse-free survival of 95%. No patients relapsed within the cranially reduced treatment volume above the top of T12. The cranial reduction of the para-aortic treatment fields resulted in a median reduction of treatment volume of 16% (range, 13-21%). The achieved median reduction in treatment volume of 16% appears to be relevant and is not associated with an increased relapse rate. This approach is recommended in analogy to the surgical approach in NSGCT to further minimize the risk of radiation-related late effects.

  18. Long-term occupational stress is associated with regional reductions in brain tissue volumes.

    Eva Blix

    Full Text Available There are increasing reports of cognitive and psychological declines related to occupational stress in subjects without psychiatric premorbidity or major life trauma. The underlying neurobiology is unknown, and many question the notion that the described disabilities represent a medical condition. Using PET we recently found that persons suffering from chronic occupational stress had limbic reductions in the 5-HT1A receptor binding potential. Here we examine whether chronic work-related stress is also associated with changes in brain structure. We performed MRI-based voxel-based morphometry and structural volumetry in stressed subjects and unstressed controls focusing on gray (GM and white matter (WM volumes, and the volumes of hippocampus, caudate, and putamen - structures known to be susceptible to neurotoxic changes. Stressed subjects exhibited significant reductions in the GM volumes of the anterior cingulate cortex and the dorsolateral prefrontal cortex. Furthermore, their caudate and putamen volumes were reduced, and the volumes correlated inversely to the degree of perceived stress. Our results add to previous data on chronic psychosocial stress, and indicate a morphological involvement of the frontostriatal circuits. The present findings of morphological changes in these regions confirm our previous conclusion that symptoms from occupational stress merit careful investigations and targeted treatment.

  19. Increased oxygen pulse after lung volume reduction surgery is associated with reduced dynamic hyperinflation.

    Lammi, Matthew R; Ciccolella, David; Marchetti, Nathaniel; Kohler, Malcolm; Criner, Gerard J


    Stroke volume augmentation during exercise is limited in chronic obstructive pulmonary disease patients because of decreased preload from dynamic hyperinflation (DH). We hypothesised that oxygen pulse and pulse pressure (PP) improve following lung volume reduction surgery (LVRS), and the magnitude of improvement correlates with reduction in DH. We compared 16 emphysema patients undergoing LVRS with six emphysema patients not undergoing LVRS. Oxygen pulse and PP were calculated from maximal cardiopulmonary exercise tests at baseline and 6 months. End-expiratory lung volume (EELV)/total lung capacity (TLC) represented DH. Comparisons were made between baseline and 6 months at metabolic isotimes (per cent maximal carbon dioxide production (V'(CO(2),max))). At baseline, the LVRS group was older with higher forced expiratory volume in 1 s, but had similar hyperinflation to the non-LVRS group. At 6 months, oxygen pulse (50%, 75%, and 100% V'(CO(2),max)) and PP (50% and 75% V'(CO(2),max)) increased in the LVRS, but not in the non-LVRS group. Baseline functional residual capacity/TLC inversely correlated with resting oxygen pulse (r= -0.449, p=0.04). Decreased EELV/TLC correlated with increased oxygen pulse at 75% (r= -0.487, p=0.02) and 100% V'(CO(2),max) (r= -0.548, p=0.008). LVRS led to increased oxygen pulse and PP during exercise at metabolic isotimes 6 months following surgery. Reductions in DH correlated with increases in oxygen pulse during exercise. Reducing lung volume may improve stroke volume response to exercise by decreasing DH.

  20. Effect of volume loading on the Frank-Starling relation during reductions in central blood volume in heat-stressed humans

    Bundgaard-Nielsen, Morten; Wilson, T E; Seifert, Thomas


    During reductions in central blood volume while heat stressed, a greater decrease in stroke volume (SV) for a similar decrease in ventricular filling pressure, compared to normothermia, suggests that the heart is operating on a steeper portion of a Frank-Starling curve. If so, volume loading...... of heat-stressed individuals would shift the operating point to a flatter portion of the heat stress Frank-Starling curve thereby attenuating the reduction in SV during subsequent decreases in central blood volume. To investigate this hypothesis, right heart catheterization was performed in eight males.......06). However, subsequent volume loading increased SV to 143 +/- 29 ml (P = 0.003). LBNP provoked a larger decrease in SV relative to the decrease in PCWP during heating (8.6 +/- 1.9 ml mmHg(1)) compared to normothermia (4.5 +/- 3.0 ml mmHg(1), P = 0.02). After volume loading while heat stressed, the reduction...


    Francis, A.J.; Dodge, C.J.


    The overall goals of this research project are to determine the mechanism of microbial dissolution and stabilization of actinides in Department of Energy’s (DOE) TRU wastes, contaminated sludges, soils, and sediments. This includes (i) investigations on the fundamental aspects of microbially catalyzed radionuclide and metal transformations (oxidation/reduction reactions, dissolution, precipitation, chelation); (ii) understanding of the microbiological processes that control speciation and alter the chemical forms of complex inorganic/organic contaminant mixtures; and (iii) development of new and improved microbially catalyzed processes resulting in immobilization of metals and radionuclides in the waste with concomitant waste volume reduction.


    Francis, A.J.; Dodge, C.J.


    The overall goals of this research project are to determine the mechanism of microbial dissolution and stabilization of actinides in Department of Energy's (DOE) TRU wastes, contaminated sludges, soils, and sediments. This includes (1) investigations on the fundamental aspects of microbially catalyzed radionuclide and metal transformations (oxidation/reduction reactions, dissolution, precipitation, chelation); (2) understanding of the microbiological processes that control speciation and alter the chemical forms of complex inorganic/organic contaminant mixtures; and (3) development of new and improved microbially catalyzed processes resulting in immobilization of metals and radionuclides in the waste with concomitant waste volume reduction.




    The overall goals of this research project are to determine the mechanism of microbial dissolution and stabilization of actinides in Department of Energy's (DOE) TRU wastes, contaminated sludges, soils, and sediments. This includes (1) investigations on the fundamental aspects of microbially catalyzed radionuclide and metal transformations (oxidation/reduction reactions, dissolution, precipitation, chelation); (2) understanding of the microbiological processes that control speciation and alter the chemical forms of complex inorganic/organic contaminant mixtures; and (3) development of new and improved microbially catalyzed processes resulting in immobilization of metals and radionuclides in the waste with concomitant waste volume reduction.

  4. Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction

    Ikander, Peder; Drejøe, Jennifer Berg; Lumholt, Pavia


    INTRODUCTION: The indication for breast reduction in a public welfare or an insurance paid setting depends on the severity of the subjective symptoms and the clinical evaluation. The purpose of this study was to evaluate the use of breast volume as an objective criterion to establish the indication...... for breast reduction surgery, thus establishing a standard decision basis that can be shared by surgeons and departments to secure patients fair and equal treatment opportunities. MATERIAL AND METHODS: A total of 427 patients who were referred to three Danish public hospitals with breast hypertrophy...

  5. Behavioral responses of goitered gazelle (Gazella subgutturosa) to parasitic activity of botflies.

    Blank, David; Yang, Weikang


    We studied behavioral responses of goitered gazelles (Gazella subgutturosa) to hypodermic botfly (family Hypodermatidae) activity in the naturally arid conditions of Kazakhstan. We found that the reactions of goitered gazelles are very similar to the insect-repelling behaviors of other ruminants and that most behavioral responses of goitered gazelles, such as frantic running, tail movements, and grooming, are not specific to botflies. The seasonal and diurnal changes in the intensity of the behavioral responses of the goitered gazelles coincided with the parasitic activities of botfly maggots. Surprisingly, the group size of the goitered gazelles decreased during the breeding of these parasitic insects instead of increasing, as was expected according to our predictions. As an alternative, the goitered gazelles chose an opposite strategy of dispersion throughout the area to avoid infestation. This strategy is well-known for other species of ungulates and was quite effective, because their infestation rate was relatively low.

  6. Lateral frontal cortex volume reduction in Tourette syndrome revealed by VBM

    Wittfoth Matthias


    Full Text Available Abstract Background Structural changes have been found predominantly in the frontal cortex and in the striatum in children and adolescents with Gilles de la Tourette syndrome (GTS. The influence of comorbid symptomatology is unclear. Here we sought to address the question of gray matter abnormalities in GTS patients with co-morbid obsessive-compulsive disorder (OCD and/or attention deficit hyperactivity disorder (ADHD using voxel-based morphometry (VBM in twenty-nine adult actually unmedicated GTS patients and twenty-five healthy control subjects. Results In GTS we detected a cluster of decreased gray matter volume in the left inferior frontal gyrus (IFG, but no regions demonstrating volume increases. By comparing subgroups of GTS with comorbid ADHD to the subgroup with comorbid OCD, we found a left-sided amygdalar volume increase. Conclusions From our results it is suggested that the left IFG may constitute a common underlying structural correlate of GTS with co-morbid OCD/ADHD. A volume reduction in this brain region that has been previously identified as a key region in OCD and was associated with the active inhibition of attentional processes may reflect the failure to control behavior. Amygdala volume increase is discussed on the background of a linkage of this structure with ADHD symptomatology. Correlations with clinical data revealed gray matter volume changes in specific brain areas that have been described in these conditions each.

  7. Lung protection: an intervention for tidal volume reduction in a teaching intensive care unit

    Briva, Arturo; Gaiero, Cristina


    Objective To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. Methods The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside. In parallel, predicted body weight was estimated from knee height and included in clinical charts. Results One hundred fifty-nine patients were included. Predicted body weight assessed by knee height instead of visual evaluation revealed that the delivered tidal volume was significantly higher than predicted. After the inclusion of predicted body weight, we observed a sustained reduction in delivered tidal volume from a mean (standard error) of 8.97 ± 0.32 to 7.49 ± 0.19mL/kg (p < 0.002). Furthermore, the protocol adherence was subsequently sustained for 12 months (delivered tidal volume 7.49 ± 0.54 versus 7.62 ± 0.20mL/kg; p = 0.103). Conclusion The lack of a reliable method to estimate the predicted body weight is a significant impairment for the application of a worldwide standard of care during mechanical ventilation. A combined intervention based on education and repeated feedbacks promoted sustained tidal volume education during the study period (12 months). PMID:27925055

  8. Hippocampal and caudate volume reductions in antipsychotic-naive first-episode schizophrenia

    Ebdrup, Bjørn Hylsebeck; Glenthøj, Birte; Rasmussen, Hans


    to be influenced by a history of substance abuse. Exploratory analyses indicated reduced volume of the nucleus accumbens in patients with first-episode schizophrenia. LIMITATIONS: This study was not a priori designed to test for differences between schizophrenia patients with or without lifetime substance abuse......BACKGROUND: Enlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode schizophrenia. Studies investigating brain structure in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether ventricular...... enlargement and hippocampal and caudate volume reductions are morphological traits of antipsychotic-naive first-episode schizophrenia. METHODS: We obtained high-resolution 3-dimensional T1-weighted magnetic resonance imaging scans for 38 antipsychotic-naive first-episode schizophrenia patients and 43 matched...

  9. Incidence of goiter among children in a village with nitrate contamination of drinking water.

    Gatseva, P; Vladeva, S; Pavlov, K


    An epidemiological survey was conducted on the incidence of goiter among children in the 6-14 years age group, permanently living in a village with an increased content of nitrate pollutants in drinking water. Their incidence of goiter was compared to that in a control group of children. The study comprised a total of 359 children--181 from the experimental village and 178 from the control village. A high percentage (40.9%) of goiter is observed among the children in the village with nitrate contamination of drinking water. A statistically significant difference in goiter incidence in children between the experimental and control village is present.

  10. Severe Emphysema Treated by Endoscopic Bronchial Volume Reduction with Lung Sealant (AeriSeal

    R. F. Falkenstern-Ge


    Full Text Available Endoscopic lung volume reduction using lung sealant is a very new and innovative treatment option for patients with severe progressive and irreversible lung emphysema. A 55-year-old ex-smoker (60 pack years referred to our center because of severe lung emphysema with progressive worsening of the obstructive ventilator pattern and clinical condition. We detected collateral channels of this patient by using the Chartis system. Therefore, we decided to treat the advanced emphysema of our patient with endoscopic volume reduction using lung sealant (AeriSeal. The foam of lung sealant AeriSeal is instilled into the peripheral airways and alveoli where it polymerizes and functions as tissue glue on the lung surface in order to seal the target region to cause durable irreversible absorption atelectasis. The follow-up evaluation 12 weeks later showed improved lung function (increased FEV 1/partial oxygen pressure/peripheral oxygen saturation and a reduction of TLC and RV with improved quality of life. Correlation between changes in primary and secondary outcome measures in the lung function parameters and 6-minute-walking test before and 12 weeks after the application of lung sealant revealed significant reduction of hyperinflation and improvement both in the flow rates and in the physical capability of this patient.

  11. Brain volume reduction predicts weight development in adolescent patients with anorexia nervosa.

    Seitz, Jochen; Walter, Martin; Mainz, Verena; Herpertz-Dahlmann, Beate; Konrad, Kerstin; von Polier, Georg


    Acute anorexia nervosa (AN) is associated with marked brain volume loss potentially leading to neuropsychological deficits. However, the mechanisms leading to this brain volume loss and its influencing factors are poorly understood and the clinical relevance of these brain alterations for the outcome of these AN-patients is yet unknown. Brain volumes of 56 female adolescent AN inpatients and 50 healthy controls (HCs) were measured using MRI scans. Multiple linear regression analyses were used to determine the impact of body weight at admission, prior weight loss, age of onset and illness duration on volume loss at admission and to analyse the association of brain volume reduction with body weight at a 1-year follow-up (N = 25). Cortical and subcortical grey matter (GM) and cortical white matter (WM) but not cerebellar GM or WM were associated with low weight at admission. Amount of weight loss, age of onset and illness duration did not independently correlate with any volume changes. Prediction of age-adjusted standardized body mass index (BMI-SDS) at 1-year follow-up could be significantly improved from 34% of variance explained by age and BMI-SDS at admission to 47.5-53% after adding cortical WM, cerebellar GM or WM at time of admission. Whereas cortical GM changes appear to be an unspecific reflection of current body weight ("state marker"), cortical WM and cerebellar volume losses seem to indicate a longer-term risk (trait or "scar" of the illness), which appear to be important for the prediction of weight rehabilitation and long-term outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Superior temporal gyrus volume reduction and P300 in schizophrenia prior to treatment

    Hirayasu, Akira; Hokama, Hiroto; Ogura, Chikara; Ohta, Hirokazu; Arakaki, Hajime; Asato, Naohiko; Yamaguchi, Keiichiro [Ryukyus Univ., Nishihara, Okinawa (Japan). Faculty of Medicine


    Authors measured the superior temporal gyrus volume by 3D MRI imaging for the schizophrenics and simultaneously recorded the P300 component during the auditory odd-ball exercise. Subjects were 8 cases of schizophrenics and the sex- and age-matched healthy control adults. In schizophrenics, the superior temporal gyrus volume reduction was found. When the superior temporal gyrus was divided into two parts, the anterior part containing the primary auditory area, and the posterior part containing the planum temporale and the Wernicle speech area, the volume reduction of left side in the posterior part was remarkable. There was no difference in the latent time and the P300 amplitude between schizophrenics and healthy controls, suggesting that the superior temporal gyrus abnormalities will appear prior to P300 abnormalities. We could not find any correlation between findings of MRI and P300 and psychic symptoms. We discuss the possible contribution on the elucidation of the pathogenesis of the schizophrenia by simultaneous recordings of 3D MRI imaging and the event-related potentials. (K.H.)

  13. Electric and Magnetic Fields (EMF) RAPID Program Engineering Project 8: FINAL REPORT, Evaluation of Field Reduction Technologies, Volume 1 (Report) and Volume 2 (Appendices)

    Commonwealth Associates, Inc.; IIT Research Institute


    This draft report consists of two volumes. Volume 1, the main body, contains an introducto~ sectionj an overview of magnetic fields sectio~ and field reduction technology evaluation section. Magnetic field reduction methods are evalpated for transmission lines, distribution Iines,sulxtations, building wiring applkmd machinery, and transportation systems. The evaluation considers effectiveness, co% and other ftiors. Volume 2 contains five appendices, Append~ A presents magnetic field shielding information. Appendices B and C present design assumptions and magnetic field plots for transmission and distribution lines, respectively. Appendices D and E present cost estimate details for transmission and distribution limes, respectively.

  14. Quality of Life and Volume Reduction in Women with Secondary Lymphoedema Related to Breast Cancer

    Marcus Lanza


    Full Text Available Purpose. To assess the quality of life (QOL as a predictor of volume reduction in women undergoing complex physical therapy (CPT for lymphoedema following breast cancer. Methods. Clinical trial in 57 women undergoing CPT. Results. At baseline, in measuring quality of life for the EORTC QLQ-C30 questionnaire subscale of functionality, the worst scores for emotional function (55 points and better social function (89 points were observed. The symptom scales showed the worst pain averaged (66 points. The overall quality of life showed a low score (40 points. In the BR 23 module, low scores were observed in the field of future perspective (47 points. After treatment of lymphoedema, absolute reduction of excess volume between the upper limbs of 282 mL was observed, representing a reduction of 15%. No association was observed between the domains of quality of life and response to treatment of lymphoedema. Conclusion. This study included 57 women with advanced and chronic lymphoedema in early treatment with CPT and low scores for quality of life. The lymphoedema therapeutic response was not influenced by the QOL at the beginning of treatment.

  15. Effect of blood donation-mediated volume reduction on regional right ventricular deformation in healthy subjects.

    Açar, Göksel; Alizade, Elnur; Avci, Anıl; Cakir, Hakan; Efe, Suleyman Cagan; Kalkan, Mehmet Emin; Tabakci, Mehmet Mustafa; Toprak, Cuneyt; Tanboğa, Ibrahim Halil; Esen, Ali Metin


    Strain (S) and strain rate (SR) are known to be altered in diseases associated with right ventricular (RV) pressure/volume overload and RV myocardial dysfunction; however determinants of S/SR are incompletely understood. The aim of this study was to examine the effect of blood donation-mediated volume reduction on regional RV deformation in healthy young adults. Study population was composed of 61 consecutive healthy subjects who were volunteers for blood donation. All underwent standard echocardiography and two-dimensional S and SR imaging by speckle tracking before and after 450 mL blood donation. We found no change in RV lateral wall SR in all three segments. However, the S in the apical and mid segments of the RV lateral wall immediately decreased after blood donation [-26.2 ± 3.3 vs. -23.2 ± 3.3 % (p subjects caused a regional difference in RV longitudinal deformation with the lower mid and apical S that was related to parameters of volume load severity. However, RV systolic SR was found to be resistant to the effects of volume depletion.

  16. Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica.

    Wang, Q; Zhang, N; Qin, W; Li, Y; Fu, Y; Li, T; Shao, J; Yang, L; Shi, F-D; Yu, C


    Whether gray matter impairment occurs in neuromyelitis optica is a matter of ongoing debate, and the association of gray matter impairment with cognitive deficits remains largely unknown. The purpose of this study was to investigate gray matter volume reductions and their association with cognitive decline in patients with neuromyelitis optica. This study included 50 patients with neuromyelitis optica and 50 sex-, age-, handedness-, and education-matched healthy subjects who underwent high-resolution structural MR imaging examinations and a battery of cognitive assessments. Gray matter volume and cognitive differences were compared between the 2 groups. The correlations of the regional gray matter volume with cognitive scores and clinical variables were explored in the patients with neuromyelitis optica. Compared with healthy controls (635.9 ± 51.18 mL), patients with neuromyelitis optica (602.8 ± 51.03 mL) had a 5.21% decrease in the mean gray matter volume of the whole brain (P optica affected the frontal and temporal cortices and the right thalamus (false discovery rate correction, P optica (Alphasim correction, P optica had impairments in memory, information processing speed, and verbal fluency (P optica and is associated with cognitive impairment and disease severity in this group. © 2015 by American Journal of Neuroradiology.

  17. [Bronchoscopic lung volume reduction is a treatment offered to patients with severe heterogenous emphysema].

    Perch, Michael; Titlestad, Ingrid L; Rychwicha-Kielek, Beata A; Bendstrup, Elisabeth; Iversen, Martin; Siemsen, Mette; Jørgensen, Ole D; Haahr, Poul Erik


    Introduction of bronchoscopic lung volume reduction as a treatment for severe emphysema has been defined as an area of development by The Danish Health and Medicines Authority. We here present the rationale for treatment, in- and exclusion criteria, and ultimately the organization for assessment, treatment and follow-up in Denmark. The treatment aim is to lower dyspnoea. There is a national protocol for patient selection according to in- and exclusion criteria. Different commercial devices are available, but endobronchial valves have been the devices mostly applied. A national database has been established to evaluate cost-effectiveness.

  18. Stressogenic aspects of diffuse toxic goiter relapse with signs of thyrotoxic myocar-dial dystrophy

    Onyushkina N.Yu.


    Full Text Available Probability of relapse development of diffuse toxic goiter during the nearest two years after treatment is determined by its results and stressogenic capacity level, which is defined by Holmes and Rage method. As long as satisfactory treatment results and level of stressogenic capacity are above 300 points, the risk of diffuse toxic goiter relapse run to 68,5%

  19. Lung Volume Reduction Coil Treatment in Chronic Obstructive Pulmonary Disease Patients with Homogeneous Emphysema : A Prospective Feasibility Trial

    Klooster, Karin; ten Hacken, Nick H. T.; Franz, Ina; Kerstjens, Huib A. M.; van Rikxoort, Eva M.; Slebos, Dirk-Jan


    Background: In patients with heterogeneous emphysema, surgical and bronchoscopic lung volume reduction (LVR) treatments are available. However, for patients with homogeneous emphysema these treatments are hardly investigated and seem less effective. Bronchoscopic LVR coil treatment has been shown to

  20. Lung Volume Reduction Coil Treatment in Chronic Obstructive Pulmonary Disease Patients with Homogeneous Emphysema: A Prospective Feasibility Trial

    Klooster, K.; Hacken, N. Ten; Franz, I.; Kerstjens, H.; Rikxoort, E.M. van; Slebos, D.J.


    Background: In patients with heterogeneous emphysema, surgical and bronchoscopic lung volume reduction ({LVR}) treatments are available. However, for patients with homogeneous emphysema these treatments are hardly investigated and seem less effective. Bronchoscopic {LVR} coil treatment has been show

  1. Lung Volume Reduction Coil Treatment in Chronic Obstructive Pulmonary Disease Patients with Homogeneous Emphysema : A Prospective Feasibility Trial

    Klooster, Karin; ten Hacken, Nick H. T.; Franz, Ina; Kerstjens, Huib A. M.; van Rikxoort, Eva M.; Slebos, Dirk-Jan


    Background: In patients with heterogeneous emphysema, surgical and bronchoscopic lung volume reduction (LVR) treatments are available. However, for patients with homogeneous emphysema these treatments are hardly investigated and seem less effective. Bronchoscopic LVR coil treatment has been shown to

  2. Obesity is associated with increased prostate growth and attenuated prostate volume reduction by dutasteride.

    Muller, Roberto L; Gerber, Leah; Moreira, Daniel M; Andriole, Gerald; Hamilton, Robert J; Fleshner, Neil; Parsons, J Kellogg; Freedland, Stephen J


    Although obesity has been associated with larger prostate volumes (PV), few studies have actually investigated whether obesity enhances PV growth, especially among men using 5α-reductase inhibitors. To examine whether obesity is associated with enhanced PV growth measured by serial transrectal ultrasound (TRUS) measurements. We conducted a secondary analysis of the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, which was originally aimed at cancer risk reduction among high-risk men with a single negative prestudy biopsy. Per-protocol randomization to placebo or dutasteride and mandatory TRUS-guided biopsies at 2 yr and 4 yr. Percentage change in PV at 2 yr and 4 yr from baseline. We tested its association with baseline body mass index (BMI) groups of Obesity enhanced PV growth and attenuated PV reduction by dutasteride. The null interaction between obesity and dutasteride for PV change implies that the effect of obesity on dutasteride-treated men is likely a combination of dutasteride-driven PV reduction with obesity-driven PV growth rather than decreased dutasteride efficacy. Copyright © 2013 European Association of Urology. All rights reserved.

  3. 2,3-Dihydroxybenzoic acid attenuates kanamycin-induced volume reduction in mouse utricular type I hair cells

    Severinsen, Stig Åvall; Kirkegaard, Mette; Nyengaard, Jens Randel


    injection. Total volume of the utricle, as well as total number of hair and supporting cells, were estimated on light microscopic sections. Total volume and mean volume of hair cell types I and II and supporting cells were estimated on digital transmission electron micrographs. Total volume of the utricular...... macula, hair cell type I and supporting cells decreased significantly in animals injected with kanamycin but not in animals co-treated with DHB. Hair and supporting cell numbers remained unchanged in all three groups. In conclusion, the kanamycin-induced volume reduction of type I hair cells...

  4. 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

    Fast, Søren; Hegedus, Laszlo; Pacini, Furio


    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...

  5. Lung volume reduction surgery for emphysema: Radiologic findings; Valutazione radiologica nell`intervento di riduzione del volume polmonare per enfisema

    Bonfioli, Claudio; Motta, Fabio; Bergonzi, Marco; Urani, Antonio; Montali, Giuseppe [Ospedale Generale `San Giuseppe`, Milan (Italy). Servizio di Radiologia; Varoli, Federico; Vergani, Contardo; Roviaro, Gian Carlo [Ospedale Generale `San Giuseppe`, Milan (Italy). Divisione di Chirurgia


    Aim of this work is to present and discuss the radiologic protocol they have developed for the preoperative assessment of patients with severe pulmonary emphysema candidate to lung volume reduction surgery (LVRS). The operation aims at improving respiratory mechanics and reducing small airway obstruction by removing variable amounts of emphysematous parenchyma. January to September, 1996, twelve patients were submitted to LVRS. Before surgery all patients were examined with standard chest radiographs during maximal inspiration and expiration, chest Computed Tomography (CT), High Resolution Computed Tomography (HRCT) and air trapping quantitation on HRCT scans. Diaphragm and chest wall excursions, patterns, site and distribution of emphysema, as well as heterogeneity were investigated, Air trapping was quantitate with a dedicated software. Post-operative studies were carried out 2 months later in 6 patients and included: maximal inspiratory and expiratory chest radiographs and air trapping assessment on 3 standardized HRCT scans. All parameters considered improved in every patient. Radiologic studies proved to be of crucial importance for patient selection and LVRS planning. The diagnostic protocol adopted in their Hospital appears a valuable tool for both pre- and post-operative assessment of the patients candidate to LVRS.

  6. Does a volume reduction of the parietal lobe contribute to freezing of gait in Parkinson's disease?

    Rubino, Alfonso; Assogna, Francesca; Piras, Fabrizio; Di Battista, Maria Elena; Imperiale, Francesca; Chiapponi, Chiara; Spalletta, Gianfranco; Meco, Giuseppe


    Freezing of gait (FOG) is as a brief, episodic absence or marked reduction of forward progression of the feet despite the intention to walk. Structural neuroimaging studies on FOG in PD using volumetric techniques yielded variable and partially conflicting findings, probably reflecting the heterogeneity and complexity of the phenomenon. The aim of this study was to further explore the differences in local gray matter (GM) volume in patients with PD with and without FOG by using Voxel-Based Morphometry (VBM). We enrolled 26 patients (7 women and 19 men) with a diagnosis of PD in stable treatment with dopaminergic therapy. Thirteen patients classified as FOG+ were matched with thirteen non-freezer (FOG-) PD patients. All 26 participants underwent a detailed neuropsychological assessment as well as a VBM analysis derived from T1 weighted 3T MRI. The patient groups did not significantly differ for age, disease duration, H&Y stage, UPDRS part-III or educational attainment. No significant differences of cognitive profile emerged. PD-FOG+ patients showed a pattern of relative GM atrophy in left posterior parietal gyrus compared with PD-FOG-. Our results suggest that a specific pattern of cortical volume reduction involving posterior parietal cortex contributes to the occurrence of FOG in PD. These data agree with the growing body of evidence considering the parietal posterior cortex as an associative area involved in spatial control of motor behavior, par-taking in response selection to sensory evaluation. Copyright © 2014. Published by Elsevier Ltd.

  7. Inspiratory and expiratory computed tomographic volumetry for lung volume reduction surgery.

    Morimura, Yuki; Chen, Fengshi; Sonobe, Makoto; Date, Hiroshi


    Three-dimensional (3D) computed tomographic (CT) volumetry has been introduced into the field of thoracic surgery, and a combination of inspiratory and expiratory 3D-CT volumetry provides useful data on regional pulmonary function as well as the volume of individual lung lobes. We report herein a case of a 62-year-old man with severe emphysema who had undergone lung volume reduction surgery (LVRS) to assess this technique as a tool for the evaluation of regional lung function and volume before and after LVRS. His postoperative pulmonary function was maintained in good condition despite a gradual slight decrease 2 years after LVRS. This trend was also confirmed by a combination of inspiratory and expiratory 3D-CT volumetry. We confirm that a combination of inspiratory and expiratory 3D-CT volumetry might be effective for the preoperative assessment of LVRS in order to determine the amount of lung tissue to be resected as well as for postoperative evaluation. This novel technique could, therefore, be used more widely to assess local lung function.

  8. Data base on dose reduction research projects for nuclear power plants. Volume 5

    Khan, T.A.; Yu, C.K.; Roecklein, A.K. [Brookhaven National Lab., Upton, NY (United States)


    This is the fifth volume in a series of reports that provide information on dose reduction research and health physics technology or nuclear power plants. The information is taken from two of several databases maintained by Brookhaven National Laboratory`s ALARA Center for the Nuclear Regulatory Commission. The research section of the report covers dose reduction projects that are in the experimental or developmental phase. It includes topics such as steam generator degradation, decontamination, robotics, improvements in reactor materials, and inspection techniques. The section on health physics technology discusses dose reduction efforts that are in place or in the process of being implemented at nuclear power plants. A total of 105 new or updated projects are described. All project abstracts from this report are available to nuclear industry professionals with access to a fax machine through the ACEFAX system or a computer with a modem and the proper communications software through the ACE system. Detailed descriptions of how to access all the databases electronically are in the appendices of the report.

  9. Dimensionality Reduction on Multi-Dimensional Transfer Functions for Multi-Channel Volume Data Sets

    Kim, Han Suk; Schulze, Jürgen P.; Cone, Angela C.; Sosinsky, Gina E.; Martone, Maryann E.


    The design of transfer functions for volume rendering is a non-trivial task. This is particularly true for multi-channel data sets, where multiple data values exist for each voxel, which requires multi-dimensional transfer functions. In this paper, we propose a new method for multi-dimensional transfer function design. Our new method provides a framework to combine multiple computational approaches and pushes the boundary of gradient-based multi-dimensional transfer functions to multiple channels, while keeping the dimensionality of transfer functions at a manageable level, i.e., a maximum of three dimensions, which can be displayed visually in a straightforward way. Our approach utilizes channel intensity, gradient, curvature and texture properties of each voxel. Applying recently developed nonlinear dimensionality reduction algorithms reduces the high-dimensional data of the domain. In this paper, we use Isomap and Locally Linear Embedding as well as a traditional algorithm, Principle Component Analysis. Our results show that these dimensionality reduction algorithms significantly improve the transfer function design process without compromising visualization accuracy. We demonstrate the effectiveness of our new dimensionality reduction algorithms with two volumetric confocal microscopy data sets. PMID:21841914

  10. The Efficacy of Neoadjuvant Androgen Deprivation Therapy as a Prostate Volume Reduction before Brachytherapy for Clinically Localized Prostate Cancer



    Full Text Available From September 2003 to December 2005, 188 patients who visited our hospital and allied institutions for the purpose of prostate brachytherapy were administrated hormonal therapy for volume reductions before brachytherapy. The pretreatment and posttreatment of prostate volume using a transrectal ultrasound volumetric study and the types and duration of hormonal therapy were analyzed. We administered 91 patients with Luteinizing hormone-releasing hormone (LH-RH agonist, 49 patients with anti-androgen (bicaltamide/flutamide, and 48 patients with maximum androgen blockade (MAB. The duration of the hormonal therapy was 1-3 months for 49 patients, 4-6 months for 59 patients, 7-9 months for 40 patients, 10-12 months for 32 patients, and over 13 months for 8 patients. Before the initiation of hormonal therapy, the mean prostate volume was 35.12 ml (11.04-78.71 ml, and the average of prostate volume before and after hormonal therapy was 36.79 ml and 24.79 ml, respectively (a 32.4% reduction. The prostate volume reduction rate was 32.0% for the LH-RH agonist only, 18.1% for the anti-androgen only and 41.2% for the MAB. No statistically significant difference was observed for the duration of hormonal therapy between 3 groups. A three-month course of the neoadjuvant LH-RH agonist indicated a sufficient volume reduction effectiveness for a large prostate volume.

  11. Lung volume reduction surgery for the management of refractory dyspnea in chronic obstructive pulmonary disease.

    Shah, Asad A; D'Amico, Thomas A


    This review describes the role of lung volume reduction surgery (LVRS) for the management of refractory dyspnea and other debilitating conditions in patients with chronic obstructive pulmonary disease. Recent studies, including a randomized trial comparing LVRS to medical therapy, are analyzed. LVRS plus optimal medical therapy is superior to medical therapy alone in treating certain subsets of patients with severe emphysema. In patients with predominantly upper lobe emphysema and low-exercise capacity, LVRS not only improves symptoms of dyspnea and exercise intolerance, but also is associated with improved survival. Furthermore, LVRS has recently been shown to be superior to medical therapy in improving other quality of life parameters, such as nutritional status, sleep quality, and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe emphysema. LVRS is an effective strategy in the treatment of properly selected patients with COPD, improving survival and quality of life, including exercise tolerance, dyspnea, oxygen requirement and functional status.

  12. Interventional pulmonology for asthma and emphysema: bronchial thermoplasty and bronchoscopic lung volume reduction.

    Miller, Russell J; Murgu, Septimiu D


    Emphysema and asthma are responsible for economic and social burden. Altering the natural course of these diseases is a field of intense research. The National Emphysema Treatment Trial showed that lung volume reduction surgery (LVRS) could significantly reduce both morbidity and mortality in properly selected patients. LVRS is seldom performed, however, due to the high morbidity associated with the surgery. Numerous bronchoscopic interventions have been introduced with the goal of providing the clinical benefits of LVRS without the surgical complications. Thus far, these modalities have not produced the results once hoped. However, through active modification of both technique and patient selection, the role of minimally invasive modalities in the treatment of emphysema continues to evolve. Bronchial thermoplasty (BT) is a method of delivering controlled heat to airway mucosa with the goal of reducing airway smooth muscle mass and hence bronchoconstriction. In patients suffering from asthma who cannot achieve control with standard medical care, BT has been shown to be safe and improves symptoms, with long lasting benefit. BT does not seem to affect traditional markers of asthma severity such as forced expiratory volume in 1 second and questions remain regarding proper patient selection for this therapy and its true physiologic effects. This article is a review of bronchoscopic modalities for emphysema and asthma.

  13. Clinical study of simultaneous lung volume reduction surgery during resection of pulmonary or esophageal neoplasms

    TANG Yi-jun; WANG Chao-yang; WANG Cheng-de; DONG Yao-zhong


    Background If the emphysema lesions are not symmetrical, unilateral lung volume reduction surgery (LVRS) can be carried out on the more severe side. The aim of this research was to evaluate the feasibility and effects of LVRS performed simultaneously with resection of pulmonary and esophageal neoplasms.Methods Forty-five patients with pulmonary neoplasm and 37 patients with esophageal neoplasm were randomly assigned to group A or group B. In group A, LVRS was performed simultaneously on the same side as thoracotomy. In group B, only tumor resection was performed. The nonfunctional lung area was determined by preoperative chest computed tomography and lung ventilation/perfusion scan. The lung volume removed was about 20% to 30% of the lobes on one side. Preoperative and postoperative indexes including pulmonary function testing variables, arterial blood gas analysis variables, dyspnea scale, 6-minute walk distance, etc., were compared between the groups.Results There were no surgical deaths in this study. The postoperative forced vital capacity in 1 second, PaO_2, PaCO_2,dyspnea scale, and 6-minute walk distance were improved significantly in group A, whereas these indexes did not change or decreased slightly in group B.Conclusions For tumor patients who have associated emphysema, simultaneous LVRS not only increases the chance of receiving surgical therapy, but also improves the postoperative quality of life of the patient. LVRS has expanded thesurgical indication for tumor patients.

  14. Waste assay and mass balance for the decontamination and volume reduction system at LANL

    Gruetzmacher, Kathleen M.; Ferran, Scott G.; Garner, Scott E.; Romero, Mike J.; Christensen, Davis V.; Bustos, Roland M.


    The Decontamination and Volume Reduction System (DVRS) operated by the Solid Waste Operations (SWO) Group at Los Alamos National Laboratory (LANL) processes large volume, legacy radioactive waste items. Waste boxes, in sizes varying from 4 ft x 4 ft x 8 ft to 10 ft x 12 ft x 40 ft, are assayed prior to entry into the processing building. Inside the building, the waste items are removed from their container, decontaminated and/or size reduced if necessary, and repackaged for shipment to the Waste Isolation Pilot Plant (WIPP) or on-site low-level waste disposal. The repackaged items and any secondary waste produced (e.g., personal protective equipment) are assayed again at the end of the process and a mass balance is done to determine whether there is any significant hold-up material left in the DVRS building. The DVRS building is currently classed as a radiological facility, with a building limit of 0.52 Ci of Pu239 and Am241, and 0.62 Ci of Pu238, the most common radionuclides processed. This requires tight controls on the flow of nuclear material. The large volume of the initial waste packages, the (relatively) small amounts of radioactive material in them, and the tight ceiling on the building inventory require accurate field measurements of the nuclear material. This paper describes the radioactive waste measurement techniques, the computer modeling used to determine the amount of nuclear material present in a waste package, the building inventory database, and the DVRS process itself. Future plans include raising the limit on the nuclear material inventory allowed in the building to accommodate higher activity waste packages. All DOE sites performing decontamination and decommissioning of radioactive process equipment face challenges related to waste assay and inventory issues. This paper describes an ongoing operation, incorporating lessons learned over the life of the project to date.

  15. Developmentally Stable Whole-Brain Volume Reductions and Developmentally Sensitive Caudate and Putamen Volume Alterations in Those With Attention-Deficit/Hyperactivity Disorder and Their Unaffected Siblings

    Greven, Corina U.; Bralten, Janita; Mennes, Maarten; O'Dwyer, Laurence; van Hulzen, Kimm J. E.; Rommelse, Nanda; Schweren, Lizanne J. S.; Hoekstra, Pieter J.; Hartman, Catharina A.; Heslenfeld, Dirk; Oosterlaan, Jaap; Faraone, Stephen V.; Franke, Barbara; Zwiers, Marcel P.; Arias-Vasquez, Alejandro; Buitelaar, Jan K.


    IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is a heritable neurodevelopmental disorder. It has been linked to reductions in total brain volume and subcortical abnormalities. However, owing to heterogeneity within and between studies and limited sample sizes, findings on the neuroanato

  16. Goiter in portraits of Judith the Jewish heroine.

    Lazzeri, Davide; Castello, Manuel Francisco; Lippi, Donatella; Weisz, George M


    Judith was a legendary Hebrew heroine who beheaded the general Holofernes and saved the children of Israel from destruction by the Assyrian army. In the Book of Judith, which is still present in the Catholic and Orthodox Christian Bibles, Judith is presented as an illustrious woman who defeated the enemy using her virtue and fortitude. The present investigation has revealed 24 portraits in which Judith has been depicted with variable grades of thyroid gland enlargement on the scene where she decapitates Holofernes. There is no doubt that the integration of a slight thyroid enlargement in the paintings is a stylistic hallmark that portrays an idealized female beauty with a balanced neck and graceful body. The large extended goiter was probably depicted by the artists as a symbol of a powerful masculine body and her courage, and at the same time, it probably also reflects better anatomic accuracy and knowledge of artists from that period.

  17. Delayed Presentation of Forgotten Thyroid Goiter - 25 Years After Thyroidectomy.

    Khan, Fazal Wahab; Muhammad, Ayesha; Abbas, Mohsin; Bin Mahmood, Syed Usman; Fatima, Benish; Fatimi, Saulat H


    Forgotten goiter is a rare occurrence (2 - 16% of retrosternal thyroid cases) that depicts recurrence of retrosternal thyroid mass due to growth of remnant thyroid tissue overlooked during an initial thyroidectomy. The patient is a 59-year female who presented with dyspnea and stridor 25 years after total thyroidectomy. She was diagnosed as having a mediastinal mass on radiographic imaging. There were only localized pressure symptoms due to mass effect. The mass was excised employing an extra-cervical approach and using a partial sternotomy. The profuse extension of thyroid tissue, adherent to vital structures in the thorax and the extra-cervical thyroidectomy was a novel experience. The mass was completely excised and the patient's symptoms alleviated after the surgery. The patient recovered without any complications and there was no recurrence at 1 year of follow-up.

  18. Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism

    Duygu Yazgan Aksoy


    Full Text Available Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.

  19. [The role of nitrates in the genesis of goiter morbidity].

    Gatseva, P; Vladeva, S; Pavlov, K


    Epidemiologic study was carried out concerning the level of goitrous morbidity in the growing up individuals aged from 3 to 14 years, permanently living in a settlement with increased nitrate content in the drinking water and natural Iodine deficiency. The data for the incidence of the goitrous morbidity were compared with those of a control group of children. The investigation included a total of 325 children. A high percentage of goitrous morbidity was recorded in the observed by us settlement with increased nitrate content in the drinking water, respectfully 35% versus 8.1% in the control settlement. Low degree of juvenile goiter predominated with slight prevalence of the female sex. A statistically reliable difference (p < 0.001) in the incidence of goitrous morbidity in the observed by us settlement and the control settlement.

  20. Goiter in portraits of Judith the Jewish heroine

    Lazzeri, Davide; Castello, Manuel Francisco; Lippi, Donatella; Weisz, George M.


    Judith was a legendary Hebrew heroine who beheaded the general Holofernes and saved the children of Israel from destruction by the Assyrian army. In the Book of Judith, which is still present in the Catholic and Orthodox Christian Bibles, Judith is presented as an illustrious woman who defeated the enemy using her virtue and fortitude. The present investigation has revealed 24 portraits in which Judith has been depicted with variable grades of thyroid gland enlargement on the scene where she decapitates Holofernes. There is no doubt that the integration of a slight thyroid enlargement in the paintings is a stylistic hallmark that portrays an idealized female beauty with a balanced neck and graceful body. The large extended goiter was probably depicted by the artists as a symbol of a powerful masculine body and her courage, and at the same time, it probably also reflects better anatomic accuracy and knowledge of artists from that period. PMID:26904480

  1. Prophylaxis of postoperative hypocalcemia in patients with diffuse toxic goiter

    M. B. Gudieva


    Full Text Available In recent years, the surgical treatment of DTG includes extirpation of the thyroid gland that can lead to the development of postoperative hypocalcemia, which causes of development are under study. Up to now, there are no clear recommendations for prophylaxis of postoperative hypocalcemia. In this connection, it is actually to carry out additional research to explore the methods of prophylaxis of postoperative hypocalcemia. The study involved 57 patients with diffuse toxic goiter, who had extirpation of the thyroid gland in period from 2010 until 2015. According to results of the performed study, it has been shown that prophylactic administration of preparations of calcium and vitamin D reduces the risk of postoperative hypocalcemia for patients with vitamin D deficiency.

  2. Papillary Microcarcinoma in Multinodular Goiter with Lymphocytic Thyroiditis

    Javalgi A.P


    Full Text Available Multi nodular goitre (MNG is one of the common presentations of various thyroid diseases. Hitherto issue is whether MNG is significantly associated with malignancy. Various studies have reported a 7 to 17% incidence of malignancy in MNG; most common documented is papillary carcinoma. Here we present a case of 40 year old woman with complains of neck swelling, since 10 months. No history of hypertension and other endocrine disorders. The laboratory investigation shows subclinical hyperthyroidism. Ultrasonography (USG of anterior neck showed a hypoechoic nodule at right lobe. Cytological diagnosis of colloid goitre was made and hemithyroidectomy was performed and specimen sent for histopathology. The case on histopathology was diagnosed as papillary microcarcinoma in multinodular goiter with lymphocytic thyroiditis which was further confirmed by immunohistochemistry. Recent studies have suggested that the micro-carcinomas classically progress to a clinically evident disease if left untreated. The treatment of papillary microcarcinoma should be similar to papillary thyroid cancer.

  3. Fulminant mediastinitis after goiter recurrence surgery: a case report

    Mittag-Bonsch Martina


    Full Text Available Abstract Introduction Necrotizing soft tissue infection is a life-threatening disease characterized by rapid progressive inflammation and necrosis of the subcutaneous and deep fascia with or without involvement of the adjacent muscles. Case presentation We report the case of a 62-year-old Caucasian woman with goiter recurrence who underwent a right-sided hemithyroidectomy. Postoperatively, she developed fulminant mediastinitis caused by group A β-hemolytic streptococcus and septic shock. Our patient survived this rare life-threatening complication. Conclusions Initial atypical postoperative symptoms, such as personality changes or an unstable circulatory system, should lead a practitioner to consider the possibility of this severe complication and to begin therapy immediately.

  4. Radioiodine plus recombinant human thyrotropin do not cause acute airway compression and are effective in reducing multinodular goiter

    Albino, C.C., E-mail: [Instituto de Diabetes e Endocrinologia de Maringa, PR (Brazil); Graf, H.; Paz-Filho, G. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital das Clinicas. Servico de Endocrinologia e Metabologia; Diehl, L.A. [Universidade Estadual de Londrina (UEL), PR (Brazil); Olandoski, M.; Sabbag, A. [Pontificia Univ. Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Nucleo de Bioestatistica; Buchpiguel, C. [Universidade de Sao Paulo (USP), SP (Brazil). Dept. de Radiologia


    Recombinant human thyrotropin (rhTSH) reduces the activity of radioiodine required to treat multinodular goiter (MNG), but acute airway compression can be a life-threatening complication. In this prospective, randomized, double-blind, placebo-controlled study, we assessed the efficacy and safety (including airway compression) of different doses of rhTSH associated with a fixed activity of {sup 131}I for treating MNG. Euthyroid patients with MNG (69.3 +- 62.0 mL, 20 females, 2 males, 64 +- 7 years) received 0.1 mg (group I, N = 8) or 0.01 mg (group II, N = 6) rhTSH or placebo (group III, N = 8), 24 h before 1.11 GBq {sup 131}I. Radioactive iodine uptake was determined at baseline and 24 h after rhTSH and thyroid volume (TV, baseline and 6 and 12 months after treatment) and tracheal cross-sectional area (TCA, baseline and 2, 7, 180, and 360 days after rhTSH) were determined by magnetic resonance; antithyroid antibodies and thyroid hormones were determined at frequent intervals. After 6 months, TV decreased significantly in groups I (28.5 +- 17.6%) and II (21.6 +- 17.8%), but not in group III (2.7 +- 15.3%). After 12 months, TV decreased significantly in groups I (36.7 +- 18.1%) and II (37.4 +- 27.1%), but not in group III (19.0 +- 24.3%). No significant changes in TCA were observed. T3 and free T4 increased transiently during the first month. After 12 months, 7 patients were hypothyroid (N 3 in group I and N = 2 in groups II and III). rhTSH plus a 1.11-GBq fixed {sup 131}I activity did not cause acute or chronic changes in TCA. After 6 and 12 months, TV reduction was more pronounced among patients treated with rhTSH plus {sup 131}I (author)

  5. Rare Intensely Fluorine-18-fluorodeoxyglucose Avid Large Retropharyngeal Goiter in a Patient with Invasive Breast Carcinoma

    Bina Kviatkovsky


    Full Text Available Diffuse increased fluorine-18-fluorodeoxyglucose ( 18 F-FDG avidity on positron emission tomography (PET scans has been demonstrated in patients with chronic thyroiditis, likely secondary to increased inflammatory cell glucose uptake. A complex association has been demonstrated between breast cancer and thyroid disease, although the mechanism remains elusive. Development of chronic thyroiditis and/or goiter in breast cancer patients has been suggested to convey a more favorable prognosis. Goiter extension is almost exclusively into retrosternal space, with only a handful of cases reported with superior extension into retropharyngeal space. We present a rare case of a diffusely enlarged goiter extending superior and posterior into the retropharyngeal space with an associated intense 18 F-FDG avidity standardized uptake value maximum (SUV max of 16.1 in a patient with invasive ductal breast cancer. To our knowledge, this represents the first published case of diffusely 18 F-FDG avid goiter with retropharyngeal extension.

  6. A case of mediastinal goiter treated surgically using a clavicle-lifting technique

    Eisaku Ito


    Conclusion: Although further study is necessary, it appears that a transcervical approach using the clavicle-lifting technique may be an acceptable treatment for mediastinal goiters that extend to the aortic arch.

  7. Asupan Yodium, Ekskresi Yodium Urine, dan Goiter pada Wanita Usia Subur di Daerah Endemis Defisiensi Yodium

    Mutalazimah Mutalazimah


    Full Text Available Rendahnya asupan yodium berhubungan dengan ekskresi yodium urine (EYU yang tidak normal. Asupan yodium yang terlalu rendah juga menyebabkan kelenjar tiroid tidak mampu mempertahankan sekresi hormon yang adekuat sehingga timbul hipertrofi tiroid yang menimbulkan goiter. Penelitian ini bertujuan menguji hubungan asupan yodium, EYU, dan goiter pada wanita usia subur (WUS di daerah endemis defisiensi yodium. Penelitian observasional potong lintang ini dilakukan pada 115 WUS di Kecamatan Prambanan Sleman yang dipilih secara random. Asupan yodium diukur menggunakan metode food recall 24 jam, EYU diukur dengan metode acid digestion, dan goiter diukur dengan cara palpasi. Hubungan antarvariabel dianalisis dengan uji kai kuadrat. Hasil penelitian menunjukkan subjek dengan asupan yodium kurang sebanyak 83,5% dan asupan yodium cukup sebanyak 16,5%. Subjek dengan goiter sebanyak 13% dan tanpa goiter sebanyak 87%. Subjek defisiensi yodium sebanyak 15,7% (tingkat berat 2,6%; tingkat sedang 3,5%; tingkat ringan 9,6%, yang normal sebanyak 31,3%, sedangkan yang lebih sebanyak 20,8% dan ekses sebanyak 32,2%. Asupan yodium berhubungan dengan EYU, tetapi goiter tidak berhubungan dengan asupan yodium dan EYU. The low iodine intake, associated with insufficiency of urinary iodine concentration (UIC. Iodine intake is too low, also causes the thyroid gland is unable to maintain adequate hormone secretion, influence the thyroid hypertrophy that causes goitre. This study aimed to examine the relationship of iodine intake, UIC, and goiter on women of childbearing age in endemic areas of iodine deficiency. This cross-sectional observational study was performed 115 randomly selected women of childbearing age at sub-district of Prambanan, Sleman Regency. Iodine intake was measured using 24-hour food recall method, UIC measured by acid digestion method, and goiter measured by palpation method.The association between variables

  8. Medical geology of endemic goiter in Kalutara, Sri Lanka; distribution and possible causes.

    Fernando, G W A R; Liyanage, P L C L; Rajapaksha, Anushka Upamali; Vithanage, Meththika


    This study assesses the distribution of goiter in the Kalutara District, Sri Lanka in order to find causative factors for the occurrence of goiter even after the salt iodization. A questionnaire survey was conducted at the household level and at the same time iodine and selenium levels of the water sources were analyzed. Questionnaire survey results indicated the highest numbers of goiter patients in the northern part where the lowest were found in the southern sector which may be due to the presence of acid sulfate soils. Females were more susceptible and it even showed a transmittance between generations. Average iodine concentrations in subsurface water of goiter endemic regions are 28.25 ± 15.47 μg/L whereas non-goiter regions show identical values at 24.74 ± 18.29 μg/L. Surface water exhibited relatively high values at 30.87 ± 16.13 μg/L. Endemic goiter was reported in some isolated patches where iodine and selenium concentrations low, latter was <10 μg/L. The formation of acid sulfate soils in the marshy lands in Kalutara district may lead to transformation of biological available iodine oxidation into volatile iodine by humic substances, at the same time organic matter rich peaty soil may have strong held of iodine and selenium which again induced by low pH and high temperature were suggested as the instrumental factors in the endemic goiter in Kalutara district. Hence, geochemical features such as soil pH, organic matter and thick lateritic cap in the Kalutara goiter endemic area play a role in controlling the available selenium and iodine for food chain through plant uptake and in water.

  9. Effect of volume loading on the Frank-Starling relation during reductions in central blood volume in heat-stressed humans.

    Bundgaard-Nielsen, M; Wilson, T E; Seifert, T; Secher, N H; Crandall, C G


    During reductions in central blood volume while heat stressed, a greater decrease in stroke volume (SV) for a similar decrease in ventricular filling pressure, compared to normothermia, suggests that the heart is operating on a steeper portion of a Frank-Starling curve. If so, volume loading of heat-stressed individuals would shift the operating point to a flatter portion of the heat stress Frank-Starling curve thereby attenuating the reduction in SV during subsequent decreases in central blood volume. To investigate this hypothesis, right heart catheterization was performed in eight males from whom pulmonary capillary wedge pressure (PCWP), central venous pressure and SV (via thermodilution) were obtained while central blood volume was reduced via lower-body negative pressure (LBNP) during normothermia, whole-body heating (increase in blood temperature 1 degrees C), and during whole-body heating after intravascular volume expansion. Volume expansion was accomplished by administration of a combination of a synthetic colloid (HES 130/0.4, Voluven) and saline. Before LBNP, SV was not affected by heating (122 +/- 30 ml; mean +/- s.d.) compared to normothermia (110 +/- 20 ml; P = 0.06). However, subsequent volume loading increased SV to 143 +/- 29 ml (P = 0.003). LBNP provoked a larger decrease in SV relative to the decrease in PCWP during heating (8.6 +/- 1.9 ml mmHg(1)) compared to normothermia (4.5 +/- 3.0 ml mmHg(1), P = 0.02). After volume loading while heat stressed, the reduction in the SV to PCWP ratio during LBNP was comparable to that observed during normothermia (4.8 +/- 2.3 ml mmHg(1); P = 0.78). These data support the hypothesis that a Frank-Starling mechanism contributes to compromised blood pressure control during simulated haemorrhage in heat-stressed individuals, and extend those findings by showing that volume infusion corrects this deficit by shifting the operating point to a flatter portion of the heat stress Frank-Starling curve.

  10. Oxygen as a stimulant: Dramatic reduction of sewage sludge volumes; Sauerstoff als Stimulanz: Der Klaerschlammanfall laesst sich dramatisch verringern

    Croissant, B. [OWAS Odenwaelder Wasser- und Abwasser-Service GmbH, Erbach (Germany); Stark, O. [Stark-Consult, Duesseldorf (Germany)


    Sludge volumes can be reduced significantly by optimising the biological processes in a sewage plant. During a trial period of eight months, a 45 percent reduction was achieved on average. Secondary effects were improved carbon and nitrate reduction. [German] Durch eine Optmierung der biologischen Prozesse in der Klaeranlage ist moeglich, den Ueberschussschlammanfall deutlich zu senken. Ueber einen Zeitraum von acht Monaten konnte der mittlere Schlammanfall um 45 Prozent reduziert werden. Sekundaere Effekte des Verfahrens waren eine verbesserte Kohlenstoffablauf- und Nitratablaufkonzentration. (orig.)

  11. Bronchoscopic lung volume reduction by endobronchial valve in advanced emphysema: the first Asian report

    Park TS


    Full Text Available Tai Sun Park,1 Yoonki Hong,2 Jae Seung Lee,1 Sang Young Oh,3 Sang Min Lee,3 Namkug Kim,3 Joon Beom Seo,3 Yeon-Mok Oh,1 Sang-Do Lee,1 Sei Won Lee1 1Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 2Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea; 3Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Purpose: Endobronchial valve (EBV therapy is increasingly being seen as a therapeutic option for advanced emphysema, but its clinical utility in Asian populations, who may have different phenotypes to other ethnic populations, has not been assessed.Patients and methods: This prospective open-label single-arm clinical trial examined the clinical efficacy and the safety of EBV in 43 consecutive patients (mean age 68.4±7.5, forced expiratory volume in 1 second [FEV1] 24.5%±10.7% predicted, residual volume 208.7%±47.9% predicted with severe emphysema with complete fissure and no collateral ventilation in a tertiary referral hospital in Korea.Results: Compared to baseline, the patients exhibited significant improvements 6 months after EBV therapy in terms of FEV1 (from 0.68±0.26 L to 0.92±0.40 L; P<0.001, 6-minute walk distance (from 233.5±114.8 m to 299.6±87.5 m; P=0.012, modified Medical Research Council dyspnea scale (from 3.7±0.6 to 2.4±1.2; P<0.001, and St George’s Respiratory Questionnaire (from 65.59±13.07 to 53.76±11.40; P=0.028. Nine patients (20.9% had a tuberculosis scar, but these scars did not affect target lobe volume reduction or pneumothorax frequency. Thirteen patients had adverse events, ten (23.3% developed pneumothorax, which included one death due to tension pneumothorax.Conclusion: EBV therapy was as effective and safe in Korean

  12. Risk factors for goiter in a previously iodine-deficient region.

    Völzke, H; Schwahn, C; Kohlmann, T; Kramer, A; Robinson, D M; John, U; Meng, W


    Little information exists from formerly iodine-deficient areas regarding gender-specific risk factors for goiter and their synergisms. The aim of the present study was to investigate such gender-specific risk factors and their interactions in a large population-based sample. The Study of Health in Pomerania (SHIP) comprised 4310 randomly selected participants, aged 20 - 79 years. SHIP was performed in a previously iodine-deficient region. Data from 3915 participants with no known thyroid disorders were analyzed. Goiter was determined by thyroid ultrasound. Sociodemographic characteristics, smoking and alcohol drinking habits, marital status, education level, urine thiocyanate concentrations, and specifically in women, parity and previous or current use of oral contraceptives and hormone replacement therapy, were considered as candidate risk factors for multivariable statistical tests. Only two variables, an advanced age and current smoking, were independently associated with an increased risk for goiter in both genders. Analyses further revealed specific risk factor profiles for goiter which were different among men, pre- and postmenopausal women. We conclude that besides previous iodine deficiency, other risk factors for goiter exist which differ between gender. Among the avoidable risk factors, current smoking was strongly associated with the risk of goiter in men and women. These findings should influence activities which are intended to prevent thyroid disease.

  13. Emphysema. Imaging for endoscopic lung volume reduction; Lungenemphysem. Bildgebung bei endoskopischer Lungenvolumenreduktion

    Storbeck, B. [LungenClinic Grosshansdorf (Germany). Dept. of Radiology; Schroeder, T.H. [Amalie Sieveking-Hospital, Diagnostic and Interventional Radiology, Hamburg (Germany); Oldigs, M.; Rabe, K.F. [LungenClinic Grosshansdorf (Germany). Dept. of Pulmonology; Weber, C. [Amalie Sieveking-Hospital, Diagnostic and Interventional Radiology, Hamburg (Germany); University Medical Center Hamburg-Eppendorf (Germany). Diagnostic and Interventional Radiology


    Chronic obstructive pulmonary disease (COPD) is characterized by two entities, the more airway-predominant type (''bronchitis'') on the one hand, and emphysema-predominant type on the other. Imaging via high-resolution computed tomography plays an important role in phenotyping COPD. For patients with advanced lung emphysema, new endoscopic lung volume reduction therapies (ELVR) have been developed. Proper selection of suitable patients requires thin-section reconstruction of volumetric CT image data sets also in coronal and sagittal orientation are required. In the current manuscript we will describe emphysema subtypes (centrilobular, paraseptal, panlobular), options for quantifying emphysema and this importance of regional distribution (homogeneous or heterogeneous, target area) as this is crucial for patient selection. Analysis of the interlobular fissures is obligatory despite the lack of standardization, as incomplete fissures indicate collateral ventilation (CV) via parenchymal bridges, which is an important criterion in choosing endoscopic methods of LVR. Every radiologist should be familiar with modern LVR therapies such as valves and coils, and furthermore should know what a lung doctor expects from radiologic evaluation (before and after ELVR). Finally we present a checklist as a quick reference for all steps concerning imaging for ELVR.

  14. Effects of radiation dose reduction in Volume Perfusion CT imaging of acute ischemic stroke

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Brockmann, Carolin; Afat, Saif; Pjontek, Rastislav; Nikobashman, Omid; Brockmann, Marc A.; Wiesmann, Martin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Yang, Zepa; Kim, Changwon [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Jong Hyo [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Center for Medical-IT Convergence Technology Research, Advanced Institute of Convergence Technology, Suwon (Korea, Republic of)


    To examine the influence of radiation dose reduction on image quality and sensitivity of Volume Perfusion CT (VPCT) maps regarding the detection of ischemic brain lesions. VPCT data of 20 patients with suspected ischemic stroke acquired at 80 kV and 180 mAs were included. Using realistic reduced-dose simulation, low-dose VPCT datasets with 144 mAs, 108 mAs, 72 mAs and 36 mAs (80 %, 60 %, 40 % and 20 % of the original levels) were generated, resulting in a total of 100 datasets. Perfusion maps were created and signal-to-noise-ratio (SNR) measurements were performed. Qualitative analyses were conducted by two blinded readers, who also assessed the presence/absence of ischemic lesions and scored CBV and CBF maps using a modified ASPECTS-score. SNR of all low-dose datasets were significantly lower than those of the original datasets (p <.05). All datasets down to 72 mAs (40 %) yielded sufficient image quality and high sensitivity with excellent inter-observer-agreements, whereas 36 mAs datasets (20 %) yielded poor image quality in 15 % of the cases with lower sensitivity and inter-observer-agreements. Low-dose VPCT using decreased tube currents down to 72 mAs (40 % of original radiation dose) produces sufficient perfusion maps for the detection of ischemic brain lesions. (orig.)

  15. Reduction of Pulmonary Function After Surgical Lung Resections of Different Volume

    Cukic, Vesna


    Introduction: In recent years an increasing number of lung resections are being done because of the rising prevalence of lung cancer that occurs mainly in patients with limited lung function, what is caused with common etiologic factor - smoking cigarettes. Objective: To determine how big the loss of lung function is after surgical resection of lung of different range. Methods: The study was done on 58 patients operated at the Clinic for thoracic surgery KCU Sarajevo, previously treated at the Clinic for pulmonary diseases “Podhrastovi” in the period from 01.06.2012. to 01.06.2014. The following resections were done: pulmectomy (left, right), lobectomy (upper, lower: left and right). The values of postoperative pulmonary function were compared with preoperative ones. As a parameter of lung function we used FEV1 (forced expiratory volume in one second), and changes in FEV1 are expressed in liters and in percentage of the recorded preoperative and normal values of FEV1. Measurements of lung function were performed seven days before and 2 months after surgery. Results: Postoperative FEV1 was decreased compared to preoperative values. After pulmectomy the maximum reduction of FEV1 was 44%, and after lobectomy it was 22% of the preoperative values. Conclusion: Patients with airway obstruction are limited in their daily life before the surgery, and an additional loss of lung tissue after resection contributes to their inability. Potential benefits of lung resection surgery should be balanced in relation to postoperative morbidity and mortality. PMID:25568542

  16. Ion Recognition Approach to Volume Reduction of Alkaline Tank Waste by Separation of Sodium Salts

    Moyer, Bruce A.; Bonnesen, Peter V.; Custelcean, Radu; Delmau, Laetitia H.; Engle, Nancy L.; Kang, Hyun-Ah; Keever, Tamara J.; Marchand, Alan P.; Gadthula, Srinivas; Gore, Vinayak K.; Huang, Zilin; Sivappa, Rasapalli; Tirunahari, Pavan K.; Levitskaia, Tatiana G.; Lumetta, Gregg J.


    The purpose of this research involving collaboration between Oak Ridge National Laboratory (ORNL) and Pacific Northwest National Laboratory (PNNL) is to explore new approaches to the separation of sodium hydroxide, sodium nitrate, and other sodium salts from high-level alkaline tank waste. The principal potential benefit is a major reduction in disposed waste volume, obviating the building of expensive new waste tanks and reducing the costs of vitrification. Principles of ion recognition are being researched toward discovery of liquid-liquid extraction systems that selectively separate sodium hydroxide and sodium nitrate from other waste components. The successful concept of pseudo hydroxide extraction using fluorinated alcohols and phenols is being developed at ORNL and PNNL toward a greater understanding of the controlling equilibria, role of solvation, and of synergistic effects involving crown ethers. Synthesis efforts are being directed toward enhanced sodium binding by crown ethers, both neutral and proton-ionizable. Studies with real tank waste at PNNL will provide feedback toward solvent compositions that have promising properties.

  17. Evaluation of patients undergoing lung volume reduction surgery: Ancillary information available from computed tomography

    Cleverley, Joanne R.; Desai, Sujal R.; Wells, Athol U.; Koyama, Hiroshi; Eastick, Sian; Schmidt, Maria A.; Charrier, Clare L.; Gatehouse, Peter D.; Goldstraw, Peter; Pepper, John R.; Geddes, Duncan M.; Hansell, David M


    AIM: A number of imaging techniques have been used for the pre-operative assessment of patients for lung volume reduction surgery (LVRS). We evaluated whether data currently acquired from perfusion scintigrams and cine MR of the diaphragm are obtainable from high resolution CT (HRCT) of the thorax. MATERIALS AND METHODS: Thirty patients taking part in a randomized controlled trial of LVRS against maximal medical therapy were evaluated. HRCT examinations (n= 30) were scored for (i) the extent and distribution of emphysema; (ii) the extent of normal pulmonary vasculature; and (iii) diaphragmatic contour, apparent defects and herniation. On scintigraphy, (n28), perfusion of the lower thirds of both lungs, as a proportion of total lung perfusion (LZ/T{sub PERF}), was expressed as a percentage of predicted values (derived from 10 normal control subjects). On cine MR (n= 25) hemidiaphragmatic excursion and coordination were recorded. RESULTS: Extensive emphysema was present on HRCT (60% {+-} 13.2%). There was strong correlation between the extent of normal pulmonary vasculature on HRCT and on perfusion scanning (r{sub s}= 0.85, P< 0.00005). Hemidiaphragmatic incoordination on MR was weakly associated with hemidiaphragmatic eventration on HRCT (P0.04). CONCLUSION: The strong correlation between lung perfusion assessed by HRCT and lung perfusion on scintigraphy suggests that perfusion scintigraphy is superfluous in the pre-operative evaluation of patients with emphysema for LVRS. Cleverley, J.R. (2000)

  18. [Effect of lung volume reduction surgery (LVRS) on nutritional status in patients with COPD].

    Kobayashi, Atsushi; Yoshikawa, Masanori; Kushibe, Keiji; Takenaka, Hideaki; Hukuoka, Atsuhiko; Tamaki, Shinji; Kimura, Hiroshi


    The beneficial effects of lung volume reduction surgery (LVRS) on patients with severe chronic obstructive pulmonary disease (COPD) on pulmonary function and exercise performance has been established. However, the impact on nutritional status and prognosis has not been demonstrated. In the present study, we investigated the changes in nutritional status in COPD patients undergoing bilateral thoracoscopic LVRS and also analyzed the relationship between nutritional status and postoperative complications and prognosis. After LVRS, body weight, fat-free mass (FFM) and caloric intake were significantly increased. Increase in FFM correlated significantly with improvement in exercise performance. In underweight patients before LVRS, the incidence of post-operative complications was significantly higher than in normal-weight patients, and a patient who was moderately-to-severely underweight (% ideal body weight nutritional status after LVRS contributes to improvement in exercise performance, and that preoperative nutritional status has a significant impact on postoperative morbidity and mortality. From our data, we concluded that preoperative nutritional assessment is an important part of the preoperative evaluation of LVRS, and that LVRS provides nutritional benefits for underweight patients with severe COPD.

  19. Xenobiotic metabolizing enzyme gene polymorphisms predict response to lung volume reduction surgery

    DeMeo Dawn L


    Full Text Available Abstract Background In the National Emphysema Treatment Trial (NETT, marked variability in response to lung volume reduction surgery (LVRS was observed. We sought to identify genetic differences which may explain some of this variability. Methods In 203 subjects from the NETT Genetics Ancillary Study, four outcome measures were used to define response to LVRS at six months: modified BODE index, post-bronchodilator FEV1, maximum work achieved on a cardiopulmonary exercise test, and University of California, San Diego shortness of breath questionnaire. Sixty-four single nucleotide polymorphisms (SNPs were genotyped in five genes previously shown to be associated with chronic obstructive pulmonary disease susceptibility, exercise capacity, or emphysema distribution. Results A SNP upstream from glutathione S-transferase pi (GSTP1; p = 0.003 and a coding SNP in microsomal epoxide hydrolase (EPHX1; p = 0.02 were each associated with change in BODE score. These effects appeared to be strongest in patients in the non-upper lobe predominant, low exercise subgroup. A promoter SNP in EPHX1 was associated with change in BODE score (p = 0.008, with the strongest effects in patients with upper lobe predominant emphysema and low exercise capacity. One additional SNP in GSTP1 and three additional SNPs in EPHX1 were associated (p Conclusion Genetic variants in GSTP1 and EPHX1, two genes encoding xenobiotic metabolizing enzymes, were predictive of response to LVRS. These polymorphisms may identify patients most likely to benefit from LVRS.

  20. Effects of tongue volume reduction on craniofacial growth: A longitudinal study on orofacial skeletons and dental arches.

    Liu, Zi-Jun; Shcherbatyy, Volodymyr; Gu, Gaoman; Perkins, Jonathan A


    The interaction between tongue size/volume and craniofacial skeletal growth is essential for understanding the mechanism of specific types of malocclusion and objectively measuring outcomes of various surgical and/or orthodontic treatments. Currently available information on this interaction is limited. This study was designed to examine how tongue body volume reduction affects craniofacial skeleton and dental arch formation during the rapid growth period in five 12-week-old Yucatan minipig sibling pairs. One of each pair received a standardized reduction glossectomy to reduce tongue volume by 15-17% (reduction group), and the other had the reduction glossectomy incisions without tissue removal (sham group). Before surgery, five stainless steel screws were implanted into standardized craniofacial skeletal locations. A series of cephalograms, lateral and axial, were obtained longitudinally at 1 week preoperative, and 2 and 4 weeks postoperative. These images were traced using superimposition, and linear and angular variables were measured digitally. Upon euthanasia, direct osteometric measurements were obtained from harvested skulls. Five en-bloc bone pieces were further cut for bone mineral examination by dual photon/energy X-ray absorptiometry (DEXA). The results indicate that: (1) while daily food consumption and weekly body weight were not significantly affected, tongue volume reduction showed an overall negative effect on the linear expansion of craniofacial skeletons; (2) premaxilla and mandibular symphysis lengths, and anterior dental arch width were significantly less in reduction than sham animals at 2 and/or 4 weeks after the surgery; (3) both premaxilla/maxilla and mandible bone mineral density and content were lower in reduction than sham animals, significantly lower in anterior mandible; (4) craniofacial skeletal and dental arch size were significantly smaller in reduction than sham animals, being most significant in the mandibular anterior length and

  1. Occupational dose reduction at nuclear power plants: Annotated bibliography of selected readings in radiation protection and ALARA. Volume 7

    Kaurin, D.G.; Khan, T.A.; Sullivan, S.G.; Baum, J.W. [Brookhaven National Lab., Upton, NY (United States)


    The ALARA Center at Brookhaven National Laboratory publishes a series of bibliographies of selected readings in radiation protection and ALARA in the continuing effort to collect and disseminate information on radiation dose reduction at nuclear power plants. This is volume 7 of the series. The abstracts in this bibliography were selected from proceedings of technical meetings and conferences, journals, research reports, and searches of the Energy Science and Technology database of the US Department of Energy. The subject material of these abstracts relates to radiation protection and dose reduction, and ranges from use of robotics to operational health physics, to water chemistry. Material on the design, planning, and management of nuclear power stations is included, as well as information on decommissioning and safe storage efforts. Volume 7 contains 293 abstract, an author index, and a subject index. The author index is specific for this volume. The subject index is cumulative and lists all abstract numbers from volumes 1 to 7. The numbers in boldface indicate the abstracts in this volume; the numbers not in boldface represent abstracts in previous volumes.

  2. Occupational dose reduction at nuclear power plants: Annotated bibliography of selected readings in radiation protection and ALARA. Volume 8

    Sullivan, S.G.; Khan, T.A.; Xie, J.W. [Brookhaven National Lab., Upton, NY (United States)


    The ALARA Center at Brookhaven National Laboratory publishes a series of bibliographies of selected readings in radiation protection and ALARA in a continuing effort to collect and disseminate information on radiation dose reduction at nuclear power plants. This volume 8 of the series. The abstracts in this bibliography were selected form proceedings of technical meetings and conference journals, research reports, and searches of the Energy Science and Technology database of the US Department of Energy. The subject material of these abstracts relates to the many aspects of radiation protection and dose reduction, and ranges form use of robotics, to operational health physics, to water chemistry. Material on the design, planning, and management of nuclear power stations is included, as well as information on decommissioning and safe storage efforts. Volume 8 contains 232 abstracts, an author index, and a subject index. The author index is specific for this volume. The subject index is cumulative and lists all abstract numbers from volumes 1 to 8. The numbers in boldface indicate the abstracts in this volume; the numbers not in boldface represent abstracts in previous volumes.

  3. Dyshormonogenetic goiter and associated non-thyroidal anomalies

    Khalid J Farooqui


    Full Text Available Background: Dyshormonogenetic goiter (DG refers to familial goitres owing to an inherited defect in the metabolism of thyroid hormones and accounts for 10-15% of all cases of congenital hypothyroidism. Aim and Objective: To identify dysmorphic features, cardiac and urogenital anomalies in patients with DG following in the pediatric endocrinology clinic. Materials and Methods: Eight adolescents following the pediatric endocrinology clinic for hypothyroidism and associated stigmata were identified with dyshormonogenesis using 99mTc radionuclide thyroid scintigraphy and confirmation by the Perchlorate discharge test during a 6-month period from January to July 2012. Screening for associated malformations was done using clinical examination, echocardiography and ultrasonography of abdomen. Results: The eight patients (two boys and six girls had a mean age of 9.87 years. The mean duration of goitre was 36.12 months. Two patients had mental retardation and delayed developmental milestones one of whom had ectopic left kidney on renal scintigraphy. Mitral regurgitation was seen in one patient whereas renal anomalies in the form of ectopic kidney and small/contracted kidney with grade III hydronephrosis was seen in two patients. Penoscrotal hypospadias was identified in one of the patients who also had small/contracted kidney with grade III hydronephrosis and underwent pyeloplasty for the same. Dysmorphic features in the form of high arched palate, depressed nasal bridge and low set ears was seen in one patient. Conclusion: DG is associated with other extra-thyroidal congenital anomaly, some of which may need to be treated.

  4. Forgotten goiter: Diagnosis and management. A case report and literature review.

    Patel, Kunal M; Parsons, Chase C


    A mediastinal thyroid mass discovered years after a total thyroidectomy represents an unusual and uncommon clinical situation. Few cases have been reported and controversy exists regarding the etiology of this ectopic thyroid tissue as well as the optimal surgical approach for resection. We herein describe a case of a mediastinal thyroid goiter discovered five years after a total thyroidectomy. A 54-year-old Hispanic female was diagnosed with a diffuse cervical goiter secondary to Hashimoto's Thyroiditis and subsequently underwent a total thyroidectomy. Five years later the patient had a chest X-ray as part of a preoperative evaluation for an unrelated and elective surgical procedure. Significant tracheal deviation was identified. A computed tomography scan was obtained and demonstrated a well encapsulated mass in the superior mediastinum resulting in tracheal deviation and compression. This "forgotten" goiter was successfully resected utilizing a standard cervical approach and the patient recovered uneventfully. A thyroid mass within the mediastinum following a total thyroidectomy is a condition often referred to as "forgotten goiter". Prior reported cases are few, and data is limited, with some uncertainty remaining as to the exact origin of this ectopic thyroid tissue. Possible etiologies include an incomplete removal of the thyroid gland during initial cervical thyroidectomy, or perhaps an autonomous intrathoracic goiter (AIG) - a thyroid gland located in the mediastinum, independent and with no parenchymatous or vascular connection with the cervical thyroid gland. A trans-thoracic or sternal splitting approach is generally not required for resection of a mediastinal goiter and our experience confirms that the case of the "forgotten goiter" can be safely approached through a cervical incision as well. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. Impact of endoscopic lung volume reduction on right ventricular myocardial function.

    Carmen Pizarro

    Full Text Available Endoscopic lung volume reduction (ELVR provides a minimally invasive therapy for patients with severe lung emphysema. As its impact on right ventricular (RtV function is undefined, we examined the extent of RtV functional changes following ELVR, as assessed by use of speckle tracking-based RtV deformation analysis.We enrolled 32 patients with severe emphysematous COPD scheduled for bronchoscopic LVR using endobronchial valves (Zephyr, PulmonX, Inc., comprising 16 matched clinical responders and 16 non-responders. Echocardiography was conducted one day prior to ELVR and at an eight-week postprocedural interval.Patients were predominantly of late middle-age (65.8 ± 8.7 yrs, male (62.5% and presented advanced COPD emphysema (means FEV1 and RV: 32.6% and 239.1% of predicted, respectively. After ELVR, RtV apical longitudinal strain improved significantly in the total study cohort (-7.96 ± 7.02% vs. -13.35 ± 11.48%, p = 0.04, whereas there were no significant changes in other parameters of RtV function such as RtV global longitudinal strain, TAPSE or pulmonary arterial systolic pressure. In responding patients, 6MWT-improvement correlated with a decrease in NT-proBNP (Pearson´s r: -0.53, p = 0.03. However, clinical non-responders did not exhibit any RtV functional improvement.ELVR beneficially impacts RtV functional parameters. Speckle tracking-based RtV apical longitudinal strain analysis allows early determination of RtV contractile gain and identification of clinical responsiveness.

  6. Animal models of disease: feline hyperthyroidism: an animal model for toxic nodular goiter.

    Peterson, Mark E


    Since first discovered just 35 years ago, the incidence of spontaneous feline hyperthyroidism has increased dramatically to the extent that it is now one of the most common disorders seen in middle-aged to senior domestic cats. Hyperthyroid cat goiters contain single or multiple autonomously (i.e. TSH-independent) functioning and growing thyroid nodules. Thus, hyperthyroidism in cats is clinically and histologically similar to toxic nodular goiter in humans. The disease in cats is mechanistically different from Graves' disease, because neither the hyperfunction nor growth of these nodules depends on extrathyroidal circulating stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells, but iodine deficiency, other nutritional goitrogens, or environmental disruptors may play a role in the disease pathogenesis. Clinical features of feline toxic nodular goiter include one or more palpable thyroid nodules, together with signs of hyperthyroidism (e.g. weight loss despite an increased appetite). Diagnosis of feline hyperthyroidism is confirmed by finding the increased serum concentrations of thyroxine and triiodothyronine, undetectable serum TSH concentrations, or increased thyroid uptake of radioiodine. Thyroid scintigraphy demonstrates a heterogeneous pattern of increased radionuclide uptake, most commonly into both thyroid lobes. Treatment options for toxic nodular goiter in cats are similar to that used in humans and include surgical thyroidectomy, radioiodine, and antithyroid drugs. Most authorities agree that ablative therapy with radioiodine is the treatment of choice for most cats with toxic nodular goiter, because the animals are older, and the disease will never go into remission.

  7. Resonant Mode Reduction in Radiofrequency Volume Coils for Ultrahigh Field Magnetic Resonance Imaging

    Xiaoliang Zhang


    Full Text Available In a multimodal volume coil, only one mode can generate homogeneous Radiofrequency (RF field for Magnetic Resonance Imaging. The existence of other modes may increase the volume coil design difficulties and potentially decreases coil performance. In this study, we introduce common-mode resonator technique to high and ultrahigh field volume coil designs to reduce the resonant mode while maintain the homogeneity of the RF field. To investigate the design method, the common-mode resonator was realized by using a microstrip line which was split along the central to become a pair of parallel transmission lines within which common-mode currents exist. Eight common-mode resonators were placed equidistantly along the circumference of a low loss dielectric cylinder to form a volume coil. Theoretical analysis and comparison between the 16-strut common-mode volume coil and a conventional 16-strut volume coil in terms of RF field homogeneity and efficiency was performed using Finite-Difference Time-Domain (FDTD method at 298.2 MHz. MR imaging experiments were performed by using a prototype of the common-mode volume coil on a whole body 7 Tesla scanner. FDTD simulation results showed the reduced number of resonant modes of the common-mode volume coil over the conventional volume coil, while the RF field homogeneity of the two type volume coils was kept at the same level. MR imaging of a water phantom and a kiwi fruit showing the feasibility of the proposed method for simplifying the volume coil design is also presented.

  8. Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

    Haj Mohammad, Nadia; Kamphuis, Martijn; Hulshof, Maarten C C M; Lutkenhaus, Lotte J; Gisbertz, Suzanne S; Bergman, Jacques J G H M; de Bruin-Bon, H A C M Rianne; Geijsen, Elisabeth D; Bel, Arjan; Boekholdt, S Mathijs; van Laarhoven, Hanneke W M


    BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in cli

  9. A numerical study on localized volume reduction in elastic media: some insights on the mechanics of anticracks

    Katsman, R; Scher, H


    Porous rocks, subjected to compressive stress, often undergo mechanical compaction via grain crushing and grain rearrangement, and chemical compaction by pressure solution. Such volume reduction processes are known to spontaneously localize under certain conditions, creating compaction and compacting shear bands, solution-seams, and stylolites. However the localization process is poorly understood. The formation and propagation of compaction bands has recently been studied using an elasto-plastic Spring Network Model [Katsman, Aharonov, and Scher, 2005]. In the current paper, the same technique was employed to systematically analyze localized volume reduction (LVR) defects and their interactions with the surrounding elastic media, i. e., the stress distribution around an LVR region. Simulation results show that LVR regions experience stress concentrations at their tips, reminiscent of Mode I cracks. However, aside from this similarity point, comparison of stress around LVR regions to stress around cracks reve...

  10. Effectiveness of Radioiodine Treatment for Toxic Nodular Goiter

    Hatice Şakı


    Full Text Available Objective: The aim of this retrospective study is to evaluate the treatment outcomes in patients with toxic nodular goiter (TNG that received radioiodine treatment (RAIT and to determine the influence of age, gender, nodule size, I-131 dose, underlying etiology and antithyroid drugs on the outcomes of RAIT. Methods: Two hundred thirty three patients (mean 64±10 years old with TNG that received RAIT were included in the study. Treatment success was analyzed according to demographic (age and gender and clinical data (thyroid function tests before and after RAIT, thyroid sonography and scintigraphy, I-131 dose, antithyroid drugs. A fixed dose of 555 MBq was administered to patients with nodules smaller than 2 cm in diameter and of 740 MBq to patients with nodules larger than 2 cm. Hyperthyroidism treatment success was defined as achieving hypothyroidism or euthyroidism six months after RAIT. Results: In our study, the cure rate was 93.9% six months after RAIT. Hypothyroidism was observed in 74 (31.7% patients, and euthyroidism was achieved in 145 (62.2% patients while 14 (6% patients remained in hyperthyroid state. Age and gender did not affect treatment outcomes. No correlation was found between underlying etiology or antithyroid drugs and therapeutic effectiveness. The effectiveness of RAIT was better in patients with nodules smaller than 2 cm. Conclusion: We observed that high cure rates were obtained in patients with TNG with 555 MBq and 740 MBq doses of I-131. While nodule diameter and RAI dose are important factors for treatment efficacy; age, gender, underlying etiology and antithyroid drugs do not affect the outcome of RAIT.


    Praveen Kumar


    Full Text Available The incidence of malignancy in nodular goiter has been found to vary from 4% to 17%. Our aim is to determine the incidence of malignancy in nodular goiter by doing the histopathological examination of thyroidectomy specimens. MATERIALS AND METHODS: This retrospective, observational study was carried out on patients who are undergone thyroidectomy for clinically diagnosed nodular goiter in Fr . Muller Medical College Hospital during 2012 - 2014 (3 yrs. All the operated specimens were subjected to a histopathological examination to determine the incidence of malignancy. RESULTS: Among the 258 nodular goitre cases which were studied, 21 (8.1% cases contained malignant foci. Among them, papillary carcinoma was the most common type of malignancy observed. CONCLUSION: The risk of malignancy in nodular goitre should not to be underestimated. Total/ Near - total thyroidectomy is the preferred operation. All the operated specimens should be sent for histopathological examination

  12. Influence of thyroid volume reduction on absorbed dose in 131I therapy studied by using Geant4 Monte Carlo simulation

    Ziaur, Rahman; Sikander, M. Mirza; Waheed, Arshed; Nasir, M. Mirza; Waheed, Ahmed


    A simulation study has been performed to quantify the effect of volume reduction on the thyroid absorbed dose per decay and to investigate the variation of energy deposition per decay due to β- and γ-activity of 131I with volume/mass of thyroid, for water, ICRP- and ICRU-soft tissue taken as thyroid material. A Monte Carlo model of the thyroid, in the Geant4 radiation transport simulation toolkit was constructed to compute the β- and γ-absorbed dose in the simulated thyroid phantom for various values of its volume. The effect of the size and shape of the thyroid on energy deposition per decay has also been studied by using spherical, ellipsoidal and cylindrical models for the thyroid and varying its volume in 1-25 cm3 range. The relative differences of Geant4 results for different models with each other and MCNP results lie well below 1.870%. The maximum relative difference among the Geant4 estimated results for water with ICRP and ICRU soft tissues is not more than 0.225%. S-values for ellipsoidal, spherical and cylindrical thyroid models were estimated and the relative difference with published results lies within 3.095%. The absorbed fraction values for beta particles show a good agreement with published values within 2.105% deviation. The Geant4 based simulation results of absorbed fractions for gammas again show a good agreement with the corresponding MCNP and EGS4 results (±6.667%) but have 29.032% higher values than that of MIRD calculated values. Consistent with previous studies, the reduction of the thyroid volume is found to have a substantial effect on the absorbed dose. Geant4 simulations confirm dose dependence on the volume/mass of thyroid in agreement with MCNP and EGS4 computed values but are substantially different from MIRD8 data. Therefore, inclusion of size/mass dependence is indicated for 131I radiotherapy of the thyroid.

  13. Reduction of contrast medium volume in abdominal aorta CTA: Multiphasic injection technique versus a test bolus volume

    Nijhof, Wouter H., E-mail: [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Vos, Charlotte S. van der, E-mail: [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Anninga, Bauke, E-mail: [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Jager, Gerrit J., E-mail: [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands); Rutten, Matthieu J.C.M., E-mail: [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands)


    Objective: The purpose of this study is to reduce the administered contrast medium volume in abdominal CTA by using a test bolus injection, with the preservation of adequate quantitative and qualitative vessel enhancement. Study design: For this technical efficacy study 30 patients, who were referred for a CTA examination of the abdominal aorta, were included. Randomly 15 patients were assigned to undergo a multiphasic injection protocol and received 89 mL of contrast medium (Optiray 350) (protocol I). Fifteen patients were assigned to the test bolus injection protocol (protocol II), which implies injection of a 10 mL test bolus of Optiray 350 prior to performing CTA with a 40 mL of contrast medium. Quantitative assessment of vascular enhancement was performed by measuring the amount of Hounsfield Units in the aorta at 30 positions from the celiac trunk to the iliac arteries in both groups. Qualitative assessment was performed by three radiologists who scored the images at a 5-point scale. Results: Quantitative assessment showed that there was no significant difference in vascular enhancement for patients between the two protocols, with mean attenuation values of 280.9 ± 50.84 HU and 258.60 ± 39.28 HU, respectively. The image quality of protocol I was rated 4.31 (range: 3.67/5.00) and of protocol II 4.11 (range: 2.67/5.00). These differences were not statistically significant. Conclusion: This study showed that by using a test bolus injection and the administration of 50 mL of contrast medium overall, CTA of the abdominal aorta can reliably be performed, with regard to quantitative and qualitative adequate vessel enhancement.

  14. Reduction of total lung capacity in obese men: comparison of total intrathoracic and gas volumes.

    Watson, R A; Pride, N B; Thomas, E Louise; Fitzpatrick, J; Durighel, G; McCarthy, J; Morin, S X; Ind, P W; Bell, J D


    Restriction of total lung capacity (TLC) is found in some obese subjects, but the mechanism is unclear. Two hypotheses are as follows: 1) increased abdominal volume prevents full descent of the diaphragm; and 2) increased intrathoracic fat reduces space for full lung expansion. We have measured total intrathoracic volume at full inflation using magnetic resonance imaging (MRI) in 14 asymptomatic obese men [mean age 52 yr, body mass index (BMI) 35-45 kg/m2] and 7 control men (mean age 50 yr, BMI 22-27 kg/m2). MRI volumes were compared with gas volumes at TLC. All measurements were made with subjects supine. Obese men had smaller functional residual capacity (FRC) and FRC-to-TLC ratio than control men. There was a 12% predicted difference in mean TLC between obese (84% predicted) and control men (96% predicted). In contrast, differences in total intrathoracic volume (MRI) at full inflation were only 4% predicted TLC (obese 116% predicted TLC, control 120% predicted TLC), because mediastinal volume was larger in obese than in control [heart and major vessels (obese 1.10 liter, control 0.87 liter, P=0.016) and intrathoracic fat (obese 0.68 liter, control 0.23 liter, P80% predicted (ON) was 26% predicted TLC. Mediastinal volume was similar in OR (1.84 liter) and ON (1.73 liter), but total intrathoracic volume was 19% predicted TLC smaller in OR than in ON. We conclude that the major factor restricting TLC in some obese men was reduced thoracic expansion at full inflation.

  15. Amyloid Goiter: A Diagnosis to Consider in Diffuse Fatty Infiltration of the Thyroid.

    Bakan, Selim; Kandemirli, Sedat Giray; Akbas, Serkan; Cingoz, Mehmet; Ozcan Guzelbey, Burcu; Kantarci, Fatih; Akman, Canan


    An amyloid goiter is the presence of amyloid protein in the thyroid in sufficient amounts to produce enlargement of the gland, accompanied by fat deposition of varying extents. It can be seen in long-standing inflammatory disorders such as familial Mediterranean fever. Imaging findings depend on the amount of fat and amyloid deposition; however, the main imaging finding is diffuse fatty infiltration of the thyroid. Herein, the multimodality imaging features in 3 cases of amyloid goiters secondary to familial Mediterranean fever are presented. © 2017 by the American Institute of Ultrasound in Medicine.

  16. Bulk Volume Reduction of the Kimmeridge Clay Formation, North Sea (UK Due to Compaction, Petroleum Generation and Expulsion

    Kenneth S. Okiongbo


    Full Text Available In this study, the effects of petroleum generation and expulsion on shale porosity is explored by evaluating the compaction of the Kimmeridge Clay Formation (KCF within the oil window using log data and shale samples from the KCF within the depth and temperature range of ~1.5-5.0 km and 90-157ºC, respectively. Petrophysical properties e.g porosity and pore-size distribution were measured, and permeability was calculated using empirical models based on the measured porosities. Transit-time values from the sonic logs recorded at depths in the wells were the cores were recovered were calibrated against the porosities determined from the core samples. Bulk geochemical parameters e.g., Total Organic Carbon (TOC, Hydrogen Index (HI were determined. The volume reduction in the KCF within the oil window due to petroleum generation and expulsion, and compaction due to loss of pore space was determined using the geochemical and log derived porosity data emplaced into empirical relations. Porosities above the oil window range from ~15-20%, but decreased to <5% at the end of the oil window. Pore-sizes decrease from ~11 nm to between 6-8 nm at the depth range of 1.5-5.0 km. Permeability decreased from 4.8 nD to ~0.095 nD. The quantitative estimations of volume reduction within the oil window indicate that for ~8.0wt% initial TOC sediment, a bulk volume reduction of 13% of the initial volume is due to oil expulsion, and ~12% is due to loss of pore space.

  17. Occupational dose reduction at Department of Energy contractor facilities: Bibliography of selected readings in radiation protection and ALARA; Volume 5

    Dionne, B.J.; Sullivan, S.G.; Baum, J.W. [Brookhaven National Lab., Upton, NY (United States)


    Promoting the exchange of information related to implementation of the As Low as Reasonably Achievable (ALARA) philosophy is a continuing objective for the Department of Energy (DOE). This report was prepared by the Brookhaven National Laboratory (BNL) ALARA Center for the DOE Office of Health. It contains the fifth in a series of bibliographies on dose reduction at DOE facilities. The BNL ALARA Center was originally established in 1983 under the sponsorship of the Nuclear Regulatory Commission to monitor dose-reduction research and ALARA activities at nuclear power plants. This effort was expanded in 1988 by the DOE`s Office of Environment, Safety and Health, to include DOE nuclear facilities. This bibliography contains abstracts relating to various aspects of ALARA program implementation and dose-reduction activities, with a specific focus on DOE facilities. Abstracts included in this bibliography were selected from proceedings of technical meetings, journals, research reports, searches of the DOE Energy, Science and Technology Database (in general, the citation and abstract information is presented as obtained from this database), and reprints of published articles provided by the authors. Facility types and activities covered in the scope of this report include: radioactive waste, uranium enrichment, fuel fabrication, spent fuel storage and reprocessing, facility decommissioning, hot laboratories, tritium production, research, test and production reactors, weapons fabrication and testing, fusion, uranium and plutonium processing, radiography, and accelerators. Information on improved shielding design, decontamination, containments, robotics, source prevention and control, job planning, improved operational and design techniques, as well as on other topics, has been included. In addition, DOE/EH reports not included in previous volumes of the bibliography are in this volume (abstracts 611 to 684). This volume (Volume 5 of the series) contains 217 abstracts.

  18. Meta-Analysis of Ultrafiltration versus Diuretics Treatment Option for Overload Volume Reduction in Patients with Acute Decompensated Heart Failure

    Barkoudah Ebrahim


    Full Text Available Introduction: Although diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF, inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF as an alternative strategy for reducing volume overloads in patients with ADHF. Objective: The aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome. Results: A total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI: −2.65 to −0.91 kg; p < 0.001 more than those who received standard diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = −0.25 mg/dL; 95% CI: −0.56 to 0.06 mg/dL; p = 0.112. The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64–1.56; p = 0.993. Conclusion: Compared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.

  19. Mother-young recognition in goitered gazelle during hiding period.

    Blank, D A; Yang, W


    The mother-young recognition process is crucial for the growth and survival of progeny. In "follower" ungulate species, vocal and visual cues have been found to play a leading role in the mother-young identification process from the first days postpartum, with olfactory cues also important in establishing the initial selective mother-young bond immediately after birth. In "hider" species, however, much less has been documented of mother-young recognition behaviors, especially in their natural habitat. In this paper, we investigated this process in goitered gazelle (Gazella subgutturosa), a typical hider species, in its native environment in Kazakhstan. Over the course of our study period, we investigated the behaviors of 257 females with twins and 158 females with singles through visual observations. We found that within the first month after birth, when females spend only a short time with their young, mothers recognized their fawns using mostly olfactory cues, while vision was used to locate their hiding offspring. Fawns vocalized very rarely, producing only distress calls that did not seem intended for individual identification. Licking of young by their mothers was observed frequently, not only during the first week after birth, when this action was very important for fawn stimulation for a number of physiological functions, but for several weeks after (until one month of age), when licking lost its physiological importance and likely became more of a recognition procedure. Fawns did not recognize their mothers at all, either through vision or vocalizations, since during their first weeks after birth, they responded to any gazelle that approached their hiding area. By a month after birth, when mothers and fawns began to stay together for longer periods of time, their recognition process became more enhanced, and in addition to olfactory cues, the mother and her young began to use more and more visual cues for longer distance identification, as well as

  20. Quantifying volume reduction and peak flow mitigation for three bioretention cells in clay soils in northeast Ohio.

    Winston, Ryan J; Dorsey, Jay D; Hunt, William F


    Green infrastructure aims to restore watershed hydrologic function by more closely mimicking pre-development groundwater recharge and evapotranspiration (ET). Bioretention has become a popular stormwater control due to its ability to reduce runoff volume through these pathways. Three bioretention cells constructed in low permeability soils in northeast Ohio were monitored for non-winter quantification of inflow, drainage, ET, and exfiltration. The inclusion of an internal water storage (IWS) zone allowed the three cells to reduce runoff by 59%, 42%, and 36% over the monitoring period, in spite of the tight underlying soils. The exfiltration rate and the IWS zone thickness were the primary determinants of volume reduction performance. Post-construction measured drawdown rates were higher than pre-construction soil vertical hydraulic conductivity tests in all cases, due to lateral exfiltration from the IWS zones and ET, which are not typically accounted for in pre-construction soil testing. The minimum rainfall depths required to produce outflow for the three cells were 5.5, 7.4, and 13.8mm. During events with 1-year design rainfall intensities, peak flow reduction varied from 24 to 96%, with the best mitigation during events where peak rainfall rate occurred before the centroid of the rainfall volume, when adequate bowl storage was available to limit overflow.

  1. Brain Volume Reductions within Multiple Cognitive Systems in Male Preterm Children at Age Twelve

    Kesler, Shelli R.; Reiss, Allan L.; Vohr, Betty; Watson, Christa; Schneider, Karen C.; Katz, Karol H.; Maller-Kesselman, Jill; Silbereis, John; Constable, R. Todd; Makuch, Robert W.; Ment, Laura R.


    Objectives To more precisely examine regional and subregional microstructural brain changes associated with preterm birth. Study design We obtained brain volumes from 29 preterm children, age 12 years, with no ultrasound scanning evidence of intraventricular hemorrhage or cystic periventricular leukomalacia in the newborn period, and 22 age- and sex-matched term control subjects. Results Preterm male subjects demonstrated significantly lower white matter volumes in bilateral cingulum, corpus callosum, corticospinal tract, prefrontal cortex, superior and inferior longitudinal fasciculi compared with term male subjects. Gray matter volumes in prefrontal cortex, basal ganglia, and temporal lobe also were significantly reduced in preterm male subjects. Brain volumes of preterm female subjects were not significantly different from those of term female control subjects. Voxel-based morphometry results were not correlated with perinatal variables or cognitive outcome. Higher maternal education was associated with higher cognitive performance in preterm male subjects. Conclusions Preterm male children continue to demonstrate abnormal neurodevelopment at 12 years of age. However, brain morphology in preterm female children may no longer differ from that of term female children. The neurodevelopmental abnormalities we detected in preterm male subjects appear to be relatively diffuse, involving multiple neural systems. The relationship between aberrant neurodevelopment and perinatal variables may be mediated by genetic factors, environmental factors, or both reflected in maternal education level. PMID:18346506

  2. A History of Psychosis in Bipolar Disorder is Associated With Gray Matter Volume Reduction.

    Ekman, Carl Johan; Petrovic, Predrag; Johansson, Anette G M; Sellgren, Carl; Ingvar, Martin; Landén, Mikael


    Psychotic symptoms are prevalent in schizophrenia, bipolar disorder, and other psychiatric and neurological disorders, yet the neurobiological underpinnings of psychosis remain obscure. In the last decade, a large number of magnetic resonance imaging studies have shown differences in local gray matter volume between patients with different psychiatric syndromes and healthy controls. Few studies have focused on the symptoms, which these syndromes are constituted of. Here, we test the association between psychosis and gray matter volume by using a sample of 167 subjects with bipolar disorder, with and without a history of psychosis, and 102 healthy controls. Magnetic resonance images were analyzed on group level using a voxel-wise mass univariate analysis (Voxel-Based Morphometry). We found that patients with a history of psychosis had smaller gray matter volume in left fusiform gyrus, the right rostral dorsolateral prefrontal cortex, and the left inferior frontal gyrus compared with patients without psychosis and with healthy controls. There was no volume difference in these areas between the no-psychosis group and healthy controls. These areas have previously been structurally and functionally coupled to delusions and hallucinations. Our finding adds further evidence to the probability of these regions as key areas in the development of psychotic symptoms. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email:

  3. Experimental Study ofa New Operative Procedure for Non-Ischemic Dilated Cardiomyopathy-Overlapping Cardiac Volume Reduction Operation

    罗滨; 孟春营; 温定国; 松居喜朗; 安田庆秀


    Objectives To assess anewly devised procedure of cardiac volume reduction without resection of cardiac muscle and evaluated in experimental settings. Methods Ten beagle dogs underwent a rapid pacing leading to heart failure for 3 weeks and received the left ventricular reduction termed overlapping cardiac volume reduction operation (OLCVR) ,which consisted of a longitudinal incision in left ventricular (LV) free wall, sutures of the left marginal to the septal wall, and the right marginal to LV free wall.A slope of the linear preload recruitable stroke work relationship (Mw) , with a X - intercept (Vo) were calculated as the precise indicators of left ventricular systolic function. The constant of isovolumic pressure decay (Tau) and a peak filling rate (PFR) were also calculated as the indicators of LV diastolic function.Results LV end- diastolic dimensions was significantly reduced by OLCVR (43±2 to 25±1; mm).Fractional shortening was significantly improved by OLCVR (11±2 to 30±4;%). Mw (erg* cm-3* 103)was also significantly improved (21±2 to 33 ±3 (p<0. 001 ) ) , whereas Vo, Tau and PFR did not show significant changes. Conclusions The OLCVR significantly increased in the early LV systolic function without detrimental effects on diastolic function. This procedure may become a therapeutic option for end - stage cardiomyopathy.

  4. Mid-term effects of lung volume reduction surgery on pulmonary function in patients with chronic obstructive pulmonary disease

    LIU Jin-ming; WU Wen; LI Xia; Jonson Bjorn; YANG Wen-lan; JIANG Ge-ning; DING Jia-an; ZHENG Wei; LIU Wen-zeng; WANG Ying-min; GAO Bei-lan; JIANG Ping


    Background Now lung volume reduction surgery (LVRS) has become one of the most effective methods for the management of some cases of severe chronic obstructive pulmonary disease (COPD). We evaluated the mid-term effects of LVRS on pulmonary function in patients with severe COPD.Methods Ten male patients with severe COPD aged 38-70 years underwent LVRS and their pulmonary function was assessed before, 3 months and 3 years after surgery. The spirometric and gas exchange parameters included residual volume, total lung capacity, inspiratory capacity, forced vital capacity, forced expiratory volume in one second, diffusion capacity for CO, and arterial blood gas. A 6-minute walk distance (6MWD) test was performed.Results As to preoperative assessment, most spirometric parameters and 6MWD were significantly improved after 3 months and slightly 3 years after LVRS. Gas exchange parameters were significantly improved 3 months after surgery,but returned to the preoperative levels after 3 years.Conclusions LVRS may significantly improve pulmonary function in patients with severe COPD indicating for LVRS.Mid-term pulmonary function 3 years after surgery can be decreased to the level at 3 months after surgery. Three years after LVRS, lung volume and pulmonary ventilation function can be significantly improved, but the improvement in gas exchange function was not significant.

  5. Effects of a multidisciplinary body weight reduction program on static and dynamic thoraco-abdominal volumes in obese adolescents.

    LoMauro, Antonella; Cesareo, Ambra; Agosti, Fiorenza; Tringali, Gabriella; Salvadego, Desy; Grassi, Bruno; Sartorio, Alessandro; Aliverti, Andrea


    The objective of this study was to characterize static and dynamic thoraco-abdominal volumes in obese adolescents and to test the effects of a 3-week multidisciplinary body weight reduction program (MBWRP), entailing an energy-restricted diet, psychological and nutritional counseling, aerobic physical activity, and respiratory muscle endurance training (RMET), on these parameters. Total chest wall (VCW), pulmonary rib cage (VRC,p), abdominal rib cage (VRC,a), and abdominal (VAB) volumes were measured on 11 male adolescents (Tanner stage: 3-5; BMI standard deviation score: >2; age: 15.9 ± 1.3 years; percent body fat: 38.4%) during rest, inspiratory capacity (IC) maneuver, and incremental exercise on a cycle ergometer at baseline and after 3 weeks of MBWRP. At baseline, the progressive increase in tidal volume was achieved by an increase in end-inspiratory VCW (p obese adolescents adopt a thoraco-abdominal operational pattern characterized by abdominal rib cage hyperinflation as a form of lung recruitment during incremental cycle exercise. Additionally, a short period of MBWRP including RMET is associated with improved exercise performance, lung and chest wall volume recruitment, unloading of respiratory muscles, and reduced dyspnea.

  6. Incidental Detection of Internal Jugular Vein Thrombosis Secondary to Undiagnosed Benign Substernal Goiter

    Mai Tone Lønnebakken


    This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.

  7. Research on iodine deficiency and goiter in the 19th and early 20th centuries

    Zimmermann, M.B.


    In 1811, Courtois noted a violet vapor arising from burning seaweed ash and Gay-Lussac subsequently identified the vapor as iodine, a new element. The Swiss physician Coindet, in 1813, hypothesized the traditional treatment of goiter with seaweed was effective because of its iodine content and succe

  8. Case report of the use of videolaryngoscopy in thyroid goiter masses: An airway challenge

    Stacey Watt, M.D.


    Discussion/Conclusion: A literature review of PubMed and Web of Science of the use of videolaryngoscopy in goiter, difficult airway, and airway obstruction yielded information supporting the use of the video laryngoscopy as a first choice for laryngoscopy with a proven benefit over direct laryngoscopy.

  9. A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time

    Lewis, Lorraine [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Cox, Jennifer [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Morgia, Marita [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Atyeo, John [Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Lamoury, Gillian [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia)


    The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time. A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch). There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm{sup 3} (4–118) and CT2ch: median 16 cm{sup 3}, (2–99), (P = 0.01), but no significant volume reduction thereafter. Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

  10. Validation of a reaction volume reduction protocol for analysis of Y chromosome haplotypes targeting DNA databases.

    Souza, C A; Oliveira, T C; Crovella, S; Santos, S M; Rabêlo, K C N; Soriano, E P; Carvalho, M V D; Junior, A F Caldas; Porto, G G; Campello, R I C; Antunes, A A; Queiroz, R A; Souza, S M


    The use of Y chromosome haplotypes, important for the detection of sexual crimes in forensics, has gained prominence with the use of databases that incorporate these genetic profiles in their system. Here, we optimized and validated an amplification protocol for Y chromosome profile retrieval in reference samples using lesser materials than those in commercial kits. FTA(®) cards (Flinders Technology Associates) were used to support the oral cells of male individuals, which were amplified directly using the SwabSolution reagent (Promega). First, we optimized and validated the process to define the volume and cycling conditions. Three reference samples and nineteen 1.2 mm-diameter perforated discs were used per sample. Amplification of one or two discs (samples) with the PowerPlex(®) Y23 kit (Promega) was performed using 25, 26, and 27 thermal cycles. Twenty percent, 32%, and 100% reagent volumes, one disc, and 26 cycles were used for the control per sample. Thereafter, all samples (N = 270) were amplified using 27 cycles, one disc, and 32% reagents (optimized conditions). Data was analyzed using a study of equilibrium values between fluorophore colors. In the samples analyzed with 20% volume, an imbalance was observed in peak heights, both inside and in-between each dye. In samples amplified with 32% reagents, the values obtained for the intra-color and inter-color standard balance calculations for verification of the quality of the analyzed peaks were similar to those of samples amplified with 100% of the recommended volume. The quality of the profiles obtained with 32% reagents was suitable for insertion into databases.


    Growing concern about health risks associated with exposure to indoor radon, a radioactive gas found in varying amounts in nearly all houses, has underscored the need for dependable radon reduction methods in existing and newly constructed houses. Responding to this need, the U....

  12. Radar Derived Spatial Statistics of Summer Rain. Volume 2; Data Reduction and Analysis

    Konrad, T. G.; Kropfli, R. A.


    Data reduction and analysis procedures are discussed along with the physical and statistical descriptors used. The statistical modeling techniques are outlined and examples of the derived statistical characterization of rain cells in terms of the several physical descriptors are presented. Recommendations concerning analyses which can be pursued using the data base collected during the experiment are included.

  13. What the Research Tells Us: Class Size Reduction. Information Capsule. Volume 1001

    Romanik, Dale


    This Information Capsule examines the background and history in addition to research findings pertaining to class size reduction (CSR). This Capsule concludes that although educational researchers have not definitively agreed upon the effectiveness of CSR, given its almost universal public appeal, there is little doubt it is here to stay in some…


    Growing concern about health risks associated with exposure to indoor radon, a radioactive gas found in varying amounts in nearly all houses, has underscored the need for dependable radon reduction methods in existing and newly constructed houses. Responding to this need, the U....

  15. Poor man medical pneumoplasty: Bronchoscopic lung volume reduction with hot saline versus dissolved doxycycline as a neoteric remedy of pulmonary emphysema

    A.M. Abumossalam


    Conclusion: Bronchoscopic lung volume reduction by hot saline and dissolved doxycycline comes into sight to be a safe and feasible profile with an acceptable outcome that presents an attractive substitute to COPD patients who are physiologically friable.

  16. Mass anomalous dimension of Adjoint QCD at large N from twisted volume reduction

    Pérez, Margarita García; Keegan, Liam; Okawa, Masanori


    In this work we consider the $SU(N)$ gauge theory with two Dirac fermions in the adjoint representation, in the limit of large $N$. In this limit the infinite-volume physics of this model can be studied by means of the corresponding twisted reduced model defined on a single site lattice. Making use of this strategy we study the reduced model for various values of $N$ up to 289. By analyzing the eigenvalue distribution of the adjoint Dirac operator we test the conformality of the theory and extract the corresponding mass anomalous dimension.

  17. Design Report of Volume Reduction and Handling Equipment of ACPF Wastes

    Kwon, K. C.; Ku, J. H.; Lee, W. K.; Lee, E. P.; Choung, W. M.; Cho, I. J.; Kook, D. H.; You, G. S.; Youn, J. S


    For the efficient disposal of wastes from the ACPF (Advanced spent fuel Conditioning Process Facility), hot cell filter press equipment, vacuum press equipment of compatible wastes and hot cell auxiliary crane were developed. The filter press equipment installed in hot cell is pneumatically driven and remotely operated. In order to avoid the contamination of hot cell by dust particles from filters being compressed, it is designed to compress filters with them put into the basket of the solid wastes cask. The performance test showed that the height of a filter was reduced by more than 75% and a basket could contain up to four compressed filters. The vacuum press equipment reduces the volume of the plastic bag containing compatible wastes such as cloth, plastic film and paper by vacuumizing the bag. It consists of the vacuum pump, the suction and HEPA filters and the manual pneumatic valve, and is designed to be easily handled and managed. Through the performance test, it is observed that the volume of wastes was reduced to a third. Also an additional crane of 300 kg capacity was manufactured and installed in the ACP hot cell to handle the salt ingot wastes container located where the overhead crane is not accessible. This report presenting the details of the design, manufacturing and performance of these equipment will be used as technical materials for the operation of the facility and the development of equipment.

  18. Reduction of the cerebrovascular volume in a transgenic mouse model of Alzheimer's disease.

    Bourasset, Fanchon; Ouellet, Mélissa; Tremblay, Cyntia; Julien, Carl; Do, Tuan Minh; Oddo, Salvatore; LaFerla, Frank; Calon, Frédéric


    Combined evidence from neuroimaging and neuropathological studies shows that signs of vascular pathology and brain hypoperfusion develop early in Alzheimer's disease (AD). To investigate the functional implication of these abnormalities, we have studied the cerebrovascular volume and selected markers of blood-brain barrier (BBB) integrity in 11-month-old 3 x Tg-AD mice, using the in situ brain perfusion technique. The cerebrovascular volume of distribution of two vascular space markers, [3H]-inulin and [14C]-sucrose, was significantly lower (-26% and -27%, respectively; p diazepam was similar between 3xTg-AD mice and controls, suggesting no difference in the functional integrity of the BBB. We also report a 32% increase (p < 0.001) in the thickness of basement membranes surrounding cortical microvessels along with a 20% increase (p < 0.05) of brain collagen content in 3xTg-AD mice compared to controls. The present data indicate that the cerebrovascular space is reduced in a mouse model of Abeta and tau accumulation, an observation consistent with the presence of cerebrovascular pathology in AD.

  19. Percutaneous microwave ablation of type I substernal goiter under ultrasonic guidance%超声引导下经皮微波消融治疗Ⅰ型胸骨后甲状腺肿

    徐庆玲; 陈云乾; 隋亚平; 王军; 王淑荣


    Objective To investigate the feasibility and clinical effect for percutaneous microwave ablation of type I substernal goiter under the guidance of ultrasound . Methods Thirteen patients with type I substernal goiter were selected . All patients underwent percutaneous microwave ablation treatment under the guidance of ultrasound . Thirteen patients with 47 medals nodules were performed ultrasound guided percutaneous microwave ablation . Intraoperative heat blocking blood flow" was used to prevent severe hemorrhage .Liquid isolation belt" and leverage from" methods were used to effectively prevent surrounding important structures against heat damage .Small amount of residual method" was used to avoid tracheal collapse . All patients were followed up post‐operative 1 ,3 ,6 ,12 months by monitoring of thyroid nodule volume change , adverse reactions , and postoperative complications . Results Thirteen patients with 47 medals nodules were successfully performed percutaneous microwave ablation guided by ultrasound . Among them ,2 patients performed the second treatment for too large volume of goiter ,tracheal displacement and poor physical tolerance of older . The postoperative ultrasound contrast and color Doppler showed that the lesions were completely inactivated . No obvious complications occurred in all 13 patients , and no permanent hoarseness occured . The symptoms of cervical oppression and discomfort disappeared for all patients within 1-4 months after surgery . Thirteen patients were followed up for 12 months after the operation . The thyroid function was normal and the volume reduction rate of thyroid nodules was (85 ± 31)% . Conclusions Percutaneous microwave ablation of type I substernal goiter under ultrasonic guidance is a safe and effective method to reduce the thyroid nodules with no serious complications . It is worth to be popularized in clinical practice .%目的:探讨超声引导下Ⅰ型胸骨后甲状腺肿微波消融治疗的可行性及

  20. Lung Volume Reduction in Chronic Obstructive Pulmonary Disease (COPD AND#8211; An Updated Review of Surgical and Endoscopic Procedures

    Ramakant Dixit


    Full Text Available The conventional medical management of emphysema using bronchodilators and anti-inflammatory agents has a limited benefit in patients having advanced hyperinflation of lungs due to destruction of elastic tissue. The natural course of Chronic Obstructive Pulmonary Disease (COPD has been shown to be altered by only smoking cessation and oxygen therapy so far. The lung volume reduction surgery is viewed as another modality to change the natural history of emphysema in recent years. For patients with more generalized emphysema, resection of lung parenchyma improves elastic recoil and chest wall mechanics. An extensive literature search has demonstrated that carefully selected patients of emphysema (i.e. upper lobe predominant disease, low exercise capacity and Forced Expiratory Volume in First Second (FEV1 and DLco and #8804; 20% of predicted receive benefits in terms of symptomatic improvement and physiologic response following Lung Volume Reduction Surgery (LVRS. The resurgent interest in LVRS and National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative methods, to improve the outcome and reduce complications associated with current LVRS techniques. These novel approaches include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices and valves and endobronchial bronchial bypass approaches. Experimental data and preliminary results are becoming available for some of these approaches. Most of the published studies so far have been uncontrolled and unblinded. Overall, extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms. [Arch Clin Exp Surg 2012; 1(4.000: 249-257

  1. Reduction of blurring in broadband volume holographic imaging using a deconvolution method

    Lv, Yanlu; Zhang, Xuanxuan; Zhang, Dong; Zhang, Lin; Luo, Yuan; Luo, Jianwen


    Volume holographic imaging (VHI) is a promising biomedical imaging tool that can simultaneously provide multi-depth or multispectral information. When a VHI system is probed with a broadband source, the intensity spreads in the horizontal direction, causing degradation of the image contrast. We theoretically analyzed the reason of the horizontal intensity spread, and the analysis was validated by the simulation and experimental results of the broadband impulse response of the VHI system. We proposed a deconvolution method to reduce the horizontal intensity spread and increase the image contrast. Imaging experiments with three different objects, including bright field illuminated USAF test target and lung tissue specimen and fluorescent beads, were carried out to test the performance of the proposed method. The results demonstrated that the proposed method can significantly improve the horizontal contrast of the image acquire by broadband VHI system. PMID:27570703

  2. High-Throughput Spheroid Screens Using Volume, Resazurin Reduction, and Acid Phosphatase Activity.

    Ivanov, Delyan P; Grabowska, Anna M; Garnett, Martin C


    Mainstream adoption of physiologically relevant three-dimensional models has been slow in the last 50 years due to long, manual protocols with poor reproducibility, high price, and closed commercial platforms. This chapter describes high-throughput, low-cost, open methods for spheroid viability assessment which use readily available reagents and open-source software to analyze spheroid volume, metabolism, and enzymatic activity. We provide two ImageJ macros for automated spheroid size determination-for both single images and images in stacks. We also share an Excel template spreadsheet allowing users to rapidly process spheroid size data, analyze plate uniformity (such as edge effects and systematic seeding errors), detect outliers, and calculate dose-response. The methods would be useful to researchers in preclinical and translational research planning to move away from simplistic monolayer studies and explore 3D spheroid screens for drug safety and efficacy without substantial investment in money or time.

  3. Pancreas volume reduction and metabolic effects in Japanese patients with severe obesity following laparoscopic sleeve gastrectomy.

    Umemura, Akira; Sasaki, Akira; Nitta, Hiroyuki; Baba, Shigeaki; Ando, Taro; Kajiwara, Takashi; Ishigaki, Yasushi


    This study aimed to assess the relationship between the metabolic effect after laparoscopic sleeve gastrectomy (LSG) in morbidly obese Japanese patients, with or without type 2 diabetes mellitus (T2DM), and improved pancreatic steatosis (PS). The study enrolled 27 morbidly obese Japanese patients who were undergoing LSG. Their clinical and metabolic effects were evaluated at baseline and six months after LSG. Pancreas volume (PV), pancreatic attenuation (PA), and splenic attenuation (SA) were measured using a 64-row computed tomography (CT). Changes in PV, PA-SA, and PA/SA were evaluated. The mean body-weight loss, body mass index loss, and percentage of excess weight loss (%EWL) were -34.4 kg (p < 0.001), -11.0 kg/m(2) (p < 0.001), and 43.7%, respectively. The mean PV was 96.7 mL at baseline, and it decreased six months after LSG (-16.3mL, p < 0.001). The mean PA significantly increased six months after LSG (9.5 HU, p < 0.001). PA-SA (-23.2 HU vs. -13.3 HU, p = 0.003), and PA/SA (0.54 vs. 0.73, p < 0.001) also significantly increased six months after LSG. In T2DM patients, decreased PV correlated with decreased fasting blood sugar, decreased insulin, and reduced liver volume. In conclusion, PV significantly decreased after LSG in morbidly obese Japanese patients, and that decrease correlated with improvements in PS. In addition, PS plays an important role of development and progression of insulin resistance and T2DM.

  4. Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia

    Schmidt Martin


    Full Text Available Abstract Background Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP. Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed. Results Computed tomography (CT scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D models of the skull and the JF. Weight matched groups (7–10 kg of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p 3; median right JF: 0.0434 cm3; p Conclusion A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF pressure waves in the subarachnoid space, independent of cerebellar herniation, as an additional pathogenetic factor for the development of SM in this breed.

  5. Efficacy of High-volume Evacuator in Aerosol Reduction: Truth or Myth? A Clinical and Microbiological Study

    Hitesh Desarda


    Full Text Available Background and aims. Basic periodontal treatment aims at eliminating supra- and sub-gingival plaque and establishing conditions which will allow effective self-performed plaque control. This aim is primarily achieved with sonic and ultrasonic scalers. However, generation of bacterial aerosols during these procedures is of great concern to patients, the dentist and the dental assistant. The aim of this study was to compare the reduction in aerosol with and without high-volume evacuator through a microbiological study. Materials and methods. For this clinical study a fumigated closed operatory was selected. Maxillary incisors and canines were selected as an area for scaling. Piezoelectric ultrasonic scaling was performed in the absence and in the presence of a high-volume evacuator at 12 and 20 inches from the patient's oral cavity. In both groups scaling was carried out for 10 minutes. Nutrient agar plates were exposed for a total of 20 minutes. After this procedure, nutrient agar plates were incubated in an incubator at 37°C for 24 hours. The next day the nutrient agar plates were examined for colony forming units by a single microbiologist. Results. The results showed no statistically significant differences in colony forming units (CFU with and without the use of a high-volume evacuator either at 12 or 20 inches from the patient’s oral cavity. Conclusion. It was concluded that high-volume evacuator, when used as a separate unit without any modification, is not effective in reducing aerosol counts and environmental contamination.

  6. A community-based case-control study to investigate the role of iron deficiency in the persistence of goiter

    Pathak, Rambha; Chaudhary, Chintu; Agarwalla, Rashmi; Shaikh, Zakirhusain; Goel, R K D; Patvegar, Bilkish


    To find out the magnitude of iron deficiency anemia in the age group of 6-12 years and investigate the role of iron deficiency as a possible contributor to endemic goiter in school children in Ambala...

  7. Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction.

    Kamakura, Miho; Maruyama, Ryoko


    A high glycemic status increases the risk for autonomic dysfunction and cardiovascular failure. The aim of this study was to investigate time-dependent changes in the autonomic response and cardiovascular dynamics and the association between the level of hemoglobin A1c (HbA1c) and autonomic response during blood volume reduction. The study population consisted of 26 preoperative participants who were scheduled for autologous blood donation (200-400 mL of whole blood) for intraoperative or postoperative use. These participants without circulatory, respiratory, or brain disease and diabetes mellitus were grouped according to their HbA1c levels: blood pressure (BP) and analyzed heart rate variability (HRV) to quantify cardiac autonomic regulation throughout blood donation. During blood volume reduction, which was about 10% of the circulating blood volume, the BP and heart rate varied within normal ranges in both groups. The high-frequency (HF) component, an index of parasympathetic nerve activity, and the ratio of low-frequency (LF) to HF components (LF/HF), an index of sympathetic nerve activity, significantly decreased and increased with the progression of blood volume reduction, respectively, in the HbA1c blood volume reduction only in the HbA1c blood volume reduction.

  8. Final cost reduction study for the Geysers Recharge Alternative. Volume 1



    The purpose of this study is to determine whether or not cost reduction opportunities exist for the Geysers Recharge Alternative as defined in the Santa Rosa Subregional Long-Term Wastewater Project EIR/EIS. The City of Santa Rosa has been directed to have a plan for reclaimed water disposal in place by 1999 which will meet future capacity needs under all weather conditions. A Draft EIR/EIS released in July 1996 and a Final EIR certified in June 1997 examine four primary alternatives plus the No Action Alternative. Two of the primary alternatives involve agricultural irrigation with reclaimed water, either in western or southern Sonoma County. Another involves increased discharge of reclaimed water into the Russian River. The fourth involves using reclaimed water to replenish the geothermal reservoir at the Geysers. The addition of this water source would enable the Geysers operators to produce more steam from the geothermal area and thereby prolong the life and economic production level of the steamfield and the geothermal power plants supplied by the steamfield. This study provides additional refined cost estimates for new scenarios which utilize an alternative pipeline alignment and a range of reclaimed water flows, which deliver less water to the Geysers than proposed in the EIR/EIS (by distributing flow to other project components). Also, electrical power rates were revised to reflect the recent changes in costs associated with deregulation of the power industry. In addition, this report provides information on sources of potential public and private funding available and future environmental documentation required if the cost reduction scenarios were to be selected by the City as part of their preferred alternative.

  9. Volume reduction outweighs biogeochemical processes in controlling phosphorus treatment in aged detention systems

    Shukla, Asmita; Shukla, Sanjay; Annable, Michael D.; Hodges, Alan W.


    Stormwater detention areas (SDAs) play an important role in treating end-of-the-farm runoff in phosphorous (P) limited agroecosystems. Phosphorus transport from the SDAs, including those through subsurface pathways, are not well understood. The prevailing understanding of these systems assumes that biogeochemical processes play the primary treatment role and that subsurface losses can be neglected. Water and P fluxes from a SDA located in a row-crop farm were measured for two years (2009-2011) to assess the SDA's role in reducing downstream P loads. The SDA treated 55% (497 kg) and 95% (205 kg) of the incoming load during Year 1 (Y1, 09-10) and Year 2 (Y2, 10-11), respectively. These treatment efficiencies were similar to surface water volumetric retention (49% in Y1 and 84% in Y2) and varied primarily with rainfall. Similar water volume and P retentions indicate that volume retention is the main process controlling P loads. A limited role of biogeochemical processes was supported by low to no remaining soil P adsorption capacity due to long-term drainage P input. The fact that outflow P concentrations (Y1 = 368.3 μg L- 1, Y2 = 230.4 μg L- 1) could be approximated by using a simple mixing of rainfall and drainage P input further confirmed the near inert biogeochemical processes. Subsurface P losses through groundwater were 304 kg (27% of inflow P) indicating that they are an important source for downstream P. Including subsurface P losses reduces the treatment efficiency to 35% (from 61%). The aboveground biomass in the SDA contained 42% (240 kg) of the average incoming P load suggesting that biomass harvesting could be a cost-effective alternative for reviving the role of biogeochemical processes to enhance P treatment in aged, P-saturated SDAs. The 20-year present economic value of P removal through harvesting was estimated to be 341,000, which if covered through a cost share or a payment for P treatment services program could be a positive outcome for both

  10. "Prevalence of Thyrotoxicosis: Clinical presentation and results of treatment in 384 patients with Goiter under 18 years "

    "Moayeri H


    Full Text Available Goiter is common among growing children and adolescents but thyrotoxicosis is a rare thyroid disorder in this age prevalence of thyrotoxicosis and clinical presentation in prevalence of thyrotoxicosis and clinical presentation of the disease among children and adolescents of the disease among children and adolescents presenting for goiter at the clinics of pediatric presenting for goiter at the clinics of pediatric Endocrinology of Tehran and Iran University of medical sciences and private offices. In a retrospective study the medical records of 424 patients with goiter were studied of whom 384 (285F, 99M and goiter and records available for review. All patients were examined by pediatric endocrinologist and their goiters were classified according to WHO criteria. Total T4, TSH, T3 and T3RU were measured. Out of the 384 cases that were diagnosed as goiter, 320 were euthyroid (83.4%, 49 were hypothyroid (12.7% and 15 were hyperthyroid (3.9%. Ninety-three percent of the hyperthyroid patients had graves’ disease and seven percent of them had toxic adenoma. The most common presenting feature in thyrotoxic patients was goiter. Sustained remission with medical treatment alone was attained in 46% with a mean treatment duration of 2.9 years. The comparison was made between the findings of this study and those of western countries indicating that the incidence of hyperthyroidism in Iranian pediatric population is not as high as in North America but is higher than in Europe. Clinical presentation, response to treatment and etiologic causes of the disease in our study was similar to other studies.

  11. Goiter prevalence, urinary iodine, and salt iodization level in sub-Himalayan Darjeeling district of West Bengal, India

    Akhil Bandhu Biswas; Dilip Kumar Das; Indranil Chakraborty; Asit Kumar Biswas; Puran Kumar Sharma; Romy Biswas


    National iodine deficiency disorders control program needs to be continuously monitored. Hence, a cross-sectional study was conducted during the period from April-May 2011 to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Darjeeling district, West Bengal. Study subjects were 2400 school children, aged 8-10 years selected through "30 cluster" sampling methodology. Goiter was assessed by standard ...

  12. 2,3-Dihydroxybenzoic acid attenuates kanamycin-induced volume reduction in mouse utricular type I hair cells

    Severinsen, Stig Åvall; Kirkegaard, Mette; Nyengaard, Jens Randel


    The aminoglycoside kanamycin is a commonly used antibiotic, but unfortunately it is oto- and nephrotoxic in large doses. The negative effects are thought to be due to the formation of free radicals which is why strong antioxidants and iron chelators like 2,3-dihydroxybenzoic acid (DHB) are of great...... interest. This study estimates cellular quantitative changes in the utricular macula of mice following systemic treatment with kanamycin alone or in combination with DHB. The animals were injected with either saline, kanamycin or kanamycin+DHB for 15 days and perfusion fixed three weeks after last...... macula, hair cell type I and supporting cells decreased significantly in animals injected with kanamycin but not in animals co-treated with DHB. Hair and supporting cell numbers remained unchanged in all three groups. In conclusion, the kanamycin-induced volume reduction of type I hair cells...

  13. Bronchoscopic lung volume reduction in a single-lung transplant recipient with natal lung hyperinflation: a case report.

    Pato, O; Rama, P; Allegue, M; Fernández, R; González, D; Borro, J M


    After single lung transplantation for emphysema native lung hyperinflation is a common complication that may cause respiratory failure. Herein we have reported satisfactory bronchoscopic lung volume reduction in a left single-lung transplant recipient with native lung hyperinflation, who suffered from Medical Research Council (MRC) class 3 dyspnea and chest pain. Three endobronchial valves (Zephyr; Emphasys Medical, Redwood, Calif, United States) were placed into the segmental bronchi of the right upper lobe, using videobronchoscopy under general anesthesia. Postoperative chest computed tomography revealed subsegmental atelectasis in that lobe. The clinical benefit was an improved MRC dyspnea class from 3 to 2, which was still present at 4 months after the procedure, although there were no remarkable changes in spirometric parameters.

  14. Novel thoracoscopic approach to posterior mediastinal goiters: report of two cases

    Strother Eric


    Full Text Available Abstract Trans-cervical resection of posterior mediastinal goiters is usually very difficult, requiring a high thoracotomy. Until recently, using conventional video-assisted thoracoscopic surgery to resect such tumors has been technically difficult and unsafe. By virtue of 3 dimensional visualization, greater dexterity, and more accurate dissection, the Da Vinci robot, for the first time, enables a completely minimally invasive approach to the posterior superior mediastinum.

  15. Genotype-phenotype correlations of dyshormonogenetic goiter in children and adolescents from South India

    Bangaraiah Gari Ramesh


    Full Text Available Background: Dyshormonogenetic goiter is one of the most common causes of hypothyroidism in children and adolescents in iodine nonendemic areas. The exact genotype-phenotypic correlations (GPCs and risk categorization of hypothyroid phenotypes of dyshormonogenetic mutations are largely speculative. The genetic studies in pediatric dyshormonogenesis are very sparse from Indian sub-continent. In this context, we analyzed the implications of TPO, NIS, and DUOX2 gene mutations in hypothyroid children with dyshormonogenetic hypothyroidism (DH from South India. Materials and Methods: This is interdisciplinary prospective study, we employed eight sets of primers and screened for 142 known single nucleotide polymorphisms in TPO, NIS, and DUOX2 genes. The subjects were children and adolescents with hypothyroidism due to dyshormonogenetic goiter. Congenital hypothyroidism, iodine deficiency, and Hashimoto's thyroiditis cases were excluded. Results: We detected nine mutations in 8/22 (36% children. All the mutations were observed in the intronic regions of NIS gene and none in TPO or DUOX2 genes. Except for bi-allelic, synonymous polymorphism of TPO gene in child number 14, all other mutations were heterozygous in nature. GPCs show that our mutations significantly expressed the phenotypic traits such as overt hypothyroidism, goiter, and existence of family history. Other phenotypic characters such as sex predilection, the age of onset and transitory nature of hypothyroidism were not significantly affected by these mutations. Conclusion: NIS gene mutations alone appears to be most prevalent mutations in DH among South Indian children and these mutations significantly influenced phenotypic expressions such as severity of hypothyroidism, goiter rates, and familial clustering.

  16. Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT: a non-surgical method of lung volume reduction

    Noppen Marc


    Full Text Available Abstract Background Lung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently, less invasive bronchoscopic approaches have been designed to utilize these principles while avoiding the associated perioperative risks. The Endobronchial Valve for Emphysema PalliatioN Trial (VENT posits that occlusion of a single pulmonary lobe through bronchoscopically placed Zephyr® endobronchial valves will effect significant improvements in lung function and exercise tolerance with an acceptable risk profile in advanced emphysema. Methods The trial design posted on Clinical, on August 10, 2005 proposed an enrollment of 270 subjects. Inclusion criteria included: diagnosis of emphysema with forced expiratory volume in one second (FEV1 100%; residual volume > 150% predicted, and heterogeneous emphysema defined using a quantitative chest computed tomography algorithm. Following standardized pulmonary rehabilitation, patients were randomized 2:1 to receive unilateral lobar placement of endobronchial valves plus optimal medical management or optimal medical management alone. The co-primary endpoint was the mean percent change in FEV1 and six minute walk distance at 180 days. Secondary end-points included mean percent change in St. George's Respiratory Questionnaire score and the mean absolute changes in the maximal work load measured by cycle ergometry, dyspnea (mMRC score, and total oxygen use per day. Per patient response rates in clinically significant improvement/maintenance of FEV1 and six minute walk distance and technical success rates of valve placement were recorded. Apriori response predictors based on quantitative CT and lung physiology were defined. Conclusion If endobronchial valves improve FEV1 and health status with an acceptable safety profile in advanced emphysema, they would offer a novel intervention for this progressive and

  17. Sonoporation with Acoustic Cluster Therapy (ACT®) induces transient tumour volume reduction in a subcutaneous xenograft model of pancreatic ductal adenocarcinoma.

    Kotopoulis, Spiros; Stigen, Endre; Popa, Mihaela; Safont, Mireia Mayoral; Healey, Andrew; Kvåle, Svein; Sontum, Per; Gjertsen, Bjørn Tore; Gilja, Odd Helge; McCormack, Emmet


    Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers with survival averaging only 3months if untreated following diagnosis. A major limitation in effectively treating PDAC using conventional and targeted chemotherapeutic agents, is inadequate drug delivery to the target location, predominantly due to a poorly vascularised, desmoplastic tumour microenvironment. Ultrasound in combination with ultrasound contrast agents, i.e., microbubbles, that flow through the vasculature and capillaries can be used to disrupt such mechanical barriers, potentially allowing for a greater therapeutic efficacy. This phenomenon is commonly referred to as sonoporation. In an attempt to improve the efficacy of sonoporation, novel microbubble formulations are being developed to address the limitation of commercially produced clinical diagnostic ultrasound contrast agents. In our work here we evaluate the ability of a novel formulation; namely Acoustic Cluster Therapy (ACT®) to improve the therapeutic efficacy of the chemotherapeutic agent paclitaxel, longitudinally in a xenograft model of PDAC. Results indicated that ACT® bubbles alone demonstrated no observable toxic effects, whilst ACT® in combination with paclitaxel can transiently reduce tumour volumes significantly, three days posttreatment (p=0.0347-0.0458). Quantitative 3D ultrasound validated the calliper measurements. Power Doppler ultrasound imaging indicated that ACT® in combination with paclitaxel was able to transiently sustain peak vasculature percentages as observed in the initial stages of tumour development. Nevertheless, there was no significant difference in tumour vasculature percentage at the end of treatment. The high vascular percentage correlated to the transient decrease and overall inhibition of the tumour volumes. In conclusion, ACT® improves the therapeutic efficacy of paclitaxel in a PDAC xenograft model allowing for transient tumour volume reduction and sustained tumour vasculature

  18. Total thyroidectomy for multinodular goiter - is it really an option in endemic region?

    Kalin Vidinov


    Full Text Available Bilateral multinodular goiter is the most common indications for surgery in endemic iodine-deficiency regions such as Bulgaria. Total thyroidectomy is currently the preferred treatment for thyroid cancer, for multinodular goiter. However many surgeons and endocrinologist still choose not to perform or recommend total thyroidectomy or lobectomy for bilateral or unilateral disease. We sought to assess whether the results support the hypothesis that total thyroidectomy is safe and can be considered as the optimal surgical approach for treating BMG in endemic region such as Bulgaria. A total of 500 patients were included in this study. They underwent thyroid operation between 2004 and 2009. We excluded patients with thyroid cancer or suspicion of thyroid malignancy. We evaluated indications for total thyroidectomy, complication rates, local recurrence rate and long-term outcome after total thyroidectomy. All patients had bilateral goiter diagnosed with ultrasound (n = 500. The incidence of permanent bilateral recurrent laryngeal nerve palsy was 0% and that of permanent unilateral recurrent laryngeal nerve palsy and permanent hypocalcaemia occurred was 0.8 - 1.2 %. Hemorrhage requiring repeat surgery occurred in 0.4-2 % of patients. There was no wound infection, and postoperative mortality was 0%. Total thyroidectomy is safe and is associated with a low incidence of disabilities. Ttotal thyroidectomy has the advantages of immediate and permanent cure and no recurrences.

  19. Artificial neural network analysis for evaluating cancer risk in multinodular goiter

    Baris Saylam


    Full Text Available Background: The aim of this study was to create a diagnostic model using the artificial neural networks (ANNs to predict malignancy in multinodular goiter patients with an indeterminate cytology. Materials and Methods: Out of 623 patients, 411 evaluated for multinodular goiter between July 2004 and March 2010 had a fine-needle aspiration biopsy. All patients underwent total thyroidectomy. The interpretation was consistent with an indeterminate lesion in 116 (18.6% patients. Patient′s medical records including age, sex, dominant nodule size, pre-operative serum thyroid-stimulating hormone level, thyroid hormone therapy and final pathologic diagnosis were collected retrospectively. Results: The mean age of the patients was 44.6 years (range, 17-78 years. About 104 (89.7% were female and 12 (10.3% were male patients. Final pathology revealed 24 malignant diseases (20.7% and 92 (79.3% benign diseases. After the completion of training, the ANN model was able to predict diagnosis of malignancy with a high degree of accuracy. The area under the curve of ANNs was 0.824. Conclusion: The ANNs technique is a useful aid in diagnosing malignancy and may help reduce unnecessary thyroidectomies in multinodular goiter patients with an indeterminate cytology. Further studies are needed to construct the optimal diagnostic model and to apply it in the clinical practice.

  20. Automated detection of masses on whole breast volume ultrasound scanner: false positive reduction using deep convolutional neural network

    Hiramatsu, Yuya; Muramatsu, Chisako; Kobayashi, Hironobu; Hara, Takeshi; Fujita, Hiroshi


    Breast cancer screening with mammography and ultrasonography is expected to improve sensitivity compared with mammography alone, especially for women with dense breast. An automated breast volume scanner (ABVS) provides the operator-independent whole breast data which facilitate double reading and comparison with past exams, contralateral breast, and multimodality images. However, large volumetric data in screening practice increase radiologists' workload. Therefore, our goal is to develop a computer-aided detection scheme of breast masses in ABVS data for assisting radiologists' diagnosis and comparison with mammographic findings. In this study, false positive (FP) reduction scheme using deep convolutional neural network (DCNN) was investigated. For training DCNN, true positive and FP samples were obtained from the result of our initial mass detection scheme using the vector convergence filter. Regions of interest including the detected regions were extracted from the multiplanar reconstraction slices. We investigated methods to select effective FP samples for training the DCNN. Based on the free response receiver operating characteristic analysis, simple random sampling from the entire candidates was most effective in this study. Using DCNN, the number of FPs could be reduced by 60%, while retaining 90% of true masses. The result indicates the potential usefulness of DCNN for FP reduction in automated mass detection on ABVS images.

  1. Comparison of distinctive models for calculating an interlobar emphysema heterogeneity index in patients prior to endoscopic lung volume reduction

    Theilig D


    Full Text Available Dorothea Theilig,1 Felix Doellinger,1 Alexander Poellinger,1 Vera Schreiter,1 Konrad Neumann,2 Ralf-Harto Hubner31Department of Radiology, Charité Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, Berlin, Germany; 2Institute of Biometrics and Clinical Epidemiology, Charité Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Germany; 3Department of Pneumology, Charité Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, Berlin, GermanyBackground: The degree of interlobar emphysema heterogeneity is thought to play an important role in the outcome of endoscopic lung volume reduction (ELVR therapy of patients with advanced COPD. There are multiple ways one could possibly define interlobar emphysema heterogeneity, and there is no standardized definition.Purpose: The aim of this study was to derive a formula for calculating an interlobar emphysema heterogeneity index (HI when evaluating a patient for ELVR. Furthermore, an attempt was made to identify a threshold for relevant interlobar emphysema heterogeneity with regard to ELVR.Patients and methods: We retrospectively analyzed 50 patients who had undergone technically successful ELVR with placement of one-way valves at our institution and had received lung function tests and computed tomography scans before and after treatment. Predictive accuracy of the different methods for HI calculation was assessed with receiver-operating characteristic curve analysis, assuming a minimum difference in forced expiratory volume in 1 second of 100 mL to indicate a clinically important change.Results: The HI defined as emphysema score of the targeted lobe (TL minus emphysema score of the ipsilateral nontargeted lobe disregarding the middle lobe yielded the best predicative accuracy (AUC =0.73, P=0.008. The HI defined as emphysema score of the TL minus emphysema score of the lung without the TL showed a similarly good predictive accuracy (AUC =0.72, P=0.009. Subgroup

  2. Effectiveness of bronchoscopic lung volume reduction using unilateral endobronchial valve: a systematic review and meta-analysis

    Choi M


    Full Text Available Miyoung Choi,1 Worl Suk Lee,1 Min Lee,1 Kyeongman Jeon,2 Seungsoo Sheen,3 Sanghoon Jheon,4 Young Sam Kim5 1National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 3Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea; 4Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; 5Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Bronchoscopic lung volume reduction (BLVR can be suggested as an alternative for surgical lung volume reduction surgery for severe emphysema patients. This article intends to evaluate by systematic review the safety and effectiveness of BLVR using a one-way endobronchial valve.Methods: A systematic search of electronic databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as eight domestic databases up to December 2013, was performed. Two reviewers independently screened all references according to selection criteria. The Scottish Intercollegiate Guidelines Network criterion was used to assess quality of literature. Data from randomized controlled trials were combined and meta-analysis was performed. Results: This review included 15 studies. Forced expiratory volume in 1 second (FEV1 improved in the intervention group compared with the control group (mean difference [MD]=6.71, 95% confidence interval [CI]: 3.31–10.11. Six-minute walking distance (MD=15.66, 95% CI: 1.69–29.64 and cycle workload (MD=4.43, 95% CI: 1.80–7.07 also improved. In addition, St George’s Respiratory Questionnaire score decreased (MD=4.29, 95% CI: -6.87 to -1.71 in the intervention group

  3. Thyroid hormone synthesis: a potential target of a Chinese herbal formula Haizao Yuhu Decoction acting on iodine-deficient goiter

    Mao, Xia; Yan, Chen; Guo, Xiaodong; Guo, Qiuyan; Liu, Zhenli; Song, Zhiqian; Lin, Na


    Haizao Yuhu Decoction (HYD), a famous multi-component herbal formula, has been widely used to treat various thyroid-related diseases, including iodine-deficient goiter. Herb pair Thallus Sargassi Pallidi (HZ) and Radix Glycyrrhizae (GC), one of the so-called “eighteen antagonistic medicaments”, contains in HYD. To explore pharmacological mechanisms of HYD acting on iodine-deficient goiter and to provide evidence for potential roles of herb pair HZ and GC in HYD, our genome-wide microarray detection and network analysis identified a list of goiter-related genes, mainly involved into the alterations in hypothalamus-pituitary-thyroid/gonad/growth axes. Then, the disease genes-drug genes interaction network illustrated the links between HYD regulating genes and goiter-related genes, and identified the candidate targets of HYD acting on goiter. Functionally, these candidate targets were closely correlated with thyroid hormone synthesis. Moreover, the potential regulating genes of herb pair HZ and GC were revealed to be crucial components in the pathway of thyroid hormone synthesis. The prediction results were all verified by following experiments based on goiter rats. Collectively, this integrative study combining microarray gene expression profiling, network analysis and experimental validations offers the convincing evidence that HYD may alleviate iodine-deficient goiter via regulating thyroid hormone synthesis, and explains the necessity of herb pair HZ and GC in HYD. Our work provides a novel and powerful means to clarify the mechanisms of action for multi-component drugs such as herbal formulae in a holistic way, which may improve drug development and applications. PMID:27384475

  4. Analysis of Orbital Volume Measurements Following Reduction and Internal Fixation Using Absorbable Mesh Plates and Screws for Patients With Orbital Floor Blowout Fractures.

    Hwang, Won Joo; Lee, Do Heon; Choi, Won; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong


    Hinge-shaped fractures are common type of orbital floor blowout fractures, for which reduction and internal fixation is ideal. Nonetheless, orbital floor reconstruction using alloplastic materials without reducing the number of bone fragments is the most frequently used procedure. Therefore, this study analyzed and compared the outcomes between open reduction and internal fixation using absorbable mesh plates and screws, and orbital floor reconstruction, by measuring the orbital volume before and after surgery. Among patients with orbital floor blowout fractures, this study was conducted on 28 patients who underwent open reduction and internal fixation, and 27 patients who underwent orbital floor reconstruction from December 2008 to September 2015. The mechanism of injury, ophthalmic symptoms before and after surgery, and the degree of enophthalmos were examined; subsequently, the volumes of the affected and unaffected sides were measured before and after surgery based on computed tomography images. This study compared the degree of recovery in the correction rate of the orbital volume, ophthalmic symptoms, and enophthalmos between the 2 groups. The patients who underwent open reduction and internal fixation, and the patients who underwent orbital floor reconstruction showed average correction rates of 100.36% and 105.24%, respectively. Open reduction and internal fixation showed statistically, significantly superior treatment outcomes compared with orbital floor reconstruction. The ophthalmic symptoms and incidence of enophthalmos completely resolved in both groups. For orbital floor blowout fractures, open reduction and internal fixation using absorbable mesh plates and screws was a feasible alternative to orbital floor reconstruction.

  5. Ultrasonographic determination of the thyroid volume in 7- 10 years old children of Bushehr port 2007

    Farzad Morad Haseli


    Full Text Available Background: Determination of thyroid volume using ultrasound has been recommended for monitoring public control of iodine deficiency programs in areas with mild iodine deficiency or with no iodine deficiency, instead of physical examination, in order to estimate the prevalence rate of goiter. The aim of this study was to determine the reference ranges of thyroid volume in Bushehr port. Methods: Thyroid volume of 1247 primary schoolchildren aged 7-10 years who were selected by probability proportionate to size method from rural and urban areas of Bushehr port was determined using ultrasonography. Medians and percentiles of thyroid volumes for age and body surface area were calculated for both genders. Results: The 97th percentiles of thyroid volume of Bushehr port schoolchildren according to age and sex were all lower than the corresponding sex-specific normative WHO reference values. Goiter prevalence was 1.68% according to WHO thyroid volume references for age in the studied population. The goiter prevalence according to age and body surface area-specific new normative WHO reference values were 7.13 and 7.17%, respectively. Conclusion: The 97th percentile for thyroid volume, calculated by ultrasonography in Bushehr port schoolchildren, were lower than the international WHO newly recommended reference values in all ages. Therefore, determination of a native reference value for estimating the prevalence rate of thyroid is highly recommended. According to ultrasonographically determined goiter prevalence, Bushehr is an iodine sufficient area.

  6. Effect of 30 mCi radioiodine on multinodular goiter previously treated with recombinant human thyroid-stimulating hormone

    Paz-Filho, G.J.; Mesa-Junior, C.O.; Boguszewski, C.L.; Carvalho, G.A.; Graf, H. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Endocrinologia e Metabologia; Olandoski, M. [Pontificia Univ. Catolica do Parana, Curitiba, PR (Brazil). Nucleo de Bioestatistica; Woellner, L.C. [Centro de Medicina Nuclear, Curitiba, PR (Brazil); Goedert, C.A. [Centro de Tomografia Computadorizada, Curitiba, PR (Brazil)


    Recombinant human thyroid-stimulating hormone (rhTSH) enhances {sup 131}I uptake, permitting a decrease in radiation for the treatment of multinodular goiter (MNG). Our objective was to evaluate the safety and efficacy of a single 0.1-mg dose of rhTSH, followed by 30 mCi {sup 131}I, in patients with MNG. Seventeen patients (15 females, 59.0 {+-} 13.1 years), who had never been submitted to {sup 131}I therapy, received a single 0.1-mg injection of rhTSH followed by 30 mCi {sup 131}I on the next day. Mean basal thyroid volume measured by computed tomography was 106.1 {+-} 64.4 mL. {sup 131}I 24-h uptake, TSH, free-T4, T3, thyroglobulin, anti-thyroid antibodies, and thyroid volume were evaluated at regular intervals of 12 months. Mean {sup 131}I 24-h uptake increased from 18.1 {+-} 9.7 to 49.6 {+-} 13.4% (P < 0.001), a median 2.6-fold increase (1.2 to 9.2). Peak hormonal levels were 10.86 {+-} 5.44 mU/L for TSH (a median 15.5-fold increase), 1.80 {+-} 0.48 ng/dL for free-T4, 204.61 {+-} 58.37 ng/dL for T3, and a median of 557.0 ng/mL for thyroglobulin. The adverse effects observed were hyperthyroidism (17.6%), painful thyroiditis (29.4%) and hypothyroidism (52.9%). Thyroid volume was reduced by 34.3 {+-} 14.3% after 6 months (P < 0.001) and by 46.0 {+-} 14.6% after 1 year (P < 0.001). Treatment of MNG with a single 0.1-mg dose of rhTSH, followed by a fixed amount of radioactivity of {sup 131}I, leads to an efficacious decrease in thyroid volume for the majority of the patients, with a moderate incidence of non-serious and readily treatable adverse effects. (author)

  7. Effect of 30 mCi radioiodine on multinodular goiter previously treated with recombinant human thyroid-stimulating hormone

    G.J. Paz-Filho


    Full Text Available Recombinant human thyroid-stimulating hormone (rhTSH enhances 131I uptake, permitting a decrease in radiation for the treatment of multinodular goiter (MNG. Our objective was to evaluate the safety and efficacy of a single 0.1-mg dose of rhTSH, followed by 30 mCi 131I, in patients with MNG. Seventeen patients (15 females, 59.0 ± 13.1 years, who had never been submitted to 131I therapy, received a single 0.1-mg injection of rhTSH followed by 30 mCi 131I on the next day. Mean basal thyroid volume measured by computed tomography was 106.1 ± 64.4 mL. 131I 24-h uptake, TSH, free-T4, T3, thyroglobulin, anti-thyroid antibodies, and thyroid volume were evaluated at regular intervals of 12 months. Mean 131I 24-h uptake increased from 18.1 ± 9.7 to 49.6 ± 13.4% (P < 0.001, a median 2.6-fold increase (1.2 to 9.2. Peak hormonal levels were 10.86 ± 5.44 mU/L for TSH (a median 15.5-fold increase, 1.80 ± 0.48 ng/dL for free-T4, 204.61 ± 58.37 ng/dL for T3, and a median of 557.0 ng/mL for thyroglobulin. The adverse effects observed were hyperthyroidism (17.6%, painful thyroiditis (29.4% and hypothyroidism (52.9%. Thyroid volume was reduced by 34.3 ± 14.3% after 6 months (P < 0.001 and by 46.0 ± 14.6% after 1 year (P < 0.001. Treatment of MNG with a single 0.1-mg dose of rhTSH, followed by a fixed amount of radioactivity of 131I, leads to an efficacious decrease in thyroid volume for the majority of the patients, with a moderate incidence of non-serious and readily treatable adverse effects.

  8. Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter

    Cramon, Per; Winther, Kristian Hillert; Watt, Torquil


    PRO scales in toxic nodular goiter (Anxiety, Overall HRQoL). However, significant disease-specific and generic HRQoL deficits persisted on multiple domains across both patient groups. Conclusions: Graves' hyperthyroidism and toxic nodular goiter cause severe disease-specific and generic HRQoL impairments......Background: The treatment of hyperthyroidism is aimed at improving health-related quality of life (HRQoL) and reducing morbidity and mortality. However, few studies have used validated questionnaires to assess HRQoL prospectively in such patients. The purpose of this study was to assess the impact...... of hyperthyroidism and its treatment on HRQoL using validated disease-specific and generic questionnaires. Methods: This prospective cohort study enrolled 88 patients with Graves' hyperthyroidism and 68 with toxic nodular goiter from endocrine outpatient clinics at two Danish university hospitals. The patients were...

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

    Bonnema, Steen J; Hegedüs, Laszlo


    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 o...... effective than (131)I therapy without rhTSH. However, no trial has yet compared (131)I therapy and surgery head-to-head, and future trials should include evaluation of quality of life and cost....

  10. The prevalence of thyroid cancers in surgically treated patients with nodular goiter in Şırnak city

    Sevda Sert Bektaş


    Full Text Available Objectives: Iodine deficiency is still considered to be the major etiological factor for endemic goiter. The pathogenesis of the goiter in iodine deficient area caries different characteristics. The aim of this study investigate the prevalence of thyroid cancers and type of thyroid cancers in surgically treated patients with nodular goiter in Şırnak city where is iodine deficiency region.Materials and methods: Thyroid surgical materials which were sent to our department were screened retrospectively from the archives between the years 2009-2010. Thyroid resection was performed on 241 patients with nodular goiter in one year. We evaluated patients who received the diagnosis of thyroid carcinoma with histhopatological examination.Results: 222 of our patients (92.1% female and 19 (7.9% were male. The youngest patient 16 and the oldest patient was 80 years old and the average age is 40.9 ± 12.8. Histopathological examination of 197 (81.7% cases of nodular goiter, 31 (12.9% cases lymphocytic thyroiditis, 13 (5.4% patients had thyroid tumors. The three tumors on the 2 cases (0.8% benign, 11 (4.6% were malignant. As a type of cancer 1 (0.4% patients, follicular carcinoma-oncocytic variant, 10 (4.2% cases were papillary carcinoma.Conclusions: Iodine deficiency area in the province of Şırnak in patients with nodular goiter who underwent surgery for thyroid cancer rate of 4.6%, and most cancers is seen as a type of thyroid papillary carcinoma.

  11. A community-based case–control study to investigate the role of iron deficiency in the persistence of goiter

    Rambha Pathak


    Full Text Available Objectives: To find out the magnitude of iron deficiency anemia in the age group of 6–12 years and investigate the role of iron deficiency as a possible contributor to endemic goiter in school children in Ambala. Materials and Methods: The present study was conducted as a subset of a cross-sectional study among 2700 children from 6 to 12 years of age to find out the prevalence of goiter. All the subjects who were found to be suffering from goiter in the cross-sectional study were enrolled in the case–control study as cases and were compared with age- and sex-matched controls (children without goiter from the same cohort. The study was conducted from February 2011 to January 2012. Results: Out of total, goiter was observed in 12.6% of the subjects. Urinary iodine excretion was found to be <100 μg/L in 57 (10.5% children. Mean hemoglobin (Hb level of the study population was 11.9 g/dL. It was noted that 71% of the goitrous children had anemia (Hb <12 g/dL as compared to 63.7% of the control group. Serum ferritin (SF was <15 ng/mL in 70% of the children. The mean ± standard deviation of SF in the goitrous and nongoitrous children was 19.65 ± 32.51 μg/L and 27.55 ± 21.07 μg/L, respectively (P = 0.012. Conclusion: The findings in the study suggest that iron deficiency anemia in children is contributing toward the persistence of goiter in the postiodization phase.

  12. Proceedings of waste stream minimization and utilization innovative concepts: An experimental technology exchange. Volume 1, Industrial solid waste processing municipal waste reduction/recycling

    Lee, V.E. [ed.; Watts, R.L.


    This two-volume proceedings summarizes the results of fifteen innovations that were funded through the US Department of Energy`s Innovative Concept Program. The fifteen innovations were presented at the sixth Innovative Concepts Fair, held in Austin, Texas, on April 22--23, 1993. The concepts in this year`s fair address innovations that can substantially reduce or use waste streams. Each paper describes the need for the proposed concept, the concept being proposed, and the concept`s economics and market potential, key experimental results, and future development needs. The papers are divided into two volumes: Volume 1 addresses innovations for industrial solid waste processing and municipal waste reduction/recycling, and Volume 2 addresses industrial liquid waste processing and industrial gaseous waste processing. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

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

    Bonnema, Steen Joop; Nielsen, Viveque E; Boel-Jørgensen, Henrik;


    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...... 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...

  14. The Impact of Homogeneous Versus Heterogeneous Emphysema on Dynamic Hyperinflation in Patients With Severe COPD Assessed for Lung Volume Reduction.

    Boutou, Afroditi K; Zoumot, Zaid; Nair, Arjun; Davey, Claire; Hansell, David M; Jamurtas, Athanasios; Polkey, Michael I; Hopkinson, Nicholas S


    Dynamic hyperinflation (DH) is a pathophysiologic hallmark of Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to investigate the impact of emphysema distribution on DH during a maximal cardiopulmonary exercise test (CPET) in patients with severe COPD. This was a retrospective analysis of prospectively collected data among severe COPD patients who underwent thoracic high-resolution computed tomography, full lung function measurements and maximal CPET with inspiratory manouvers as assessment for a lung volume reduction procedure. ΔIC was calculated by subtracting the end-exercise inspiratory capacity (eIC) from resting IC (rIC) and expressed as a percentage of rIC (ΔIC%). Emphysema quantification was conducted at 3 predefined levels using the syngo PULMO-CT (Siemens AG); a difference >25% between best and worse slice was defined as heterogeneous emphysema. Fifty patients with heterogeneous (62.7% male; 60.9 ± 7.5 years old; FEV1% = 32.4 ± 11.4) and 14 with homogeneous emphysema (61.5% male; 62.5 ± 5.9 years old; FEV1% = 28.1 ± 10.3) fulfilled the enrolment criteria. The groups were matched for all baseline variables. ΔIC% was significantly higher in homogeneous emphysema (39.8% ± 9.8% vs.31.2% ± 13%, p = 0.031), while no other CPET parameter differed between the groups. Upper lobe predominance of emphysema correlated positively with peak oxygen pulse, peak oxygen uptake and peak respiratory rate, and negatively with ΔIC%. Homogeneous emphysema is associated with more DH during maximum exercise in COPD patients.

  15. Bone marrow response in treated patients with Gaucher disease: evaluation by T1-weighted magnetic resonance images and correlation with reduction in liver and spleen volume

    Terk, M.R. [University of Southern California, Los Angeles, CA (United States). Dept. of Radiology; LAC/USC Imaging Science Center, Los Angeles, CA (United States); Dardashti, S. [University of Southern California, Los Angeles, CA (United States). Dept. of Radiology; Liebman, H.A. [University of Southern California, Los Angeles, CA (United States). Dept. of Medicine


    Purpose. To determine whether T1-weighted magnetic resonance (MR) images can demonstrate response in the marrow of patients with type 1 Gaucher disease treated with enzyme replacement therapy (ERT) and to determine whether a relationship exists between liver and spleen volume reductions and visible marrow changes.Patients. Forty-two patients with type 1 Gaucher disease were evaluated on at least two occasions. Thirty-two patients received ERT. Of these patients, 15 had a baseline examination prior to the initiation of ERT. The remaining 10 patients did not receive ERT.Design. T1-weighted and gradient recalled echo (GRE) coronal images of the femurs and hips were obtained. Concurrently, liver and spleen volumes were determined using contiguous breath-hold axial gradient-echo images. T1-weighted images of the hips and femurs were evaluated to determine change or lack of change in the yellow marrow.Results. Of the 32 patients receiving ERT, 14 (44%) demonstrated increased signal on T1-weighted images suggesting an increase in the amount of yellow marrow. If only the 15 patients with a baseline examination were considered, the response rate to ERT was 67%. Using Student's t-test a highly significant correlation (P<0.005) was found between marrow response and reduction in liver and spleen volume.Conclusions. Marrow changes in patients receiving ERT can be detected by T1-weighted images. This response correlated with reductions in visceral volumes (P<0.0005). (orig.)

  16. An outbreak of thyroid hyperplasia (goiter) with high mortality in budgerigars (Melopsittacus undulatus).

    Loukopoulos, Panayiotis; Bautista, Adrienne C; Puschner, Birgit; Murphy, Brian; Crossley, Beate M; Holser, Ian; Gomes, Lucy; Shivaprasad, H L; Uzal, Francisco A


    An outbreak of goiter with high morbidity and mortality in a flock of budgerigars (Melopsittacus undulatus) in California is described. Forty-five out of 400 adult birds exhibited signs of illness, weight loss, and enlargement in the crop area; 15 of the 45 birds died over a 2-3-month period. Diet consisted of a commercial mixture with the addition of broccoli, whole oats, and carrots, but no minerals or supplements. Six budgerigars were subjected to necropsy; all 6 birds had severely enlarged thyroid glands. Thyroid follicular hyperplasia was histologically observed in all birds examined, while granulomatous thyroiditis and microfollicular adenoma were observed in 2 birds, respectively. Virological, bacteriological, parasitological, and heavy metal analyses were negative or within normal limits. The total iodine in the thyroid glands of affected birds was measured by inductively coupled plasma-mass spectrometry. Following iodine supplementation and removal of broccoli from the diet, the owner reported weight gain and a reduced death rate among clinically affected birds; no additional birds became sick. The presence of broccoli with its iodine-binding ability and the complete lack of added minerals in the diet of these animals were thought to be the predisposing factors for the outbreak in the present study. Outbreaks of goiter accompanied by high mortality are rare in any species and, to the best of the authors' knowledge, have not been described previously in any avian species. Recognition of this condition may help improve medical, welfare, and trade standards concerning this species.

  17. Surgery for thyroid goiter in western India. A prospective analysis of 334 cases.

    Bapat R


    Full Text Available 334 consecutive cases of thyroid swellings operated by a single surgical unit over 9 years have been analysed prospectively. There was a female preponderence (4.39:1. The swellings were clinically differentiated into uninodular (39.52%, multinodular (47.31% and diffuse (13.17%. Hyperthyroidism was manifested in 49 cases (14.67%. Pressure symptoms were present in only 1.5% cases. FNAC detected malignancy in 14 of 162 cases (8.64%. The initial 100 cases were operated upon by standard Lahey′s technique and the latter 234 by modified technique described by Bapat et al for benign thyroid disease. Operations performed included nodulectomies (5.39%, hemithyroidectomies (41.92%, partial thyroidectomies (25.75%, subtotal (25.45% and near total thyroidectomies (1.5%. Post-operative complications were higher in the first group and included unilateral cord palsies-5 (5%. hypocalcemia-4 (4% hypoparathyroidism-1 (1% haemorrhage-1 (1% and mortality-1 (1% vis a vis cord palsies-2 (0.85%, hypocalcemia-3 (1.28%, hypoparathyroidism-1 (0.43% and there was no mortality. Histopathology revealed 83 (24.85% colloid goiters, 193 (57.78% nodular goiters, 21 (6.29% follicular adenomas, 7 (2.10% cases of thyroiditis and 30 (8.98% malignancies. This study reveals the lower incidence of RLN palsy after modified thyroidectomies, and a low incidence of malignancy.

  18. 重度肺气肿的内镜下肺减容治疗技术%Application of endoscopic lung volume reduction technique in severe emphysema

    迟晶; 郭述良; 贾晋伟; 李一诗


    慢性阻塞性肺病(chronic obstructive pulmonary diseases,COPD)在世界范围的发病率和死亡率占主要因素.COPD发展至重度肺气肿阶段时严重影响患者生活质量.内镜肺减容术(endoscopic lung volume reduction,ELVR)是通过支气管镜技术使过度充气的肺叶产生不张,疗效较传统的内科治疗更为确切,与外科肺减容术相比,ELVR以其微创,操作相对简单,并发症和死亡率降低等优点,引起了世界医学界的广泛研究.目前国内外研究较多的内镜下肺减容技术主要包括支气管内单向活瓣技术(one-way endobronchial valves,EBV)、气道旁路支架(airway bypass stents,ABS)、聚合物肺减容术(polymeric lung volume reduction,PLVR)、经支气管镜热蒸汽消融术(bronchoscopic thermal vapor ablation,BTVA)和肺减容弹簧圈(lung volume reduction coil,LVRC)等5种.本文将就上述内镜肺减容技术作一综述.%Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide.Once the disease develops into severe emphysema,it seriously affects the patients' life quality.Endoscopic lung volume reduction(ELVR) with bronchoscopic techniques to bring about atelectasis of the hyperinflated lobe has been developed and studied widely over the past decade,because it has a better clinical effect than the traditional medicine treatment.The techniques have the advantages of minimally invasive and simple with less complications and lower mortality compared to the open surgical approach.Nowadays the most commonly used ELVR techniques include one-way endobronchial valves (EBV),airway bypass stents (ABS),polymeric lung volume reduction (PLVR),bronchoscopic thermal vapor ablation (BTVA) and lung volume reduction coil (LVRC).In this paper the ELVR techniques are reviewed.

  19. A novel mutation in the thyroglobulin gene that causes goiter and dwarfism in Wistar Hannover GALAS rats.

    Sato, Akira; Abe, Kuniya; Yuzuriha, Misako; Fujii, Sakiko; Takahashi, Naofumi; Hojo, Hitoshi; Teramoto, Shoji; Aoyama, Hiroaki


    Outbred stocks of rats have been used extensively in biomedical, pharmaceutical and/or toxicological studies as a model of genetically heterogeneous human populations. One of such stocks is the Wistar Hannover GALAS rat. However, the colony of Wistar Hannover GALAS rat has been suspected of keeping a problematic mutation that manifests two distinct spontaneous abnormalities, goiter and dwarfism, which often confuses study results. We have successfully identified the responsible mutation, a guanine to thymine transversion at the acceptor site (3' end) of intron 6 in the thyroglobulin (Tg) gene (Tgc.749-1G>T), that induces a complete missing of exon 7 from the whole Tg transcript by mating experiments and subsequent molecular analyses. The following observations confirmed that Tgc.749-1G>T/Tgc.749-1G>T homozygotes manifested both dwarfism and goiter, while Tgc.749-1G>T/+ heterozygotes had only a goiter with normal appearance, suggesting that the mutant phenotypes inherit as an autosomal semi-dominant trait. The mutant phenotypes, goiter and dwarfism, mimicked those caused by typical endocrine disrupters attacking the thyroid. Hence a simple and reliable diagnostic methodology has been developed for genomic DNA-based genotyping of animals. The diagnostic methodology reported here would allow users of Wistar Hannover GALAS rats to evaluate their study results precisely by carefully interpreting the data obtained from Tgc.749-1G>T/+ heterozygotes having externally undetectable thyroidal lesions. Copyright © 2014 Elsevier B.V. All rights reserved.


    E.A. Troshina


    Full Text Available The article highlights the evaluation results of the IQ indices demonstrated by the school students, who reside in the regions with different degrees of the iodine deficiency severity and iodine provided regions. The authors performed the comparative analysis of the IQ indices among children with clinically euthyroid diffusive goiter and among children with normal sizes of the thyroid gland. The research included 260 children aged from 8 to 10 from 13 regions of the Russian Federation: 130 patients with the goiter diagnosed subject to the data of the ultrasound investigation and 130 children, who have normal sizes of the thyroid gland (reference group. The comparison groups were homogenous according to the education conditions (as only children from the city comprehensive schools took part in the research. For the evaluation of the intellectual development, authors used R. Kettell's intellect test free from the cultural impact (Сulture-Fair Intelligence Test, CFIT — CF 2А form. Despite the fact that the average IQ indices in the group of children with goiter were slightly lower than among children with normal sizes of the thyroid gland, the researchers failed to identify statistically significant differences between the average IQ indices among children in the compared groups (р > 0,05. Both in the group of children with goiter and in the reference group, the average IQ indices fell within «the low normal» (80–89 points.Key words: iodine, hypothyroidism, IQ intellect index, children.

  1. [Surgical treatment of multinodular goiter at the Instituto Nacional de la Nutrición Salvador Zubirán].

    López, L H; Herrera, M F; Gamino, R; González, O; Pérez-Enriquez, B; Rivera, R; Gamboa-Domínguez, A; Angeles-Angeles, A; Rull, J A


    Surgical treatment is the first option for patients with obstructive multinodular goiter. The extent of the resection and the use of postoperative hormonal therapy are, on the other hand, still under debate. To analyze the results of surgical treatment in 101 patient with multinodular goiter seen from 1980 to 1995. The clinical/pathologic charts of all patients were reviewed with emphasis to the clinical diagnosis, extent of resection, final histology, type and number of complications, and long-term follow-up. The mean follow-up was three years (range 0.5-12). Ten males and 91 females with a mean age of 46 years were included. Surgery was recommended for a nodule suspicious of malignancy in 60 patients, for airway compression in 33, and for cosmetic reasons in eight. Unilateral lobectomy was performed in 30, bilateral subtotal thyroidectomy in 55 and total thyroidectomy in 16. Postoperative hormone therapy was administrated to 83 patients. Surgical complications occurred in six patients. Four developed permanent hypoparathyroidism and two vocal cord paralysis. There was no operative mortality. A final diagnosis of multinodular goiter was established in 89 whereas 12 had cancer. There were three asymptomatic recurrences in the group with benign lesions (they had undergone unilateral lobectomy followed by hormonal therapy). Bilateral subtotal thyroidectomy was the best treatment for multinodular goiter in our series. This procedure had few complications and there was no recurrence of the disease.

  2. Goiter prevalence, urinary iodine, and salt iodization level in sub-Himalayan Darjeeling district of West Bengal, India.

    Biswas, Akhil Bandhu; Das, Dilip Kumar; Chakraborty, Indranil; Biswas, Asit Kumar; Sharma, Puran Kumar; Biswas, Romy


    National iodine deficiency disorders control program needs to be continuously monitored. Hence, a cross-sectional study was conducted during the period from April-May 2011 to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Darjeeling district, West Bengal. Study subjects were 2400 school children, aged 8-10 years selected through "30 cluster" sampling methodology. Goiter was assessed by standard palpation technique, UIE was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. Overall goiter prevalence rate was 8.7% (95% confidence intervals = 7.6-9.8) and goiter prevalence was significantly different with respect to gender. Median UIE level was 15.6 mcg/dL (normal range: 10-20 mcg/dL). About 92.6% of the salt samples tested had adequate iodine content of ≥15 ppm. Findings of the present study indicate that the district is in a transition phase from iodine-deficiency to iodine sufficiency.

  3. Survey of thyroid diseases among inhabitants exposed to fallout radiation from the nuclear power station explosion at Chernobyl, 2; Prevalence of palpable goiter in school children

    Sugenoya, Akira; Masuda, Hiroyuki; Asanuma, Kazuhiko; Iida, Futoshi (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine); Skidanenko, G.S.


    We report the prevalence of diffuse goiter and thyroid nodules in children aged 10-15 years living at Chechelsk city, Byelorussia, which is one of the high radioactive fallout areas after the Chernobyl accident. Seven hundred thirteen children (330 males and 383 females) were enrolled in the study. The goiter staging was defined according to the WHO classification. Those who showed apparent goiter from Grade I to III were additionally examined by ultrasonography. The prevalence of palpable goiter was 41.5% in males and 56.9% in females. The incidence in females was significantly higher than that in males (p<0.01). In the ultrasonography survey, 9 (3 males and 6 females) of 196 children revealed one or several small nodules in diffuse goiter, which were less than 1 cm in size and appeared as irregular hypoechoic lesions. These school children with nodular lesions require further medical examination for defined diagnosis and proper treatment. Future investigation regarding both the endemic goiter of this district and goiter prevalence in non-affected neighboring areas is crucial for evaluating the effects of radioactive fallout correctly. (author).

  4. Eleventh annual Department of Energy low-level waste management conference. Volume 3: Waste characterization, waste reduction and minimization, prototype licensing application



    Thirteen papers are presented in volume 3. The seven papers on waste characterization discuss sampling, analysis, and certification techniques for low-level radioactive wastes. Three papers discuss US DOE waste minimization policies and regulations, Y-12 Plant`s reduction of chlorinated solvents, and C-14 removal from spent resins. The last three papers discuss the licensing studies for earth-mounded concrete bunkers for LLW disposal. Papers have been processed separately for inclusion on the data base.

  5. Eleventh annual Department of Energy low-level waste management conference. Volume 3: Waste characterization, waste reduction and minimization, prototype licensing application



    Thirteen papers are presented in volume 3. The seven papers on waste characterization discuss sampling, analysis, and certification techniques for low-level radioactive wastes. Three papers discuss US DOE waste minimization policies and regulations, Y-12 Plant`s reduction of chlorinated solvents, and C-14 removal from spent resins. The last three papers discuss the licensing studies for earth-mounded concrete bunkers for LLW disposal. Papers have been processed separately for inclusion on the data base.

  6. Retrosternal Goiter

    Mehmet Erol


    1-      Hong CM, Ahn BC, Jeong SY, Lee SW, Lee J. Distant metastatic lesions in patients with differentiated thyroid carcinoma. Clinical implications of radioiodine and FDG uptake. Nuklearmedizin. 2013 Aug 8;52(4:121-9

  7. [Amyloid goiter].

    Hrívó, A; Péter, I; Bánkúti, B; Péley, G; Baska, F; Besznyák, I


    Amyloid goitre is at an extremely rare occurrence. Authors review the origin of disease and its symptoms, diagnostic and therapeutic tools. The disease may be due to either primary or secondary systemic or local amyloidosis. Diagnosis may be made even before surgery on anamnestic data, on very rapid growth of thyroid glands, on diffuse appearance, on other symptoms of systemic amyloidosis, on findings of iconographic procedures and on detection of amyloid in aspirates. Final diagnosis is based on histology. Surgical therapy is aiming at avoidance of the existing and the threatening consequences of expanding mass. The outcome is independent from thyroid surgery, it is related to other manifestations of amyloidosis. Concerning with the present case the chronic superior vena cava syndrome and chylous pleural effusion as first described symptoms and asymptomatic hyperthyroxinaemia is emphasised. Neither other organ involvement, nor primary amyloidogenous molecula was found during the 18 months follow up, so patient has secondary and localised amyloidosis.

  8. Nodal colloid goiter: clinical and morphological criteria of thyroid autonomy and progressive growth

    S S Antonova


    Full Text Available Goal. To work up clinical and morphological criteria of thyroid authonomy and progressive growth in nodal colloid goiter (NCG. Methods. A group of patients with nodal euthyroid goiter (NEG (40 patients and a group of patients with nodular toxic goiter (NTG (40 patients were formed to compare clinical and morphological criteria of NCG growth to/with development of functional autonomy (FA. All patients were conducted research including physical examination, thyroid palpation, ultrasound, blood level of TSH and T4, scintigraphy, aspiration (needle biopsy, immunocytological and immunohistological reactions and statistics. In the study the method of indirect immunoperoxidase reaction with monoclonal rat/mouse antigens to Ki-67, TSH, galectin-3, Apo-test (“Dako Corporation”, “Novocastra Laboratories Ltd.” was used. Results. 1. In NEG expression of cell proliferation marker Ki-67 for certain rises pro rata to increase of proliferation degree, and in NTG grows according to FA development. 2. Apoptosis expression in NEG decreases according to degree of thyrocytes in a nodule, but in NTG falls pro rata to accumulation of thyroid FA. 3. Positive reaction for TSH in NEG tissue was found in 100%, whereas negative reaction for this receptor in NTG tissue was observed in 81% of all cases. 4. Galectin-3 was expressed in focuses of severe dysplasia of thyroid nodes tissue comparable to galectin-3 expression in the tissue of high-grade differentiated adenocarcinomas. Summary/conclusion. 1. Severe and moderate expression of Ki-67 and mild or negative immunomorphological reaction for Apo-test allows to refer such kinds of nodules to fast-growing/rapid-growing ones. 2. Reliable negative expression TSH receptor in the tissue of NCG is evidence of FA development and is an indication for a treatment of radioactive iodine or for an operation. 3. Galectin-3 probably is an early marker of malignant transformation in thyroid tissue. 4. Having conducted complex

  9. [Analysis of predictors of malignancy of nodular goiters: about 500 cases].

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou


    Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only

  10. Iodine nutritional status and goiter prevalence in primary school children aged 6-12 of Panchmahal district, Gujarat, India

    Vihang Mazumdar


    Full Text Available Introduction: Iodine deficiency disorders (IDD create major public health problems in India, including Gujarat. Panchmahal district is known for endemic iodine deficiency. The present study was conducted to (1 estimate the prevalence of goiter in primary school children, (2 determine median urinary iodine concentration, (3 assess the level of iodine in salt samples at the household and retail shop level, and (4 profile of salt sold at retail shops in Panchmahal district, Gujarat. Methods: A total of 70 students including five boys and five girls from 1st to 7th standard who were present on the day of the first visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each standard in each cluster. From the community, at least 28 students, including two boys and two girls from each standard in the same age group, were examined, and salt samples were tested from their households. A total of 2100 students were examined in schools and 928 students were examined in the selected villages. From each village, one retail shop was visited, and salts purchased from those shops were immediately tested for iodine with spot kits.Results: Among young primary school children, goiter prevalence was 23.35% (grade 1—18.35%, grade 2—5.0%. As the ages increase, goiter prevalence also increases except for 9-year-olds. The median urinary iodine excretion level was 110 µg/L. An iodine level >15 ppm was found in 78.3% of the salt samples tested at household level. Conclusion: The present study showed considerable goiter prevalence in primary school children in Panchmahal district of Gujarat and an inadequate iodine content of salt at the household level.

  11. Regional Brain Volumes Moderate, but Do Not Mediate, the Effects of Group-Based Exercise Training on Reductions in Loneliness in Older Adults

    Diane K. Ehlers


    Full Text Available Introduction: Despite the prevalence of and negative health consequences associated with perceived loneliness in older adults, few studies have examined interactions among behavioral, psychosocial, and neural mechanisms. Research suggests that physical activity and improvements in perceived social support and stress are related to reductions in loneliness. Yet, the influence of brain structure on these changes is unknown. The present study examined whether change in regional brain volume mediated the effects of changes in social support and stress on change in perceived loneliness after an exercise intervention. We also examined the extent to which baseline brain volumes moderated the relationship between changes in social support, stress, and loneliness.Methods: Participants were 247 older adults (65.4 ± 4.6 years-old enrolled in a 6-month randomized controlled trial comprised of four exercise conditions: Dance (n = 69, Strength/Stretching/Stability (n = 70, Walk (n = 54, and Walk Plus (n = 54. All groups met for 1 h, three times weekly. Participants completed questionnaires assessing perceived social support, stress, and loneliness at baseline and post-intervention. Regional brain volumes (amygdala, prefrontal cortex [PFC], hippocampus before and after intervention were measured with automatic segmentation of each participant's T1-weighted structural MRI. Data were analyzed in a latent modeling framework.Results: Perceived social support increased (p = 0.003, while stress (p < 0.001, and loneliness (p = 0.001 decreased over the intervention. Increased social support directly (−0.63, p < 0.01 and indirectly, through decreased stress (−0.10, p = 0.02, predicted decreased loneliness. Changes in amygdala, PFC, and hippocampus volumes were unrelated to change in psychosocial variables (all p ≥ 0.44. However, individuals with larger baseline amygdalae experienced greater decreases in loneliness due to greater reductions in stress (0.35, p = 0

  12. Regional Brain Volumes Moderate, but Do Not Mediate, the Effects of Group-Based Exercise Training on Reductions in Loneliness in Older Adults.

    Ehlers, Diane K; Daugherty, Ana M; Burzynska, Agnieszka Z; Fanning, Jason; Awick, Elizabeth A; Chaddock-Heyman, Laura; Kramer, Arthur F; McAuley, Edward


    Introduction: Despite the prevalence of and negative health consequences associated with perceived loneliness in older adults, few studies have examined interactions among behavioral, psychosocial, and neural mechanisms. Research suggests that physical activity and improvements in perceived social support and stress are related to reductions in loneliness. Yet, the influence of brain structure on these changes is unknown. The present study examined whether change in regional brain volume mediated the effects of changes in social support and stress on change in perceived loneliness after an exercise intervention. We also examined the extent to which baseline brain volumes moderated the relationship between changes in social support, stress, and loneliness. Methods: Participants were 247 older adults (65.4 ± 4.6 years-old) enrolled in a 6-month randomized controlled trial comprised of four exercise conditions: Dance (n = 69), Strength/Stretching/Stability (n = 70), Walk (n = 54), and Walk Plus (n = 54). All groups met for 1 h, three times weekly. Participants completed questionnaires assessing perceived social support, stress, and loneliness at baseline and post-intervention. Regional brain volumes (amygdala, prefrontal cortex [PFC], hippocampus) before and after intervention were measured with automatic segmentation of each participant's T1-weighted structural MRI. Data were analyzed in a latent modeling framework. Results: Perceived social support increased (p = 0.003), while stress (p < 0.001), and loneliness (p = 0.001) decreased over the intervention. Increased social support directly (-0.63, p < 0.01) and indirectly, through decreased stress (-0.10, p = 0.02), predicted decreased loneliness. Changes in amygdala, PFC, and hippocampus volumes were unrelated to change in psychosocial variables (all p ≥ 0.44). However, individuals with larger baseline amygdalae experienced greater decreases in loneliness due to greater reductions in stress (0.35, p = 0

  13. Unusual presentation of a cutaneous leiomyoma of the neck simulating a goiter

    Kouame Kanga


    Full Text Available We report an unusual case of a large cutaneous leiomyoma. Dermal leiomyomas are rare and benign skin tumors derived from the smooth erector muscles of the hair. The patient was a 12-year-old child who came in for a consultation on a big cervical tumor of the anterior part of the neck which simulated goiter. The lesion evolved since the patient was five years old; it was consistently firm and was associated with skin ulceration and significant deep suppurations. Computed tomography (CT scan revealed that this tumor was limited to the soft and cutaneous tissues without invading the thoracic muscles. Surgical treatment allowed the excision of the gelatinous and well vascularized skin tumor measuring about 15 cm in diameter. Final histological examination confirmed the diagnosis of dermal leiomyoma.

  14. Diffuse infiltration of Aspergillus hyphae in the thyroid gland with multinodular goiter

    Havva Erdem


    Full Text Available A 35-year-old woman presented with a thyroid mass, weakness and shortness of breath of 3 years duration. On physical examination, she had a diffusely enlarged thyroid gland with multiple nodules. There were no signs to suggest immune suppression. The patient farmed and raised livestock. Biochemical tests and hemogram were normal. She underwent surgery, and a histological examination of the surgical specimen revealed nodular hyperplasia. Microscopically, silver methenamine (PASM stain-positive hyphae that divided into branches at 45° and conidia were detected beside the thyroid capsule, with conidia in the cystic nodule. Moreover, ischemic changes of the thyroid tissue were observed closer to the capsule. We report a case of Aspergillosis of the thyroid of a patient who underwent surgery for a multinodular goiter.

  15. Multinodular goiter treatment with radioiodine aided by recombinant human TSH in different doses: a randomized, double-blind, placebo-controlled study;Administracao previa do TSH humano recombinante, em diferentes doses, no tratamento do bocio multinodular com iodo radioativo: um estudo randomizado, duplo cego, controlado com placebo

    Albino, Claudio Cordeiro


    Background: There is not an optimal treatment for multinodular goiter (MNG). Surgery is the main therapeutic option because it decreases thyroid volume, reduces compression symptoms and provide histological diagnosis. Radioiodine ({sup 131}I) is an efficient therapeutic option for the treatment of MNG mainly when surgery is not indicated or when the patient refused it. However, high activities of {sup 131}I are frequently required for clinically significant results. This procedure increases the body radiation exposure and the hospitalization costs. Recombinant human TSH (rh TSH) allows a reduction in the administered activity of {sup 131}I with effective thyroid volume (TV) reduction. However, this combination therapeutic can increase collateral effects. Objective: To evaluate the efficacy and safety of low and intermediate doses of rh TSH compared to placebo, associated with a fixed activity of {sup 131}I in MNG treatment. Patients and Methods: Thirty patients with MNG received 0.1 mg of rh TSH (group I, n=10), 0.01 mg of rh TSH (group II, n=10), or placebo (control group, n=10). After 24 hours, 30 mCi of {sup 131}I was given to all patients. Radioactive iodine uptake (RAIU) was determined before and 24 hours after rh TSH. Before and 2, 7, 180 and 360 days after the TV was measured by magnetic resonance image (MRI). The smallest cross-sectional area of tracheal lumen (Scat) was also measured with MRI before, 2 and 7 days after treatment. Antithyroid antibodies, TSH, T3 and free T4 were assessed regularly. Results: After 6 months, the decrease in TV was more significant in groups I (30.3 +- 16.5%) and II (22.6 +- 14.5%), than in control group (5.0 +- 14.6%; p=0.01). After 12 months, TV decreased more in group I (39.2 +- 16.9%) and group II (38.8 +- 24.4%) than in group III (23.4 +- 23.59%) but it was not statistically significant (p=0.205). During the first 30 days,total T3 and free T4 increased, without reaching thyrotoxic levels and TSH decreased. After 12 months

  16. Magnetic resonance imaging signal reduction may precede volume loss in the pituitary gland of transfusion-dependent beta-thalassemic patients

    Hekmatnia, Ali; Rahmani, Ali Asghar; Adibi, Atoosa (Image Processing and Signal Research Center, Dept. of Radiology, Isfahan Univ. of Medical Sciences, Isfahan (Iran)); Radmard, Amir Reza (Dept. of Radiology, Shariati Hospital, Tehran Univ. of Medical Sciences, Tehran (Iran)); Khademi, Hooman (Shariati Hospital, Tehran Univ. of Medical Sciences, Tehran (Iran)), e-mail:


    Background: Pituitary iron overload in patients with transfusion-dependent beta-thalassemia may lead to delayed puberty. Magnetic resonance imaging (MRI) has the potential to estimate tissue iron concentration by detecting its paramagnetic effect and hypophyseal damage by measuring its dimensions indirectly. Purpose: To investigate the association of pituitary MRI findings and pubertal status in thalassemic patients as well as to demonstrate any priority in appearance of them. Material and Methods: Twenty-seven beta-thalassemic patients, aged 15-25 years, were divided into 13 with (group A) and 14 without hypogonadism (group B), matched by age, gender, duration of transfusion, and chelation therapy. Thirty-eight age- and sex-adjusted healthy control individuals were also included (group C). All participants underwent pituitary MRI using a 1.5T unit. Pituitary-to-fat signal intensity ratios (SIR) were calculated from coronal T2-weighted images. Estimated pituitary volumes were measured using pituitary height, width, and length on T1-weighted images. Results: The mean values of pituitary-to-fat SIRs were significantly lower in group A as compared with group B (P <0.001), and likewise group B had statistically lower values than group C (P=0.03). The pituitary height and volume were significantly decreased in group A compared to group B (P = 0.006 and P = 0.002, respectively), while these differences did not demonstrate statistically significance between groups B and C. Conclusion: Pituitary MRI findings such as signal intensity reduction and decrease in volume can be useful markers in estimating pituitary dysfunction in beta-thalassemic patients. Compared to healthy controls, lower values of pituitary-to-fat SIRs in thalassemic patients experiencing normal puberty, without marked decrease in volume, indicate that signal reduction may precede volume loss and could be expected first on MRI

  17. Evaluation of endemic goiter prevalence in Bulgarian schoolchildren: results from national strategies for prevention and control of iodine-deficiency disorders.

    Gatseva, Penka; Vladeva, Stefka; Argirova, Mariana


    Iodine deficiency is a major health problem worldwide. The environment of the Balkan countries, including Bulgaria, is distinguished for its low iodine content. In 1994, the strategies for the prevention and control of iodinedeficiency disorders were actualized in Bulgaria and universal salt iodization and supplementation for the risk population groups (schoolchildren, pregnant women) were introduced. The aim of this study was to assess the effectiveness of the iodine prophylaxis in schoolchildren, living in an endemic for goiter area after the introduction of salt iodization in Bulgaria. For this purpose, the goiter prevalence and iodine status in 483 schoolchildren (274 boys and 209 girls) aged between 8 and 15 yr, living in an endemic for goiter area in Bulgaria were evaluated. Despite the normalization of iodine supply, mild iodine deficiency on the basis of goiter prevalence (16.15%) and urinary iodine excretion was found. These data indicate the need for reevaluation of the national strategy for prevention of iodine deficiency.

  18. Localized gray matter volume reductions in the pars triangularis of the inferior frontal gyrus in individuals at clinical high-risk for psychosis and first episode for schizophrenia.

    Iwashiro, Norichika; Suga, Motomu; Takano, Yosuke; Inoue, Hideyuki; Natsubori, Tatsunobu; Satomura, Yoshihiro; Koike, Shinsuke; Yahata, Noriaki; Murakami, Mizuho; Katsura, Masaki; Gonoi, Wataru; Sasaki, Hiroki; Takao, Hidemasa; Abe, Osamu; Kasai, Kiyoto; Yamasue, Hidenori


    Recent studies have suggested an important role for Broca's region and its right hemisphere counterpart in the pathophysiology of schizophrenia, owing to its roles in language and interpersonal information processing. Broca's region consists of the pars opercularis (PO) and the pars triangularis (PT). Neuroimaging studies have suggested that they have differential functional roles in healthy individuals and contribute differentially to the pathogenesis of schizophrenic symptoms. However, volume changes in these regions in subjects with ultra-high risk for psychosis (UHR) or first-episode schizophrenia (FES) have not been clarified. In the present 3 Tesla magnetic resonance imaging study, we separately measured the gray matter volumes of the PO and PT using a reliable manual-tracing volumetry in 80 participants (20 with UHR, 20 with FES, and 40 matched controls). The controls constituted two groups: the first group was matched for age, sex, parental socioeconomic background, and intelligence quotient to UHR (n=20); the second was matched for those to FES (n=20). Compared with matched controls, the volume of the bilateral PT, but not that of the PO, was significantly reduced in the subjects with UHR and FES. The reduced right PT volume, which showed the largest effect size among regions-of-interest in the both UHR and FES groups, correlated with the severity of the positive symptoms also in the both groups. These results suggest that localized gray matter volume reductions of the bilateral PT represent a vulnerability to schizophrenia in contrast to the PO volume, which was previously found to be reduced in patients with chronic schizophrenia. The right PT might preferentially contribute to the pathogenesis of psychotic symptoms.

  19. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.


    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

  20. HPA-axis function and grey matter volume reductions: imaging the diathesis-stress model in individuals at ultra-high risk of psychosis.

    Valli, I; Crossley, N A; Day, F; Stone, J; Tognin, S; Mondelli, V; Howes, O; Valmaggia, L; Pariante, C; McGuire, P


    The onset of psychosis is thought to involve interactions between environmental stressors and the brain, with cortisol as a putative mediator. We examined the relationship between the cortisol stress response and brain structure in subjects at ultra-high risk (UHR) for psychosis. Waking salivary cortisol was measured in 22 individuals at UHR for psychosis and 17 healthy controls. Grey matter volume was assessed using magnetic resonance imaging at 3 T. The relationship between the stress response and grey matter volume was investigated using voxel-based analyses. Our predictions of the topography of cortisol action as a structural brain modulator were informed by measures of brain glucocorticoid and mineralcorticoid receptor distribution obtained from the multimodal neuroanatomical and genetic Allen Brain Atlas. Across all subjects, reduced responsivity of the hypothalamus-pituitary-adrenal (HPA) axis was correlated with smaller grey matter volumes in the frontal, parietal and temporal cortex and in the hippocampus. This relationship was particularly marked in the UHR subjects in the right prefrontal, left parahippocampal/fusiform and parietal cortices. The subgroup that subsequently developed psychosis showed a significant blunting of HPA stress response, observed at trend level also in the whole UHR sample. Altered responses to stress in people at high risk of psychosis are related to reductions in grey matter volume in areas implicated in the vulnerability to psychotic disorders. These areas may represent the neural components of a stress vulnerability model.

  1. Leito de drenagem: sistema natural para redução de volume de lodo de estação de tratamento de água Draining beds: natural system for sludge volume reduction in the water treatment plant

    Cali Laguna Achon


    Full Text Available As Estações de Tratamento de Água (ETAs tem funcionamento semelhante a uma indústria e podem em diversas etapas gerar resíduos que, na maioria das ETAs, são lançados nos corpos d’água sem tratamento. Neste trabalho avaliou-se o desempenho de Leitos de Drenagem, para o desaguamento de lodo, provenientes de ETAs de ciclo completo que empregam sulfato de alumínio e cloreto de polialumínio (PACl, como coagulantes. Analisou-se as características, a drenagem e secagem dos amostras de lodo e característica do drenado. Os Leitos de Drenagem mostraram-se eficientes para desaguamento e redução de volume de lodo de ETA, de forma natural, sem consumo de energia ou adição de produtos químicos. Obteve-se, aos sete dias, reduções da ordem de 87 % em volume para os lodos de PACl e 83 % para o lodo de Sulfato de Alumínio e teor de sólidos totais 28% e 31% respectivamente.In this work the performance of Draining Beds for sludge dewatering was assessed. The sludge was provided from full cycle Water Treatment Plants (WTPs that employ aluminum sulfate and polyaluminium chloride (PACl as coagulants. The characteristics, drainage and drying of samples of sludge and characteristic of drained were analysed. The Draining Beds were shown to be efficient for dewatering and sludge volume reduction in the WTP, in a natural way, without energy consumption or adding of chemical products. On the seventh day, it was possible to obtain reduction around 87% in volume for PACl sludge and 83% for the aluminum sulfate sludge and total solids content of 28 and 31% respectively.

  2. Prevalence of simple nodular goiter and Hashimoto's thyroiditis in current, previous, and never smokers in a geographical area with mild iodine deficiency.

    Rendina, D; De Palma, D; De Filippo, G; De Pascale, F; Muscariello, R; Ippolito, R; Fazio, V; Fiengo, A; Benvenuto, D; Strazzullo, P; Galletti, F


    Simple nodular goiter and Hashimoto's thyroiditis are 2 frequent nonmalignant thyroid diseases. Tobacco smoking has detrimental effects on the endocrine system and in particular on thyroid function and morphology. The objective of this cross-sectional study, involving 1800 Caucasian adults from a geographical area with mild iodine deficiency, was to evaluate the relationship between tobacco smoking, smoking cessation, and the prevalence of simple nodular goiter and Hashimoto's thyroiditis. Thyroid status was evaluated by ultrasonic exploration of the neck, measurement of FT3, FT4, TSH, antibodies against thyroid peroxidase and thyroglobulin, and urinary iodine excretion. The fine-needle aspiration biopsy of significant nodules was also performed. Smoking habits were evaluated by a specific questionnaire and the calculation of number of pack years. Both current and previous smokers showed an increased risk of simple nodular goiter compared to never smokers after adjustment for potential confounders and known goitrogen factors. Interestingly, the simple nodular goiter risk was similar for never smokers and for previous smokers declaring a time since cessation of smoking for more than 69 months. Smoking habit was not associated to an increased risk of Hashimoto's thyroiditis.Smoking appears to be an independent risk factor for simple nodular goiter but not for Hashimoto's thyroiditis in an area with mild iodine deficiency. A prolonged withdrawal of smoking dramatically reduces the risk of simple nodular goiter occurrence.

  3. 支气管镜肺减容现状和展望%Current status and prospects of lung volume reduction surgery

    孙沁莹; 林冰


    The application of lung volume reduction surgery (LVRS) in clinical practice is limited by high postoperative morbidity and stringent selection criteria. Bronchoscopic lung-volume reduction has recently been explored as safer alternatives to LVRS for treating advanced emphysema. The currently available data on efficacy of bronchoscopic lung volume reduction are not conclusive and subjective benefit in dyspnoea scores,6MWT distance (6MWD) ,quality of life (SCRQ) are more frequent findings than improvements on spirometry or exercise tolerance. Safety data are more promising with rare procedure-related mortality, short hospital length of stay and few complications such as COPD exacerbation, peumonia, pneumo-thorax. The field of bronrhoscopic lung volume reduction continues to evolve as ongoing prospective randomized trials build on earlier feasibility data to clarify the true efficacy of such techniques.%外科肺减容手术治疗重度肺气肿术后病死率较高,适应证少,不适宜临床推广.支气管镜肺减容术通过支气管镜下的技术操作,简便、安全,有望替代外科肺减容术治疗重度肺气肿.目前研究比较有效的方法有支气管腔内单向阀、生物胶、蒸汽消融和肺减容线圈.支气管镜肺减容术治疗重度肺气肿,可以明显改善气促指数、6 min步行距离及生活质量(SGRQ)评分等主观指标,但对于评价该项技术有效性的客观指标如肺功能指标及运动耐力仅有部分改善.采用该项技术安全性好,住院时间短,极少出现危及生命的严重并发症,可能出现的并发症包括慢性阻塞性肺疾病急性加重、肺炎和气胸.下一步需开展前瞻性的随机对照研究,证实支气管镜肺减容术的确切疗效.

  4. Brazil - Poverty Reduction, Growth, and Fiscal Stability in the State of Ceara : A State Economic Memorandum, Volume 1. Policy Report

    World Bank


    Although the State of Ceara, in Brazil, is a model of good economic, and fiscal performance given its poverty status, recent analysis show poverty remains severe, in spite of significant reductions over the last decade. The combination of good governance, and sound fiscal management, industrial promotion, and public investments have been successful, but the report questions whether differe...

  5. Echocardiographic image tracker with a speckle adaptive noise reduction filter for the automatic measurement of the left atrial volume curve.

    Kusunose, Kenya; Chono, Tomoaki; Tabata, Tomotsugu; Yamada, Hirotsugu; Sata, Masataka


    Since tracking accuracy in left atrial (LA) images decreases due to low image quality around the LA in the apical view, a practical tracking method for LA images has not yet been proposed. The aim of this study was to assess an accurate and high-speed LA volume tracking (LAVT) method for the automatic measurement of LA volume (LAV) curves. We used three approved protocols in this study: (i) LAV curves were measured by LAVT on computer-simulated images; (ii) in 20 healthy volunteers, we assessed the feasibility and accuracy of this method compared with expert's measurements; and (iii) echocardiography and multi-detector row computed tomography (MDCT) imaging were performed on the same day in 20 patients with suspected coronary artery disease. On computer-simulated images, mean absolute percentage LAVT error in one cardiac cycle was 3% in filtered images and 16% in original images. In 20 healthy volunteers, there are strong correlations between LAVT and the expert's LA measurements (LA maximum volume; R = 0.93, P images with 20 patients, an excellent correlation was obtained between LAVs using echocardiography and MDCT (R = 0.98, P mean) and narrow limits of agreement (+15% of the mean). The mean time required for the LAVT analysis was 1.8 min, for the MDCT analysis was 35.8 min, and for the manual echocardiographic analysis was 14.0 min. This LAVT method is fast, valid, accurate, and reproducible for determining LAV in both simulated images and the clinical setting.

  6. Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter

    Saif Al-Yaarubi


    Full Text Available Background: Fine-needle aspiration (FNA is a useful method for evaluating multinodular goiter; however, its role is still controversial. The aim of this study was to assess the utility of ultrasound-guided thyroid FNA in detecting malignancy in patients with multinodular goiter in Oman. Materials and Methods: This was a retrospective study where all patients with multinodular goiter seen at the Sultan Qaboos University Hospital endocrinology clinic in Oman in 2005 were evaluated. The thyroid FNA results were grouped into either malignancy (positive result or others (negative result. They were compared to those of final histopathological examination in order to calculate the value of the test in diagnosing malignancy. Analyses were evaluated using descriptive statistics. Results: A total of 272 patients were included in the study. The mean age was 39΁13 years with an age range from 5 to 85 years. The majority of the patients were females (n=236; 87%. The results of thyroid FNA revealed that 6% (n=15 of the patients had malignancies while histopathological results showed that the proportion of subjects with malignancies was 18% (n=49. Out of the 15 cases identified to have malignances by thyroid FNA, only 53% (n=8 of the subjects were confirmed to have malignancy by biopsy. Overall, the results of the tests were poor, revealing a sensitivity of 16%, specificity of 97% and a diagnostic accuracy of 82%, with a positive predictive value of 53% and a negative predictive value of 84%. Conclusion: Thyroid FNA is not a useful test in differentiating multinodular goiter from malignancy, as more than 80% of the malignancies go unnoticed.

  7. Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters

    Prescott, E; Netterstrøm, B; Faber, J


    It has previously been shown that long-term oral exposure to cobalt can cause goiter and myxedema. The effect of industrial cobalt exposure on thyroid volume and function was determined for 61 female plate painters exposed to cobalt blue dyes in two Danish porcelain factories and 48 unexposed ref...

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

    Bonnema, Steen J; Stovgaard, Elisabeth S; Fast, Søren;


    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....... in the thyroid gland, but the study supports that (131)I therapy of benign nodular goiter carries no or only a minute risk of developing subsequent malignancies. It remains to be explored whether our findings also apply to hyperthyroid disorders.......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.......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...

  9. An outbreak of Salmonella enterica serotype Choleraesuis in goitered gazelle (Gazella subgutrosa subgutrosa) and a Malayan tapir (Tapirus indicus).

    Wolf, Tiffany M; Wünschmann, Arno; Morningstar-Shaw, Brenda; Pantlin, Gayle C; Rasmussen, James M; Thompson, Rachel L


    An outbreak of Salmonella enterica serotype Choleraesuis enteritis occurred in two juvenile goitered gazelles and an adult Malayan tapir over a period of 5 wk at the Minnesota Zoo. Diagnosis was made postmortem on one gazelle and one tapir, and a second gazelle was diagnosed via fecal culture. The death of the tapir was attributed to S. enterica serovar Choleraesuis septicemia, while salmonellosis was considered to be a contributing factor besides ostertagiasis for the death of one goitered gazelle and for the diarrhea of another goitered gazelle. A third gazelle became ill in the same time period, but Salmonella infection was not confirmed by culture. All exhibited the clinical signs of profuse, watery diarrhea. The gazelles developed a protein-losing enteropathy, and the tapir showed signs of sepsis and endotoxemia. Serotyping and pulsed-field gel electrophoresis revealed the Salmonella isolates to be indistinguishable from each other. One year prior to this outbreak, Salmonella sp. was cultured from a Visayan warty pig (Sus cebifrons) housed in the same building as the tapir. After further investigation into the outbreak, spread of this pathogen was speculated to be associated with human movement across animal areas.

  10. Archaeal community structure in leachate and solid waste is correlated to methane generation and volume reduction during biodegradation of municipal solid waste.

    Fei, Xunchang; Zekkos, Dimitrios; Raskin, Lutgarde


    Duplicate carefully-characterized municipal solid waste (MSW) specimens were reconstituted with waste constituents obtained from a MSW landfill and biodegraded in large-scale landfill simulators for about a year. Repeatability and relationships between changes in physical, chemical, and microbial characteristics taking place during the biodegradation process were evaluated. Parameters such as rate of change of soluble chemical oxygen demand in the leachate (rsCOD), rate of methane generation (rCH4), rate of specimen volume reduction (rVt), DNA concentration in the leachate, and archaeal community structures in the leachate and solid waste were monitored during operation. The DNA concentration in the leachate was correlated to rCH4 and rVt. The rCH4 was related to rsCOD and rVt when waste biodegradation was intensive. The structures of archaeal communities in the leachate and solid waste of both simulators were very similar and Methanobacteriaceae were the dominant archaeal family throughout the testing period. Monitoring the chemical and microbial characteristics of the leachate was informative of the biodegradation process and volume reduction in the simulators, suggesting that leachate monitoring could be informative of the extent of biodegradation in a full-scale landfill.

  11. Maximum likelihood estimate of life expectancy in the prehistoric Jomon: Canine pulp volume reduction suggests a longer life expectancy than previously thought.

    Sasaki, Tomohiko; Kondo, Osamu


    Recent theoretical progress potentially refutes past claims that paleodemographic estimations are flawed by statistical problems, including age mimicry and sample bias due to differential preservation. The life expectancy at age 15 of the Jomon period prehistoric populace in Japan was initially estimated to have been ∼16 years while a more recent analysis suggested 31.5 years. In this study, we provide alternative results based on a new methodology. The material comprises 234 mandibular canines from Jomon period skeletal remains and a reference sample of 363 mandibular canines of recent-modern Japanese. Dental pulp reduction is used as the age-indicator, which because of tooth durability is presumed to minimize the effect of differential preservation. Maximum likelihood estimation, which theoretically avoids age mimicry, was applied. Our methods also adjusted for the known pulp volume reduction rate among recent-modern Japanese to provide a better fit for observations in the Jomon period sample. Without adjustment for the known rate in pulp volume reduction, estimates of Jomon life expectancy at age 15 were dubiously long. However, when the rate was adjusted, the estimate results in a value that falls within the range of modern hunter-gatherers, with significantly better fit to the observations. The rate-adjusted result of 32.2 years more likely represents the true life expectancy of the Jomon people at age 15, than the result without adjustment. Considering ∼7% rate of antemortem loss of the mandibular canine observed in our Jomon period sample, actual life expectancy at age 15 may have been as high as ∼35.3 years. © 2016 Wiley Periodicals, Inc.

  12. Research and cure: knowledge and prophylaxis of endemic goiter in Argentina (1916-1958

    Feld, Adriana


    Full Text Available The present paper focuses on the reconstruction of the historical circumstances of knowledge production as well as and the debates about endemic goiter disease during the period 1916-1955 in Argentina. Taking into account the social, political and material dimensions, this text explores the re-signification of scientific and medical knowledge oriented to the prevention and health treatment, through the positioning of several social actors engaged all along the period, and the diverse historical and institutional contexts.

    El presente trabajo se orienta a reconstruir el recorrido histórico de la producción de conocimiento, así como los debates acerca de la enfermedad del bocio endémico en Argentina, fundamentalmente entre 1916 y 1955. Tomando en cuenta aspectos sociales, políticos y materiales, el trabajo explora la resignificación del conocimiento científico y médico en términos de medidas de prevención y tratamiento de la salud, a través del posicionamiento de diversos actores sociales implicados y de diversos contextos históricos e institucionales.

  13. Thyrocyte-specific Gq/G11 deficiency impairs thyroid function and prevents goiter development.

    Kero, Jukka; Ahmed, Kashan; Wettschureck, Nina; Tunaru, Sorin; Wintermantel, Tim; Greiner, Erich; Schütz, Günther; Offermanns, Stefan


    The function of the adult thyroid is regulated by thyroid-stimulating hormone (TSH), which acts through a G protein-coupled receptor. Overactivation of the TSH receptor results in hyperthyroidism and goiter. The Gs-mediated stimulation of adenylyl cyclase-dependent cAMP formation has been regarded as the principal intracellular signaling mechanism mediating the action of TSH. Here we show that the Gq/G11-mediated signaling pathway plays an unexpected and essential role in the regulation of thyroid function. Mice lacking the alpha subunits of Gq and G11 specifically in thyroid epithelial cells showed severely reduced iodine organification and thyroid hormone secretion in response to TSH, and many developed hypothyroidism within months after birth. In addition, thyrocyte-specific Galphaq/Galpha11-deficient mice lacked the normal proliferative thyroid response to TSH or goitrogenic diet, indicating an essential role of this pathway in the adaptive growth of the thyroid gland. Our data suggest that Gq/G11 and their downstream effectors are promising targets to interfere with increased thyroid function and growth.

  14. Goiter prevalence in school-going children: A cross-sectional study in two border districts of sub-Himalayan Jammu and Kashmir.

    Gupta, Rajiv Kumar; Langer, Bhavna; Raina, Sunil Kumar; Kumari, Rashmi; Jan, Reyaz; Rani, Renu


    Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6-12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch) children age 6-12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400) to estimate iodine content in the salt. The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9-12 years age group as compared to 6-9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02). Estimation of iodine content of the salt samples revealed that all of them (100%) had adequate iodine content. Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence.

  15. Goiter prevalence in school-going children: A cross-sectional study in two border districts of sub-Himalayan Jammu and Kashmir

    Rajiv Kumar Gupta


    Full Text Available Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6–12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch children age 6–12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400 to estimate iodine content in the salt. Results: The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9–12 years age group as compared to 6–9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02. Estimation of iodine content of the salt samples revealed that all of them (100% had adequate iodine content. Conclusion: Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence.

  16. Dead space reduction by Kolobow's endotracheal tube does not justify the waiving of volume monitoring in small, ventilated lungs.

    Proquitté, Hans; Wendel, Rena; Roehr, Charles C; Wauer, Roland R; Schmalisch, Gerd


    In ventilated preterm infants the flow sensor contributes significantly to the total apparatus dead space, which may impair gas exchange. The aim of the study was to quantify to which extent a dead space reduced Kolobow tube (KB) without flow sensor improves the gas exchange compared with a conventional ventilator circuit with flow sensor [Babylog 8000 (BL)]. In a cross-over trial in 14 tracheotomized, surfactant-depleted (saline lavage) and mechanically ventilated newborn piglets (age space of BL and KB including the endotracheal tube were 3.0 and 1.34 mL. Despite a 50 % apparatus dead space reduction with KB compared to BL statistically significant improvements were only observed for body weights monitoring.

  17. Defectivity and particle reduction for mask life extension, and imprint mask replication for high-volume semiconductor manufacturing

    Emoto, Keiji; Sakai, Fumio; Sato, Chiaki; Takabayashi, Yukio; Nakano, Hitoshi; Takabayashi, Tsuneo; Yamamoto, Kiyohito; Hattori, Tadashi; Hiura, Mitsuru; Ando, Toshiaki; Kawanobe, Yoshio; Azuma, Hisanobu; Iwanaga, Takehiko; Choi, Jin; Aghili, Ali; Jones, Chris; Irving, J. W.; Fletcher, Brian; Ye, Zhengmao


    Imprint lithography has been shown to be an effective technique for replication of nano-scale features. Jet and Flash* Imprint Lithography (J-FIL*) involves the field-by-field deposition and exposure of a low viscosity resist deposited by jetting technology onto the substrate. The patterned mask is lowered into the fluid which then quickly flows into the relief patterns in the mask by capillary action. Following this filling step, the resist is crosslinked under UV radiation, and then the mask is removed, leaving a patterned resist on the substrate. Criteria specific to any lithographic process for the semiconductor industry include overlay, throughput and defectivity. The purpose of this paper is to describe the technology advancements made in the reduction of particle adders in an imprint tool and introduce the new mask replication tool that will enable the fabrication of replica masks with added residual image placement errors suitable for memory devices with half pitches smaller than 15nm. Hard particles on a wafer or mask create the possibility of creating a permanent defect on the mask that can impact device yield and mask life. By using material methods to reduce particle shedding and by introducing an air curtain system, test stand results demonstrate the potential for extending mask life to better than 1000 wafers. Additionally, a new replication tool, the FPA-1100 NR2 is introduced. Mask chuck flatness simulation results were also performed and demonstrate that residual image placement errors can be reduced to as little as 1nm.

  18. Lung volume reduction in pulmonary emphysema from the radiologist's perspective; Lungenvolumenreduktion beim Lungenemphysem aus der Sicht des Radiologen

    Doellinger, F.; Poellinger, A. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Huebner, R.H. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Internal Medicine/Infectious and Respiratory Diseases; Kuhnigk, J.M. [Fraunhofer MEVIS, Bremen (Germany). Inst. for Medical Image Computing


    Pulmonary emphysema causes decrease in lung function due to irreversible dilatation of intrapulmonary air spaces, which is linked to high morbidity and mortality. Lung volume reduction (LVR) is an invasive therapeutical option for pulmonary emphysema in order to improve ventilation mechanics. LVR can be carried out by lung resection surgery or different minimally invasive endoscopical procedures. All LVR-options require mandatory preinterventional evaluation to detect hyperinflated dysfunctional lung areas as target structures for treatment. Quantitative computed tomography can determine the volume percentage of emphysematous lung and its topographical distribution based on the lung's radiodensity. Modern techniques allow for lobebased quantification that facilitates treatment planning. Clinical tests still play the most important role in post-interventional therapy monitoring, but CT is crucial in the detection of postoperative complications and foreshadows the method's high potential in sophisticated experimental studies. Within the last ten years, LVR with endobronchial valves has become an extensively researched minimally-invasive treatment option. However, this therapy is considerably complicated by the frequent occurrence of functional interlobar shunts. The presence of ''collateral ventilation'' has to be ruled out prior to valve implantations, as the presence of these extraanatomical connections between different lobes may jeopardize the success of therapy. Recent experimental studies evaluated the automatic detection of incomplete lobar fissures from CT scans, because they are considered to be a predictor for the existence of shunts. To date, these methods are yet to show acceptable results.

  19. Early treatment volume reduction rate as a prognostic factor in patients treated with chemoradiotherapy for limited stage small cell lung cancer

    Lee, Joo Hwan; Lee, Jeong Shin; Lee, Chang Geol; Cho, Jae Ho [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Jin Hyun; Kim, Jun Won [Dept. of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)


    To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC). We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%). With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group. ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.


    Djoko Kartono, PhD


    Full Text Available Based on the National Mapping Survey on Iodine Deficiency Disorders (IDD 1996/1998, Sub-District of Sungai Selan at District of Bangka Tengah, Province of Kep.Bangka Belitung was in category of severe endemic goitre. The objective of this study is to know risk factors that influence on the development of thyroid gland in Sub-district of Sungai Selan. Location of study was student of grade 3, 4 and 5 of 3 Primary School in Sub-district of Sungai Selan (severe endemic dan another 3 Primary School in Sub-district of Pangkalan Baru (non-endemic. These 6 Primary Schools were the location surveyed in 199611998. Data collection included urinary iodine concentration (UIC, iodine rich food consumption, thiocyanate rich food consumption, iodine content in salt consumed by household and iodine content in drinking water. Score of iodine rich food and score of thiocyanate rich food consumptions higher in non-endemic than in endemic area. Median value of UIC in endemic area was higher in endemic ar.ea although the median in both areas was in category of excess iodine i.e. 310 µg/L in non-endemic and 488 µg/L in endemic area respectively. All subject, in endemic and non-endemic areas, consumed iodised salt. Iodine content in salt was 35.5 part per million (ppm in non-endemic and 29,8 ppm in endemic area. The conclusion was that consumption of iodine and thiocyanate rich food and iodine content in salt and in drinking water were not the risk factors of IDD in that area.   Key words: risk factor, goiter, salt, drinking water, urinary iodine

  1. Intrathoracic Goiter. A Case Report Bocio endotorácico. Presentación de un caso

    José Alberto Puerto Lorenzo


    Full Text Available Goiter is an enlargement of the thyroid gland in the anterolateral part of the neck. It is estimated that approximately 3 % of the population worldwide suffer from this condition, although the incidence of nodular goiter has decreased in some countries due to the intake of iodized salt and iodine-rich food. A case of a 59 year-old female patient who attended consultation with an enlargement of the neck, accompanied by weakness, palpitations and dysphagia is presented. After being examined, she underwent surgery which confirmed the diagnosis of intrathoracic goiter. Since this is a rare pathology, it is of scientific interest for professionals dealing with the study and treatment of thyroid conditions.Se denomina bocio al aumento de volumen de la glándula tiroides en la región antero-lateral del cuello. Se calcula que aproximadamente el 3 % de los pobladores del mundo lo tienen, aunque la incidencia del bocio nodular ha disminuido debido a la ingestión en algunos países de sal yodada y alimentos ricos en yodo. Se presenta el caso de una paciente de 59 años que acudió a consulta por presentar aumento de volumen del cuello, acompañado de decaimiento, palpitaciones y disfagia, la cual después de ser estudiada en consulta fue intervenida quirúrgicamente, en la que se corroboró el diagnóstico de un bocio endotorácico. Por ser esta patología poco frecuente, se considera de interés científico para los profesionales dedicados al estudio y tratamiento de las afecciones tiroideas.

  2. Goiter prevalence and iodine nutritional status of school children in a sub-Himalayan Tarai region of eastern Uttar Pradesh.

    Chandra, A K; Bhattacharjee, A; Malik, T; Ghosh, S


    The present work was undertaken to evaluate the prevalence of goiter, state of iodine nutrition of the population, distribution of iodine through edible salt, bioavailability of iodine, consumption of common goitrogenic food that generally interfere with iodine nutrition in Naugarh sub-division of Siddharthnagar district in Uttar Pradesh, India. Five areas were selected from 5 Community Development (CD) Blocks taking one from each by purposive sampling method. In each area, Primary and Junior high schools were selected by simple random sampling to get representative target population. Clinical goiter survey was conducted in 1663 school-aged children from both sexes (6-12 yrs), along with the biochemical analysis of iodine (I) and thiocyanate (SCN) in 200 urine samples, iodine content in 175 edible salt samples and 20 water samples collected from the selected study areas. The studied region is severely affected by Iodine deficiency disorders (IDD) as goiter prevalence is 30.2% (grade 1: 27.1% grade 2:3.1%). Median urinary iodine level was 96 microg/L indicating biochemical iodine deficiency. The mean urinary thiocyanate was 0.810+/-0.490 mg/dL and mean of I/SCN ratios in all the studied areas were above the critical level of 7. However, 22% of the individual had I/SCN ratio salt samples had adequate iodine i.e., >or=15 ppm while iodine content in drinking water varied between 7.5-10.7 microg/L. Iodine deficiency is the primary cause, however the consumption of cyanogenic food may have important role for the persistence of IDD in the studied region during post salt iodization phase.

  3. Thyroid Ultrasonography Consistently Identifies Goiter in Adults Over the Age of 30 Years Despite a Diminished Response with Aging of the Thyroid Gland to the Effects of Goitrogenesis

    Sheela R. Brahmbhatt


    Full Text Available Iodine deficiency is a national health problem in India and we have recently reported on the severity of IDD in adults and children in Gujarat province. The aim of this study was to determine the utility of thyroid ultrasonography to detect goiter in adults from an iodine-deficient population of Gujarat. We studied 472 adults selected by random household surveys. Data were collected on height, body weight, mid-upper arm circumference, thigh circumference, triceps skinfold thickness, thyroid size (palpation and ultrasonography, and diet. Casual urine samples for iodine (UI and blood spots for TSH estimation were obtained. Endemic goiter is a major public health problem in Gujarat State, India and is probably caused by multiple factors including iodine deficiency, malnutrition, and other dietary goitrogens. These results indicate that thyroid US consistently detects goiter in adults despite a diminished thyroidal response to variable goitrogenic stimuli.

  4. 2010年浙江省弥漫性甲状腺肿患病状况与影响因素分析%Analysis of the prevalence and its influencing factors of diffuse goiter in Zhejiang

    毛光明; 丁钢强; 楼晓明; 朱文明; 王晓峰; 莫哲; 周金水


    Objective To evaluate the status of diffuse goiter of population in Zhejiang Province and to analyze the relevant influencing factors.Methods A total of 18 188 subjects were recruited in the cross sectional survey,by multistage stratified cluster random sampling method.B ultrasound measurement were carried among the subjects to detect the thyroid volume,and the basic information and life styles were interviewed by questionnaires.Then,we analyzed the distribution and its influencing factors of diffuse goiter.Results The ratio of diffuse goiter among the surveyed population was 2.2% (403/18 188),the difference showed statistical significance (x2 =267.11,P < 0.05).The ratio among the group aged 6-7 years old and 8-10 years old was comparatively high,separately 10.3% (27/262) and 9.8% (51/519).The ratio among women (2.9%,305/10 470) was higher than it among men (1.3%,97/7672) (x2 =55.55,P < 0.05).The residents from inland areas had the highest prevalence (3.2%,138/4374),followed by residents from sub-coastal areas (2.0%,131/6411),coastal areas minimum (1.8%,138/4374) (x2 =24.31,P < 0.05).The content of water iodine and salt iodine among people with symptoms of goiter had statistical difference with it among ordinary population (water iodine:x2 =4.95,P =0.026 ; salt iodine:x2 =11.03,P < 0.01).The median (quartile) of water iodine in ordinary population was 2.41 (1.96-6.15) μg/L and among people with symptoms of goiter was 1.88 (1.49-5.15) μg/L.The median (quartile) of salt iodine in ordinary population was 30.18 (24.69-32.65) mg/kg and among people with symptoms of goiter was 29.1 (24.70-31.95) mg/kg.The influential factors of goiter were as follows:the family income,the education degree,the job and profession status,the diet character,the habitual sea food consumption,the alcohol intake status (x2 were separately 8.08,37.85,98.78,68.69,10.91,12.21,26.94,P < 0.05).Multi-factor analysis showed the results as follows:female (OR =0.27 95% CI:0

  5. Growth inhibition of human thyroid carcinoma and goiter cells in vitro by the isoflavone derivative 7-(O)-carboxymethyl daidzein conjugated to N-t-boc-hexylenediamine.

    Somjen, Dalia; Grafi-Cohen, Meital; Weisinger, Gary; Izkhakov, Elena; Sharon, Orli; Kraiem, Zaki; Fliss, Dan; Zikk, Daniel; Kohen, Fortune; Stern, Naftali


    Estrogens may enhance thyroid cancer cell growth. We have recently reported that a novel isoflavone-derived anti-estrogenic compound developed in our laboratory, the N-t-boc-hexylenediamine derivative of 7-(O)-carboxymethyl daidzein (cD-tboc), can induce apoptosis and retard growth in human thyroid carcinoma cell lines through inhibitory interaction on estrogen receptor β. Here we tested the hypothesis that cD-tboc can likewise retard cell growth in cultured human thyroid papillary carcinoma cells, normal thyroid cells, and goiter cells removed during thyroidectomy. In vitro experiments in cultured human thyroid normal, goiter, and papillary thyroid carcinoma (PTC) cells were performed. Estrogen receptors α and β (ERα and ERβ), DNA synthesis and creatine kinase (a marker of estrogenic genomic response), and the effects of cD-tboc on DNA synthesis in cultured human PTC cells were assessed. First, all cell types thus harvested and grown in culture expressed both ERα and ERβ, with a variably higher abundance of ERβ over ERα seen in the goiter and PTC cells, but not in the normal thyroid cells. Second, DNA synthesis and creatine kinase were increased in response to estradiol-17β (E2), the ERα agonist propyl-pyrazole-trisphenol as well as the ERβ agonist diarylpropionitrile. Third, cD-tboc dose-dependently inhibited DNA synthesis in cultured human PTC cells (-65%) and to a lesser extent in goiter cells (∼-30%). This study provides the first evidence that cD-tboc can act to inhibit growth in primary cultures of human PTC cells and goiter cells removed during thyroidectomy. Whether this can be utilized for the treatment of human thyroid cancer and/or goiter remains to be explored.

  6. [Prevalence of goiter in the Aachen area. Ultrasound volumetry of the thyroid gland of 1,336 adults in an endemic goiter region].

    Riehl, J; Kierdorf, H; Schmitt, H; Suiter, T; Sieberth, H G


    The aim of the study was to assess the prevalence of thyroid enlargement by ultrasonic volume measurements. 1336 adults living in the iodine-deficient area of Aachen, West Germany (760 females, 576 males, mean age: 54.05 +/- 16.09 years) were included in the investigation. The ultrasonic examination was carried out in patients who did not suffer from thyroid disease at the time of study. The thyroid volume was age-dependent and varied from 13.3 +/- 10.4 ml in patients 70 years. The prevalence of thyroid enlargement ranged from 14.3% in young people to 51.3% in the elderly. There was no difference in the volumes of the left and right thyroid lobe. The prevalence of thyroid enlargement was higher in females compared to males (p 70 years. There is evidence of a high prevalence of thyroid enlargement in iodine-deficient areas.

  7. Goiter prevalence in school-going children: A cross-sectional study in two border districts of sub-Himalayan Jammu and Kashmir

    Rajiv Kumar Gupta; Bhavna Langer; Sunil Kumar Raina; Rashmi Kumari; Reyaz Jan; Renu Rani


    Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6?12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted amon...

  8. Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy

    Jabbour, Salma K., E-mail: [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Kim, Sinae [Division of Biometrics, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Department of Biostatistics, School of Public Health, Rutgers University, New Brunswick, New Jersey (United States); Haider, Syed A. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Xu, Xiaoting [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow (China); Wu, Alson [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Surakanti, Sujani; Aisner, Joseph [Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Langenfeld, John [Division of Surgery, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States); Yue, Ning J.; Haffty, Bruce G.; Zou, Wei [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey (United States)


    Purpose: We sought to evaluate whether tumor response using cone beam computed tomography (CBCT) performed as part of the routine care during chemoradiation therapy (CRT) could forecast the outcome of unresectable, locally advanced, non-small cell lung cancer (NSCLC). Methods and Materials: We manually delineated primary tumor volumes (TV) of patients with NSCLC who were treated with radical CRT on days 1, 8, 15, 22, 29, 36, and 43 on CBCTs obtained as part of the standard radiation treatment course. Percentage reductions in TV were calculated and then correlated to survival and pattern of recurrence using Cox proportional hazard models. Clinical information including histologic subtype was also considered in the study of such associations. Results: We evaluated 38 patients with a median follow-up time of 23.4 months. The median TV reduction was 39.3% (range, 7.3%-69.3%) from day 1 (D1) to day 43 (D43) CBCTs. Overall survival was associated with TV reduction from D1 to D43 (hazard ratio [HR] 0.557, 95% CI 0.39-0.79, P=.0009). For every 10% decrease in TV from D1 to D43, the risk of death decreased by 44.3%. For patients whose TV decreased ≥39.3 or <39.3%, log-rank test demonstrated a separation in survival (P=.02), with median survivals of 31 months versus 10 months, respectively. Neither local recurrence (HR 0.791, 95% CI 0.51-1.23, P=.29), nor distant recurrence (HR 0.78, 95% CI 0.57-1.08, P=.137) correlated with TV decrease from D1 to D43. Histologic subtype showed no impact on our findings. Conclusions: TV reduction as determined by CBCT during CRT as part of routine care predicts post-CRT survival. Such knowledge may justify intensification of RT or application of additional therapies. Assessment of genomic characteristics of these tumors may permit a better understanding of behavior or prediction of therapeutic outcomes.

  9. Evaluations of Factors Predicting the Need for an Extra-Cervical Approach for Intra-Thoracic Goiter

    Ali Sadrizadeh


    Full Text Available Introduction: Intra-thoracic goiter refers to the extension of enlarged thyroid tissue into the thoracic inlet. This condition can produce symptoms of compression on adjacent organs and can sometimes be accompanied by malignant transformation. Therefore surgical treatment is almost always necessary. In order to remove the pathology with the fewest post-operative complications, selection of the appropriate surgical approach is essential. In this study we aimed to detect the criteria which help us select the best therapeutic approach.   Materials and Methods: In this retrospective study, 82 patients with intra-thoracic goiter were investigated. Their data were extracted from medical records and analyzed using SPSS software.   Results: Overall 82 patients, 18 (21% males and 64 (78% females with mean age of 56.38 years were studied. The most common clinical symptoms were mass (95% and dyspnea (73%. In most patients, the surgical approach was cervical (90.2%, while 9.8% of patients required an extra-cervical approach. Post-operation complications were observed in 17.1% of patients; the most common being transient recurrent laryngeal nerve paralysis (4.9%. Malignancy was reported in the histopathology of seven patients (8.5%. The most common malignant histopathology was papillary thyroid carcinoma (7.3%. Extension of the thyroid tissue below the uppermost level of the aortic arch was significantly correlated with the need for an extra-cervical approach to surgery (P

  10. Clinical and Epidemiological Clinical and Epidemiological Characteristics of Colloid Goiter Patients Undergoing Reoperation for Recurrent Thyroid Disease

    Gladys Iglesias Díaz


    Full Text Available Background: thyroid disease is one of the most prevalent medical conditions and thyroid cancer is the most common endocrine neoplasm. Thyroid reoperations are more common than it might seem.Objective: to establish the clinical and epidemiological characteristics of patients operated on for colloid goiter undergoing reoperation for recurrent thyroid disease.Methods: a case-series study was conducted at the León Cuervo Rubio Clinical-Surgical Hospital in Pinar del Rio. The sample included all patients (n = 29 who underwent thyroid operation and were reoperated on for recurrent thyroid disease in 2010, 2011 and 2012. The information was obtained from medical records and the register of histopathological diagnoses.Results: most patients (27.6% were in the 40-49 age group and females (79.3% were most affected. Recurrence was observed 5 to 9 years after surgery. Mixed nodules (55.2% followed by cysts (17.2% were the most frequent ultrasound diagnoses. Recurrent thyroid disease was malignant in 9% of patients.Conclusions: patients reoperated on for thyroid disease were mostly females in the fourth and fifth decade of life. The disease recurred in a period of 10 years after the first surgery in a greater number of cases. Follicular-patterned lesions, colloid goiter and cancer were the most common histologic diagnosis.

  11. Statistics for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater runoff best management practices (BMPs)

    Granato, Gregory E.


    The U.S. Geological Survey (USGS) developed the Stochastic Empirical Loading and Dilution Model (SELDM) in cooperation with the Federal Highway Administration (FHWA) to indicate the risk for stormwater concentrations, flows, and loads to be above user-selected water-quality goals and the potential effectiveness of mitigation measures to reduce such risks. SELDM models the potential effect of mitigation measures by using Monte Carlo methods with statistics that approximate the net effects of structural and nonstructural best management practices (BMPs). In this report, structural BMPs are defined as the components of the drainage pathway between the source of runoff and a stormwater discharge location that affect the volume, timing, or quality of runoff. SELDM uses a simple stochastic statistical model of BMP performance to develop planning-level estimates of runoff-event characteristics. This statistical approach can be used to represent a single BMP or an assemblage of BMPs. The SELDM BMP-treatment module has provisions for stochastic modeling of three stormwater treatments: volume reduction, hydrograph extension, and water-quality treatment. In SELDM, these three treatment variables are modeled by using the trapezoidal distribution and the rank correlation with the associated highway-runoff variables. This report describes methods for calculating the trapezoidal-distribution statistics and rank correlation coefficients for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater BMPs and provides the calculated values for these variables. This report also provides robust methods for estimating the minimum irreducible concentration (MIC), which is the lowest expected effluent concentration from a particular BMP site or a class of BMPs. These statistics are different from the statistics commonly used to characterize or compare BMPs. They are designed to provide a stochastic transfer function to approximate

  12. Determination of Thyroid Volume by Ultrasonography among Schoolchildren in Philippines

    Bu Kyung Kim


    Full Text Available Objective. Iodine deficiency is defined by the goiter and the urinary iodine concentration. However, a lack of local thyroid volume reference data resulted in the vague definition of goiter, especially in school-aged children. The aim of this paper was to determine the thyroid volumes by ultrasonography in schoolchildren aged 6 to 12 years living in Cagayan areas in Philippine. Methods. Cross-sectional thyroid ultrasonographic data of 158 schoolchildren aged 6–12 years from Tuguegarao and Lagum in Cagayan valley, Philippine were used. Thyroid volumes were compared based on logistic issue and urban and rural area and compared with other previously reported data. Results. The mean values of thyroid volume in Tuguerago and Lagum were 2.99±1.34 mL and 2.42±0.92 mL. The thyroid size was significantly in association with age (P<0.00, weight (P<0.00, height (P<0.00, and BSA (P<0.00 by Pearson’s correlation. The median thyroid volumes of schoolchildren investigated in this study were generally low compared to international reference data by age group but not by BSA. Conclusions. We propose for the first time local reference ultrasound values for thyroid volumes in 6–12 aged schoolchildren that should be used for monitoring iodine deficiency disorders.

  13. Surgical treatment of 27 patients with retrosternal goiter%27例胸骨后甲状腺肿手术治疗分析

    张志国; 段志军


    目的总结胸骨后甲状腺肿手术治疗经验及疗效.方法回顾性分析27例胸骨后甲状腺肿行颈低领式切口手术切除的临床资料.结果27例均获治愈,术后声嘶2例,发生一过性手足抽搐3例;均在1个月内恢复.27例均获随访12~26个月,无复发病例.结论经颈部切口切除胸骨后甲状腺肿适合绝大多数患者,术前CT扫描对手术方式的选择具有指导意义.%Objective: To sum up experience and curative effect from the surgical therapy of substernal goiter. Methods: The clinical data of 27 cases of substernal goiter subject to cervical collar incision were reviewed. Results: All of the patients achieved good results. In the 2 patients occurred hoarseness, three cases were with transient tetany, postoperative recovery was in in one months. no one’s goiter recurrence. Conclusions:Low neck collar incision removed substernal goiter is feasible for most patients. The choice of operation methods were established mainly on the basis of the preoperative CT scan.

  14. An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter

    Janczak D


    Full Text Available Dariusz Janczak,1,2 Wiktor Pawlowski,1 Tadeusz Dorobisz,1,3 Dawid Janczak,4 Karolina Dorobisz,5 Michal Lesniak,1 Agnieszka Ziomek,1 Mariusz Chabowski1,2 1Department of Surgery, 4th Military Teaching Hospital, 2Department of Clinical Nursing, Division of Nursing in Surgical Procedures, 3Department of Clinical Basics of Physiotherapy, 4Department of Palliative Care Nursing, Faculty of Health Science, 5Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland Background: Thyroid cancer (TC comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40–50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%–30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA biopsy. The FNA biopsy is favored for its simplicity, safety, and high specificity and sensitivity rates. Aim: The aim of our study was to evaluate the clinical efficacy of FNA based on the patients’ register. Materials and methods: In the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, 2,133 patients underwent thyroid surgery for thyroid goiter between 1996 and 2015. One hundred and eight cases of TC were diagnosed and of these, 66 patients had a preoperative FNA. Results: Fourteen FNA biopsies (21% revealed cancer, all of which were confirmed in the postoperative histopathology, although six cases of FNA-diagnosed cancer revealed a different histological type postoperatively. Eighteen FNA biopsies (27% were suspected of being malignant. A disturbingly high rate of “benign” FNA biopsies (32 cases; 48% revealed TC after surgery. Conclusion: It is of great importance that the quality and quantity of

  15. Prevalence of goiter and urinary iodine status in six-twelve-year-old rural primary school children of Bharuch district, Gujarat, India

    Haresh Rameshkumar Chandwani


    Full Text Available Background: Iodine deficiency disorder (IDD creates major public health problems in India, including Gujarat. The Bharuch district is a known iodine deficiency endemic area. This study was conducted to estimate the prevalence of goiter in primary school children; to determine the median urinary iodine concentration; to assess the level of iodine in salt samples at the household and retail shop levels; and to study the profile of salt sold at retail shops. Methods: This study was carried out by using the 30-cluster survey method in the primary schools of the rural areas in Bharuch district. A total of 70 students, including five boys and five girls from the first to seventh classes, who were present in class on the day of the visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each class in each cluster. From each community, a maximum of two boys and two girls from each standard in the same age group were examined and also salt samples were tested from their households. From each village, one retail shop was visited and the salt purchased from those shops was immediately tested for iodine with spot kits. Results: We found a goiter prevalence of 23.2% (grade 1 - 17.4% and grade 2 - 5.8%. As the age increased, the goiter prevalence decreased except in nine-year-olds. The median urinary iodine excretion level was 110 μg/L. An Iodine level > 15 ppm was found in 93% of the salt samples tested at the household level. Conclusion: The present study showed moderate goiter prevalence in primary school children in the Bharuch district of Gujarat and an inadequate iodine content of salt at some household levels.

  16. Clinical Pathological Features of 1 168 Cases of Nodular Goiter%结节性甲状腺肿1168例临床病理分析

    赵时梅; 罗宇; 史琳


    目的 探讨结节性甲状腺肿的临床病理特征.方法 回顾性分析1 168例结节性甲状腺肿的临床病理资料.结果 1 168例结节性甲状腺肿中,女性患者占88.1%,中位发病年龄为48岁.结节性甲状腺肿伴发或继发病变发生率高达57.6%,其中出血、坏死、钙化、囊性变,灶性淋巴细胞增生及桥本甲状腺炎发生率分别为20.4%、28.0%和0.3%.乳头状增生发生率为5.3%,甲状腺癌继发率为3.1%.结论 结节性甲状腺肿女性多发,继发病变多,诊断时应给予重视.%Objective To explore the clinical pathological features of nodular goiter. Methods The data of 1 168 nodular goiter were studied retrospectively. Results In all the 1168 cases,female patients occupied 88. 1% ,medianage was 48. Nodular goiter with the secondary cases was 57. 6% . Hemorrhage, necrosis, calcify, cystis degeneration; focal lymphoid hyperplasia; and hashimotos thyroiditis incidence in NG was 20. 4% ,28. 0% and 0. 3% ,respectively. The papillary hyperplasia was found in 5. 3% and the thyroid carcinoma was 3.1%. Conclusion Nodular goiter is more common in female than in male. The secondary cases are often found in nodular goiter and it should be given more attention.

  17. 胸骨后甲状腺肿26例的诊断与治疗%Diagnosis and surgical treatment of retrosternal goiter

    李长江; 袁启东; 程相超


    目的 探讨胸骨后甲状腺肿的外科治疗方法.方法 回顾性分析26例胸骨后甲状腺肿患者临床资料.结果 26例患者均行手术切除胸骨后甲状腺肿物,20例经颈部低位领式切口,6例经颈部低位领式切口加胸骨劈开.病理证实为结节性甲状腺肿18例,滤泡性腺瘤6例,甲状腺乳头状癌2例.术后出现喉返神经损伤表现2例,术后出血1例,经再次手术止血治愈,无手术死亡病例.结论 颈部低位领式切口入路可以完成大部分胸骨后甲状腺肿的手术切除,经胸手术入路对可疑癌变和巨大肿瘤患者安全可靠.%Objective To observe the diagnosis and surgical treatment of substemal goiter. Methods The clinical data of 26 cases with substemal goiter underwent thyroidresection were retrospectively analyzed. Results All the 26 cases were treated by operation. 20 cases were operated by Lower collar incision. 6 cases were operated by ster-notomy. The pathological results showed nodular goiter in 18 cases,follicular adenoma in 6 cases,and papillary carcinoma in 2 cases. Conclusions Surgery via cervical collar incision was fit for most of retrostemal thyroid nodules,and sternotomy or thoracotoray were safely fit for large or carcinomatous substemal goiter. Most cases of retrostemal goiter could be removed by Lower collar incision.


    V. A. Petrukhin


    Full Text Available Background: The course of pregnancy and delivery in patients with diffuse toxic goiter (DTG is often complicated by preeclampsia, fetoplacental insufficiency, placental abruption and associated with higher maternal and perinatal mortality. Aim: To study particulars of fetoplacental complex functioning in DTG. Materials and methods: We assessed pregnant patients with DTG (n = 92 and their newborns (n = 94. By the time of delivery, 86 of patients were clinically and biochemically euthyroid. Functions of fetoplacental complex (by levels of placental lactogen, α-fetoprotein, estriol, progesterone and cortisol were assessed by radioimmune and immunoenzyme assays. Fetometrical parameters of fetuses were studied by ultrasound method. Complex assessment of placentas was done by light and electronic microscopy. Results: Eighty seven (94,6% patients with DTG had combined complications of pregnancy. The most frequent were: the threat of termination of pregnancy, in 68 (73.9% of cases, low placenta placement, in 23 (25%, anemia, in 56 (60.9%, pre-eclampsia, in 56 (60.9%. In 59 of patients (64.1%, fetoplacental insufficiency was diagnosed, with predominance of strain or exhaustion reactions. Critical status of fetoplacental complex was found in pregnant patients with uncontrolled DTG and duration of control of less than 20 weeks, as well as in pregnant patients with DTG relapses. The values of main hormones (placental lactogen, α-fetoprotein and progesterone were below 10th percentile.According to the results of the ultrasound assessments, fetuses from mothers with DTG during gestation demonstrated decrease of the majority or percentile parameters, such as biparietal cranial size, fetal femoral length, abdomen diameter, that was especially prominent in the groups with relapsing DTG.Eighty eight of 94 newborns (93.6% were born full-term. In total, every third baby (29.3% had some degree of intrauterine developmental delay at birth. Among the cases with

  19. Hubungan Paparan Pestisida Dengan Kejadian Goiter Pada Petani Hortikultura Di Kecamatan Ngablak Kabupaten Magelang

    Hendra Budi Sungkawa


    Full Text Available ABSTRACT Background: Pesticides are toxic material  or a substance or mixture of substances used to kill a pest or  intended for preventing, destroying, repelling or mitigating any pest.[2] A pesticide may be a chemical substance, biological agent (such as a virus or bacterium, antimicrobial, disinfectant or device used against any pest. Pests in agriculture  include insects, plant pathogens, weeds, molluscs, birds, mammals, fish, nematodes (roundworms.  Although there are benefits to the use of pesticides, there are also drawbacks, such as potential toxicity to humans and environment. Usage pesticide which do not well  managed  may  generate negative impact. Chronic poisoning of pesticides may produce adverse effect on health, including, cancer, genetic mutation, thyroid diasease, reproductive disorders and neurodegenerative disases. Preliminary researh showed that farmer in district of Ngablak   98 %  have experience of pesticide exposure. Result of study indicate that 16,5 % farmer of horticulture that have pesticide exposure  district of Ngablak  have a disorder of  thyroid and manifest as goiter. This research objective was to find out the relation between pesticides exposure and the incidence of goitre on farmer exposed to pesticides. Method: this research used a case control design with  68 case and 68 control. The variable of the research include age, education, work duration, time of activity per day, pesticide type, pesticide dose, spraying frequency, time of  spraying, farmer position to wind direction while spraying and using of personal protective equipment. Result: Research result indicated  that variables that related to the incidence of endemic goitre were age (OR = 3,83; CI 95%= 1,88 – 7,81, work duration (OR = 12, 79; CI 95% = 2,85 – 57,53, time of activity per day (OR = 2,47; CI 95% = 1,16 – 5,23, pesticide type (OR = 5,86; CI 95% = 2,73 – 12,56, pesticide dose (OR = 2,96; CI 95% = 1,37 – 6

  20. Several clinical interests regarding lung volume reduction surgery for severe emphysema: meta-analysis and systematic review of randomized controlled trials

    Huang Wei


    Full Text Available Abstract Objectives We aim to address several clinical interests regarding lung volume reduction surgery (LVRS for severe emphysema using meta-analysis and systematic review of randomized controlled trials (RCTs. Methods Eight RCTs published from 1999 to 2010 were identified and synthesized to compare the efficacy and safety of LVRS vs conservative medical therapy. One RCT was obtained regarding comparison of median sternotomy (MS and video-assisted thoracoscopic surgery (VATS. And three RCTs were available evaluating clinical efficacy of using bovine pericardium for buttressing, autologous fibrin sealant and BioGlue, respectively. Results Odds ratio (95%CI, expressed as the mortality of group A (the group underwent LVRS versus group B (conservative medical therapies, was 5.16(2.84, 9.35 in 3 months, 3(0.94, 9.57 in 6 months, 1.05(0.82, 1.33 in 12 months, respectively. On the 3rd, 6th and 12th month, all lung function indices of group A were improved more significantly as compared with group B. PaO2 and PaCO2 on the 6th and 12th month showed the same trend. 6MWD of group A on the 6th month and 12th month were improved significantly than of group B, despite no difference on the 3rd month. Quality of life (QOL of group A was better than of group B in 6 and 12 months. VATS is preferred to MS, due to the earlier recovery and lower cost. And autologous fibrin sealant and BioGlue seems to be the efficacious methods to reduce air leak following LVRS. Conclusions LVRS offers the more benefits regarding survival, lung function, gas exchange, exercise capacity and QOL, despite the higher mortality in initial three postoperative months. LVRS, with the optimization of surgical approach and material for reinforcement of the staple lines, should be recommended to patients suffering from severe heterogeneous emphysema.

  1. [Surgical treatment of benign recurrent goiter with pre-existing unilateral recurrent laryngeal nerve paralysis--a report of experiences].

    Wasiak, J; Pohle, T


    Operations for recurrent goiter are considered to range among the most difficult procedures in thyroid surgery, because the risk of a permanent recurrent nerve palsy increases to 10 or 30%. In case of pre-existing unilateral lesion of the nerve the danger of bilateral paralysis of the vocal chord will become even larger. The results from 29 patients with an intracapsular resection (nearly total removement of the thyroid tissue without the preparation of the recurrent nerve) are presented and compared with those found in 4 patients with an extracapsular approach. All four patients, where the operation was performed extracapsularly, must be tracheotomized although the palsy did recover within 21 days till 14 months. After an intracapsular resection of the recurrence at the side of an intact nerve (29 patients) a tracheotomy had not been necessary.

  2. Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves` disease; Volumenreduktion der Schilddruese nach Radiojodtherapie bei Patienten mit Schilddruesenautonomie und Morbus Basedow

    Dederichs, B. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Otte, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Klink, J.E. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany)


    Aim: It is well known that radioiodine therapy (RITh) leads to a significant thyroid volume reduction (TVR). But until now only little data has been presented due to the course of time and the extent of TVR. Method: Therefore the data of 33 patients with Graves` disease (GD), 36 patients with multifocal (MAG) and 31 with solitary (SAG) autonomous goitre were analyzed retrospectively. Results: All the patients showed a highly significant (p<0.001) TVR, which continued up to 1 year after RITh. Receiving equal effective radiation doses, the extent of TVR was significantly greater for GD than for MAG. This difference developed within six weeks up to 3 months after RITh. Conclusion: This observation suggests that the underlying thyroid disease affects the therapeutic effect of RITh and may be partially explained by the total suppression of non-autonomous thyroid tissue in AG at the time of RITh. In patients with SAG with a 1.7 times higher effective radiation dose than in MAG relative TVR was about 1.6 times stronger in SAG than in MAG. This demonstrates a direct relation between the effective radiation dose and the extent of the TVR after RITh. (orig.) [Deutsch] Ziel: Es ist bekannt, dass die Radiojodtherapie (RJTh) zu einer relvanten Schilddruesenvolumenreduktion (SVR) fuehrt. Bisher wurden jedoch nur vereinzelt systematische Daten zum zeitlichen Verlauf und quantitativen Ausmass der SVR veroeffentlicht. Methode: Daher fuehrten wir eine retrospektive Auswertung der Daten von 33 Patienten mit Morbus Basedow (MB), 36 Patienten mit multifokaler (MFA) und 31 mit unifokaler (UFA) Autonomie der Schilddruese durch. Ergebnisse: Fuer alle Patientengruppen ergab sich eine hochsignifikante (p<0,001) SVR, welche sich bis ein Jahr nach RJTh signifikant fortsetzte. Obwohl die effektive Herddosis nicht signifikant verschieden war, war das Ausmass der SVR fuer Patienten mit MB signifikant groesser als fuer Patienten mit MFA. Dieser Unterschied war bereits innerhalb der ersten 6

  3. 秦山核电基地放射性废物减容技术研究%Research on Radioactive Waste Volume Reduction Technology in Qinshan Nuclear Power Base



    分析秦山核电基地放射性废物的现状及其处理与贮存方式,主要研究针对蒸残液固化物、可压缩废物和废树脂3类产生量较大的固体废物的减容技术.研究表明秦山核电基地的放射性废物还有很大的减容空间,并提出增加秦山核电基地固体废物贮存时间5a以上的减容方案,可有效缓解废物贮存库容的压力.%The paper analyzes the present situation of radioactive wastes in Qinshan nuclear power base and its processing and storage, and focuses on the volume reduction technology for large number of solid wastes including steamed residual liquid condensates, compressible waste and waste resin. Research shows that there is great potential for volume reduction of radioactive wastes in Qinshan nuclear power base, and the volume reduction scheme is provided. With the proposed scheme, the storage capacity for solid wastes in Qinshan nuclear power base can be increased by more than 5 years, which will effectively relieve the pressure for waste storage capacity.

  4. Analysis of Waste Gas Volume and Pollutants Reduction Potential for Cement Industry in China%我国水泥工业废气量减排与污染物减排潜力分析

    王红梅; 刘宇; 王凡; 都基峻; 张凡; 石应杰


    水泥工业是颗粒物等大气污染物排放量较大的行业,因排放标准中颗粒物等污染物浓度限值已非常严格,依靠加严标准减排污染物的空间已经越来越小,标准减排难以使水泥工业实现更高的减排目标。水泥生产多个工序会排放废气,在排放标准限值不变的条件下,各类废气的排放总量决定了颗粒物等污染物的排放总量。通过实例分析得出利用窑头余风再循环、减少窑头喂煤一次风比例和分解炉喂煤风机的风量可实现高温废气量的减排,利用窑头窑尾低温废热进行烘干物料可实现低温烘干废气量的减排,将常温废气作为水泥窑窑头和分解炉煤粉的助燃空气可实现常温废气量的减排,进一步分析了通过废气量减排可实现颗粒物等污染物的减排量。%Cement industry yields a large air pollution emission including particulate matters.As the particulate concentration limits in the industrial emission standard has been very strict, it leaves smaller and smaller space to further reduce the pollutant emission by setting stricter standard limits.Therefore, the emission reduction by standard has been difficult to make cement industry to achieve a higher reduction target.There are several processes in cement production that emit waste gases.Under the same emission standard limits, the total emissions of various pollutants will be determined by the total waste gas volumes of various kinds.Through case studies, it was shown that the kiln end afterwinds could be recycled to reduce the primary air ratio in kiln end coal feeding and the coal-feeding fan air volume in calcining combustors, so as to realize reduction of high-temperature waste gas volume. The cement kiln end low-temperature waste heat could be used to dry materials and thus realize reduction of waste gas volume in low-temperature drying.The room-temperature exhaust gas could be used as pulverized coal combustion air

  5. Efficacy evaluation of retrospectively applying the Varian normal breathing predictive filter for volume definition and artifact reduction in 4D CT lung patients.

    Malone, Ciaran; Rock, Luke; Skourou, Christina


    Phase-based sorting of four-dimensional computed tomography (4D CT) datasets is prone to image artifacts due to patient's breathing irregularities that occur during the image acquisition. The purpose of this study is to investigate the effect of the Varian normal breathing predictive filter (NBPF) as a retrospective phase-sorting parameter in 4D CT. Ten 4D CT lung cancer datasets were obtained. The volumes of all tumors present, as well as the total lung volume, were calculated on the maximum intensity projection (MIP) images as well as each individual phase image. The NBPF was varied retrospectively within the available range, and changes in volume and image quality were recorded. The patients' breathing trace was analysed and the magnitude and location of any breathing irregularities were correlated to the behavior of the NBPF. The NBPF was found to have a considerable effect on the quality of the images in MIP and single-phase datasets. When used appropriately, the NBPF is shown to have the ability to account for and correct image artifacts. However, when turned off (0%) or set above a critical level (approximately 40%), it resulted in erroneous volume reconstructions with variations in tumor volume up to 26.6%. Those phases associated with peak inspiration were found to be more susceptible to changes in the NBPF. The NBPF settings selected prior to exporting the breathing trace for patients evaluated using 4D CT directly affect the accuracy of the targeting and volume estimation of lung tumors. Recommendations are made to address potential errors in patient anatomy introduced by breathing irregularities, specifically deep breath or cough irregularities, by implementing the proper settings and use of this tool.

  6. Long-term follow-up after iodine-131 treatment for Plummer's disease (autonomous goiter)

    Wiener, J.D.


    A follow-up study is presented in 88 patients treated with I-131 for Plummer's disease (localized autonomous thyroid function, either multifocal or as a solitary nodule) one to 17 years before the present study. Studies included clinical examination, scintigraphy, and function tests. One patient was hypothyroid, seven were marginally hyperthyroid, and five still received low dose antithyroid drugs. Of 75 euthyroid patients, the thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) was absent in 16 (generally with scintigraphic evidence of autonomous function), subnormal in 20, and normal in 39. A single autonomous nodule prior to treatment was found relatively frequently in males and in patients with a normal TRH test at follow-up. Most goiters had become smaller and one third of all solitary nodules could not be detected anymore. Autonomous function at follow-up was probably due to residual rather than recurrent disease in most, if not all, cases. It is concluded that I-131 therapy is at least as satisfactory as partial thyroidectomy in the treatment of Plummer's disease; lifelong follow-up was not found to be necessary.

  7. Application of reburn techniques for NOx reduction to cogeneration prime movers. Volume 1. Rich-burn engine application. Final report, June 1984 to July 1988

    Brown, R.A.; Lips, H.; Kuby, W.C.


    The report describes the results of a design and experimental program to develop a post-combustion NOx control technique for gas-fired I.C. engines and gas turbines as applied to cogeneration. Emissions and performance data of both rich-burn and lean-burn engines were used to develop a conceptual reburner design to be placed between an engine and a waste heat boiler. This reburner design was then modeled for testing in a 100,000 Btu/hr subscale test facility. Parametric testing achieved 50 percent NOx reduction at a fuel fraction of 30 percent for rich-burn and mid-O2 range engine exhausts. Lean-burn NOx reductions were limited to 35 percent at the same fuel fraction. With the addition of a NiO catalyst in the rich zone, NOx reductions of up to 90 percent were achieved in the subscale testing. A full-scale system was designed, fabricated, and tested on a 150 kW Caterpillar engine. NOx reductions of 40 to 50 percent were achieved without a catalyst; reductions of up to 75 percent were achieved with a NiO catalyst.

  8. Environment-friendly Dredging with Geotextile Tubes for Dewatering and Volume Reduction of Sediments in Lake and Reservoir%环保疏浚联合土工管袋用于湖库底泥的脱水减容

    王松; 魏新庆; 王立彤


    The engineering case of using environment-friendly dredging with geotextile tubes for dredging, dewatering and volume reduction of sediments in Hangu Sewage Reservoir is introduced. It mainly includes design of environment-friendly dredging, preparation of dewatering and volume reduction site, selection of the geotextile tubes, filling of geotextile tubes, dosing of the flocculant and so on.Through the design and whole process practice of this engineering, the design parameters and process of environment-friendly dredging with geotextile tubes for dewatering and volume reduction of sediments in lake and reservoir are found to lay the foundation for its large-scale application in the future.%介绍了汉沽污水库现场试验工程采用环保疏浚联合土工管袋的方式,对底泥进行清淤和脱水减容的工程实例,主要内容包括环保疏浚设计、脱水减容场地准备、土工管袋选型、土工管袋充填、絮凝剂投加等.通过对本工程的设计和全过程跟踪实践,摸索出环保疏浚联合土工管袋用于湖库底泥脱水减容的设计参数和操作流程,为今后规模化应用奠定了基础.

  9. Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease.

    Choi, Hoon Sung; Yoo, Won Sang


    Anti-thyroid drug therapy is considered a treatment of choice for Graves' disease; however, treatment response varies among individuals. Although several studies have reported risk factors for relapse after initial treatment, few have assessed responsiveness during the early treatment period. Our study aimed to identify the clinical characteristics for responsiveness to methimazole. We included 99 patients diagnosed with Graves' disease for the first time. Drug responsiveness was defined as the correlation coefficients between decreasing rates of free thyroxine level per month and methimazole exposure dose. According to their responsiveness to treatment, the patients were classified into rapid or slow responder groups, and age, sex, free thyroxine level, and thyrotropin binding inhibiting immunoglobulin (TBII) titers were compared between groups. The mean patient age was 44.0±13.5 years and 40 patients were male (40%). The mean TBII titer was 36.6±74.4 IU/L, and the mean free thyroxine concentration was 48.9±21.9 pmol/L. The rapid responder group showed higher TBII titer and free thyroxine level at diagnosis, while age, sex, smoking, and presence of goiter did not differ between the two groups. Logistic regression analyses revealed that high level of serum thyroxine, high titer of TBII, and absence of goiter were significantly associated with a rapid response, while age, sex, and smoking were not significant factors for the prediction of responsiveness. In patients with new onset Graves' disease, high level of free thyroxine, high titer of TBII, and absence of goiter were associated with rapid responsiveness to methimazole treatment.

  10. Changes of hard dental and bone tissue of alveolar process in rats on the orthodontic tooth movement on the background of an experimental goiter

    Kamila A. Kolesnik


    Full Text Available Aim of this study was to study the state of dental hard and bone tissues of alveolar process in rats with the model of orthodontic tooth movement at the experimental goiter based on the analysis of bone phosphatases and proteases activity. Material and Methods —Experimental study with the model of goiter and orthodontic tooth movement in rats. The experiment was carried out with 30 Wistar rats of gregarious breeding. During the first stage of the experiment the goitre was being simulated by giving 1% solution of potassium perchlorate with drinking water for 20 days. During the second experimental stage using thiopental the orthodontic model of tooth movement (OMtM was being reproduced for 21 days. The lower jaw in rats served to reveal carious cavities and atrophy rate of alveolar process, the upper jaw served for determining the common activity of alkaline, acid phosphatase, elastase and total proteolytic activity (OPA, the pulp of incisors served to determine the activity of bone phosphatases. Statistical analysis — One way analysis of variance (ANOVA. Сomparison between experimental groups was carried out with the help of t-Student U and Mann-Whitney test (p.asymp.sig<0.05 was considered significant. Results — in animals under experiment the orthodontic tooth movement together with thyroid disorders is accompanied by increased proteases activity of bone tissue and impaired activity of bone phosphatases. Conclusions — sudden aggravation in the resorption processes of bone tissue of alveolar process, demineralization of hard dental tissue during the orthodontic tooth movement in relation to experimental goiter show that child with the thyroid gland disorders are in need of active treatment and preventive measures during active apparatus treatment of dentoalveolar anomalies.

  11. Contrast volume reduction using third generation dual source computed tomography for the evaluation of patients prior to transcatheter aortic valve implantation

    Bittner, Daniel O. [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Internal Medicine 2 (Cardiology), Erlangen (Germany); Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Boston, MA (United States); Arnold, Martin; Klinghammer, Lutz; Schuhbaeck, Annika; Hell, Michaela M.; Muschiol, Gerd; Gauss, Soeren; Achenbach, Stephan; Marwan, Mohamed [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Internal Medicine 2 (Cardiology), Erlangen (Germany); Lell, Michael; Uder, Michael [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Radiology, Erlangen (Germany); Hoffmann, Udo [Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Boston, MA (United States)


    Chronic renal failure is common in patients referred for transcatheter aortic valve implantation (TAVI). CT angiography is recommended and provides crucial information prior to TAVI. We evaluated the feasibility of a reduced contrast volume protocol for pre-procedural CT imaging. Forty consecutive patients were examined with prospectively ECG-triggered high-pitch spiral acquisition using a novel third-generation dual-source CT system; 38 ml contrast agent was used. Image quality was graded on a visual scale (1-4). Contrast attenuation was measured at the level of the aortic root and at the iliac bifurcation. Mean patient age was 82 ± 6 years (23 males; 58 %). Mean attenuation/average image quality was 285 ± 60 HU/1.5 at the aortic annulus compared to 289 ± 74 HU/1.8 at the iliac bifurcation (p = 0.77/p = 0.29). Mean estimated effective radiation dose was 2.9 ± 0.3 mSv. A repeat acquisition was necessary in one patient due to image quality. Out of the 35 patients who underwent TAVI, 31 (89 %) patients had no or mild aortic regurgitation. Thirty-two (91 %) patients were discharged successfully. Pre-procedural CTA with a total of 38 ml contrast volume is feasible and clinically useful, using third-generation dual-source CT, allowing comprehensive imaging for procedural success. (orig.)

  12. Curcumin and sertraline prevent the reduction of the number of neurons and glial cells and the volume of rats' medial prefrontal cortex induced by stress.

    Noorafshan, Ali; Abdollahifar, Mohammad-Amin; Asadi-Golshan, Reza; Rashidian-Rashidabadi, Ali; Karbalay-Doust, Saied


    Chronic stress induces morphological changes in the neurons of several brain regions, including medial prefrontal cortex (mPFC). This region is involved in variety of behavioral tasks, including learning and memory. Our previous work showed that stress impaired function. The present work extends the earlier work to study mPFC in stressed and non-stressed rats with or without sertraline or curcumin treatments using stereological methods. Sertraline is a selective serotonin reuptake inhibitor and curcumin is the main ingredient of turmeric with neuroprotective effects. In this study, 42 male rats were randomly assigned to seven groups: stress + distilled water, stress + olive oil, stress + curcumin (100 mg/kg/day), stress + sertraline (10 mg/kg/day), curcumin, sertraline, and control groups. After 56 days, the right mPFC was removed. The volume of mPFC and its subdivisions and the total number of neurons and glia were estimated. The results showed ~8%, ~8%, and 24% decrease in the volume of the mPFC and its prelimbic and infralimbic subdivisions, respectively. However, the anterior cingulated cortex remained unchanged. Also, the total number of the neurons and glial cells was significantly reduced (11% and 5%, respectively) in stress (+distilled water or olive oil) group in comparison to the non-stressed rats (Psertraline and stress + curcumin groups in comparison to the non-treated stressed rats (Psertraline could prevent the stress-induced changes in mPFC.

  13. Prevalence of goiter and thyroid nodules before and after implementation of the universal salt iodization program in mainland China from 1985 to 2014: a systematic review and meta-analysis.

    Wei Zhao

    Full Text Available OBJECTIVES: We comprehensively estimated the prevalence of goiter and thyroid nodules (TNs before and after the implementation of the Universal Salt Iodization (USI program in mainland China and provided information for creating effective health policies. METHODS: PubMed, Google Scholar, CNKI, Chinese Wanfang and Chongqing VIP databases were searched for relevant studies from Jan 1985 to Feb 2014. Data from eligible citations were extracted by two independent reviewers. All analyses were performed with Stata 11.0 and SPSS 17.0. RESULTS: Eligible articles (N = 31; 4 in English and 27 in Chinese included 52 studies (15 about goiter rates made before 1996 and 14 afterwards, and 23 about TNs. Our meta-analysis suggests a pooled prevalence for goiter before and after 1996 and for TNs of 22.8% (95% CI: 15.3%, 30.3%, 12.6% (95% CI: 9.4%, 15.8% and 22.7% (95% CI: 18.3%, 27.0%, respectively. Egger's test of three independent categories revealed no evidence of publication bias (p = 0.101, 0.148 and 0.113, respectively. CONCLUSIONS: The prevalence of goiter was reduced by almost half after 1996 in mainland China, so the USI program was considered beneficial. However, subgroup analysis suggests that both insufficient and excess iodine may be associated with goiter. The prevalence of goiter and TNs increased significantly after 2002, suggesting a risk of excessive iodine intake. Thus, salt iodization standardizations should be set according to local conditions.

  14. SU-E-T-13: A Comparative Dosimetric Study On Radio-Dynamic Therapy for Pelvic Cancer Treatment: Strategies for Bone Marrow Dose and Volume Reduction

    Li, C [Fox Chase Cancer Center, Philadelphia, PA (United States); Renmin Hospital of Wuhan University, Wuhan, Hubei Province (China); Wang, B; Dong, Z; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States); Ge, W; Xu, L [Renmin Hospital of Wuhan University, Wuhan, Hubei Province (China)


    Purpose: Radio-dynamic therapy (RDT) is a potentially effective modality for local and systemic cancer treatment. Using RDT, the administration of a radio-sensitizer enhances the biological effect of high-energy photons. Although the sensitizer uptake ratio of tumor to normal tissue is normally high, one cannot simply neglect its effect on critical structures. In this study, we aim to explore planning strategies to improve bone marrow sparing without compromising the plan quality for RDT treatment of pelvic cancers. Methods: Ten cervical and ten prostate cancer patients who previously received radiotherapy at our institution were selected for this study. For each patient, nine plans were created using the Varian Eclipse treatmentplanning-system (TPS) with 3D-CRT, IMRT, and VMAT delivery techniques containing various gantry angle combinations and optimization parameters (dose constraints to the bone marrow). To evaluate the plans for bone marrow sparing, the dose-volume parameters V5, V10, V15, V20, V30, and V40 for bone marrow were examined. Effective doseenhancement factors for the sensitizer were used to weigh the dose-volume histograms for various tissues from individual fractions. Results: The planning strategies had different impacts on bone marrow sparing for the cervical and prostate cases. For the cervical cases, provided the bone marrow constraints were properly set during optimization, the dose to bone marrow sparing was found to be comparable between different IMRT and VMAT plans regardless of the gantry angle selection. For the prostate cases, however, careful selection of gantry angles could dramatically improve the bone marrow sparing, although the dose distribution in bone marrow was clinically acceptable for all prostate plans that we created. Conclusion: For intensity-modulated RDT planning for cervical cancer, planners should set bone marrow constraints properly to avoid any adverse damage, while for prostate cancer one can carefully select gantry

  15. Four weeks of speed endurance training reduces energy expenditure during exercise and maintains muscle oxidative capacity despite a reduction in training volume

    Iaia, F. Marcello; Hellsten, Ylva; Nielsen, Jens Jung;


    We studied the effect of an alteration from regular endurance to speed endurance training on muscle oxidative capacity, capillarization, as well as energy expenditure during submaximal exercise and its relationship to mitochondrial uncoupling protein 3 (UCP3) in humans. Seventeen endurance...... in Con. No changes in blood lactate during submaximal running were observed. After the IT period, the protein expression of skeletal muscle UCP3 tended to be higher in SET (34 +/- 6 vs. 47 +/- 7 arbitrary units; P = 0.06). Activity of muscle citrate synthase and 3-hydroxyacyl-CoA dehydrogenase, as well...... by lowered mitochondrial UCP3 expression. Furthermore, speed endurance training can maintain muscle oxidative capacity, capillarization, and endurance performance in already trained individuals despite significant reduction in the amount of training....

  16. Multiple Myeloma Presenting as Massive Amyloid Deposition in a Parathyroid Gland Associated with Amyloid Goiter: A Medullary Thyroid Carcinoma Mimic on Intra-operative Frozen Section.

    Hill, Kirk; Diaz, Jason; Hagemann, Ian S; Chernock, Rebecca D


    Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.

  17. [Effectiveness of iodine prophylaxis and frequency of thyroid enlargement (thyroid goiter) and clinical diagnosis of thyroid diseases in inhabitants of the Szczecin region after the Czernobyl accident].

    Syrenicz, A; Goździk, J; Pynka, S; Pilarska, K; Gruszczyńska, M; Gołebiowska, I; Syrenicz, M; Miazgowski, T; Listewnik, M; Krzyzanowska, B


    The study, supported by program MZ-XVII, was carried on 4567 inhabitants of the area of Szczecin (2350 females and 2217 males). The population was chosen randomly, according to a simple drawing scheme. All subjects were clinically examined using standardised questionnaires. In 3468 persons (including 1807 girls and women, 1661 boys and men) apart form clinical examination, the assessment of thyrotropin, thyroxine and triiodothyronine in serum and frequency of antithyroglobulin antibodies and antithyroid membrane antibodies were evaluated. The data indicate that 94% of children in Szczecin's region received the prophylactic dose of iodine, mostly between the 1st and the 5th of May 1986. Only 17% of the adults received iodine. The most common preparation was Lugol solution given in a single dose. Among all persons who received iodine, only in 5% of subjects the side effects were noted (mostly in children), including symptoms of gastrointestinal tract (vomiting, abdomen pain) and occasionally intrathyroid side effects (thyroid pains). In examined population the high frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of clinical diagnosis of thyroid disease was higher in women than in man (most often the diffuse goiter, rarely the nodular goiter). The frequency of thyroid enlargement and clinical diagnosis of thyroid disease was not dependent on prophylactic iodine intake. The iodine prophylaxis did not influence on thyroid hormones and TSH serum levels and on frequency of antithyroid antibodies.

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

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


    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)

  19. Dose reduction in dynamic perfusion CT of the brain: effects of the scan frequency on measurements of cerebral blood flow, cerebral blood volume, and mean transit time

    Wiesmann, Martin [University of Munich, Department of Neuroradiology, Muenchen (Germany); Klinikum der Universitaet Muenchen - Grosshadern, Abteilung fuer Neuroradiologie, Muenchen (Germany); Berg, Scott; Stoeckelhuber, B.M. [University of Luebeck, Department of Radiology, Luebeck (Germany); Bohner, G.; Klingebiel, R. [University Medicine Berlin, Department of Neuroradiology, Charite, Berlin (Germany); Schoepf, V.; Yousry, I.; Linn, J. [University of Munich, Department of Neuroradiology, Muenchen (Germany); Missler, U. [Evangelisches Krankenhaus Duisburg-Nord, Department of Neuroradiology, Duisburg (Germany)


    The influence of the frequency of computed tomography (CT) image acquistion on the diagnostic quality of dynamic perfusion CT (PCT) studies of the brain was investigated. Eight patients with clinically suspected acute ischemia of one hemisphere underwent PCT, performed on average 3.4 h after the onset of symptoms. Sixty consecutive images per slice were obtained with individual CT images obtained at a temporal resolution of two images per second. Eight additional data sets were reconstructed with temporal resolutions ranging from one image per second to one image per 5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) measurements were performed in identical regions of interest. Two neuroradiologists evaluated the PCT images visually to identify areas of abnormal perfusion. Perfusion images created up to a temporal resolution of one image per 3 s were rated to be diagnostically equal to the original data. Even at one image per 4 s, all areas of infarction were identified. Quantitative differences of CBF, CBV and MTT measurements were {<=}10% up to one image per 3 s. For PCT of the brain, temporal resolution can be reduced to one image per 3 s without significant compromise in image quality. This significantly reduces the radiation dose of the patient. (orig.)

  20. A process for containment removal and waste volume reduction to remediate groundwater containing certain radionuclides, toxic metals and organics. Final report

    Buckley, L.P.; Killey, D.R.W.; Vijayan, S.; Wong, P.C.F. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.


    A project to remove groundwater contaminants by an improved treatment process was performed during 1990 October--1992 March by Atomic Energy of Canada Limited for the United States Department of Energy, managed by Argonne National Laboratory. The goal was to generate high-quality effluent while minimizing secondary waste volume. Two effluent target levels, within an order of magnitude, or less than the US Drinking Water Limit, were set to judge the process effectiveness. The program employed mixed waste feeds containing cadmium, uranium, lead, iron, calcium, strontium-85-90, cesium-137, benzene and trichlorethylene in simulated and actual groundwater and soil leachate solutions. A combination of process steps consisting of sequential chemical conditioning, cross-flow microfiltration and dewatering by low temperature-evaporation, or filter pressing were effective for the treatment of mixed waste having diverse physico-chemical properties. A simplified single-stage version of the process was implemented to treat ground and surface waters contaminated with strontium-90 at the Chalk River Laboratories site. Effluent targets and project goals were met successfully.

  1. Can a partial volume edge effect reduction algorithm improve the repeatability of subject-specific finite element models of femurs obtained from CT data?

    Peleg, Eran; Herblum, Ryan; Beek, Maarten; Joskowicz, Leo; Liebergall, Meir; Mosheiff, Rami; Whyne, Cari


    The reliability of patient-specific finite element (FE) modelling is dependent on the ability to provide repeatable analyses. Differences of inter-operator generated grids can produce variability in strain and stress readings at a desired location, which are magnified at the surface of the model as a result of the partial volume edge effects (PVEEs). In this study, a new approach is introduced based on an in-house developed algorithm which adjusts the location of the model's surface nodes to a consistent predefined threshold Hounsfield unit value. Three cadaveric human femora specimens were CT scanned, and surface models were created after a semi-automatic segmentation by three different experienced operators. A FE analysis was conducted for each model, with and without applying the surface-adjustment algorithm (a total of 18 models), implementing identical boundary conditions. Maximum principal strain and stress and spatial coordinates were probed at six equivalent surface nodes from the six generated models for each of the three specimens at locations commonly utilised for experimental strain guage measurement validation. A Wilcoxon signed-ranks test was conducted to determine inter-operator variability and the impact of the PVEE-adjustment algorithm. The average inter-operator difference in stress values was significantly reduced after applying the adjustment algorithm (before: 3.32 ± 4.35 MPa, after: 1.47 ± 1.77 MPa, p = 0.025). Strain values were found to be less sensitive to inter-operative variability (p = 0.286). In summary, the new approach as presented in this study may provide a means to improve the repeatability of subject-specific FE models of bone obtained from CT data.

  2. Significant Reduction in Mitral Regurgitation Volume Is the Main Contributor for Increase in Systolic Forward Flow in Patients with Functional Mitral Regurgitation after Transcatheter Aortic Valve Replacement: Hemodynamic Analysis Using Echocardiography.

    Itabashi, Yuji; Shibayama, Kentaro; Mihara, Hirotsugu; Utsunomiya, Hiroto; Berdejo, Javier; Arsanjani, Reza; Siegel, Robert; Chakravarty, Tarun; Jilaihawi, Hasan; Makkar, Raj R; Shiota, Takahiro


    Reduction in mitral regurgitation (MR) after transcatheter aortic valve replacement (TAVR) has previously been reported. However, the hemodynamic effects of TAVR in patients with MR have not been previously evaluated. We analyzed 571 patients who underwent TAVR from December 2010 to December 2013. We studied 20 patients with moderate or severe preprocedural functional mitral regurgitation (FMR) who also had a follow-up transthoracic echocardiography (TTE) examination between 90 and 360 days (median 213 days) after TAVR (Significant FMR Group). We also studied age- and gender-matched 20 patients with mild or lesser MR (Nonsignificant MR Group). Left ventricular functional measurements were assessed using echocardiography before and after TAVR. Left ventricular outflow tract stroke volume measurements using pulsed-wave Doppler (SVLVOT ) were calculated as a representative of systolic forward flow, and stroke volume by the Simpson's method (SVSimpson ) was calculated as a parameter of degree of LV contraction. MR grade improved in 22 of 40 patients after TAVR. In both groups, BNP level decreased, left ventricular ejection fraction increased, and SVLVOT increased after TAVR. SVSimpson increased in the Nonsignificant MR Group and remained unchanged in the Significant FMR Group. Vena contracta width of MR (MRVC) decreased in the Significant FMR Group. Using multivariable analysis in the Significant FMR Group, the increase in SVLVOT significantly correlated with the decrease in MRVC (P FMR. In these patients, increase in SVLVOT after TAVR was associated with decrease in severity of MR. © 2015, Wiley Periodicals, Inc.

  3. Test plan for composting studies involving weight and volume reduction of leaf and stalk biomass: DOE/OTD TTP{number_sign} SR17SS53 {ampersand} TTP{number_sign} SR18SS41

    Wilde, E.W.; Kastner, J.; Murphy, C.; Santo Domingo, J.


    SRTC and a panel of experts from off-site previously determined that composting was the most attractive alternative for reducing the volume and weight of biomass that was slightly radioactive. The SRTC proposed scope of work for Subtask 2 of TTP{number_sign} SR17SS53 and TTP{number_sign} SR18SS41 involves bench scale studies to assess the rates and efficiencies of various composting schemes for volume and weight reduction of leaf and stalk biomass (SB). Ultimately, the data will be used to design a composting process for biomass proposed by MSE for phytoremediation studies at SRS. This could drastically reduce costs for transporting and disposing of contaminated biomass resulting from a future major phytoremediation effort for soil clean-up at the site. The composting studies at SRTC includes collaboration with personnel from the University of Georgia, who will conduct chemical analyses of the plant material after harvest, pre-treatment, and composting for specific time periods. Parameters to be measured will include: lignin, hemicellulose, cellulose, carbon and nitrogen. The overall objective of this project is to identify or develop: (1) an inexpensive source of inoculum (consisting of nutrients and/or microorganisms) capable of significantly enhancing biomass degradation, (2) an optimum range of operating parameters for the composting process, and (3) a process design for the solid state degradation of lignocellulosic biomass contaminated with radionuclides that is superior to existing alternatives for dealing with such waste.

  4. Modified-Release Recombinant Human TSH (MRrhTSH) Augments the Effect of 131I Therapy in Benign Multinodular Goiter: Results from a Multicenter International, Randomized, Placebo-Controlled Study

    Graf, H; Fast, S; Pacini, F


    Background: Recombinant human TSH (rhTSH) can be used to enhance (131)I therapy for shrinkage of multinodular goiter (MG). Objective, Design, and Setting: The objective of the study was to compare the efficacy and safety of 0.01 and 0.03 mg modified-release (MR) rhTSH as an adjuvant to (131)I the...

  5. Effect of advanced aircraft noise reduction technology on the 1990 projected noise environment around Patrick Henry Airport. [development of noise exposure forecast contours for projected traffic volume and aircraft types

    Cawthorn, J. M.; Brown, C. G.


    A study has been conducted of the future noise environment of Patric Henry Airport and its neighboring communities projected for the year 1990. An assessment was made of the impact of advanced noise reduction technologies which are currently being considered. These advanced technologies include a two-segment landing approach procedure and aircraft hardware modifications or retrofits which would add sound absorbent material in the nacelles of the engines or which would replace the present two- and three-stage fans with a single-stage fan of larger diameter. Noise Exposure Forecast (NEF) contours were computed for the baseline (nonretrofitted) aircraft for the projected traffic volume and fleet mix for the year 1990. These NEF contours are presented along with contours for a variety of retrofit options. Comparisons of the baseline with the noise reduction options are given in terms of total land area exposed to 30 and 40 NEF levels. Results are also presented of the effects on noise exposure area of the total number of daily operations.

  6. [Plunging and mediastinal goiters].

    Barrault, S; Gandon, J; Le Guillou, C


    Of 185 cases of substernal goitre operated upon between 1976 and 1985, four were patients with autonomous mediastinal goitre. Diagnosis was established from results of clinical examination, a scan of mediastinum and radiologie imaging with a cervical and mediastinal CT scan as the investigation of choice. Treatment is exclusively surgical because of the risk of mediastinal compression. Most cases in this series were operated upon through a purely cervical approach, but 22 patients required partial upper sternotomy combined with cervicotomy, this minimal approach route allowing very good exposure of upper mediastinum.

  7. Toxic nodular goiter

    ... adult may be less able to tolerate the effect of the disease on the heart. However, the condition is often treatable with medicines. Possible Complications Heart complications: Heart failure Irregular heartbeat ( ...

  8. Mediastinal goiter resection via cervical low collar incision%颈部低位领式切口进路切除纵隔甲状腺肿的探讨

    李虹; 闫悦; 石胜利


    目的:探讨颈部低位领式切口进路切除纵隔甲状腺肿对于减少副损伤的作用。方法:回顾性分析我科2009-2012年20例纵隔甲状腺肿患者的临床资料。结果:2例患者放弃手术治疗,其余18例患者全部采用颈部低位领式切口进路行纵隔甲状腺肿切除术,均完整切除肿物,术后无1例发生喉返神经损伤、窒息或出血等并发症。结论:颈部低位领式切口进路切除纵隔甲状腺肿,在完整切除肿物的同时,能极大的减少手术副损伤。%Objective:To discuss the advantage of the mediastinal goiter resection via cervical low collar incision. Methods:Retrospectively analyze the clinical data of 20 cases of mediastinal goiter. Results:Except 2 cases giving up surgery,the other 18 cases were operated successfully whose mediastinal goiters were all resected completely and no one developed postoperative complications such as laryngeal recurrent nerve injuries,asphyxia or bleeding. Conclu-sion:Mediastinal goiter resection via cervical low collar incision can not only resect the mediastinal goiter completely but also reduce the collateral damage greatly.

  9. Changes of pulmonary function and quality of life in mid-term after lung volume reduction surgery%肺减容术后中期肺功能变化和生活质量评估

    赵旭东; 石开虎; 吴君旭; 徐盛松


    Objective To observe the mid-term changes of pulmonary function and quality of life in the patients with emphysema who have undergone lung volume reduction surgery.Methods 44 subjects with severe emphysema underwent single or double lung volume reduction surgery through thoracoscope.There were 33 male and 11 female in the population analyzed with an age range of 46 to 70 years old.The mean age of the patients was (65.2-± 6.0) years.The pulmonary function and quality of life evaluation were determined over 3 time periods:prior to surgery,12 months postsurgery,and 24 months postsurgery Pulmonary function measurement project including the forced expiratory volume in 1 second (FEV 1),FEV 1% of predicted value,residual volume (RV),RV % of predicted value,partial pressure of oxygen(PO2),partial pressure of carbon dioxide (PCO2),life quality evaluation performed in the form of questionnaire,including whether under anhelation,satisfactory sleep,living by self-care,participating in household duties,taking part in social work,whether to have a good mental state and have a hobby.Results There was 1 death of 44 patients from respiratory failure.43 patients recovered smoothly.4 cases were lost to follow-up.In 39.patients with follow-up,1 patient succumbed to cerebrovascular at 13 months after surgery.The other 38 cases compared with the preoperative at 12 and 24 months postsurgery,postoperative forced expiratory volume in 1 second (FEV1) increased,P < 0.05,residual gas volume (RV) decreased,P < 0.05,partial pressure of oxygen (PO2) increased,P < 0.05,partial pressure of carbon dioxide (PCO2) decreased,P < 0.05,meanwhile,the quality of life has improved significantly.Conclusion Lung volume reduction surgery in patients with severe obstructive emphysema can improve pulmonary function and quality of life.And its effect would not disappeared in the short term.%目的 对接受肺减容手术的重度阻塞性肺气肿患者,进行术后肺功能中期随访,以

  10. A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter.

    Santhosh, Sampath; Bhattacharya, Anish; Verma, Roshan Kumar; Lal, Anupam; Mittal, Bhagwant Rai


    A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions.

  11. A case of papillary microcarcinoma of the thyroid with abundant colloid (masquerading as colloid goiter with papillary hyperplasia: Cytological evaluation with histopathological correlation

    Elancheran Muthalagan


    Full Text Available Papillary thyroid carcinoma (PTC is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.

  12. 外科治疗胸内甲状腺肿的临床研究%Clinical Study of Surgical Treatment of Intrathoracic Goiter

    林凌; 冯键; 胡定中


    目的 探讨外科治疗对胸内甲状腺肿的治疗意义与手术方式的选择.方法 回顾性分析2004年1月至2010年12月在我院胸外科接受手术治疗的52例胸内甲状腺肿患者的术前检查、手术治疗情况与随访资料.结果 根治性切除51例,姑息性切除1例.低位颈部领式切口45例(86.5%),低位颈部领式切口+胸骨正中小劈开4例(7.7%),右后外侧开胸3例(5.8%).术后并发症总发生率为7.7%.52例患者中,失访者6例,1例甲状腺低分化癌患者于术后18个月死于肿瘤转移,余45例未见复发或死亡.结论 外科手术治疗是胸内甲状腺肿治疗的首选.低位颈部领式切口因暴露佳、切除率高、创伤小、符合美观要求,适合绝大多数早期患者.肿块大伴外侵应在充分检查的基础上选择右后外侧切口第四肋间进胸进行探查切除.%Objective To investigate the clinical significance of surgical treatment in treating intrathoracic goiter and the choice among different surgical procedures. Methods 52 patients with intrathoracic goiter who were admitted into our hospital from January 2004 to December 2010 were selected in this study,whose preoper-ative examinations, surgical procedures, and follow-up date were retrospectively analyzed in this paper. Results All patients received surgical treatment, and 51 were radically resected and 1 palliatively; 45 cases( 86. 5% ) were resected via cervical collar incision,4 cases( 7. 7% ) via cervical collar incision plus mini-sternotomy, 3cases( 5.8% )via right posterolateral thoractomy. All postoperative complication rate was 7.7%. Among 52 patients, 6 cases lost follow-up, 1 case died from metastasis of low-differentiation carcinoma of goiter 18 months after surgery,45 cases remained health and no sings of replacement. Conclusion Surgery is the first choice of treating intrathoracic goiter. The choice of different surgical procedures should depend on the location, size and the local invasion of the

  13. To estimate the effect of relationship of salt iodine level and prevalence of goiter among women of reproductive age group (15-49 years).

    Kousar, Junaid; Kawoosa, Zaffar; Hamid, Sajad; Munshi, Iftikhar Hussain; Hamid, Shahnawaz; Rashid, Arsalaan F


    The present study is a Cross-Sectional Study and was conducted in Post-graduate department of Community Medicine, Govt. Medical College, Srinagar between Feb. 2012 and Jan. 2013. The sample size of 1,041 was estimated. The study was conducted to estimate the effect of relationship of salt iodine level and prevalence of goiter among women of reproductive age group in two districts of Kashmir valley, district Srinagar and district Ganderbal, which were selected randomly. A frame of the blocks and villages in the two districts and their population was formed. From each district 10% of the blocks were selected using simple random sampling. From each block, 5% of the villages were selected using simple random sampling. A door to door survey was conducted in the selected villages and all the women in the reproductive age group (15-49 years) identified and examined clinically for goiter after taking informed consent. Salt samples (one teaspoonful) from every household were taken and assessed for iodine content on spot and the iodine content of salt was assessed qualitatively by spot testing kits. The results of the present study have indicated that iodine deficiency continues to be a health problem. Almost the whole population consumes powdered salt but the storage and cooking practices diminish the iodine content of salt and results in decreased intake. Thus the need of the hour is to make people aware about proper storage and cooking practices. Women in the reproductive age group especially need to be made aware about the importance of consumption of adequately iodized salt because of the wide range of ill effects of iodine deficiency on the developing fetus and the growing child. In addition monitoring of iodine content of salt at distributor level should be done.

  14. Electroencephalography reveals lower regional blood perfusion and atrophy of the temporoparietal network associated with memory deficits and hippocampal volume reduction in mild cognitive impairment due to Alzheimer’s disease

    Moretti DV


    Full Text Available Davide Vito MorettiNational Institute for the research and cure of Alzheimer’s disease, S. John of God, Fatebenefratelli, Brescia, Italy Background: An increased electroencephalographic (EEG upper/lower alpha power ratio has been associated with less regional blood perfusion, atrophy of the temporoparietal region of the brain, and reduction of hippocampal volume in subjects affected by mild cognitive impairment due to Alzheimer’s disease as compared with subjects who do not develop the disease. Moreover, EEG theta frequency activity is quite different in these groups. This study investigated the correlation between biomarkers and memory performance.Methods: EEG α3/α2 power ratio and cortical thickness were computed in 74 adult subjects with prodromal Alzheimer’s disease. Twenty of these subjects also underwent assessment of blood perfusion by single-photon emission computed tomography (SPECT. Pearson’s r was used to assess the correlation between cortical thinning, brain perfusion, and memory impairment.Results: In the higher α3/α2 frequency power ratio group, greater cortical atrophy and lower regional perfusion in the temporoparietal cortex was correlated with an increase in EEG theta frequency. Memory impairment was more pronounced in the magnetic resonance imaging group and SPECT groups.Conclusion: A high EEG upper/low alpha power ratio was associated with cortical thinning and less perfusion in the temporoparietal area. Moreover, atrophy and less regional perfusion were significantly correlated with memory impairment in subjects with prodromal Alzheimer’s disease. The EEG upper/lower alpha frequency power ratio could be useful for identifying individuals at risk for progression to Alzheimer’s dementia and may be of value in the clinical context.Keywords: electroencephalography, perfusion, atrophy, temporoparietal network, memory deficits, hippocampal volume, mild cognitive impairment, Alzheimer’s disease

  15. Pressing Municipal Solid Waste Incineration Fly Ash Bricks for Landfill Volume Reduction%生活垃圾焚烧飞灰压制砌块与减容填埋技术

    朱新才; 赵由才; 周雄; 张骏; 夏发发; 陈善平; 全学军


    The construction speed of municipal solid waste incineration (MSWI )is currently faster than that of hazardous waste landfill in China,so that the disposal of MSWI fly ash becomes a pressing problem of the day.In comparison with other technologies,the chemical stabilization is applied widely,while still consume plenty of chelating agent and landfill volume.Restriction from total volume and service life of hazardous waste landfill,it is urgent to find a novel,economical and efficient technology for quick disposal of MSWI fly ash.In this study,the fly ash was pressed at high hydraulic load to reduce considerably both the volume and the quantity of chelating agents so that remarkably extend the service life of landfill.It was shown that the volume can be reduced over 60 %and the heavy metals leaching concentration of MSWI bricks was down obviously after pressing,which indicated the usage of chelating agent can be reduced by 30% ~70%.A novel volume reduction landfill process was proposed,the investment and benefit were evaluated.The service life can be prolonged for more than one to two times.The direct cost for the disposal of fly ash could be decreased by 200 RMB/t (not including the investment of equipment).The MSWI fly ash bricks were of regular shape and tight texture,which can avoid the dust in conventional landfill,promote automation, improve management and efficiency.%目前我国生活垃圾焚烧厂的建设速度远远超过危险废物填埋场的建设速度,大量的飞灰亟待安全处置。相对于其他处置技术,化学稳定化填埋被广泛应用,但需耗费大量重金属螯合剂以及填埋场库容,且满足技术规范的危废填埋场的填埋能力和使用年限均受限制。针对以上问题,对生活垃圾焚烧飞灰砌块减容潜力、重金属降低浸出进行研究,分析了飞灰压制砌块-减容填埋的可行性,并进行工艺设计,初步确定了工艺投入和综合效益。结果表明:生活垃

  16. 低温等离子减容术治疗儿童扁桃体肥大78例%Effects of Coblation Tonsil Volume Reduction for Tonsillar Hypertrophy in 78 Children

    潘明金; 郑灵; 王宏伟; 陈康; 王东升; 欧阳进; 黄茜


    Objective To investigate effects of coblation tonsil volume reduction for tonsillar hypertrophy in children. Methods The study was designed to review the incidence of intraoperative and postoperative complications in 78 children patients undergoing coblation-assisted subtotal tonsillectomy.All the 78 patients had chronic tonsillar hypertrophy.The lowest SaO2 ( LSaO2 ) levels were compared between preoperative and postoperative periods. Results All of the 78 children were cured.They were followed up for 6-12 months after operation.The tonsil volume decreased by two-thirds, including 56 cases of gradeⅠand 22 cases of normal size.Patients’ snore noise was significantly reduced in 47 cases and disappeared in 31 cases.Their LSaO2 levels increased obviously after operation [(89.5 ±7.2)%vs.(81.7 ±8.5)%;t=19.375, P=0.000]. Conclusions Coblation tonsil volume reduction gives less tissue damage and postoperative complications and is safe and effective.Moreover, it preserves the immunity functions from the tonsils.It is optimal for children with chronic tonsillar hypertrophy.%目的:探讨低温等离子减容术治疗儿童扁桃体肥大的疗效。方法2007年10月~2012年10月对78例单纯扁桃体肥大儿童在全麻下使用美国Arthrocare公司低温等离子手术系统(Ⅱ型)和一次性Reflex刀头,在扁桃体内打孔,使扁桃体容积减少,比较患儿术前1周与术后6个月最低血氧饱和度( LSaO2)的变化。结果78例随访6~12个月,扁桃体体积缩小2/3以上,其中缩至Ⅰ度56例,缩至正常大小22例,患儿鼾声明显减小47例,鼾声消失31例。最低血氧饱和度由术前(81.7±8.5)%提高到术后(89.5±7.2)%(t=19.375,P=0.000)。结论低温等离子减容术治疗儿童扁桃体肥大,不损伤儿童的免疫力,安全、创伤小,特别适合婴幼儿时期扁桃体过度肥大。

  17. Prostate cancer treated with image-guided helical TomoTherapy {sup registered} and image-guided LINAC-IMRT. Correlation between high-dose bladder volume, margin reduction, and genitourinary toxicity

    Drozdz, Sonia; Wendt, Thomas G. [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Radiation Oncology, Jena (Germany); Schwedas, Michael; Salz, Henning [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Radiation Oncology, Section of Medical Physics, Jena (Germany); Foller, Susan [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Urology, Jena (Germany)


    We compared different image-guidance (IG) strategies for prostate cancer with high-precision IG intensity-modulated radiation therapy (IMRT) using TomoTherapy {sup registered} (Accuray Inc., Madison, WI, USA) and linear accelerator (LINAC)-IMRT and their impact on planning target volume (PTV) margin reduction. Follow-up data showed reduced bladder toxicity in TomoTherapy patients compared to LINAC-IMRT. The purpose of this study was to quantify whether the treatment delivery technique and decreased margins affect reductions in bladder toxicity. Setup corrections from 30 patients treated with helical TomoTherapy and 30 treated with a LINAC were analyzed. These data were used to simulate three IG protocols based on setup error correction and a limited number of imaging sessions. For all patients, gastrointestinal (GI) and genitourinary (GU) toxicity was documented and correlated with the treatment delivery technique. For fiducial marker (FM)-based RT, a margin reduction of up to 3.1, 3.0, and 4.8 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions, respectively, could be achieved with calculation of a setup correction from the first three fractions and IG every second day. Although the bladder volume was treated with mean doses of 35 Gy in the TomoTherapy group vs. 22 Gy in the LINAC group, we observed less GU toxicity after TomoTherapy. Intraprostate FMs allow for small safety margins, help decrease imaging frequency after setup correction, and minimize the dose to bladder and rectum, resulting in lower GU toxicity. In addition, IMRT delivered with TomoTherapy helps to avoid hotspots in the bladder neck, a critical anatomic structure associated with post-RT urinary toxicity. (orig.) [German] Wir haben im Rahmen der Prostatakarzinombehandlung verschiedene bildgefuehrte (IG) Strategien der hochpraezisen intensitaetsmodulierten Radiotherapie (IMRT) unter Einsatz der Tomotherapie (TomoTherapy {sup registered}, Accuray Inc., Madison

  18. Volume Entropy

    Astuti, Valerio; Rovelli, Carlo


    Building on a technical result by Brunnemann and Rideout on the spectrum of the Volume operator in Loop Quantum Gravity, we show that the dimension of the space of the quadrivalent states --with finite-volume individual nodes-- describing a region with total volume smaller than $V$, has \\emph{finite} dimension, bounded by $V \\log V$. This allows us to introduce the notion of "volume entropy": the von Neumann entropy associated to the measurement of volume.

  19. Primary ectopic intrathoracic goiter in posterior mediastinum: a case report and review of the literature; Bocio ectopico intratoracico primario no mediastino posterior: relato de caso e revisao da literatura

    Barros, Cristiano Ventorim de [Santa Casa de Misericordia de Vitoria, ES (Brazil)]. E-mail:; Tornin, Olger de Souza [Hospital Heliopolis, Sao Paulo, SP (Brazil). Ciencias da Saude; Ribeiro, Sergio Marrone; Yamashita, Seizo; Morceli, Jose [UNESP, Botucatu, SP (Brazil). Faculdade de Medicina. Dept. de Doencas Tropicais e Diagnostico por Imagem


    The ectopic primary intrathoracic goiter is an uncommon tumor that corresponds to a hyperplasia of an ectopic thyroid tissue, that develops in the thorax, distinct from the cervical thyroid gland, which usually exists on its normal aspect. We report the case of a 61-year-old female patient, with the aspects of the radiograph and computed tomography examinations, comparing them with the literature, demonstrating the image aspects, differential diagnosis, possible etiology factors and treatments of the disease. (author)

  20. Poverty Reduction

    Ortiz, Isabel


    The paper reviews poverty trends and measurements, poverty reduction in historical perspective, the poverty-inequality-growth debate, national poverty reduction strategies, criticisms of the agenda and the need for redistribution, international policies for poverty reduction, and ultimately understanding poverty at a global scale. It belongs to a series of backgrounders developed at Joseph Stiglitz's Initiative for Policy Dialogue.

  1. Estimation of efficacy of echinacea compositum C and teraflex application in orthodontic moving of teeth on the background of experimental goiter

    Kolesnik K.A.


    Full Text Available Disturbances of the thyroid status may be negatively reflected on the biological processes underlying orthodontic tooth movement. Research object – in experiment to estimate efficacy of application of drug complex with osteotropic and immunomodulating action in orthodontic moving of teeth (ОМT on the background of euthyroid goiter. In 75 rats of Vistar line of gregarious breeding (females, 5 months, 210±28 g experimental goiter was modeled by injection of 1% perchlorate potassium solution with drinking water within 20 days. Intragastric solution of potassium Iodidum (PI in the dose of 20 mkg/kg was introduced to rats of the 3rd, 4th and 5th groups from the 22nd day. Intragastrically drug «Echinacea compositum C» was introduced to animals of the 3rd and 5th groups from the 22nd day during 5 days. OMT was reproduced on the 29th day from the beginning of experiment. On the background of PI injection, teraflex in a dose on glucosaminglican of 750 mg/kg was introduced to the rats of the 4th and 5th groups. A mandible for calculation of carious cavities and definition of atrophy degree of an alveolar process, and the maxilla – for definition of alkaline activity, acidic phosphatase, elastase and general proteolytic activity (GPA, pulp of incisors – for phosphatases definition of activity were isolated. Echinacea compositum, potassium Iodidum and teraflex in the idea of monotherapy caused some positive influence on phosphatases of an alveolar bone. To completely prevent disturbances of activity of bone phosphatases and proteinases was possibly only at application of a full complex: PІ – throughout all treatment, echinacea compositum C – before fixation of closing springs, teraflex – after fixation. Thus, stage-by-stage use of drugs – potassium Iodidum, «Echinacea compositum C» and Teraflex promoted to normalization of activity of alkaline and acidic phosphatase in pulp and bone tissue of alveolar process, and rendered protective

  2. Emphysema quantification on low-dose CT using percentage of low-attenuation volume and size distribution of low-attenuation lung regions: Effects of adaptive iterative dose reduction using 3D processing

    Nishio, Mizuho, E-mail: [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Matsumoto, Sumiaki, E-mail: [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Seki, Shinichiro, E-mail: [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Koyama, Hisanobu, E-mail: [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Ohno, Yoshiharu, E-mail: [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Fujisawa, Yasuko, E-mail: [Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi 324-8550 (Japan); Sugihara, Naoki, E-mail: [Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi 324-8550 (Japan); and others


    Highlights: • Emphysema quantification (LAV% and D) was affected by image noise on low-dose CT. • For LAV% and D, AIDR 3D improved agreement of quantification on low-dose CT. • AIDR 3D has the potential to quantify emphysema accurately on low-dose CT. - Abstract: Purpose: To evaluate the effects of adaptive iterative dose reduction using 3D processing (AIDR 3D) for quantification of two measures of emphysema: percentage of low-attenuation volume (LAV%) and size distribution of low-attenuation lung regions. Method and materials: : Fifty-two patients who underwent standard-dose (SDCT) and low-dose CT (LDCT) were included. SDCT without AIDR 3D, LDCT without AIDR 3D, and LDCT with AIDR 3D were used for emphysema quantification. First, LAV% was computed at 10 thresholds from −990 to −900 HU. Next, at the same thresholds, linear regression on a log–log plot was used to compute the power law exponent (D) for the cumulative frequency-size distribution of low-attenuation lung regions. Bland–Altman analysis was used to assess whether AIDR 3D improved agreement between LDCT and SDCT for emphysema quantification of LAV% and D. Results: The mean relative differences in LAV% between LDCT without AIDR 3D and SDCT were 3.73%–88.18% and between LDCT with AIDR 3D and SDCT were −6.61% to 0.406%. The mean relative differences in D between LDCT without AIDR 3D and SDCT were 8.22%–19.11% and between LDCT with AIDR 3D and SDCT were 1.82%–4.79%. AIDR 3D improved agreement between LDCT and SDCT at thresholds from −930 to −990 HU for LAV% and at all thresholds for D. Conclusion: AIDR 3D improved the consistency between LDCT and SDCT for emphysema quantification of LAV% and D.

  3. Elevated Serum Thyroglobulin and Low Iodine Intake Are Associated with Nontoxic Nodular Goiter among Adults Living near the Eastern Mediterranean Coast

    Yaniv S. Ovadia


    Full Text Available Background. Information about iodine intake is crucial for preventing thyroid diseases. Inadequate iodine intake can lead to thyroid diseases, including nontoxic nodular goiter (NNG. Objective. To estimate iodine intake and explore its correlation with thyroid diseases among Israeli adults living near the Mediterranean coast, where iodine-depleted desalinated water has become a major source of drinking water. Methods. Cross-sectional study of patients attending Barzilai Medical Center Ashkelon. Participants, who were classified as either NNG (n=17, hypothyroidism (n=14, or control (n=31, provided serum thyroglobulin (Tg and completed a semiquantitative iodine food frequency questionnaire. Results. Elevated serum Tg values (Tg > 60 ng/mL were significantly more prevalent in the NNG group than in the other groups (29% versus 7% and 0% for hypothyroidism and controls, resp., P<0.05. Mean estimated iodine intake was significantly lower in the NNG group (65±30 μg/d than in controls (115±60 μg/d (P<0.05 with intermediate intake in the hypothyroid group (73±38 μg/d. Conclusions. Elevated serum Tg values and low dietary iodine intake are associated with NNG among adult patients in Ashkelon District, Israel. Larger studies are needed in order to expand on these important initial findings.

  4. Estrogen receptor (ER)-beta, but not ER-alpha, is present in thyroid vessels: immunohistochemical evaluations in multinodular goiter and papillary thyroid carcinoma.

    Ceresini, Graziano; Morganti, Simonetta; Graiani, Virna; Saccani, Maria; Milli, Bruna; Usberti, Elisa; Valenti, Giorgio; Ceda, Gian Paolo; Corcione, Luigi


    Estrogen receptors (ERs) have been demostrated in the vessel structures of several systems. Little is known on the presence of ERs in the thyroid vessels. We immunohistochemically evaluated both ER-alpha and ER-beta immunoreactivity (IR) in both vascular and follicular thyroid cells in tissue samples from 17 cases of multinodular goiter (MNG) and 17 cases of papillary thyroid carcinoma (PTC). ER-alpha IR was undetectable in either tissue examined. In 100% of MNG samples, nuclear ER-beta IR was detected in both endothelial and follicular cells. In PTC samples, endothelial nuclear ER-beta IR was found in 100% of cases, whereas the nuclear staining of follicular cells was found in 83% of cases. The intensity of staining of the endothelial ER-beta IR was comparable between MNG and PTC. However, when follicular cells were considered, a tendency toward a decrease in nuclear staining and a significant increase in cytoplasmic staining were found in PTC lesions as compared to MNG. This study demonstrated that ER-beta, but not ER-alpha, IR is present in the endothelium of thyroid vessels. Furthermore, although data need to be confirmed in larger observations, these results suggest the lack of differences in the pattern of vascular ER-beta IR between MNG and PTC.

  5. The incidence of lymphocytic thyroid infiltration and Hashimoto's thyroiditis increased in patients operated for benign goiter over a 31-year period.

    Ott, Johannes; Meusel, Moritz; Schultheis, Andrea; Promberger, Regina; Pallikunnel, Shannon Joan; Neuhold, Nikolaus; Hermann, Michael


    The incidence of Hashimoto's thyroiditis (HT) seems to have increased over the last several decades. Since there is a lack of recent studies in the literature that evaluate this phenomenon on a histological basis, we aimed to assess the incidence of lymphocytic thyroid infiltration (LTI) in our large surgical patient collective over a 31-year period. In our study, a total of 1,050 patients who had undergone uni- or bilateral thyroid surgery for benign goiter were included (150 patients in each group, during 1979 to 2009). The stored histological sections of the removed thyroid specimens were re-analyzed, including routine grading of LTI severity on a scale of 0-4, according to Williams and Doniach. Positive correlations were seen for the incidences of LTI grading (0-4) (r = 0.077, p = 0.013) and HT (r = 0.044, p = 0.078) over the years. Furthermore, when comparing the years 1979-1989 and 1994-2009, i.e., before and after the second iodine prophylaxis had been introduced in Austria, a higher incidence of HT was found for the later years (2 out of 450, 0.4%, vs. 6 out of 600, 1.0%, respectively; p < 0.0001). In conclusion, the data demonstrate that the incidence of LTI and HT has increased substantially over the last 31 years.

  6. Structure of a Thyroid Gland Pathologies in a Population of Children and the Teenagers Living in Conditions Endemic Goiter of Northern Territories by Results of Ultrasonic Researches

    Y Girsh


    Full Text Available For studying structure pathologies of a thyroid gland at children and the teenagers living in northern territories Khanty-Mansiysk of autonomous region, for the period 2000–2008 the retrospective analysis of results of 3002 ultrasonic researches of a thyroid gland is lead To 32.7% of cases at children and teenagers attributes endemic goiter a craw are revealed. Chronic lymphocytic thyroiditis, changes thyroid gland, are revealed in 4.2% of cases. The one-central and multinodal craw was made with 2.1 and 0.7%, accordingly. In 60.3% according to ultrasonic of inspection of pathology a thyroid gland it is not revealed. The basic ultrasonic models colloidal a craw, central cellular a craw and an adenoma of a thyroid gland are developed. The estimation of criteria the importance of the given models is lead, the estimation of results has allowed to consider, that the received ultrasonic models were adequate for ultrasound research.

  7. Radioiondine therapy for Graves hyperthyroidism with large goiter: feasibility, efficacy and safety%131I治疗巨大与非巨大甲状腺肿性Graves甲亢疗效对比

    冯会娟; 欧阳伟; 胡瑞; 刘金华; 刘伟英


    Objective To evaluate the feasibility, efficacy and safety of radioiondine therapy in the treatment of Graves' hyperthyroidism with large goiter. Methods A total of 128 patients with Graves; hyperthyroidism with large goiter (thyroid weight>70 g) as the study group were treated with radioiondine, using 318 concurrent patients with Graves disease with a smaller goiter (thyroid weight<70 g) as the control group. The cure rate following a single-session treatment, the total cure rate and the incidence of hypothyroidism were compared between the two groups. Results In the large goiter group, the total cure rate was 95.3%, and the cure rate following a single-session treatment was 46.9%, with the incidence of hypothyroidism of 4.7%, as compared with 90.9%, 65.7%, and 9.1% in the control group, respectively. A significant difference was noted in the cure rate following a single-session treatment (P=0.000), but not in the total cure rate or the incidence of early-onset hypothyroidism (P=0.115) between the two groups. No tracheal compression, laryngeal edema, or hyperthyroidism crisis occurred in the large goiter group after the treatment. Conclusion Radioiondine is safe and effective for treatment of Graves' hyperthyroidism with large goiter, and results in a total cure rate and incidence of early-onset hypothyroidism similar to those in patients with goiters of a smaller size.%目的 通过与非巨大性甲状腺肿组的对比,探讨131I治疗巨大性甲状腺肿性Graves甲亢的临床疗效.方法 选取经过131I治疗的甲状腺质量>70 g的甲亢患者128例作为研究组,同期经过131I治疗的甲状腺质量<70 g的甲亢患者318例作为对照组,对比131Ⅰ治疗后两组患者一次治愈率、总治愈率及甲状腺功能减退发生情况.结果 131I治疗巨大甲状腺肿性Graves甲亢的总治愈率95.3%,一次治愈率46.9%,早发甲减发生率4.7%;对照组总治愈率90.9%,一次治愈率65.7%,早发甲减发生率9.1%.

  8. Impact of 18-fluorodeoxyglucose positron emission tomography on computed tomography defined target volumes in radiation treatment planning of esophageal cancer : reduction in geographic misses with equal inter-observer variability

    Schreurs, Liesbeth; Busz, D. M.; Paardekooper, G. M. R. M.; Beukema, J. C.; Jager, P. L.; Van der Jagt, E. J.; van Dam, G. M.; Groen, H.; Plukker, J. Th. M.; Langendijk, J. A.


    P>Target volume definition in modern radiotherapy is based on planning computed tomography (CT). So far, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) has not been included in planning modality in volume definition of esophageal cancer. This study evaluates fusion of FDG-PET and CT in

  9. Advances research on bronchoscopic lung volume reduction surgery for obstructive airway diseases%内科肺减容术在慢性阻塞性肺疾病最新研究进展

    谢栓栓; 王昌惠


    阻塞性呼吸道疾病是多种疾病组成的,但它们都可因炎症导致气道狭窄,从而导致呼吸做功增加.由于其患病人数多,病死率高,严重影响患者的劳动能力和生活质量.不同群体的哮喘、慢性支气管炎和肺气肿最佳治疗策略应该是多方面的,如高危肺气肿患者应包括药物学和非药物方法以及手术治疗.回顾当前支气管镜介入水平,近十年其发展目标是更好地控制哮喘症状和缓解由于不适合肺减容手术的肺气肿患者症状,由此可见,新型支气管镜技术针对气道阻塞性疾病治疗有很大帮助.%Obstructivepulmonary disease is composed of a variety of diseases,nevertheless,they are able to induce the airway narrow and result in increase of work of breathing force.The incidence and mortality are high,which seriously influence the patients' ability to work and quality of life.There are many optimal treatment strategies of asthma,chronic bronchitis,and emphysema in different groups,such as pharmacological and non-pharmacological methods as well as surgery for high-risk patients with emphysema.In recent decades,the development objective of bronchoscopic intervention is to better control asthma symptoms and relieve symptoms of patients with emphysema who are not suitable for the lung volume reduction surgery.This demonstrates that new bronchoscopic techniques will be helpful for treatment of airway obstruction disease in future.

  10. Dewatering and Volume Reduction of Heavy Metal-contaminated Sediments in Lake and Reservoir Using Geotextile Tubes%重金属污染底泥的土工管袋高效脱水减容研究

    张景辉; 刘朝辉; 西伟力; 王旭东; 董晶; 毕涛; 王文茜


    基于环保疏浚过程中湖库重金属污染底泥的特点,研究了土工管袋处理技术脱水减容重金属污泥的效果.通过试验筛选和优化,获得了土工管袋脱水效果最佳的重金属螯合钝化调质剂ECO-DEMETAL及其最佳添加量.通过容量为25 L的小袋脱水试验研究发现,脱水7d后污泥含固率由5%提高到70%左右,污泥脱水后重金属浸出毒性的检测结果远优于《生活垃圾填埋场污染控制标准》( GB 16889-2008)的指标要求.通过土工管袋1:1现场扩大试验,获得了容量为1 000 m3的大型土工管袋污泥脱水工程应用经验,脱水效果非常理想,含固率>50%,重金属钝化效果也完全满足填埋造岛资源化处置的环保要求.%Based on characters of heavy metal-contaminated sediments in lake and reservoir during environment-friendly dredging, the dewatering and volume reduction of heavy metal-contaminated sediments with geotextile tubes were studied. A conditioner, known as ECO-DEMETAL for heavy metal che-lation and passivation with the optimal dewatering efficiency of geotextile tubes as well as its optimal dosage were obtained by selection and optimization experiments. The dewatering result of 25 L geotextile tube show that the solid content of sludge is increased from 5% to 70% within 7 days, and the toxicity characteristic leaching procedure ( TCLP) result meets to the requirement of the Standard for Pollution Control on the Landfill Site for Domestic Waste ( GB 16889 -2008). Dewatering experiments in pilot scale were carried out for verification of dewatering performance of 1 000 m geotextile tube. The pilot results show that the dewatering efficiency is ideal, the solid content of sludge is more than 50% , and the passivation effect of heavy metals also meets the environmental requirement in landfdl resource disposal for island creation.

  11. Volume reduction and conditioning campaigns, upon low level solid waste drums, realised in ENEA centres of Trisaia (ITREC plant) and Saluggia (EUTREX plant); Campagne di trattamento di rifiuti radioattivi solidi a bassa attivita` provenienti dagli impianti pilota di ritrattamento EUREX ed ITREC dell`ENEA

    Gili, M. [ENEA, Saluggia (Italy). Dipt. Energia


    The volume reduction and conditioning campaigns, upon low level solid waste drums, realized between 1989 and 1993 in the ENEA (Italian Agency for New Technologies, Energy and the Environment) centres of Trisaia (ITREC plant) and Saluggia (EUREX plant), by the mean of supercompactation, and cement immobilization inside over packs, are hereby described. The operational techniques and the equipments used, the whole volume reduction factors obtained and some final considerations over this solid rad wastes treatment procedure are shown. This method, where correctly operated and coupled to an accurate radiological characterization, permits to save space for the waste storage in the short period and to obtain final manufacts, certified suitable for shallow burial disposal, according to Italian technical guide no. 26.

  12. Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial.

    Sewefy, Alaa M; Tohamy, Tohamy A; Esmael, Tarek M; Atyia, Ahmed M


    Due to high recurrence rate after subtotal thyroidectomy, most of centers have shifted to total thyroidectomy as a surgical treatment for benign multinodular goiter (BMNG), but serious complications, as laryngeal nerve affection & hypocalcaemia, are still present. This study aimed to evaluate treatment of BMNG using intra-capsular total thyroid enucleation in comparison to standard total thyroidectomy. This is a prospective randomized controlled clinical trial conducted in a hospital in the period from December 2009 to December 2015. Of total 224 patients with clinically BMNG. 112 patients operated by intracapsular total thyroid enucleation (ITTE group) and the other 112 patients operated by standard total thyroidectomy (STT group). The minimal follow up period was 36 months. The mean operative time in ITTE group was (93.7 ± 9.6 min) compared to (86.9 ± 8.3 min) in STT group. Transient recurrent laryngeal nerve (RLN) palsy was 0% in ITTE group VS 7.1% in STT group. No cases (0%) developed permanent RLN palsy in ITTE group VS 0.9% in STT group. Symptomatic transient hypocalcaemia occurred in 1.8% in ITTE group VS 11.6% in STT group. No cases (0%) developed permanent hypocalcaemia in ITTE group VS 0.9% in STT group. No recurrence (0%) in both groups after minimal 3 years of follow up. Intracapsular Total thyroid enucleation technique is safe with the least serious complications, especially RLN injury and hypoparathyroidism, with no recurrence, but this technique still not radical so couldn't be used in suspicious cases for malignancy. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Epidemiology of palpable goiter in Greater Buenos Aires, an iodine-sufficient area Epidemiología del bocio palpable en el Gran Buenos Aires, un área suficiente en yodo

    Hugo Niepomniszcze


    Full Text Available The Hospital de Clínicas organized a free program of goiter detection by palpation. This campaign was aimed at the population of the metropolitan area of Greater Buenos Aires (11 million inhabitants, with the prerequisite that each participant should be quite unaware whether he/she was a carrier of any thyroid disease. Attendees were split into two groups, i.e., Random and Induced. The former consisted of 542 individuals who came to consultation due to mere curiosity, while the latter involved 500 subjects, comprising consanguineous family members of patients with thyroid disorders and also individuals who suffered from other ailments. Ages ranged from 2 to 85 years. In the Random Group, goiter prevalence of 8.7% was observed, while in the Induced Group it climbed to 14.4%. Since both groups were mostly made up of women (87.2%, a correction based on the masculinity index was applied to members of the Random Group. Thus, the total observed prevalence of goiter was 6%, diffuse goiters corresponding to 3.5% and nodular ones to 2.5%. The frequency of nodules increased with age, 90.5% occurring in those over 40 years. In the Induced Group, goiter prevalence among relatives of patients with thyroid disorders proved to be 13.1%, rising to 17.8% in those who suffered from other complaints. The epidemic data presented herein are the first arising from a screening survey carried out in a large iodine-sufficient population of the southernmost tip of the American continent. These results are useful to build up the world map of goiter prevalence in non-endemic areas.El Hospital de Clínicas organizó un programa gratuito para la detección de bocio por palpación. Esta campaña estuvo dirigida a la población del área metropolitana del Gran Buenos Aires, con el prerrequisito de que cada participante debía desconocer si padecía alguna enfermedad tiroidea. De acuerdo a las motivaciones que llevaron a los pacientes a la evaluación, se dividieron en 2

  14. Cirurgia redutora de volume pulmonar: critérios de seleção de pacientes no Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ Lung volume reduction surgery (LVRS: criteria for selecting patient in Antonio Pedro Hospital, Federal Fluminense University, Niterói city, Rio de Janeiro, Brazil

    Rodolfo Fred Behrsin


    mais de um fator mórbido a contra-indicar o seu procedimento. A maioria dos pacientes com critérios para CRVP, a recusa, com receio do procedimento ou após programas de reabilitação pulmonar. O critério mais significativo que indicou CRVP em um paciente operado foi a presença de enfisema heterogênio bilateral nos lobos superiores.BACKGROUND: Chronic Obstructive Pulmonary Disease (CPOD is an important problem in Brazil and other countries. The clinical treatment of ambulatory patients is now reasonably standardized. Lung volume reduction surgery (LVRS is an alternative of surgical treatment of emphysema (aside from lung transplantation. OBJECTIVES: The aim of this study was to analyse patient selection criteria for LVRS. METHODS: This study was carried out using a sample of 31 patients referred to and given assistance to at the Smoking and Chronic Obstructive Pulmonary Disease Outpatient Ward Antonio Pedro Hospital, who were evaluated to check whether or not they could be eligible for LVRS. Aiming at evaluating the major criteria for eligibility for LVRS, the patients underwent a protocol including standardized anamnesis and physical examination, spirometry with maximum inspiratory and expiratory flow volume curves associated with post-bronchodilatator test, room air arterial blood gases, a six-minute walking test, plain chest roentgenograms and left lateral chest roentgenograms, high-resolution chest computed tomographic scans and lung perfusion scans. Statistical analysis was conducted with description of data proportions. RESULTS: Contraindications to surgery included chronic bronchitis (29% or nine patients, forced expiratory volume in one second (FEV 1 more than 80 percent predicted (13% or four patients, negative consent for surgery (10% or three patients, fibrosis pattern, severe depression and bronchiectasis (two patients each one, solitary pulmonary nodule, severe obesity, severe bullous emphysema, pulmonary hipertension, pulmonary resection history

  15. 分期双侧单孔胸腔镜肺减容术的临床分析%Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis

    张淼; 潘雪峰; 张辉


    目的 评估分期双侧单孔胸腔镜肺减容术(LVRS)治疗慢性阻塞性肺气肿(COPE)的可行性及疗效.方法 回顾性分析2013年1月至2014年6月东南大学附属徐州市中心医院11例双侧COPE合并肺大泡的男性患者行分期双侧单孔胸腔镜LVRS的临床资料,年龄(60.27±12.11)岁.采用腔镜切割缝合器(Endo-GIA)切除过度充气的肺大泡组织,用4-0 Prolene线连续缝合加固切缘并涂抹生物蛋白胶.比较患者术前、单侧术后3个月与双侧术后3个月的肺功能、血气分析、6分钟步行距离(6-MWD)及生活质量(SF-36量表评分).结果 无围术期死亡病例,术后胸腔引流管留置时间(9.09±1.31)d,住院时间(15.73±2.75)d.术后持续肺漏气5例次,肺部感染7例次,均治愈.单侧或双侧术后3个月肺功能、动脉血氧分压、6-MWD及生活质量均较术前改善,而单侧与双侧LVRS术后比较无差异.结论 分期双侧单孔胸腔镜LVRS可改善COPE患者的近期生活质量.%Objective To investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for the patients with chronic obstructive pulmonary emphysema (COPE).Methods We retrospectively analyzed clinical data of eleven male patients with bilateral COPE and bullae in Xuzhou Central Hospital Affiliated to Southeast University from January 2013 through June 2014.All the patients underwent staged bilateral single-port thoracoscopic LVRS with their age of 60.27± 12.11 years.The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA),followed by continuous suture and biological glue for reinforcement of the margin.Besides,the pulmonary function,blood gas assay,6-minute walk distance (6-MWD),and life quality evaluated by short form 36 Health survey questionnaire (SF-36) were recorded before and after LVRS respectively.Results All the patients survived after surgery.Chest tube drainage time was 9.09±1.31 days

  16. Dose evaluation in function of the thyroid captivation percentage and mass in patients under radiotherapy for toxic goiter treatment;Avaliacao da dose em funcao do percentual de captacao e massa tireoidiana em pacientes submetidos a radioterapia para tratamento de bocio toxico com {sup 131}I

    Alves, Aline Nunes [Universidade Catolica de Pernambuco (DF/UNICAP), Recife, PE (Brazil). Dept. de Fisica; Antonio Filho, Joao [Universidade Federal de Pernambuco (DEN/UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear


    Rarely the patient's metabolism is pondered when the quantity of radioactive material administrated to the patient is calculated. Nowadays, realizing till 150 mCi/g activities treatments are not indicated to toxic goiter radiotherapy. This paper objectives to establish a group of {sup 13I}-treatment options optimization for owner toxic goiter patients to maximize benefits and minimize radiological detriments. Methodology consisted of effective and absorbed whole-body and the other organs doses evaluations. And to observe the relation between these values and the thyroid mass and captivation percentage. The results, in spite of characteristic variations of each patient, showed such a homogeneity. This phenomenon happens because of explicit dependency on the real activity administrated to the patient. Used protocols for the toxic goiter treatment optimization avoiding waste of radioisotopes. (author)

  17. Impact of 18-fluorodeoxyglucose positron emission tomography on computed tomography defined target volumes in radiation treatment planning of esophageal cancer: reduction in geographic misses with equal inter-observer variability: PET/CT improves esophageal target definition.

    Schreurs, L M A; Busz, D M; Paardekooper, G M R M; Beukema, J C; Jager, P L; Van der Jagt, E J; van Dam, G M; Groen, H; Plukker, J Th M; Langendijk, J A


    Target volume definition in modern radiotherapy is based on planning computed tomography (CT). So far, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) has not been included in planning modality in volume definition of esophageal cancer. This study evaluates fusion of FDG-PET and CT in patients with esophageal cancer in terms of geographic misses and inter-observer variability in volume definition. In 28 esophageal cancer patients, gross, clinical and planning tumor volumes (GTV; CTV; PTV) were defined on planning CT by three radiation oncologists. After software-based emission tomography and computed tomography (PET/CT) fusion, tumor delineations were redefined by the same radiation-oncologists. Concordance indexes (CCI's) for CT and PET/CT based GTV, CTV and PTV were calculated for each pair of observers. Incorporation of PET/CT modified tumor delineation in 17/28 subjects (61%) in cranial and/or caudal direction. Mean concordance indexes for CT-based CTV and PTV were 72 (55-86)% and 77 (61-88)%, respectively, vs. 72 (47-99)% and 76 (54-87)% for PET/CT-based CTV and PTV. Paired analyses showed no significant difference in CCI between CT and PET/CT. Combining FDG-PET and CT may improve target volume definition with less geographic misses, but without significant effects on inter-observer variability in esophageal cancer.

  18. Innovative Clean Coal Technology (ICCT). Demonstration of Selective Catalytic Reduction (SCR) technology for the control of nitrogen oxide (NO{sub x}) emissions from high-sulfur coal-fired boilers: Volume 3, Appendices O--T. Final report



    Volume 3 contains the following appendices: Appendix O, Second Series-Manual APH Tests; Appendix P, Third Series-Manual APH Tests; Appendix Q, ABB Analysis of Air Preheaters-Final Report; Appendix R, ABB Corrosion Analysis Study; Appendix S, SRI Waste Stream Impacts Study; and Appendix T, Economic Evaluation.

  19. Effects of High Volume MOSFET Usage on Dosimetry in Pediatric CT, Pediatric Lens of the Eye Dose Reduction Using Siemens Care kV, & Designing Quality Assurance of a Cesium Calibration Source

    Smith, Aaron Kenneth

    Project 1: Effects of High Volume MOSFET Usage on Dosimetry in Pediatric CT: Purpose: The objective of this study was to determine if using large numbers of Metal-Oxide-Semiconducting-Field-Effect Transistors, MOSFETs, effects the results of dosimetry studies done with pediatric phantoms due to the attenuation properties of the MOSFETs. The two primary focuses of the study were first to experimentally determine the degree to which high numbers of MOSFET detectors attenuate an X-ray beam of Computed Tomography (CT) quality and second, to experimentally verify the effect that the large number of MOSFETs have on dose in a pediatric phantom undergoing a routine CT examination. Materials and Methods: A Precision X-Ray X-Rad 320 set to 120kVp with an effective half value layer of 7.30mm aluminum was used in concert with a tissue equivalent block phantom and several used MOSFET cables to determine the attenuation properties of the MOSFET cables by measuring the dose (via a 0.18cc ion chamber) given to a point in the center of the phantom in a 0.5 min exposure with a variety of MOSFET arrangements. After the attenuating properties of the cables were known, a GE Discovery 750 CT scanner was employed using a routine chest CT protocol in concert with a 10-year-old Atom Dosimetry Phantom and MOSFET dosimeters in 5 different locations in and on the phantom (upper left lung (ULL), upper right lung (URL), lower left lung (LLL), lower right lung (LRL), and the center of the chest to represent skin dose). Twenty-eight used MOSFET cables were arranged and taped on the chest of the phantom to cover 30% of the circumference of the phantom (19.2 cm). Scans using tube current modulation and not using tube current modulation were taken at 30, 20, 10, and 0% circumference coverage and 28 MOSFETs bundled and laid to the side of the phantom. The dose to the various MOSFET locations in and on the chest were calculated and the image quality was accessed in several of these situations by

  20. Comprehensive Application of 64-slice Spiral CT Scan Techniques on Diagnosis Value of Nodular Goiter%64排CT的综合运用对诊断结节性甲状腺肿价值探讨

    肖继伟; 王晓燕; 胡道予


    目的:探讨64排螺旋CT扫描技术的综合运用对结节性甲状腺肿的诊断及鉴别诊断方面的价值。方法:选择41例经过病理证实的结节性甲状腺肿,甲状腺肿瘤及其他结节性甲状腺疾病若干,全部行64排螺旋CT平扫及动态增强扫描加后续重建,观察病灶的大小、形态、密度、边缘、强化特点及有无侵犯和转移等,总结和归纳病灶的影像学表象及特征。结果:结节性甲状腺肿、甲状腺肿瘤及其他结节性甲状腺疾病在CT影像上的表现可能少部分有所重叠,但大多数趋于不同,且有一定规律可循。结论:基于64排CT扫描技术的综合运用可在很大程度上掌握结节性甲状腺肿及相似疾病的表象及特征,对结节性甲状腺肿诊断及鉴别诊断具有重要意义。%Objective:To discuss the comprehensive application of 64-slice spiral CT scan techniques on the diagnosis value of nodular goiter and its differential diagnostic value. Methods:41 cases of nodular goiter,thyroid tumors and other nodular thyroid diseases,which had been verified by pathology,were selected to conduct 64-slice spiral CT scan and dynamic contrast-enhanced scan plus follow-up reconstruction. With observing the size,shape,density,edge,enhancing char-acteristics of the lesion as well as its infringement and metastasis,imaging characteristics of the le-sion were concluded. Results:The imaging manifestations of nodular goiter,thyroid tumors and oth-er nodular thyroid diseases overlap only in small portion on CT,but mostly they are different. Con-clusion:The comprehensive application of 64-slice spiral CT scan techniques can considerably di-agnose the representations and characteristics of nodular goiter and similar diseases,which is signifi-cant to the diagnosis and differential diagnosis of nodular goiter.

  1. Clinical Efifcacy of Unilateral Lung Volume Reduction Surgery for Intractable Pneumothorax With Severe Emphysema%探讨单侧肺减容手术治疗难治性气胸合并重度肺气肿的临床疗效



    目的:探讨单侧肺减容手术治疗难治性气胸合并重度肺气肿的疗效。方法56例难治性气胸合并重度肺气肿患者进行单侧肺减容手术治疗,统计患者的治疗效果。结果所有患者均成功完成手术,患者治疗后PaO2、FVC、FEV1与治疗前相比明显较高(P<0.05),PaCO2、TLC与治疗前相比明显较低(P<0.05)。结论单侧肺减容手术能有效改善患者血气状况及肺功能,可在难治性气胸合并重度肺气肿患者中运用。%Objective To explore the efficacy of unilateral lung volume reduction surgery for intractable pneumothorax with severe emphysema. Methods 56 cases of patients with intractable pneumothorax with severe emphysema received unilateral lung volume reduction surgery, the patients’ treatment effects were analyzed. Results All patients successfully completed surgery, PaO2, FVC and FEV1 of patients compared with before treatment was signiifcantly higher (P<0.05), PaCO2 and TLC were signiifcantly lower (P<0.05). Conclusion The unilateral lung volume reduction surgery can improve blood gas status and lung function, and it can be used in patients with intractable pneumothorax and severe emphysema.

  2. First investigation at elevated pressures to confirm the exact nature of the gated electron-transfer systems: volume profiles of the gated reduction reaction and nongated reverse oxidation reaction involving a [Cu(dmp)2(solvent)]2+/[Cu(dmp)2]+ couple (dmp = 2,9-dimethyl-1,10-phenanthroline).

    Itoh, Sumitaka; Noda, Kyoko; Yamane, Ryouhei; Kishikawa, Nobuyuki; Takagi, Hideo D


    Redox reactions involving the [Cu(dmp)2]2+/+ couple (dmp = 2,9-dimethyl-1,10-phenanthroline) in acetonitrile were examined at elevated pressures up to 200 MPa. Activation volumes were determined as -8.8 and -6.3 cm3 mol-1 for the reduction cross-reaction by [Co(bipy)3]2+ (bipy = 2,2'-bipyridine) and for the oxidation cross-reaction by [Ni(tacn)2]3+ (tacn = 1,4,7-triazacyclononane), respectively. The activation volume for the hypothetical gated mode of the self-exchange reaction estimated from the reduction cross-reaction was -13.9 cm3 mol-1, indicating extensive electrostrictive rearrangement of solvent molecules around the CuII complex during the change in the coordination geometry before the electron-transfer step. On the other hand, the activation volume for the self-exchange reaction estimated from the oxidation cross-reaction was -2.7 +/- 1.5 cm3 mol-1. Although this value was within the range that can be interpreted by the concept of the ordinary concerted process, from theoretical considerations it was concluded that the reverse (oxidation) cross-reaction of the gated reduction reaction of the [Cu(dmp)2(CH3CN)]2+/[Cu(dmp)2]+ couple proceeds through the product excited state while the direct self-exchange reaction between [Cu(dmp)2(CH3CN)]2+ and [Cu(dmp)2]+ proceeds through an ordinary concerted process.

  3. Factors influencing the difference between forecasted and actual drug sales volumes under the price-volume agreement in South Korea.

    Park, Sun-Young; Han, Euna; Kim, Jini; Lee, Eui-Kyung


    This study analyzed factors contributing to increases in the actual sales volumes relative to forecasted volumes of drugs under price-volume agreement (PVA) policy in South Korea. Sales volumes of newly listed drugs on the national formulary are monitored under PVA policy. When actual sales volume exceeds the pre-agreed forecasted volume by 30% or more, the drug is subject to price-reduction. Logistic regression assessed the factors related to whether drugs were the PVA price-reduction drugs. A generalized linear model with gamma distribution and log-link assessed the factors influencing the increase in actual volumes compared to forecasted volume in the PVA price-reduction drugs. Of 186 PVA monitored drugs, 34.9% were price-reduction drugs. Drugs marketed by pharmaceutical companies with previous-occupation in the therapeutic markets were more likely to be PVA price-reduction drugs than drugs marketed by firms with no previous-occupation. Drugs of multinational pharmaceutical companies were more likely to be PVA price-reduction drugs than those of domestic companies. Having more alternative existing drugs was significantly associated with higher odds of being PVA price-reduction drugs. Among the PVA price-reduction drugs, the increasing rate of actual volume compared to forecasted volume was significantly higher in drugs with clinical usefulness. By focusing the negotiation efforts on those target drugs, PVA policy can be administered more efficiently with the improved predictability of the drug sales volumes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Larger Thyroid Volume and Adequate Iodine Nutrition in Chinese Schoolchildren: Local Normative Reference Values Compared with WHO/IGN

    Zhe Mo


    Full Text Available Objective. Thyroid volume measured by ultrasound to define goiter needs reliable local thyroid volume reference from iodine-sufficient populations. The aim of this study is to explore the reference interval for normal thyroid volume in schoolchildren aged 8–10 years from Zhejiang Province, China. Methods. A probability-proportionate-to-size sampling method was applied to select a representative sample of 1213 children aged 8–10 years in Zhejiang Province to detect the thyroid volume, salt iodine, and urine iodine. Results. Median urinary iodine concentration in involved schoolchildren was 178.30 (125.00 μg l−1, with the percentage of samples less than 100 μg l−1 as 12.69% and more than 300 μg l−1 as 15.25%. Thyroid volume was significantly correlated with age and anthropometric measurements independently of each other. The 97th percentile of thyroid volume in our study was larger generally than the new international reference. Conclusions. The iodine nutritional status in Zhejiang Province was at an adequate level. Despite some limitations in this study, we initially established the reference values for thyroid volume in 8–10-year-old schoolchildren in Zhejiang Province, China, as a local reference to be used for monitoring iodine deficiency disorders.

  5. Renormalized Volume

    Gover, A. Rod; Waldron, Andrew


    We develop a universal distributional calculus for regulated volumes of metrics that are suitably singular along hypersurfaces. When the hypersurface is a conformal infinity we give simple integrated distribution expressions for the divergences and anomaly of the regulated volume functional valid for any choice of regulator. For closed hypersurfaces or conformally compact geometries, methods from a previously developed boundary calculus for conformally compact manifolds can be applied to give explicit holographic formulæ for the divergences and anomaly expressed as hypersurface integrals over local quantities (the method also extends to non-closed hypersurfaces). The resulting anomaly does not depend on any particular choice of regulator, while the regulator dependence of the divergences is precisely captured by these formulæ. Conformal hypersurface invariants can be studied by demanding that the singular metric obey, smoothly and formally to a suitable order, a Yamabe type problem with boundary data along the conformal infinity. We prove that the volume anomaly for these singular Yamabe solutions is a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. Recently, Graham proved that the first variation of the volume anomaly recovers the density obstructing smooth solutions to this singular Yamabe problem; we give a new proof of this result employing our boundary calculus. Physical applications of our results include studies of quantum corrections to entanglement entropies.

  6. Tratamiento del bocio tóxico difuso con 131I en dosis de 80 µCi/g de tejido tiroideo Treatment of diffuse toxic goiter with 131I at doses of 80 µCi/g of thyroid tissue

    Francisco Ochoa Torres


    follow-up was performed every 2 months for 3 years by the same specialist and with identical procedures. The efficiency of the treatment with the first dose was 85.2 %. The frequency of hypothyroidism at 3 years of evolution was 29.5. The age of the patient, the sex, the goiter size and the treatment with PTU did not influence on the response to it. The advantages showed by the method were: high efficiency, the dose of 131I may be easily calculated, simple application, decrease of the cost, since it is not necessary to assess the functional state of the gland, and reduction of visits.

  7. Mechanism of Reduction Action of Unsaturated Polyester Resin


    The reduction action mechanism of the unsatrurated polyester resin reducer is analysed by the free space volume theory.Through measuring the reduction magnitude in each phase of solidification,the authors predicted the rate of reduction is in concordance with the results from experiments.From this we presented corresponding solutions to different causes of the reduction action of the unsaturated polyester resin.

  8. Graves病患者甲状腺肿大及眼征的影响因素分析%Influencing factors on goiter and thyroid eye in patients with Graves′disease

    黄莹芝; 汤步阳; 常琳; 郭法平


    Objective To investigate the factors associated with goiter and thyroid eye of Graves'disease( GD) . Methods A total of 154 patients with GD were recruited in the study from Jan. 2011 to Dec. 2013. The patients were divided into two groups according to goiter and thyroid eye. Serum levels of free triiodothyronine(FT3), free thyroxine(FT4), thyroid stimulating hormone(TSH), thyroid peroxydase antibody( TPOAb) , thyroglobulin antibody( TGAb) and TSH receptors antibody( TRAb) were measured in chemiluminescence method. Age, FT3, FT4, TSH, TPOAb, TGAb and TRAb were compared between the two groups. Results In Graves'disease, there were 112 cases of goiter(72. 7%) and 62 cases of thyroid eye (40. 3%). Patients in group goiter showed higher FT3, FT4, TPOAb and TRAb. (P<0. 05 or P<0. 01), and lower age compared to those in group with no goiter(P<0. 01). Patients in group thyroid eye showed higher TPOAb, TGAb and TRAb compared to those in group with no thyroid eye(P<0. 05 or P<0. 01). Correlation analysis showed goiter was related to age, TPOAb and TRAb (correlation coefficient=0. 149, 0. 295, 0. 198, P<0. 05, respectively). Thyroid eye was related to TGAb and TRAb (correlation coefficient=0. 280,0. 228, P<0. 05, respectively). Conclusion In Graves'disease, goiter is related to age, higher level of TPOAb and TRAb. Thyroid eye is related to higher level of TGAb and TRAb.%目的 探讨Graves病患者甲状腺肿大及眼征的影响因素.方法 选取皖北煤电集团总医院内分泌科2011年1月至2013年12月就诊的Graves病患者154例.分别按照患者有无甲状腺肿及有无甲状腺眼征,分为甲状腺肿大组(A组)和无甲状腺肿大组(B组)以及有眼征组(C组)和无眼征组(D组).应用化学发光法检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺激素受体抗体(TRAb).分别比较两组

  9. Innovative Clean Coal Technology (ICCT). Demonstration of Selective Catalytic Reduction (SCR) technology for the control of nitrogen oxide (NO{sub x}) emissions from high-sulfur coal-fired boilers: Volume 2, Appendices A--N. Final report



    Volume 2 contains the following appendices: Appendix A, Example Material Safety Data Sheet; Appendix B, Initial Site Characterization Test Results; Appendix C, Testing Proposal, Southern Research Institute; Appendix D, Example Laboratory Catalyst Test Protocol; Appendix E, Detailed Coal Analysis Data; Appendix F, Standard Methods-QA/QC Document; Appendix G, Task No. 1 Commissioning Tests; Appendix H, Task No. 2 Commissioning Tests; Appendix I, First Parametric Sequence Spreadsheets; Appendix J, Second Parametric Sequence Spreadsheets; Appendix K, Third Parametric Sequence Spreadsheets; Appendix L, Fourth Parametric Sequence Spreadsheets; Appendix M, Fifth Parametric Sequence Spreadsheets; and Appendix N, First Series-Manual APH Tests.

  10. Goiter and Multiple Food Allergies

    Stefanie Leniszewski


    Full Text Available Severe iodine deficiency results in impaired thyroid hormone synthesis and thyroid enlargement. In the United States, adequate iodine intake is a concern for women of childbearing age and pregnant women. Beyond this high risk group iodine deficiency is not considered to be a significant problem. This case report describes a 12-year-old male with severe iodine deficiency disorder (IDD resulting from restricted dietary intake due to multiple food allergies. We describe iodine replacement for this patient and continued monitoring for iodine sufficiency. Children with multiple food allergies, in particular those with restrictions to iodized salt and seafood, should be considered high risk for severe iodine deficiency.

  11. Nodular goiter (epidemiology and diagnostics

    R A Chernikov


    Full Text Available Thyroid nodules measuring 1cm and more revealed in 27% adult inhabitants of region. Malignant tumors were diag nosed in 2.9% of them. There was increase in the number of people with nodules in the territories exposed to radioactive fallout after Chernobyl accident in comparison to the territories without such pollution – 57.3%/42.4% as well as malignant tumors among them (5.2%/2.7% Comparison of thyroid palpation and ultrasound in detection of thyroid nodules revealed that thyroid nodules of 10 mm were detected only in every 10th patient by means of pal pation: and nodules of 11–15 mm in every 4th patient, comparing to ultrasound data of the same patients’ group. Malignant tumors were detected on cytology in 2.9% of thyroid nodules less than 2 cm (30171 patients and in 1.9% of thyroid nodules larger than 2 cm (15 656 patients. At the same time the frequency of regional lymph node metas tases was significantly higher in patients with thyroid nodules larger than 2 cm (34.8%, than in patients with nod ules less than 2 cm – 18.3%. Only one malignant tumor was detected among 358 patients with autonomously func tioning nodules. Risk groups with higher rate of malignancy were patients living in the areas with Chernobyl’s fall out, and patients in whom nodules with “suspicious” sonographic features were revealed (rough edges, capsule inva sion, microcalcifications. Patients with high risk of malignant transformation should be submitted to FNAB regard less of thyroid nodule size. Biopsy is unnecessary for the patients with autonomously functioning nodules detected by scintigraphy.

  12. Moment Maps and Equivariant Volumes

    Alberto DELLA VEDOVA; Roberto PAOLETTI


    The study of the volume of big line bundles on a complex projective manifold M has been one of the main veins in the recent interest in the asymptotic properties of linear series. In this article,we consider an equivariant version of this problem, in the presence of a linear action of a reductive group on M.

  13. Modern Chemical Technology, Volume 5.

    Pecsok, Robert L., Ed.; Chapman, Kenneth, Ed.

    This volume contains chapters 26-31 for the American Chemical Society (ACS) "Modern Chemical Technology" (ChemTeC) instructional material intended to prepare chemical technologists. Chapter 26 reviews oxidation and reduction, including applications in titrations with potassium permanganate and iodometry. Coordination compounds are…

  14. Operation Skill for Removal of Giant Substernal Goiters Through Cervical Approach%巨大胸骨后甲状腺肿经颈入路手术切除的技巧

    连金山; 王龙龙; 刘婕; 高珊; 芦语昕


    Objective To investigate the operation skill for removal of giant substernal goiters through cervical approach.Methods A retrospective analysis of 5 cases clinical materials of giant substernal goiters.Results All cases were performed through low-collar cervical approach, no deaths in the intraoperative or postoperative were no deaths, with less bleeding, shorter operative time and showing no any adverse physical postoperative symptoms, such as hemothorax, pneumothorax, tracheomalacia, esophageal injury and impairment of recurrent laryngeal nerve. No postoperative recurrence cases in follow-up for 6-12 months.Conclusion Giant substernal goiters can be removed through cervical approach without sternotomy, with advertages such as little trauma, short operation time, quick recovery, less complications, short hospitalization time, low cost and so on, worthy of clinical application.%目的:探讨经颈部低领切口手术切除巨大胸骨后甲状腺肿的技巧。方法回顾性分析5例巨大胸骨后甲状腺肿的临床资料。结果全组病例均经低领颈部切口手术切除,术中及术后均无死亡病例,术中出血量少,手术时间短,术后无血胸、气胸、气管软化、食道损伤及喉返神经损伤,术后随访6~12个月无复发病例。结论巨大胸骨后甲状腺肿可经颈部低领切口切除,无需胸骨劈开,具有创伤小、手术时间短、恢复快、并发症少、住院天数短、费用少等优点,值得临床推广应用。

  15. Exceptional Reductions

    Marrani, Alessio; Riccioni, Fabio


    Starting from basic identities of the group E8, we perform progressive reductions, namely decompositions with respect to the maximal and symmetric embeddings of E7xSU(2) and then of E6xU(1). This procedure provides a systematic approach to the basic identities involving invariant primitive tensor structures of various irreprs. of finite-dimensional exceptional Lie groups. We derive novel identities for E7 and E6, highlighting the E8 origin of some well known ones. In order to elucidate the connections of this formalism to four-dimensional Maxwell-Einstein supergravity theories based on symmetric scalar manifolds (and related to irreducible Euclidean Jordan algebras, the unique exception being the triality-symmetric N = 2 stu model), we then derive a fundamental identity involving the unique rank-4 symmetric invariant tensor of the 0-brane charge symplectic irrepr. of U-duality groups, with potential applications in the quantization of the charge orbits of supergravity theories, as well as in the study of mult...

  16. Roles of AQP5/AQP5-G103D in carbamylcholine-induced volume decrease and in reduction of the activation energy for water transport by rat parotid acinar cells.

    Satoh, Keitaro; Seo, Yoshiteru; Matsuo, Shinsuke; Karabasil, Mileva Ratko; Matsuki-Fukushima, Miwako; Nakahari, Takashi; Hosoi, Kazuo


    In order to assess the contribution of the water channel aquaporin-5 (AQP5) to water transport by salivary gland acinar cells, we measured the cell volume and activation energy (E (a)) of diffusive water permeability in isolated parotid acinar cells obtained from AQP5-G103D mutant and their wild-type rats. Immunohistochemistry showed that there was no change induced by carbamylcholine (CCh; 1 μM) in the AQP5 detected in the acinar cells in the wild-type rat. Acinar cells from mutant rats, producing low levels of AQP5 in the apical membrane, showed a minimal increase in the AQP5 due to the CCh. In the wild-type rat, CCh caused a transient swelling of the acinus, followed by a rapid agonist-induced cell shrinkage, reaching a plateau at 30 s. In the mutant rat, the acinus did not swell by CCh challenge, and the agonist-induced cell shrinkage was delayed by 8 s, reaching a transient minimum at around 1 min, and recovered spontaneously even though CCh was persistently present. In the unstimulated wild-type acinar cells, E (a) was 3.4 ± 0.6 kcal mol(-1) and showed no detectable change after CCh stimulation. In the unstimulated mutant acinar cells, high E (a) value (5.9 ± 0.1 kcal mol(-1)) was detected and showed a minimal decrease after CCh stimulation (5.0 ± 0.3 kcal mol(-1)). These results suggested that AQP5 was the main pathway for water transport in the acinar cells and that it was responsible for the rapid agonist-induced acinar cell shrinkage and also necessary to keep the acinar cell volume reduced during the steady secretion in the wild-type rat.

  17. Histopathological characteristics of human non-tumor thyroid tissues in a long-term model of adenomatous goiter xenografts in the NOD/Shi-scid, IL-2Rγ(null) mouse.

    Fujii, Etsuko; Kato, Atsuhiko; Chen, Yu Jau; Matsubara, Koichi; Ohnishi, Yasuyuki; Suzuki, Masami


    There is a growing need for modeling the human thyroid to link data obtained from animals to humans because of its sensitivity to radiation exposure and endocrine disruption chemicals. In a scid mouse model produced by transplanting human thyroid tissues, leakiness and thymic lymphoma that occurs spontaneously in the scid mouse can complicate the interpretation of experimental results. Considering that the NOD.Cg-Prkdc(scid)Il2rg(tm1Sug)/Jic mouse (NOD/Shi-scid, IL-2Rγ(null) or NOG mouse) may be a better host because this strain has low incidence of leakiness and thymic lymphoma, we have evaluated the potential of a model that allows long-term observation of non-tumor human thyroid tissues in this mouse. We transplanted tissues of human adenomatous goiter into NOG mice and examined the tissues histopathologically. The morphology of human adenomatous goiter tissues was maintained from 24 to 44 weeks after transplantation in NOG mice with no noted differences between donor-matched tissues or the weeks after transplantation. The tissues expressed thyroglobulin protein and mRNA as well as thyroperoxidase. Endothelial cells originating from human were found in the transplanted tissues and were thought to be a characteristic of this model. The intactness of the tissues before transplantation was found to affect the rate of tissue engraftment. From the present results we have concluded that transplanted thyroid tissues in NOG mice maintain the histopathological characteristics of their origin for long terms. Therefore this model was thought feasible for toxicity evaluation. Copyright © 2014 Elsevier GmbH. All rights reserved.

  18. 结节性甲状腺肿合并甲状腺癌的临床分析%Clinical analysis of patients with nodular goiter concomitant thyroid cancer

    米泰宇; 刘开坤


    Objective To study the clinical features, diagnosis and treatment of patients with nodular goiter concomitant thyroid cancer. Methods The clinical data of 142 cases with concomitant thyroid cancer in 1 859 cases of nodular goiter admitted from January 2008 to January 2011 were retrospectively analyzed. Results All the 142 patients underwent surgical treatment, of which, there were 112 cases of primary surgery and 30 cases of secondary surgery. The ratio of men to women was 1 : 3. 1 , and the patients predominantly manifested as nodular goiter. Fifty-five cases (38. 7% ) were suspected of having concomitant thyroid cancer as suggested by preoperative ultrasound examination, of which 21 cases ( 18. 7 % ) had nodular psammomatous calcification. Twelve cases had cervical lymph node enlargement. Ninety patients underwent high-resolution color Doppler ultrasound examination, of which 68 cases (75. 6%) were suspected of having malignant lesion. Fine needle aspirations ( FNA ) were performed in 45 cases and the correct diagnostic rate was 48. 9%. The pathological examinations of intraoperative fast frozen section wereperformed in 138 patients , with accuracy rate of 96. 4% , 5 false negative cases and no false positive case. Of the patients with thyroid cancer, 83 cases were unifocal and 59 cases were multifocal, lesions less than 2. 0 cm accounted for 75. 3% , the main pathological type was papillary carcinoma (75. 4% ) , and 64 cases showed lymph node metastasis. The surgical procedures comprised ipsilateral total lobectomy combined with isthmusectomy, ipsilateral total lobectomy combined with isthmusectomy plus contralateral subtotal lobectomy or total thyroidectomy, and ipsilateral or bilateral central compartment ( level VI) lymph node dissection. The patients with enlarged cervical lymph nodes and suspected of having cervical lymph node metastasis before or during surgery underwent additional modified neck dissection. After surgery, all the 142 patients received

  19. Logistics Reduction Technologies for Exploration Missions

    Broyan, James L., Jr.; Ewert, Michael K.; Fink, Patrick W.


    Human exploration missions under study are limited by the launch mass capacity of existing and planned launch vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Although mass is typically the focus of exploration missions, due to its strong impact on launch vehicle and habitable volume for the crew, logistics volume also needs to be considered. NASA's Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing six logistics technologies guided by a systems engineering cradle-to-grave approach to enable after-use crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the use of autonomous logistics management technologies, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion gases. Reduction of mass has a corresponding and significant impact to logistical volume. The reduction of logistical volume can reduce the overall pressurized vehicle mass directly, or indirectly benefit the mission by allowing for an increase in habitable volume during the mission. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as mission durations increase. Early studies have shown that the use of advanced logistics technologies can save approximately 20 m(sup 3) of volume during transit alone for a six-person Mars conjunction class mission.

  20. Renormalized Volume

    Gover, A Rod


    For any conformally compact manifold with hypersurface boundary we define a canonical renormalized volume functional and compute an explicit, holographic formula for the corresponding anomaly. For the special case of asymptotically Einstein manifolds, our method recovers the known results. The anomaly does not depend on any particular choice of regulator, but the coefficients of divergences do. We give explicit formulae for these divergences valid for any choice of regulating hypersurface; these should be relevant to recent studies of quantum corrections to entanglement entropies. The anomaly is expressed as a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. We show that the variation of these energy functionals is exactly the obstruction to solving a singular Yamabe type problem with boundary data along the...

  1. Innovative Clean Coal Technology (ICCT). Demonstration of Selective Catalytic Reduction (SCR) technology for the control of nitrogen oxide (NO{sub x}) emissions from high-sulfur coal-fired boilers: Volume 1. Final report



    The objective of this project is to demonstrate and evaluate commercially available Selective Catalytic Reduction (SCR) catalysts from U.S., Japanese and European catalyst suppliers on a high-sulfur U.S. coal-fired boiler. SCR is a post-combustion nitrogen oxide (NO.) control technology that involves injecting ammonia into the flue gas generated from coal combustion in an electric utility boiler. The flue gas containing ammonia is then passed through a reactor that contains a specialized catalyst. In the presence of the catalyst, the ammonia reacts with NO. to convert it to nitrogen and water vapor. Although SCR is widely practiced in Japan and Europe on gas-, oil-, and low-sulfur coal- fired boilers, there are several technical uncertainties associated with applying SCR to U.S. coals. These uncertainties include: 1) potential catalyst deactivation due to poisoning by trace metal species present in U.S. coals that are not present in other fuels. 2) performance of the technology and effects on the balance-of- plant equipment in the presence of high amounts of SO{sub 2} and SO{sub 3}. 3) performance of a wide variety of SCR catalyst compositions, geometries and methods of manufacturer under typical high-sulfur coal-fired utility operating conditions. These uncertainties were explored by operating nine small-scale SCR reactors and simultaneously exposing different SCR catalysts to flue gas derived from the combustion of high sulfur U.S. coal. In addition, the test facility operating experience provided a basis for an economic study investigating the implementation of SCR technology.

  2. Scenarios for Deep Carbon Emission Reductions from Electricity by 2050 in Western North America using the Switch Electric Power Sector Planning Model: California's Carbon Challenge Phase II, Volume II

    Nelson, James; Mileva, Ana; Johnston, Josiah; Kammen, Daniel; Wei, Max; Greenblatt, Jeffrey


    This study used a state-of-the-art planning model called SWITCH for the electric power system to investigate the evolution of the power systems of California and western North America from present-day to 2050 in the context of deep decarbonization of the economy. Researchers concluded that drastic power system carbon emission reductions were feasible by 2050 under a wide range of possible futures. The average cost of power in 2050 would range between $149 to $232 per megawatt hour across scenarios, a 21 to 88 percent increase relative to a business-as-usual scenario, and a 38 to 115 percent increase relative to the present-day cost of power. The power system would need to undergo sweeping change to rapidly decarbonize. Between present-day and 2030 the evolution of the Western Electricity Coordinating Council power system was dominated by implementing aggressive energy efficiency measures, installing renewable energy and gas-fired generation facilities and retiring coal-fired generation. Deploying wind, solar and geothermal power in the 2040 timeframe reduced power system emissions by displacing gas-fired generation. This trend continued for wind and solar in the 2050 timeframe but was accompanied by large amounts of new storage and long-distance high-voltage transmission capacity. Electricity storage was used primarily to move solar energy from the daytime into the night to charge electric vehicles and meet demand from electrified heating. Transmission capacity over the California border increased by 40 - 220 percent by 2050, implying that transmission siting, permitting, and regional cooperation will become increasingly important. California remained a net electricity importer in all scenarios investigated. Wind and solar power were key elements in power system decarbonization in 2050 if no new nuclear capacity was built. The amount of installed gas capacity remained relatively constant between present-day and 2050, although carbon capture and sequestration was

  3. Model reduction of parametrized systems

    Ohlberger, Mario; Patera, Anthony; Rozza, Gianluigi; Urban, Karsten


    The special volume offers a global guide to new concepts and approaches concerning the following topics: reduced basis methods, proper orthogonal decomposition, proper generalized decomposition, approximation theory related to model reduction, learning theory and compressed sensing, stochastic and high-dimensional problems, system-theoretic methods, nonlinear model reduction, reduction of coupled problems/multiphysics, optimization and optimal control, state estimation and control, reduced order models and domain decomposition methods, Krylov-subspace and interpolatory methods, and applications to real industrial and complex problems. The book represents the state of the art in the development of reduced order methods. It contains contributions from internationally respected experts, guaranteeing a wide range of expertise and topics. Further, it reflects an important effor t, carried out over the last 12 years, to build a growing research community in this field. Though not a textbook, some of the chapters ca...

  4. 纤维支气管镜肺减容术治疗绵羊肺气肿模型的实验研究%Treatment of pulmonary emphysema sheep model through bronchoscopic lung volume reduction:an experimental study

    冯志军; 路武杰; 滕伟; 郭俊华; 黄志昂; 王红燕; 靳建军; 王静


    目的:探讨经纤支镜射频置管建立气道旁路肺减容术治疗绵羊肺气肿模型的有效性及优越性.方法:将16只6月龄雌性绵羊随机分为A、B2组,木瓜蛋白酶方法建立肺气肿模型.A组经纤支镜射频建立气道旁路并放置支架,2组均给予内科治疗.分别测2组绵羊术前和术后24 h、4、8周的第1秒用力呼气容积(forced expiratory volume in one second,FEV10),且进行比较,A组定期行胸部CT检查,2组动物治疗8周均予以处死,行病理学检查.结果:①成功复制绵羊肺气肿动物模型16只,A组术中、术后无并发症出现;②A组胸部CT示术后4周及8周,在治疗区均出现肺容积缩小,出现肺不张表现;③2组不同时间点FEV10水平差异有统计学意义(F时间=1 352.409,P=0.000),2种治疗手段效果差异有统计学意义(F组间=5 004.278,P=0.000),治疗手段和时间之间有交互作用(F交互=1 325.058,P=0.000);④病理示A组治疗区见肺泡萎陷区,非治疗区域见肺气肿,肺泡萎陷区见粒细胞和淋巴细胞浸润;B组见肺气肿的肺泡组织.结论:该技术治疗绵羊肺气肿模型具有有效性及优越性.

  5. Medical hypothesis: can gonadotropins influence thyroid volume in women with PCOS?

    Cakir Evrim


    Full Text Available Abstract It has been reported that luteinizing hormone (LH had thyropropic effect on rat and human thyroid membrane. It has been known that patients with PCOS have elevated LH levels in comparison to healthy controls. The goiter prevalence is more common in women than in men regardless of population. The higher incidence of thyroid diseases in women has been previously attributed to higher estradiol levels. Estradiol has been shown to enhance proliferative and mitogenic activities of thyroid cells. However, in recent years chronic estradiol treatment has been shown to reduce volume densities of thyroid follicles, follicular epithelium and thyroid gland volume. It is thought to be due to LH suppression. Therefore we suggested that increased LH levels might provide a stimulus for growth on thyroid and alter thyroid function. Therefore patients with PCOS who had elevated LH levels should be treated by combined estradiol pills such as estrogen-progestin contraceptives for suppression of LH secretion. Further studies are needed to evaluate the association between LH, LH suppression and thyroid volume in patients with PCOS.

  6. Childhood maltreatment modifies the relationship of depression with hippocampal volume

    Gerritsen, L.; van Velzen, L.; Schmaal, L.; van der Graaf, Y.; van der Wee, N.; van Tol, M. -J.; Penninx, B.; Geerlings, M.


    Background. Childhood maltreatment (CM) may modify the relationship between major depressive disorder (MDD) and hippocampal volume reduction. To disentangle the impact of MDD and CM on hippocampal volume we investigated the association between MDD and hippocampal volume in persons with and without a

  7. Coexistência das síndromes de Capgras e Frégoli associadas à redução de volume frontotemporal e hiperintensidades em substância branca cerebral Coexistence of Capgras and Frégoli syndromes associated to frontotemporal volume reduction and cerebral white matter hyperintensities

    Gizela Turkiewicz


    Full Text Available CONTEXTO: Transtornos delirantes de identificação são condições nas quais os pacientes identificam de maneira patologicamente equivocada pessoas, lugares, objetos ou eventos. Esses transtornos têm sido categorizados em quatro diferentes subtipos: Capgras, Frégoli, intermetamorfose e síndrome do duplo subjetivo. Tais síndromes podem estar presentes em diferentes transtornos psiquiátricos, como esquizofrenia e transtornos do humor, bem como em diferentes doenças neurológicas, como Alzheimer, Parkinson, lesões cerebrais traumáticas ou vasculares. OBJETIVOS: Descrever e discutir um caso de coexistência entre as síndromes de Capgras e Frégoli em uma paciente com esquizofrenia paranoide e com alterações cerebrais. MÉTODOS: Entrevista psiquiátrica e ressonância magnética de crânio. RESULTADOS: A paciente apresentava hiperintensidades periventriculares em aquisição flair e de substância branca subcortical concentradas principalmente na região frontotemporal direita, bem como perda do volume da região frontotemporal bilateral. DISCUSSÃO: As alterações descritas podem representar substrato orgânico das síndromes dos transtornos delirantes de identificação. Os delírios nas síndromes de Capgras e Frégoli podem ocorrer como resultado de uma desconexão têmporo-límbica-frontal direita, resultando em uma impossibilidade de associar memórias prévias a novas informações, levando consequentemente a alterações na capacidade de reconhecimento. Ademais, uma perda do volume de tais regiões cerebrais também pode desempenhar papel importante no desenvolvimento de tais síndromes delirantes de identificação.BACKGROUND: Delusional misidentification syndromes are conditions in which the patients pathologically misidentify people, places, objects or events. They have been categorized in four subtypes: Capgras, Frégoli, intermetamorphosis and subjective double syndromes. Such syndromes may be present in patients with

  8. Clinical Research on the Effect of Therapy in Huge Goiter Merge Graves131I for Hyperthyroidism%巨大甲状腺肿合并Graves甲亢131Ⅰ治疗临床疗效研究



    Objective To observe the clinical efficacy of131I treatment of huge goiter merge graves hyperthyroidism.Methods 40 cases of large goiter hyperthyroidism patients with Graves in our hospital from 2013 October to 2014 October who were treated,according to 131I per gram of thyroid tissue from 2 to 6.3 MBq/g drug treatment,patients were discharged after 4~8 months visit.ResultsAfter 4 months and131I treatment,22 cases(55%) of the thyroid function was normal,11 cases(27.5%)of the hyperthyroidism,7 cases(17.5%)of hypothyroidism,33 cases(82.5%)of the thyroidenlargement returned to normal,7 cases of thyroid weight are decreased. After 8 months and131I treatment,27 cases(67.5%)of the thyroid function was normal,8 cases(20%)of the hyperthyroidism,5 cases(12.5%)of hypothyroidism,37 cases(92.5%)of the thyroid enlargement returned to normal,the remaining 3 cases thyroid weight decreased.Conclusion The clinical curative effect of clinical application of131I treatment of huge goiter merge graves hyperthyroidism has significant.%目的:观察131I治疗巨大甲状腺肿合并Graves甲亢的临床疗效。方法选取我院自2013年10月~2014年10月期间收治的巨大甲状腺肿合并Graves甲亢患者40例,对患者进行131I按照每克甲状腺组织2~6.3 MBq/g给药治疗,患者出院后4~8个月回访。结果经过131I治疗后的4个月,22例(55%)的甲状腺功能恢复正常,11例(27.5%)的甲状腺功能亢进,7例(17.5%)的甲状腺功能减退,其中有33例(82.5%)的甲状腺肿大恢复正常,7例的甲状腺重量均有所下降。经过131I治疗后的8个月,27例(67.5%)甲状腺功能恢复正常,8例(20%)甲状腺功能亢进,5例(12.5%)甲状腺功能减退,其中有37例(92.5%)的甲状腺肿大恢复正常,剩余3例的甲状腺重量均有所下降。结论临床上应用131I治疗巨大甲状腺肿合并Graves甲亢取得的临床疗效显著。

  9. 胸骨后结节性甲状腺肿的外科治疗及并发症防治%Surgical treatment and complications prevention of substernal thyroid goiter

    罗东林; 高博; 姜燕; 张姝; 郭翎佶; 田武国; 张晓华; 赵健洁; 严洁


    Objective:To investigate the surgical treatment and complications prevention of substernal thyroid goiter.Methods: Clinical features of 28 patients with substernal thyroid goiter underwent surgery in our hospital from January 2004 to December 2014 were summa-rized and analyzed.Results:All patients were received surgery, 24 patients underwent cervical collar incision while 4 patients underwent combined cervical-thoracic incision.Postoperative hypocalcemia occurred in 3 patients, hoarseness occurred in 1 patient, tracheomalacia occurred in 5 patients, intraoperative trachea suspension in 4 persons, tracheotomy in 1 person, extubation and discharge after seven days, hypothyroidism occurred in 8 patients.There was no bleeding, thyroid storm and other serious complications.All patients were clinically cured, who were followed up for 6 months to 10 years, no recurrence happened.Conclusion:Cervical collar incision was nearly always adequate for most cases of substernal goiter, if intraoperative operate difficultly, thoracotomy should be chosen immediately.Furthermore, trachea suspension can effectively prevent breathing difficult caused by tracheal collapse.%目的:探讨胸骨后结节性甲状腺肿的外科治疗方法及其并发症防治。方法:总结分析2004年1月~2014年12月在我院行手术治疗的28例胸骨后结节性甲状腺肿患者的临床资料。结果:全部病例均行手术治疗,颈部切口入路24例,颈胸联合切口入路4例。术后发生低钙血症3例,声音嘶哑1例,气管塌陷软化5例,术中行气管悬吊4例,行气管切开1例,术后7天拔管出院,发生甲状腺功能减退8例,无大出血及甲状腺危象等严重并发症,均临床治愈出院。随访6个月~10年,无复发。结论:大部分胸骨后结节性甲状腺肿可经颈部低领状切口完成手术,如术中操作困难,应果断开胸手术,气管悬吊可有效预防气管塌陷致呼吸困难的发生。

  10. Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters.

    Prescott, E; Netterstrøm, B; Faber, J; Hegedüs, L; Suadicani, P; Christensen, J M


    It has previously been shown that long-term oral exposure to cobalt can cause goiter and myxedema. The effect of industrial cobalt exposure on thyroid volume and function was determined for 61 female plate painters exposed to cobalt blue dyes in two Danish porcelain factories and 48 unexposed referents. Thyroid volume was determined by ultrasonography. The cobalt blue dyes were used in one of two forms, cobalt aluminate (insoluble) and cobalt-zinc silicate (semisoluble). Only the subjects exposed to semisoluble cobalt had a significantly increased urinary cobalt content (1.17 micrograms.mmol-1 versus 0.13 micrograms.mmol-1, P less than 0.0001). These subjects also had increased levels of serum thyroxine (T4) and free thyroxine (FT4I) (P = 0.0001 and 0.0029, respectively), unaltered serum thyroid stimulating hormone (TSH), and marginally reduced 3,5,3'-triiodothyronine (T3), whereas thyroid volume tended to be lower (P = 0.14). The group exposed to insoluble cobalt did not differ significantly in any thyroid-related parameters. No correlation between urinary cobalt and FT4I or thyroid volume was found. The study demonstrates an effect of cobalt on thyroid hormone metabolism.

  11. 临床路径在结节性甲状腺肿手术患者中的应用%Application of clinical pathway in nodular goiter surgery patient



    目的:探讨临床路径在结节性甲状腺肿手术患者中的应用,评价其应用效果。方法将106例结节性甲状腺肿手术患者随机分为观察组和对照组各53例,观察组由主管医生和责任护士按照临床路径表的内容进行全程规范的检查、治疗、护理、观察及健康教育,对照组采用常规治疗、护理和健康教育。结果观察组患者对健康教育知识掌握优良率和对护理工作满意度均明显高于对照组( P<0.05)。结论临床路径的实施,有利于提高健康教育的效果及患者对护理工作的满意度。%Objective To observe the application of clinical pathway in nodular goiter surgery patient and e-valuate its effect.Methods 106 patients with nodular goiter surgery were randomly divided into observation group and control group, with 53 patients of each group.53 cases of observation group were standardized examined, treated, cared, observed and healthily educated by competent doctors and responsible nurses in accordance with the contents of the clini-cal pathway table.53 cases of control group were treated, cared and healthily educated normally.Results Excellent rate of patients grasping the health education and the nursing satisfaction in observation group were higher than those of control group ( P<0.05 ) .Conclusions The implement of clinical pathway is useful to improve the effect of health ed-ucation and the nursing satisfaction of patients.

  12. Lymphedema Risk Reduction Practices

    ... now! Position Paper: Lymphedema Risk Reduction Practices Category: Position Papers Tags: Risks Archives Treatment risk reduction garments surgery obesity infection blood pressure trauma morbid obesity body weight ...

  13. Shear-induced Volume Decrease in MDCK Cells

    Heo, Jinseok; Sachs, Frederick; Wang, Jianbin; Hua, Susan Z.


    Using a microfluidic cell volume sensor we measured the change in the cell volume of Madin-Darby Canine Kidney (MDCK) cells induced by shear stress. An increase in shear stress from 0.2 to 2.0 dyn/cm2 resulted in a volume decrease to a steady state volume ~ 20 – 30 % smaller than the initial resting cell volume. Independent experiments based on fluorescence quenching confirmed the volume reduction. This shear-induced cell shrinkage was irreversible on the time scale of the experiment (~ 30 min). Treatment of 0.1 μM Hg2+ significantly inhibited the volume decrease, suggesting that the shear-induced cell shrinkage is associated with water efflux through aquaporins. The volume decrease cannot be inhibited by 75 mM TEA, 100 μM DIDS, or 100 μM Gd3+ suggesting that volume reduction is not directly mediated by K+ and Cl− channels that typically function during regulatory volume decrease (RVD), nor is it through cationic stretch-activated ion channels (SACs). The process also appears to be Ca2+ independent because it was insensitive to intracellular Ca2+ level. Since cell volume is determined by the intracellular water content, we postulate that the shear induced reductions in cell volume may arise from increased intracellular hydrostatic pressure as the cell is deformed under flow, which promotes the efflux of water. The increase in internal pressure in a deformable object under the flow is supported by the finite element mechanical model. PMID:22759987

  14. Studies in the carbothermic reduction of phosphogypsum

    Kale, Bharat B.; Pande, Anita R.; Gokarn, Ashok N.


    Phosphogypsum has been reduced in the solid state by active charcoal both in the presence and absence of catalysts. Kinetic data could be fitted to the modified volume reaction model. Mixed catalysts like potassium dichromate were found to enhance the reaction rate quite satisfactorily. This result could be fruitfully employed during reduction with industrial coke also.

  15. Simulation for volume reduction of site remediation at UCP

    Hong, Sang Bum; Seo, Bum Kyoung; Moon, Jei Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)


    A characterization survey, sufficient time, and a proper budget are required after decommissioning work to carry out a final survey in preparing for an unexpected contamination. In this study, the optimized amount of soil waste during site remediation of the Uranium Conversion Plant was evaluated by considering the hop spot concept which was suggested in MARSSIM and geo statistics methods. The objective of any remedial action is to reduce the risks to human health to acceptable levels by removing the source of contamination. The project period was extended twice for the initial planning because of the unexpected soil contamination under the UCP building. The importance of the characterization survey and optimization of site remediation cannot be overestimated in the decommissioning project. In order to provide a reliable cost and schedule for site remediation, it requires optimization methods as well as appropriate data processing techniques. The optimized amount of soil waste during site remediation of the Uranium Conversion Plant was evaluated by considering the spatial analysis with the hot spot concept in MARSSIM. The combined methods of the hot spot concept in MARSSIM and geo statistics method pave a way to optimization of the site remediation.

  16. Volume reduction of solid waste by biological conversion of cellulosics

    Strandberg, G.W.


    It has been demonstrated that the types of cellulosic wastes generated at ORNL can be effectively degraded in an anaerboic bioreactor. The rate and extent of anaerobic microbial digestion of blotter paper, cloth, sanitary napkins, and pine sawdust in various types and sizes of bench-scale anaerobic bioreactors are described. Preliminary tests indicate that the resulting digests are amenable to incorporation into hydrofracture grouts.

  17. Aircraft Configuration Noise Reduction. Volume 3. Computer Program Source Listing



  18. Endoscopic Lung Volume Reduction : An Expert Panel Recommendation

    Herth, Felix J. F.; Slebos, Dirk-Jan; Rabe, Klaus F.; Shah, Pallav L.


    Chronic obstructive pulmonary disease (COPD) is a progressive condition comprising a constellation of disorders from chronic bronchitis, airflow obstruction through to emphysema. The global burden of COPD is estimated at more than 6% of the population. The standard of care is based on a combination

  19. Vowel Reduction in Japanese

    Shirai; Setsuko


    This paper reports the result that vowel reduction occurs in Japanese and vowel reduction is the part of the language universality.Compared with English,the effect of the vowel reduction in Japanese is relatively weak might because of the absence of stress in Japanese.Since spectral vowel reduction occurs in Japanese,various types of researches would be possible.

  20. Infinitary Combinatory Reduction Systems: Normalising Reduction Strategies

    Ketema, Jeroen; Simonsen, Jakob Grue


    We study normalising reduction strategies for infinitary Combinatory Reduction Systems (iCRSs). We prove that all fair, outermost-fair, and needed-fair strategies are normalising for orthogonal, fully-extended iCRSs. These facts properly generalise a number of results on normalising strategies in fi

  1. Development of limb volume measuring system

    Bhagat, P. K.; Kadaba, P. K.


    The mechanisms underlying the reductions in orthostatic tolerance associated with weightlessness are not well established. Contradictory results from measurements of leg volume changes suggest that altered venomotor tone and reduced blood flow may not be the only contributors to orthostatic intolerance. It is felt that a more accurate limb volume system which is insensitive to environmental factors will aid in better quantification of the hemodynamics of the leg. Of the varous limb volume techniques presently available, the ultrasonic limb volume system has proven to be the best choice. The system as described herein is free from environmental effects, safe, simple to operate and causes negligible radio frequency interference problems. The segmental ultrasonic ultrasonic plethysmograph is expected to provide a better measurement of limb volume change since it is based on cross-sectional area measurements.

  2. Graves' disease in two pregnancies complicated by fetal goitrous hypothyroidism: successful in utero treatment with levothyroxine

    Bliddal, Sofie; Rasmussen, Åse Krogh; Sundberg, Karin Milner


    Treatment of Graves' disease during pregnancy with antithyroid drugs (ATDs) poses a risk of inducing hypothyroidism and, thus, development of a goiter to the fetus. PATIENT FINDINGS: We report two patients referred to our department after discovery of a fetal goiter by ultrasound examination in t...... hypothyroidism as the cause of goiter development. Reduction of maternal ATD dose and injection of levothyroxine intra-amniotically quickly reduced the goiter size, and both babies were born euthyroid and without goiters....

  3. Local reduction in physics

    Rosaler, Joshua


    A conventional wisdom about the progress of physics holds that successive theories wholly encompass the domains of their predecessors through a process that is often called "reduction." While certain influential accounts of inter-theory reduction in physics take reduction to require a single "global" derivation of one theory's laws from those of another, I show that global reductions are not available in all cases where the conventional wisdom requires reduction to hold. However, I argue that a weaker "local" form of reduction, which defines reduction between theories in terms of a more fundamental notion of reduction between models of a single fixed system, is available in such cases and moreover suffices to uphold the conventional wisdom. To illustrate the sort of fixed-system, inter-model reduction that grounds inter-theoretic reduction on this picture, I specialize to a particular class of cases in which both models are dynamical systems. I show that reduction in these cases is underwritten by a mathematical relationship that follows a certain liberalized construal of Nagel/Schaffner reduction, and support this claim with several examples. Moreover, I show that this broadly Nagelian analysis of inter-model reduction encompasses several cases that are sometimes cited as instances of the "physicist's" limit-based notion of reduction.

  4. Reduction in language testing

    Dimova, Slobodanka; Jensen, Christian


    /video recorded speech samples and written reports produced by two experienced raters after testing. Our findings suggest that reduction or reduction-like pronunciation features are found in tested L2 speech, but whenever raters identify and comment on such reductions, they tend to assess reductions negatively......This study represents an initial exploration of raters' comments and actual realisations of form reductions in L2 test speech performances. Performances of three L2 speakers were selected as case studies and illustrations of how reductions are evaluated by the raters. The analysis is based on audio...

  5. Ovarian volume throughout life

    Kelsey, Thomas W; Dodwell, Sarah K; Wilkinson, A Graham


    cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n=59,994) we have generated and robustly validated the first model of ovarian volume from...... to about 2.8 mL (95% CI 2.7-2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis...

  6. Modern Reduction Methods

    Andersson, Pher G


    With its comprehensive overview of modern reduction methods, this book features high quality contributions allowing readers to find reliable solutions quickly and easily. The monograph treats the reduction of carbonyles, alkenes, imines and alkynes, as well as reductive aminations and cross and heck couplings, before finishing off with sections on kinetic resolutions and hydrogenolysis. An indispensable lab companion for every chemist.

  7. 结节性甲状腺肿的弹性成像声触诊组织定量影响因素分析%Influence factors analysis for the virtual touch tissue quantification of nodular goiter

    王书隽; 徐辉雄; 张一峰; 刘畅; 王帅; 吴蓉; 郭乐杭


    目的 分析结节性甲状腺肿声脉冲辐射力(ARFI)弹性成像声触诊组织定量(VTQ)的影响因素.方法 应用ARFIVTQ技术检测结节性甲状腺肿病灶103个,记录结节的横向剪切波速度(SWV)、部位、直径、形态、边界、回声、钙化、血流,并记录其周围相同深度甲状腺组织的SWV.利用Fisher判别分析定性地分析结节SWV与患者性别、年龄、结节部位、直径、形态、边界、回声、钙化、血流、周围组织SWV间的联系.利用多元线性逐步回归定量地分析结节SWV与患者性别、年龄、结节部位、直径、形态、边界、回声、钙化、血流、周围组织SWV之间的关系.结果 结节性甲状腺肿的SWV平均值为2.11±0.71 m/s(0.61~ 4.14 m/s).定性分析利用Fisher判别分析将结节SWV值按照低于和高于均值(2.1 m/s)归为弹性较软和较硬两类,将其他属性作为自变量,得出Fisher线性判别函数,对于较软的结节为0.45×直径+0.488×年龄+13.478×周围SWV-29.826,对于较硬的结节为0.393×直径+ 0.539×年龄+14.857×周围SWV-34.203.定量分析利用多元线性逐步回归分析,将结节SWV作为因变量,将其它属性作为自变量得出线性回归函数结节SWV=-3.491×直径+3.338×周围SWV +4.026.结论 结节直径、结节周围组织的SWV和患者年龄与结节SWV的相关度较大,是影响结节SWV大小的主要因素.直径大的结节相对偏软,年龄大的患者结节相对偏硬,周围组织较硬的结节也相对偏硬.患者性别,结节部位、形态、边界、回声、钙化、血流与其硬度关系不大.%Objective To analyze the influence factors for acoustic radiation force impulse (ARFI) virtual touch tissue quantification (VTQ) of nodular goiter.Methods VTQ of ARFI elastography was used to examine 103 nodular goiter lesions.The shear wave velocity (SWV),position,diameter,shape,bound,echo,calcification,flow signal of the nodules and the SWV of the adjacent thyroid tissues

  8. Mean nuclear volume

    Mogensen, O.; Sørensen, Flemming Brandt; Bichel, P.


    We evaluated the following nine parameters with respect to their prognostic value in females with endometrial cancer: four stereologic parameters [mean nuclear volume (MNV), nuclear volume fraction, nuclear index and mitotic index], the immunohistochemical expression of cancer antigen (CA125...

  9. Hippocampal subfield volumes in mood disorders.

    Cao, B; Passos, I C; Mwangi, B; Amaral-Silva, H; Tannous, J; Wu, M-J; Zunta-Soares, G B; Soares, J C


    Volume reduction and shape abnormality of the hippocampus have been associated with mood disorders. However, the hippocampus is not a uniform structure and consists of several subfields, such as the cornu ammonis (CA) subfields CA1-4, the dentate gyrus (DG) including a granule cell layer (GCL) and a molecular layer (ML) that continuously crosses adjacent subiculum (Sub) and CA fields. It is known that cellular and molecular mechanisms associated with mood disorders may be localized to specific hippocampal subfields. Thus, it is necessary to investigate the link between the in vivo hippocampal subfield volumes and specific mood disorders, such as bipolar disorder (BD) and major depressive disorder (MDD). In the present study, we used a state-of-the-art hippocampal segmentation approach, and we found that patients with BD had reduced volumes of hippocampal subfields, specifically in the left CA4, GCL, ML and both sides of the hippocampal tail, compared with healthy subjects and patients with MDD. The volume reduction was especially severe in patients with bipolar I disorder (BD-I). We also demonstrated that hippocampal subfield volume reduction was associated with the progression of the illness. For patients with BD-I, the volumes of the right CA1, ML and Sub decreased as the illness duration increased, and the volumes of both sides of the CA2/3, CA4 and hippocampal tail had negative correlations with the number of manic episodes. These results indicated that among the mood disorders the hippocampal subfields were more affected in BD-I compared with BD-II and MDD, and manic episodes had focused progressive effect on the CA2/3 and CA4 and hippocampal tail.Molecular Psychiatry advance online publication, 24 January 2017; doi:10.1038/mp.2016.262.

  10. Bacterial chromate reduction and product characterization

    Mehlhorn, R.J. [Lawrence Berkeley Lab., CA (United States); Buchanan, B.B.; Leighton, T. [California Univ., Berkeley, CA (United States)


    Bacillus subtilis reduced hexavalent chromate to trivalent chromium under either aerobic or anaerobic conditions. Reduction of CR(VI) and appearance of extracellular Cr(III) were demonstrated by electron spin resonance and spectrophotometry. Chromate reduction was stimulated more than five-fold by freeze-thawing, indicating that intracellular reductases or chemical reductants reduce chromate more rapidly than do intact cells. Moderately concentrated cells (10% pellet volume after centrifugation) reduced approximately 40 {mu}M chromate/min (2 mg Cr/1-min) when exposed to 100 {mu}M chromate (5 mg Cr/1). Highly concentrated cells (70% pellet volume) reduced more than 99.8% of 2 mM chromate (100 mg Cr/1) within 15 min. This rate of chromate reduction was of the same order of magnitude as the rate of respiration in aerobic cells. A substantial fraction of the reduction product (ca. 75%) was extracellular Cr(M), which could readily be separated from the cells by centrifugation. At high chromate concentrations, some fraction of reduced CR(VI) appeared to be taken up by cells, consistent with a detection of intracellular paramagnetic products. At low chromate concentrations, undefined growth medium alone reduced Cr(VI), but at a slow rate, relative to cells. Under appropriate conditions, B. subtilis appears to be an organism of choice for detoxifying chromate-contaminated soil and water.

  11. Colloid volume loading does not mitigate decreases in central blood volume during simulated hemorrhage while heat stressed

    Crandall, Craig G; Wilson, Thad E; Marving, Jens


    Heat stress results in profound reductions in the capacity to withstand a simulated hemorrhagic challenge; however, this capacity is normalized if the individual is volume loaded prior to the challenge. The present study tested the hypothesis that volume loading during passive heat stress attenua...



    A symplectic reduction method for symplectic G-spaces is given in this paper without using the existence of momentum mappings.By a method similar to the above one,the arthors give a symplectic reduction method for the Poisson action of Poisson Lie groups on symplectic manifolds,also without using the existence of momentum mappings.The symplectic reduction method for momentum mappings is thus a special case of the above results.

  13. Finding optimal exact reducts

    AbouEisha, Hassan M.


    The problem of attribute reduction is an important problem related to feature selection and knowledge discovery. The problem of finding reducts with minimum cardinality is NP-hard. This paper suggests a new algorithm for finding exact reducts with minimum cardinality. This algorithm transforms the initial table to a decision table of a special kind, apply a set of simplification steps to this table, and use a dynamic programming algorithm to finish the construction of an optimal reduct. I present results of computer experiments for a collection of decision tables from UCIML Repository. For many of the experimented tables, the simplification steps solved the problem.



  15. 超声引导下射频消融治疗结节性甲状腺肿46例报告%Doppler Ultrasound-guided Radiofrequency Ablation for Nodular Goiter: Report of 46 Cases

    刘金涛; 郭文斌; 杨世财; 葛述科


    目的 探讨超声引导下射频消融( radiofrequency ablation,RFA)治疗结节性甲状腺肿的临床效果. 方法 2009年6月~ 2010年9月对46例甲状腺良性结节在局部麻醉下行超声引导下RFA治疗,在颈部皮肤取1 mm切口,切开皮肤及皮下组织,将射频针穿刺在结节的中心部位开启射频,应用能量为4~6W,其中心温度可达95℃. 结果 均成功行RFA,术中无明显并发症发生,1例出现穿刺部位感染.RFA术后6个月47.8% (22/46)患者结节全部吸收,26.1% (12/46)结节体积较术前缩小≥50%,26.1% (12/26)结节体积较术前缩小25% ~ 50%. 结论 超声引导下RFA治疗结节性甲状腺肿疗效好、微创优势明显,是一种值得推广的手术方法.%Objective To explore the efficacy of Doppler ultrasound-guided radiofrequency ablation ( RFA) for benign thyroid nodules. Methods From June 2009 to September 2010, we performed RFA under the guidance by Doppler ultrasonography on 46 patients with benign thyroid nodules. We made a 1-mm incision at the neck, cut the skin and subcutaneous tissues, and then inserted a radiofrequency needle into the center point of the nodules for RFA (4-6 W, center temperature 95 ℃ ). Results The procedure was completed in all the patients without causing severe complications. One patient developed infection at the puncture site. Six months after the RFA, 22 of the patients (47. 8% ) had all the nodules disappeared, 12 patients (26. 1% ) had the size of the nodules reduced by ≥50% , while in the other 12 patients the nodules were reduced by 25% -50% . Conclusions RFA is a safe, effective, and minimally invasive method for the treatment of nodular goiter. It is worth being widely used.

  16. Volume Regulated Channels

    Klausen, Thomas Kjær

    - serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...... of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume......, controlled cell death and cellular migration. Volume regulatory mechanisms has long been in focus for regulating cellular proliferation and my thesis work have been focusing on the role of Cl- channels in proliferation with specific emphasis on ICl, swell. Pharmacological blockage of the ubiquitously...

  17. Strategies for poverty reduction

    Øyen, Else


    SIU konferanse Solstrand 6.-7. October 2003 Higher education has a value of its own. When linked to the issue of poverty reduction it is necessary to ask another set of questions, including the crutial one whether higher education in general is the best tool for poverty reduction.

  18. Strategies for poverty reduction

    Øyen, Else


    SIU konferanse Solstrand 6.-7. October 2003 Higher education has a value of its own. When linked to the issue of poverty reduction it is necessary to ask another set of questions, including the crutial one whether higher education in general is the best tool for poverty reduction.

  19. Reduct and Attribute Order

    Su-Qing Han; Jue Wang


    Based on the principle of discernibility matrix,a kind of reduction algorithm with attribute order has been developed and its solution has been proved to be complete for reduct and unique for a given attribute order.Being called the reduct problem,this algorithm can be regarded as a mapping R = Reduct(S)from the attribute order space θ to the reduct space R for an information system ,where U is the universe and C and D are two sets of condition and decision attributes respectively.This paper focuses on the reverse problem of reduct problem S = Order(R),i.e.,for a given reduct R of an information system,we determine the solution of S = Order(R)in the space θ.First,we need to prove that there is at least one attribute order S such that S = Order(R).Then,some decision rules are proposed,which can be used directly to decide whether the pair of attribute orders has the same reduct.The main method is based on the fact that an attribute order can be transformed into another one by moving the attribute for limited times.Thus,the decision of the pair of attribute orders can be altered to the decision of the sequence of neighboring pairs of attribute orders.Therefore,the basic theorem of neighboring pair of attribute orders is first proved,then,the decision theorem of attribute order is proved accordingly by the second attribute.

  20. Precision volume measurement system.

    Fischer, Erin E.; Shugard, Andrew D.


    A new precision volume measurement system based on a Kansas City Plant (KCP) design was built to support the volume measurement needs of the Gas Transfer Systems (GTS) department at Sandia National Labs (SNL) in California. An engineering study was undertaken to verify or refute KCP's claims of 0.5% accuracy. The study assesses the accuracy and precision of the system. The system uses the ideal gas law and precise pressure measurements (of low-pressure helium) in a temperature and computer controlled environment to ratio a known volume to an unknown volume.

  1. Radiology residents' experience with intussusception reduction.

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang


    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  2. Study on mechanism of traditional Chinese medicines reducing phlegm and resolving masses in treatment of goiter%化痰散结中药治疗甲状腺肿的作用机制

    崔鹏; 王英娜; 高天舒; 齐腾澈; 梅兰; 尹慧丝


    Objective:To discuss the mechanism of traditional Chinese medicines reducing phlegm and resolving masses in treatment of iodine deficiency-induced goiter by observing the expression of growth factors and the balance-regulating mechanism of proliferation and apoptosis. Method: 180 four-week-old Wistar rats were selected to establish the iodine deficiency model. After the modeling , the rats were randomly divided into six groups; the normal control group, the model control group, the iodine group, the phlegm compound group, the L-T4 group and the phlegm compound and L-T4 group. At the 21st day and 77th day after administration, 15 rats in each group were killed to collect specimens. Doses were calculated and adjusted according to body surface area and body weight. TT3, TT4 radioimmunoassay, TSH, immunoradiometric method were adopted. Fas, FasL and PCNA protein expressions are detected using immunohistochemical methods. Result: Compared with the normal group and the model group, the expressions of fas and FasL in the phlegm Group significantly increased, the expressions of fas and FasL in the phlegm and L-T4 group were also increased significantly. The expression of fas in the L-T4 Group was significantly lower than that of the L-T4 group and the phlegm compound and L-T4 group. Compared with the normal group, the expression of PCNA of the phlegm group and the phlegm and L-T4 group was significantly lower. Compared with the model group, the expression of PCNA of the iodine group, the phlegm groups and the phlegm and L-T4 group were significantly lower. Compared with the normal group, the expression of VEGF in the iodine group significantly decreased after treatment. Compared with the iodine group, the expression of VEGF in the phlegm group and the L-T4 group significantly reduced. Compared with the normal group, the expression of TGF-β1 in the model group and the phlegm group significantly increased. Compared with model group, the expression of TGF-β1 in the iodine

  3. Octreotide reduces hepatic, renal and breast cystic volume in autosomal-dominant polycystic kidney disease.

    Peces, Ramón; Cuesta-López, Emilio; Peces, Carlos; Pérez-Dueñas, Virginia; Vega-Cabrera, Cristina; Selgas, Rafael


    A 43-year-old woman with autosomal-dominant polycystic kidney disease (ADPKD) received octreotide for 12 months, and this was associated with a 6.3% reduction in liver volume, an 8% reduction in total kidney volume and stabilization of renal function. There was also a reduction of cyst size in fibrocystic disease of breast. These data suggest that the cyst fluid accumulation in different organs from patients with ADPKD is a dynamic process which can be reversed by octreotide. This is the first report of a case of simultaneous reduction in hepatic, renal and breast cystic volume with preservation of renal function in a patient with ADPKD receiving octreotide.

  4. Variable volume combustor

    Ostebee, Heath Michael; Ziminsky, Willy Steve; Johnson, Thomas Edward; Keener, Christopher Paul


    The present application provides a variable volume combustor for use with a gas turbine engine. The variable volume combustor may include a liner, a number of micro-mixer fuel nozzles positioned within the liner, and a linear actuator so as to maneuver the micro-mixer fuel nozzles axially along the liner.

  5. Volume Regulated Channels

    Klausen, Thomas Kjær

    of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume...... but are also essential for a number of physiological processes such as proliferation, controlled cell death, migration and endocrinology. The thesis have been focusing on two Channels, namely the swelling activated Cl- channel (ICl, swell) and the transient receptor potential Vanilloid (TRPV4) channel. I: Cl......- serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...

  6. Lymphedema Risk Reduction Practices

    ... LSAP Perspective (9) 2017 NLN International Conference Position Paper: Lymphedema Risk Reduction Practices Category: Position Papers Tags: ... and water, pat dry, then apply a topical antibacterial. d. Wear non-constricting protective gear over the ...

  7. Reduction Redux of Adinkras

    Gates,, S James; Stiffler, Kory


    We show performing general ``0-brane reduction'' along an arbitrary fixed direction in spacetime and applied to the starting point of minimal, off-shell 4D, $\\cal N$ $=$ 1 irreducible supermultiplets, yields adinkras whose adjacency matrices are among some of the special cases proposed by Kuznetsova, Rojas, and Toppan. However, these more general reductions also can lead to `Garden Algebra' structures beyond those described in their work. It is also shown that for light-like directions, reduction to the 0-brane breaks the equality in the number of fermions and bosons for dynamical theories. This implies that light-like reductions should be done instead to the space of 1-branes or equivalently to the worldsheet.

  8. Breast Reduction Surgery

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  9. Work Truck Idling Reduction



    Hybrid utility trucks, with auxiliary power sources for on-board equipment, significantly reduce unnecessary idling resulting in fuel costs savings, less engine wear, and reduction in noise and emissions.

  10. New Reductive Desulfurization Technology


    @@ The project for the research of the pulse plasma reductive desulfurization technology undertaken by Huazhong University of Science and Technology recently passed the research achievement appraisal in Wuhan, Hubei province.

  11. Seamounts, Direct Blast and Volume Reverberation Upgrades


    Highway. Suits 1204. Arlington, VA 22202-4302. "n to the Office of Management and Budget. Peperworik Reduction Project (0704-0188). Washington. DC 2050M. 1...Subtitle. 5. Funding Numbers. Seamounts, Direct Blast And Volume Reverberation Upgrades proram Eemen No 3 7 85N Project No R02017 6. Author(s). L...Section Pae 1 INTRODUCTION ................................. 1-1 2 ASERT: DATA PREPARATION FOR ASTRAL ........... 2-1 2.1 Overview and Purpose of

  12. Cell volume regulation: physiology and pathophysiology

    Lambert, I H; Hoffmann, E K; Pedersen, Stine Helene Falsig


    not only under physiological conditions, e.g. following accumulation of nutrients, during epithelial absorption/secretion processes, following hormonal/autocrine stimulation, and during induction of apoptosis, but also under pathophysiological conditions, e.g. hypoxia, ischaemia and hyponatremia....../hypernatremia. On the other hand, it has recently become clear that an increase or reduction in cell volume can also serve as a specific signal in the regulation of physiological processes such as transepithelial transport, cell migration, proliferation and death. Although the mechanisms by which cell volume perturbations...... are sensed are still far from clear, significant progress has been made with respect to the nature of the sensors, transducers and effectors that convert a change in cell volume into a physiological response. In the present review, we summarize recent major developments in the field, and emphasize...

  13. Dissimilatory metal reduction.

    Lovley, D R


    Microorganisms can enzymatically reduce a variety of metals in metabolic processes that are not related to metal assimilation. Some microorganisms can conserve energy to support growth by coupling the oxidation of simple organic acids and alcohols, H2, or aromatic compounds to the reduction of Fe(III) or Mn(IV). This dissimilatory Fe(III) and Mn(IV) reduction influences the organic as well as the inorganic geochemistry of anaerobic aquatic sediments and ground water. Microorganisms that use U(VI) as a terminal electron acceptor play an important role in uranium geochemistry and may be a useful tool for removing uranium from contaminated environments. Se(VI) serves as a terminal electron acceptor to support anaerobic growth of some microorganisms. Reduction of Se(VI) to Se(O) is an important mechanism for the precipitation of selenium from contaminated waters. Enzymatic reduction of Cr(VI) to the less mobile and less toxic Cr(III), and reduction of soluble Hg(II) to volatile Hg(O) may affect the fate of these compounds in the environment and might be used as a remediation strategy. Microorganisms can also enzymatically reduce other metals such as technetium, vanadium, molybdenum, gold, silver, and copper, but reduction of these metals has not been studied extensively.

  14. [Total thyroidectomy treatment of bening multinodular goiter].

    Palas, César; Álvarez, Facundo; Ferreira, Gastón; Gramática, Luis h


    Introducción. El tratamiento del bocio multinodular beningo (BMNB) es motivo de continuo debate en las últimas décadas pese a la evidencia de que la tiroidectomía total (TT) está relacionada a una reducción significativa en la recurrencia de la enfermedad y a una mínima morbilidad en manos entrenadas. Objetivo. Determinar la recurrencia del BMNB al cabo de 10 años en 100 pacientes tratados con TT y evaluar las complicaciones relacionadas a la técnica.Diseño. Prospectivo no randomizado.Material y métodos. Desde marzo del 1999 a marzo del 2001, cien pacientes, 95 del sexo femenino, con un promedio de edad de 42,4 años (rango: 23-67), fueron sometidos a una TT por padecer un BMNB, el cual fue confirmado por la ecografía cervical, la que además sirvió de guía para realizar la punción aspiración con aguja fina (PAAF). En todos los casos se realizó un laringoscopía inderecta pre y post postquirúrgica. Resultados. El tiempo operatorio promedio fue de 49 minutos (rango: 35-58). Registramos una parálisis recurrencial (1%) y cinco hipoparatiroidismos (5%), ambos transitorios y ningún caso definitivo. Todos los pacientes fueron dados de alta antes de las 24 horas de la cirugía. No objetivamos ninguna recurrencia del BMNB en un período de seguimiento de más de 10 años.Conclusión. La TT es el tratamiento elección del BMNB, por ser un procedimiento eficaz, seguro, con mínimas tasas de complicaciones y por evitar o reducir significativamente la recurrencia de esta enfermedad.

  15. Understanding the heterogeneity in volume overload and fluid distribution in decompensated heart failure is key to optimal volume management: role for blood volume quantitation.

    Miller, Wayne L; Mullan, Brian P


    This study sought to quantitate total blood volume (TBV) in patients hospitalized for decompensated chronic heart failure (DCHF) and to determine the extent of volume overload, and the magnitude and distribution of blood volume and body water changes following diuretic therapy. The accurate assessment and management of volume overload in patients with DCHF remains problematic. TBV was measured by a radiolabeled-albumin dilution technique with intravascular volume, pre-to-post-diuretic therapy, evaluated at hospital admission and at discharge. Change in body weight in relation to quantitated TBV was used to determine interstitial volume contribution to total fluid loss. Twenty-six patients were prospectively evaluated. Two patients had normal TBV at admission. Twenty-four patients were hypervolemic with TBV (7.4 ± 1.6 liters) increased by +39 ± 22% (range, +9.5% to +107%) above the expected normal volume. With diuresis, TBV decreased marginally (+30 ± 16%). Body weight declined by 6.9 ± 5.2 kg, and fluid intake/fluid output was a net negative 8.4 ± 5.2 liters. Interstitial compartment fluid loss was calculated at 6.2 ± 4.0 liters, accounting for 85 ± 15% of the total fluid reduction. TBV analysis demonstrated a wide range in the extent of intravascular overload. Dismissal measurements revealed marginally reduced intravascular volume post-diuretic therapy despite large reductions in body weight. Mobilization of interstitial fluid to the intravascular compartment with diuresis accounted for this disparity. Intravascular volume, however, remained increased at dismissal. The extent, composition, and distribution of volume overload are highly variable in DCHF, and this variability needs to be taken into account in the approach to individualized therapy. TBV quantitation, particularly serial measurements, can facilitate informed volume management with respect to a goal of treating to euvolemia. Copyright © 2014 American College of Cardiology Foundation. Published

  16. Lake Nasser evaporation reduction study

    Hala M.I. Ebaid


    Full Text Available This study aims to evaluate the reduction of evaporation of Lake Nasser’s water caused by disconnecting (fully or partially some of its secondary channels (khors. This evaluation integrates remote sensing, Geographic Information System (GIS techniques, aerodynamic principles, and Landsat7 ETM+ images. Three main procedures were carried out in this study; the first derived the surface temperature from Landsat thermal band; the second derived evaporation depth and approximate evaporation volume for the entire lake, and quantified evaporation loss to the secondary channels’ level over one month (March by applied aerodynamic principles on surface temperature of the raster data; the third procedure applied GIS suitability analysis to determine which of these secondary channels (khors should be disconnected. The results showed evaporation depth ranging from 2.73 mm/day at the middle of the lake to 9.58 mm/day at the edge. The evaporated water-loss value throughout the entire lake was about 0.86 billion m3/month (March. The analysis suggests that it is possible to save an approximate total evaporation volume loss of 19.7 million m3/month (March, and thus 2.4 billion m3/year, by disconnecting two khors with approximate construction heights of 8 m and 15 m. In conclusion, remote sensing and GIS are useful for applications in remote locations where field-based information is not readily available and thus recommended for decision makers remotely planning in water conservation and management.

  17. Volume regulation in epithelia

    Larsen, Erik Hviid; Hoffmann, Else Kay


    function of iso-osmotic fluid transport that depends on Na+ recirculation. The causative relationship is discussed for a fluid-absorbing and a fluid-secreting epithelium of which the Na+ recirculation mechanisms have been identified. A large number of transporters and ion channels involved in cell volume...... regulation are cloned. The volume-regulated anion channel (VRAC) exhibiting specific electrophysiological characteristics seems exclusive to serve cell volume regulation. This is contrary to K+ channels as well as cotransporters and exchange mechanisms that may serve both transepithelial transport and cell...

  18. Towards the Amplituhedron Volume

    Ferro, Livia; Orta, Andrea; Parisi, Matteo


    It has been recently conjectured that scattering amplitudes in planar N=4 super Yang-Mills are given by the volume of the (dual) amplituhedron. In this paper we show some interesting connections between the tree-level amplituhedron and a special class of differential equations. In particular we demonstrate how the amplituhedron volume for NMHV amplitudes is determined by these differential equations. The new formulation allows for a straightforward geometric description, without any reference to triangulations. Finally we discuss possible implications for volumes related to generic N^kMHV amplitudes.

  19. Unsteady flow volumes

    Becker, B.G.; Lane, D.A.; Max, N.L.


    Flow volumes are extended for use in unsteady (time-dependent) flows. The resulting unsteady flow volumes are the 3 dimensional analog of streamlines. There are few examples where methods other than particle tracing have been used to visualize time varying flows. Since particle paths can become convoluted in time there are additional considerations to be made when extending any visualization technique to unsteady flows. We will present some solutions to the problems which occur in subdivision, rendering, and system design. We will apply the unsteady flow volumes to a variety of field types including moving multi-zoned curvilinear grids.

  20. Exploration Mission Benefits From Logistics Reduction Technologies

    Broyan, James Lee, Jr.; Schlesinger, Thilini; Ewert, Michael K.


    Technologies that reduce logistical mass, volume, and the crew time dedicated to logistics management become more important as exploration missions extend further from the Earth. Even modest reductions in logical mass can have a significant impact because it also reduces the packing burden. NASA's Advanced Exploration Systems' Logistics Reduction Project is developing technologies that can directly reduce the mass and volume of crew clothing and metabolic waste collection. Also, cargo bags have been developed that can be reconfigured for crew outfitting and trash processing technologies to increase habitable volume and improve protection against solar storm events are under development. Additionally, Mars class missions are sufficiently distant that even logistics management without resupply can be problematic due to the communication time delay with Earth. Although exploration vehicles are launched with all consumables and logistics in a defined configuration, the configuration continually changes as the mission progresses. Traditionally significant ground and crew time has been required to understand the evolving configuration and locate misplaced items. For key mission events and unplanned contingencies, the crew will not be able to rely on the ground for logistics localization assistance. NASA has been developing a radio frequency identification autonomous logistics management system to reduce crew time for general inventory and enable greater crew self-response to unplanned events when a wide range of items may need to be located in a very short time period. This paper provides a status of the technologies being developed and there mission benefits for exploration missions.

  1. Mission Benefits Analysis of Logistics Reduction Technologies

    Ewert, Michael K.; Broyan, James Lee, Jr.


    Future space exploration missions will need to use less logistical supplies if humans are to live for longer periods away from our home planet. Anything that can be done to reduce initial mass and volume of supplies or reuse or recycle items that have been launched will be very valuable. Reuse and recycling also reduce the trash burden and associated nuisances, such as smell, but require good systems engineering and operations integration to reap the greatest benefits. A systems analysis was conducted to quantify the mass and volume savings of four different technologies currently under development by NASA s Advanced Exploration Systems (AES) Logistics Reduction and Repurposing project. Advanced clothing systems lead to savings by direct mass reduction and increased wear duration. Reuse of logistical items, such as packaging, for a second purpose allows fewer items to be launched. A device known as a heat melt compactor drastically reduces the volume of trash, recovers water and produces a stable tile that can be used instead of launching additional radiation protection. The fourth technology, called trash-to-gas, can benefit a mission by supplying fuel such as methane to the propulsion system. This systems engineering work will help improve logistics planning and overall mission architectures by determining the most effective use, and reuse, of all resources.

  2. 成安县部分高碘乡镇停供碘盐前后甲状腺肿流行病学调查%Epidemiological investigation of goiter before and after discontinuation of salt iodization in some excessive iodine townships of Cheng'an County

    李雪红; 魏美丽; 高亚敏; 武书敏; 周丽霞


    [Objective] To study the effect of the discontinuation of iodized salt on the incidence of goiter among residents in excessive iodine regions. [ Methods] Children aged 8-10 years old were randomly selected from 2 excessive iodine townships, the endemi-c goiter was diagnosed by B-ultrasound, and the consumption status of iodized salt among residents was detected. [ Results] The incidence rate of goiter among children before the discontinuation of iodized salt was 10.57% , that at one year after the discontinuation was 5.36% , and the difference was statistically significant (χ2 =4.84, P<0.05). There was significant difference in coverage rate of iodized salt between before the discontinuation of iodized salt and one year after the discontinuation (χ2 = 104. 53, P<0.01). [Conclusion] Cheng an County is the aquagenic excessive iodine region, and residents should use the non-iodized salt.%目的 研究高碘地区居民停止食用碘盐对甲状腺肿的影响.方法 随机抽取2个高碘乡8 ~ 10岁儿童用B超法诊断地方性甲状腺肿,同时检测居民的食用碘盐情况.结果 停供碘盐前儿童甲状腺肿大率为10.57%,停供碘盐后1年时儿童甲状腺肿大率为5.36%,差异有统计学意义(x2=4.84,P<0.05).停供碘盐前与停供碘盐后1年时,碘盐覆盖率差异有统计学意义(x2 =104.53,P<0.01).结论 该县属水源性高碘地区,居民应食用无碘盐.

  3. Free volume under shear

    Maiti, Moumita; Vinutha, H. A.; Sastry, Srikanth; Heussinger, Claus


    Using an athermal quasistatic simulation protocol, we study the distribution of free volumes in sheared hard-particle packings close to, but below, the random-close packing threshold. We show that under shear, and independent of volume fraction, the free volumes develop features similar to close-packed systems — particles self-organize in a manner as to mimick the isotropically jammed state. We compare athermally sheared packings with thermalized packings and show that thermalization leads to an erasure of these structural features. The temporal evolution in particular the opening-up and the closing of free-volume patches is associated with the single-particle dynamics, showing a crossover from ballistic to diffusive behavior.

  4. Integers annual volume 2013

    Landman, Bruce


    ""Integers"" is a refereed online journal devoted to research in the area of combinatorial number theory. It publishes original research articles in combinatorics and number theory. This work presents all papers of the 2013 volume in book form.

  5. Renormalized Volumes with Boundary

    Gover, A Rod


    We develop a general regulated volume expansion for the volume of a manifold with boundary whose measure is suitably singular along a separating hypersurface. The expansion is shown to have a regulator independent anomaly term and a renormalized volume term given by the primitive of an associated anomaly operator. These results apply to a wide range of structures. We detail applications in the setting of measures derived from a conformally singular metric. In particular, we show that the anomaly generates invariant (Q-curvature, transgression)-type pairs for hypersurfaces with boundary. For the special case of anomalies coming from the volume enclosed by a minimal hypersurface ending on the boundary of a Poincare--Einstein structure, this result recovers Branson's Q-curvature and corresponding transgression. When the singular metric solves a boundary version of the constant scalar curvature Yamabe problem, the anomaly gives generalized Willmore energy functionals for hypersurfaces with boundary. Our approach ...

  6. Environmental chemistry: Volume A

    Yen, T.F.


    This is an extensive introduction to environmental chemistry for engineering and chemical professionals. The contents of Volume A include a brief review of basic chemistry prior to coverage of litho, atmo, hydro, pedo, and biospheres.

  7. Reduction zero-knowledge

    ZHAO Yunlei; DENG Xiaotie; LEE C. H.; ZHU Hong


    The nature of zero-knowledge is re-examined and the evidence for the following belief is shown:the classic simulation based definitions of zero-knowledge(simulation zero-knowledge)may be somewhat too strong to include some "nice" protocols in which the malicious verifier seems to learn nothing but we do not know how to construct a zero-knowledge simulator for it.To overcome this problem a new relaxation of zero-knowledge,reduction zero-knowledge,is introduced.It is shown that reduction zero-knowledge just lies between simulation zero-knowledge and witness indistinguishability.Under the assumption of existence of one-way permutations a 4-round public-coin reduction zero-knowledge proof system for NP is presented and in practice this protocol works in 3 rounds since the first verifier's message can be fixed once and for all.

  8. The cyclic reduction algorithm

    Bini, Dario; Meini, Beatrice


    Cyclic reduction is an algorithm invented by G.H. Golub and R. W. Hockney in the mid 1960s for solving linear systems related to the finite differences discretization of the Poisson equation over a rectangle. Among the algorithms of Gene Golub, it is one of the most versatile and powerful ever created. Recently, it has been applied to solve different problems from different applicative areas. In this paper we survey the main features of cyclic reduction, relate it to properties of analytic functions, recall its extension to solving more general finite and infinite linear systems, and different kinds of nonlinear matrix equations, including algebraic Riccati equations, with applications to Markov chains, queueing models and transport theory. Some new results concerning the convergence properties of cyclic reduction and its applicability are proved under very weak assumptions. New formulae for overcoming breakdown are provided.

  9. Generalized Partial Volume

    Darkner, Sune; Sporring, Jon


    Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV). Their theoret......Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV...

  10. Reachable volume RRT

    McMahon, Troy


    © 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.


    Swegle, J.; Tincher, D.


    This paper briefly summarizes the series in which we consider the possibilities for losing, or compromising, key capabilities of the U.S. nuclear force in the face of modernization and reductions. The first of the three papers takes an historical perspective, considering capabilities that were eliminated in past force reductions. The second paper is our attempt to define the needed capabilities looking forward in the context of the current framework for force modernization and the current picture of the evolving challenges of deterrence and assurance. The third paper then provides an example for each of our undesirable outcomes: the creation of roach motels, box canyons, and wrong turns.

  12. Time, Chance, and Reduction

    Ernst, Gerhard; Hüttemann, Andreas


    List of contributors; 1. Introduction Gerhard Ernst and Andreas Hütteman; Part I. The Arrows of Time: 2. Does a low-entropy constraint prevent us from influencing the past? Mathias Frisch; 3. The part hypothesis meets gravity Craig Callender; 4. Quantum gravity and the arrow of time Claus Kiefer; Part II. Probability and Chance: 5. The natural-range conception of probability Jacob Rosenthal; 6. Probability in Boltzmannian statistical mechanics Roman Frigg; 7. Humean mechanics versus a metaphysics of powers Michael Esfeld; Part III. Reduction: 8. The crystallisation of Clausius's phenomenological thermodynamics C. Ulises Moulines; 9. Reduction and renormalization Robert W. Batterman; 10. Irreversibility in stochastic dynamics Jos Uffink; Index.

  13. Dimensionality Reduction Mappings

    Bunte, Kerstin; Biehl, Michael; Hammer, Barbara


    A wealth of powerful dimensionality reduction methods has been established which can be used for data visualization and preprocessing. These are accompanied by formal evaluation schemes, which allow a quantitative evaluation along general principles and which even lead to further visualization schem

  14. Management of Asymmetry After Breast Reduction.

    Garcia, Onelio


    Breast reduction surgery has achieved one of the highest patient satisfaction rates among plastic surgery procedures. Most of the complications encountered are usually minor and related to wound healing. Revision surgery to address these problems is common and usually consists of scar revisions. Postoperative breast asymmetry of a mild degree is also common; however, postoperative asymmetry severe enough to warrant surgical revision is a rare event, occurring in less than 1% of cases. Postmammaplasty revision surgery needs to be individualized. The asymmetry could be the result of nipple malposition or it could consist of a volume or shape discrepancy between the breast mounds.

  15. 浙江省象山县结节性甲状腺肿检出率及影响因素调查研究%Investigation in Eetection Rate and Influencing Factors of Nodular Goiter in Xiangshan County of Zhejiang Province

    叶众; 陈磊; 陆昱养; 郑广勇; 陈子萌


    Objective To investigate the detection rate of nodular goiter and the influencing factors for nodular goiter in Xiangshan county. Methods Used the multi - stage cluster random sampling in 2013,5 towns were sampled from 17 towns in Xiangshan county;2 villages were sampled from those 5 towns respectively,hence 10 villages were sampled in total. The population was divided by topographical features into 4 groups:town group,mountain group,plain group and island group. Residents older than 18 years old and resided in Xiangshan county longer than 6 months were enrolled in this study. The people included were examined if they suffered from thyroid nodules by color Doppler ultrasonography. The patients diagnosed with nodular goiter were arranged into case group;the same amount of people without nodular goiter diagnosed by B-ultrasonography in the same townships and villages were arranged into control group;the two groups matched in gender,age( ± 3)and region, and the match ratio was 1: 1. The research objects included were surveyed with questionnaire about influencing factors such as occupational exposure history,personality and psychology,lifestyle,diet and medical history. The data was analyzed by univariate and multivariate Logistic regression method. Results 1 220 cases were screened and 510 patients were diagnosed with nodular goiter,with detection rate of 41. 80% . There was significant difference in the detection rate of nodular goiter for people lived in different areas( χ2 = 5. 43,P 18周岁的象山县户籍常住人口纳为调查对象。使用彩色多普勒超声诊断仪检测调查人群甲状腺。将确诊的甲状腺结节患者纳入病例组;以性别、年龄(±3)岁、地区等因素进行1:1匹配,选取相同数量同乡镇、同村甲状腺 B 超检查阴性者作为对照组。进行问卷调查,调查内容包括:职业接触史、性格及心理因素、生活方式、食物特点、医疗史

  16. Kinetics of Reduction Reaction in Micro-Fluidized Bed

    LINYin-he; GUOZhan—cheng; TANGHui—qing; REN Shan; LIJing—wei


    Micro-fluidized bed reactor is a new research method for the reduction of iron ore fines. The reactor is op- erated as a differential reactor to ensure a constant gas concentration and temperature within the reactor volume. In order to understand the dynamic process of the reduction reaction in micro-fluidized bed, a series of kinetic experi- ments were designed. In the micro fluidized bed, the use of shrinking core model describes the dynamic behavior of reduction of iron ore. And the apparent activation energy is calculated in the range of 700--850 ~C while the initial atmosphere is 100% content of CO.

  17. Volumes of chain links

    Kaiser, James; Rollins, Clint


    Agol has conjectured that minimally twisted n-chain links are the smallest volume hyperbolic manifolds with n cusps, for n at most 10. In his thesis, Venzke mentions that these cannot be smallest volume for n at least 11, but does not provide a proof. In this paper, we give a proof of Venzke's statement. The proof for n at least 60 is completely rigorous. The proof for n between 11 and 59 uses a computer calculation, and can be made rigorous for manifolds of small enough complexity, using methods of Moser and Milley. Finally, we prove that the n-chain link with 2m or 2m+1 half-twists cannot be the minimal volume hyperbolic manifold with n cusps, provided n is at least 60 or |m| is at least 8, and we give computational data indicating this remains true for smaller n and |m|.


    Bogdan DINU


    Full Text Available Big Data can revolutionize humanity. Hidden within the huge amounts and variety of the data we are creating we may find information, facts, social insights and benchmarks that were once virtually impossible to find or were simply inexistent. Large volumes of data allow organizations to tap in real time the full potential of all the internal or external information they possess. Big data calls for quick decisions and innovative ways to assist customers and the society as a whole. Big data platforms and product portfolio will help customers harness to the full the value of big data volumes. This paper deals with technical and technological issues related to handling big data volumes in the Big Data environment.

  19. In-treatment stroke volume predicts cardiovascular risk in hypertension

    Lønnebakken, Mai T; Gerdts, Eva; Boman, Kurt


    To evaluate whether lower stroke volume during antihypertensive treatment is a predictor of cardiovascular events independent of left ventricular geometric pattern. Methods: The association between left ventricular stroke volume and combined cardiovascular death, stroke and myocardial infarction......, the prespecified primary study endpoint, was assessed in Cox regression analysis using data from baseline and annual follow-up visits in 855 patients during 4.8 years of randomized losartan-based or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography...... resistance, more concentric left ventricular geometry and impaired diastolic relaxation (all P treatment left ventricular stroke volume indexed for height2.04 was associated...

  20. Technology transfer package on seismic base isolation - Volume III



    This Technology Transfer Package provides some detailed information for the U.S. Department of Energy (DOE) and its contractors about seismic base isolation. Intended users of this three-volume package are DOE Design and Safety Engineers as well as DOE Facility Managers who are responsible for reducing the effects of natural phenomena hazards (NPH), specifically earthquakes, on their facilities. The package was developed as part of DOE's efforts to study and implement techniques for protecting lives and property from the effects of natural phenomena and to support the International Decade for Natural Disaster Reduction. Volume III contains supporting materials not included in Volumes I and II.

  1. Waste reduction plan for The Oak Ridge National Laboratory

    Schultz, R.M.


    The Oak Ridge National Laboratory (ORNL) is a multipurpose Research and Development (R D) facility. These R D activities generate numerous small waste streams. Waste minimization is defined as any action that minimizes the volume or toxicity of waste by avoiding its generation or recycling. This is accomplished by material substitution, changes to processes, or recycling wastes for reuse. Waste reduction is defined as waste minimization plus treatment which results in volume or toxicity reduction. The ORNL Waste Reduction Program will include both waste minimization and waste reduction efforts. Federal regulations, DOE policies and guidelines, increased costs and liabilities associated with the management of wastes, limited disposal options and facility capacities, and public consciousness have been motivating factors for implementing comprehensive waste reduction programs. DOE Order 5820.2A, Section 3.c.2.4 requires DOE facilities to establish an auditable waste reduction program for all LLW generators. In addition, it further states that any new facilities, or changes to existing facilities, incorporate waste minimization into design considerations. A more recent DOE Order, 3400.1, Section 4.b, requires the preparation of a waste reduction program plan which must be reviewed annually and updated every three years. Implementation of a waste minimization program for hazardous and radioactive mixed wastes is sited in DOE Order 5400.3, Section 7.d.5. This document has been prepared to address these requirements. 6 refs., 1 fig., 2 tabs.

  2. Fully Awake Breast Reduction.

    Filson, Simon A; Yarhi, Danielle; Ramon, Yitzhak


    The authors present 25 cases and an in-depth 4-minute video of fully awake aesthetic breast reduction, which was made possible by thoracic epidural anesthesia. There are obvious and important advantages to this technique. Not only does this allow for intraoperative patient cooperation (i.e., patient self-positioning and opinion for comparison of breasts), meaning a shorter and more efficient intraoperative time, there also is a reduction in postoperative pain, complications, recovery, and discharge times. The authors have also enjoyed great success and no complications with this technique in over 150 awake abdominoplasty/total body lift patients. The authors feel that the elimination of the need for general anesthesia by thoracic epidural sensorial-only anesthesia is a highly effective and efficient technique, with very few disadvantages/complications, providing advantages to both patients and surgeons. Therapeutic, IV.

  3. Injury reduction at Fermilab

    Griffing, Bill; /Fermilab


    In a recent DOE Program Review, Fermilab's director presented results of the laboratory's effort to reduce the injury rate over the last decade. The results, shown in the figure below, reveal a consistent and dramatic downward trend in OSHA recordable injuries at Fermilab. The High Energy Physics Program Office has asked Fermilab to report in detail on how the laboratory has achieved the reduction. In fact, the reduction in the injury rate reflects a change in safety culture at Fermilab, which has evolved slowly over this period, due to a series of events, both planned and unplanned. This paper attempts to describe those significant events and analyze how each of them has shaped the safety culture that, in turn, has reduced the rate of injury at Fermilab to its current value.

  4. Topological Active Volumes

    Barreira N


    Full Text Available The topological active volumes (TAVs model is a general model for 3D image segmentation. It is based on deformable models and integrates features of region-based and boundary-based segmentation techniques. Besides segmentation, it can also be used for surface reconstruction and topological analysis of the inside of detected objects. The TAV structure is flexible and allows topological changes in order to improve the adjustment to object's local characteristics, find several objects in the scene, and identify and delimit holes in detected structures. This paper describes the main features of the TAV model and shows its ability to segment volumes in an automated manner.

  5. Aperiodic Volume Optics

    Gerke, Tim D.

    Presented in this thesis is an investigation into aperiodic volume optical devices. The three main topics of research and discussion are the aperiodic volume optical devices that we call computer-generated volume holograms (CGVH), defects within periodic 3D photonic crystals, and non-periodic, but ordered 3D quasicrystals. The first of these devices, CGVHs, are designed and investigated numerically and experimentally. We study the performance of multi-layered amplitude computer-generated volume holograms in terms of efficiency and angular/frequency selectivity. Simulation results show that such aperiodic devices can increase diffraction efficiency relative to periodic amplitude volume holograms while maintaining angular and wavelength selectivity. CGVHs are also designed as voxelated volumes using a new projection optimization algorithm. They are investigated using a volumetric diffraction simulation and a standard 3D beam propagation technique as well as experimentally. Both simulation and experiment verify that the structures function according to their design. These represent the first diffractive structures that have the capacity for generating arbitrary transmission and reflection wave fronts and that provide the ability for multiplexing arbitrary functionality given different illumination conditions. Also investigated and discussed in this thesis are 3D photonic crystals and quasicrystals. We demonstrate that these devices can be fabricated using a femtosecond laser direct writing system that is particularly appropriate for fabrication of such arbitrary 3D structures. We also show that these devices can provide 3D partial bandgaps which could become complete bandgaps if fabricated using high index materials or by coating lower index materials with high index metals. Our fabrication method is particularly suited to the fabrication of engineered defects within the periodic or quasi-periodic systems. We demonstrate the potential for fabricating defects within

  6. Jet Engine Noise Reduction


    Technology Solutions, Lockheed Martin Robert S. Carnes , M.D. NRAC Member, Battelle Memorial Institute MajGen Paul A. Fratarangelo, USMC (Ret) NRAC...Development, Acquisition) (VADM Architzel). The Naval Research Advisory Committee members (Bowes, Bowler, Carnes and Fratarangelo) have broad...Lockheed Martin ADP Boeing: Jet Engine Noise Reduction for Tactical Fighter Aircraft Mr. Tom Kaemming, K. Viswanathan, Ph . D. Tactical Jet Noise

  7. Reduction of noise in medullary renograms from dynamic MR images.

    Giele, E L; de Priester, J A; Blom, J A; den Boer, J A; van Engelshoven, J M; Hasman, A


    Dynamic magnetic resonance images of the kidney can be used to acquire separate renograms of the cortex and medulla. A high-quality cortical renogram can be determined directly from a region of interest (ROI) placed in the cortex. Due to partial volume effects, part of the signal from a ROI placed in the medulla is caused by cortical tissue. By subtracting a fraction of the cortical signal from the cortico-medullary signal, a purer medullary renogram can be obtained. A side effect of this subtraction is an increase in noise level. The noise level increases with larger partial volume fractions. Using a matched image filter, it is possible to exclude those areas from the ROI that have a high partial volume content, thus reducing the amount of cortical signal that has to be separated from the medullary signal. Noise reductions of up to 50% have been achieved in the medullary renogram, with an average reduction of 23%.

  8. The volume of a soliton

    Adam, C., E-mail: [Departamento de Física de Partículas, Universidad de Santiago de Compostela and Instituto Galego de Física de Altas Enerxias (IGFAE), E-15782 Santiago de Compostela (Spain); Haberichter, M. [School of Mathematics, Statistics and Actuarial Science, University of Kent, Canterbury, CT2 7NF (United Kingdom); Wereszczynski, A. [Institute of Physics, Jagiellonian University, Lojasiewicza 11, Kraków (Poland)


    There exists, in general, no unique definition of the size (volume, area, etc., depending on dimension) of a soliton. Here we demonstrate that the geometric volume (area etc.) of a soliton is singled out in the sense that it exactly coincides with the thermodynamical or continuum-mechanical volume. In addition, this volume may be defined uniquely for rather arbitrary solitons in arbitrary dimensions.

  9. The Nature of Reduction in Space Weathering

    McKay, D. S.; Allen, C. C.


    Space weathering is a broad term that includes a number of complex effects of the exposure of materials to the environment of space. The processes that drive space weathering include micrometeorite impact, radiation from the Sun and cosmic rays, and exposure to the vacuum of space. One of the important effects caused by these processes is the tendency for chemical reduction of oxide and silicate materials (including glasses), with accompanying loss of oxygen and production of reduced metal. Such chemical reduction and accompanying metal production may have an important influence on the chemistry of the outermost volume of individual grains as well as on the optical properties of this material. Hapke [1] discussed five processes that have been suggested for producing submicroscopic iron metal in the lunar soil: (1) shock reduction, (2) heating in a thermal blanket in vacuum, (3) shock heating of solar-wind-impregnated grains, (4) coatings deposited by solar wind sputtering, and (5) coatings deposited by impact vaporization. As noted by Hapke, "Processes (1) and (2) have been refuted by laboratory experiments. Processes (4) and (5) have produced submicroscopic iron metal in laboratory simulations. Although no experiments have been done to simulate process (3), it is widely accepted." We have been performing experimental reduction of simulated and actual lunar materials [2-5] and have shown that, under conditions of exposure to hydrogen at elevated temperatures, reduction of FeO readily occurs in ilmenite and lunar composition glass, and occurs at a slower rate in pyroxene and olivine. Even plagioclase feldspar containing minor FeO is readily reduced with formation of metallic iron blebs on surfaces [4]. A comparison of natural lunar samples to hydrogen-reduced samples or simulants in which we are searching for reduction evidence in various soil phases is underway. Preliminary data for mature soils show, in agreement with earlier results, that reduced iron produced in

  10. Introduction to the Volume.

    Emihovich, Catherine; Schroder, Barbara; Panofsky, Carolyn P.


    Introduces a volume that examines the issue of critical thinking and whether or not it is culturally specific, discussing recent research on the subject. The papers focus on critical thinking and culture, historical consciousness and critical thinking, critical thinking as cultural-historical practice, culture and the development of critical…

  11. Effects of Polymer Parameters on Drag Reduction.

    Safieddine, Abbas Mohammad

    The effects of polymer parameters on fluid drag reduction using polyethylene oxide (PEO), polyacrylamide (PAM), guar gum (GG) and hydroxyethyl cellulose (HEC) were investigated. Due to the unavailability of high molecular weight (MW) water-soluble polymers having narrow molecular weight distribution (MWD), an aqueous preparative size exclusion chromatography (SEC) system capable of fractionating over wide MW ranges was constructed. An online low shear viscometer, coupled to the SEC, measured the instantaneous intrinsic viscosity of the eluting polymer solution and, therefore, served as a MW detector since Mark-Houwink "K" and "a" values for all four polymers were known. With the aid of the viscometer, the SEC system was calibrated. The preparative nature of the chromatography system allowed the collection of large volumes of nearly monodisperse fractions (MWD SEC approach allowed drag reduction (DR) experiments using well-characterized, narrowly dispersed polymer solutions under controlled tube flow conditions. Correlations of drag reduction performance with primary polymer parameters (i.e., concentration, intrinsic viscosity ((eta)), volume fraction (c(eta)), number of chain links (N), and combinations thereof) were used to test the validity of several theoretical DR models. Walsh's energy model, as well as the Deborah argument, did not completely account for drag reduction behavior under all experimental conditions. Within each of the flexible or rigid polymer groups, the extensional viscosity model was successful in correlating c(eta) N with DR under all turbulent conditions. However, it failed to account for the differences in chemical structure between the two polymer groups. However, when the cellulosic repeat unit was used instead of the carbon-carbon bond as the chain link for the rigid polymers (GG and HEC), all DR versus c (eta) N curves under all turbulent conditions collapsed into a single function. This has been predicted by the recent "yo-yo" model of

  12. Study on the quality of life and its influencing factors in patients with diffuse toxic goiter%毒性弥漫性甲状腺肿患者生存质量及其影响因素分析

    于世鹏; 贾传鲁; 伊鹏飞; 王娜


    目的 探讨影响毒性弥漫性甲状腺肿(GD)患者生存质量的社会及临床因素.方法 采用自编调查问卷和简明健康调查量表(SF-36),对确诊的66例GD患者和66例正常对照人群进行调查和测量分析.结果 测得GD患者SF-36量表8个维度的得分低于正常对照组,并且均差异有显著性(P<0.05).其中GD患者要和正常对照组得分生理功能为[(70.45±19.25)分,(92.8±6.51)分,t=8.898,P=0.001];生理角色限制为[(39.42±39.00)分,(90.97±21.67)分,t=8.582,P=0.001];躯体疼痛为[(79.36±19.18)分,(85.98±12.88)分,t=2.453,P=0.017];社会功能为[(75.95±19.46)分,(83.79±13.17)分,t=4.457,P=0.001];情感职能为[(37.88±40.04)分,(71.21±41.30)分,t=5.732,P=0.001];精神健康为[(52.91±17.31)分.(68.67±13.33)分,t=4.519,P=0.001].SF-36总分、牛理健康综合得分和心理健康综合得分均与年龄、文化程度、临床症状计数正相关(P<0.05).GD患者的生存质量与文化程度呈正相关,与临床症状计数、年龄呈负相关.结论 GD患者生存质量明显下降,影响GD患者生存质量的主要因素是临床症状计数、年龄和文化程度.%Objective To compare the quality of life of the patients with diffuse toxic goiter( GD) and normal controls using 36-item Short Form Health Survey (SF-36) in Chinese, to explore the social and clinical factors which influence the quality of GD's life. Methods 66 patients and 66 normal controls were assessed using self-composing questionnaire and 36-item Short Form Health Survey ( SF-36 ). Results Scores of eight dimensions of quality of life were lower than that of health controls, had significantly differences than that of health controls. There were statistical significant differences in terms of the score difference of eight dimensions between the GD patients and normal controls (P < 0.05 ). The scores of physical functioning dimension in GD patients, normal controls were 70.45 ± 19.25, 92.8 ± 6.51 ( P < 0.01), respectively

  13. Reduction of turbomachinery noise

    Waitz, Ian A. (Inventor); Brookfield, John M. (Inventor); Sell, Julian (Inventor); Hayden, Belva J. (Inventor); Ingard, K. Uno (Inventor)


    In the invention, propagating broad band and tonal acoustic components of noise characteristic of interaction of a turbomachine blade wake, produced by a turbomachine blade as the blade rotates, with a turbomachine component downstream of the rotating blade, are reduced. This is accomplished by injection of fluid into the blade wake through a port in the rotor blade. The mass flow rate of the fluid injected into the blade wake is selected to reduce the momentum deficit of the wake to correspondingly increase the time-mean velocity of the wake and decrease the turbulent velocity fluctuations of the wake. With this fluid injection, reduction of both propagating broad band and tonal acoustic components of noise produced by interaction of the blade wake with a turbomachine component downstream of the rotating blade is achieved. In a further noise reduction technique, boundary layer fluid is suctioned into the turbomachine blade through a suction port on the side of the blade that is characterized as the relatively low-pressure blade side. As with the fluid injection technique, the mass flow rate of the fluid suctioned into the blade is here selected to reduce the momentum deficit of the wake to correspondingly increase the time-mean velocity of the wake and decrease the turbulent velocity fluctuations of the wake; reduction of both propagating broad band and tonal acoustic components of noise produced by interaction of the blade wake with a turbomachine component downstream of the rotating blade is achieved with this suction technique. Blowing and suction techniques are also provided in the invention for reducing noise associated with the wake produced by fluid flow around a stationary blade upstream of a rotating turbomachine.

  14. Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume decrease

    Hocquelet, A.; Cornelis, F.; Le Bras, Y.; Meyer, M.; Tricaud, E.; Lasserre, A.S.; Grenier, N. [Centre Hospitalier Universitaire Pellegrin, Diagnostic and Therapeutic Urology and Vascular Imaging, Bordeaux (France); Ferriere, J.M.; Robert, G. [Centre Hospitalier Universitaire Pellegrin, Urology Service, Bordeaux (France)


    To evaluate the efficacy of selective arterial embolization (SAE) of angiomyolipomas based on the percentage volume reduction after embolization and to identify predictive factors of volume decrease. Patients receiving prophylactic SAE of renal angiomyolipomas were included retrospectively over 3 years. The volume change after SAE and haemorrhagic or surgical events were recorded. Initial tumour volume, percentage tumour fat content, mean tumour density, embolic agent used, number of angiomyolipomas and tuberous sclerosis disease were evaluated as predictive factors of volume decrease. A total of 19 patients with 39 angiomyolipomas were included with median follow-up of 28 months (interquartile range 21-37 months). All treatments were technically successful (92 % primary and 8 % secondary). No distal bleeding or any increase in size or surgical nephrectomy after SAE was recorded. Mean volume reduction was 72 % (±24 %). Volumes before SAE (R{sup 2} = 0.276; p = 0.001), percentage fat content (R{sup 2} = 0.612; p < 0.0001) and mean angiomyolipoma density (R{sup 2} = 0.536; p < 0.0001) were identified as predictive factors of volume decrease. In multivariate regression, only percentage fat content influenced volume decreases. SAE is an efficient treatment for angiomyolipoma devascularisation and volume reduction. A significant reduction of volume is modulated by the initial volume and tissue composition of the tumour. (orig.)

  15. Infinitary Combinatory Reduction Systems

    Ketema, Jeroen; Simonsen, Jakob Grue


    We define infinitary Combinatory Reduction Systems (iCRSs), thus providing the first notion of infinitary higher-order rewriting. The systems defined are sufficiently general that ordinary infinitary term rewriting and infinitary ¿-calculus are special cases. Furthermore,we generalise a number...... of knownresults fromfirst-order infinitary rewriting and infinitary ¿-calculus to iCRSs. In particular, for fully-extended, left-linear iCRSs we prove the well-known compression property, and for orthogonal iCRSs we prove that (1) if a set of redexes U has a complete development, then all complete developments...

  16. Oxygen Reduction on Platinum

    Nesselberger, Markus

    This thesis investigates the electro reduction of oxygen on platinum nanoparticles, which serve as catalyst in low temperature fuel cells. Kinetic studies on model catalysts as well as commercially used systems are presented in order to investigate the particle size effect, the particle proximity...... carbon (HSAC) supported Pt nanoparticle (Pt/C) catalysts (of various size between 1 and 5 nm). The difference in SA between the individual Pt/C catalysts (1 to 5 nm) is very small and within the error of the measurements. The factor four of loss in SA when comparing platinum bulk and Pt/C can largely...

  17. Reduction operators of Burgers equation.

    Pocheketa, Oleksandr A; Popovych, Roman O


    The solution of the problem on reduction operators and nonclassical reductions of the Burgers equation is systematically treated and completed. A new proof of the theorem on the special "no-go" case of regular reduction operators is presented, and the representation of the coefficients of operators in terms of solutions of the initial equation is constructed for this case. All possible nonclassical reductions of the Burgers equation to single ordinary differential equations are exhaustively described. Any Lie reduction of the Burgers equation proves to be equivalent via the Hopf-Cole transformation to a parameterized family of Lie reductions of the linear heat equation.

  18. Microbial reduction of iodate

    Councell, T.B.; Landa, E.R.; Lovley, D.R.


    The different oxidation species of iodine have markedly different sorption properties. Hence, changes in iodine redox states can greatly affect the mobility of iodine in the environment. Although a major microbial role has been suggested in the past to account for these redox changes, little has been done to elucidate the responsible microorganisms or the mechanisms involved. In the work presented here, direct microbial reduction of iodate was demonstrated with anaerobic cell suspensions of the sulfate reducing bacterium Desulfovibrio desulfuricans which reduced 96% of an initial 100 ??M iodate to iodide at pH 7 in 30 mM NaHCO3 buffer, whereas anaerobic cell suspensions of the dissimilatory Fe(III)-reducing bacterium Shewanella putrefaciens were unable to reduce iodate in 30 mM NaHCO3 buffer (pH 7). Both D. desulfuricans and S. putrefaciens were able to reduce iodate at pH 7 in 10 mM HEPES buffer. Both soluble ferrous iron and sulfide, as well as iron monosulfide (FeS) were shown to abiologically reduce iodate to iodide. These results indicate that ferric iron and/or sulfate reducing bacteria are capable of mediating both direct, enzymatic, as well as abiotic reduction of iodate in natural anaerobic environments. These microbially mediated reactions may be important factors in the fate and transport of 129I in natural systems.

  19. Islam and harm reduction.

    Kamarulzaman, A; Saifuddeen, S M


    Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed.

  20. The relationship of CCR7 and EMT in thyroid goiter and thyroid papillary carcinoma%CCR7在结节性甲状腺肿与甲状腺癌中的表达及其与EMT关系的研究

    吕顺增; 赵婧; 邹知耕; 田铧; 李菲; 房云海; 索宁; 杨春林; 刘书涛


    目的 研究并探讨趋化因子受体-7(chemokine receptor 7,CCR7)在结节性甲状腺肿与甲状腺乳头状癌中与上皮间质转化(epithelial mesenchymal transition,EMT)的关系.方法 采用免疫组化检测CCR7、N-cadherin与基质金属蛋白酶-9(matrix metalloproteinase 9,MMP9)在50例结节性甲状腺肿与50例甲状腺乳头状癌中的表达,分析其与患者病理资料的关系.结果 CCR7、N-cadherin在结节性甲状腺肿的结节期滤泡上皮均呈高表达(分别为83.7%、90.7%),且为正相关(P<0.01),而在胶质贮存期滤泡上皮(分别为2.0%,8.2%)与结节期纤维组织(分别为6.7%,31.1%)低表达.CCR7、N-cadherin与MMP9在甲状腺乳头状癌的淋巴结转移组的阳性表达率为87.1%,90.3%,96.8%,而无淋巴结转移组的阳性表达率为42.1%,57.9%,63.2%,差异有统计学意义(P <0.01);CCR7与N-cadherin、MMP9在甲状腺乳头状癌的表达呈正相关(P<0.01).结论 CCR7在结节性甲状腺肿与甲状腺乳头状癌中均与EMT的指标具有相关性,CCR7可能参与调节滤泡上皮EMT发生.%Objective To explore the relationship of chemokine receptor 7 (CCR7) and epithelial mesenchymal transition (EMT) in thyroid goiter and thyroid papillary carcinoma.Methods CCR7,N-cadherin and MMP9 were detected by immunohistochemical technique in 50 cases of thyroid goiter tissues and 50 cases of thyroid papillary carcinoma tissues.The correlation between clinical pathological data and CCR7 expression were retrospectively analyzed.Results CCR7 and N-cadherin mainly located in nodular follicular epithelium (83.7%,90.7%) in thyroid goiter and correlated with each other statistically(P <0.01),the expression of CCR7 and N-cadherin were low in the follicular epithelium of storage period (2.0%,8.2%) and the nodular fibrous tissues (6.7%,31.1%) of thyroid goiter.The expression rate of CCR7,N-cadherin and MMP9 in thyroid papillary carcinoma tissues with lymph node