Incidental cancer in multinodular goitre post thyroidectomy

African Journals Online (AJOL)

of choice to rule out cancer in patients presenting with MNG is fine- ... Method. Records of patients who underwent thyroidectomy between January 2005 and December 2010 at Chris Hani .... each of benign goitre and atypical cells, one Hurthle cell lesion .... 6%) in their retrospective audit of MNG post thyroidectomy. The.

Low socio-economic status and familial occurrence of goitre are associated with a high prevalence of goitre

International Nuclear Information System (INIS)

Knudsen, N.; Buelow, I.; Laurberg, P.; Ovesen, L.; Perrild, H.; Jorgensen, T.

2003-01-01

The occurrence of goitre is dependent on genetic and environmental factors, but the associations with socio-economic and life-style factors have only been examined briefly. A cohort of 4649 participants from the general population was examined with questionnaires, thyroid ultrasonography, clinical examination and blood tests. Data were analysed in linear models and logistic regression analysis. Thyroid volume and serum thyroglobulin were closely associated with educational level with higher values in the group with the lowest levels of education (p < 0.001). The same pattern applied to thyroid multinodularity at ultrasonography (p = 0.002) and palpable goitre (p = 0.01). Physical activity in leisure time was negatively associated with thyroid enlargement (p = 0.02) and serum thyroglobulin (p < 0.001). These associations diminished markedly if adjustment was made for smoking habits, alcohol consumption and iodine intake. Familial occurrence of goitre was associated with goitre prevalence (Odds Ratio 2.5, 95% CI: 1.6-3.9), but did not confound the socio-economic associations. In conclusion, social imbalances in the occurrence of goitre were identified. These imbalances could in part be explained by differences in smoking habits and iodine intake

Treatment of goitre

Energy Technology Data Exchange (ETDEWEB)

Bonnema, S.J.; Hegedues, L. [Dept. of Endocrinology and Metabolism, Odense Univ. Hospital (Denmark)

2005-06-01

No consensus exists regarding the optimum treatment of benign non-toxic goitre. L-thyroxine suppressive therapy is widely used for treatment of goitre, but there is poor evidence of its efficacy, and the suppression of serum TSH may have serious adverse effects on health. Iodine supplementation is no better than L-thyroxine in comparative trials. Surgery is first choice in large goitres or if malignancy is suspected. Post-surgery, risk of goitre recurrence is inversely correlated with the extent of the operation. {sup 131}I therapy results in a one-year goitre reduction of around 50% in multinodular and 70% in diffuse goitres, usually with a high degree of patient satisfaction and improvement of the inspiratory capacity. The effect is attenuated with increasing goitre size. The risk of hypothyroidism is 22-58% within 5-8 years. A sufficient thyroid {sup 131}I uptake is mandatory for {sup 131}I therapy to be feasible. Prestimulation with recombinant human TSH (rhTSH) may increase the thyroid {sup 131}I uptake considerably. This leads to an increased absorbed thyroid dose by approx. 75%, mainly in those patients with the lowest thyroid {sup 131}I uptake. In addition, rhTSH results in a more homogeneous intrathyroidal isotope distribution. Recent studies with rhTSH stimulation before {sup 131}I therapy are encouraging. Pre-stimulation with even a small dose of rhTSH allows a reduction of the {sup 131}I activity while still achieving a mean goitre reduction of approximately 40% within the first 12 months. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged {sup 131}I activity, rhTSH pre-stimulation seems to improve the goitre reduction by up to 50%. However, this is at the expense of a higher rate of hypothyroidism in addition to other side effects like cervical pain and transient thyrotoxicosis. Of particular concern is the observation made in healthy persons, that rhTSH results in a transient average thyroid volume increase

Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

Energy Technology Data Exchange (ETDEWEB)

Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura [Ospedale Maggiore IRCCS (Pad. Granelli), Institute of Endocrine Sciences, Milan (Italy); Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara [Istituto Clinico Humanitas, Nuclear Medicine Unit, Milan (Italy)

2005-09-01

This study aimed to evaluate the effects of radioiodine ({sup 131}I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive {sup 131}I plus lithium (group I+L) or {sup 131}I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, {sup 131}I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after {sup 131}I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after {sup 131}I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, {sup 131}I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low {sup 131}I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

International Nuclear Information System (INIS)

Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura; Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara

2005-01-01

This study aimed to evaluate the effects of radioiodine ( 131 I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive 131 I plus lithium (group I+L) or 131 I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, 131 I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after 131 I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after 131 I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, 131 I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low 131 I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

Mutational analysis of Peroxiredoxin IV: exclusion of a positional candidate for multinodular goitre

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Bonifazi Emanuela

2002-07-01

Full Text Available Abstract Background Multinodular goitre (MNG is a common disorder characterised by an enlargement of the thyroid, occurring as a compensatory response to hormonogenesis impairment. The incidence of MNG is dependent on sex (female:male ratio 5:1 and several reports have documented a genetic basis for the disease. Last year we mapped a MNG locus to chromosome Xp22 in a region containing the peroxiredoxin IV (Prx-IV gene. Since Prx-IV is involved in the removal of H2O2 in thyroid cells, we hypothesize that mutations in Prx-IV gene are involved in pathogenesis of MNG. Methods Four individuals (2 affected, 2 unrelated unaffected were sequenced using automated methods. All individuals were originated from the original three-generation Italian family described in previous studies. A Southern blot analysis using a Prx-IV full-length cDNA as a probe was performed in order to exclude genomic rearrangements and/or intronic mutations. In addition a RT-PCR of PRX-IV was performed in order to investigate expression alterations. Results No causative mutations were found. Two adjacent nucleotide substitutions were detected within introns 1 and 4. These changes were also detected in unaffected individuals, suggesting that they were innocuous polymorphisms. No gross genomic rearrangements and/or restriction fragment alterations were observed on Southern analysis. Finally, using RT-PCR from tissue-specific RNA, no differences of PRX-IV expression-levels were detected between affected and unaffected samples. Conclusions Based on sequence and genomic analysis, Prx-IV is very unlikely to be the MNG2 gene.

High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area

DEFF Research Database (Denmark)

Laurberg, P; Pedersen, K M; Vestergaard, H

1991-01-01

Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East-Jutland Denmark with a low average...... that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid...... iodine intake but no endemic goitre, and the incidence in Iceland with a relatively high iodine intake. Hyperthyroidism was more common in East-Jutland than in Iceland, due to a much higher incidence of multinodular toxic goitre and also of single toxic adenoma. Most of the patients with these diseases...

Time to reconsider nonsurgical therapy of benign nontoxic multinodular goitre. Focus on recombinant human TSH (rhTSH) augmented radioiodine therapy

DEFF Research Database (Denmark)

Fast, Søren; Nielsen, Viveque; Bonnema, Steen

2009-01-01

alternatives are needed. Until recently, levothyroxine therapy was the preferred non-surgical alternative, but due to low efficacy and potential side-effects, it is not recommended for routine use in recent international guidelines. Conventional radioiodine (131I)-therapy has been used for two decades......, which makes 131I-therapy less feasible. Another challenge is the negative correlation between initial goitre size and goitre volume reduction (GVR). With its ability to more than double the thyroid 131I-uptake, recombinant human TSH (rhTSH) increases the absorbed radiation dose and thus enhances the GVR...... efficacy. Thus, although in its infancy, and still experimental, rhTSH-augmented 131I-therapy may profoundly alter the nonsurgical treatment of benign non-toxic MNG....

An association of myasthenia gravis with Hashimoto’s thyroiditis in a patient with a multinodular goitre

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Nik Siti Fatimah Mohamed

2017-08-01

Full Text Available Introduction: The association of myasthenia gravis (MG with other autoimmune diseases including autoimmune thyroid disease (ATD is well recognised, although rare. The occurrence of both diseases can occur in two ways: either disease preceding the other, or concurrently. The presentation of MG in association with ATD can range from ocular to generalised disease. Case Summary: A 26-year-old Malay female with persistent hyperthyroidism secondary to Hashimoto’s thyroiditis in multinodular goitre was diagnosed with generalised MG after 2 years. She presented with right eye ptosis (ocular and difficulty in swallowing and chewing (bulbar. The diagnosis of MG was confirmed by fatigability testing, electromyography and the presence of AChR antibodies. Her symptoms showed improvement with pyridostigmine (Mestinon 60 mg 6-hourly. Her antithyroid drug was tapered down according to her thyroid function test. Throughout a year of follow-ups, her hyperthyroidism and fatigability symptoms improved with treatment. She was later counselled for total thyroidectomy and thymectomy. Conclusion: Myasthenia gravis and hyperthyroidism may present with similar symptoms such as dysphagia due to neuromuscular weakness or fatigue. When the diseases occur together, one of the diagnoses may be missed. Therefore, the occurrence of new symptoms in a patient with underlying ATD should should trigger the early identification of other autoimmune diseases by primary care doctors.

Phrenic Nerve Palsy as Initial Presentation of Large Retrosternal Goitre.

Science.gov (United States)

Hakeem, Arsheed Hussain; Hakeem, Imtiyaz Hussain; Wani, Fozia Jeelani

2016-12-01

Unilateral phrenic nerve palsy as initial presentation of the retrosternal goitre is extremely rare event. This is a case report of a 57-year-old woman with history of cough and breathlessness of 3 months duration, unaware of the thyroid mass. She had large cervico-mediastinal goiter and chest radiograph revealed raised left sided hemidiaphragm. Chest CT scan did not reveal any lung parenchymal or mediastinal pathology. The patient underwent a total thyroidectomy through a cervical approach. The final pathology was in favor of multinodular goitre. Even after 1 year of follow up, phrenic nerve palsy did not improve indicating permanent damage. Phrenic nerve palsy as initial presentation of the retrosternal goitre is unusual event. This case is reported not only because of the rare nature of presentation, but also to make clinicians aware of the entity so that early intervention may prevent attendant morbidity.

A Giant Euthyroid Endemic Multinodular Goiter with No Obstructive or Compressive Symptoms

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Ahmed Nada

2011-01-01

Full Text Available Diffusely enlarged thyroid glands (goitres are becoming increasingly infrequent. However, in some geographical areas they are still relatively common and can cause compressive symptoms involving the trachea, oesophagus, and recurrent laryngeal nerve. Surgical treatment of diffusely enlarged thyroid glands requires a high level of expertise and may lead to severe complications. Here we present a case report of surgical treatment of an extremely enlarged thyroid gland, found in a 61-year-old female patient. The patient underwent surgery, and a thyroidectomy was performed. The resulting specimen weighed 4.7 kg (10.4 lbs. Histopathological examination revealed a multinodular goitre with multiple cysts and areas of haemorrhage and necrosis. Surgical excision can immediately resolve local symptoms and is often recommended when substernal extension is evident. To the best of our knowledge, this is the largest thyroid gland ever reported in the literature. Only experienced surgeons should treat large thyroid goitres. Ideally, large thyroid goitres should be treated before they reach a substernal component, otherwise any sudden growth in gland size could seriously compromise respiration.

131I therapy for hyperthyroidism with large goitre

International Nuclear Information System (INIS)

Zhang Chenggang

2002-01-01

Objective: This retrospective analysis is to study the effects of radioiodine in hyperthyroidism with large goitre and observe the possibility to take the place of surgery. Methods: 82 patients (pts) with hyperthyroidism including 51 female and 31 male, age ranging from 11 to 75 years old (mean 35.43 ± 12.14), were treated with 131 I. All patients presented with typical clinical and biochemical hyperthyroidism and were followed up for 3-38 months after 131 I treatment. Patients were categorized into 2 diagnostic groups: Graves disease (43 pts) and toxic multinodular goitres (39 pts). Gland weights were estimated by palpation and scintigraphy. Cold nodule had not been found in scintigraphy in all pts. The dose in mCi administered were determined according to therapeutic history, thyroid weight (g), rate of uptake 131 I, patient's symptoms and course of disease, etc. 76 pts (92.7%) had iII degree goitre. Goitre weight was stratified into 150-200 g (67 pts), 201-300 g (13 pts) and 400-500 g (2pts). 71 pts (86.6%) were given one dose of 131 I, 10 pts (12.2%) two doses, one patient had three doses. The mean first dose was 39.26 ± 19.63 mCi (14-130 mCi). The mean first μCi/g was 142.89±32.29 μCi (59-200). Results: 24 pts (29.3%) had complete remission (euthyroid), 19 pts (23.2%) had partial resolution. 39 (47.6%) pts had hypothyroidism (HP) including 8 permanent HP, 11 transient HP, 3 subclinical HP and 17 indeterminate HP. The later group had HP that could not be decided to be transient or permanent because the time of following up was less than one year. After 131 I therapy, goitres of 43 pts (52.4%) became 0 degree, 34 pts (41.5%) became I degree, 4 pts (4.9%) had II degree and only one pt still had a III degree goitre. Conclusions: 131 I therapy is a safe and effective method for treating hyperthyroidism with large goitre. If the large goitre does not have cold nodule in scintigraphy, 131 I treatment may replace surgery

Gender specific determinants of goitre

International Nuclear Information System (INIS)

Jamshid, F.; Kerstin, C.; Elena, G.; Wilhelm, O.; Karl, W.; Hwe, M.

2004-01-01

Despite the strong implications of differences between females and males in the risk of goitre, gender-specific issues have not been extensively addressed in investigations of goitre prevalence. The Objective of our analysis was to investigate the gender-specific determinants of goitre. Methods: A total of 853 healthy employees from 4 institutions in western part of Germany aged between 18 and 68 years were examined by ultrasound of the neck to determine the thyroid volume between April 2001 and April 2002. Information on sex, age, daily use of iodised salt, the history of goitre in the first degree relatives, type and amount of' smoking, oral contraceptives and number of pregnancies were assessed by standardised questionnaires. Gender-specific predictors of goitre prevalence were assessed by multivariate logistic regression. Results: The overall prevalence of goitre among study subjects was (204/853) 23.9%. Goitre was present in 80 out of 370 females (21.6%) vs. 124/483 (25.7%) in males.In general smoking (<0.0001), increasing age (p<0.0001) and lack of daily intake of iodised salt (p=0.004) associated with goitre prevalence, but not sex (0.4) and family history of goitre (p=0.2). In 370 females, parity (p=0.004) and lack of daily intake of iodised salt (p=0.01) were the major determinants for goitre, whereas, age (p=0.2), oral contraceptives (p=0.8), family history of goitre (p=0.3), and smoking (p=0.1) did not affect the goitre prevalence. In 483 males, smoking (p<0.0001) and age (p<0.001) affected the goitre prevalence, but not family history of goitre (p=0.4) and the iodine status failed just to reach the significant level (p=0.08) in this analysis. Conclusions: Gender specific determinants of goitre are parity and iodine status in females and smoking and increasing age in males. (authors)

Prevalence of upper airway obstruction in patients with apparently asymptomatic euthyroid multi nodular goitre

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Sunil K Menon

2011-01-01

Full Text Available Aims: To study the prevalence of upper airway obstruction (UAO in "apparently asymptomatic" patients with euthyroid multinodular goitre (MNG and find correlation between clinical features, UAO on pulmonary function test (PFT and tracheal narrowing on computerised tomography (CT. Materials and Methods: Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest. Statistical Analysis Used: Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher′s exact test. P value of <0.05 was considered to be significant. Results: Fifty-six patients (52 females and four males were studied. The prevalence of UAO (PFT and significant tracheal narrowing (CT was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT did not correlate with UAO (PFT. Volume of goitre significantly correlated with degree of tracheal narrowing. Conclusions: Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG.

Prevalence of upper airway obstruction in patients with apparently asymptomatic euthyroid multi nodular goitre

Science.gov (United States)

Menon, Sunil K.; Jagtap, Varsha S.; Sarathi, Vijaya; Lila, Anurag R.; Bandgar, Tushar R.; Menon, Padmavathy S; Shah, Nalini S.

2011-01-01

Aims: To study the prevalence of upper airway obstruction (UAO) in “apparently asymptomatic” patients with euthyroid multinodular goitre (MNG) and find correlation between clinical features, UAO on pulmonary function test (PFT) and tracheal narrowing on computerised tomography (CT). Materials and Methods: Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest. Statistical Analysis Used: Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher's exact test. P value of <0.05 was considered to be significant. Results: Fifty-six patients (52 females and four males) were studied. The prevalence of UAO (PFT) and significant tracheal narrowing (CT) was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT) did not correlate with UAO (PFT). Volume of goitre significantly correlated with degree of tracheal narrowing. Conclusions: Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG. PMID:21966649

Study of factors that influence the outcome of 131I treatment in hyperthyroidism secondary to nodular goitre.

Science.gov (United States)

Tabuenca-Dopico, O; Boente-Varela, R; Lamas-Ferreiro, J L

To assess the outcome after 131 I treatment in patients with multinodular (MNG) and nodular toxic goitre (NTG) according to the administered dose and other factors related to the patient, pathology, or previous treatments. A retrospective study was conducted on 108 patients (67 MNG and 41 NTG) treated in our department, with a follow-up period of at least 2 years. Development of hypothyroidism and treatment failure were evaluated along with their relationship with the administered dose and other factors such as age, sex, grade of hyperthyroidism, type of goitre, presence of autoimmunity, or previous antithyroid medication. More than one-third (36.9%) of MNG patients, and even higher proportion of NTG patients (51.2%) developed non-transient hypothyroidism, particularly in those receiving 740MBq (66.7%). No relationship was found with any other variable. The development of early hypothyroidism (before one year) was also not related to any variable. Treatment failure was not related to the dose, but in MNG there was a relationship with male gender, presence of autoimmunity, or previous antithyroid drugs use. The high rate of hypothyroidism obtained with high doses of 131 I in hyperthyroidism secondary to nodular goitre treatment suggests that lower doses might be sufficient to control the disease without an increase in treatment failures. Only patients with positive autoimmunity, in previous anti-thyroid medication, and perhaps male gender in MNG might be given higher doses, as the failure rate increases, but further studies are required. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Feasibility of thoracoscopic approach for retrosternal goitre (posterior mediastinal goitre: Personal experiences of 11 cases

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Panchangam Ramakanth Bhargav

2016-01-01

Full Text Available Introduction: Posterior mediastinal goitres constitute of a unique surgical thyroid disorder that requires expert management. Occasionally, they require thoracic approach for the completion of thyroidectomy. In this paper, we describe the feasibility and utility of a novel thoracoscopic approach for such goitres. Materials and Methods: This is a retrospective study conducted at a tertiary care endocrine surgery department in South India over a period of 5 years from January 2010 to December 2014. We developed a novel thoracoscopic technique for posterior mediastinal goitres instead of a more morbid thoracotomy or sternotomy. All the clinical, investigative, operative, pathological and follow-up data were collected from our prospectively filled database. Statistical analysis was done with SPSS 15.0 version. Descriptive analysis was done. Operative Technique of Thoracoscopic Thyroidectomy: Single lumen endotracheal tube (SLETT was used of anaesthetic intubation and general inhalational anaesthesia. Operative decubitus was supine with extension and abduction of the ipsilateral arm. Access to mediastinum was obtained by two working ports in the third and fifth intercostal spaces. Mediastinal extension was dissected thoracoscopically and delivered cervically. Results: Out of 1,446 surgical goitres operated during the study period, 72 (5% had retrosternal goitre. Also, 27/72 (37.5% cases had posterior mediastinal extension (PME, out of which 11 cases required thoracic approach. We utilised thoracoscopic technique for these 11 cases. The post-operative course was uneventful with no major morbidity. There was one case of recurrent laryngeal nerve (RLN injury and hoarseness of voice in the third case. Histopathologies in 10 cases were benign, out of which two had subclinical hyperthyroidism. One case had multifocal papillary microcarcinoma. Conclusions: We opine that novel thoracoscopic technique is a feasibly optimal approach for posterior mediastinal

Thyroid cancer in toxic and non-toxic multinodular goiter

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Cerci C

2007-01-01

Full Text Available Background : Many authors have claimed that hyperthyroidism protects against thyroid cancer and believed that the incidence of malignancy is lower in patients with toxic multinodular goiter (TMG than in those with non-toxic multinodular goiter. But in recent studies, it was reported that the incidence of malignancy with TMG is not as low as previously thought. Aim : To compare the thyroid cancer incidence in patients with toxic and non-toxic multinodular goiter. Settings and Design : Histology reports of patients treated surgically with a preoperative diagnosis of toxic and non-toxic multinodular goiter were reviewed to identify the thyroid cancer incidence. Patients having a history of neck irradiation or radioactive iodine therapy were excluded from the study. Materials and Methods : We reviewed 294 patients operated between 2001-2005 from toxic and non-toxic multinodular goiter. One hundred and twenty-four of them were toxic and 170 were non-toxic. Hyperthyroidism was diagnosed by elevated tri-iodothyroinine / thyroxine ratios and low thyroid-stimulating hormone with clinical signs and symptoms. All patients were evaluated with ultrasonography and scintigraphy and fine needle aspiration biopsy. Statistical Analysis Used : Significance of the various parameters was calculated by using ANOVA test. Results : The incidence of malignancy was 9% in the toxic and 10.58% in the non-toxic multinodular goiter group. Any significant difference in the incidence of cancer and tumor size between the two groups could not be detected. Conclusions : The incidence of malignancy in toxic multinodular goiter is not very low as thought earlier and is nearly the same in non-toxic multinodular goiter.

Riedel's goitre - rare and difficult to diagnose reason

International Nuclear Information System (INIS)

Bula, G.; Truchanowski, W.; Gawrychowski, J.

2009-01-01

Introduction: The paper reports a female patient treated surgically for Riedel's goitre. A total of 4775 patients were treated surgically between 1 January 2000 and 31 December 2007 for various types of goitres. Thyroiditis was diagnosed in 193 (4.0%) cases. Among them Riedel's goitre was found in one (0.5%). Case report: A 51-year-old woman P.G. (case record No. 1377/2007) was admitted to our hospital with considerable dyspnea, both inspiratory and expiratory, accompanied by marked stridor and retrosternal goitre, the latter suspected of neoplasmic process. Thyroid gland was hard, its left lobe extending behind the sternum. No disorders in thyroid hormonal function or high antibody titre against thyroid peroxidase were observed. Ultrasonography revealed large thyroid gland with mediastinal invasion, nodulated and hypoechogenic. Fineneedle biopsy suggested thyroid colloidal tumor. X-ray of the chest and neck revealed wide upper portion of the mediastinum and narrow trachea. Laryngological examination confirmed paralysis of left vocal fold. The patient was operated under general endotracheal anesthesia. Both thyroid lobes were partially resected together with the isthmus, and malacic trachea was decompressed. No complications were observed during postoperative period. Paraffin histopathological examination confirmed the presence of Riedel's goitre.The patient was discharged in general good condition. She was under regular follow-up control and died 1.5 year after operation from further progress of the disease. Conclusions: Clinical course of Riedel's goitre may cause remarkable diagnostic problems, and requires a differentiation with thyroid malignant tumor. Surgical treatment of Riedel's goitres helps to quickly obtain correct diagnosis and improve both clinical condition and life comfort of the patients. (authors)

Genetic and non-iodine-related factors in the aetiology of nodular goitre.

Science.gov (United States)

Knudsen, Nils; Brix, Thomas Heiberg

2014-08-01

Genetic and a large number of environmental non-iodine-related factors play a role in the cause of nodular goitre. Most evidence for the influence of genetic and environmental factors in the cause of goitre is from cross-sectional, population-based studies. Only a few studies have included prospective data on risk factors for nodular goitre, although few prospective data are available on the effect of iodine and tobacco smoking on goitre development. Goitre is not one single phenotype. Many epidemiological studies do not distinguish diffuse from nodular goitre, as the investigated parameter is often thyroid volume or frequency with increased thyroid volume. Moreover, information on the presence and effect of gene-environment, gene-gene, and environment-environment effect modifications is limited. Thus, firm conclusions about the relative contributions and causality of the investigated risk factors should be made with caution. Smoking seems to be an established risk factor for nodular goitre, possibly with effect modification from iodine intake, as the risk associated with smoking is smaller or absent in areas with sufficient iodine intake. The use of oral contraceptives might have protective effects against goitre, and childbirth is an increased risk factor for goitre in areas with non-optimal iodine intake. Insulin resistance is a recently investigated risk factor, and the risk of goitre may be reversible with metformin treatment. Iodine remains the major environmental risk factor for nodular goitre. Copyright © 2014 Elsevier Ltd. All rights reserved.

Amyloid goitre following chronic osteomyelitis: case report and ...

African Journals Online (AJOL)

Amyloid goitre following chronic osteomyelitis: case report and review of literature. AZ Mohammed, ST Edino, O Ochicha. Abstract. Amyloid Goitre is a rare clinical entity associated with systemic amyloidosis. It poses a significant diagnostic and therapeutic challenge and may be confused with a neoplastic goiter. We present ...

Genetic and non-iodine-related factors in the aetiology of nodular goitre

DEFF Research Database (Denmark)

Knudsen, Nils; Brix, Thomas Heiberg

2014-01-01

Genetic and a large number of environmental non-iodine-related factors play a role in the cause of nodular goitre. Most evidence for the influence of genetic and environmental factors in the cause of goitre is from cross-sectional, population-based studies. Only a few studies have included...... prospective data on risk factors for nodular goitre, although few prospective data are available on the effect of iodine and tobacco smoking on goitre development. Goitre is not one single phenotype. Many epidemiological studies do not distinguish diffuse from nodular goitre, as the investigated parameter...... is often thyroid volume or frequency with increased thyroid volume. Moreover, information on the presence and effect of gene-environment, gene-gene, and environment-environment effect modifications is limited. Thus, firm conclusions about the relative contributions and causality of the investigated risk...

The frequency of carcinoma in solitary thyroid nodules and in ...

African Journals Online (AJOL)

Muhimbili Medical Centre, Dar es Salaam was made to determine the frequency of malignancy in patients with solitary non-toxic thyroid nodule (STN) and in those with multinodular goitre (MNG). There were 60 cases of STN and. 178 with MNG. Nodular goitre was found to be predominantly a disease of females with sex.

The role of radioiodine therapy in benign nodular goitre

DEFF Research Database (Denmark)

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

2014-01-01

For treatment of benign nodular goitre the choice usually stands between surgery and (131)I therapy. (131)I therapy, used for 30 years for this condition, leads to a goitre volume reduction of 35-50% within 1-2 years. However, this treatment has limited efficacy if the thyroid (131)I uptake is low...... for additional therapy due to insufficient goitre reduction, but the price is a higher rate of hypothyroidism. Another approach with rhTSH-stimulation is to reduce the administered (131)I activity by a factor that equals the increase in the thyroid (131)I uptake. Using this approach, radiation exposure...

Hypocalcaemia following thyroidectomy for treatment of Graves' disease: implications for patient management and cost-effectiveness.

Science.gov (United States)

Hughes, O R; Scott-Coombes, D M

2011-08-01

No consensus exists on optimal treatment for Graves' disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive iodine or life-long anti-thyroid medication, but hypocalcaemia is an important complication, leading to longer hospital admissions and increased prescription costs. This study aimed to compare the relative risk of hypocalcaemia requiring medical treatment for patients with Graves' disease. Prospective cohort study of patients undergoing total thyroidectomy for Graves' disease and for multinodular goitre, calculating serum calcium levels 24-hours post-operatively and prescription rates. Mean corrected calcium concentrations 24 hours post-operatively were 2.05 mmol/l for Graves' disease patients and 2.14 mmol/l for multinodular goitre patients (p = 0.003). Biochemical hypocalcaemia developed in 92 per cent (n = 34) of Graves' disease patients and 71 per cent (n = 43) of multinodular goitre patients (p = 0.012). Graves' disease patients were more likely to be prescribed calcium supplementation pre-discharge (p = 0.037). Total thyroidectomy for Graves' disease carries an increased risk of hypocalcaemia at 24 hours, and of calcium supplementation pre-discharge. Graves' disease patients should be informed of the increased risk of hypocalcaemia associated with total thyroidectomy, and this risk must be factored into future cost-effectiveness analysis.

Recurrent transient thyrotoxicosis in multinodular goitre.

OpenAIRE

Arem, R.

1990-01-01

A patient initially presented with an autonomously functioning right thyroid nodule and transient hyperthyroidism which lasted for a few months. Several months after resolution of thyrotoxicosis, the patient had a recurrent episode of hyperthyroidism and was found to have a left hot nodule. The right hyperfunctioning nodule had become cold on scintigraphy, and its aspiration revealed haemorrhagic fluid suggesting haemorrhagic infarction as the mechanism of resolution of the first episode of h...

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

DEFF Research Database (Denmark)

Bonnema, Steen J; Hegedüs, Laszlo

2009-01-01

rate of permanent hypothyroidism, whereas other side-effects are very modest when using a rhTSH dose of 0.1 mg or below. SUMMARY: RhTSH-stimulated radioiodine therapy of benign nontoxic multinodular goiter is still an off-label use but several trials have shown that this treatment is significantly more......PURPOSE OF REVIEW: There is no consensus on the ideal treatment of patients with a benign nontoxic multinodular goiter. In some European countries, (131)I therapy has replaced surgery as the treatment of choice in these patients. Recombinant human thyrotropin (rhTSH) is a very potent stimulator...... of the thyroid gland and this review focuses on rhTSH-stimulated (131)I therapy. RECENT FINDINGS: The concept of rhTSH-stimulated (131)I therapy has been tested in several trials during the last 8 years. With this treatment, the goiter reduction is improved by 35-55%, compared with (131)I therapy without rh...

LES GOITRES PLONGEANTS : PARTICULARITES CLINIQUES ...

African Journals Online (AJOL)

SUBSTERNAL GOITERS : SPECIAL CLINICAL,. RADIOLOGICAL AND THERAPEUTIC. M. Ben Amor, S. Dhambri, I. Hariga, W. Abid, R. Hannachi, O. Ben Gamra, S. Zribi, CH. .... L'indication chirurgicale est formelle dans les goitres plon- geantsdevant le risque de détresse respiratoire aiguë met- tant en jeu le pronostic vital ...

Grave's Eye disease developing following radioiodine treatment for toxic nodular goitre.

Science.gov (United States)

Tahrani, A A; Rangan, S; Moulik, P

2007-07-01

The development of Grave's ophthalmopathy (GO) following radioiodine (RI) treatment for Grave's thyrotoxicosis, though controversial, is well described. The development of ophthalmopathy following RI treatment for toxic nodular goitre is much less recognised. We report a 49 year-old female patient who developed thyrotoxicosis and GO after receiving RI treatment for toxic nodular goitre and we also review the relevant literature.

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

DEFF Research Database (Denmark)

Biondi, Bernadette; Bartalena, Luigi; Cooper, David S

2015-01-01

Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective...

Postoperative recurrent nontoxic nodular (multinodular goiter

Directory of Open Access Journals (Sweden)

Tolstokorov A.S.

2011-12-01

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.

Hyperfunctioning thyroid nodules

DEFF Research Database (Denmark)

Laurberg, P; Pedersen, K M; Vestergaard, P

1991-01-01

The authors describe the principal clinical and pathological aspects of the solitary hyperfunctioning adenoma or the multifocal hyperfunction of a multinodular goitre. Successively they report the incidence of these conditions in countries with different iodine intake as well as the age distribut...

Increased Chromosomal and Oxidative DNA Damage in Patients with Multinodular Goiter and Their Association with Cancer

Directory of Open Access Journals (Sweden)

Hamiyet Donmez-Altuntas

2017-01-01

Full Text Available Thyroid nodules are a common clinical problem worldwide. Although thyroid cancer accounts for a small percentage of thyroid nodules, the majority are benign. 8-Hydroxy-2′-deoxyguanosine (8-OHdG levels are a marker of oxidative stress and play a key role in the initiation and development of a range of diseases and cancer types. This study evaluates cytokinesis-block micronucleus cytome (CBMN-cyt assay parameters and plasma 8-OHdG levels and their association with thyroid nodule size and thyroid hormones in patients with multinodular goiter. The study included 32 patients with multinodular goiter and 18 age- and sex-matched healthy controls. CBMN-cyt assay parameters in peripheral blood lymphocytes of patients with multinodular goiter and controls were evaluated, and plasma 8-OHdG levels were measured. The micronucleus (MN frequency (chromosomal DNA damage, apoptotic and necrotic cells (cytotoxicity, and plasma 8-OHdG levels (oxidative DNA damage were significantly higher among patients with multinodular goiter. Our study is the first report of increased chromosomal and oxidative DNA damage in patients with multinodular goiter, which may predict an increased risk of thyroid cancer in these patients. MN frequency and plasma 8-OHdG levels may be markers of the carcinogenic potential of multinodular goiters and could be used for early detection of different cancer types, including thyroid cancer.

Hyperfunctioning thyroid nodules in toxic multinodular goiter share activating thyrotropin receptor mutations with solitary toxic adenoma.

Science.gov (United States)

Tonacchera, M; Chiovato, L; Pinchera, A; Agretti, P; Fiore, E; Cetani, F; Rocchi, R; Viacava, P; Miccoli, P; Vitti, P

1998-02-01

Toxic multinodular goiter is a cause of nonautoimmune hyperthyroidism and is believed to differ in its nature and pathogenesis from toxic adenoma. Gain-of-function mutations of the TSH receptor gene have been identified as a cause of toxic adenoma. The pathogenesis at the molecular level of hyperfunctioning nodules in toxic multinodular goiter has yet not been reported. Six patients with a single hot nodule within a multinodular goiter and 11 patients with toxic thyroid adenoma were enrolled in our study. At histology five hyperfunctioning nodules in multinodular goiters showed the features of adenomas, and one was identified as a hyperplastic nodule. The entire exon 10 of the TSH receptor gene was directly sequenced after PCR amplification from genomic DNA obtained from surgical specimens. Functional studies of mutated receptors were performed in COS-7 cells. Five out of 6 (83%) hyperfunctioning nodules within toxic multinodular goiters harbored a TSH receptor mutation. A TSH receptor mutation was also evident in the hyperfunctioning nodule that at histology had the features of noncapsulated hyperplastic nodule. Among toxic adenomas, 8 out of 11 (72%) nodules harbored a TSH receptor mutation. All the mutations were heterozygotic and somatic. Nonfunctioning nodules, whether adenomas or hyperplastic nodules present in association with hyperfunctioning nodules in the same multinodular goiters, had no TSH receptor mutation. All the mutations identified had constitutive activity as assessed by cAMP production after expression in COS-7 cells. Hyperfunctioning thyroid nodules in multinodular goiters recognize the same pathogenetic event (TSH receptor mutation) as toxic adenoma. Other mechanisms are implicated in the growth of nonfunctioning thyroid nodules coexistent in the same gland.

Plexiform (multinodular) schwannoma of soft palate. Report of a case.

Science.gov (United States)

Kapetanakis, Stylianos; Vasileiadis, Ioannis; Petousis, Aristotelis; Fiska, Aliki; Stavrianaki, Anna

2012-01-01

Plexiform schwannoma is a rare benign neoplasm of the neural sheath characterized by a multinodular plexiform growth pattern. Only 5% of schwannomas have a plexiform or multinodular growth pattern. Schwannoma apparently derives from the Schwann cells. Extracranially, 25% of all schwannomas are located in the head and neck region, but only 1% show an intraoral origin. The intraoral lesions show a predilection for the tongue, followed by the palate, buccal mucosa, lip and gingival. Microscopic examination is necessary to confirm the diagnosis. Characteristic histological signs are the palisading of the spindle-shaped Schwann cells around the central acellular area, so called Verocay bodies. We report a case of a 21-year-old woman with a smooth mass of the soft palate that was gradually increasing. Surgical excision of the mass was done and the histopathology and immunohistochemistry study of the excised lesion revealed a multinodular plexiform schwannoma of the soft palate. The patient is under regular clinical control, with no signs of recurrence after 17 months. Plexiform schwannomas of the soft palate are mentioned very rarely in the English literature. This rare benign tumor is worthy of recognition because it can be misdiagnosed as plexiform neurofibroma.

Goitre in girls at the age of puberty. Part 2. Determination of thyroid iodine uptake and triiodothyronine-binding index

International Nuclear Information System (INIS)

Mach, W.

1977-01-01

Thyroid iodine uptake and 125 I-triiodothyronine-binding index (T 3 BC) were determined in 114 girls with juvenile goitre and the results were related to the size of the goitre and its duration. Measurements of thyroid iodine uptake showed a gradual decrease of its value with increasing size of goitre and its longer duration without reaching, however, the values regarded as normal. T 3 BC showed no significant changes in relation to the size of goitre and its duration. (author)

Myopericytoma proliferating in an unusual anastomosing multinodular fashion.

Science.gov (United States)

Inoue, Takuya; Misago, Noriyuki; Asami, Akihiko; Tokunaga, Osamu; Narisawa, Yutaka

2016-05-01

We herein describe a case of myopericytoma that proliferated in an unusual fashion. Myopericytoma is described as a group of rare, benign, dermal or subcutaneous tumors that are characterized histologically by a striking, concentric, perivascular proliferation of spindle cells and showing apparent differentiation towards perivascular myoid cells. Myopericytoma forms a morphological continuum with myofibroma/myofibromatosis, glomus tumor and angioleiomyoma. The patient was a 64-year-old woman who demonstrated a recurrent ulcer on an atrophic plaque on her left shin. A histopathological examination of the plaque demonstrated that tumor cells proliferated in an anastomosing multinodular fashion along the vessels in the dermis and subcutaneous tissue. In those nodules, there were numerous, small, concentric proliferations of myoid-appearing spindle cells around small vascular lumina. The present case is an unusual example of myopericytoma, manifesting in a characteristic anastomosing, multinodular, infiltrating fashion. © 2015 Japanese Dermatological Association.

The majority of Danish nontoxic goitre patients are ineligible for Levothyroxine suppressive therapy

DEFF Research Database (Denmark)

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

2008-01-01

evaluated clinically including fine needle aspiration biopsy, thyroid scintigraphy and ultrasound. Seven-hundred and forty-five patients (627 women and 118 men; median age 47 years, range 11-90) were potential candidates for LT4-therapy. Based on guidelines we defined conditions where LT4-therapy......OBJECTIVE: Levothyroxine suppressive therapy (LT4-therapy), aimed at shrinking thyroid nodules is controversial. Despite evidence of limited effect and long-term side-effects, questionnaire surveys indicate widespread use. Our aim was to determine, in consecutive nontoxic goitre patients...... serum TSH, post-menopausal status, a large goitre or clinical suspicion of malignancy. CONCLUSION: The vast majority of consecutive Danish nontoxic goitre patients (84%) were ineligible for LT4-therapy. Due to low efficacy and potential long-term adverse effects on the skeleton and cardiovascular system...

Selenium and iodine in soil, rice and drinking water in relation to endemic goitre in Sri Lanka

International Nuclear Information System (INIS)

Fordyce, F.M.; Johnson, C.C.; Appleton, J.D.; Navaratna, U.R.B.; Dissanayake, C.B.

2000-01-01

Endemic goitre has been reported in the climatic wet zone of south-west Sri Lanka for the past 50 years, but rarely occurs in the northern dry zone. Despite government-sponsored iodised salt programmes, endemic goitre is still prevalent. In recent years, it has been suggested that Se deficiency may be an important factor in the onset of goitre and other iodine deficiency disorders (IDD). Prior to the present study, environmental concentrations of Se in Sri Lanka and the possible relationships between Se deficiency and endemic goitre had not been investigated. During the present study, chemical differences in the environment (measured in soil, rice and drinking water) and the Se-status of the human population (demonstrated by hair samples from women) were determined for 15 villages. The villages were characterised by low ( 25%) goitre incidence (NIDD, MIDD and HIDD, respectively). Results show that concentrations of soil total Se and iodine are highest in the HIDD villages, however, the soil clay and organic matter content appear to inhibit the bioavailability of these elements. Concentrations of iodine in rice are low (≤58 ng/g) and rice does not provide a significant source of iodine in the Sri Lankan diet. High concentrations of iodine (up to 84 μg/l) in drinking water in the dry zone may, in part, explain why goitre is uncommon in this area. This study has shown for the first time that significant proportions of the Sri Lankan female population may be Se deficient (24, 24 and 40% in the NIDD, MIDD and HIDD villages, respectively). Although Se deficiency is not restricted to areas where goitre is prevalent, a combination of iodine and Se deficiency could be involved in the pathogenesis of goitre in Sri Lanka. The distribution of red rice cultivation in Sri Lanka is coincident with the HIDD villages. Varieties of red rice grown in other countries contain anthocyanins and procyanidins, compounds which in other foodstuffs are known goitrogens. The potential

Congenital Hypothyroidism and Goitre in Childhood

OpenAIRE

Davis, Albert J.; Curtis, Joseph

1990-01-01

The problems of congenital hypothyroidism and goitre are relatively common in childhood. The investigation and treatment of these disorders requires a knowledge of their various causes, appropriate investigation, and referral for specialist consultation as necessary, as well as involvement of the family physician in the monitoring of effectiveness of and compliance with treatment. Many of these disorders have life-long implications for the individual affected.

[Thyroid proteins in endemic goitre and their relationship to the intrathyroidal thyroid hormone concentration].

Science.gov (United States)

Platzer, S; Groebner, P; Hausen, A; Obendorf, L; Riccabona, G

1980-02-01

According to several reports we suspected that the pathogenesis of endemic goitre cannot be explained by iodine deficiency only, but that other--partially endogenous--goitrogenic factors must be present. We therefore studied 16 cases of "euthyroid" endemic goitre from the endemic goitre area of the province of Bolzano in Italy. After fractionation of tissue homogenates, T 4 and T 3 were measured by RIA and the I concentration was also termined. Thyroglobulin and its fractions were measured by ultracentrifuge procedures after assessment of the total protein concentration. Evaluation of the present results suggests that an insufficient synthesis of thyroglobulin in the examined goitres induces an inadequate adaptation of the organism to iodine deficiency, which, in turn, decreases the thyroid hormone concentration in thyroid tissue and enhances goitrogenesis. Considering the normal iodine content of the examined tissues, there obviously seems to be two intrathyroidal iodine pools, one of which supplies the body with thyroid hormones under pituitary stimulation even though its thyroglobulin pool is reduced, while a significant amount of the thyroidal iodine pool is bound in metabolically inert protein molecules and therefore increases the goitrogenic effect of iodine deficiency.

Application of radioisotope techniques to the study of endemic goitre on Idjwi Island; Utilisation de methodes radioisotopiques dans l' etude du goitre endemique de l'Ile Idjwi

Energy Technology Data Exchange (ETDEWEB)

Delange, F.; Thilly, C.; Pourbadc, P.; Ermans, A. M. [CEMUBAC auprès de l' IRSAC, Lwiro (Congo, The Democratic Republic of the); Université libre de Bruxelles, Brussels (Belgium)

1970-01-15

On a world-wide scale endemic goitre represents one of the major problems of public health inasmuch as at least 200 million people are affected by this disease. Endemic goitre is particularly prevalent in Africa. The authors have recently undertaken a study of endemic goitre on Idjwi Island (Lake Kivu). The inhabitants of this island comprise an isolated population group. The island is geographically divided into a north and south zone with only occasional contact between the populations of the two zones. The entire population of the island has been examined and three zones can be distinguished as far as the prevalence of goitre is concerned: in the north of the island the number of cases is very high (averaging 54.4% of the population), whereas it drops to 5.3% in a limited region in the south-west; in the south and south-east of the island it is somewhere between the two. Radioisotope techniques have been applied to the study of three basic public health aspects of the disease. (author) [French] Le goitre endémique constitue à l’échelle mondiale un des problèmes majeurs de la santé publique puisque 200 millions de sujets au moins sont atteints par la maladie. Les endémies goitreuses sont particulièrement importantes en Afrique. Les auteurs ont entrepris récemment l'étude de l’endémie goitreuse de l'îleIdjwi (lac Kivu). Cette île constitue un groupe isolé de population. Elle est séparée géographiquement en deux zones: nord et sud. Les contacts entre les populations de ces deux zones sont épisodiques. La totalité de la population de l’île a été examinée. Trois zones peuvent être distinguées en ce qui concerne la prévalence du goitre: dans le nord de l’île elle est très élevée (valeur moyenne 54,4% de la population); par contre elle tombe à 5,3% dans une région limitée du sud-ouest; dans le sud et le sud-est de l’île elle est intermédiaire entre les deux premières. Des méthodes radioisotopiques ont été appliquées à l

A fifteen year experience of total thyroidectomy for the management ...

African Journals Online (AJOL)

Tracheostomy was required in 35 (5.8%) patients but none was permanent. Conclusion: Total thyroidectomy is a relatively safe treatment option for patients who have simple multinodular goitre. It provides a permanent cure with a low postoperative morbidity risk. The burden of replacement l-thyroxine needs to be discussed ...

An unusual case of the Capgras syndrome.

Science.gov (United States)

Fialkov, M J; Robins, A H

1978-04-01

A variant of the Capgras syndrome is described in a 43-year-old woman who had vitiligo and multinodular goitre. The unusual feature of the case was that the patient not only misidentified members of her own family but also claimed that she herself had been replaced by a double.

Iodine nutritional status and risk factors for goitre among schoolchildren in South Tajikistan

Science.gov (United States)

2013-01-01

Background Iodine deficiency affects nearly 1.9 billion people worldwide, but it can be prevented by salt iodization. This cross-sectional survey assessed current iodine status, iodized salt coverage and risk factors for goitre among schoolchildren in South Tajikistan. Methods Ten primary schools in four districts in South Tajikistan were randomly selected. In schoolchildren aged 7 to 11 years, a spot urine sample was collected for measurement of urinary iodine, dried blood spots were collected for measurement of thyroglobulin, and goitre was assessed by palpation. Iodine content of salt samples and local selling points was determined by coloration using rapid test kits and titration method. Results Of 623 schoolchildren enrolled, complete data was obtained from 589. The overall median urinary iodine concentration (UIC) was 51.2 μg/L indicating mild-to-moderate iodine deficiency. Among all children, 46.6% (95% Confidence Interval (CI) = 42.4%-50.6%) of children were found to be goitrous (grade 1 goitre: 30.6%, 95% CI = 26.9%-34.5%; grade 2 goitre: 16.0%, 95% CI = 13.1%-19.2%). The risk factor for goitre remaining significant in the multivariable logistic regression model was 'buying salt once a month’ (OR = 2.89, 95% CI = 1.01-8.22) and 'buying salt once every six months’ (OR = 2.26, 95% CI = 1.01-5.04) compared to 'buying salt every one or two weeks’. The overall median thyroglobulin concentration was elevated at 13.9 μg/L. Of the salt samples from households and selling points, one third were adequately iodised, one third insufficiently and one third were not iodised. Conclusion Iodine deficiency remains a serious health issue among children in southern Tajikistan. There is a persisting high prevalence of goitre, elevated thyroglobulin and low UIC despite interventions implemented by Tajikistan and international partners. Quality control of salt iodine content needs to be improved. Continued efforts to raise awareness of the

Radioiodine therapy in non toxic multi nodular goitre, preliminary results

International Nuclear Information System (INIS)

Chiti, A.; Travaini, L.L.; Tadayyon, S.; Vannucchi, G.; Fugazzola, L.; Beck-Peccoz, P.

2002-01-01

Aim: Aim of our study was to assess the efficacy of 131 I therapy in patients (pts) affected by non toxic multinodular goitre (NTMG). NTMG is a thyroid disease with a high prevalence, especially in low-iodine intake regions. Treatment of NTMG often requires surgery. However, thyroidectomy may be risky in some patients and radioiodine therapy could be an alternative treatment to reduce thyroid volume. We also evaluated if lithium administration can improve the efficacy of radioiodine treatment in this pts. Material and Methods: We enrolled 39 pts (8 males, 31 females; mean age 59 y, range 40-79 y) affected by NTMG. Mean thyroid volume (TV) at ultrasound was of 46.8 ml (range 18.5-87.3). Pts were randomised in 2 groups. Group 1: iodine therapy + lithium therapy 900 mg/die for 6 days; Group 2: iodine therapy alone. We also define 3 clusters of pts by TV. A:15-30 ml; B:31-40 ml; C: > 40 ml. The 131 I activity (MBq) was calculated as follows: [4.44 (MBq) x 100/24 hours uptake (%)] x TV. All patients are evaluated for thyroid function and TV at 3, 6, 12, 18 and 24 months after treatment, since we postulate that major reduction in thyroid volume will occur 1 year after 131 I therapy. Results: Up to now 16 pts were treated with 131 I (mean activity: 512 MBq) and no side effects from 131 I and lithium therapy were reported. Four out of 5 pts evaluated at 3 months (2 of group 1 and 3 of group 2) had a reduction in TV (mean value: 8.8 ml). Five out of 10 pts had sub-clinical hyperthyroidism at 1 week, likely as a consequence of thyroid tissue destruction. Conclusion: Our preliminary results suggest the safety and effectiveness of 131 I treatment in NTMG. We expect to clarify the role of lithium administration in improving 131 I efficacy. This therapy could have a future role in patients with NTMG that can't be submitted to surgery

Activating thyrotropin receptor mutations in histologically heterogeneous hyperfunctioning nodules of multinodular goiter.

Science.gov (United States)

Tonacchera, M; Vitti, P; Agretti, P; Giulianetti, B; Mazzi, B; Cavaliere, R; Ceccarini, G; Fiore, E; Viacava, P; Naccarato, A; Pinchera, A; Chiovato, L

1998-07-01

Activating thyrotropin (TSH) receptor mutations have been found in toxic adenomas and in hot nodules contained in toxic multinodular goiter. The typical feature of multinodular goiter is the heterogeneity in morphology and function of different follicles within the same enlarged gland. In this report we describe a patient with a huge multinodular goiter, normal free triiodothyronine (FT3) and free thyroxine (FT4) serum values, and subnormal TSH serum concentration. Thyroid scintiscan showed two hot areas corresponding to the basal and apical nodules of the left lobe. The right lobe was poorly visualized by the radioisotope. The patient underwent thyroidectomy, and histological examination of the tissue was performed. Genomic DNA was extracted from the tissue specimen and direct sequencing of the TSH receptor and Gs alpha genes was done. At histology, one hyperfunctioning nodule had the typical microscopic structure of thyroid adenomas, and the other contained multiple macrofollicular areas not confined by a capsule. In spite of this histological difference, both hyperfunctioning nodules harbored a mutation of the thyrotropin receptor (TSHr) gene: an isoleucine instead of a threonine in position 632 (T632I) in the first nodule and a methionine instead of an isoleucine in position 486 (I486M) in the second nodule. In conclusion, our findings show for the first time that gain-of-function TSHr mutations are not only present in hyperfunctioning thyroid nodules with the histological features of the true thyroid adenomas, but also in hyperfunctioning hyperplastic nodules contained in the same multinodular goiter.

Euthyroid goitre with and without functional autonomy: A comparison

International Nuclear Information System (INIS)

Hillenhinrichs, H.; Emrich, D.

1998-01-01

Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99m Tc thyroid uptake of ≥3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [de

Hyperthyroidism

OpenAIRE

Sharma, Mala; Aronow, Wilbert S.; Patel, Laxesh; Gandhi, Kaushang; Desai, Harit

2011-01-01

Summary Hyperthyroidism is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormone. The most common cause of this syndrome is Graves? disease, followed by toxic multinodular goitre, and solitary hyperfunctioning nodules. Autoimmune postpartum and subacute thyroiditis, tumors that secrete thyrotropin, and drug-induced thyroid dysfunction, are also important causes.

Hyperthyroidism (primary)

DEFF Research Database (Denmark)

Nygaard, Birte

2010-01-01

Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism. ME...... Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA)....

Goitre-Related Factors for Predicting Difficult Intubation in Patients ...

African Journals Online (AJOL)

2018-03-01

Mar 1, 2018 ... canula on the forearm or dorsum of the hand. The anaesthesia workstation was checked to be functional while various sizes of cuffed endotracheal tubes, and .... goitres distorted airway anatomy such that only the epiglottis is seen even with maximal external laryngeal manipulation. In such situations, a.

Hyperthyroidism (primary)

OpenAIRE

Nygaard, Birte

2010-01-01

Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone (TSH). Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma.About 20 times more women than men have hyperthyroidism.

Colchicum autumnale in Patients with Goitre with Euthyroidism or Mild Hyperthyroidism: Indications for a Therapeutic Regulative Effect?Results of an Observational Study

OpenAIRE

Scheffer, Christian; Debus, Marion; Heckmann, Christian; Cysarz, Dirk; Girke, Matthias

2016-01-01

Introduction. Goitre with euthyroid function or with subclinical or mild hyperthyroidism due to thyroid autonomy is common. In anthroposophic medicine various thyroid disorders are treated with Colchicum autumnale (CAU). We examined the effects of CAU in patients with goitre of both functional states. Patients and methods. In an observational study, 24 patients with goitre having suppressed thyroid stimulating hormone (TSH) levels with normal or slightly elevated free thyroxine (fT4) and free...

Familial tendency and dietary association of goitre in Gamo-Gofa ...

African Journals Online (AJOL)

Objective: To assess the familial tendency and dietary association of goitre. Design: Ciaectional study with descripEve and analytical components. Setting: Goma-Gofa, south Ethiopia. Subjects: Five hundred and ninety seven elementary school children aged 6-18 years and their biological parents. Results: Prevalence of ...

The goitre rate, its association with reproductive failure, and the knowledge of iodine deficiency disorders (IDD among women in Ethiopia: Cross-section community based study

Directory of Open Access Journals (Sweden)

Berhane Yemane

2007-11-01

Full Text Available Abstract Background Iodine deficiency is severe public health problem in Ethiopia. Although urinary iodine excretion level (UIE is a better indicator for IDD the goitre rate is commonly used to mark the public health significance. The range of ill effect of IDD is however beyond goitre in Ethiopia. In this study the prevalence of goitre and its association with reproductive failure, and the knowledge of women on Iodine Deficiency were investigated. Methods A cross-section community based study was conducted during February to May 2005 in 10998 women in child bearing age of 15 to 49 years. To assess the state of iodine deficiency in Ethiopia, a multistage "Proportional to Population Size" (PPS sampling methods was used, and WHO/UNICEF/ICCIDD recommended method for goitre classification. Results Total goitre prevalence (weighted was 35.8% (95% CI 34.5–37.1, 24.3% palpable and 11.5% visible goitre. This demonstrates that more than 6 million women were affected by goitre. Goitre prevalence in four regional states namely Southern Nation Nationalities and People (SNNP, Oromia, Bebshandul-Gumuz and Tigray was greater than 30%, an indication of severe iodine deficiency. In the rest of the regions except Gambella, the IDD situation was mild to moderate. According to WHO/UNICEF/ICCIDD this is a lucid indication that IDD is a major public health problem in Ethiopia. Women with goitre experience more pregnancy failure (X2 = 16.5, p 2 = 67.52; p Conclusion Ethiopia is at risk of iodine deficiency disorders. The findings presented in this report emphasis on a sustainable iodine intervention program targeted at population particularly reproductive age women. Nutrition education along with Universal Salt Iodization program and iodized oil capsule distribution in some peripheries where iodine deficiency is severe is urgently required.

Management of multinodular goiter in Germany (Papillon 2005). Do the approaches of thyroid specialists and primary care practitioners differ?

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Dietlein, M.; Schmidt, M.; Schicha, H. [Koeln Univ. (Germany). Dept. of Nuclear Medicine; Wegscheider, K. [Hamburg Univ. (Germany). Inst. of Statistics and Econometrics; Vaupel, R. [Sanofi-Aventis Deutschland GmbH, Berlin (Germany)

2007-07-01

Aim: Large-scale survey to focus on management of multinodular goiter and to compare the approaches of practitioners in primary care and thyroid specialists in Germany. Methods: Replies to a questionnaire were received from 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The hypothetical cases and their modifications described multinodular goiters of different sizes with and without toxic nodules. Results: In the workup, TSH determination and thyroid sonography were found to be standard procedures. Scintigraphy was selected by 80.2% of practitioners and 92.9% of specialists (p <0.001), in preference to fine needle aspiration cytology (17.9% of practitioners and 34.5% of the specialists, p <0.001). Only 6.1% of practitioners and 24.4% of specialists (p <0.001) advocated calcitonin screening. Euthyroid multinodular goiter (50-80 ml) was treated medically by 67.1% of practitioners and 65.6% of specialists, the combination of levothyroxine with iodine being clearly preferred (54.5% of practitioners, 52.3% of specialists). For toxic nodular goiter the preference for radioiodine therapy was significantly higher (p <0.001) among specialists (67.7%) than among practitioners (47.5%). Referral to surgery was recommended for cold nodules with negative cytology by 64.9% of practitioners and 73.5% of specialists (p = 0.004). Conclusions: Treatment and diagnostic procedures are used to nearly the same extent in primary care and specialist institutions, but the opinions diverge over the issues of calcitonin screening and referral for radioiodine therapy. (orig.)

Management of multinodular goiter in Germany (Papillon 2005). Do the approaches of thyroid specialists and primary care practitioners differ?

International Nuclear Information System (INIS)

Dietlein, M.; Schmidt, M.; Schicha, H.

2007-01-01

Aim: Large-scale survey to focus on management of multinodular goiter and to compare the approaches of practitioners in primary care and thyroid specialists in Germany. Methods: Replies to a questionnaire were received from 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The hypothetical cases and their modifications described multinodular goiters of different sizes with and without toxic nodules. Results: In the workup, TSH determination and thyroid sonography were found to be standard procedures. Scintigraphy was selected by 80.2% of practitioners and 92.9% of specialists (p <0.001), in preference to fine needle aspiration cytology (17.9% of practitioners and 34.5% of the specialists, p <0.001). Only 6.1% of practitioners and 24.4% of specialists (p <0.001) advocated calcitonin screening. Euthyroid multinodular goiter (50-80 ml) was treated medically by 67.1% of practitioners and 65.6% of specialists, the combination of levothyroxine with iodine being clearly preferred (54.5% of practitioners, 52.3% of specialists). For toxic nodular goiter the preference for radioiodine therapy was significantly higher (p <0.001) among specialists (67.7%) than among practitioners (47.5%). Referral to surgery was recommended for cold nodules with negative cytology by 64.9% of practitioners and 73.5% of specialists (p 0.004). Conclusions: Treatment and diagnostic procedures are used to nearly the same extent in primary care and specialist institutions, but the opinions diverge over the issues of calcitonin screening and referral for radioiodine therapy. (orig.)

Spectrum of goitrous lesions in patients at a tertiary care center of Sikkim

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Subhabrata Sengupta

2014-01-01

Full Text Available Background: Sikkim is declared as a goitre endemic state with an estimated prevalence of 54%. The spectrums of diseases include simple goitre, thyroiditis, adenoma, carcinoma, multinodular goitre and Graves′ disease. The present study aims to determine the pattern of thyroid swelling in a hospital setup at Sikkim. Materials and Methods: This study is a retrospective analysis of records of all patients presenting with thyroid swelling in a tertiary care hospital at Gangtok, Sikkim during the period of 4 years between 1 st January 2008 and 31 st December 2011. Patients were diagnosed by clinical examination, FNAC, USG, CT scan and hormone estimation. Histopatholgical confirmation was done in surgical cases. Clinic opathological and demographic data of 166 such patients were obtained and analyzed for the present study. Results: The most common goitrous disease was simple goitre (69.27% followed by thyroiditis (10.24%, toxic goitre (7.83% and malignancy (12.65%. Papillary variant was the commonest carcinoma. Overall female:male ratio was 4.9:1. The prevalence goitrous lesion was highest in the middle age group between 30-39 years, while the extremes of age (below 10 years and above 70 years were rarely involved. Conclusions: The prevalence of goitre in Sikkim is still very high despite iodisation programs by the Government. There is urgent need for more data on autoimmunity and goitrogens status to explain the high prevalence of goitre in this population.

Iodine deficiency and endemic goitre in the Langkloof area of South ...

African Journals Online (AJOL)

available at the local grocery stores but only small percentages of households ..... dietary factor or factors, did, however, improve the situation in this area during the .... guarantee success in eradicating iodine deficiency and endemic goitre. ... lB, ads. The Prevenrion and Control of lod;ne Deficiency Disorders. Amsterdam: ...

The Role Of Changing Diet And Altitude On Goitre Prevalence In ...

African Journals Online (AJOL)

Conclusion: Besides low level of iodine intake, cassava consumption and living in high altitude were responsible for the observed variation and severity in goitre rates. IDD affects several dimensions of human life including school enrolment and marriage. Addressing IDD in-terms of salt iodization and training communities ...

Thyroid Hemiagenesis Associated with Hyperthyroidism

OpenAIRE

Gurleyik, Gunay; Gurleyik, Emin

2015-01-01

Thyroid hemiagenesis (TH), very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism. Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot no...

Aetiology of hyperthyroidism in Canada and Wales.

OpenAIRE

Williams, I; Ankrett, V O; Lazarus, J H; Volpe, R

1983-01-01

A retrospective, comparative review of 100 consecutive new outpatients presenting with hyperthyroidism in Cardiff, South Wales, and in Toronto, Canada, was performed. The aim was to quantify the causes of hyperthyroidism with particular emphasis on the prevalence of viral thyroiditis and "silent" thyroiditis. The proportional morbidity of Graves' disease (approximately 70%) was similar in the two groups. Toxic multinodular goitre and toxic adenoma (Plummers' disease) occurred significantly mo...

Geographical distribution of drinking-water with high iodine level and association between high iodine level in drinking-water and goitre: a Chinese national investigation.

Science.gov (United States)

Shen, Hongmei; Liu, Shoujun; Sun, Dianjun; Zhang, Shubin; Su, Xiaohui; Shen, Yanfeng; Han, Hepeng

2011-07-01

Excessive iodine intake can cause thyroid function disorders as can be caused by iodine deficiency. There are many people residing in areas with high iodine levels in drinking-water in China. The main aim of the present study was to map the geographical distribution of drinking-water with high iodine level in China and to determine the relationship between high iodine level in drinking-water and goitre prevalence. Iodine in drinking-water was measured in 1978 towns of eleven provinces in China, with a total of 28,857 water samples. We randomly selected children of 8-10 years old, examined the presence of goitre and measured their urinary iodine in 299 towns of nine provinces. Of the 1978 towns studied, 488 had iodine levels between 150 and 300 μg/l in drinking-water, and in 246 towns, the iodine level was >300 μg/l. These towns are mainly distributed along the original Yellow River flood areas, the second largest river in China. Of the 56 751 children examined, goitre prevalence was 6.3 % in the areas with drinking-water iodine levels of 150-300 μg/l and 11.0 % in the areas with drinking-water iodine >300 μg/l. Goitre prevalence increased with water and urinary iodine levels. For children with urinary iodine >1500 μg/l, goitre prevalence was 3.69 times higher than that for those with urinary iodine levels of 100-199 μg/l. The present study suggests that drinking-water with high iodine levels is distributed in eleven provinces of China. Goitre becomes more prevalent with the increase in iodine level in drinking-water. Therefore, it becomes important to prevent goitre through stopping the provision of iodised salt and providing normal drinking-water iodine through pipelines in these areas in China.

Thyroid Hemiagenesis Associated with Hyperthyroidism

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Gunay Gurleyik

2015-01-01

Full Text Available Thyroid hemiagenesis (TH, very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism. Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot nodules in the right one. The diagnosis was toxic multinodular goitre. Case Two. The thyroid was not palpable in this patient presented with signs and symptoms of thyrotoxicosis. Biochemical analysis revealed the diagnosis of autoimmune thyrotoxicosis. Ultrasound showed mild diffuse hyperplasia of the right lobe and agenesis of the left lobe. Nuclear scan, confirming absence of the left lobe, showed increasing diffuse uptake of radiotracer in the right one. The diagnosis was Graves’ disease in this patient. After antithyroid medication, the patients were surgically treated with total excision of the thyroid tissue. TH is sometimes associated with disorders of the thyroid. Hyperthyroidism makes TH cases symptomatic. During evaluation of patients, ultrasound and nuclear scan usually report agenesis of one lobe and establish the diagnosis of TH. The surgical treatment is total removal of hyperactive tissue and total excision of the remaining lobe.

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

Science.gov (United States)

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

1997-01-01

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.

Colchicum autumnale in Patients with Goitre with Euthyroidism or Mild Hyperthyroidism: Indications for a Therapeutic Regulative Effect-Results of an Observational Study.

Science.gov (United States)

Scheffer, Christian; Debus, Marion; Heckmann, Christian; Cysarz, Dirk; Girke, Matthias

2016-01-01

Introduction. Goitre with euthyroid function or with subclinical or mild hyperthyroidism due to thyroid autonomy is common. In anthroposophic medicine various thyroid disorders are treated with Colchicum autumnale (CAU). We examined the effects of CAU in patients with goitre of both functional states. Patients and methods. In an observational study, 24 patients with goitre having suppressed thyroid stimulating hormone (TSH) levels with normal or slightly elevated free thyroxine (fT4) and free triiodothyronine (fT3) (group 1, n = 12) or normal TSH, fT3, and fT4 (group 2, n = 12) were included. After 3 months and after 6 to 12 months of CAU treatment, we investigated clinical pathology using the Hyperthyroid Symptom Scale (HSS), hormone status (TSH, fT4, and fT3), and thyroidal volume (tV). Results. After treatment with CAU, in group 1 the median HSS decreased from 4.5 (2.3-11.8) to 2 (1.3-3) (p hyperthyroidism and thyroidal volume in patients with euthyroid goitre by normalization of the regulation of thyroidal hormones.

Colchicum autumnale in Patients with Goitre with Euthyroidism or Mild Hyperthyroidism: Indications for a Therapeutic Regulative Effect—Results of an Observational Study

Science.gov (United States)

Scheffer, Christian; Debus, Marion; Heckmann, Christian; Cysarz, Dirk; Girke, Matthias

2016-01-01

Introduction. Goitre with euthyroid function or with subclinical or mild hyperthyroidism due to thyroid autonomy is common. In anthroposophic medicine various thyroid disorders are treated with Colchicum autumnale (CAU). We examined the effects of CAU in patients with goitre of both functional states. Patients and methods. In an observational study, 24 patients with goitre having suppressed thyroid stimulating hormone (TSH) levels with normal or slightly elevated free thyroxine (fT4) and free triiodothyronine (fT3) (group 1, n = 12) or normal TSH, fT3, and fT4 (group 2, n = 12) were included. After 3 months and after 6 to 12 months of CAU treatment, we investigated clinical pathology using the Hyperthyroid Symptom Scale (HSS), hormone status (TSH, fT4, and fT3), and thyroidal volume (tV). Results. After treatment with CAU, in group 1 the median HSS decreased from 4.5 (2.3–11.8) to 2 (1.3–3) (p hyperthyroidism and thyroidal volume in patients with euthyroid goitre by normalization of the regulation of thyroidal hormones. PMID:26955394

Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre.

Science.gov (United States)

Bové, Kira Bang; Watt, Torquil; Vogel, Asmus; Hegedüs, Laszlo; Bjoerner, Jakob Bue; Groenvold, Mogens; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla

2014-09-01

Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease. 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable 'anxiety'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression. In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms. Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.

Activating thyrotropin receptor mutations are present in nonadenomatous hyperfunctioning nodules of toxic or autonomous multinodular goiter.

Science.gov (United States)

Tonacchera, M; Agretti, P; Chiovato, L; Rosellini, V; Ceccarini, G; Perri, A; Viacava, P; Naccarato, A G; Miccoli, P; Pinchera, A; Vitti, P

2000-06-01

Toxic multinodular goiter, a heterogeneous disease producing hyperthyroidism, is frequently found in iodine-deficient areas. The pathogenesis of this common clinical entity is still unclear. The aim of the present study was to search for activating TSH receptor (TSHr) or Gs alpha mutations in areas of toxic or functionally autonomous multinodular goiters that appeared hyperfunctioning at thyroid scintiscan but did not clearly correspond to definite nodules at physical or ultrasonographic examination. Surgical tissue specimens from nine patients were carefully dissected, matching thyroid scintiscan and thyroid ultrasonography, to isolate hyperfunctioning and nonfunctioning areas even if they did not correspond to well-defined nodules. TSHr and Gs alpha mutations were searched for by direct sequencing after PCR amplification of genomic DNA. Only 2 adenomas were identified at microscopic examination, whereas the remaining 18 hyperfunctioning areas corresponded to hyperplastic nodules containing multiple aggregates of micromacrofollicules not surrounded by a capsule. Activating TSHr mutations were detected in 14 of these 20 hyperfunctioning areas, whereas no mutation was identified in nonfunctioning nodules or areas contained in the same gland. No Gs alpha mutation was found. In conclusion, activating TSHr mutations are present in the majority of nonadenomatous hyperfunctioning nodules scattered throughout the gland in patients with toxic or functionally autonomous multinodular goiter.

Standard dose 131I therapy for toxic multinodular goiter in an endemic goiter region

International Nuclear Information System (INIS)

Goncalves, E.; Castro, J.A.S.; Gross, J.L.

1986-01-01

The effect of the standard 15 mCi dose of 131 I on the thyroid function of 25 patients from an endemic goiter region with toxic multinodular goiter of different sizes was determined. The patients were followed for 1 to 5 years and 7 months (mean: 2 years and 10 months). Eighteen patients were treated with the antithyroid drugs propylthiouracil or methimazole before 131 I and seven only received 131 I. All but three patients achieved euthyroidism after a single dose of 131 I. Two patients in the antithyroid treatment group became hypothyroid 2 months and 2 years after the isotope therapy, respectively. Pretreatment with antithyroid drugs did not significantly modify the effectiveness of 131 I treatment. This simplified dose regimen of 131 I was effective in the treatment of hyperthyroidism caused by multinodular goiter in an endemic region, and the efficacy was independent of the size of the goiter. (author)

Nuclear thyroid hormone receptor binding in human mononuclear blood cells after goitre resection

DEFF Research Database (Denmark)

Kvetny, J; Matzen, L E; Blichert-Toft, M

1989-01-01

Nuclear thyroxine and triiodothyronine receptor-binding in human mononuclear blood cells were examined in 14 euthyroid persons prior to and 1, 6, 24 and 53 weeks after goitre resection. One week after resection decreased serum T3 from 1.47 nmol/l to 1.14 nmol/l (P less than 0.05), FT4I from 103 a...

Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism

Directory of Open Access Journals (Sweden)

Duygu Yazgan Aksoy

2013-01-01

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.

Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism.

Science.gov (United States)

Aksoy, Duygu Yazgan; Gedik, Arzu; Cinar, Nese; Soylemezoglu, Figen; Berker, Mustafa; Gurlek, Omer Alper

2013-11-01

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.

A contribution to radioactive iodine therapy of the euthyroid goitre

International Nuclear Information System (INIS)

Langenbruch, K.; Rische, D.

1982-01-01

It is shown that radioactive iodine therapy is an alternative method in the treatment even of large goitres provided this method of treatment is confined to patients beyond the age of 40. If the patient is generally inoperable, this is in fact the method of choice. The success rate can be compared with that of other methods of treatment. In this connection, special attention is drawn to the high rate of alleviation of complaints. No significant sinde effects are seen; in a few cases only, treatment will have to be repeated. (orig.) [de

Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

DEFF Research Database (Denmark)

Bové, Kira Bang; Watt, Torquil; Vogel, Asmus

2014-01-01

BACKGROUND AND OBJECTIVE: Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves......' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression.RESULTS: In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves...

Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey

International Nuclear Information System (INIS)

Erdogan, G.; Erdogan, M.F.; Delange, F.; Sav, H.; Guellue, S.; Kamel, N.

2000-01-01

Endemic goitre is still an important and underestimated health concern in Turkey. The overall prevalence had been calculated as 30.3% by palpation in a national survey conducted in 1995. However, direct evidence that iodine deficiency (ID) is the major cause of the endemic were lacking until now. We measured sonographic thyroid volumes (STV), urinary iodine concentrations (UIC) in 1226 school age children (SAC) (9-11 year old) from Ankara the capital of Turkey located in the central Anatolia, and three highly endemic goitre areas of the Black Sea region. A considerable number of school age children (SAC) were found to have STV exceeding the recommended upper normal limits for their age and gender obtained from iodine-replete European children (i.e. 26.7, 40.3, 44.8 and 51.7% of children from Ankara, Kastamonu, Bayburt and Trabzon respectively). UIC indicated moderate to severe ID in these areas with median concentrations of 25.5, 30.5, 16.0 and 14 μg/L respectively. This study showed severe to moderate ID as the primary etiological factor for the goitre endemic observed in Ankara and the Black Sea region of Turkey

Small cell lung cancer with metastasis to the thyroid in a patient with toxic multinodular goiter.

Science.gov (United States)

Ozgu, Eylem Sercan; Gen, Ramazan; Ilvan, Ahmet; Ozge, Cengiz; Polat, Ayşe; Vayisoglu, Yusuf

2012-11-01

Thyroid metastasis of lung cancer is rarely observed in clinical practice. The primary cancers which metastasize to the thyroid gland are mostly renal cell carcinoma, lung cancer, and breast cancer. Transient destructive thyrotoxicosis is caused by massive metastasis of extrathyroid tumors. We herein present a case report of a patient with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. A 66-year-old man complained of swelling around the right side of the neck, dyspnea, progressive weight loss, and palpitation starting since 3 months before his admission. The patient was diagnosed with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. The case report presented here illustrates the challenge of making a definitive and adequate diagnosis, particularly if the patient presents with 2 potential causes of thyrotoxicosis. Thyroid scintigraphy is an important tool for differential diagnosis of thyrotoxicosis.

Colchicum autumnale in Patients with Goitre with Euthyroidism or Mild Hyperthyroidism: Indications for a Therapeutic Regulative Effect—Results of an Observational Study

Directory of Open Access Journals (Sweden)

Christian Scheffer

2016-01-01

Full Text Available Introduction. Goitre with euthyroid function or with subclinical or mild hyperthyroidism due to thyroid autonomy is common. In anthroposophic medicine various thyroid disorders are treated with Colchicum autumnale (CAU. We examined the effects of CAU in patients with goitre of both functional states. Patients and methods. In an observational study, 24 patients with goitre having suppressed thyroid stimulating hormone (TSH levels with normal or slightly elevated free thyroxine (fT4 and free triiodothyronine (fT3 (group 1, n=12 or normal TSH, fT3, and fT4 (group 2, n=12 were included. After 3 months and after 6 to 12 months of CAU treatment, we investigated clinical pathology using the Hyperthyroid Symptom Scale (HSS, hormone status (TSH, fT4, and fT3, and thyroidal volume (tV. Results. After treatment with CAU, in group 1 the median HSS decreased from 4.5 (2.3–11.8 to 2 (1.3–3 (p<0.01 and fT3 decreased from 3.85 (3.5–4.78 to 3.45 (3.3–3.78 pg/mL (p<0.05. In group 2 tV (13.9% (18.5%–6.1% and TSH (p<0.01 were reduced. Linear regression for TSH and fT3 in both groups indicated a regulative therapeutic effect of CAU. Conclusions. CAU positively changed the clinical pathology of subclinical hyperthyroidism and thyroidal volume in patients with euthyroid goitre by normalization of the regulation of thyroidal hormones.

Isotopes in Shangri-la

International Nuclear Information System (INIS)

1965-01-01

In a remote valley of the Andes, snow-bound for half the year, a small community of Pewenche Indians lives in almost complete isolation. Among these people there is a high degree of consanguinity, and most of them suffer from endemic goitre. These conditions offered an opportunity of studying the part played by congenital defects in the prevalence of the disease. With the support of IAEA, an expedition was sent to the place in November 1963 to study goitre with the help of radioisotopes.With these subjects we used - in accordance with various clearly defined research methods - radioactive tracers in the form of inorganic or organic iodine molecules, like thyroxine, tri-iodothyronine or di-iodotyrosine, labelled with iodine-131 or iodine-125. Repeated measurements were made either in vivo or on plasma or urine samples. The latter, combined with micro-measurements of stable iodine (iodine-127), made it possible to calculate various metabolic aspects of the iodine cycle and of thyroid hormone pre duct ion in these patients. A quantitative study of iodine metabolism was carried out on 77 subjects by observing the evolution of specific activities of circulating organic iodine before and after isotopic equilibrium or after stimulation by exogenous thyrotropic hormone. In some cases the thyroid seemed to function in a homogeneous manner while other patients showed a clear functional heterogeneity of the thyroid. While the adaptation of the thyroid gland seemed satisfactory in the cases of diffused goitre, it seemed incomplete in multinodular goitres

Spectrum of thyroid lesions in hospital Universiti Sains Malaysia over 11years and a review of thyroid cancers in Malaysia.

Science.gov (United States)

Othman, Nor Hayati; Omar, Effat; Naing, Nyi Nyi

2009-01-01

Endemic goitre is a major concern in many nations including Malaysia. Seven states in the country have been identified by Ministry of Health of Malaysia to have high incidence of goitre and one of these is Kelantan. This is a retrospective study over an 11-year period from 1994 to 2004 on all thyroid specimens submitted to the Pathology Department, Hospital Universiti Sains Malaysia (HUSM), in Kelantan. Epidemiological data were retrieved from the patients' records and pathology findings from the pathology reports. During this period, Department of Pathology HUSM received a total of 1,486 thyroid specimens. The female to male ratio was 6:1 and the median age was 40.0 years. The duration of goitre ranged from one to 15 years. Histopathological examination showed 71.9 percent were non-neoplastic and 28.1 percent neoplastic lesions. The hospital-based incidence of nodular hyperplasia was 9.9 per 100,000 admitted patients per year. The hospital-based incidence of all types of malignant thyroid cancers was 3.5 per 100,000. The most common malignancy was papillary carcinoma 76.6 percent. The majority of the cancers (59.5 percent) occurred in a background of nodular hyperplasia. Thyroid cancers made up 4.9 percent of all cancers seen in HUSM. This study suggests that malignant thyroid lesions arising from multi-nodular goitre are high in a population living in an iodine-deficiency area.

Thyroid stimulating immunoglobulins in Graves' disease with goitre growth, low thyroxine and increasing triiodothyronine during PTU treatment

DEFF Research Database (Denmark)

Hegedüs, Laszlo; Hansen, J M; Bech, K

1984-01-01

In 50 consecutive patients with Graves' disease treated with PTU, 7 (group 1) developed increasing goitre in spite of unmeasurable TSH. Thyroid variables were compared with those from 10 controls with an ordinary response to PTU (group 2). Serum T4 decreased in group 1 from 246 +/- 47 nmol/l (mea...

Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves' disease

International Nuclear Information System (INIS)

Dederichs, B.; Otte, R.; Klink, J.E.; Schicha, H.

1996-01-01

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 [de

[Isolated thyroid gland sarcoidosis and hyperthyroidism].

Science.gov (United States)

Langsteger, W; Lind, P; Beham, A; Költringer, P; Eber, O

1989-04-29

A case of isolated sarcoidosis of the thyroid gland, associated with hyperthyroidism, is reported in a 28-year-old male patient whose thyroid was removed for hyperthyroid multinodular goitre. Histology revealed a regressive adenoma and sarcoidosis in non-adenomatous thyroid residue. Further diagnosis, therapeutic management and a 3-year follow-up did not disclose any specific changes or involvement of other tissues. Isolated thyroidal sarcoidosis with hyperthyroid alterations are extremely rare and mostly chance findings; simultaneous occurrence of thyroid sarcoidosis and hyperthyroidism may be a symptom of gland infiltration for which an adequate explanation is still lacking.

The place of radioactive iodine in the treatment of hyperthyroidism

International Nuclear Information System (INIS)

Hennemann, G.; Krenning, E.P.; Erasmus Univ., Rotterdam; Sankaranaranayan, K.

1986-01-01

The effect of treatment of thyrotoxicosis with drugs, radioactive iodine, or surgery in different age groups is reviewed. In Graves' disease and toxic multinodular goitre the remission rate is about 40-50% after antithyroid drugs, but these drugs have little effect in toxic adenoma. Hypothyroidism developed in 35-49% of patients who had had thyroidectomy, and the risks of operation are high. The risk of malignant disease and genetic abnormalities was statistically not significantly greater after treatment with radioactive iodine in any age group. In general, treatment with radioactive iodine should have priority over thyroidectomy at all ages. (Auth.)

Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New "Leave Me Alone" Lesion with a Characteristic Imaging Pattern.

Science.gov (United States)

Nunes, R H; Hsu, C C; da Rocha, A J; do Amaral, L L F; Godoy, L F S; Watkins, T W; Marussi, V H; Warmuth-Metz, M; Alves, H C; Goncalves, F G; Kleinschmidt-DeMasters, B K; Osborn, A G

2017-10-01

Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. We report 33 cases of presumed multinodular and vacuolating neuronal tumor of the cerebrum that exhibit a remarkably similar pattern of imaging findings consisting of a subcortical cluster of nodular lesions located on the inner surface of an otherwise normal-appearing cortex, principally within the deep cortical ribbon and superficial subcortical white matter, which is hyperintense on FLAIR. Only 4 of our cases are biopsy-proven because most were asymptomatic and incidentally discovered. The remaining were followed for a minimum of 24 months (mean, 3 years) without interval change. We demonstrate that these are benign, nonaggressive lesions that do not require biopsy in asymptomatic patients and behave more like a malformative process than a true neoplasm. © 2017 by American Journal of Neuroradiology.

Diagnosing diseases of the thyroid gland by means of scintiscanning and puncture cytology taking into consideration the nodular goitre

International Nuclear Information System (INIS)

Eitel, M.

1981-01-01

This paper contains the results of scintigraphical and puncture-cytological examinations carried out during an observation period of appr. 3 years on 548 patients with goiters from the Upper-Bavarien endemis region. In total, we had 484 thyroid gland scintigrams which showed 335 uninodular, 71 multinodular, and 78 diffuse goiters. The 335 solitary nodular goiters were allocated 278 cold, 36 warm, and 18 hot nodes; in three cases, the scintigram could not be assessed due to exogenous iodine contamination. In the 71 multinodular goiters, we found 118 cold, 28 warm, and 9 hot nodes. Cytological findings were established in 548 patients. In 484 cases, the findings were negative, in 19 cases suspicious, and in 17 cases positive. The efficiency of cytological diagnosis of malignant tumours can be stated to be 87.5%. The rate of falsely negative smears was 12.5%; cytologically, in 10.9% of the preparations falsely suspicious diagnoses were established, and in 1.6% the diagnoses were falsely positive. (orig./MG) [de

Non-hyperfunctioning nodules from multinodular goiters: a minor role in pathogenesis for somatic activating mutations in the TSH-receptor and Gsalpha subunit genes.

Science.gov (United States)

Derrien, C; Sonnet, E; Gicquel, I; Le Gall, J Y; Poirier, J Y; David, V; Maugendre, D

2001-05-01

Constitutive activation of the cAMP pathway stimulates thyrocyte proliferation. Gain-of-function mutations in Gsalpha protein have already been identified in thyroid nodules which have lost the ability to trap iodine. In contrast, most of the studies failed to detect somatic activating mutations in the thyrotropin receptor (TSH-R) in non-hyperfunctioning thyroid tumors. The aim of this study was to screen for mutations TSH-R exon 10, encoding the whole intracytoplasmic area involved in signal transduction, and Gsalpha exons 8 and 9, containing the two hot-spot codons 201 and 227, in a subset of non-hyperfunctioning nodules from multinodular goiter. Identified by matching ultrasonography and scintiscan, 22 eufunctioning (normal 99Tc uptake) and 15 nonfunctioning (decreased 99Tc uptake) nodules from 27 non-toxic multinodular goiters were isolated. After DNA extraction, TSH-R exon 10 was analyzed by direct sequencing of the PCR products and Gsalpha exons 8 and 9 by Denaturing Gradient Gel Electrophoresis. No mutation of TSH-R or Gsalpha was detected in the 37 nodules analyzed. This absence of mutation, despite the use of two sensitive screening methods associated with the analysis of the TSH-R whole intracytoplasmic area and Gsalpha two hot-spot codons, suggests that TSH-R and Gsalpha play a minor role in the pathogenesis of non-toxic nodules from multinodular goiters.

Autonomy in euthyroid goitre: Precursor of non-immunogenic hyperthyroidism in an area of iodine deficiency

International Nuclear Information System (INIS)

Emrich, D.; Schicha, H.

1984-01-01

There is evidence that in an area of iodine deficiency NIM-HY exists to a considerable percentage, probably originating from euthyroid goitre with autonomy, especially if iodine intake is suddenly increased. Separation of IM-HY and NIM-HY is possible with a probability of 90% by clinical criteria and available laboratory investigations. This might be important not only from a pathophysiological point of view but also for diagnosis and selection of the kind of therapy. (orig.)

Global 99mTc-uptake in the differentiation between normal thyroid, goitre with euthyroidism, and thyroid autonomy in an area of iodine deficiency

International Nuclear Information System (INIS)

Kreisig, T.; Vaitl, C.; Kirsch, C.M.; Knesewitsch, P.; Pickardt, C.R.; Horn, K.; Bechtner, G.

1990-01-01

Global TcTU was determined in 568 patients without any specific thyroid drug intake - 54 with normal thyroid, 274 with goitre and euthyroidism and 240 with thyroid autonomy. 57 patients with autonomy and overt hyperthyroidism were the only group with TcTU values significantly higher than normals. Common to all groups was a large scatter of the TcTU values. In 332, the effects of individual iodine supply were studied by measuring the iodine concentration in spot urine samples. There was a significant inverse correlation between the TcTU values and the urinary iodine excretion in the groups of normal thyroids and of goitres with euthyroidism. In the group with autonomy an effect of iodine supply could only be seen in cases of greatly increased urinary iodine excretion, resulting in very low TcTU values. Out of 20 patients with autonomy and iodine contamination, only 4 showed overt hyperthyroidism. The large scatter of TcTU values in all groups may be explained by the persistent iodine deficiency as well as by the frequent exposure to unknown amounts of iodine in patients with thyroid disease. Therefore, the spontaneous TcTU alone cannot identify a small group of patients with autonomy and high risk of iodine-induced hyperthyroidism, from a very large group of patients with goitre. (orig.) [de

Endemic goitre and iodine metabolism in schoolchildren from the Daunia uplands (province of Foggia, Italy).

Science.gov (United States)

De Filippis, V; Cenderelli, G; Cocco, U; Di Cerbo, A; Lo Iudice, G; Costa, A

1978-04-01

A study of endemic goitre was carried out in the western part of the province of Foggia (Daunia's pre-Appennines). About 50% of a total of 2719 children aged 6-15 years examined in the agricultural and hill towns of Accadia, Bovino, Candela, Deliceto and Sant'Agata di Puglia (500 to 800 m above sea level), presented a thyroid enlargement (usually of Grade 1). Urinary creatinine values were normal, while urinary iodine was low: 37.7 +/- 28.39 mug/g creatinine (mean +/- SD for 319 subjects). Serum levels of thyroid hormones were normal: T4 = 7.89 +/- 2.61 mug/dl; T3 = 114.72 +/- 40 ng/dl; T3 (T4 X 100) = 0.166 +/- 0.09. Subjects with Grade 2 thyroid enlargement had significant lower urinary iodine and serum T4, and higher T3 and T3/T4 ratio than children without goitre (Grade 0). Serum thyrotropin was rather high (3.79 +/- 4.17 muU/ml), but bore no straight relation to the thyroid size; in subjects with Grade 2 thyroids there was an inverse relationship between plasma T4 and TSH levels. Drinking water iodine was generally low (2-3 mug/l), though some richer sources (18, 38, 66 mug/l) were noted. Iodine contents of locally produced foodstuffs were below those found in food on Turin markets.

Comparison of three competitive immunoassays for measurement of TSH receptor antibodies in patients with Graves' disease

DEFF Research Database (Denmark)

Doroudian, Sara; Pedersen, Inge Bülow; Knudsen, Cindy Soendersoe

2017-01-01

with three different assays [H-TRAb (BRAHMS Diagnostica), M22-Man (RSR Limited) and M22-Aut (Roche Diagnostics)] in 387 participants who were recruited from two Danish population-based studies and diagnosed with GD (n = 101), multinodular toxic goitre (n = 88), primary autoimmune hypothyroidism (n = 100...... revealed a high sensitivity (H-TRAb: 95%, M22-Man: 93%, M22-Aut: 95%) and specificity (H-TRAb: 99%, M22-Man: 99%, M22-Aut: 97%) for the diagnosis of GD with all assays. Comparison of TRAb levels showed inter-assay variability and values were considerably lower with the M22-Man assay. All TRAb assays showed...

Large Multinodular Toxic Goiter: Is Surgery Always Necessary?

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Roberto Negro

2016-01-01

Full Text Available Patients suffering from multinodular toxic goiter (MNTG are candidates to thyroidectomy or radioiodine 131I (131I therapy. Thyroidectomy may be preferable especially when the volume of hyperfunctioning tissue is so large that a single administration of 131I is unlikely to cure the patient in terms of nodule’s volume reduction and thyroid function. We describe the case of a 71-year-old man suffering from thyrotoxic state for the presence of two large hyperfunctioning thyroid nodules. As the patient refused surgery, at first we administered 600 MBq dose of 131I, which was unable to solve hyperthyroidism and local compressive symptoms. Then, before administering another 131I dose, the patient underwent a laser ablation treatment (LAT in both nodules. After a significant shrinkage due to LAT, the patient received 400 MBq 131I. This procedure was able to definitely cure hyperthyroidism, to induce a significant reduction of nodules’ volume, and to render the patient asymptomatic for compressive symptoms. This case demonstrates that 131I preceded by LAT represents a valid alternative strategy to surgery, even in the presence of two large coexistent hot nodules.

Asymptomatic multinodular splenoma (splenic hamartoma in a child with sickle cell anemia

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Elenga N

2017-07-01

Full Text Available Narcisse Elenga,1 Sylvain Labbé,2 Nicolas Leduc,2 Anicet Sika,1 Emma Cuadro,1 Laurence Long,1 Falucar Njuieyon,1 Rémi Kom-Tchameni,1 Thierry Basset1 1Department of Pediatrics and Pediatric Surgery, Pediatric Medicine and Surgery, 2Pathological Anatomy Department, Cayenne Hospital, Cayenne Cedex, French Guiana Abstract: Splenoma is a rare and benign malformation usually fortuitously diagnosed during imaging, surgery or, unfortunately, at autopsy. Although splenoma was first described in 1861, its association with hematological pathology is a very unusual condition in children. We report the case of an asymptomatic splenoma in an 8-year-old boy with sickle cell anemia, whose diagnosis was confirmed after conventional splenectomy. Keywords: multinodular splenoma, child, sickle cell anemia, conventional splenectomy

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

International Nuclear Information System (INIS)

Petrovski, Z.P.

2002-01-01

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

Late follow up results after J - 131 therapy of toxic multi-nodular goiter

International Nuclear Information System (INIS)

Petrovski, Z.

2015-01-01

Full text of publication follows. Objective: the aim of this study was to analyze success of radioiodine therapy in patients with toxic multi-nodular goiter (TMG). Methods: The group of 43 patients (36 females / 7 males, aged 47 ± 11 yrs, range 27 - 75 yrs) with TMG were treated with radioiodine. 28 patients were treated with one dose, 12 patients with two doses and 7 patients with three and more doses according to Marinelli's formula. The administered activity of J -131 was established basing on radioiodine uptake and goiter size ( median 555 MBq, range: 370 - 1100 MBq). Patients were evaluated by clinical and thyroid examination of TSH, FT4, FT3 after 1 - 3 months. Thyroid scintigraphy was performed 3 months after radioiodine therapy. Prior to treatment with J -131 all patients were treated with antithyroid medications, who were suspended 4 - 7 days and restarted one week after J - 131 therapy. Results: in 76,8% (33/43) patients there was control of disease after the first J -131 dose and in 95,2% (40/43) patients after the second and more doses. At 20 years of follow up, there were 84,4% (36/43) patients euthyroid, 13,9% (6/43) patients hypothyroid and 4,6% (2/43) patients hyperthyroid. Reduction of gland weight were in 74,4% (32/43) patients. During 20 years of follow up no adverse side effects were observed after J - 131 therapy. Conclusion: radioiodine therapy is the right choice of treatment for toxic multi-nodular goiter and single dose of J -131 is successful in most of the cases. A single higher radioiodine dose diminishes the need for additional J -131 therapy, without increasing of developing hypothyroidism. (authors)

Studies on simple goitre epidemiology and aetiology in Sudan

Energy Technology Data Exchange (ETDEWEB)

Medani, A M. H. [Atomic Energy Researches Coordination Council, Sudan Academy of Sciences, Khartoum (Sudan)

2008-03-15

and Nyala cities. The Mean{+-} SD serum concentration of thyroid related hormones T{sub 4}, T{sub 3}, TSH and Tg were 103.23{+-}28.15 n mole/1, 1.942.0.52{+-}0.52 n mole/1,2.25{+-}1.58 mu/I and 38.0{+-}22.1 ng/ml respectively. They were all within the normal reference range. Water samples analyses indicated that, calcium, magnesium, total hardness, chloride and fluoride ions were present in high concentrations that exceeded in some samples the maximum permissible concentrations. There were strong correlations between water chemical components and the thyroid related hormones as well as with the goitre prevalence. The results of this study indicated that the high concentrations of water chemicals mainly Ca and Cl are strongly interfering with the iodine metabolism and consequent thyroid function and anatomy. There were no statistical correlations between goitre prevalence and urinary iodine or thiocyanate execrations. The results of thyroid related hormones indicated that serum T{sub 4}, T{sub 3} and TSH were in the normal rang in iodine deficient pupils. measurement of these hormones did no reflect the iodine status or goiter prevalence in the populations studied. Thus, determination of these hormones was not the suitable indicator for goiter monitoring programs. Although there was no statistical correlation between serum thyroglobulin concentration and the prevalence of goitre, the highest serum thyroglobulin concentrations were found in Kosti where the iodine intake was minimum, and in Port Sudan where high concentrations of water chemicals overt antithyroid activity. The serum thyroglobulin level in this study as well as the urinary iodine concentration can be taken as base-line data for the iodine supplementation program.(Author)

Studies on simple goitre epidemiology and aetiology in Sudan

International Nuclear Information System (INIS)

Medani, A. M. H.

2008-03-01

. The Mean± SD serum concentration of thyroid related hormones T 4 , T 3 , TSH and Tg were 103.23±28.15 n mole/1, 1.942.0.52±0.52 n mole/1,2.25±1.58 mu/I and 38.0±22.1 ng/ml respectively. They were all within the normal reference range. Water samples analyses indicated that, calcium, magnesium, total hardness, chloride and fluoride ions were present in high concentrations that exceeded in some samples the maximum permissible concentrations. There were strong correlations between water chemical components and the thyroid related hormones as well as with the goitre prevalence. The results of this study indicated that the high concentrations of water chemicals mainly Ca and Cl are strongly interfering with the iodine metabolism and consequent thyroid function and anatomy. There were no statistical correlations between goitre prevalence and urinary iodine or thiocyanate execrations. The results of thyroid related hormones indicated that serum T 4 , T 3 and TSH were in the normal rang in iodine deficient pupils. measurement of these hormones did no reflect the iodine status or goiter prevalence in the populations studied. Thus, determination of these hormones was not the suitable indicator for goiter monitoring programs. Although there was no statistical correlation between serum thyroglobulin concentration and the prevalence of goitre, the highest serum thyroglobulin concentrations were found in Kosti where the iodine intake was minimum, and in Port Sudan where high concentrations of water chemicals overt antithyroid activity. The serum thyroglobulin level in this study as well as the urinary iodine concentration can be taken as base-line data for the iodine supplementation program.(Author)

TSH-receptor-autoantibody-titers in untreated toxic diffuse goitres - an early indicator of relapse

International Nuclear Information System (INIS)

Becker, W.; Reiners, C.; Boerner, W.

1984-01-01

TSH-receptor-auto antibodies were determined in follow-up of 30 patients with relapse of toxic diffuse goitres, i.e. patients with Graves' disease and toxic disseminated autonomy, and in 13 patients with spontaneous remission after antithyroid drug therapy by use of a commercially available TSH-radioreceptorassay (TRAK-assay). All the patients with very high receptor-autoantibody-titers in untreated thyrotoxicosis (F > 20%) had one or more periods of hyperthyroidism or a very severe course of disease. None of these patients showed a spontaneous remission of disease. They all could be identified as Graves' patients. Patients with TRAK-titers 3% [de

Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: A quality improvement project

OpenAIRE

Mitra, Sujata; Muthu, Sonai G

2012-01-01

Introduction: Radioiodine (I-131) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after I-131 therapy. The present study was undertaken to reduce treatment failure rate of I-131 therapy in TMNG patients. Materials and Methods: Multiple causes may have lead to treatment failure of I-131 in TMNG patients making it difficult to establish a direct cause?effect relationship and take corrective action. Therefore, the JURAN methodology...

ULTRASOUND EVALUATION OF THYROID DISEASES

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Battula

2016-04-01

Full Text Available AIMS & OBJECTIVES: 1. To differentiate cystic lesions from solid lesions. 2. The possibility to differentiate the intrinsic thyroid lesions from those arising from adjoining structures. 3. To evaluate the neoplasms and to differentiate benign from malignant lesions by USG characteristics and to correlate with FNAC reports. 4. Role of USG in rapidly growing thyroid lesions: To differentiate haemorrhage into the cystic lesions and rapidly growing malignant tumours. 5. Compare the results of our study with similar studies available in the present literature. MATERIALS & METHODS This study included 75 patients who attended outpatient departments of the Endocrinology, Medical and Surgical Units and also those who were inpatients. RESULTS Broadly pathological conditions of thyroid glands can be divided into nodular and diffuse thyroid diseases. Among Nodular Diseases Majority are benign, only few are malignant. Characteristics of benign lesions are: 1. Well-differentiated margins. 2. Thin complete peripheral sonolucent halo. 3. Coarse peripheral calcifications. Characteristics of malignant nodules are: 1. Ill-defined margins. 2. Thick incomplete peripheral halo. 3. Fine punctuate calcifications. Diffuse Thyroid Diseases 1. Hashimoto’s thyroiditis: Painless diffuse enlargement of thyroid gland usually in women with coarse echotexture and no normal gland tissue. There may be discrete hypoechoic nodules within it with cervical lymphadenopathy. 2. Goitres: a Simple diffuse goitre: Symmetrical enlargement of gland without tenderness or bruit or lymphadenopathy, T3, T4 and TSH are within normal limits and no thyroid autoantibodies in the serum. a Diffuse Toxic goitre: Diffuse enlargement of gland with increased vascularity on colour Doppler study. b Multinodular goitre: Multiple hypoechoic nodule within normal thyroid parenchyma. c Colloid goitre: Present as single or multiple swellings in the thyroid gland. CONCLUSION USG is the fast and cost effective

Anaplastic Carcinoma and Toxic Multinodular Goiter: An Unusual Presentation

Science.gov (United States)

Marcelino, Mafalda; Marques, Pedro; Lopes, Luis; Leite, Valeriano; de Castro, João Jácome

2014-01-01

A 70-year-old male was referred with hyperthyroidism and multinodular goiter (MNG). Thyroid ultrasonography showed 2 nodules, one in the isthmus and the other in the left lobe, 51 and 38 mm in diameter, respectively. Neck CT showed a large MNG, thyroid scintigraphy showed increased uptake in the nodule in the left lobe, and fine-needle aspiration biopsy showed a benign cytology of the nodule in the isthmus. The patient declined surgery and was treated with methimazole. After being lost to follow-up for 3 years, the patient returned with complaints of dyspnea, dysphagia, and hoarseness; he was still hyperthyroid. Cervical CT showed a large mass in the isthmus and left lobe with invasion of surrounding tissues, the trachea, the esophagus, and the recurrent laryngeal nerve. Bronchoscopy showed extensive infiltration and compression of the trachea to 20% of its caliber. A tracheal biopsy revealed an anaplastic thyroid carcinoma. The tumor was considered unresectable, and radiotherapy was given. One month later, the patient died. The association between a toxic thyroid nodule and anaplastic thyroid carcinoma has apparently not been reported so far. PMID:25759806

The epidemiology, pathalogy, and management of goiter in Yemen

International Nuclear Information System (INIS)

Al-Hureibi, Khalid A.; Abdulmughni, Yasser A.; Ghafoor, Mohammad A.; Al-Hureibi, Mohammed A.; Al-Hureibi, Yahia A.

2004-01-01

The total goitre rate in Yemen declined by half after the country adopted universal salt iodisation in 1995. We investigated the recent epidemiology, pathalogy, and management of goiter so as to evaluate changes since the initiation of salt iodisation programme. We also sought to determine the effect of new diagnostic tools in the pre-operative work-up of surgically treated patients. Data were collected from the records of 667 patients with goitre seen in Kuwait University Hospital between 1997 and 2001. Females constituted 92.5% (n=617) of the series. The mean age of all patients was 35.2+-11.58 years range (13 to 90 years). Most patients (93%) came from highland areas with an average altitude of 2000 to 2600 meters above sea level. The average duration since patients noticed swelling untill the diagnosis was made was about 4 years. Multinodular bilateral swelling was the most common clinical finding (44.9%), while solitary nodules constituted the least common (17.4%). The most common associated symptom was dyspnoea (20.5%). The most common histopathological finding was nodular and colloid goitre (62.8%), while malignancy accounted for 17.7%. Subtotal thyroidectomy was the most frequent procedure, and the most common postoperative complication was hypocalcaemia. Goitre is a national problem in Yemen. The late presentation, which may be important in malignant transformationof the thyroid gland, makes surgery inoperative. The salt iodisation programme has been associated with a decrease in the malignancy rate. Yemen is the great need of experienced cytologists and radiologists to increase the efficacy of fine needle aspiration cytology and ultrasonography in the diagnosis of thyroid lesions. Patients need to be educated about the importance of post-operative follow up. (author)

Diffuse Non-toxic Goitre Therapy with Iodine Alone or with Combination of Iodine and Levothyroxine

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N Galkina

2008-12-01

Full Text Available Aim: to assess the efficacy and tolerability of low-dose iodine therapy compared with the combination of iodine and levothyroxine in endemic goitre patients. Methods: 12-month prospective study was performed, in which 81 patients were randomized on two groups: Group 1 (n = 40 - KI (200 micrograms/day and Group 2 (n = 41 - KI (100 mcg/day + L-T4 (1.0 mcg/kg. Thyroid volume, TSH and Anti-TPO-Ab levels were evaluated at baseline, at 8 month of the treatment and at 12 month (4 month after the cessation of the therapy. Results: the significant decreasing of thyroid volumes was found in group 1 at 8 month compared with baseline (20.5 ml at baseline and 16,4 ml at 8 month р < 0.001. After the therapy cessation the further benefit of a sustained effect was demonstrated (16.4 ml at 8 month and 16.1 ml at 12 month, р = 0.31. Iodine-induced hypo- and hyperthyroidism were not observed. High Anti-TPO-Ab level was found in one of 31 patients (3%. In group 2 significant difference between thyroid volumes was found at 8 month compared with baseline (20,5 ml at baseline and 16.2 ml at 8 month р < 0.001. The sustained effect was revealed at least 4 month after the therapy cessation (16.2 ml at 8 month and 16.1 ml at 12 month, р = 0.77. One man had iodine-induced subclinical hyperthyroidism. Anti-TPO-Ab was not detected in this group. No significant difference between thyroid volume decreasing, TSH and Anti-TPO-Ab levels in two comparable groups was observed. Conclusion: KI alone (200 mcg/day or the combination of L-T4 (1.0 mcg/kg and KI (100 mcg/day are equally effective and tolerable for endemic goitre therapy.

Radioiodine-treatment (RIT) of functional thyroidal autonomy

International Nuclear Information System (INIS)

Meller, J.; Sahlmann, C.O.; Becker, W.

2002-01-01

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

The role of thyroid scanning in hyperthyroidism

International Nuclear Information System (INIS)

Fogelman, I.; Cooke, S.G.; Maisey, M.N.

1986-01-01

Radionuclide thyroid imaging was performed in 872 consecutive patients with hyperthyroidism. Of these, 84% were found to have diffuse toxic hyperplasia (Graves' disease), while 12% had autonomously functioning nodules (Plummer's disease), 3% had Graves' disease developing in a multinodular gland, and in the remaining 1%, either a clear diagnosis could not be established or the hyperthyroidism was due to thyroiditis or the Jod-Basedow phenomenon. It was found that a thyroid scan seldom provides additional diagnostic information in patients with Graves' disease when a diffuse goitre is present. However, if patients are to be treated with radioiodine ( 131 I), thyroid imaging with tracer quantitation can replace a 24-h 131 I uptake measurement, this having the advantages that the patients are required to attend only once, and that the gland size can be measured. In addition, visual confirmation of tracer uptake by the thyroid is obtained and patients with thyroiditis will not receive inappropriate therapy. When single or multiple thyroid nodules are palpated, a thyroid scan is crucial in establishing an accurate diagnosis, as it is not otherwise possible to differentiate between Plummer's disease and Graves' disease developing in a multinodular gland. Indeed, in 20 of our 63 patients (32%) with single autonomously functioning nodules, the initial clinical assessment had been incorrect. (orig.)

Data quality and practical challenges of thyroid volume assessment by ultrasound under field conditions - observer errors may affect prevalence estimates of goitre

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Torheim Liv E

2010-12-01

Full Text Available Abstract Background The ultrasonographic estimation of thyroid size has been advocated as being more precise than palpation to diagnose goitre. However, ultrasound also requires technical proficiency. This study was conducted among Saharawi refugees, where goitre is highly prevalent. The objectives were to assess the overall data quality of ultrasound measurements of thyroid volume (Tvol, including the intra- and inter-observer agreement, under field conditions, and to describe some of the practical challenges encountered. Methods In 2007 a cross-sectional study of 419 children (6-14 years old and 405 women (15-45 years old was performed on a population of Saharawi refugees with prevalent goitre, who reside in the Algerian desert. Tvol was measured by two trained fieldworkers using portable ultrasound equipment (examiner 1 measured 406 individuals, and examiner 2, 418 individuals. Intra- and inter-observer agreement was estimated in 12 children selected from the study population but not part of the main study. In the main study, an observer error was found in one examiner whose ultrasound images were corrected by linear regression after printing and remeasuring a sample of 272 images. Results The intra-observer agreement in Tvol was higher in examiner 1, with an intraclass correlation coefficient (ICC of 0.97 (95% CI: 0.91, 0.99 compared to 0.86 (95% CI: 0.60, 0.96 in examiner 2. The ICC for inter-observer agreement in Tvol was 0.38 (95% CI: -0.20, 0.77. Linear regression coefficients indicated a significant scaling bias in the original measurements of the AP and ML diameter and a systematic underestimation of Tvol (a product of AP, ML, CC and a constant. The agreement between re-measured and original Tvol measured by ICC (95% CI was 0.76 (0.71, 0.81. The agreement between re-measured and corrected Tvol measured by ICC (95% CI was 0.97 (0.96, 0.97. Conclusions An important challenge when using ultrasound to assess thyroid volume under field

Treatment of Thyrotoxicosis Using Radioactive Iodine 131

International Nuclear Information System (INIS)

JAJA, Salvador Bessarione

1998-01-01

Throtoxicosis is common in the Sudan, and its management constitute a significant health problem in terms of expenses, in addition to dilemma of best therapy between the physician's choice and the patients' reference. As the role of Radioactive lodine is becoming more acceptable. It is wise to evaluate our experience and compare it to the current literature, aiming to use the treatment more effectively in our setting. The objective is to evaluate the effectively of radioiodine and factors affecting them, and to find out the possible complications, and compare the cost of treatment to that of surgery and antithyroid drugs, as well as to find out the patient attitude and knowledge towards the treatment. 103 thyrotoxic patients referred to Radioisotope center and received Radioiodine therapy in the period between 1986-1997 were considered in the study. Those who received the treatment in 1997 were followed up prospectively for minimum of 12 months. Clinical feature, severity of the disease, size and type of goitre and complications were considered. Patients were treated as out patients and followed up in the referred clinic. 115 patients (88.5%) were female and 15(11.5%) were male. The mean age was (49±)10.7), the majority (43.9%) were fluocortolonum state and the least (1.5%) from Southern states. Most of the patients (58%) were referred from medical units in the hospitals, their mean thyroxine level (212.285±36.753) and mean weight (58.031±8.724)kg. (54.6%) had diffused goitre and 36% multinodular goitre and 9.2% had solitary nodule. 48.5% of the patients had moderate size goitre, 32.3% large size and 19.2% small size goitre. The main indication was replace after medical treatment (40%). Out of the 59 patients interviewed (77.9%) have no knowledge about the therapy, and (48.4%) accepted the treatment without difficulty. 22 patients presented with complications, and most of the complications were cardiac, heart failure with arrhythmia (50%) 15 patients had

Severe Anemia with Hemoperitoneum as a First Presentation for Multinodular Hepatocellular Carcinoma: A Rare Event in Western Countries

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Thein Swe

2016-01-01

Full Text Available Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma is a life-threatening and rare condition in western countries with an incidence of less than 3% because of early detection of cirrhosis and neoplasm. Here, we describe a case of a 66-year-old male patient with altered mental status with hemorrhagic shock. Computed tomography scan of abdomen revealed hemoperitoneum and mass in liver. Patient underwent resection of liver tumor and biopsy revealed multinodular hepatocellular carcinoma. A high degree of suspicion is required where severe anemia and hemoperitoneum can be a first presentation for hepatocellular carcinoma especially in patients with chronic hepatitis C infection. Early diagnosis is crucial since mortality rates remain high for untreated cases.

Analyse des facteurs prédictifs de malignité des goitres nodulaires : à propos de 500 cas

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

2016-01-01

Les nodules thyroïdiens sont très fréquents et moins de 10% d'entre eux sont malin. Ils posent un véritable problème diagnostique et thérapeutique surtout par rapport à leur nature bénigne ou maligne. L’étude de certains facteurs cliniques et paracliniques de présomption de malignité permet de bien codifier la stratégie thérapeutique. Le but de ce travail est d’étudier les facteurs prédictifs de malignité des goitres nodulaires et comparer nos résultats à ceux de la littérature. Il s'agit d'une étude rétrospective à propos de 500 cas de goitres nodulaires opérés au service d'Oto-rhino-laryngologie (ORL) et Chirurgie cervico-faciale (CCF) de l'hôpital militaire Avicenne de Marrakech entre 2006 et 2012. Le pourcentage de cancers a été de 6,8%. L’âge moyen de nos patients était de 46 ans, avec une sex-ratio de 5 (F/H). A la palpation cervicale; le caractère dure du nodule a été constaté dans 94,4% des cas de cancer, avec des limites irrégulières dans 64,70% des cas de cancer. Trois nodules étaient fixes et ils étaient tous malins. Les adénopathies cervicales ont été constatées chez 8 malades dont 7 présentaient des cancers. A l’échographie, 61,8% des nodules malins présentaient un aspect hypoéchogène, avec des contours flous dans 88,24% des cas. La vascularisation intra nodulaire était présente dans 35,3% de ces cas des cancers avec des microcalcifications chez 55,9% d'entre eux. Le halo hypoéchogene périnodulaire était incomplet dans 73,5% des cas de cancer. Nos patients étaient en euthyroïdie dans 84,6% des cas. Les facteurs prédictifs de malignité d'un goitre nodulaire, étaient donc dans notre étude d'abord cliniques: l’âge supérieur à 60 ans, la consistance dure du nodule, sa fixité, son caractère irrégulier et mal limité à la palpation, ainsi que la présence d'adénopathie(s) cervicale(s) à l'examen; et échographiques: le caractère hypoéchogène, les limites floues, la présence de

Mutations in the thyrotropin receptor signal transduction pathway in the hyperfunctioning thyroid nodules from multinodular goiters: a study in the Turkish population.

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Gozu, Hulya; Avsar, Melike; Bircan, Rifat; Sahin, Serap; Deyneli, Oguzhan; Cirakoglu, Beyazit; Akalin, Sema

2005-10-01

Many studies have been carried out to determine G(s) alpha and TSHR mutations in autonomously functioning thyroid nodules. Variable prevalences for somatic constitutively activating TSHR mutations in hot nodules have been reported. Moreover, the increased prevalence of toxic multinodular goiters in iodine-deficient regions is well known. In Turkey, a country with high incidence rates of goiter due to iodine deficiency, the frequency of mutations in the thyrotropin receptor signal transduction pathway has not been evaluated up to now. In the present study, a part of the genes of the TSHR, G(s)alpha and the catalytic subunit of the PKA were checked for activating mutations. Thirty-five patients who underwent thyroidectomy for multinodular goiters were examined. Genomic DNAs were extracted from 58 hyperactive nodular specimens and surrounding normal thyroid tissues. Mutation screening was done by single-strand conformational polymorphism (SSCP) analysis. In those cases where a mutation was detected, the localization of the mutation was determined by automatic DNA sequencing. No G(s)alpha or PKA mutations were detected, whereas ten mutations (17%) were identified in the TSHR gene. All mutations were somatic and heterozygotic. In conclusion, the frequency of mutations in the cAMP signal transduction pathway was found to be lower than expected in the Turkish population most likely because of the use of SSCP as a screening method and sequencing only a part of TSHR exon 10.

CLINICAL STUDY OF HASHIMOTO’S THYROIDITIS & ITS MANAGEMENT

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Purnaiah

2016-03-01

Full Text Available INTRODUCTION Hashimoto’s Thyroiditis is a well-known clinical condition affecting the thyroid gland predominantly in women during 4 th decade & is often under diagnosed due its wide spectrum of clinical features. It could present as a multinodular goitre, diffuse goitre, or as a solitary nodule with features of Hypothyroidism, Hyperthyroidism or Euthyroid state. AIMS 1. To detect HT by FNAC, Antibody titers finally by Histopathology of excised Thyroid gland. 2. To know its various clinical features. 3. To study Sex ratio & Age it affects. 4. Management i.e. by conservative or surgical. 5. Complications & malignant transformation including Lymphomas. MATERIALS & METHODS 60 patients were taken for 2 years’ period from March 2014 to Feb 2016 attending Government General Hospital-Nizamabad; Telangana State. OBSERVATIONS  56 case are females, 4 cases are males; common age is 30-39 yrs., >50 yrs.-2 cases.  All cases presented with swelling in front of neck, only 5 had toxicity, 2 had obstructive symptoms. None had voice change.  36 Cases- 60% had MNG, 18 Cases- 30% diffuse goitre and 6 cases- 10%- solitary nodule.  The Hypothyroid, Euthyroid & Hyperthyroid state here are 48%, 44% & 8% comparative to Fenn et al -44%, 47% and 7%,  FNAC- was positive 90% here where as Lakshman Rao et al study has 77%.  We had 80% Anti Thyroid Antibodies positivity, others shown 63% and 84%. MANAGEMENT All are put on Hormone-Thyroxine replacement or suppression therapy and all patients found to be clinically Euthyroid during follow up. All patients showed decrease in size of gland except those with MNG. 8 patients underwent surgery- Subtotal Thyroidectomy. Of these 6 were Colloid goiters, later on diagnosed as HT by final HPE. One case was operated for cosmetic reason and the other for obstructive symptoms which was noticed to be lymphoma after HPE.

Bocio multinodular gigante deformante. Presentación de un caso sin síntomas obstructivos

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Paul Bogucki

2014-04-01

Full Text Available Se presenta el caso de un paciente masculino de 50 años, con una tumoración en la parte anterior de cuello de 25 años de evolución, sin síntomas de compresión. Al examen físico se aprecia una glándula tiroides de gran tamaño que deforma el cuello, de superficie lisa y nodular, de aproximadamente 16x12cm. Los estudios de imágenes y de laboratorio confirmaron el diagnóstico. Se practicó una tiroidectomía total, obteniéndose una glándula de 17x12cm. Se identificaron y preservaron ambos nervios laríngeos recurrentes y las glándulas paratiroides. No hubo complicaciones postoperatorias y el resultado estético fue satisfactorio. En conclusión el bocio es una patología común en las zonas con insuficiente aporte de Yodo, donde tiene una incidencia aproximada de 11%. Las estadísticas obtenidas en nuestro hospital se corresponden con lo publicado en la literatura internacional. La variedad gigante es infrecuente, constituyendo una causa de síntomas compresivos y disconformidad estética, por lo que la cirugía es la indicación terapéutica. Abstract Giant multinodular goiter. A case report with no obstructive symptoms In this report we show a 50 years male patient with a tumor in the anterior part of neck of 25 years of evolution, without symptoms of compression. Physical examination shows a large thyroid gland, which deforms the neck, smooth and nodular, painless to palpation, approximately 16x12cm. Imaging studies and laboratory-confirmed diagnosis of multinodular goiter. A total thyroidectomy was performed, with a gland 17x12cm. Were identified and preserved both recurrent laryngeal nerves and parathyroid glands. There were no postoperative complications and the aesthetic result was satisfactory. In conclusion the goiter is a condition common in areas with insufficient supply of iodine, which has an incidence of approximately 11%. The statistics obtained in our hospital are as published in the international literature to endemic

Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre.

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Joshi J

1993-07-01

Full Text Available Menstrual and reproductive history of 178 women referred to the thyroid clinic was compared with 49 healthy controls. Cases were classified as euthyroid, hypothyroid or hyperthyroid after clinical examination and after serum T3, T4, TSH measurements. Reproductive history was related chronologically to symptoms and signs of thyroid dysfunction. Only 31.8% of hypothyroid and 35.3% of hyperthyroid women had normal menstrual pattern in contrast with 56.3% of Euthyroid and 87.8% of healthy controls (p < 0.001. Reproductive failure (infertility, pregnancy wastage, failure of lactation occurred in 37.5% of hypothyroid and 36.5% of hyperthyroid cases against 16.3% of euthyroid and 16.7% of healthy controls (p < 0.05. Interestingly, in 45% of cases with menstrual abnormality, the anomaly was antecedent to other clinical features by a variable period of two months to ten years. Reproductive failure and lactation failure also preceded thyroid dysfunction or goitre. Reproductive dysfunction may therefore be considered as one of the presenting symptoms of thyroid disorders in women, keeping in mind both menstrual irregularities and lactation failure may also arise from other common or idiopathic origins. Especially in women with menstrual irregularities in the perimenopausal age if thyroid dysfunction is detected, pharmacotherapy may be a superior alternative to surgical interventions like hysterectomy.

A retrospective assessment of the effectiveness of radioiodine treatment of hyperthyroid patients from 1997 to 2003 in the north-eastern region of Poland

International Nuclear Information System (INIS)

Budlewski, T.; Rogowski, F.; Szumowski, P.; Parfienczyk, A.; Sopotyk, A.; Kociura-Sawicka, A.; Abdelrazek, S.

2005-01-01

Full text: The first clinical studies concerning treatment of hyperthyroid patients with 131-I date back as far as 1941. However, it was the following years that brought a wide application of these methods. In Podlasie region (north-eastern Poland) radioiodine treatment was first introduced in 1997. Hyperthyroidism in this region affects about 1.5% of population. The number of new patients is about 3,500 per year. Because iodine deficiency is high in this region, toxic nodular goitre rather than Graves' disease tends to be the main cause of hyperthyroidism. The aim of this study was a retrospective analysis of the results of radioiodine treatment of hyperthyroid patients from 1997 to 2003. From 1997 to 2003, 4913 hyperthyroid patients underwent treatment with 131-I (131-I Polatom, Swierk) in the Nuclear Medicine Department of the Medical University of Bialystok. The tested group included: 2106 patients with single solitary nodule, 1968 with multinodular goitre and 839 with Graves' disease. The diagnosis was made on the basis of physical examination and biochemical test results including TSH, fT4 and fT3. All patients had scintigraphic studies with 24 and 48 h uptake of 131-I. They also underwent ultrasound scans to enable assessment of the goitre size and to discover the nodules. All patients with nodules revealed by physical examination and ultrasound scans had biopsy performed under ultrasonographic control. The therapeutic doses of 131-I were calculated on the basis of iodine uptake, goitre size and an assumed absorbed dose. Marinnneli's formula was applied. The assumed absorbed doses were diversified according to the cause of hyperthyroidism and the size of goitre, and ranged from 80 to 350 Gy. In case of small goitres the absorbed doses varied from 80 to 100 Gy. In case of Graves' disease - from 80 to 150 Gy, in solitary nodules from 200 to 350 Gy. 131-I was given to patients orally in capsules. The administered therapeutic doses ranged from 200 mCi to 800 m

Euthyroid goitre with and without functional autonomy: A comparison; Jodmangelstruma mit und ohne funktionelle Autonomie in der euthyreoten Phase: Ein Vergleich

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Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

1998-05-01

Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller

Effects of radioiodine on thyrotrophin binding inhibiting immunoglobulins in Graves' disease

International Nuclear Information System (INIS)

McGregor, A.M.; Petersen, M.M.; Capiferri, R.; Evered, D.C.; Rees Smith, B.; Hall, R.

1979-01-01

The effects of 131 I therapy on thyrotrophin binding inhibiting immunoglobulins (TBII) were studied in fifty-five patients with Graves' disease and five patients with toxic multinodular goitre (MNG). A group of forty patients with Graves' disease and four patients with toxic MNG were treated with drugs and acted as controls. In 78% of patients treated with 131 I there was a dramatic increase in serum TBII activity during the 3 months following therapy, whereas drug-treated patients showed a decrease (77%) or no change in TBII activity over the same period. TBII activity was not detectable in patients with toxic MNG before or after drug or 131 I therapy. Consideration of the mechanisms involved in the changes in serum TBII activity after 131 I treatment or during drug treatment provide insight into the basic defects responsible for the development of Graves' disease and suggest that both the thyroid and immune system are involved. (author)

Dose-dependent acute effects of recombinant human TSH (rhTSH) on thyroid size and function. Comparison of 0.1, 0.3 and 0.9 mg of rhTSH

DEFF Research Database (Denmark)

Fast, Søren; Nielsen, Viveque Egsgaard; Bonnema, Steen Joop

2009-01-01

Context: Recombinant human TSH (rhTSH) is used to augment the effect of radioiodine therapy for nontoxic multinodular goitre. Reports of acute thyroid swelling and hyperthyroidism warrant safety studies evaluating whether these side-effects are dose-dependent. Objective: To determine the effects...... on thyroid size and function of various doses of rhTSH. Design: In nine healthy male volunteers the effect of placebo, 0.1, 0.3 and 0.9 mg of rhTSH was examined in a paired design including four consecutive study rounds. Main outcome measures: Were evaluated at baseline, 24h, 48h, 96h, 7 days and 28 days...... after rhTSH and included: Thyroid volume (TV) estimation by planimetric ultrasound, and thyroid function by serum TSH, freeT3, freeT4 and Tg levels. Results: Following placebo or 0.1 mg rhTSH the TV did not change significantly from baseline at any time. At 24 and 48 hours after administration of 0.3 mg...

Tuberculous Dactylitis with Concomitant Thyroid Involvement: A Rare Presentation of Childhood Tuberculosis.

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Qamar, Sobia; Naz, Farrah; Naz, Samia; Ejaz, Iftikhar

2017-03-01

Extrapulmonary tuberculosis rarely presents as thyroid involvement along with other manifestations, and poses a diagnostic challenge on account of paucibacillary nature of disease. In general, the diagnosis of tuberculosis is based on epidemiological risk factors, clinical features, imaging studies, in addition to a positive skin testing or Interferon Gamma Release Assay (IGRA). A 14-year boy presented with history of fever and weight loss for one year. On examination, he had painful swelling of fingers and toes along with a painless thyroid nodule and squint. Hand X-ray showed lytic-sclerotic lesions in phalanges. MRI of brian showed multiple ring enhancing lesions and radionuclide thyroid scan showed multinodular goitre. Histology showed epithelioid cell granulomas (thyroid and bone) and tuberculomas of brain confirmed tuberculosis. He responded well to four-drug anti-tuberculous therapy and his fever, squint, thyroid nodule, and dactylitis disappeared. Tuberculosis of thyroid, a rare phenomenon, can be diagnosed and treated well; if clinical index of suspicion is kept high, particularly in tuberculosis prevalent areas.

Changes in haemostasis and thrombosis associated with thyroid disease: Presentation of 2 cases.

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Rodilla Fiz, A M; Garví López, M; Gómez Garrido, M; Girón la Casa, M

2016-01-01

There is a relationship between thyroid diseases and primary and secondary changes in haemostasis. The most frequent association between them are hypocoagulability states with clinical hypothyroidism and vascular thrombophilia (hypercoagulability and/or hypofibrinolysis) with hyperparathyroidism. However, there are recent studies that have detected changes in haemostasis -primary and secondary- associated with thyroid diseases with normal hormone levels, suggesting other pathogenic mechanisms not yet known. The cases are presented of 2 patients with thyroid disease that required surgery: one multinodular goitre and one papillary carcinoma of the thyroid, both with normal hormone levels. They were shown to have haemostasis disorders during the preoperative work up. These showed a Factor VII deficiency and a Factor XI deficiency along with a thrombotic disease of unknown origin, respectively. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Harmonic scalpel in multinodular goiter surgery: impact on surgery and cost analysis.

Science.gov (United States)

Sebag, Frederic; Fortanier, Cécile; Ippolito, Guiseppe; Lagier, Aude; Auquier, Pascal; Henry, Jean-Francois

2009-04-01

The aim of this study was to evaluate the potential advantages and the general operative cost of the Harmonic Scalpel (HS) in surgery for multinodular goiter (MNG). Patients undergoing total thyroidectomy (TT) for MNG were prospectively allocated in a conventional tie-and-clip (TC) group (n = 50) and an HS group (n = 50). All pre- and postoperative data were recorded. The economic evaluation was based on a microcost measurement and aimed to consider all the resources consumed for each patient during the surgical procedure. To compare the results, we used the nonparametric unpaired two-tailed Mann-Whitney test. There were 81 women and 19 men (mean age, 55 +/- 15 years). Mean preoperative TSH level was 1.2 (SD, 1.1) (TC) and 1.3 (SD, 2) (HS) (P = NS). Mean body mass index was 24.72 (SD, 8) (TC) and 25.6 (SD, 8) (HS) (P = NS). Four patients experienced a transient hypocalcemia (2 in each group). One patient had a postoperative hematoma requiring surgical evacuation (HS). One patient experienced a transient recurrent nerve palsy (TC). Mean length of surgery was 104 (SD, 32) (TC) and 84 minutes (SD, 17) (HS) (P = .0001). Mean length of hospitalization was 2 days in both groups (SD, 1) (P = NS). Mean operative cost per patient was 990 euro (SD, 191) in the TC group and 1,024 euro (SD, 143) in the HS group (P = NS). Safety and efficiency of the HS is comparable to the tie-and-clip technique in thyroid surgery. The use of the HS in MNG surgery allows for a significant reduction in the length of the procedure with a comparable cost.

[Low levels of TSH measured by a sensitive assay: do they reflect hyperthyroidism? A critical analysis of 580 cases].

Science.gov (United States)

Rohmer, V; Ligeard-Ducoroy, A; Perdrisot, R; Beldent, V; Jallet, P; Bigorgne, J C

1990-05-12

Highly sensitive TSH assays make it easier to diagnose thyroid diseases. During one year, we performed 5,300 sensitive TSH assays (normal range: 0.15-4 mU/l) in various patients. The purpose of this work was to test the value of the low TSH plasma concentrations found in 580 patients. In 99.7 percent of the cases, low TSH levels were the consequence of a thyroid disorder or a treatment by thyroid hormones; non thyroidal illnesses were detected in only 0.3 percent. However, not all TSH values below 0.15 mU/l were associated with overt or occult thyrotoxicosis. When TSH was undetectable (less than 0.04 mU/l), and excluding thyroid hormone-treated patients, thyrotoxicosis was present in 97 percent of the cases. On the other hand, when TSH values were between 0.04 and 0.15 mU/l, 41 percent of the patients failed to show any sign or symptom of hyperthyroidism, although they had functioning thyroid nodules, multinodular goitre or iodine overload, or they received thyroid hormones.

Thyroid carcinoma in Graves' disease: A meta-analysis.

Science.gov (United States)

Staniforth, Joy U L; Erdirimanne, Senarath; Eslick, Guy D

2016-03-01

The incidence of thyroid carcinoma is increasing worldwide. Graves' disease is the most common hyperthyroid disease. Studies have suggested an increased risk of thyroid malignancy in Graves' disease: there has not yet been a meta-analysis to allow quantitative comparison. The purpose of this study was to determine the risk of thyroid carcinoma in Graves' disease, and to gather information on the histological subtypes of carcinoma and the co-existence of thyroid nodules. Several databases and article reference lists were searched. Inclusion criteria included appropriate diagnostic criteria for thyroid conditions and a diagnoses of carcinoma based on histology. 33 studies were selected, all reporting on surgically-resected specimens. The event rate of thyroid carcinoma in Graves' disease was 0.07 (95% CI 0.04 to 0.12). There was no data to allow comparison with patients without hyperthyroid diseases. There was no increase in the odds of developing carcinoma in Graves' disease compared to toxic multinodular goitre and toxic uninodular goitre. 88% of thyroid carcinomas in Graves' disease were papillary, with solitary papillary micro-carcinoma (diameter 10 mm or less) comprising 23% of all detected thyroid carcinomas. Patients with Graves' disease and co-existing thyroid nodules were almost 5 times more likely to be diagnosed with thyroid carcinoma than those without nodules. Thyroid malignancy in Graves' disease requiring surgical treatment should be considered as likely as in other hyperthyroid diseases needing surgical treatment. Clinicians should consider screening selected patients with Graves' disease for nodules whilst being aware of potentially over-diagnosing papillary micro-carcinoma. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis.

Science.gov (United States)

Woliński, Kosma; Stangierski, Adam; Gurgul, Edyta; Bromińska, Barbara; Czarnywojtek, Agata; Lodyga, Martha; Ruchała, Marek

2017-01-01

Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors. We searched medical documentation of patients with acromegaly treated in our department between 2003 and 2013. The prevalence of thyroid abnormalities was compared with the group of patients with hormonally inactive adrenal incidentalomas. To perform the meta-analytic part of the paper we also searched ten databases to find relevant papers. Two hundred and five patients with acromegaly and 184 patients with incidentalomas were included. Any thyroid lesions were present in 77.6% of patients with acromegaly vs. 63.0% with incidentalomas (p = 0.002), multinodular goitre - 66.8% vs. 47.8% (p = 0.0002), and TC- 5.4% vs. 2.7% (p = 0.21) respectively. For thyroid lesions the pooled odds ratio (OR) was 3.1 (95% confidence interval [CI] 1.8-5.5), and for TCs the OR was 4.5 (95% CI 1.9-10.3). According to our results thyroid lesions were significantly more common in patients with acromegaly; in case of TC the difference was not significant. The updated meta-analysis showed significantly increased prevalence of both disorders. In conclusion, systematic thyroid examination should be an important part of follow-up in case of acromegalic patients. (Endokrynol Pol 2017; 68 (1): 2-6).

Treatment of Goiter with Traditional Chinese Medicine Regimen Xing Qi Hua Ying Tang: A Clinical Study on 72 Patients with Multinodular and Diffuse Goiter.

Science.gov (United States)

Yang, Ming-Li; Lu, Bo

2018-04-01

The present work aimed to further explore the therapeutic potential of Xing Qi Hua Ying Tang (XQHYT) by conducting a systemic clinical study in patients with goiter. Seventy-two patients with either multinodular or diffuse goiter were enrolled and randomly assigned into treatment group receiving XQHYT (n = 36) and control group receiving Hai Zao Yu Hu Tang (n = 36). Traditional Chinese Medicine Hospital of Shanxi. Patients were diagnosed multinodular goiter or diffuse goiter resulting from Qi stagnation. All patients took the extract twice a day (100 mL each time) for two courses of treatment, of which a single course lasted for 3 months. Before the treatment was commenced and after the completion of the treatment, general body checks, thyroid function test, and goiter size examination were performed. Scoring of the clinical symptoms using Chinese medicine symptomatology was also done. The symptom score of the treatment group was significantly lower than that of the control group (treatment group, 8.26 ± 2.62; control group, 10.02 ± 2.62; p < 0.05). Substantial reduction in goiter size was seen in 82.3% of XQHYT-treated patients, whereas in the control group only 67.7% of patients exhibited constricted goiter. When assessed by both the Chinese medicine criteria and goiter size, the overall effective rate of the treatment group was 91.2%, whereas that of the control group was only 67.7%. The difference was statistically significant (p < 0.05). XQHYT did not affect the normal functions of liver, kidney, and heart. For both groups of patients, their levels of thyroid-stimulating hormone, free T4 and free T3 were normal before the treatment, and were not affected by the treatment. XQHYT was shown to be a promising therapeutic regimen for the treatment of goiter. The herbal regimen ameliorated clinical symptoms of patients that were accompanied with reduction in the size of goiter.

Natural history of lesions with the MR imaging appearance of multinodular and vacuolating neuronal tumor

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Alsufayan, Reema [University of Toronto, Toronto (Canada); Alcaide-Leon, Paula; De Tilly, Lyne Noel [University of Toronto, St. Michael' s Hospital, Toronto (Canada); Mandell, Daniel M.; Krings, Timo [University of Toronto, Toronto Western Hospital, UHN Division of Neuroradiology, Toronto, ON (Canada)

2017-09-15

Multinodular and vacuolating neuronal tumor (MVNT) have been recently added to the WHO classification of CNS tumors and has not been extensively reported upon in the radiological literature. We report the first radiological and the largest series of cases, aiming to highlight the natural history of lesions with the imaging appearance of MVNT with long follow-up time. In this retrospective study, we collected cases with the imaging appearance of MVNT. All lesions were evaluated by using routine MR imaging, with follow-up of up to 93 months. Patient demographics, clinical course, and MRI features of the lesions were recorded. Twenty-four subjects were enrolled, f/m = 16:8, age range 24-59 years, with a median age of 45 years. The patients' symptoms were often episodic and most frequently due to headaches in 12 (50%), visual symptoms in 6 (25%), seizures in 5 ± 1 (20-25%), paresthesia in 4 (∝17%), cognitive difficulties in 4 (∝17%), in addition to other variable neurological symptoms, or incidental. A total of 30 lesions identified, 77% of the lesions had gadolinium-enhanced MRI and only 13% showed enhancement. A 6.7% of the lesions that had MRI followed up showed progression, while the rest remained stable up to 93 months interval. All patients had intact neurological examinations (except one case that was diagnosed with optic neuritis), were managed conservatively, and did well. The natural history of lesions with imaging features of MVNT is overall stable from a clinical and imaging appearance over time. (orig.)

Natural history of lesions with the MR imaging appearance of multinodular and vacuolating neuronal tumor

International Nuclear Information System (INIS)

Alsufayan, Reema; Alcaide-Leon, Paula; De Tilly, Lyne Noel; Mandell, Daniel M.; Krings, Timo

2017-01-01

Multinodular and vacuolating neuronal tumor (MVNT) have been recently added to the WHO classification of CNS tumors and has not been extensively reported upon in the radiological literature. We report the first radiological and the largest series of cases, aiming to highlight the natural history of lesions with the imaging appearance of MVNT with long follow-up time. In this retrospective study, we collected cases with the imaging appearance of MVNT. All lesions were evaluated by using routine MR imaging, with follow-up of up to 93 months. Patient demographics, clinical course, and MRI features of the lesions were recorded. Twenty-four subjects were enrolled, f/m = 16:8, age range 24-59 years, with a median age of 45 years. The patients' symptoms were often episodic and most frequently due to headaches in 12 (50%), visual symptoms in 6 (25%), seizures in 5 ± 1 (20-25%), paresthesia in 4 (∝17%), cognitive difficulties in 4 (∝17%), in addition to other variable neurological symptoms, or incidental. A total of 30 lesions identified, 77% of the lesions had gadolinium-enhanced MRI and only 13% showed enhancement. A 6.7% of the lesions that had MRI followed up showed progression, while the rest remained stable up to 93 months interval. All patients had intact neurological examinations (except one case that was diagnosed with optic neuritis), were managed conservatively, and did well. The natural history of lesions with imaging features of MVNT is overall stable from a clinical and imaging appearance over time. (orig.)

Lipid peroxidation and antioxidants status in human malignant and non-malignant thyroid tumours.

Science.gov (United States)

Stanley, J A; Neelamohan, R; Suthagar, E; Vengatesh, G; Jayakumar, J; Chandrasekaran, M; Banu, S K; Aruldhas, M M

2016-06-01

Thyroid epithelial cells produce moderate amounts of reactive oxygen species that are physiologically required for thyroid hormone synthesis. Nevertheless, when they are produced in excessive amounts, they may become toxic. The present study is aimed to compare the lipid peroxidation (LPO), antioxidant enzymes - superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and non-protein thiols (reduced glutathione (GSH)) in human thyroid tissues with malignant and non-malignant disorders. The study used human thyroid tissues and blood samples from 157 women (147 diseased and 10 normal). Thyroid hormones, oxidative stress markers and antioxidants were estimated by standard methods. LPO significantly increased in most of the papillary thyroid carcinoma (PTC: 82.9%) and follicular thyroid adenoma (FTA: 72.9%) tissues, whilst in a majority of nodular goitre (69.2%) and Hashimoto's thyroiditis (HT: 73.7%) thyroid tissues, it remained unaltered. GSH increased in PTC (55.3%), remained unaltered in FTA (97.3%) and all other goiter samples studied. SOD increased in PTC (51.1%) and all other malignant thyroid tissues studied. CAT remained unaltered in PTC (95.7%), FTA (97.3%) and all other non-malignant samples (HT, MNG, TMNG) studied. GPx increased in PTC (63.8%), all other malignant thyroid tissues and remained unaltered in many of the FTA (91.9%) tissues and all other non-malignant samples (HT, MNG, TMNG) studied. In the case of non-malignant thyroid tumours, the oxidant-antioxidant balance was undisturbed, whilst in malignant tumours the balance was altered, and the change in r value observed in the LPO and SOD pairs between normal and PTC tissues and also in many pairs with multi-nodular goitre (MNG)/toxic MNG tissues may be used as a marker to differentiate/detect different malignant/non-malignant thyroid tumours. © The Author(s) 2015.

Evaluation of thyroid function in female subjects living in the high natural background radiation area of Karunagappally, Kerala

International Nuclear Information System (INIS)

Sreekumar, A.; Nair, Raghu Ram K.; Jayalakshmi, P.; Sebastian, P.; Akiba, S.

2010-01-01

Radiation exposure has been reported to cause non cancer thyroid abnormalities like diffuse goiter and thyroid nodules. The present study was undertaken to see if there are any morphological and functional changes taking place in the thyroid due to chronic low level radiation exposure. 257 female subjects living in the four high background radiation panchayats of Chavara, Neendakara, Alappad and Panmana were selected for the study after getting informed consent. 5 ml of blood was drawn from these subjects for assessing thyroid function. The subjects were all staying in the same area since their birth and had not moved out for more than one year at a stretch. The average age of the subjects was 40.5y with a range of 17-66y. The cumulative dose had a mean of 226.3 mGy and a range of 20.6-937.8 mGy. 95 subjects from the low background area of Oachira and Thevalakkara were selected as controls in the age group of 18-63y with a mean age of 47.1y. The mean cumulative dose of this group was 35.9 mGy with a minimum of 5.3 mGy and a maximum of 106.8 mGy. 5 ml blood was collected from these subjects for thyroid function studies. All the subjects underwent ultrasound examination of the thyroid using a 10 MHz frequency linear probe. The following parameters were studied to assess thyroid function: Free T4, TSH, Antithyroglobulin antibody (ATG), Parathyroid hormone. Ultrasound images showed the following common features: Normal - 171, Suggestive of Thyroiditis - 106, Multinodular Goitre - 63, Diffuse Goitre - 5, Solitary Nodule - 31. 73 subjects had elevated TSH and 190 subjects had raised ATG. A significant numbers of subjects had features of thyroiditis. A comparative evaluation with control subjects will be done to assess its significance with reference to cumulative dose

Effects of diuretics on iodine uptake in non-toxic goitre: comparison with low-iodine diet

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Kapucu, L.Ozlem; Azizoglu, Firat [Department of Nuclear Medicine, Gazi University, Ankara (Turkey); Ayvaz, Goksun; Karakoc, Ayhan [Department of Endocrinology, Gazi University, Ankara (Turkey)

2003-09-01

Low-iodine diet has been employed to achieve iodine depletion prior to radioiodine (RI) therapy. However, treatment with diuretics may be more effective than low-iodine diet in causing iodine depletion and subsequent increase in RI uptake by the thyroid. Fifty-five patients with non-toxic goitre were given 0.20 MBq RI p.o. on the first day of the study and thyroid uptake was measured. In 15 patients, a low-iodine diet was started and continued for 14 days. The remaining 40 patients received furosemide 40 mg/day orally for 5 days with an unrestricted diet. On the 15th day of the study, all patients were given 0.20 MBq RI p.o. and thyroid RI uptake was measured again. Additionally, 24-h urinary iodine excretion and RI clearance were measured on the 1st and 6th days in 21 patients from the furosemide group and on the 1st and 15th days in eight patients from the diet group. Furosemide administration led to a 58.40% increase in iodine uptake over the baseline value, which was significantly higher than the increase caused by low-iodine diet (17.22%) (P<0.0001). Urinary excretion of RI decreased in both groups similarly (furosemide, 29.45%; low-iodine diet, 21.06%; P=0.33). Iodine clearance also decreased in each group similarly (10.61% vs 7.53%, P=0.53). Treatment with furosemide prior to administration of RI increases the uptake of RI by the thyroid more effectively than does low-iodine diet. (orig.)

ULTRASOUND SCREENING OF THYROID GLAND AMONG A SECTION OF POPULATION IN CENTRAL KERALA

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Ashok Chirathalattu Babu

2017-06-01

Full Text Available BACKGROUND Thyroid diseases are commonest endocrine disorders in India. Studies have shown that one in ten adults in India suffer from hypothyroidism. But it is often underdiagnosed and goes undetected for years. The present study was intended to perform thyroid ultrasound screening among a section of Thrissur population for evaluating the prevalence, various patterns of thyroid pathologies, its age and sex relation. MATERIALS AND METHODS Ultrasound screening for thyroid gland was done for 100 individuals selected from a skewed population of St. Joseph’s Church, Kuriachira, Thrissur, Kerala between Nov. 16– Nov. 30 of 2016. RESULTS Among 100 individuals, 51 were found to have thyroid diseases. Among these 51, various patterns of thyroid diseases were noted; thyroiditis (17, multinodular goitre (12, benign nodules (17 and atypical nodules (7. 47 out of 73 females and 4 out of 27 males had thyroid abnormalities. The study also demonstrated that prevalence of thyroid disease was more in the age group of 60-70 years (78.5%. CONCLUSION Our study demonstrated high prevalence of thyroid diseases (5 in 10 in the study population. Association with increasing age and female predisposition for thyroid diseases also noted.

Iodine-induced hyperthyroidism as combination of different etiologies: an overlooked entity in the elderly.

Science.gov (United States)

Foppiani, Luca; Cascio, Christian; Lo Pinto, Giuliano

2016-10-01

Iodine-induced thyrotoxicosis, which raises several diagnostic and therapeutical challenges, is often overlooked. Hyperthyroidism can induce atrial fibrillation, a harmful arrhythmia which can precipitate heart failure and cause stroke. We report the case of an elderly man who was diagnosed with tachyfibrillation secondary to hyperthyroidism. Thyroid hyperfunction was subsequently related both to previous amiodarone therapy (probably mixed form) and the recent use of iodinated contrast medium for computed tomography scan. Thyroid ultrasonography showed a plongeant multinodular goitre. After initial worsening, thyroid function improved slowly but progressively on high-dose thyreostatic therapy combined with steroid therapy; tachyfibrillation caused heart failure and a thrombus in the left atrium, and proved initially resistant to combined antiarrhythmic treatments. Progressive reduction in thyroid hormone levels, together with combined cardiologic therapies, controlled the heart rate, though atrial fibrillation persisted; anticoagulant therapy resolved the atrial thrombus. Alterations in thyroid function are common in amiodarone-treated patients, who therefore require regular hormonal checks. The different forms of amiodarone-induced thyrotoxicosis must be investigated, since they require different therapies, though mixed forms often occur. The superimposition of further iodine excess due to other causes may be catastrophic and cause severe cardiac problems in these patients.

Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

International Nuclear Information System (INIS)

Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C.

2001-01-01

There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT 3 and FT 4 levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

Changes of the blood lymphocyte subpopulations and their functions following 131I treatment for nodular goitre and 32P treatment for polycythemia vera

International Nuclear Information System (INIS)

Wasserman, Jerzy; Petrini, Bjorn; Stedingk, L.-V. von; Blomgren, Henric; Svedmyr, Erik; Schnell, P.-O.; Lundell, G.

1988-01-01

The blood lymphocyte population was examined in 34 patients treated with 131 I for toxic or atoxic nodular goitre. One to three doses of 300-550 MBq of 131 I were administered at 1-week intervals. Results, with the exception of mitogen reactivity, were largely similar to those occurring following external radiation therapy for cancer. It is suggested that blood lymphocytes passing through the continuously irradiated gland are damaged mainly by β-rays. The effect of 32 P treatment on the blood lymphocyte population was examined in 16 patients with polycythemia vera. Following a single oral dose of 32 P(150-305 MBq), which normalized the production of erythrocytes and/or platelets, blood lymphocyte counts were reduced by approximately 40% 12 weeks after treatment. Examination of subsets demonstrated the proportion of B-cells was decreased by the highest relative extent, but lymphocytes expressing the T cell markers were increased. 32 P treatment markedly increased PHA reactivity but further reduced PWM-induced Ig secreation, in agreement with the finding that serum concentrations of Ig were reduced after treatment. (U.K.)

Thyroid growth immunoglobulins in large multinodular endemic goiters: effect of iodized oil.

Science.gov (United States)

Medeiros-Neto, G A; Halpern, A; Cozzi, Z S; Lima, N; Kohn, L D

1986-09-01

-promoting activity and serum Tg concentrations (r = 0.58; P less than 0.001), but no significant correlation was found with other parameters (TSH, T4, and T3). We conclude that growth-promoting IgGs lacking ability to stimulate cAMP production may play a role in the large multinodular goiters due to chronic iodine deficiency.

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

International Nuclear Information System (INIS)

Mitra, Sujata; Muthu, Sonai G.

2012-01-01

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

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

Science.gov (United States)

Biondi, Bernadette; Bartalena, Luigi; Cooper, David S.; Hegedüs, Laszlo; Laurberg, Peter; Kahaly, George J.

2015-01-01

Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associated with increased risk of coronary heart disease mortality, incident atrial fibrillation, heart failure, fractures and excess mortality in patients with serum TSH levels treatment is indicated in patients older than 65 years with grade 2 SHyper to potentially avoid these serious cardiovascular events, fractures and the risk of progression to overt hyperthyroidism. Treatment could be considered in patients older than 65 years with TSH levels 0.1-0.39 mIU/l (grade 1 SHyper) because of their increased risk of atrial fibrillation, and might also be reasonable in younger (treatment due to the low risk of progression to overt hyperthyroidism and the weaker evidence for adverse health outcomes. PMID:26558232

Subclinical thyrotoxicosis in an outpatient population - predictors of outcome.

Science.gov (United States)

Schouten, Belinda J; Brownlie, Bevan E W; Frampton, Chris M; Turner, John G

2011-02-01

Individuals with endogenous subclinical thyrotoxicosis (SCT) may subsequently require treatment for overt disease. We aimed to evaluate the frequency of progression to hyperthyroidism and factors influencing this outcome. This is a retrospective analysis of outcome in 96 consecutive patients (aged 16-91 years) diagnosed with SCT over a 6-year period. Individuals with secondary causes of TSH suppression were excluded. Mean follow-up was 3·8 years. The significance of age, gender, family history of thyrotoxicosis, symptoms at presentation, thyroid nodule(s) on clinical examination, entry TSH level, antithyroid antibody status and (99m) Tc pertechnetate thyroid imaging results on subsequent development of overt thyrotoxicosis was assessed. Progression to overt thyrotoxicosis was seen in 8% at 1 year, 16% at 2 years, 21% at 3 years and 26% at 5 years. Multivariate analysis determined that diagnosis as determined by scintiscan to be the only independent predictor of outcome (P = 0·003) with the cumulative percentage requiring therapy at 5 years being 9% for subclinical Graves' disease, 21% for multinodular goitre and 61% for the autonomous nodule subgroup. Progression of SCT to overt hyperthyroidism occurred at a rate of 5-8% per year with disease aetiology, as determined by thyroid scintigraphy, significantly influencing risk of progression. © 2011 Blackwell Publishing Ltd.

Changes of the blood lymphocyte subpopulations and their functions following /sup 131/I treatment for nodular goitre and /sup 32/P treatment for polycythemia vera

Energy Technology Data Exchange (ETDEWEB)

Wasserman, J.; Petrini, B.; Stedingk, L.-V. von; Blomgren, H.; Svedmyr, E.; Schnell, P.-O.; Lundell, G.

1988-01-01

The blood lymphocyte population was examined in 34 patients treated with /sup 131/I for toxic or atoxic nodular goitre. One to three doses of 300-550 MBq of /sup 131/I were administered at 1-week intervals. Results, with the exception of mitogen reactivity, were largely similar to those occurring following external radiation therapy for cancer. It is suggested that blood lymphocytes passing through the continuously irradiated gland are damaged mainly by ..beta..-rays. The effect of /sup 32/P treatment on the blood lymphocyte population was examined in 16 patients with polycythemia vera. Following a single oral dose of /sup 32/P(150-305 MBq), which normalized the production of erythrocytes andor platelets, blood lymphocyte counts were reduced by approximately 40% 12 weeks after treatment. Examination of subsets demonstrated the proportion of B-cells was decreased by the highest relative extent, but lymphocytes expressing the T cell markers were increased. /sup 32/P treatment markedly increased PHA reactivity but further reduced PWM-induced Ig secreation, in agreement with the finding that serum concentrations of Ig were reduced after treatment. (U.K.)

Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

Energy Technology Data Exchange (ETDEWEB)

Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C. [Wuerzburg Univ. (Germany). Abt. fuer Nuklearmedizin

2001-09-01

There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT{sub 3} and FT{sub 4} levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

Mitra, Sujata; Muthu, Sonai G., E-mail: sujatamitra@tatasteel.com [Department of Nuclear Medicine, Tata Main Hospital, Jamshedpur (India)

2012-01-15

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

WEST AFRICAN JOURNAL OF MEDICINE

African Journals Online (AJOL)

a mass scale in Ghana is yet to have its fullest impact on thyroid diseases. Goitres are still large and cause pressure effects. Toxic, inflammatory and malignant goitres are gaining prominence, and surgery for malignant goitre was oncologically inadequate.Near total thyroidectomy is recommended as the minimum surgery to ...

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

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Albino, C.C., E-mail: ccalbino@uol.com.b [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

2006-03-15

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)

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

International Nuclear Information System (INIS)

Albino, C.C.; Graf, H.; Paz-Filho, G.; Olandoski, M.; Sabbag, A.; Buchpiguel, C.

2006-01-01

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 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 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 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 131 I (author)

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

Energy Technology Data Exchange (ETDEWEB)

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)

2007-12-15

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)

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

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G.J. Paz-Filho

2007-12-01

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.

Cardiovascular involvement in patients with different causes of hyperthyroidism.

Science.gov (United States)

Biondi, Bernadette; Kahaly, George J

2010-08-01

Various clinical disorders can cause hyperthyroidism, the effects of which vary according to the patient's age, severity of clinical presentation and association with other comorbidities. Hyperthyroidism is associated with increased morbidity and mortality from cardiovascular disease, although whether the risk of specific cardiovascular complications is related to the etiology of hyperthyroidism is unknown. This article will focus on patients with Graves disease, toxic adenoma and toxic multinodular goiter, and will compare the cardiovascular risks associated with these diseases. Patients with toxic multinodular goiter have a higher cardiovascular risk than do patients with Graves disease, although cardiovascular complications in both groups are differentially influenced by the patient's age and the cause of hyperthyroidism. Atrial fibrillation, atrial enlargement and congestive heart failure are important cardiac complications of hyperthyroidism and are prevalent in patients aged > or = 60 years with toxic multinodular goiter, particularly in those with underlying cardiac disease. An increased risk of stroke is common in patients > 65 years of age with atrial fibrillation. Graves disease is linked with autoimmune complications, such as cardiac valve involvement, pulmonary arterial hypertension and specific cardiomyopathy. Consequently, the etiology of hyperthyroidism must be established to enable correct treatment of the disease and the cardiovascular complications.

Radioiodine-131 treatment of thyrotoxicosis: Dose required for and some factors affecting the early induction of hypothyroidism

International Nuclear Information System (INIS)

Alevizaki, C.C.; Alevizaki-Harhalaki, M.C.; Ikkos, D.G.

1985-01-01

The results of 131 I treatment of thyrotoxicosis in 1,168 patients (302 males, 866 females; 58.5% diffuse and 41.5% multinodular toxic goitre) are presented. At the end of the 1st year post-treatment, 54.4% were hypothyroid, and the incidence of hypothyroidism after the 2nd year increased by 3% per year. When the results were analysed according to the calculated radiation dose the thyroid, it was found that the cumulative incidence of hypothyroidism from 6 months to 2 years post-treatment rose almost proportionally to the dose in cases of doses of 1,500-15,0000 rad, but increased very little for higher doses; however, the long-term incidence of hypothyroidism was almost independent of the thyroid dose. Multivariate analysis showed that the results of 131 I therapy at 6 months depended also on sex (treatment being more effective in women), the consistency of the thyroid gland and the year of treatment, with the same radiation dose giving a higher incidence of hypothyroidism in patients treated recently, in comparison to those treated in early in the period studied. Of the patients treated in the period 1978-1982 (mean dose, 300 μCi/g), 93.5% were cured with a single dose of 131 I, and 78% were hypothyroid at 6 months post-treatment. (orig.)

Radioiodine-131 treatment of thyrotoxicosis: Dose required for and some factors affecting the early induction of hypothyroidism

Energy Technology Data Exchange (ETDEWEB)

Alevizaki, C C; Alevizaki-Harhalaki, M C; Ikkos, D G

1985-05-01

The results of /sup 131/I treatment of thyrotoxicosis in 1,168 patients (302 males, 866 females; 58.5% diffuse and 41.5% multinodular toxic goitre) are presented. At the end of the 1st year post-treatment, 54.4% were hypothyroid, and the incidence of hypothyroidism after the 2nd year increased by 3% per year. When the results were analysed according to the calculated radiation dose the thyroid, it was found that the cumulative incidence of hypothyroidism from 6 months to 2 years post-treatment rose almost proportionally to the dose in cases of doses of 1,500-15,0000 rad, but increased very little for higher doses; however, the long-term incidence of hypothyroidism was almost independent of the thyroid dose. Multivariate analysis showed that the results of /sup 131/I therapy at 6 months depended also on sex (treatment being more effective in women), the consistency of the thyroid gland and the year of treatment, with the same radiation dose giving a higher incidence of hypothyroidism in patients treated recently, in comparison to those treated in early in the period studied. Of the patients treated in the period 1978-1982 (mean dose, 300 ..mu..Ci/g), 93.5% were cured with a single dose of /sup 131/I, and 78% were hypothyroid at 6 months post-treatment.

Total thyroidectomy: a clue to understanding the metabolic changes induced by subclinical hyperthyroidism?

Science.gov (United States)

Bel Lassen, Pierre; Kyrilli, Aglaia; Lytrivi, Maria; Ruiz Patino, Maria; Corvilain, Bernard

2017-02-01

The effects of endogenous subclinical hyperthyroidism (eSCH) on heart and bone have been well documented. There are only limited data available regarding the impact of eSCH on weight regulation and lipid metabolism. Our aim was to evaluate the changes in body weight and metabolic parameters after total thyroidectomy in patients with pre-operative eSCH compared with pre-operative patients with euthyroid (EUT). A retrospective study of 505 patients who underwent total thyroidectomy for benign multinodular goitre in an academic hospital in Brussels (Belgium) was performed. Two hundred and 25 patients were included (eSCH group: n = 74; EUT group: n = 151). The mean follow-up time was 26·1 ± 0·8 months and was similar in both groups. Absolute BMI gain was significantly greater in the eSCH group than in the EUT group (1·11 ± 0·17 vs 0·33 ± 0·13 kg/m 2 ; P = 0·003). A significant increase in LDL cholesterol was observed in the eSCH group (16·1 ± 3·8 mg/dl; P effect of eSCH on body weight regulation and lipid metabolism. © 2016 John Wiley & Sons Ltd.

Experience in thyroid scintigraphy with Ethiopian patients

International Nuclear Information System (INIS)

Demena, Solomon

1993-01-01

One thousand and thirty seven thyroid scintigraphy examinations done in the Nuclear Medicine Unit of Tikur Anbesma Hospital, Addis Abeba, Ethiopia between December 1984 and September 1989 were analyzed to assess their diagnostic value. Thirty one percent of the referrals were to investigate clinically detectable solitary nodules, and of these fifty-six percent had ''cold'' nodules and twenty-three percent ''hot'' nodules. Fifty-five percent of the referrals for evaluation of goitre were for multi nodular goitres and twelve percent for diffuse. Thirteen of fifty-three cases with suspected ectopic thyroid tissue were positive. Little useful information was obtained in the evaluation of goitre. It is concluded that thyroid scintigraphy was an unnecessary investigation in the evaluation of goitres in euthyroid patients. Its primary role was in the investigation of the solitary nodule, ectopic thyroid tissue and the retresternal goitre. Therefore, only selected patients should be investigated with thyroid scintigraphy

Therapy of endemic goiter and hypothyroidism

Energy Technology Data Exchange (ETDEWEB)

Luft, D.

1983-09-12

Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with latent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients.

Therapy of endemic goiter and hypothyroidism

International Nuclear Information System (INIS)

Luft, D.

1983-01-01

Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with laent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients. (orig.) [de

Development and clinical application of radioimmunoassay techniques for the measurement of thyroid and parathyroid hormones. Part of a coordinated programme on in vitro assay techniques

International Nuclear Information System (INIS)

Carlos Stevenson, R.

1976-08-01

Radioimmunoassay procedures were utilized to investigate the aetiology and pathology of endemic goitre in Pirque and Petregosa, Chile. The studies were carried out on adult woman and on children. The basal levels of TSH, T3 and T4 were determined. Significant differences were observed between the results in both localities. No children under the age of 5 were observed with goitre in Pedregosa, but goitre incidence increased with age up to 74% at age 18, the percentage being higher for femals. Conclusion: Aetiology and pathology of goitre may vary considerably even within a given country and both dietary and ethnic factors may play a part in this variation

Pendred syndrome (goitre and sensorineural hearing loss) maps to chromosome 7 in the region containing the nonsyndromic deafness gene DFNB4.

Science.gov (United States)

Coyle, B; Coffey, R; Armour, J A; Gausden, E; Hochberg, Z; Grossman, A; Britton, K; Pembrey, M; Reardon, W; Trembath, R

1996-04-01

Inherited causes account for about 50% of individuals presenting with childhood (prelingual) hearing loss, of which 70% are due to mutation in numerous single genes which impair auditory function alone (non-syndromic). The remainder are associated with other developmental anomalies termed syndromic deafness. Genes responsible for syndromic forms of hearing loss include the COL4A5 gene in Alport syndrome and the PAX3 and MITF genes in Waardenburg syndrome. Pendred syndrome is an autosomal recessive disorder associated with developmental abnormalities of the cochlea, sensorineural hearing loss and diffuse thyroid enlargement (goitre). Pendred syndrome is the most common syndromal form of deafness, yet the primary defect remains unknown. We have established a panel of 12 families with two or more affected individuals and used them to search for the location of the Pendred gene by linkage analysis. We excluded localization to four previously mapped nonsyndromic deafness loci but obtained conclusive evidence for linkage of the Pendred syndrome gene to microsatellite markers on chromosome 7q31 (D7S495 Zmax 7.32, Qmax = 0). This region contains a gene, DFNBL, for autosomal recessive non-syndromic sensorineural hearing loss. Multipoint analysis indicates that DFNB4 and Pendred syndrome co-localize to the same 5.5 centiMorgan (cM) interval flanked by D7S501 and D7S523. These data raise the possibility that Pendred syndrome is either allelic with DFNB4 or may represent an inherited contiguous gene disorder, not clinically manifest in the heterozygote.

Iodine status in a Sherpa community in a village of the Khumbu region of Nepal.

Science.gov (United States)

Heydon, Emma E; Thomson, Christine D; Mann, Jim; Williams, Sheila M; Skeaff, Sheila A; Sherpa, Kami T; Heydon, John L

2009-09-01

To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal. Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroid-stimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine. Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90% in the 1960s prior to iodine intervention. Two hundred and fifteen of 219 permanent residents of Kunde were studied. Overall prevalence of goitre was 31% (Grade 1 goitre, 27.0%; Grade 2, 4.2%). When adjusted to a world population, goitre prevalence was 27% (95% CI 23, 32%); Grade 2 goitre prevalence was 2.8% (95% CI 1.0, 4.6%). Median UIC was 97 microg/l, but only 75 microg/l in women of childbearing age. Thirty per cent had UIC 300 microg/l. Ten per cent of participants had TSH concentrations >5 microU/ml. The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.

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

International Nuclear Information System (INIS)

Mitra, S.; Muthu, G.S.

2007-01-01

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

Prophylactic iodine in two Tasmanian cultures in an otherwise moderately iodine-deficient environment

International Nuclear Information System (INIS)

Richards, P.A.C.

1998-01-01

Full text: The incidence of goitre in two separate cultural groups in Tasmania, the island State of Australia, is discussed, firstly on the basis of serendipitous iodine prophylaxis by a ''primitive race'' (Tasmanian Aborigine), and secondly the deliberate dietary supplementation by European occupation in the 20th Century. The Tasmanian Aborigine did not suffer from goitre. Cultural habits that included diet and craft enabled them to avoid this disease in an otherwise moderately iodine-deficient environment. Following an extended occupation since 1803, and with an eventual change in dietary habit, loss of traditional craft and culture, the population that survived both the introduction of European diseases and incarceration succumbed to goitre that was evidenced in the last half of the 19th Century. This paper explores the reasons why the Tasmanian Aborigines did not develop goitre until after European occupation. It also highlights the fortuitious introduction of iodine as a prophylactic measure in the prevention of goitre in the State of Tasmania during the second half of the 20th Century

Thyroid cancer in patients with hyperthyroidism

International Nuclear Information System (INIS)

Kabir, M.F.; Nahar, N.; Haque, F.S.; Alam, F.; Hasan, M.

2007-01-01

Full text: The coexistence of hyperthyroidism and thyroid cancer is a rare event. The aim of this study was to evaluate the relevance of the association of hyperthyroidism and thyroid cancer. Method: From 1st January 2006 to 31st December 2006, a total of 388 new hyperthyroid patients attended the Institute of Nuclear Medicine and Ultrasound for radioiodine therapy. Eighty-two of them were selected before radioiodine therapy, on the basis of findings on palpation and ultrasound (USG) examination, to undergo fine needle aspiration cytology (FNAC) for cytological diagnosis. USG examination was performed to localize and mark the position of nodule/nodules for FNAC and, in cases of nonpalpable nodules, USG guided FNAC was done. In the case of non-nodular patients, guided FNAC was done in sonographically suspicious areas. Results: FNAC report was positive for thyroid cancer in 4 patients. Histopathology examination revealed the presence of papillary carcinoma. Among the four positive cases, one had multi-nodular goitre, two had uni-nodular goiters and one had no nodule. Another patient had a negative FNAC report but due to a huge goiter, the patient underwent surgery and histopathology revealed the presence of papillary carcinoma. Conclusion: Although the occurrence of thyroid cancer in hyperthyroid patients is rare, the presence of a nodule should be carefully evaluated to exclude the presence of concurrent malignancy. FNAC (USG guided in case of non-palpable nodules) is found helpful before radioiodine therapy or surgery. (author)

[Short-term results of treatment with 131I in patients with multinodular goiter: effect of the associated degree of hyperthyroidism and other variables].

Science.gov (United States)

Boj Carceller, D; Liévano Segundo, P; Navarro Beltrán, P; Sanz París, A; de Castro Hernández, P; Monreal Villanueva, M; Abós Olivares, D

2011-01-01

To assess the effectiveness of radioactive iodine (RAI) therapy and the incidence of hypothyroidism post RAI in patients with subclinical hyperthyroidism or clinical hyperthyroidism with Multinodular Goiter (MNG). A retrospective study of 69 consecutive patients treated with (131)I for MNG during the year 2008 observed for six months. All patients received a single fixed dose of 16 mCi (592 MBq) weighted by the gland size. They were categorized into two groups: subclinical hyperthyroidism or clinical hyperthyroidism. We compared the success rate and the incidence of hypothyroidism. The thyroid dysfunction was corrected in 82.09% of the patients. Success rate was 100% in the clinical hyperthyroidism group and 78.13% in the subclinical hyperthyroidism group (P=0.105). The overall incidence of hypothyroidism was 16.42%; 25.00% of patients with clinical hyperthyroidism and 14.55% with subclinical hyperthyroidism developed this secondary effect (P=0.400). No statistically significant differences were found in the success rate in the incidence of hypothyroidism when the results were analyzed according to the thyrotropin decrease in patients with subclinical hyperthyroidism. Seven patients had positive anti-thyroid peroxidase antibodies (anti-TPO) before therapy. The incidence of hypothyroidism was significantly higher in them (57.14% vs 11.67%; P=0.011). Cardiac arrhythmias were four times more frequent in patients with clinical hyperthyroidism. Previous treatment with thiamazol positively affected the outcome. A single fixed weighted dose of (131)I is highly effective and safe for the control of clinical and subclinical hyperthyroidism due to MNG. Patients with anti-TPO antibodies may have a high risk of developing post-iodine hypothyroidism. Copyright © 2010 Elsevier España, S.L. y SEMNIM. All rights reserved.

IN-UTERO DIAGNOSIS AND TREATMENT OF FETAL GOITROUS HYPOTHYROIDISM, CAUSED BY MATERNAL USE OF PROPYLTHIOURACIL

NARCIS (Netherlands)

VANLOON, AJ; DERKSEN, JTM; BOS, AF; ROUWE, CW

A fetal goitre is a potentially dangerous phenomenon because of mechanical obstruction and possible fetal thyroid function disorders. In this report we describe a patient with Graves' disease diagnosed in early pregnancy and treated with propylthiouracil, which resulted in a large fetal goitre and

Measurement of thyroid-stimulating autoantibodies using a radioreceptor-assay (TRAK-assay)

International Nuclear Information System (INIS)

Becker, W.; Reiners, C.; Boerner, W.

1983-01-01

Autoantibodes against TSH-receptors were determined with a new radioreceptorassay (TRAK-assay) in 37 patients with untreated toxic diffus goitre and in 73 patients with non immunogenic thyroid diseases (41 healthy controls, respectively patients with euthyroid diffus or nodular goitres as well as 32 patients with toxic nodular goitre). The upper limit of normal is a TRAK-Titer of 20% without considerable fluctuations during titers in follow-up. According to this preliminary results it seems to be recommendable to treat patients with TRAK-titer F 20% (expected risk of relapse) primarily by operation or radioiodine. (orig.) [de

Iodine deficiency status of school going children in coastal region of bangladesh

International Nuclear Information System (INIS)

Sayedur Rahman Miah; Chowdhury Habibur Rasul; Ashoke Kumar Paul

2004-01-01

Objective: Bangladesh is an iodine deficient zone, affected mainly in the northern part i.e., in Himalayan belt along Brahmaputra and Jamuna River. Severity of' iodine deficiency can be assessed by prevalence of goitre and urinary iodine excretion. The latest nationwide survey of Iodine Deficiency Disorders of' Bangladesh in 1993 showed prevalence of goitre 47.1% in all age and sex group and 69% of the population had urinary iodine excretion 100 mcg/L. Conclusion: On the basis of goitre prevalence and urinary iodine excretion, coastal region of Bangladesh is a mild iodine deficient zone. (authors)

A Clinical Study on 125IT3 Resin Uptake Rate and Serum Thyroxin(T4) in Hyperthyroidism

International Nuclear Information System (INIS)

MooN, Ern Soo; Park, Yoh Han; Cho, Chang Ho; Park, In Soo; Lee, Chong Suk; Lee, Hak Choong

1978-01-01

Hyperthyroidism may be defined as those clinical conditions which result from an increase in the circulating levels of one or both thyroid hormones. Hyperthyroidism in broad sense could be classified with toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter on the basis of the circulating thyroid hormone levels. For this study, the subject included 94 cases with hyperthyroidism were presented in 77 with toxic diffuse goiter, 8 with toxic adenomatous goiter, and 9 with toxic multinodular goiter on the levels of 125 IT 3 resin uptake rate and serum thyroxine (T 4 ). The observed results were as follows: 1) In the cases of hyperthyroidism including toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter, 20.21% of the patients were male and 79.79% female. The majority of the patients were in 2nd to 4th decades of their lives. 2) There were objective signs clearly manifested in hyperthyroidism including toxic diffuse goiter and toxic adenomatous goiter which were rare in the multinodular goiter. The clinical signs in toxic diffuse and toxic adenomatous goiter included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor and warm skin etc. 3) The most frequent complaints of the patients with hyperthyroidism were palpitation, weight loss, increased appetite, perspiration, heat intolerance, nervousness, exertional dyspnea, and menstrual disturbance etc. There was no clear difference in the incidence of symptoms between toxic diffuse goiter and toxic adenomatous goiter, but there was clear difference between toxic multinodular goiter. 4) Considering of results of 125 IT 3 resin uptake rate and serum T 4 level in toxic diffuse goiter, toxic adenomatous goiter and toxic multinodular goiter, 125 IT 3 resin uptake rate was 49.15±9.94% (mean) and serum T 4 21.29±7.04 ug/dl (mean) in toxic diffuse goiter. In toxic multinodular goiter, 125 I T 3 resin uptake rate was 32.47±6.74% (mean) and serum T 4 level 11.03�

Thiamazole Pretreatment Lowers the (131)I Activity Needed to Cure Hyperthyroidism in Patients With Nodular Goiter.

Science.gov (United States)

Kyrilli, Aglaia; Tang, Bich-Ngoc-Thanh; Huyge, Valérie; Blocklet, Didier; Goldman, Serge; Corvilain, Bernard; Moreno-Reyes, Rodrigo

2015-06-01

Relatively low radioiodine uptake (RAIU) represents a common obstacle for radioiodine ((131)I) therapy in patients with multinodular goiter complicated by hyperthyroidism. To evaluate whether thiamazole (MTZ) pretreatment can increase (131)I therapeutic efficacy. Twenty-two patients with multinodular goiter, subclinical hyperthyroidism, and RAIU effective option than LID.

Causes of discordant or negative ultrasound of parathyroid glands in treatment naïve patients with primary hyperparathyroidism

International Nuclear Information System (INIS)

Chandramohan, Anuradha; Sathyakumar, Kirthi; Irodi, Aparna; Abraham, Deepak; Paul, M.J.

2012-01-01

Objectives: To describe causes of discordant or negative parathyroid ultrasound and to assess factors influencing them. Materials and methods: Retrospective review of patients who underwent parathyroidectomy between 2000 and 2012 was done. Imaging findings were compared with operative findings and pathology to identify discrepant (n = 60; 32 negative, 28 incorrect) parathyroid ultrasounds. Results: Fifty (83.3%) patients had parathyroid adenoma, of which 10 (16.6%) were ectopic and three were double adenomas; 8 (13.3%) had multigland hyperplasia and two had parathyroid carcinoma. Discrepant reports were due to incorrect localisation in 8 (13.3%); difficulty in differentiating thyroid from parathyroid lesion in 12 (20%); large and small size in two and three patients, respectively; overcall in 5 (8.3%) and satisfaction of search in 7 (11.7%) patients. There was significant correlation between presence of multi-nodular goitre and incorrect reports (χ 2 = 4.112, p = 0.04). Experience of ultrasound operators performing initial and second look ultrasound was significantly different (p < 0.0001). Second look ultrasound was concordant with surgical findings in 39(65%) patients; 21 (66%) patients with initially negative ultrasound and four out of five extra-mediastinal ectopic lesions. Ten patients with negative initial ultrasound had elongated parathyroid lesion. Scintigraphy was concordant in 44 (73.3%) patients and nine were ectopic. Conclusion: Second look ultrasound performed by experienced operator for negative or discordant initial ultrasound of parathyroid is a useful strategy which will improve the accuracy of parathyroid ultrasound. Being able to differentiate thyroid from parathyroid lesion is a factor which will influence performance of parathyroid ultrasound.

Etiology of Overt or Subclinical Hyperthyroidism and Iodine Status in Older Than Sixty Years

Directory of Open Access Journals (Sweden)

Oguzhan Aksu

2016-04-01

Full Text Available Aim: Thyroid dysfunction is common among older people associated with morbidity and mortality. Overall, the most common cause of hyperthyroidism is Grave%u2019s Disease (GD. In the older population however, Toxic Multinodular Goitre (TMG is more common. Iodine is an essential molecule for thyroid hormone synthesis. This may be due to the presence of autonomic areas with a higher sensitivity to iodine in the thyroid gland. The aim of this study was to detect the etiology of hyperthyroidism among cases older than 60 years.Material and Method: The study included 100 patients %u226560 years or older with hyperthyroidism. Demographic and clinical features of the patients were recorded. All patients were tested for anti-thyroid autoantibodies and underwent thyroid ultrasonographic (USG and scintigraphic examination. Iodine exposure was detected in 24-hour urine specimens. Results: Eighty-one patients (81% had overt and the remaining 19 (19% had subclinical hyperthyroidism and the mean age was 70.48 ± 6.16 (range 60-88. Thirteen patients had recent exposure to iodine and 11 had Jod Basedow Phenomenon (JBP. The most common disease was TMNG (29.2% and 8 patients had no definitive diagnosis; they were designated nondiagnostic (ND. Discussion: This is the first study that investigates the causes of thyrotoxicosis amoung older people in our country. The results indicated that TMNG was the most common cause. JBP cases had a history of exposure to iodine. For this reason, radiocontrast use in older people should be carefully evaluated with this respect.

MANAGEMENT OF ENDOCRINE DISEASE: Subclinical thyrotoxicosis: prevalence, causes and choice of therapy.

Science.gov (United States)

Carlé, Allan; Andersen, Stine Linding; Boelaert, Kristien; Laurberg, Peter

2017-06-01

Subclinical thyrotoxicosis is a condition affecting up to 10% of the population in some studies. We have reviewed literature and identified studies describing prevalences, causes and outcomes of this condition. Treatment should be considered in all subjects if this biochemical abnormality is persistent, especially in case of symptoms of thyrotoxicosis or in the presence of any complication. In particular, treatment should be offered in those subclinically thyrotoxic patients with a sustained serum TSH below 0.1 U/L. However it is important to recognise that there are no large controlled intervention studies in the field and thus there is no high quality evidence to guide treatment recommendations. In particular, there is no evidence for therapy and there is weak evidence of harm from thyrotoxicosis if serum TSH is in the 0.1-0.4 IU/L range. In this review, we describe the different causes of subclinical thyrotoxicosis, and how treatment should be tailored to the specific cause. We advocate radioactive iodine treatment to be the first-line treatment in majority of patients suffering from subclinical thyrotoxicosis due to multinodular toxic goitre and solitary toxic adenoma, but we do generally not recommend it as the first-line treatment in patients suffering from subclinical Graves' hyperthyroidism. Such patients may benefit mostly from antithyroid drug therapy. Subclinical thyrotoxicosis in early pregnancy should in general be observed, not treated. Moreover, we advocate a general restriction of therapy in cases where no specific cause for the presumed thyroid hyperactivity has been proven. © 2017 European Society of Endocrinology.

Causes of discordant or negative ultrasound of parathyroid glands in treatment naïve patients with primary hyperparathyroidism

Energy Technology Data Exchange (ETDEWEB)

Chandramohan, Anuradha, E-mail: anuradhachandramohan@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Sathyakumar, Kirthi, E-mail: kirthi86s@yahoo.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Irodi, Aparna, E-mail: aparnashyam@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Abraham, Deepak, E-mail: abrahamdt@gmail.com [Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Paul, M.J., E-mail: mjpaul@cmcvellore.ac.in [Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu 632004 (India)

2012-12-15

Objectives: To describe causes of discordant or negative parathyroid ultrasound and to assess factors influencing them. Materials and methods: Retrospective review of patients who underwent parathyroidectomy between 2000 and 2012 was done. Imaging findings were compared with operative findings and pathology to identify discrepant (n = 60; 32 negative, 28 incorrect) parathyroid ultrasounds. Results: Fifty (83.3%) patients had parathyroid adenoma, of which 10 (16.6%) were ectopic and three were double adenomas; 8 (13.3%) had multigland hyperplasia and two had parathyroid carcinoma. Discrepant reports were due to incorrect localisation in 8 (13.3%); difficulty in differentiating thyroid from parathyroid lesion in 12 (20%); large and small size in two and three patients, respectively; overcall in 5 (8.3%) and satisfaction of search in 7 (11.7%) patients. There was significant correlation between presence of multi-nodular goitre and incorrect reports (χ{sup 2} = 4.112, p = 0.04). Experience of ultrasound operators performing initial and second look ultrasound was significantly different (p < 0.0001). Second look ultrasound was concordant with surgical findings in 39(65%) patients; 21 (66%) patients with initially negative ultrasound and four out of five extra-mediastinal ectopic lesions. Ten patients with negative initial ultrasound had elongated parathyroid lesion. Scintigraphy was concordant in 44 (73.3%) patients and nine were ectopic. Conclusion: Second look ultrasound performed by experienced operator for negative or discordant initial ultrasound of parathyroid is a useful strategy which will improve the accuracy of parathyroid ultrasound. Being able to differentiate thyroid from parathyroid lesion is a factor which will influence performance of parathyroid ultrasound.

A Clinical Study on {sup 125}IT{sub 3} Resin Uptake Rate and Serum Thyroxin(T{sub 4}) in Hyperthyroidism

Energy Technology Data Exchange (ETDEWEB)

MooN, Ern Soo; Park, Yoh Han; Cho, Chang Ho; Park, In Soo; Lee, Chong Suk; Lee, Hak Choong [National Medical Center, Seoul (Korea, Republic of)

1978-09-15

Hyperthyroidism may be defined as those clinical conditions which result from an increase in the circulating levels of one or both thyroid hormones. Hyperthyroidism in broad sense could be classified with toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter on the basis of the circulating thyroid hormone levels. For this study, the subject included 94 cases with hyperthyroidism were presented in 77 with toxic diffuse goiter, 8 with toxic adenomatous goiter, and 9 with toxic multinodular goiter on the levels of {sup 125}IT{sub 3} resin uptake rate and serum thyroxine (T{sub 4}). The observed results were as follows: 1) In the cases of hyperthyroidism including toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter, 20.21% of the patients were male and 79.79% female. The majority of the patients were in 2nd to 4th decades of their lives. 2) There were objective signs clearly manifested in hyperthyroidism including toxic diffuse goiter and toxic adenomatous goiter which were rare in the multinodular goiter. The clinical signs in toxic diffuse and toxic adenomatous goiter included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor and warm skin etc. 3) The most frequent complaints of the patients with hyperthyroidism were palpitation, weight loss, increased appetite, perspiration, heat intolerance, nervousness, exertional dyspnea, and menstrual disturbance etc. There was no clear difference in the incidence of symptoms between toxic diffuse goiter and toxic adenomatous goiter, but there was clear difference between toxic multinodular goiter. 4) Considering of results of {sup 125}IT{sub 3} resin uptake rate and serum T{sub 4} level in toxic diffuse goiter, toxic adenomatous goiter and toxic multinodular goiter, {sup 125}IT{sub 3} resin uptake rate was 49.15+-9.94% (mean) and serum T{sub 4} 21.29+-7.04 ug/dl (mean) in toxic diffuse goiter. In toxic multinodular goiter, {sup 125}I T{sub 3} resin uptake

Carcinoma thyroid in multi and uni nodular goiter

International Nuclear Information System (INIS)

Iqbal, M.; Mehmood, Z.; Rasul, S.; Inamullah, S.; Sagheer, H.; Bokhari, I.

2010-01-01

To determine the frequency and profile of carcinoma in multi-nodular goiter and solitary thyroid nodule. Study Design: Case series. Place and Duration of Study: Surgical Unit-I, Ward-3 of Jinnah Postgraduate Medical Centre, Karachi, from January 1999 to January 2009. Methodology: Cases with solitary thyroid nodules and multi-nodular goiter were included. Patients under 12 years of age, cystic benign lesion in solitary thyroid nodules or those multi-nodular goiters which were not causing pressure symptoms, cosmetic problems or sign of malignancy were excluded. In solitary thyroid nodule, hemithyroidectomy was done and if histopathology examination revealed carcinoma thyroid then completion thyroidectomy was done. In multi-nodular goiter sub-total thyroidectomy done. Results were described as frequency percentages and mean. Results: Out of 397 patients of multi-nodular goiter only one patient was found to be papillary carcinoma (0.25%). In 220 patients of solitary thyroid nodules, 93 patients were diagnosed as carcinoma of thyroid (42.27%). Others diagnosed in solitary thyroid nodule were thyroid adenoma, colloid goiter, thyroiditis and multi-nodular goiter. The frequency of papillary carcinoma in 65.95% occurring females of 12-30 years of age and being multifocal in 6.45%, follicular carcinoma in 23.40%, medullary carcinoma in 7.44%, anaplastic carcinoma in 2.12% and lymphoma in 1.01%. Female were predominantly involved and papillary carcinoma was common in 12-30 years of age (71.63%) and follicular was common in 30-40 years of age (68.18%). 6.45% of papillary carcinoma was found to be multifocal in nature. Conclusion: Frequency of carcinoma of thyroid is very high in solitary thyroid nodule (42.27%), but markedly low in multi nodular goiter. Papillary carcinoma is the most common variety, most of in younger female. (author)

Case report

African Journals Online (AJOL)

ebutamanya

11 août 2015 ... 3 des struma ovarii, elle cesse après l'exérèse tumorale. Parfois, un goitre ovarien sécrétant peut mettre au repos l'axe hypothalamo- hypophysaire avec risque d'hypothyroïdie postopératoire. Quelques cas de goitre ovarien avec manifestations d'auto-immunité de type maladie d'Hashimoto ou maladie de ...

Need for thyroidectomy in patients treated with radioactive iodide for benign thyroid disease

DEFF Research Database (Denmark)

Villadsen, Mette Jegstrup; Sørensen, Christian Hjort; Godballe, Christian

2011-01-01

Nodular toxic and non-toxic goitres are seen in approximately 15% of Danish women, and the pros and cons of thyroidectomy versus radioiodine (RI) therapy are often discussed. The purpose of this study was to evaluate the type and number of patients treated on the indication of hyperthyroidism...... or benign goitre who did not achieve a sufficient effect of RI therapy and therefore needed thyroidectomy....

Case series

African Journals Online (AJOL)

abp

26 mai 2015 ... La définition du goitre plongeant, la plus couramment employée, est tout goitre ne siégeant pas dans la région cervicale en position opératoire. Le but d'évaluer sa .... plusieurs auteurs ont essayé de donner leurs propres définitions. la plus part .... de compression, d'hyperthyroïdie et devant le risque de.

Evaluation of thyroid tissue by Raman spectroscopy

Science.gov (United States)

Teixeira, C. S. B.; Bitar, R. A.; Santos, A. B. O.; Kulcsar, M. A. V.; Friguglietti, C. U. M.; Martinho, H. S.; da Costa, R. B.; Martin, A. A.

2010-02-01

Thyroid gland is a small gland in the neck consisting of two lobes connected by an isthmus. Thyroid's main function is to produce the hormones thyroxine (T4), triiodothyronine (T3) and calcitonin. Thyroid disorders can disturb the production of these hormones, which will affect numerous processes within the body such as: regulating metabolism and increasing utilization of cholesterol, fats, proteins, and carbohydrates. The gland itself can also be injured; for example, neoplasias, which have been considered the most important, causing damage of to the gland and are difficult to diagnose. There are several types of thyroid cancer: Papillary, Follicular, Medullary, and Anaplastic. The occurrence rate, in general is between 4 and 7%; which is on the increase (30%), probably due to new technology that is able to find small thyroid cancers that may not have been found previously. The most common method used for thyroid diagnoses are: anamnesis, ultrasonography, and laboratory exams (Fine Needle Aspiration Biopsy- FNAB). However, the sensitivity of those test are rather poor, with a high rate of false-negative results, therefore there is an urgent need to develop new diagnostic techniques. Raman spectroscopy has been presented as a valuable tool for cancer diagnosis in many different tissues. In this work, 27 fragments of the thyroid were collected from 18 patients, comprising the following histologic groups: goitre adjacent tissue, goitre nodular tissue, follicular adenoma, follicular carcinoma, and papillary carcinoma. Spectral collection was done with a commercial FTRaman Spectrometer (Bruker RFS100/S) using a 1064 nm laser excitation and Ge detector. Principal Component Analysis, Cluster Analysis, and Linear Discriminant Analysis with cross-validation were applied as spectral classification algorithm. Comparing the goitre adjacent tissue with the goitre nodular region, an index of 58.3% of correct classification was obtained. Between goitre (nodular region and

Relative quantification of PIK3CA gene expression level in fine-needle aspiration biopsy thyroid specimens collected from patients with papillary thyroid carcinoma and non-toxic goitre by real-time RT-PCR

Directory of Open Access Journals (Sweden)

Wojciechowska-Durczyńska Katarzyna

2010-08-01

Full Text Available Abstract Background Recent studies have shown that the phosphatidylinositol 3-kinase (PI3K signaling pathway is important regulator of many cellular events, including apoptosis, proliferation and motility. PI3K pathway alterations (PIK3CA gene mutations and/or amplification have been observed in various human tumours. In the majority of diagnosed cases, mutations are localized in one of the three "hot spots" in the gene, responsible for coding catalytic subunit α of class I PI3K (PIK3CA. Mutations and amplification of PIK3CA gene are characteristic for thyroid cancer, as well. Methods The aim of our study was to examine a gene expression level of PIK3CA in fine-needle aspiration biopsy (FNAB thyroid specimens in two types of thyroid lesions, papillary thyroid carcinoma (PTC and non-toxic goitre (NTG. Following conventional cytological examination, 42 thyroid FNAB specimens, received from patients with PTC (n = 20 and NTG (n = 22, were quantitatively evaluated regarding PIK3CA expression level by real-time PCR in the ABI PRISM® 7500 Sequence Detection System. Results Significantly higher expression level (RQ of PIK3CA in PTC group has been noted in comparison with NTG group (p Conclusion These observations may suggest role of PIK3CA alterations in PTC carcinogenesis.

Effect of 131I in the treatment of hyperthyroidism at Hospital San Juan de Dios for the period from January 1, 2005 to December 31, 2007

International Nuclear Information System (INIS)

Badilla Barboza, Oscar Yuran

2011-01-01

Radioactive iodine 131 ( 131 I) is used for the treatment of hyperthyroidism at Hospital San Juan de Dios. The most common causes of hyperthyroidism have been Graves disease or diffuse goiter, toxic multinodular goiter and toxic nodular goiter, among others; but, the results are unknown and factors that have influenced the treatment with 131 I. The study has included only patients with these causes, and have been administered radioactive iodine 131 as treatment. 180 cases have been treated with radioactive iodine, 75.0% have presented diffuse goiter, 22.2% multinodular goiter and 2.8% nodular goiter, where were been 144 female patients (80%) and 36 male patients (20%). Women have had predominance in the three groups that were analyzed pathologies, according to medical literature, an approximate incidence of 0.4 cases has existed per thousand women to year. A proportional relationship between clinical size of goiter and failure of therapy with 131 I has been in diffuse goiter for the handling of hyperthyroidism. Likewise, male sex has been risk factor in the failure of such therapy. Multinodular goiter and nodular goiter have not had difference between the results according to sex and size of goiter. Most hyperthyroid patients with diffuse goiter, nodular and multinodular have received 131 I as treatment, and previously this, they have received propylthiouracil; treatment outcome was unaffected. Treatment with 131 I in hyperthyroid patients has managed to be effective for reduction in size of the thyroid gland in diffuse goiter, nodular goiter and multinodular [es

Treatment of thyroid carcinoma as a problem of internal medicine

International Nuclear Information System (INIS)

Roos, J.

1975-01-01

The usefulness of gallium-67 as a radiopharmaceutical for the detection of carcinoma of the thyroid gland is investigated. Gallium-67 does not accumulate in a benign goitre. In combination with iodide and pertechnetate scintigraphy of the thyroid, the application of gallium-67 is important for the detection of malignancy in large goitres. To increase the efficiency of iodine-131 therapy, a low-iodine diet and intensive diuresis during four days preceding administration of radioactive iodide is recommended

Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area.

Science.gov (United States)

Bree, Laura; Gallagher, Barbara A; Shiel, Robert E; Mooney, Carmel T

2018-01-01

Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T 4 ) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T 4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre ( P  weight loss ( P  hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant ( P  hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.

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

Energy Technology Data Exchange (ETDEWEB)

Albino, Claudio Cordeiro

2009-07-01

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

131I-therapy of graves' disease and non-immunogenic thyrotoxicosis

International Nuclear Information System (INIS)

Hoeschel, M.; Heinze, H.G.

1984-01-01

From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with 131 I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with 131 I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated 131 I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis. (orig.) [de

Visible signs of illness from the 14th to the 20th century: systematic review of portraits

Science.gov (United States)

Als, C; Stüssi, Y; Boschung, U; Tröhler, U; Wäber, J H

2002-01-01

Objectives To see whether a collection of portraits depicting inhabitants of a defined geographical region and covering several centuries is a useful source for studying the sociocultural significance and epidemiology of particular visible diseases, such as goitre, which is known to have been common in this region. Design Systematic review of portraits and description of visible signs of illness. Setting The Burgerbibliothek (archives of the burghers' community) in Berne, Switzerland. Data sources 3615 portraits; 2989 of individuals whose identity is known and 626 of individuals whose identity is unknown. Main outcome measures Visible signs of illness evaluated by means of a standardised visual assessment. Results Visible signs of illness in portraits were common and appeared in up to 82% (451/553) of paintings from the 17th and 18th centuries. The most common findings were signs of goitre in women and overweight in men. In only the portraits where the neck region could be evaluated, 41% of women with known identities (139/343) had goitre compared with 24% of men with known identities (21/86). The prevalence of goitre was even higher in sitters whose identities were unknown: 63% in men (5/8) and 68% in women (82/121). Overweight in people with known identities was more common in men than in women (30%, 346/1145 v 44%, 811/1844). Overweight was most common in sitters aged >40 than in those aged 40 or younger. Other conditions, such as missing teeth, amputated limbs, or osteoarthritic deformations were surprisingly rare in the portraits under evaluation. Conclusions Goitre and other diseases are under-represented in the people depicted in these portraits. Artistic idealisation is a likely explanation for this observation: what was reproduced depended on what was considered pathological or shameful at the time, and therefore depended on age and sex. Stigmatising details may have been omitted. Further, artistic skills and contemporary fashion may have influenced the

Substantial interobserver variation of thyroid volume and function by visual evaluation of thyroid (99m)Tc scintigraphy

DEFF Research Database (Denmark)

Soelberg, Kerstin; Grupe, Peter; Boel-Jørgensen, Henrik

2014-01-01

(99m)Tc-pertechnetate scintigraphy is much used in the evaluation of patients with nodular goitre. We investigated the ability of experienced observers to estimate the thyroid 24-h (131)I uptake (RAIU) and the thyroid volume by visual evaluation of the scintigram.......(99m)Tc-pertechnetate scintigraphy is much used in the evaluation of patients with nodular goitre. We investigated the ability of experienced observers to estimate the thyroid 24-h (131)I uptake (RAIU) and the thyroid volume by visual evaluation of the scintigram....

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

International Nuclear Information System (INIS)

Paul, A.K.; Rahman, H.A.; Jahan, N.

2002-01-01

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

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

Science.gov (United States)

Lumachi, F; Marzola, M C; Zucchetta, P; Tregnaghi, A; Cecchin, D; Bui, F

2003-09-01

A series of 112 consecutive patients with primary hyperparathyroidism who underwent both high-resolution neck ultrasonography (US) and 99mTc-sestamibi/99mTc-pertechnetate subtraction scintigraphy (SS) prior to successful parathyroidectomy was reviewed. There were 29 (25.9%) men and 83 (74.1%) women, with a median age of 58 years (range 13-78 years). Patients were divided into two groups, according to the preoperative US findings: group A (87 patients, 77.7%) without thyroid diseases, and group B (25 patients, 22.3%) with either multinodular goitre or a solitary nontoxic thyroid nodule. In group B patients partial or total thyroidectomy was also performed, according to the intraoperative findings and frozen-section examination results. Final histopathology showed 99 (88.4%) solitary parathyroid (PT) adenomas and 3 (2.7%) PT carcinomas, while 10 (8.9%) patients had a multiglandular disease. The sensitivity and positive predictive value (PPV) were (group A vs group B) 79.8% vs 70.8% (P=0.25) and 95.7% vs 94.4% (P=0.58) for US, and 83.3% vs 87.0% (P=0.47) and 95.9% vs 90.9% (P=0.32) for SS respectively. Better but similar (P=not significant) results were obtained in patients with solitary PT tumours: 81.5% vs 77.8% (US) and 85.0 vs 94.1% (SS) sensitivity; 97.1% vs 93.3% (US) and 95.8% vs 88.9% (SS) PPV. Overall, the combination of US and SS was 92.9% sensitive (group A=93.1%, group B=92.0%; P=0.55), and the PPV reached 100% in each group. In conclusion, in patients with primary hyperparathyroidism the results of both US and SS are independent of coexistent thyroid disease, especially in patients with solitary PT tumours.

Treatment of hyperthyroidism with radioactive iodine

International Nuclear Information System (INIS)

Bell, R.L.

1974-01-01

While radioactive iodine is clearly the therapy of choice for Graves' disease (even in younger patients) the use of radioactive iodine for therapy of the toxic multinodular or uninodular goiter presents an entirely different problem. Although these two entities can be treated with radioactive iodine provided there is some suppression of the tissue that is not autonomous, transient release of thyroid hormone may induce symptoms of thyroid storm in the very large multinodular toxic goiter treated with radioiodine therapy. These toxic nodules generally require much larger doses of radioiodine than is commonly used for classical Graves' disease and may either require fractional administration of radioisotopes or concomitant use of antithyroid drugs and iodides. In general, surgery remains the treatment of choice for large toxic multinodular goiters, after proper preparation by medical means including radioactive iodine. Radioactive iodine therapy for hyperthyroidism is contraindicated in pregnancy and generally is not used in children below five years of age. (U.S.)

Retrosternal thyroid tumors

International Nuclear Information System (INIS)

Mehta, A.R.; Sarkar, Sudeep

1999-01-01

Computerized axial tomography scans permit proper distinction between primary and secondary goitres and help in preoperative planning. Advances in anesthetic techniques and the use of small-caliber endotracheal tubes facilitate proper perioperative management, even for patients with significant respiratory compression symptoms. A tracheotomy is rarely necessary. Aggressive surgical therapy for retrosternal goitres avoids life-threatening situations and results in minimal morbidity and practically zero mortality when performed by a surgeon experienced in managing such patients. Radioactive iodine therapy is used in the treatment of metastases of differentiated thyroid carcinoma if they concentrate 131 I

Dansk jodberigelse af salt og forekomst af thyroideasygdom

DEFF Research Database (Denmark)

Laurberg, Peter; Jørgensen, Torben; Ovesen, Lars

2011-01-01

Until 2000 Denmark was iodine deficient with moderate deficiency in the western part and mild deficiency in the eastern part. The occurrence of goitre and autonomous hyperthyroidism was high, and pregnancy was associated with a reduction in thyroid function. After cautious mandatory iodization...... of household salt and salt used for bread production, the iodine intake in Denmark is now low normal. The DanThyr monitoring has shown a transient increase in hyperthyroidism followed by a decrease, and goitre is becoming less common. Hypothyroidism has become more common, and this has to be followed....

Hashimoto's thyroiditis in children and adolescents

Directory of Open Access Journals (Sweden)

Marković Slavica

2008-01-01

Full Text Available INTRODUCTION Hashimoto's thyroiditis (HT is a common cause of goitre and hypothyroidism in children and adolescents. Spontaneous remission may occur in up to 50% patients, but the development of hypothyroidism is possible. OBJECTIVE We investigated the clinical manifestations, course and long-term outcome of HT. METHOD We reviewed charts of 43 children (36 females with HT, mean age at presentation 12.3 years, and mean follow-up duration 4.6 years. RESULTS HT is five times more common in females. The common complaints leading to referral were goitre in 19 children (44.3%, diffuse in 17 children (89.5%. As to the prevalence of goitre, it accounted for significantly more referrals in females (14 girls, and 5 boys; 73.7% vs 26.3%, t-test; p<0.005. Goitre was either isolated in 15 (34.4% or associated with other complaints in 4 children: anemia in 7 (16.2%, fatigue in 5 (11.8%, increased appetite in 4 (9.7%, weight gain in 3 (7.0%, growth retardation in 2 children (4.7%, at irregular menses in 3 pubertal girls. Hypothyroidism was present in 18 patients (41.1%, 7 (38.8% on initial admission, and 11 (61.8% had the mean follow-up duration of 4.6 years. There were 25 euthyroid HT patients (59.9%. The family history of the thyroid disease was positive in 16 children (37.1% and 12 of them (71.4% had hypothyroidism. There were 6 patients (13.9% in whom the disease was associated with some other autoimmune disease. CONCLUSION HT is five times more common in females. The usual complaints leading to referral were diffuse goitre, which accounted for significantly more referrals in females. A positive family history of autoimmune thyroid disease is associated with a higher risk of hypothyroidism in children with HT. Hypothyroid patients may appear in higher percentage of children and adolescents than previously reported.

Measurements of {sup 131}I-Labelled Triiodothyronine Uptake by a Resin as a Means of Diagnosing Iodine-Basedow Produced by Intramuscular Administration of Iodized Oil in an Area of Endemic Goitre; Utilidad de la Prueba de la Captacion de Triyodotironina Marcada con {sup 131}I por Resina en el Diagnostico de Yod-Basedow Producido por la Administracion Intramuscular de Aceite Yodado, en una Area de Bocio Endemico

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Fierro-Benitez, R.; Ramirez, I. [Instituto de Ciencias Nucleares, Escuela Politecnica Nacional y Facultad de Medicina, Universidad Central, Quito (Ecuador)

1970-02-15

The authors gave intramuscular injections of iodized oil with a view to studying its prophylactic effects on endemic goitre and related defects (such as endemic cretinism) in isolated areas where more traditional techniques have serious limitations. This system had been tried earlier in New Guinea, where the results showed a reduction in the prevalence of goitre and proved the technique to be both safe and practical. However, because of the remoteness of the population in question it was impossible to continue the observations and no information was obtained regarding the effectiveness of iodized oil in reducing the incidence of defects associated with endemic goitre, Ecuador's program, involving studies of the whole population of two rural communities in the Andes, was begun in March 1966. The final control check came three years later. Ethiodol (37% iodized oil, 450 mg iodine per cm{sup 3}, obtained from Fougera, Hicksville, Long Island, N.Y. United States of America) was injected intramuscularly, 2 cm{sup 3} being administered to subjects 12 years of age and older and proportionately smaller doses to younger children. The ethiodol produced extensive changes in the physiological behaviour of the thyroid. {sup 131}I uptake was depressed for six months and afterwards remained normal. Similarly, BEI and T{sub 4} returned to and stayed at normal levels from the very first control checks onwards, which indicated that even during the first few months the thyroid glands of these subjects were maintaining a normal capacity to secrete thyronines, i.e. that they were not exhibiting the effect described by Wolff and Chaikoff, PBI and BII maintained high livels in all the controls. Urinary excretion of iodine followed a double exponential path: calculations indicated that the subjects would still be excreting significant amounts five years after the injection. Six months after injection there was an unequivocal diagnosis of Iodine-Basedow in three older women with large

Tanzania national survey on iodine deficiency: impact after twelve years of salt iodation

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Kimboka Sabas

2009-09-01

Full Text Available Abstract Background In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal salt iodation (USI as an intervention strategy, but its impact remained unknown. Methods We report on the first national survey in mainland Tanzania, conducted in 2004 to assess the extent to which iodated salt was used and its apparent impact on the total goitre prevalence (TGP and urinary iodine concentrations (UIC among the schoolchildren after USI was initiated. In 2004, a cross-sectional goitre survey was conducted; covering 140,758 schoolchildren aged 6 - 18 years were graded for goitre according to new WHO goitre classification system. Comparisons were made with district surveys conducted throughout most of the country during the 1980s and 90s. 131,941 salt samples from households were tested for iodine using rapid field test kits. UIC was determined spectrophotometrically using the ammonium persulfate digestion method in 4523 sub-sampled children. Results 83.6% (95% CI: 83.4 - 83.8 of salt samples tested positive for iodine. Whereas the TGP was about 25% on average in the earlier surveys, it was 6.9% (95%CI: 6.8-7.0 in 2004. The TGP for the younger children, 6-9 years old, was 4.2% (95%CI: 4.0-4.4, n = 41,965. In the 27 goitre-endemic districts, TGP decreased from 61% (1980s to 12.3% (2004. The median UIC was 204 (95% CF: 192-215 μg/L. Only 25% of children had UIC Conclusion Our study demonstrates a marked improvement in iodine nutrition in Tanzania, twelve years after the initiation of salt iodation programme. The challenge in sustaining IDD elimination in Tanzania is now two-fold: to better reach the areas with low coverage of iodated salt, and to reduce iodine intake in areas where it is excessive. Particular attention is needed in improving quality control at production level and

Management of hyperthyroidism

International Nuclear Information System (INIS)

Poshyachinda, M.

2001-01-01

There are many clinical form of hyperthyroidism. It is necessary to determine the specific cause in order to direct the treatment strategy accordingly. The most common form is Graves' disease, an autoimmune disorder characterized by the presence of thyroid stimulating immunoglobulin that bind to and stimulate the thyrotropin receptor resulting in thyroid overactivity. Toxic nodular goitres, the next in prevalence, is more common in iodine deficient region and causes by autonomous hyperfunctioning thyroid nodules. The therapeutic approaches to treat hyperthyroidism are 1) antithyroid drugs to block hormones synthesis and release, 2) surgery and 3) radioiodine ablation of thyroid tissue. All therapeutic modalities are effective but the latter two methods are most probably the definitive means to achieve remission of the hyperthyroidism. Antithyroid drug therapy is the preferred treatment for all children with Graves' disease and patients with small goitres and short duration. However, a long term remission from antithyroid drug treatment is approximately 50%. Surgery is appropriate treatment for patient who has a very large goitre with symptoms of compression in the neck or patient with a cold nodule on thyroid scan. Currently radioiodine therapy is the most common therapy for Graves' disease. It is increasingly used as first-line therapy especially in elderly patients. It is the treatment of choice for patients with recurrent hyperthyroidism after antithyroid drug or surgical treatment. Radioiodine is also the preferred treatment for toxic nodular goitre. It is effective, safe and low cost. However it may aggravated Graves' ophthalmopathy. The only major disadvantage is high incidence of hypothyroidism. It is crucial that the patient be followed annually post treatment so that hypothyroidism can be detected early and proper treatment initiated. (author)

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

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.; Dressler, J.; Gruenwald, F.; Leisner, B.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

2004-01-01

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

Jodindtagelse i Danmark

DEFF Research Database (Denmark)

Pedersen, K M; Nøhr, S B; Laurberg, P

1997-01-01

Iodine deficiency with a high frequency of goitre and, in severely affected areas, cretinism is common in some areas of the world. In Denmark the iodine intake as evaluated by urinary iodine excretion has been at a stable low level for many years, except for the part of the population now taking...... iodine supplementation as part of vitamin/ mineral preparations. The iodine intake is lowest in the western part of the country where an epidemiological study of elderly subjects has demonstrated a high frequency of goitre and hyperthyroidism in women. This supports the suggestion of a controlled...... moderate increase in iodine intake via an iodine supplementation program. Udgivelsesdato: 1997-Apr-7...

Iodine intake in Denmark

International Nuclear Information System (INIS)

Pedersen, K.M.; Noehr, S.B.; Laurberg, P.

1997-01-01

Iodine deficiency with a high frequency of goitre and, in severely affected areas, cretinism is common in some areas of the world. In Denmark the iodine intake as evaluated by urinary iodine excretion has been at a stable low level for many years, except for the part of the population now taking iodine supplementation as part of vitamin/mineral preparations. The iodine intake is lowest in the western part to the country where an epidemiological study of elderly subjects has demonstrated a high frequency of goitre and hyperthyroidism in women. This supports the suggestion of a controlled moderate increase in iodine intake via an iodine supplementation program. (au) 40 refs

High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area

DEFF Research Database (Denmark)

Laurberg, P; Pedersen, K M; Vestergaard, H

1991-01-01

that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid...... iodine deficiency, otherwise Graves' disease may be induced in the young population.......Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East-Jutland Denmark with a low average...

Autonomous functioning of the goitre

International Nuclear Information System (INIS)

Emrich, D.

1994-01-01

The article summarizes the status of knowledge on functional autonomy of the thyroid gland from the standpoint of definition, pathogenesis, pathophysiology, epidemiology, diagnostics and treatment. (orig.) [de

Molecular analysis of congenital goitres with hypothyroidism caused by defective thyroglobulin synthesis. Identification of a novel c.7006C>T [p.R2317X] mutation and expression of minigenes containing nonsense mutations in exon 7.

Science.gov (United States)

Machiavelli, Gloria A; Caputo, Mariela; Rivolta, Carina M; Olcese, María C; Gruñeiro-Papendieck, Laura; Chiesa, Ana; González-Sarmiento, Rogelio; Targovnik, Héctor M

2010-01-01

Thyroglobulin (TG) deficiency is an autosomal-recessive disorder that results in thyroid dyshormonogenesis. A number of distinct mutations have been identified as causing human hypothyroid goitre. The purpose of this study was to identify and characterize new mutations in the TG gene in an attempt to increase the understanding of the genetic mechanism responsible for this disorder. A total of six patients from four nonconsanguineous families with marked impairment of TG synthesis were studied. Single-strand conformation polymorphism (SSCP) analysis, sequencing of DNA, genotyping, expression of chimeric minigenes and bioinformatic analysis were performed. Four different inactivating TG mutations were identified: one novel mutation (c.7006C>T [p.R2317X]) and three previously reported (c.886C>T [p.R277X], c.6701C>A [p.A2215D] and c.6725G>A [p.R2223H]). Consequently, one patient carried a compound heterozygous for p.R2223H/p.R2317X mutations; two brothers showed a homozygous p.A2215D substitution and the remaining three patients, from two families with typical phenotype, had a single p.R277X mutated allele. We also showed functional evidences that premature stop codons inserted at different positions in exon 7, which disrupt exonic splicing enhancer (ESE) sequences, do not interfere with exon definition and processing. In this study, we have identified a novel nonsense mutation p.R2317X in the acetylcholinesterase homology domain of TG. We have also observed that nonsense mutations do not interfere with the pre-mRNA splicing of exon 7. The results are in accordance with previous observations confirming the genetic heterogeneity of TG defects.

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

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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)

1996-10-01

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

Pathomorphological study on thorotrast-induced hepatic angiosarcoma

International Nuclear Information System (INIS)

Umezu, Tohru

1984-01-01

Pathomorphological study on 18 cases of hepatic angiosarcoma among 93 cases of Thorotrast deposition was carried out. Macroscopically, hepatic angiosarcoma was classified into 4 types: multinodular, massive and diffuse types in addition to mixed type with massive and multinodular. Histologically, hepatic angiosarcoma consisted of 3 main patterns: cavernous, sinusoidal and solid, and they were coexisted in varying degrees in all cases. Factor VIII related antigen was found positive in normal and/or hyperplastic endothelial cells by a peroxidase-antiperoxidase (PAP) method, but negative in neoplastic cells while lysozyme was also negative in neoplastic cells. Varying degrees of hyperplastic changes of endothelial cells were considered as the precursor changes of angiosarcoma, and peliosis was considered as the secondary change. (author)

Congenital thyroid hemiagenesis with multinodular goiter

International Nuclear Information System (INIS)

Bhartiya, SK; Verma, A; Basu, S; Shukla, VK

2014-01-01

Thyroid hemiagenesis is a rare form of thyroid dysgenesis characterized by an absence of half of the thyroid gland. Developmental hemi-thyroid anomalies can result from either an abnormal descent or an agenesis of one lobe of the thyroid gland. We report a case of a 40-year-old woman with history of a longstanding gradually progressive thyroid swelling without any complication. An ultrasonographic examination diagnosed the absence of the left thyroid lobe and enlargement of the right lobe, which was confirmed on a computed tomography (CT) angiogram and a radionuclide scan of the neck. A cytological examination showed nodular goiter with cystic degeneration. Right subtotal thyroidectomy was performed and histopathological examination confirmed adenomatous goiter with degenerative changes. We report the rarity of the condition and emphasize the role of a comprehensive radiological, cytological, and radionuclide algorithm for an accurate preoperative diagnosis and subsequent management

Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

Science.gov (United States)

Bunevicius, Robertas; Prange, Arthur J

2006-01-01

Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

The influence of radioiodine therapy in 1470 patients with subclinical hyperthyroidism

International Nuclear Information System (INIS)

Abdelrazek, S.; Szumowski, P.; Mysliwiec, J.; Mojsak, M.; Kraszynska, A.; Amelian-Filonowicz, A.

2015-01-01

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

Sonographic evaluation of thyroiditis with color flow study.

Science.gov (United States)

Sultana, N; Rima, S; Rahman, S; Azad, S A; Karim, M E; Shawkat, S; Ahsan, M; Kamal, M M; Begum, M

2014-01-01

This cross sectional study was carried out in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Bangladesh in collaboration with the Department of Endocrinology and Department of Histopathology of the same hospital during the period of March 2007 to February 2008 to determine efficacy of ultrasonogram in the evaluation of thyroiditis and to compare its results with color flow Doppler study. For this purpose, a total of 50 patients having clinical suspicion of thyroiditis were enrolled in this study. Ultrasound and color Doppler were done in all these patients. Then all patients underwent for FNAC in the Histopathology department. Correlation between sonographic diagnosis and histopathological diagnosis were observed. Out of these 50 patients 10(20%) were male and 40 (80%) were female with age ranging from 12 to 50 years, highest between 21 to 30 years. The mean age of the patients was 30.42±9.57 years. On unltrasonographic findings of thyroid gland 42.0% patients had regular and 58.0% had irregular margin. Seventy percent had fibrosis, 14.0% had feature of necrosis, 48.0% had lymphadenopathy. Out of all patients 6.0% had normal echogenic feature, 16.0% had increased and 78.0% decreased echogeneic feature. Twelve percent (12.0%) patients had homogeneous and 88.0% had heterogeneous pattern of echogenecity. Thirty eight percent (38%) patients had focal nodules. Sixty percent (60.0%) patients had focal swelling and 40.0% had diffuse swelling. On color flow Doppler 28.0% had normal, 38.0% had increased and 34.0% decreased vascular flow pattern. USG reports revealed that 48.0% had thyromegaly, 36.0% had thyroid nodule, 10.0% had multinodular goiter and 6.0% had thyroid abscess. FNAC diagnosis revealed that 34.0% patients had Hashimoto's thyroiditis, 24.0% had lymphocytic thyroiditis, 18.0% had granulomatous thyroiditis, 6.0% had abscess, 8.0% had goitre and 10.0% nonspecific. USG and CFD are recommended modalities for the diagnosis of

[Transoral thyroid and parathyroid surgery : Implementation and evaluation of the transoral endoscopic technique via the vestibular approach (TOETVA)].

Science.gov (United States)

Karakas, E; Anuwong, A; Ketwong, K; Kounnamas, A; Schopf, S; Klein, G

2018-04-10

More than 10 years ago various research groups in Germany first reported the possibility of transoral surgery of the thyroid and parathyroid glands. These were developed and evaluated within the framework of natural orifice transluminal endoscopic surgery (NOTES). While development of these innovative and new techniques that enabled surgery without visible scars did not become well accepted in Europe and America, it led to an optimized transoral endoscopic thyroidectomy vestibular approach (TOETVA), which was implemented particularly in Asia. We report the preparation, step-by-step implementation, and first promising results for TOETVA of an international surgical cooperation. A Thai-Austrian-German cooperation was started in June 2017. Between June and November 2017 the first 10 TOETVA procedures were performed in female and male patient(s) presenting with single thyroid nodules, sporadic primary hyperparathyroidism and solitary parathyroid adenoma or thyroglossal duct cysts. The TOETVA technique was performed using 3 laparoscopic ports inserted at the oral vestibule and a CO 2 insufflation pressure at 6-8 mm Hg. Each surgery was performed using laparoscopic instruments and ultrasonic or bipolar devices. Surgical outcome, complications and conversions to an open technique were recorded. Of the patients six presented with single thyroid nodules, two patients had multinodular goitre with scintigraphically cold nodules and multifocal hyperfunctioning thyroid tissue, one patient suffered from sporadic primary hyperparathyroidism with a left sided parathyroid adenoma and one patient suffered from a thyroglossal duct cyst. No conversion to conventional open surgery was necessary. Average tumor size was 3.1 cm (range 1-4 cm). There was no relevant loss of blood or subsequent bleeding. No temporary or permanent hoarseness or mental nerve injury occurred, while transient hypoparathyroidism was evident after successful parathyroid resection. Of the patients five

Registration of symptoms and diagnoses in patients of a Belarussian-Dutch outpatient clinic in Gomel, October 1991 - September 1993

Energy Technology Data Exchange (ETDEWEB)

Van Oostrum, I.E.A.; Svalkoul, T.J.F. [National Poison Control Centre, RIVM, Bilthoven (Netherlands); Joore, J.C.A. [Department of Intensive Care and Clinical Toxicology, AZU, Utrecht (Netherlands); Volkova, G.V.; Savkova, M.I.; Derzhitski, V.E. [Gomel Regional Specialized Dispensary, Gomel (Belarus); Bootsma, P.A. [Bureau for International Cooperation, RIVM, Bilthoven (Netherlands)

1995-09-01

The results of a survey of the medical consumption of 4,500 patients at the Belarussian-Dutch Outpatient Clinic in Gomel during 1991-1993 are presented and discussed. Analysis of the patient registration data was focused on complaints related to possible enhanced radiation exposure of the patients since the reactor incident at Chernobyl in 1986. The pattern of complaints and diagnoses was comparable to the situation in a Dutch outpatient clinic, except for a higher number of goitre, gastritis, gastric and duodenal ulcers. Diagnoses that could be attributed to increased radiation exposure were not enhanced compared to the pattern in a Dutch population of similar size, except for a higher number of thyroid disease. 19 refs.

On the Effect of Pouring Temperature on Spheroidal Graphite Cast Iron Solidification

Directory of Open Access Journals (Sweden)

Alex Escobar

2015-04-01

Full Text Available This work is focused on the effect of pouring temperature on the thermal-microstructural response of an eutectic spheroidal graphite cast iron (SGCI. To this end, experiments as well as numerical simulations were carried out. Solidification tests in a wedge-like part were cast at two different pouring temperatures. Five specific locations exhibiting distinct cooling rates along the sample were chosen for temperature measurements and metallographic analysis to obtain the number and size of graphite nodules at the end of the process. The numerical simulations were performed using a multinodular-based model. Reasonably good numerical-experimental agreements were obtained for both the cooling curves and the graphite nodule counts.

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-09-01

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

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

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger; Brink, Ingo; Krause, Thomas M.

2002-01-01

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

Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy

International Nuclear Information System (INIS)

Baehre, M.; Lindemann, C.; Emrich, D.; Hilgers, R.

1988-01-01

This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99m Tc pertechnetate uptake under suppression (TcU s ), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by highresolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. ΔTSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcU s . I these classes, free thyroxie index (FT 4 I) and total triiodothyronine (TT 3 ) icreased with increasing TcU s , whereas ΔTSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT 4 I, TT 3 and ΔTSH in each of the TcU s classes depended on the individual iodine supply. It is concluded that, in patients with thyroid autonomy, actual thyroid hormone concentrations and TSH stimulation are determined by two major factors: the extent of autonomy and the individual iodine supply. Therefore, in iodine deficiency, the TRH test may be normal

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-09-01

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

Amiodarone-induced thyroid dysfunction

African Journals Online (AJOL)

multinodular disease or Graves' disease, who on exposure to an excessive .... where the cardiovascular status permitted this, radioactive ... antedating the initiation of amiodarone therapy in the current cohort. .... an evidence-based protocol.

LES GOITRES BÉNINS EN ORL

African Journals Online (AJOL)

18 juin 2007 ... Montury S., de Clermont H, Gatina J.H. Prévalence des cancers thyroïdiennes à la Réunion à partir des données scinti- graphiques. Bull Patho Exot, 1997. 9. Moumen M, Touhami M, Elaoui M.E, Fares F.El. Les micro-carcinomes thyroïdiens. Médecine du Maghreb, 1992, 31 :25-28. 10. Ntyonga-Pono M.P.

HUBUNGAN PENYAKIT GONDOK DENGAN PRESTASI BELAJAR DAN TINGGI BADAN ANAK MADRASAH IBTIDAIYAH NEGERI (MIN KORONG GADANG KECAMATAN KURANJI KOTA PADANG

Directory of Open Access Journals (Sweden)

Yusri Dianne Jurnalis

2008-09-01

necessary for the development of nervous system in the fetus and infant. Lack of dietary iodine is cause of goitre, an enlargement of the thyroidARTIKEL PENELITIAN161gland. Endemic goiter results from increased thyroid stimulation by thyroid stimulating hormone (TSH to maximize the utilization of available iodine and thus respresents maladaption to iodine deficiency. However, the most damaging disorders induced by iodine deficiency are irreversible mental retardation and growth restriction. Within 5 years, prevalence of goitre in Padang City increased from 8.5% to 21.5%.The aim of this study was to investigate the prevalence of goiter and its relation with academic performance and stature of Madrasah Ibtidaiyah Negeri (MIN students in Korong Gadang Kuranji District, Padang City.A cross sectional study has been done in 169 students of the second, third, fourth, fifth, and sixth degree of Madrasah Ibtidaiyah Negeri (MIN Korong Gadang Kuranji District, Padang City. Data of academic performance was taken from the result of study in a semester. Stature was determined based on height for age.During the research, there were 84 children (49.7% who suffered from goitre. The correlation between goitre and academic performance are unsignificant (p>0.05. This study was also found that there was no correlation between goitre and physical growth (p>0.05.Keywords: Goitre, Academic Performance, Child Stature

Focusing ethnography

DEFF Research Database (Denmark)

Woermann, Niklas

2018-01-01

underpinnings of focusing ethnographic research by comparing different schools of thought and suggesting a practice theory-based approach. It argues that many research projects are focused but do not reflect on the process of focusing, describes how to identify focal settings or practices, and introduces......Building theory with ethnography and filmic research increasingly requires focussing on key practices or settings, instead of painting a broad panorama of a culture. But few authors discuss why and how to focus. This article provides a systematic discussion of the theoretical and methodological...

Surgical management of hyperthyroidism.

Science.gov (United States)

Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

2015-04-01

Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

STRUCTURE OF THE NODULAR GOITER IN CHILDREN

Directory of Open Access Journals (Sweden)

O. S. Rogova

2015-01-01

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

Focused Ethnography

Directory of Open Access Journals (Sweden)

Hubert Knoblauch

2005-09-01

Full Text Available In this paper I focus on a distinctive kind of sociological ethnography which is particularly, though not exclusively, adopted in applied research. It has been proposed that this branch of ethno­graphy be referred to as focused ethnography. Focused ethnography shall be delineated within the context of other common conceptions of what may be called conventional ethnography. However, rather than being opposed to it, focused ethno­graphy is rather complementary to conventional ethnography, particularly in fields that are charac­teristic of socially and functionally differentiated contemporary society. The paper outlines the back­ground as well as the major methodological features of focused ethnography, such as short-term field visits, data intensity and time intensity, so as to provide a background for future studies in this area. URN: urn:nbn:de:0114-fqs0503440

East And Central African Journal of Surgery Volume 11 Number 2 ...

African Journals Online (AJOL)

user

2006-12-02

Dec 2, 2006 ... Radionuclide Scan and Other Diagnostic Studies in Goitre Patients in Tanzania ... When diagnosed by ultrasound the incidence raises to 30-50% 4,5. ..... breast cancer (unpublished) in Tanzania has been shown to be low.

Browse Title Index

African Journals Online (AJOL)

Items 401 - 450 of 623 ... Vol 32, No 1 (2013), Pathology and the Surgical Management of Goitre in an ... Perceived, desired, and normatively determined orthodontic treatment needs ... Vol 31, No 2 (2012), Pre-Hypertension and Hypertension in ...

Focus Groups Help To Focus the Marketing Strategy.

Science.gov (United States)

Ashar, Hanna; Lane, Maureen

1996-01-01

A university-based degree completion program for adults conducted focus group research to refine market positioning and promotion. Focus groups averaged five current students and recent graduates who reflected, demographically, the current student population. Results gave insight into reasons for selecting the university, aspects of the program…

Ultrasound and computed tomographic demonstration of portal vein thrombosis in hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Pauls, C H

1981-07-15

Two cases of multinodular hepatocellular carcinoma (HCC) in which ultrasound and computed tomography (CT) revealed portal vein thrombosis are presented. The diagnostic value of determining the presence of portal vein thrombosis in patients with suspected HCC is discussed.

Evaluation of human thyroid tumors by proton nuclear magnetic resonance

International Nuclear Information System (INIS)

deCertaines, J.; Herry, J.Y.; Lancien, G.; Benoist, L.; Bernard, A.M.; LeClech, G.

1982-01-01

Proton nuclear magnetic resonance (NMR) was used in a study of 40 patients with thyroid tumors following partial or total thyroidectomy. Three patient groups were considered: those with nodules showing increased uptake, those with solitary nodules with decreased uptake, and those with multinodular goiters. Spin-lattice and spin-spin relaxation times (T 1 and T 2 ) were measured on samples of nodular and extranodular tissue from each patient. Increased T 1 and T 2 were observed for benign cold nodules, an increase in T 1 alone for nodules with increased uptake, and a wide fluctuation in T 1 and T 2 for multinodular goiters. The four cancers in the series did not show a distinctive proton NMR pattern in comparison with the other nodular structures studied. The results point to the feasibility of applying NMR techniques to the detection of thyroid disease

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

Directory of Open Access Journals (Sweden)

Hendra Budi Sungkawa

2015-12-01

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

Without 'Focus'

Directory of Open Access Journals (Sweden)

Aldo Sevi

2010-12-01

Full Text Available It is widely accepted that a notion of 'focus', more or less as conceived of in Jackendoff (1972, must be incorporated into our theory of grammar, as a means of accounting for certain observed correlations between prosodic facts and semantic/pragmatic facts. In this paper, we put forth the somewhat radical idea that the time has come to give up this customary view, and eliminate 'focus' from our theory of grammar. We argue that such a move is both economical and fruitful.Research over the years has revealed that the correlations between prosody, 'focus', and the alleged semantic/pragmatic effects of focus are much less clear and systematic than we may have initially hoped. First we argue that this state of affairs detracts significantly from the utility of our notion of 'focus', to the point of calling into question the very motivation for including it in the grammar. Then we look at some of the central data, and show how they might be analyzed without recourse to a notion of 'focus'. We concentrate on (i the effect of pitch accent placement on discourse congruence, and (ii the choice of 'associate' for the so-called 'focus sensitive' adverb only. We argue that our focus-free approach to the data improves empirical coverage, and begins to reveal patterns that have previously been obscured by preconceptions about 'focus'.ReferencesBeaver, D. & Clark, B. 2008. Sense and Sensitivity: How Focus Determines Meaning. Blackwell.Beaver, D., Clark, B., Flemming, E., Jaeger, T. F. & Wolters, M. 2007. ‘When semantics meets phonetics: Acoustical studies of second occurrence focus’. Language 83.2: 245–76.http://dx.doi.org/10.1353/lan.2007.0053Beckman, M. & Hirschberg, J. 1994. ‘The ToBI Annotation Conventions’. Ms.,http://www.cs.columbia.edu/~julia/files/conv.pdf.Bolinger, D. 1972. ‘Accent is predictable (if you are a mind-reader’. Language 48.3: 633–44.http://dx.doi.org/10.2307/412039Büring, D. 2006. ‘Focus projection and default

Focus on focusing

International Nuclear Information System (INIS)

Anon.

1985-01-01

The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics

Focus on focusing

Energy Technology Data Exchange (ETDEWEB)

Anon.

1985-10-15

The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics.

TSH test

Science.gov (United States)

... an underactive thyroid gland ( hypothyroidism ). There are many causes of this problem. A lower-than-normal level may be due to an overactive thyroid gland, which can be caused by: Graves disease Toxic nodular goiter or multinodular goiter Too much ...

Dansk jodberigelse af salt og forekomst af thyroideasygdom

DEFF Research Database (Denmark)

Laurberg, Peter; Jørgensen, Torben; Ovesen, Lars

2011-01-01

Until 2000 Denmark was iodine deficient with moderate deficiency in the western part and mild deficiency in the eastern part. The occurrence of goitre and autonomous hyperthyroidism was high, and pregnancy was associated with a reduction in thyroid function. After cautious mandatory iodization...

Increased risk of affective disorder following hospitalisation with hyperthyroidism - a register-based study

DEFF Research Database (Denmark)

Thomsen, Anders F; Kvist, Tine K; Andersen, Per K

2005-01-01

by their International Classification of Diseases (ICD) diagnoses at discharge from hospital and consisted of all patients with a first hospital admission with the index diagnoses of hyperthyroidism, osteoarthritis, or non-toxic goitre. Later admissions to psychiatric hospital wards with discharge ICD diagnoses...

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-09-15

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

Electric motors in the focus; Elektroantrieb im Focus

Energy Technology Data Exchange (ETDEWEB)

Wilms, Jan

2013-05-15

In August 2013, the first electric series production model of Ford comes to the market: the Focus Electric. A 23-kWh lithium-ion battery supplies the 107 kilowatts (145 hp) electric motor of the Focus Electric with energy. This battery enables a range of 162 kilometers and a limited top speed of 136 kilometers per hour. However, with 40,000 Euro this electric-powered vehicles is too expensive.

Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy.

Science.gov (United States)

Keefe, John R; Solomonov, Nili; Derubeis, Robert J; Phillips, Alexander C; Busch, Fredric N; Barber, Jacques P; Chambless, Dianne L; Milrod, Barbara L

2018-04-18

This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.

Focusators for laser-branding

Science.gov (United States)

Doskolovich, L. L.; Kazanskiy, N. L.; Kharitonov, S. I.; Uspleniev, G. V.

A new method is investigated for synthesis of computer-generated optical elements: focusators that are able to focus the radial-symmetrical laser beam into complex focal contours, in particular into alphanumeric symbols. The method is based on decomposition of the focal contour into segments of straight lines and semi-circles, following corresponding spacing out of the focusator on elementary segments (concentric rings or sectors) and solution of the inverse task of focusing from focusator segments into corresponding elements of the focal contour. The results of numerical computing of the field from synthesized focusators into the letters are presented. The theoretical efficiency of the focusators discussed is no less than 85%. The amplitude masks and the results of operational studies of synthesized focusators are presented.

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

DEFF Research Database (Denmark)

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

2011-01-01

Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...

Follicular carcinoma of the thyroid with hyperthyroidism. A case report.

Science.gov (United States)

Sharma, Prashant; Kumar, Neeta; Gupta, Ruchika; Jain, Shyama

2004-01-01

Follicular carcinoma of the thyroid in association with hyperthyroidism is rare. The malignant lesion may remain occult for a long time. Certain clinical and cytologic features may be helpful in raising the alarm. An elderly male with a history of occupational exposure to X rays, long-standing toxic multinodular goiter and clinical hyperthyroidism presented with a rapidly enlarging mass in the neck. Cytologic smears showed a prominent microfollicular pattern, scanty colloid, anisonucleosis and nuclear overlapping. The noteworthy feature was the presence of marginal vacuoles. The cytologic diagnosis of follicular neoplasm with highly suggestive malignancy was made. Subsequently, multiple pulmonary nodules provided radiologic evidence of possible metastatic spread. This case report demonstrates the rare association of follicular carcinoma of the thyroid with hyperthyroidism and analyzes certain high-risk clinical and cytologic features to be considered in the follow-up of long-standing hyperfunctioning multinodular goiter.

Plasma focus breeder

International Nuclear Information System (INIS)

Ikuta, Kazunari.

1981-09-01

Instead of using linear accelerators, it is possible to breed fissile fuels with the help of high current plasma focus device. A mechanism of accelerating proton beam in plasma focus device to high energy would be a change of inductance in plasma column because of rapid growth of plasma instability. A possible scheme of plasma focus breeder is also proposed. (author)

Plutonium focus area

International Nuclear Information System (INIS)

1996-08-01

To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this new approach, EM developed a management structure and principles that led to the creation of specific Focus Areas. These organizations were designed to focus the scientific and technical talent throughout DOE and the national scientific community on the major environmental restoration and waste management problems facing DOE. The Focus Area approach provides the framework for intersite cooperation and leveraging of resources on common problems. After the original establishment of five major Focus Areas within the Office of Technology Development (EM-50, now called the Office of Science and Technology), the Nuclear Materials Stabilization Task Group (EM-66) followed the structure already in place in EM-50 and chartered the Plutonium Focus Area (PFA). The following information outlines the scope and mission of the EM, EM-60, and EM-66 organizations as related to the PFA organizational structure

Drains after Thyroidectomy for Benign Thyroid Disorders; Are ...

African Journals Online (AJOL)

Prophylactic drainage after thyroidectomy has been a regular practice at Kenyatta National Hospital( KNH). This has been ... stay and post-operative pain. Introduction. Prophylactic drains are still regularly used in ..... Total versus subtotal thyroidectomy for the management of benign multinodular goiter in an endemic region.

Intracranial Hemorrhage Revealing Pseudohypoparathyroidism as a Cause of Fahr Syndrome

Directory of Open Access Journals (Sweden)

Abhijit Swami

2011-01-01

Full Text Available Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT4, low FT3, and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.

[Pre-verbality in focusing and the need for self check. An attempt at "focusing check"].

Science.gov (United States)

Masui, T; Ikemi, A; Murayama, S

1983-06-01

Though the Focusing process is not entirely non-verbal, in Focusing, careful attention is paid by the Focuser and the Listener to the pre-verbal experiential process. In other words, Focusing involves attending to the felt sense that is not easily expressed in words immediately. Hence, during the process of learning to Focus, the Focusing teacher attempts to communicate the experiences of Focusing to the student which are not easily done by words. Due to such difficulties, the Focusing student may (and quite frequently does) mistake the experiential process in Focusing with other processes. Often, the felt sense can be confused with other phenomena such as "autogenic discharge". Also the Focuser may not stay with the felt sense and drift into "free association" or frequently, certain processes in "meditation" can be confused with Focusing. Therefore, there is a need for a "check" by which the Focusing student can confirm the Focusing experience for himself. For the Focusing student, such a "check" serves not only to confirm the Focusing process, but also an aid to learning Focusing. We will report here a "Focusing Check" which we developed by translating Eugene Gendlin's "Focusing Check" and making several modifications in it so that it will be more understandable to the Japanese. Along with the "Focusing Check" we developed, the authors discuss the need for such a check.

Iodine. Do we need an enrichment program in Denmark?

DEFF Research Database (Denmark)

Rasmussen, Lone Banke; Andersson, G.; Haraldsdottir, J.

1996-01-01

A working group was established to evaluate the need for iodine enrichment in Denmark. Judged from studies of urinary iodine excretion and one dietary survey the intake of iodine in Denmark is low compared with recommended intakes. The occurrence of non-toxic goitre is relatively high; between 9...

Focus group discussions

CERN Document Server

Hennink, Monique M

2014-01-01

The Understanding Research series focuses on the process of writing up social research. The series is broken down into three categories: Understanding Statistics, Understanding Measurement, and Understanding Qualitative Research. The books provide researchers with guides to understanding, writing, and evaluating social research. Each volume demonstrates how research should be represented, including how to write up the methodology as well as the research findings. Each volume also reviews how to appropriately evaluate published research. Focus Group Discussions addresses the challenges associated with conducting and writing focus group research. It provides detailed guidance on the practical and theoretical considerations in conducting focus group discussions including: designing the discussion guide, recruiting participants, training a field team, moderating techniques and ethical considerations. Monique Hennink describes how a methodology section is read and evaluated by others, such as journal reviewers or ...

Near-field flat focusing mirrors

Science.gov (United States)

Cheng, Yu-Chieh; Staliunas, Kestutis

2018-03-01

This article reviews recent progress towards the design of near-field flat focusing mirrors, focusing/imaging light patterns in reflection. An important feature of such flat focusing mirrors is their transverse invariance, as they do not possess any optical axis. We start with a review of the physical background to the different focusing mechanisms of near- and far-field focusing. These near-field focusing devices like flat lenses and the reviewed near-field focusing mirrors can implement planar focusing devices without any optical axis. In contrast, various types of far-field planar focusing devices, such as high-contrast gratings and metasurfaces, unavoidably break the transverse invariance due to their radially symmetrical structures. The particular realizations of near-field flat focusing mirrors including Bragg-like dielectric mirrors and dielectric subwavelength gratings are the main subjects of the review. The first flat focusing mirror was demonstrated with a chirped mirror and was shown to manage an angular dispersion for beam focusing, similar to the management of chromatic dispersion for pulse compression. Furthermore, the reviewed optimized chirped mirror demonstrated a long near-field focal length, hardly achieved by a flat lens or a planar hyperlens. Two more different configurations of dielectric subwavelength gratings that focus a light beam at normal or oblique incidence are also reviewed. We also summarize and compare focusing performance, limitations, and future perspectives between the reviewed flat focusing mirrors and other planar focusing devices including a flat lens with a negative-index material, a planar hyperlens, a high-contrast grating, and a metasurface.

BrightFocus Foundation

Science.gov (United States)

... About BrightFocus Foundation Featured Content BrightFocus: Investing in Science to Save Mind and Sight We're here to help. Explore ... recognition is very important. Monday, November 6, 2017 New Diagnosis? Managing a mind and sight disease is a journey. And you’ ...

The Effect of Radioiodine on the Intima Media Thickness of the Carotid Artery

Directory of Open Access Journals (Sweden)

Erdem Sürücü

2013-12-01

Full Text Available Aim: The radiation can induce vessel injury. The result of this injury can be severe and life-threatening. There are a few studies demonstrating an increase in intima-media thickness (IMT of the common carotid artery (CCA after radiotherapy, especially in head and neck cancers. We evaluated the effect of I-131 to the IMT of the CCA in the patients who were treated for hyperthyroidism. Methods: 38 patients (25M, 13W referred to our department for radioiodine treatment with the diagnosis of nodular goitre (25 patients and diffuse hyperplasia (Graves disease (GD, 13 patients were included to the prospective study. An USG was performed for all the patients before therapy, 3, 6 and 12 months after radioiodine therapy in order to measure IMT of CCA and the femoral artery (FA. The IMT was measured at the level of proximal part of bulbus anteriorly on the left and right side. The IMT of FA was measured just before the bifurcation. Results: There was a statistically significant increase in IMT of both CCA and FA bilaterally in nodular hyperthyroid patients. However, in the patients with Graves disease, there was only statistically significant increase in the left IMT of CCA at 0-3rd, 0-6th month measurements and in the right IMT of FA at 0-3rd month measurements. Conclusion: Though the limitation of the study is the interobserver and intraobserver variability, it was seen that I-131 therapy might affect the IMT of CCA in the patients with NG. I-131 effect on the IMT of CCA in patients with nodular goitre was higher than the IMT of CCA in patients with GD. I-131 effect on the IMT of CCA might be due to administered dose and adjacency. The interesting point of our study was the increased thickness of IMT in FA. We think that the increase in IMT is due to the systemic effect of radioactivity circulating in the blood vessel. I-131 effect on the IMT of FA in patients with nodular goitre was higher than the IMT of FA in the patients with GD due to I-131 uptake

Cotyledonoid Leiomyoma

African Journals Online (AJOL)

Cotyledonoid leiomyoma is a very rare tumor among the ever expanding repertoire of growth variants described in benign uterine leiomyoma. We report a case of cotyledonoid leiomyoma in a 39-year-old (unmarried) women presented with lump in abdomen. On laparotomy, a large multinodular, tan colored, exophytic, ...

Submucous dissection of the nasopharynx complicating ...

African Journals Online (AJOL)

We present the case of a 60-year old woman, who had an unusual complication of nasotracheal intubation, which was carried out to relieve post-thyroidectomy respiratory distress at the University of Ilorin Teaching Hospital (UITH). She presented with a huge malignant goitre complicated by severe respiratory distress due ...

JUNE 2010.for Ogidi (final).cdr

African Journals Online (AJOL)

User

procedure for carcinoma was 89% with a sensitivity of 35%, specificity of 97%, positive predictive value of. 64%, and a negative predictive value of ... evaluation of patients who present with goitres. The outcome of the test can be used .... disadvantages caused by the delay in surgery and availability of histopathology reports.

Dansk jodberigelse af salt og forekomst af thyroideasygdom

DEFF Research Database (Denmark)

Laurberg, Peter; Jørgensen, Torben; Ovesen, Lars

2011-01-01

of household salt and salt used for bread production, the iodine intake in Denmark is now low normal. The DanThyr monitoring has shown a transient increase in hyperthyroidism followed by a decrease, and goitre is becoming less common. Hypothyroidism has become more common, and this has to be followed....

Plasma focus matching conditions

International Nuclear Information System (INIS)

Soliman, H.M.; Masoud, M.M.; Elkhalafawy, T.A.

1988-01-01

A snow-plough and slug models have been used to obtain the optimum matching conditions of the plasma in the focus. The dimensions of the plasma focus device are, inner electrode radius = 2 cm, outer electrode radius = 5.5 cm, and its length = 8 cm. It was found that the maximum magnetic energy of 12.26 kJ has to be delivered to plasma focus whose density is 10 19 /cm 3 at focusing time of 2.55 μs and with total external inductance of 24.2 n H. The same method is used to evaluate the optimum matching conditions for the previous coaxial discharge system which had inner electrode radius = 1.6 cm, outer electrode radius = 3.3 cm and its length = 31.5 cm. These conditions are charging voltage = 12 kV, capacity of the condenser bank = 430 μf, plasma focus density = 10 19 /cm 3 focusing time = 8 μs and total external inductance = 60.32 n H.3 fig., 2 tab

Focused ultrasound in ophthalmology

Directory of Open Access Journals (Sweden)

Silverman RH

2016-09-01

Full Text Available Ronald H Silverman1,2 1Department of Ophthalmology, Columbia University Medical Center, 2F.L. Lizzi Center for Biomedical Engineering, Riverside Research, New York, NY, USA Abstract: The use of focused ultrasound to obtain diagnostically significant information about the eye goes back to the 1950s. This review describes the historical and technological development of ophthalmic ultrasound and its clinical application and impact. Ultrasound, like light, can be focused, which is crucial for formation of high-resolution, diagnostically useful images. Focused, single-element, mechanically scanned transducers are most common in ophthalmology. Specially designed transducers have been used to generate focused, high-intensity ultrasound that through thermal effects has been used to treat glaucoma (via cilio-destruction, tumors, and other pathologies. Linear and annular transducer arrays offer synthetic focusing in which precise timing of the excitation of independently addressable array elements allows formation of a converging wavefront to create a focus at one or more programmable depths. Most recently, linear array-based plane-wave ultrasound, in which the array emits an unfocused wavefront and focusing is performed solely on received data, has been demonstrated for imaging ocular anatomy and blood flow. While the history of ophthalmic ultrasound extends back over half-a-century, new and powerful technologic advances continue to be made, offering the prospect of novel diagnostic capabilities. Keywords: ophthalmic ultrasound, ultrasound biomicroscopy (UBM, high-intensity focused ultrasound (HIFU, ultrafast imaging, Doppler imaging 

Plasma focus project

International Nuclear Information System (INIS)

Sahlin, H.L.

1975-12-01

The primary objective of this project is to provide a relatively simple pulsed power source for high density pulsed fusion studies with a variety of DT and other fusion microexplosion targets. The plasma focus operated on DT at 1 MJ should produce greater than or equal to 10 15 DT neutrons per pulse corresponding to 2800 J of nuclear energy release and for low pressure operation and appropriately configured high Z anode center should yield an x-ray burst of about 1000 J with a substantial fraction of this x-ray energy concentrated in the 5-100 kV range. Because of its x-ray and neutron production potential, the operation of the focus as an x-ray source is also under study and an initial design study for a repetitively pulsed 1 MJ plasma focus as a pulsed neutron materials testing source has been completed. The plasma focus seems particularly appropriate for application as a materials testing source for pulsed fusion reactors, for example, based on laser driven fusion microexplosions. The construction status of the device is described

The Role of Infiltrative Local Anaesthesia in Thyroidectomy

African Journals Online (AJOL)

anaesthesia if we were to offer services to all the scheduled patients. We included all patients who had class 2 goitre and gave informed consent. We excluded ... local anaesthesia prior to cleaning and draping the surgical field. After draping, a collar crease incision was performed and a sub-platysmal flap raised, after.

Submucous dissection of the nasopharynx complicating ...

African Journals Online (AJOL)

Adele

2003-09-12

Sep 12, 2003 ... way (dental, otorhinolaryngological) or may be preferred for long- term intubation. Complications arising from the use of this tech- nique have been .... Chondromalacia occurs as a result of erosion of the tracheal cartilages by a large goitre, but is rare unless the actual tracheal car- tilage is removed in ...

The focus factor

DEFF Research Database (Denmark)

Nicolaisen, Jeppe; Frandsen, Tove Faber

2015-01-01

Introduction. We present a new bibliometric indicator to measure journal specialisation over time, named the focus factor. This new indicator is based on bibliographic coupling and counts the percentage of re-citations given in subsequent years. Method. The applicability of the new indicator....... To validate re-citations as caused by specialisation, other possible causes were measured and correlated (obsolescence, journal self-citations and number of references). Results. The results indicate that the focus factor is capable of distinguishing between general and specialised journals and thus...... effectively measures the intended phenomenon (i.e., journal specialisation). Only weak correlations were found between journal re-citations and obsolescence, journal self-citations, and number of references. Conclusions. The focus factor successfully measures journal specialisation over time. Measures based...

Technetium-99m tetrofosmin imaging in thyroid diseases: comparison with Tc-99m-pertechnetate, thallium-201 and Tc-99m-methoxyisobutylisonitrile scans

International Nuclear Information System (INIS)

Klain, M.; Cuocolo, A.; Marzano, L.; Lombardi, G.; Salvatore, M.; Univ. di Napoli

1996-01-01

In this study, tetrofosmin whole-body scintigraphy was performed in 35 patients with evidence of thyroid diseases. All patients underwent laboratory evaluation of thyroid function as well as 99m Tc pertechnetate scan, thallium-201 99m Tc-methoxyisobutylisonitrile (MIBI) whole-body studies. Thyroid images were semi-quantitatively analysed by a 4-point score: 0=no significant uptake; 1=uptake increased but inferior to normal thyroid tissue; 2=uptake equal to normal thyroid tissue; 3=uptake superior to normal thyroid tissue. A total of 41 thyroid nodules were detected, of which 15 were goitre nodules, 13 adenomas and 13 malignant lesions. In goitre nodules, concordant results of tetrofosmin and pertechnetate uptake (score 1 or 0) were observed in the majority of lesions (87%). In function adenomas both tetrofosmin uptake and pertechnetate uptake were score 3. In non-function adenomas tetrofosmin uptake was score 3, while pertechnetate uptake was score 0. In six malignant lesions, tetrofosmin uptake was score 3, while pertechnetate uptake was score 0; in the other seven lesions, where a prevalence of goitre abnormalities was observed, results of tetrofosmin and pertechnetate uptake were similar (score 0 or 1). In (70%) patients with malignant nodules, whole-body tetrofosmin images showed increased abnormal uptake in a total of 28 extra-thyroid tumour sites, as subsequently confirmed by other techniques. When tetrofosmin images were compared to 201 Tl and 99m Tc-MIBI scans, concordant results were observed in all cases. In conclusion, tetrofosmin imaging may be particularly useful to characterize and stage patients with malignant thyroid nodules; it shows similar results to thallium but provides better image quality. Comparable findings were observed between tetrofosmin and MIBI studies. Thus, tetrofosmin may be an alternative to thallium and MIBI in the aforementioned patients. (orig.). With 4 figs., 3 tabs

Comparison of clinical and radiological findings in patients with retrosternal and cervical goiters

International Nuclear Information System (INIS)

Vizner, B.; Vilibic, T.; Sikic, E.; Sekso, M.; Vrkljan, M.; Hat, J.

1994-01-01

We analyzed the correlation of clinical and radiological findings in the diagnosis of large cervical and retrosternal nodular goitres. Fourteen symptomatic patients were studied (12 female and 2 male). Nine of them had retrosternal goitre. All underwent computed tomography (CT) of the neck and upper mediastinum, thyroid scintigraphy using Tc-99m-pertechnetate and contrast radiology of the oesophagus. Problems with respiration (stridor) were present in five patients, but four of them had CT findings of tracheal compression. The other nine patients had no respiratory problems, and CT revealed tracheal compression in two cases. Nine patients had the dislocation of the trachea on CT. Dysphagia was present in eight cases but only three patients had radiological signs of oesophageal narrowing. These patients also had the dislocation of the oesophagus, revealed by contrast radiology, just as five others without any swallowing problems. The results demonstrate that all patients with respiratory problems do not necessary have tracheal compression (indicating the possible affection of the phrenic nerve). On the other hand, some patients can have tracheal narrowing without any respiratory problems. (author)

FOREWORD: Focus on Advanced Ceramics Focus on Advanced Ceramics

Science.gov (United States)

Ohashi, Naoki

2011-06-01

Much research has been devoted recently to developing technologies for renewable energy and improving the efficiency of the processes and devices used in industry and everyday life. Efficient solutions have been found using novel materials such as platinum and palladium-based catalysts for car exhaust systems, samarium-cobalt and neodymium-iron-boron permanent magnets for electrical motors, and so on. However, their realization has resulted in an increasing demand for rare elements and in their deficit, the development of new materials based on more abundant elements and new functionalities of traditional materials. Moreover, increasing environmental and health concerns demand substitution of toxic or hazardous substances with nature-friendly alternatives. In this context, this focus issue on advanced ceramics aims to review current trends in ceramics science and technology. It is related to the International Conference on Science and Technology of Advanced Ceramics (STAC) held annually to discuss the emerging issues in the field of ceramics. An important direction of ceramic science is the collaboration between experimental and theoretical sciences. Recent developments in density functional theory and computer technology have enabled the prediction of physical and chemical properties of ceramics, thereby assisting the design of new materials. Therefore, this focus issue includes articles devoted to theory and advanced characterization techniques. As mentioned above, the potential shortage of rare elements is becoming critical to the industry and has resulted in a Japanese government initiative called the 'Ubiquitous Element Strategy'. This focus issue also includes articles related to this strategy and to the associated topics of energy conversion, such as phosphors for high-efficiency lighting and photocatalysts for solar-energy harvesting. We hope that this focus issue will provide a timely overview of current trends and problems in ceramics science and

Thyroid carcinoma

International Nuclear Information System (INIS)

Lambertini, Roberto; Dalurzo, Liliana; Jaen, Ana del V.

2008-01-01

In this document the case of a 66-year old woman is presented, with record of multi nodular goiter of 5 year of evolution, which is derived to scan ultrasound office to make a puncture-aspiration with thin needle because of the growth of nodular thyroid injuries. The ultrasound scan examination made before the puncture determine multiple dominant nodules of hyperplasia aspect between 15 and 25 mm of diameter and a small nodule of 6 mm suspected proliferate process. Despite its size, it was decided to include small nodule in injuries to a biopsy. The cytological study reveals nodular hyperplasia with carcinoma in the small nodule of 6 mm. A thyroidectomy is practiced on the patient. The deferred histological study of the thyroid gland confirms the finding of multi-nodular goiter with a small focus of papillar carcinoma. The ganglions examined were negative in the deferred examination [es

Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice.

Science.gov (United States)

Guastamacchia, Edoardo; Triggiani, Vincenzo; Aglialoro, Alberto; Aiello, Antimo; Ianni, Lucia; Maccario, Mauro; Zini, Michele; Giorda, Carlo; Guglielmi, Rinaldo; Betterle, Corrado; Attanasio, Roberto; Borretta, Giorgio; Garofalo, Piernicola; Papini, Enrico; Castello, Roberto; Ceriello, Antonio

2015-06-01

Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes. Moreover, the treatments used for both diabetes and thyroid disease, respectively, can impact one other. Finally, multinodular goiter, but not thyroid carcinoma, was shown to be more prevalent in type 2 diabetes mellitus. Aim of the present Position Statement is to focus on the evidence concerning the association of thyroid disease and diabetes mellitus and to provide some practical suggestions for an updated clinical management.

Finding focus: a study of the historical development of focus in English

NARCIS (Netherlands)

Komen, E.R.

2013-01-01

This study reveals how two important focus articulations change over time in written English. Constituent focus, often accompanied by contrast, makes use of the clause-initial position in the oldest stages of English, but as this position comes to be used for the grammatical subject over time, the

Thyrotoxicosis Associated with a Hypopharyngeal Toxic Nodular Thyroid

Directory of Open Access Journals (Sweden)

S. Ali Imran

2017-01-01

Full Text Available Ectopic thyroid is a rare developmental anomaly which may be either asymptomatic or present with thyroid dysfunction as well as pressure symptoms. Here we present a novel case of thyrotoxicosis associated with a hypopharyngeal multinodular thyroid in a female. Removal of the ectopic thyroid led to normalization of the thyroid status.

A clinical study on 125I T3 resin uptake rate and serum thyroxin (T4) in hyperthyroidism

International Nuclear Information System (INIS)

Moon, E.S.; Park, Y.H.; Cho, C.H.; Park, I.S.; Lee, C.S.; Lee, H.C.

1978-01-01

Total of 94 cases of hyperthyroidism were classified as toxic diffuse goiter (77 case) as toxic adematous goiter (8 case) and as toxic multinodular goiter (9 case) on the levels of T 3 - 125 I resin uptake rate and the measurement of serum T 4 levels. Various clinical symptoms and diagnostic characteristics were discussed. (author)

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

DEFF Research Database (Denmark)

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

2006-01-01

multinodular goiters (TMG) and 13 toxic adenomas (TA)]. Thyroid status was determined by TSH, fT3 and fT4 levels, and outcome was rendered successful when hyperthyroidism was absent. Relation between low 24 h RIU (below median) or high 24 h RIU (above or equal to median) and outcome was evaluated. RESULTS...

EPA Region 7 Aquatic Focus Areas (ECO_RES.R7_AQUATIC_FOCUS_AREAS)

Data.gov (United States)

U.S. Environmental Protection Agency — This shapefile consists of 347 individual Aquatic Ecological System (AES) polygons that are the Aquatic Conservation Focus Areas for EPA Region 7. The focus areas...

Iodide-trapping defect of the thyroid

International Nuclear Information System (INIS)

Pannall, P.R.; Steyn, A.F.; Van Reenen, O.

1978-01-01

We describe a grossly hypothyroid 50-year-old woman, mentally retarded since birth. On the basis of her history of recurrent goitre, absence of 131 I neck uptake and a low saliva/plasma 131 I ratio, congenital hypothyroidism due to a defect of the iodide-trapping mechanism was diagnosed. Other family members studied did not have the defect

False radioimmunoassay of thyroxine and triiodothyronine in the presence of hormone binding autoantibodies in serum

International Nuclear Information System (INIS)

Herrmann, J.; Kley, H.K.; Rudorff, K.H.; Kroell, H.J.; Krueskemper, H.L.

1976-01-01

Radioimmuno-assay of thyroxine and triiodothyronine in a 14-year-old girl with primary hypothyroidism and nodular goitre as a result of Hashimoto's thyroiditis gave falsely low values due to the presence of hormone-binding antibodies. Such antibodies occur in Hashimoto's thyroiditis and thyroid carcinoma. Their presence requires special methods for determining these hormones. (orig.) [de

Deep-Focusing Time-Distance Helioseismology

Science.gov (United States)

Duvall, T. L., Jr.; Jensen, J. M.; Kosovichev, A. G.; Birch, A. C.; Fisher, Richard R. (Technical Monitor)

2001-01-01

Much progress has been made by measuring the travel times of solar acoustic waves from a central surface location to points at equal arc distance away. Depth information is obtained from the range of arc distances examined, with the larger distances revealing the deeper layers. This method we will call surface-focusing, as the common point, or focus, is at the surface. To obtain a clearer picture of the subsurface region, it would, no doubt, be better to focus on points below the surface. Our first attempt to do this used the ray theory to pick surface location pairs that would focus on a particular subsurface point. This is not the ideal procedure, as Born approximation kernels suggest that this focus should have zero sensitivity to sound speed inhomogeneities. However, the sensitivity is concentrated below the surface in a much better way than the old surface-focusing method, and so we expect the deep-focusing method to be more sensitive. A large sunspot group was studied by both methods. Inversions based on both methods will be compared.

Serum 8-OHdG and HIF-1α levels: do they affect the development of malignancy in patients with hypoactive thyroid nodules?

Science.gov (United States)

Ece, Harman; Mehmet, Erdogan; Cigir, Biray Avci; Yavuz, Dodurga; Muammer, Karadeniz; Cumhur, Gunduz; Mustafa, Harman; Sevki, Cetinkalp; Fusun, Saygılı; Gokhan, Ozgen Ahmet

2013-01-01

This study aimed to evaluate 8-OHdG and hypoxia-inducible factor 1 (HIF-1α) levels in patients with hypoactive thyroid nodules (toxic multi-nodular goiter, Graves' disease, and Hashimoto's thyroiditis), as these parameters may be related to oxidative stress and the pathogenesis of cancer. The study included patients diagnosed with Graves' disease (n = 20), toxic multinodular goiter (n = 20), and Hashimoto thyroiditis (n = 20), and 20 healthy controls. HIF-1α levels were measured in blood samples and 8-OHdG levels were measured in urine - both via ELISA. HIF-1α and 8-OHdG levels were significantly higher in the patient groups than in the control group (p 0.05). There was no significant difference in 8-OHdG or HIF-1α levels between the patients with biopsy results that were benign, malignant, and non-diagnostic (p > 0.05). Serum HIF-1α and urine 8-OHdG levels were significantly higher in the patients with thyroid diseases; however, a relationship with cancer was not observed.

Thyroidectomy under local anaesthesia: experience with giant goitres

African Journals Online (AJOL)

Adele

the thyroid notch and the lower flap down to the suprasternal notch. The investing fascia is then incised ... required in thyroid gland mobilization especially when done under local anaesthesia and traction on the .... Gitau W. An analysis of thyroid diseases seen at Kenyatta Hospital. E. Afr. Med. J. 1975; 52:564-570. 4.

EFEKTIVITAS PENAMBAHAN VITAMIN A DAN ZAT BESI PADA GARAM YODIUM TERHADAP STATUS GIZI DAN KONSENTRASI BELAJAR ANAK SEKOLAH DASAR

Directory of Open Access Journals (Sweden)

M. Saidin

2012-11-01

Full Text Available THE EFFECT OF VITAMIN A AND IRON ADDED INTO IODIZED SALT ON NUTRITION STATUS AND LEARNING CONCENTRATION OF ELEMENTARY SCHOOL CHILDREN.Background: It was assumed that in some areas of Indonesia previously recognized as area of endemic goitre, thenutrition problem in that area became more complex due to crisis of economy. Probably some people in that area not only suffering from 100 but also vitamin A and iron deficiency. In this condition intervention of multinutrient is more reasonable than of single nutrient in improving nutrition status.Objectives: The aim of this study was to investigate the effect of vitamin A and iron added into iodized salt on iodine status and learning concentration of elementary school children in moderate endemic goiter area.Methods: The study design was "field trial". Study sites covered two subdistricts, namely Nagak subdistrict and Pelabuhan ratu subdistrict of Sukabumi District, West Java. A total of 221 boys and girls students in the fourth, fifth and sixth grades with positive goitre at grade I, by palpation were randomly assigned into four groups. Each group received different treatment. Group I received iodized salt (43 ppm of Iodine + 180 ppm of vitamin A (A formula, group II received iodized salt (52 ppm + 1500 ppm of iron (8 formula, group III received iodized salt only (37 ppm (C formula and group IV received iodized salt only (20 ppm. Data evaluation was collected 18 week after intervention.Results: The result of study revealed that proportion of goitre measured by palpation decreased in all groups, group I (14%, group II (7%, group III (21% as well as group IV (19%. The increment of serum tetraiodotirosine (thyroxine hormone (T4 of group II (5.02 ug/dl and group I (4.60 ug/dl were significantly higher than that of group Ill (2.04 ug/dl or group IV (2.91 ug/dl. There were no significant differences in the increment of serum triiodotirosine hormone (T3 among group. The haemoglobin level of group II increased

Prosodic Focus Marking in Bai.

NARCIS (Netherlands)

Liu, Zenghui; Chen, A.; Van de Velde, Hans

2014-01-01

This study investigates prosodic marking of focus in Bai, a Sino-Tibetan language spoken in the Southwest of China, by adopting a semi-spontaneous experimental approach. Our data show that Bai speakers increase the duration of the focused constituent and reduce the duration of the post-focus

Optical fiber plasmonic lens for near-field focusing fabricated through focused ion beam

Science.gov (United States)

Sloyan, Karen; Melkonyan, Henrik; Moreira, Paulo; Dahlem, Marcus S.

2017-02-01

We report on numerical simulations and fabrication of an optical fiber plasmonic lens for near-field focusing applications. The plasmonic lens consists of an Archimedean spiral structure etched through a 100 nm-thick Au layer on the tip of a single-mode SM600 optical fiber operating at a wavelength of 632:8 nm. Three-dimensional finite-difference time-domain computations show that the relative electric field intensity of the focused spot increases 2:1 times when the number of turns increases from 2 to 12. Furthermore, a reduction of the intensity is observed when the initial inner radius is increased. The optimized plasmonic lens focuses light into a spot with a full-width at half-maximum of 182 nm, beyond the diffraction limit. The lens was fabricated by focused ion beam milling, with a 200nm slit width.

Numerical experimentation on focusing time and neutron yield in GN1 plasma focus machine

International Nuclear Information System (INIS)

Singh, Arwinder; Lee, Sing; Saw, S.H.

2014-01-01

In this paper, we have shown how we have fitted Lee's six phase model code to analyze the current waveform of the GN1 plasma focus machine working in deuterium gas. The Lee's 6-phase model codes was later configured to work between 0.5 to 6 Torr and the results of both focusing time and neutron yield was then compared with the published experimental results. The final results indicate that Lee's code, gives realistic plasma dynamics and focus properties together with a realistic neutron yield for GN1 plasma focus, without the need of any adjustable parameters, needing only to fit the computed current trace to a measured current trace. (author)

Space Focus Lead Report

Energy Technology Data Exchange (ETDEWEB)

Reeves, Geoffrey D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-08-10

The Space Focus team is tasked with the definition of the Space Focused Science Topics, and with the review and ranking of the CSES proposals received in all the program areas. This is achieved by dedicated meetings or a series of informal discussions and/or e-mail reviews.

Plutonium focus area: Technology summary

International Nuclear Information System (INIS)

1996-03-01

To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this approach, EM developed a management structure and principles that led to creation of specific focus areas. These organizations were designed to focus scientific and technical talent throughout DOE and the national scientific community on major environmental restoration and waste management problems facing DOE. The focus area approach provides the framework for inter-site cooperation and leveraging of resources on common problems. After the original establishment of five major focus areas within the Office of Technology Development (EM-50), the Nuclear Materials Stabilization Task Group (NMSTG, EM-66) followed EM-50's structure and chartered the Plutonium Focus Area (PFA). NMSTG's charter to the PFA, described in detail later in this book, plays a major role in meeting the EM-66 commitments to the Defense Nuclear Facilities Safety Board (DNFSB). The PFA is a new program for FY96 and as such, the primary focus of revision 0 of this Technology Summary is an introduction to the Focus Area; its history, development, and management structure, including summaries of selected technologies being developed. Revision 1 to the Plutonium Focus Area Technology Summary is slated to include details on all technologies being developed, and is currently planned for release in August 1996. The following report outlines the scope and mission of the Office of Environmental Management, EM-60, and EM-66 organizations as related to the PFA organizational structure

Faktor-faktor pada kejadian GAKY ibu hamil di Tabunganen Barito Kuala, Kalimantan Selatan

Directory of Open Access Journals (Sweden)

Alfi tri

2016-03-01

Full Text Available ABSTRACTBackground: Iodine Defi ciency Disorder (IDD is a health problem that affects quality of human resources. IDD happens not only due to iodine defi ciency but also other disorders such as goitrogenic substance (thiocyanate, pollutants of heavy metals (Pb and micronutrient defi ciency (Fe that inhibit thyroid hormone biosynthesis which cause the sweling of goitre glands.Objective: To identify the association between consumption of iodine, thiocyanate, Fe consumption, status of anemia and Pb and status of IDD in pregnant mothers at Subdistrict of Tabunganen, District of Barito Kuala, Province of Kalimantan Selatan.Method: The study was observational using case control design and quantitative method. Data were obtained through the palpation of goitre glands, measurement of thyroid stimulating hormone (TSH level using ELISA method, iodine and thiocyanate consumption using food recall 2x24 hours and food frequency questionnaire (FFQ, Fe consumption using FFQ, Hb level using photometric method and Pb level using AAS method. Data were analysed by using chi-square and logistic regression.Result: There was signifi cant association (p<0.05 between consumption of iodine (fi sh based on FFQ and IDD status (goitre with OR=3.44 and IDD status (TSH with OR=8.00. There was no association between consumption of thiocyanate and Fe measured with food recall, FFQ and IDD status (goitre and TSH. There was signifi cant association (p<0.05 between Pb status and IDD status (TSH with OR=9.35.Conclusion: There was association between iodine consumption based on FFQ (fi sh and IDD status (goitre after the control of iodine consumption status (food recall. There was association between iodine consumption status (FFQ in fi sh together with anemia status and the prevalence of IDD disorder (TSH after the control of Pb status. KEYWORDS: iodine defi ciency disorder, pregnant mothers, iodine, thiocyanate, Fe, anemia, PbABSTRAKLatar Belakang: Gangguan akibat

Primary Lymphoma of the Thyroid: Diagnostic and Therapeutic Considerations

Directory of Open Access Journals (Sweden)

Basro Sarinah

2010-01-01

Conclusion: The diagnosis of primary thyroid lymphoma should be considered when dealing with rapidly growing goitres. The role of FNAC in diagnosing thyroid lymphoma is limited but it is still useful in the initial work-up. Nevertheless, surgical intervention is often required to establish the diagnosis and relieve critical airway compression. A combination of chemotherapy and irradiation is the mainstay of management.

Regulatory focus affects physician risk tolerance.

Science.gov (United States)

Veazie, Peter J; McIntosh, Scott; Chapman, Benjamin P; Dolan, James G

2014-01-01

Risk tolerance is a source of variation in physician decision-making. This variation, if independent of clinical concerns, can result in mistaken utilization of health services. To address such problems, it will be helpful to identify nonclinical factors of risk tolerance, particularly those amendable to intervention-regulatory focus theory suggests such a factor. This study tested whether regulatory focus affects risk tolerance among primary care physicians. Twenty-seven primary care physicians were assigned to promotion-focused or prevention-focused manipulations and compared on the Risk Taking Attitudes in Medical Decision Making scale using a randomization test. Results provide evidence that physicians assigned to the promotion-focus manipulation adopted an attitude of greater risk tolerance than the physicians assigned to the prevention-focused manipulation (p = 0.01). The Cohen's d statistic was conventionally large at 0.92. Results imply that situational regulatory focus in primary care physicians affects risk tolerance and may thereby be a nonclinical source of practice variation. Results also provide marginal evidence that chronic regulatory focus is associated with risk tolerance (p = 0.05), but the mechanism remains unclear. Research and intervention targeting physician risk tolerance may benefit by considering situational regulatory focus as an explanatory factor.

Diagnosis of thyroid multinodular goiter using diffraction-enhanced imaging

International Nuclear Information System (INIS)

Rocha, H.S.; Lopes, R.T.; Valiante, P.M.; Tirao, G.; Mazzaro, I.; Hoennicke, M.G.; Cusatis, C.; Giles, C.

2005-01-01

Diffraction-enhanced images (DEI) have been obtained using two silicon crystals. A first channel-cut silicon crystal using the Si(3 3 3) reflection is employed to reduce the divergence of the pre-monochromated Si(1 1 1) beam of the light line to 60 microradian (12 arcsec). A second channel-cut Si(3 3 3) crystal was used as a Bragg analyzer to obtain bright and dark field images by changing its angular position. This technique is ideally suited for soft-tissue imaging or objects with the same absorption coefficient interfaces. DEI was developed at the XRD-2 beamline at the Brazilian Synchrotron (LNLS) in Campinas-Brazil. Feasibility tests on acquired images, which allow the diagnosis of thyroid nodular goiter, were performed. This disease is ordinary. The tissue developed on the cervical area causes compression of the nearby structures and undesirable aesthetic deformities with worldwide distribution. DEI of the tissues were taken to observe their morphology and to compare with the microscopic analysis (histopathological). This technique allows cutting sections a hundred times thicker than conventional histological techniques allowing a complete vision of the disease morphology. DEI show details not clearly seen with conventional techniques

Refractory Cushing's disease caused by multinodular ACTH-cell hyperplasia.

Science.gov (United States)

McKeever, P E; Koppelman, M C; Metcalf, D; Quindlen, E; Kornblith, P L; Strott, C A; Howard, R; Smith, B H

1982-09-01

A patient with pituitary-dependent hypercortisolism, unresponsive to resection of nodules in the anterior lobe, is described. Histochemical stains of the nodules showed multiple, focal, cellular expansions of the fibrovascular stroma. Transitions between normal and expanded adenohypophysial acini were present. Immunoperoxidase stains for ACTH and other pituitary hormones revealed that these multiple foci contained an excess of ACTH-positive cells. Less than 10% of the cells in these foci were negative for ACTH and positive for other hormones. Serial sections showed that these foci of predominantly ACTH-producing acini were not connected. Clinical, morphological, and immunohistochemical data indicated that ACTH-cell hyperplasia caused Crushing's disease in this patient. Pathologic study of individual cases should concentrate on determining whether hyperplasia or adenoma exist at the time of surgical exploration of the pituitary gland, since this determination is important to proper treatment. Tentative criteria to recognize ACTH-cell hyperplasia are: 1. Multiple foci of ACTH laden cells. 2. A minor subpopulation of cells of alternate hormone series. 3. Expansion without destruction of acini in the adenohypophysis.

Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism

OpenAIRE

Aksoy, Duygu Yazgan; Gedik, Arzu; Cinar, Nese; Soylemezoglu, Figen; Berker, Mustafa; Gurlek, Omer Alper

2013-01-01

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...

Kinetics of cesium lead halide perovskite nanoparticle growth; focusing and de-focusing of size distribution

Science.gov (United States)

Koolyk, Miriam; Amgar, Daniel; Aharon, Sigalit; Etgar, Lioz

2016-03-01

In this work we study the kinetics of cesium lead halide perovskite nanoparticle (NP) growth; the focusing and de-focusing of the NP size distribution. Cesium lead halide perovskite NPs are considered to be attractive materials for optoelectronic applications. Understanding the kinetics of the formation of these all-inorganic perovskite NPs is critical for reproducibly and reliably generating large amounts of uniformly sized NPs. Here we investigate different growth durations for CsPbI3 and CsPbBr3 NPs, tracking their growth by high-resolution transmission electron microscopy and size distribution analysis. As a result, we are able to provide a detailed model for the kinetics of their growth. It was observed that the CsPbI3 NPs exhibit focusing of the size distribution in the first 20 seconds of growth, followed by de-focusing over longer growth durations, while the CsPbBr3 NPs show de-focusing of the size distribution starting from the beginning of the growth. The monomer concentration is depleted faster in the case of CsPbBr3 than in the case of CsPbI3, due to faster diffusion of the monomers, which increases the critical radius and results in de-focusing of the population. Accordingly, focusing is not observed within 40 seconds of growth in the case of CsPbBr3. This study provides important knowledge on how to achieve a narrow size distribution of cesium lead halide perovskite NPs when generating large amounts of these promising, highly luminescent NPs.In this work we study the kinetics of cesium lead halide perovskite nanoparticle (NP) growth; the focusing and de-focusing of the NP size distribution. Cesium lead halide perovskite NPs are considered to be attractive materials for optoelectronic applications. Understanding the kinetics of the formation of these all-inorganic perovskite NPs is critical for reproducibly and reliably generating large amounts of uniformly sized NPs. Here we investigate different growth durations for CsPbI3 and CsPbBr3 NPs, tracking

Self-focused and other-focused resiliency: Plausible mechanisms linking early family adversity to health problems in college women.

Science.gov (United States)

Coleman, Sulamunn R M; Zawadzki, Matthew J; Heron, Kristin E; Vartanian, Lenny R; Smyth, Joshua M

2016-01-01

This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Female students (N = 795) participated between October 2009 and May 2010. Participants completed self-report measures of early family adversity, self-focused (self-esteem, personal growth initiative) and other-focused (perceived social support, gratitude) resiliency, stress, subjective health, and health behaviors. Using structural equation modeling, self-focused resiliency associated with less stress, better subjective health, more sleep, less smoking, and less weekend alcohol consumption. Other-focused resiliency associated with more exercise, greater stress, and more weekend alcohol consumption. Early family adversity was indirectly related to all health outcomes, except smoking, via self-focused and other-focused resiliency. Self-focused and other-focused resiliency represent plausible mechanisms through which early family adversity relates to stress and health in college women. This highlights areas for future research in disease prevention and management.

Thermal self-focusing at oblique incidence

International Nuclear Information System (INIS)

Craxton, R.S.; McCrory, R.L.

1984-03-01

Thermal self-focusing at oblique incidence has been investigated in two-dimensional line-focus geometry using the Eulerian hydrodynamics simulation code SAGE. The laser beam interacts with a long-scale-length preformed plasma with an expontial density profiele. Questions to be addressed include: (1) What happens when a self-focusing channel reaches the turning point of the incident rays, and (2) Does the unabsorbed light return in the specular direction or back along the channel. A comparison is also made between thermal self-focusing at normal incidence in cylindrical and line-focus geometries: in cylindrical geometry the self-focusing mechanism is enhanced by the relative ease with which plasma may be expelled from a small cylindrical channel

Verum focus and polar questions

Directory of Open Access Journals (Sweden)

Ion Giurgea

2012-11-01

Full Text Available We argue that some word order phenomena in Romanian and Sardinian are the result of a checking operation in the left periphery involving verum focus (i.e. focus on the polarity component of the sentence. In particular, this operation accounts for some word order patterns found in polar questions. In Romanian, polarity fronting is realized as head-movement of (V+T to a higher peripheral head which bears a Focus-probe. This licenses VS orders for predications in which VS is not allowed as a neutral order (i-level predicates, iteratives, generics. In Sardinian, an entire phrase headed by the lexical predicate (verbal non-finite form or non-verbal predicate is fronted before the auxiliary. We argue that this order is obtained by two movement operations, head-raising of Aux to Foc and movement of the predicate phrase to SpecFoc. We also present the semantics of polarity focus, distinguishing several types of focus (informational, emphatic, contrastive.

Ion Motion in the Adiabatic Focuser

International Nuclear Information System (INIS)

Henestroza, E.; Sessler, A.M.; Yu, S.S.

2006-01-01

In this paper we numerically study the effect of ion motion in an adiabatic focuser, motivated by a recent suggestion that ion motion in an adiabatic focuser might be significant and even preclude operation of the focuser as previously envisioned. It is shown that despite ion motion the adiabatic focuser should work as well as originally envisioned

Focusing liquid microjets with nozzles

International Nuclear Information System (INIS)

Acero, A J; Ferrera, C; Montanero, J M; Gañán-Calvo, A M

2012-01-01

The stability of flow focusing taking place in a converging–diverging nozzle, as well as the size of the resulting microjets, is examined experimentally in this paper. The results obtained in most aspects of the problem are similar to those of the classical plate-orifice configuration. There is, however, a notable difference between flow focusing in nozzles and in the plate-orifice configuration. In the former case, the liquid meniscus oscillates laterally (global whipping) for a significant area of the control parameter plane, a phenomenon never observed when focusing with the plate-orifice configuration. Global whipping may constitute an important drawback of flow focusing with nozzles because it reduces the robustness of the technique. (paper)

Dysembryoplastic Neuroepithelial Tumors

Directory of Open Access Journals (Sweden)

Yeon-Lim Suh

2015-11-01

Full Text Available Dysembryoplastic neuroepithelial tumor (DNT is a benign glioneuronal neoplasm that most commonly occurs in children and young adults and may present with medically intractable, chronic seizures. Radiologically, this tumor is characterized by a cortical topography and lack of mass effect or perilesional edema. Partial complex seizures are the most common presentation. Three histologic subtypes of DNTs have been described. Histologically, the recognition of a unique, specific glioneuronal element in brain tumor samples from patients with medically intractable, chronic epilepsy serves as a diagnostic feature for complex or simple DNT types. However, nonspecific DNT has diagnostic difficulty because its histology is indistinguishable from conventional gliomas and because a specific glioneuronal element and/or multinodularity are absent. This review will focus on the clinical, radiographic, histopathological, and immunohistochemical features as well as the molecular genetics of all three variants of DNTs. The histological and cytological differential diagnoses for this lesion, especially the nonspecific variant, will be discussed.

Sources of circulating 3,5,3 - Triiodothyronine in hyperthyroidism estimated after blocking of type 1 and type 2 iodothyronine deiodinases

DEFF Research Database (Denmark)

Laurberg, P.; Vestergaard, Henrik; Nielsen, Søren

2007-01-01

of therapy in patients with Graves' disease. The addition of KI to PTU led to a greater fall in T(3) and T(4), but the balance was unaltered. After PTU plus ipodate, T(3)/T(4) on d 4 was lower, 34.1 +/- 1.2% of the initial value. Similar variations were observed in patients with multinodular toxic goiter...

Differentiated thyroid cancer following radioiodide 131I therapy of hyperthyroidism: a case report

Energy Technology Data Exchange (ETDEWEB)

Nemec, J; Soumar, J; Zeman, V; Nahodil, V; Zamrazil, V; Smejkal, V Jr

1978-01-01

Differentiated (papillary) thyroid cancer was detected 17 years following radioiodide 131I treatment for toxic multinodular goiter. Twenty-one cases of thyroid cancers with previous 131I therapy for hyperthyroidism were summarized. This combination is rare compared to the incidence of thyroid cancers following external irradiation. This may be due to higher absorbed dose to thyroid in 131I treatment.

Mesotelioma pleural com metástase renal em gato Pleural mesothelioma with renal metastasis in a cat

Directory of Open Access Journals (Sweden)

A.M. Piacenti

2004-08-01

Full Text Available It has been described the anatomopathological and immunohistochemical characteristics of a multinodular neoplasm distributed in the parietal and visceral pleurae, pericardium, thoracic portion of the diaphragm and renal cortex of an eight year-old, female, mixed breed, cat. Based on the anatomopathological and immunohistochemical findings it was firmed the diagnosis of biphasic pleural mesotelioma with renal metastasis.

Regulatory focus and generalized trust: the impact of prevention-focused self-regulation on trusting others.

Science.gov (United States)

Keller, Johannes; Mayo, Ruth; Greifeneder, Rainer; Pfattheicher, Stefan

2015-01-01

The current research suggests that taking self-regulatory mechanisms into account provides insights regarding individuals' responses to threats in social interactions. In general, based on the notion that a prevention-focused orientation of self-regulation is associated with a need for security and a vigilant tendency to avoid losses and other types of negative events we advocate that a prevention-focused orientation, both as a disposition as well as a situationally induced state, lowers generalized trust, thus hindering cooperation within social interactions that entail threats. Specifically, we found that the more individuals' habitual self-regulatory orientation is dominated by a prevention focus, the less likely they are to score high on a self-report measure of generalized trust (Study 1), and to express trust in a trust game paradigm as manifested in lower sums of transferred money (Studies 2 and 3). Similar findings were found when prevention focus was situationally manipulated (Study 4). Finally, one possible factor underlying the impact of prevention-focused self-regulation on generalized trust was demonstrated as individuals with a special sensitivity to negative information were significantly affected by a subtle prevention focus manipulation (versus control condition) in that they reacted with reduced trust in the trust game (Study 5). In sum, the current findings document the crucial relevance of self-regulatory orientations as conceptualized in regulatory focus theory regarding generalized trust and responses to threats within a social interaction. The theoretical and applied implications of the findings are discussed.

Regulatory Focus and Generalized Trust: The Impact of Prevention-focused Self-regulation on Trusting Others

Directory of Open Access Journals (Sweden)

Johannes eKeller

2015-03-01

Full Text Available The current research suggests that taking self-regulatory mechanisms into account provides insights regarding individuals’ responses to threats in social interactions. In general, based on the notion that a prevention-focused orientation of self-regulation is associated with a need for security and a vigilant tendency to avoid losses and other types of negative events we advocate that a prevention-focused orientation, both as a disposition as well as a situationally induced state, lowers generalized trust, thus hindering cooperation within social interactions that entail threats. Specifically, we found that the more individuals’ habitual self-regulatory orientation is dominated by a prevention focus, the less likely they are to score high on a self-report measure of generalized trust (Study 1, and to express trust in a trust game paradigm as manifested in lower sums of transferred money (Studies 2 and 3. Similar findings were found when prevention focus was situationally manipulated (Study 4. Finally, one possible factor underlying the impact of prevention-focused self-regulation on generalized trust was demonstrated as individuals with a special sensitivity to negative information were significantly affected by a subtle prevention focus manipulation (vs. control condition in that they reacted with reduced trust in the trust game (Study 5. In sum, the current findings document the crucial relevance of self-regulatory orientations as conceptualized in regulatory focus theory regarding generalized trust and responses to threats within a social interaction. The theoretical and applied implications of the findings are discussed.

Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke

Science.gov (United States)

Kal, E. C.; van der Kamp, J.; Houdijk, H.; Groet, E.; van Bennekom, C. A. M.; Scherder, E. J. A.

2015-01-01

Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients’ automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p’s ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients’ attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients’ strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor

Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke.

Science.gov (United States)

Kal, E C; van der Kamp, J; Houdijk, H; Groet, E; van Bennekom, C A M; Scherder, E J A

2015-01-01

Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients' automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p's ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients' attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients' strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor control

Thyroid cancer in child (about 9 cases)

International Nuclear Information System (INIS)

Ech-Charraq, I.; Ben Rais, N.

2009-01-01

Children thyroid cancer is a very uncommon affection. Its incidence has sharply risen among the patients who underwent therapeutic irradiation and after the Chernobylsk accident in the contaminated regions. Our study consists of emphasizing the distinctive features of children thyroid cancer on the epidemiological, clinical and para clinical aspects, in order to discuss diagnostic difficulties, prognostic elements as well as a therapeutic approach. Through a study conducted in the nuclear medical department of Rabat, we brought together 9 cases of thyroid cancer in children aged between 11 and 15 years old. In our series, the average age is 13 years, with a feminine prevalence. A family notion of goitre is reported in one case, without notion of irradiation, the revealing mode is mainly an euthyroid goitre and the cervical adenopathies, with good general health conditions being maintained. The scintigraphy showed a cold nodule, witch anatomo-pathological examination is papillary carcinoma. Extensive surgery, ira therapy and substitute hormonal treatment combined allowed a high recovery rate among our patients, with no side effects. The medium-term evolution was positive even in metastases cases. The prognostic is generally good, especially in the differentiated forms. (authors)

Iodine deficiency disorders in Sarawak, Malaysia.

Science.gov (United States)

Kiyu, A; Tambi, Z; Ahmad, Y

1998-12-01

The state of Sarawak in Malaysia has a high prevalence of iodine deficiency disorders (IDD). This has been revealed through a review of goitre surveys that were carried out in the State from the early 1970s to the 1990s. The primary cause was low iodine intake. Contributory factors were low iodine content in the soil and water as well as high cassava consumption. Virtual elimination of IDD is one of the nutritional goals of the IDD prevention and control programs. The strategies adopted include the iodination of coarse salt, which is sold in the market by shopkeepers and also provided free from government health clinics; legislation requiring that salt sold in IDD-gazetted areas must be iodised; and the use of iodinators to iodise water supplied by the gravity-feed system to villages and boarding schools in rural areas. The indicators used in the monitoring and evaluation of the program include the availability of iodised salt in the market and households, iodine levels in water supply that had been fitted with iodinators, goitre volume measured by ultrasound, and urinary iodine excretion among school children.

Therapy of hyperthyroidism

International Nuclear Information System (INIS)

Wildmeister, W.

1982-01-01

The etiology of hyperthyroidism is still largely unknown and therefore no causal therapy of this condition is possible. Antithyroid drug treatment is usually carried out with thiocarbamides. When an euthyroid state is achieved synthetic thyroid hormones are added. Pregnancy and iodine contamination (after exposure to contrast medium) require individual treatment. In this paper the advantages, indications and contraindications are discussed as well as supportive drug therapy necessary in specific cases. Radioiodine therapy is reserved for patients over 35 years of age; the individual dose is calculated according to the size of the thyroid gland and the iodine uptake. Disadvantageous is the late onset of therapeutic efficiency, the small effect on the size of goitre and the exposure to radiation. A patient should be operated upon in an euthyroid state, i.e. after preoperative drug therapy. Operations are normally performed on individuals with a coexistent goitre or where antithyroid drugs or radioiodine therapy are contraindicated. Paresis of the recurrent laryngeal nerve and hypoparathyroidism are rare complications. 3 to 4 g of thyroid tissues should remain. Of great importance in all cases are precise diagnostics both before and after commencing treatment and adequate follow up. (orig./MG) [de

Decontamination & decommissioning focus area

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-08-01

In January 1994, the US Department of Energy Office of Environmental Management (DOE EM) formally introduced its new approach to managing DOE`s environmental research and technology development activities. The goal of the new approach is to conduct research and development in critical areas of interest to DOE, utilizing the best talent in the Department and in the national science community. To facilitate this solutions-oriented approach, the Office of Science and Technology (EM-50, formerly the Office of Technology Development) formed five Focus AReas to stimulate the required basic research, development, and demonstration efforts to seek new, innovative cleanup methods. In February 1995, EM-50 selected the DOE Morgantown Energy Technology Center (METC) to lead implementation of one of these Focus Areas: the Decontamination and Decommissioning (D & D) Focus Area.

Nonlinear focal shift beyond the geometrical focus in moderately focused acoustic beams.

Science.gov (United States)

Camarena, Francisco; Adrián-Martínez, Silvia; Jiménez, Noé; Sánchez-Morcillo, Víctor

2013-08-01

The phenomenon of the displacement of the position along the axis of the pressure, intensity, and radiation force maxima of focused acoustic beams under increasing driving voltages (nonlinear focal shift) is studied for the case of a moderately focused beam. The theoretical and experimental results show the existence of this shift along the axis when the initial pressure in the transducer increases until the acoustic field reaches the fully developed nonlinear regime of propagation. Experimental data show that at high amplitudes and for moderate focusing, the position of the on-axis pressure maximum and radiation force maximum can surpass the geometrical focal length. On the contrary, the on-axis pressure minimum approaches the transducer under increasing driving voltages, increasing the distance between the positive and negative peak pressure in the beam. These results are in agreement with numerical KZK model predictions and the existed data of other authors and can be explained according to the effect of self-refraction characteristic of the nonlinear regime of propagation.

A study of plasma focus

International Nuclear Information System (INIS)

Hirano, Katsumi; Majima, Kazuo

1976-01-01

The behavior of the plasma acceleration between electrodes, the phenomena due to the pinch effect at the top of the electrodes and the neutron emission mechanism were experimentally studied. The plasma focus device was a Mather type coaxial discharge device, and the instruments used for the present purpose were a Rogoski coil, an image converter camera, a scintillation detector and a silver foil activation counter. The results of the present experiment were as follows. Plasma focus was not definitely made under the same condition. When the focus was seen, a dip was observed in the discharge wave form, and the emissions of X-ray and neutrons were detected. The angular anisotropy of neutron emission was observed, and corresponds to a beam target model. The phenomena showing the occurrence of focus were seen, when the current sheet was produced at a delayed time after discharge, and arrived at the muzzle with large velocity. The relation between the number of emitted neutrons and the velocity of the current sheet was obtained, whereas no systematic relation exists between the number of emitted neutrons and the velocity of pinch. When the focus was not observed, no dip was seen in current wave form, and the emissions of X-ray and neutrons were not detected. The reason of no focus was considered. (Kato, T.)

Synthetic focusing in ultrasound modulated tomography

KAUST Repository

Kuchment, Peter; Kunyansky, Leonid

2010-01-01

Several hybrid tomographic methods utilizing ultrasound modulation have been introduced lately. Success of these methods hinges on the feasibility of focusing ultrasound waves at an arbitrary point of interest. Such focusing, however, is difficult to achieve in practice. We thus propose a way to avoid the use of focused waves through what we call synthetic focusing, i.e. by reconstructing the would-be response to the focused modulation from the measurements corresponding to realistic unfocused waves. Examples of reconstructions from simulated data are provided. This non-technical paper describes only the general concept, while technical details will appear elsewhere. © 2010 American Institute of Mathematical Sciences.

Synthetic focusing in ultrasound modulated tomography

KAUST Repository

Kuchment, Peter

2010-09-01

Several hybrid tomographic methods utilizing ultrasound modulation have been introduced lately. Success of these methods hinges on the feasibility of focusing ultrasound waves at an arbitrary point of interest. Such focusing, however, is difficult to achieve in practice. We thus propose a way to avoid the use of focused waves through what we call synthetic focusing, i.e. by reconstructing the would-be response to the focused modulation from the measurements corresponding to realistic unfocused waves. Examples of reconstructions from simulated data are provided. This non-technical paper describes only the general concept, while technical details will appear elsewhere. © 2010 American Institute of Mathematical Sciences.

Self-focusing in laser produced spark

International Nuclear Information System (INIS)

Bakos, J.S.; Foeldes, I.B.

1983-05-01

The self-focusing effect appearing in different phases of development of laser produced breakdown plasma in air is investigated. Self-focusing during the ionization process is demonstrated. Thermal self-focusing was observed in the later stage of the plasma development at moderate light intensities. Plasma development was investigated by forward and side scattering of the laser light in the plasma. A crossed beam experiment gave evidence of the thermal mechanism of self-focusing. (author)

Collective focusing ion accelerator

International Nuclear Information System (INIS)

Goldin, F.J.

1986-01-01

The principal subject of this dissertation is the trapping confinement of pure electron plasmas in bumpy toroidal magnetic fields, with particular attention given to the trapping procedure and the behavior of the plasma during the final equilibrium. The most important aspects of the equilibrium studied were the qualitative nature of the plasma configuration and motion and its density, distribution and stability. The motivation for this study was that an unneutralized cloud of electrons contained in a toroidal system, sufficiently dense and stable, may serve to electrostatically focus ions (against centrifugal and self space charge forces) in a cyclic ion accelerator. Such an accelerator, known as a Collective Focusing Ion Accelerator (CFIA) could be far smaller than conventional designs (which use external magnetic fields directly to focus the ions) due to the smaller gyro-radium of an electron in a magnetic field of given strength. The electron cloud generally drifted poloidally at a finite radius from the toroidal minor axis. As this would preclude focusing ions with such clouds, damping this motion was investigated. Finite resistance in the normally perfectly conductive vessel wall did this. In further preparation for a working CFIA, additional experiments studied the effect of ions on the stability of the electron cloud

A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism

OpenAIRE

Khoohaphatthanakul, Somdul; Sriwijitkamol, Apiradee

2016-01-01

Graves’ hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; ...

Hyperthyroidism

OpenAIRE

De Leo, Simone; Lee, Sun Y; Braverman, Lewis E

2016-01-01

Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves’ disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. T...

Hyperthyroidism: diagnosis and treatment.

Science.gov (United States)

Reid, Jeri R; Wheeler, Stephen F

2005-08-15

The proper treatment of hyperthyroidism depends on recognition of the signs and symptoms of the disease and determination of the etiology. The most common cause of hyperthyroidism is Graves' disease. Other common causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications. The diagnostic workup begins with a thyroid-stimulating hormone level test. When test results are uncertain, measuring radionuclide uptake helps distinguish among possible causes. When thyroiditis is the cause, symptomatic treatment usually is sufficient because the associated hyperthyroidism is transient. Graves' disease, toxic multinodular goiter, and toxic adenoma can be treated with radioactive iodine, antithyroid drugs, or surgery, but in the United States, radioactive iodine is the treatment of choice in patients without contraindications. Thyroidectomy is an option when other treatments fail or are contraindicated, or when a goiter is causing compressive symptoms. Some new therapies are under investigation. Special treatment consideration must be given to patients who are pregnant or breastfeeding, as well as those with Graves' ophthalmopathy or amiodarone-induced hyperthyroidism. Patients' desires must be considered when deciding on appropriate therapy, and dose monitoring is essential.

Coexistence of hyperthyroidism and thyroid cancer

Directory of Open Access Journals (Sweden)

Fatih Taşkesen

2014-06-01

Full Text Available Objective: Thyroid cancer can be associated with thyrotoxicosis caused by Graves' disease, toxic multinodular goiter, or toxic nodular goiter. The aim of this study was considered to be endemic in our region have received the diagnosis of hyperthyroidism, thyroid cancer is detected thyroidectomy performed and patients were retrospectively evaluate. Methods: We retrospectively studied 69 patients assessed for hyperthyroidism between 2006 and 2012. Clinical hyperthyroidism was diagnosed by elevated tri-iodothyronine/thyroxine (T3/T4 ratios and low thyroid-stimulating hormone (TSH levels, with clinical signs and symptoms. The criteria for surgery were cytological evidence of malignancy, a goiter causing symptoms of tracheal or esophageal compression, side effects of antithyroid drug therapy, or Graves’ disease with multiple relapses after therapy withdrawal or responsiveness to antithyroid drugs. Results: Totally 69 patients were included. In 20 (28.9% patients there was toxic multinodular goiter, in 28 (40.6% Graves’s disease, and in 21 (30.5% patients there was toxic nodular goiter. Of these patients, 12 (17.4% had thyroid cancer. Conclusions: As a result; low likelihood of malignancy in patients with hyperthyroidism, though suspicious lesions detected in the lymph nodes and neck adenopathies be examined in detail.

Meaning-focused vs Form-focused L2 Instruction: Implications for ...

African Journals Online (AJOL)

KATEVG

focus-on-meaning approach to English language instruction) compare with ... L2 use. Proponents of this view are concerned with the question of how this conversion ... processing, it may draw learners' attention to "notice" the form of the target ...

High harmonics focusing undulator

Energy Technology Data Exchange (ETDEWEB)

Varfolomeev, A.A.; Hairetdinov, A.H.; Smirnov, A.V.; Khlebnikov, A.S. [Kurchatov Institute, Moscow (Russian Federation)

1995-12-31

It was shown in our previous work that there exist a possibility to enhance significantly the {open_quote}natural{close_quote} focusing properties of the hybrid undulator. Here we analyze the actual undulator configurations which could provide such field structure. Numerical simulations using 2D code PANDIRA were carried out and the enhanced focusing properties of the undulator were demonstrated. The obtained results provide the solution for the beam transport in a very long (short wavelength) undulator schemes.

The Individually Focused Interview

DEFF Research Database (Denmark)

Clausen, Aksel Skovgaard

2012-01-01

relatively “strong” interviewees (interview persons: IPs) with diverse backgrounds; (2) thorough planning of the interview with well-focused themes; and (3) a thorough and repeated introduction to the interview. The omission of audio transcriptions is an obvious solution to the researcher who wants a breadth...... of range of statements stemming from the use of many more interviewees than is often possible. The Individually Focused Interview (TIFI) also provides more time for involvement in the field and further analysis....

Intraparenchymal schwannoma of the frontal lobe.

Directory of Open Access Journals (Sweden)

Deogaonkar M

1994-10-01

Full Text Available A 45 year old woman with bifrontal headaches and progressive diminution in vision over 6 months was found to have bilateral papilloedema. CT scan showed large right frontal lesion with surrounding oedema. Right basal frontotemporal craniotomy was performed to excise the multinodular, intraparenchymatous tumor. Hispathology confirmed the diagnosis of schwannoma. Post-operative course was uneventful with disappearance of pre-operative signs and symptoms.

Profile of Hashimoto's Thyroiditis in Sri Lankans: Is There an Increased Risk of Ancillary Pathologies in Hashimoto's Thyroiditis?

OpenAIRE

Siriweera, Eranga Himalee; Ratnatunga, Neelakanthi Vajira Illangakoon

2010-01-01

Hashimoto's thyroiditis has been reported to be associated with many neoplastic and nonneoplastic thyroid pathologies. This retrospective study aims to determine the demographic profile of Hashimoto's thyroiditis in Sri Lankans, document ancillary pathologies in Hashimoto's thyroiditis, and determine whether there is an increased risk of occurrence of malignancies, benign neoplasms, and nonneoplastic benign lesions in Hashimoto's thyroiditis by comparing with thyroids showing multinodular goi...

Thermal self-focusing with multiple beams

International Nuclear Information System (INIS)

Craxton, R.S.; McCrory, R.L.

1986-07-01

Self-focusing in underdense plasmas in the presence of overlapping beams is of interest for multibeam laser-irradiation systems. The hydrodynamics/ray-tracing simulation code SAGE is used to model thermal self-focusing in two-dimensional line-focus geometry with beams incident obliquely at different angles. The conjecture that multiple overlapping beams may suppress self-focusing is investigated for parameters appropriate to reactor-sized targets; in particular, the dependence upon intensity, scale length and pulse width is examined. While the full problem is three-dimensional, insight may be gained from two-dimensional simulations

Stability of expanded plasma focus

International Nuclear Information System (INIS)

Soliman, H.M.

1994-01-01

In this study, the stabilization of the expanded plasma focus formed by 4.5 kJ plasma focus device of Mather type by magnetic field is presented. The experimental results of the induced axial magnetic field and electric probe measurements of the expanded plasma focus show that, the plasma consists of three plasmoids, electron temperature measurements off the plasmoids at a point close to the muzzle are 26 eV, 30 eV and 27 eV respectively and the electron densities are 6.6 x 10 14 , 6.1 x 10 14 / cm 3 respectively. The presence of external axial magnetic field (B 2 = 1.6 kg) at the mid distance between the breech and the muzzle has a less effect on the stability of expanded focus and it causes a restriction for the plasma motion. the electron temperature of the three plasmoids are found to increase in that case by 23%, 18.5% respectively. When this axial magnetic field is applied at the muzzle end, it leads to a more stable expanded plasma focus which consists mainly of one plasmoid with electron temperature of 39 eV and density of 3.4 x 10 14 / cm 3 . 5 figs

A new electrophoretic focusing principle: focusing of nonamphoteric weak ionogenic analytes using inverse electromigration dispersion profiles.

Science.gov (United States)

Gebauer, Petr; Malá, Zdena; Bocek, Petr

2010-03-01

This contribution introduces a new separation principle in CE which offers focusing of weak nonamphoteric ionogenic species and their inherent transport to the detector. The prerequisite condition for application of this principle is the existence of an inverse electromigration dispersion profile, i.e. a profile where pH is decreasing toward the anode or cathode for focusing of anionic or cationic weak analytes, respectively. The theory presented defines the principal conditions under which an analyte is focused on a profile of this type. Since electromigration dispersion profiles are migrating ones, the new principle offers inherent transport of focused analytes into the detection cell. The focusing principle described utilizes a mechanism different from both CZE (where separation is based on the difference in mobilities) and IEF (where separation is based on difference in pI), and hence, offers another separation dimension in CE. The new principle and its theory presented here are supplemented by convincing experiments as their proof.

Magnetic Focusing Horn

CERN Multimedia

1974-01-01

This magnetic focusing horn was used for the AA (antiproton accumulator). Its development was an important step towards using CERN's Super Proton Synchrotron as a proton - antiproton collider. This eventually led to the discovery of the W and Z particles in 1983. Making an antiproton beam took a lot of time and effort. Firstly, protons were accelerated to an energy of 26 GeV in the PS and ejected onto a metal target. From the spray of emerging particles, a magnetic horn picked out 3.6 GeV antiprotons for injection into the AA through a wide-aperture focusing quadrupole magnet. For a million protons hitting the target, just one antiproton was captured, 'cooled' and accumulated. It took 3 days to make a beam of 3 x 10^11 -, three hundred thousand million - antiprotons.

Focus on Delivery

DEFF Research Database (Denmark)

Hasman, Kirsten; Barfoed, Anne

Background: Compared to other Nordic countries, Denmark has a high incidence of anal sphincter injury. Recent studies indicate that a strict focus on prevention of severe perineal trauma has decreased the incidence (1). This has resulted in changed clinical procedures in several Danish labour wards...... (2). It is, however, not clarified which of the multifaceted aspects of preventing perineal injury that might explain the decrease (3). Aims: We hypothesized that the use of structured reflection on a clinical practice by midwives and midwifery students would increase both parts’ knowledge on how...... attended the delivery, facilitated the midwife’s and the student’s structured reflection. Further, the project midwife held daily simulation workshops with midwives and students. Two focus group interviews with students and midwives were conducted and analyzed using content analysis. Results and conclusion...

Verum focus and polar questions

Directory of Open Access Journals (Sweden)

Ion Giurgea

2012-01-01

Full Text Available We argue that some word order phenomena in Romanian and Sardinian are the result of a checkingoperation in the left periphery involving verum focus (i.e. focus on the polarity component of the sentence.In particular, this operation accounts for some word order patterns found in polar questions. In Romanian,polarity fronting is realized as head-movement of (V+T to a higher peripheral head which bears a Focusprobe.This licenses VS orders for predications in which VS is not allowed as a neutral order (i-levelpredicates, iteratives, generics. In Sardinian, an entire phrase headed by the lexical predicate (verbal nonfiniteform or non-verbal predicate is fronted before the auxiliary. We argue that this order is obtained bytwo movement operations, head-raising of Aux to Foc and movement of the predicate phrase to SpecFoc. Wealso present the semantics of polarity focus, distinguishing several types of focus (informational, emphatic,contrastive.

Optimal Focusing and Scaling Law for Uniform Photo-Polymerization in a Thick Medium Using a Focused UV Laser

Directory of Open Access Journals (Sweden)

Jui-Teng Lin

2014-02-01

Full Text Available We present a modeling study of photoinitiated polymerization in a thick polymer-absorbing medium using a focused UV laser. Transient profiles of the initiator concentration at various focusing conditions are analyzed to define the polymerization boundary. Furthermore, we demonstrate the optimal focusing conditions that yield more uniform polymerization over a larger volume than the collimated or non-optimal cases. Too much focusing with the focal length f < f* (an optimal focal length yields a fast process; however, it provides a smaller polymerization volume at a given time than in the optimal focusing case. Finally, a scaling law is derived and shows that f* is inverse proportional to the product of the extinction coefficient and the initiator initial concentration. The scaling law provides useful guidance for the prediction of optimal conditions for photoinitiated polymerization under a focused UV laser irradiation. The focusing technique also provides a novel and unique means for obtaining uniform photo-polymerization within a limited irradiation time.

Final focus nomenclature

International Nuclear Information System (INIS)

Erickson, R.

1986-01-01

The formal names and common names for all devices in the final focus system of the SLC are listed. The formal names consist of a device type designator, microprocessor designator, and a four-digit unit number

On the Semantics of Focus

Science.gov (United States)

Kess, Joseph F.

1975-01-01

This article discusses the semantics of the notion of focus, insofar as it relates to Filipino languages. The evolution of this notion is reviewed, and an alternative explanation of it is given, stressing the fact that grammar and semantics should be kept separate in a discussion of focus. (CLK)

Final focus systems for linear colliders

International Nuclear Information System (INIS)

Erickson, R.A.

1987-11-01

The final focus system of a linear collider must perform two primary functions, it must focus the two opposing beams so that their transverse dimensions at the interaction point are small enough to yield acceptable luminosity, and it must steer the beams together to maintain collisions. In addition, the final focus system must transport the outgoing beams to a location where they can be recycled or safely dumped. Elementary optical considerations for linear collider final focus systems are discussed, followed by chromatic aberrations. The design of the final focus system of the SLAC Linear Collider (SLC) is described. Tuning and diagnostics and steering to collision are discussed. Most of the examples illustrating the concepts covered are drawn from the SLC, but the principles and conclusions are said to be generally applicable to other linear collider designs as well. 26 refs., 17 figs

Final focus nomenclature

Energy Technology Data Exchange (ETDEWEB)

Erickson, R.

1986-08-08

The formal names and common names for all devices in the final focus system of the SLC are listed. The formal names consist of a device type designator, microprocessor designator, and a four-digit unit number. (LEW)

Compact electron beam focusing column

Science.gov (United States)

Persaud, Arun; Leung, Ka-Ngo; Reijonen, Jani

2001-12-01

A novel design for an electron beam focusing column has been developed at LBNL. The design is based on a low-energy spread multicusp plasma source which is used as a cathode for electron beam production. The focusing column is 10 mm in length. The electron beam is focused by means of electrostatic fields. The column is designed for a maximum voltage of 50 kV. Simulations of the electron trajectories have been performed by using the 2D simulation code IGUN and EGUN. The electron temperature has also been incorporated into the simulations. The electron beam simulations, column design and fabrication will be discussed in this presentation.

Regulatory focus in groupt contexts

NARCIS (Netherlands)

Faddegon, Krispijn Johannes

2009-01-01

The thesis examines the influence of group processes on the regulatory focus of individual group members. It is demonstrated that the group situation can affect group members' regulatory focus both in a top-down fashion (via the identitiy of the group) and in a bottom-up fashion (emerging from the

Radiodine treatment of hyperthyroidism with a simplified dosimetric approach. Clinical results

International Nuclear Information System (INIS)

Giovanella, L.; De Palma, D.; Ceriani, L.; Garancini, S.; Vanoli, P.; Tordiglione, M.; Tarolo, G. L.

2000-01-01

In this article is evaluated the clinical and effectiveness of a simplified dosimetric approach to the iodine-131 treatment of hyperthyroidism due to Graves' disease or uninodular and multinodular toxic goiter. 189 patients with biochemically confirmed hyperthyroidism and performed thyroid ultrasonography and scintigraphy obtaining the diagnosis of Graves' disease in 43 patients, uninodular toxic goiter in 57 patients and multinodular toxic goiter in 89 patients were enrolled in order to be examined. It was found in 28 patients cold thyroid nodules and performed fine-needle aspiration with negative cytology for thyroid malignancy in all cases. Antithyroid drugs were stopped 5 days till radioiodine administration and, if necessary, restored 15 days after the treatment. Radioiodine uptake test was performed in all patients and therapeutic activity calculated to obtain a minimal activity of 185 MBq in the thyroid 24 hours after administration. The minimal activity was adjusted based on clinical, biochemical and imaging data to obtain a maximal activity of 370 MBq after 24 hours. Biochemical and clinical tests were scheduled at 3 and 12 months posttreatment and thyroxine treatment was started when hypothyroidism occurred. In Graves' disease patients a mean activity of 370 MBq (distribution 259-555 MBq) was administered. Three months after treatment and at least 15 days after methimazole discontinuation 32 of 43 (74%) patients were hypothyroid , 5 of 43 (11%) euthyroid and 6 of 43 (15%) hyperthyroid. Three of the latter were immediately submitted to a new radioiodine administration while 32 hypothyroid patients received thyroxine treatment. One year after the radioiodine treatment no patient had hyperthyroidism; 38 of 43 (89%) were on a replacement treatment while 5 (11%) remained euthyroid. In uni-and multinodular toxic goiter a mean activity of 444 MBq (distribution 259-555 MBq) was administered. Three months posttreatment 134 of 146 (92%) patients were euthyroid and

An adiabatic focuser

International Nuclear Information System (INIS)

Chen, P.; Oide, K.; Sessler, A.M.; Yu, S.S.

1989-08-01

Theoretical analysis is made of an intense relativistic electron beam, such as would be available from a linear collider, moving through a plasma of increasing density, but density always less than that of the beam (underdense). In this situation, the plasma electrons are expelled from the beam channel and the electrons are subject to an ever-increasing focusing force provided by the channel ions. Analysis is made on the beam radiation energy loss in the classical, the transition, and the quantum regimes. It is shown that the focuser is insensitive to the beam energy spread behaviors in the nonclassical regimes, the radiation limit on lenses (the Oide limit) can be exceeded. The sensitivity of the system to the topic mismatch and the nonlinearity is also analyzed. Examples are given with SLC-type and TLC-type parameters. 9 refs., 1 tab

CTE's Focus on Continuous Improvement

Science.gov (United States)

Foster, John; Kelley, Patricia; Pritz, Sandy; Hodes, Carol

2011-01-01

Just one of the ways career and technical education (CTE) is revamping its image is through increased attention to data-driven instructional techniques as a means of improving and focusing instruction on what matters most. Accountability and data have increasingly become a core focus of research, news, and commentary about education in recent…

Thyroidectomy for Graves' disease: is hypothyroidism inevitable?

OpenAIRE

Davenport, M.; Talbot, C. H.

1989-01-01

The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroi...

Three-dimensional light distribution near the focus of a tightly focused beam of few-cycle optical pulses

International Nuclear Information System (INIS)

Romallosa, Kristine Marie; Bantang, Johnrob; Saloma, Caesar

2003-01-01

Via the Richards-Wolf vector diffraction theory, we analyze the three-dimensional intensity distribution of the focal volume that is produced by a strongly focused 750-nm beam of ultrafast, Gaussian-shaped optical pulses (10 -9 s≥ pulse width τ≥1 fs=10 -15 s). Knowledge of the three-dimensional distribution near focus is essential in determining the diffraction-limited resolution of an optical microscope. The optical spectrum of a short pulse is characterized by side frequencies about the carrier frequency. The effect of spectral broadening on the focused intensity distribution is evaluated via the Linfoot's criteria of fidelity, structural content, and correlation quality and with reference to a 750-nm cw focused beam. Different values are considered for τ and numerical aperture of the focusing lens (0.1≤X NA ≤1.2). At X NA =0.8, rapid deterioration of the focused intensity distribution is observed at τ=1.2 fs. This happens because a 750-nm optical pulse with τ=1.2 fs has an associated coherence length of 359.7 nm which is less than the Nyquist sampling interval of 375 nm that is required to sample 750 nm sinusoid without loss of information. The ill-effects of spectral broadening is weaker in two-photon excitation microscope than in its single-photon counterpart for the same focusing lens and light source

Magnetically focused liquid drop radiator

Science.gov (United States)

Botts, Thomas E.; Powell, James R.; Lenard, Roger

1986-01-01

A magnetically focused liquid drop radiator for application in rejecting rgy from a spacecraft, characterized by a magnetizable liquid or slurry disposed in operative relationship within the liquid droplet generator and its fluid delivery system, in combination with magnetic means disposed in operative relationship around a liquid droplet collector of the LDR. The magnetic means are effective to focus streams of droplets directed from the generator toward the collector, thereby to assure that essentially all of the droplets are directed into the collector, even though some of the streams may be misdirected as they leave the generator. The magnetic focusing means is also effective to suppress splashing of liquid when the droplets impinge on the collector.

Attentional Focusing Instructions and Force Production

Directory of Open Access Journals (Sweden)

David C Marchant

2011-01-01

Full Text Available Research progress assessing the role of attentional focusing instructions on skill acquisition and performance has lead researchers to apply this approach to force production tasks. Initial converging evidence indicates that force production tasks are sensitive to verbal instruction; externally focused instructions (onto movement outcomes, or onto the object force is being exerted against are shown to be more beneficial than internally focused instructions (focusing attention onto the movements being executed. These benefits are observed for maximal and accurate force production, as well as the maintenance of force production in prolonged tasks. A range of mechanisms are identified supporting the proposal that an external focus promotes movement efficiency in line with energy and effort conservation. Future research is required to assess how this developing body of work interacts with the broader understanding of psychological and physiological factors implicated in the effective production, maintenance and limitation of maximal or sub-maximal forces.

The Therapeutic Alliance in Schema-Focused Therapy and Transference-Focused Psychotherapy for Borderline Personality Disorder

Science.gov (United States)

Spinhoven, Philip; Giesen-Bloo, Josephine; van Dyck, Richard; Kooiman, Kees; Arntz, Arnoud

2007-01-01

This study investigated the quality and development of the therapeutic alliance as a mediator of change in schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder. Seventy-eight patients were randomly allocated to 3 years of biweekly SFT or TFP. Scores of both therapists and patients for the…

Direct marketing of parenting programs: comparing a promotion-focused and a prevention-focused strategy.

Science.gov (United States)

Salari, Raziye; Backman, Anna

2017-06-01

: For parenting programs to achieve a public health impact, it is necessary to develop more effective marketing strategies to increase public awareness of these programs and promote parental participation. In this article, we compared a promotion-focused and a prevention-focused strategy via two studies. : We designed two ads inviting parents to participate in a universal parenting program; one ad focused on the program increasing the likelihood of positive outcomes for children (promotion-focused) and the other on the program reducing the likelihood of negative outcomes (prevention-focused). In study I, the two ads were run online simultaneously. Those who clicked on an ad were directed to a website where they could read about and sign up for the program. In study II, a community sample of 706 parents answered a questionnaire about the ads. : In study I, over 85 days, the prevention ad generated more clicks. There was no difference in the number of pages visited on the website nor in the number of parents who signed up for the program. In study II, parents showed a preference for the promotion ad, perceiving it as more relevant and rating it as more effective in getting them interested in the program. : A prevention strategy may be more effective in drawing public attention, in general. However, a promotion strategy is more likely to reach parents, in particular, and inspire them to consider participating in parenting programs. These strategies should be developed further and tested in both general and clinical populations. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Nonverbal communication in the focus-group

Directory of Open Access Journals (Sweden)

Alina Simona TECĂU

2015-12-01

Full Text Available In the process of analysing the information obtained through focus group qualitative marketing research, a very important source of data is represented by non-verbal communication. Although the literature reveals an abundance of published material that describes how data obtained through focus group should be analysed, one of the least addressed issue is the interpretation of signals from participants: gestures, posture, dynamic and rhythm of speech or even the silence. This Article addresses precisely aspects of non-verbal communication in the focus group's and although not intended to examine in detail the results of a focus group, it shows how some of signals transmitted by participants of such research have been analysed and interpreted.

Microflow Cytometers with Integrated Hydrodynamic Focusing

Directory of Open Access Journals (Sweden)

Martin Schmidt

2013-04-01

Full Text Available This study demonstrates the suitability of microfluidic structures for high throughput blood cell analysis. The microfluidic chips exploit fully integrated hydrodynamic focusing based on two different concepts: Two-stage cascade focusing and spin focusing (vortex principle. The sample—A suspension of micro particles or blood cells—is injected into a sheath fluid streaming at a substantially higher flow rate, which assures positioning of the particles in the center of the flow channel. Particle velocities of a few m/s are achieved as required for high throughput blood cell analysis. The stability of hydrodynamic particle positioning was evaluated by measuring the pulse heights distributions of fluorescence signals from calibration beads. Quantitative assessment based on coefficient of variation for the fluorescence intensity distributions resulted in a value of about 3% determined for the micro-device exploiting cascade hydrodynamic focusing. For the spin focusing approach similar values were achieved for sample flow rates being 1.5 times lower. Our results indicate that the performances of both variants of hydrodynamic focusing suit for blood cell differentiation and counting. The potential of the micro flow cytometer is demonstrated by detecting immunologically labeled CD3 positive and CD4 positive T-lymphocytes in blood.

Reviewing the Focus: A Summary and Critique of Child-Focused Sexual Abuse Prevention.

Science.gov (United States)

Rudolph, Julia; Zimmer-Gembeck, Melanie J

2016-10-26

Due to the high incidence, and widespread detrimental health consequences, of child sexual abuse (CSA), effective prevention remains at the forefront of public and mental health research, prevention and intervention agendas. To date much of the focus of prevention has been on school-based education programs designed to teach children skills to evade adult sexual advances, and disclose past or ongoing abuse. Evaluation of sexual abuse prevention programs demonstrate their effectiveness in increasing children's knowledge of CSA concepts and protection skills, but little is known about their effects on children's capacity to prevent abuse. Moreover, concerns persist about the unintended side-effects for young children such as anxiety, worry and wariness of touch. This paper summarizes the recent history of CSA prevention and the critique of child-focused protection programs in order to demonstrate the need to compliment or replace these programs by focusing more on protectors in the children's ecology, specifically parents, in order to create safer environments in which abuse is less likely to occur. © The Author(s) 2016.

Needs of Non Energy-Focused Contractors

Energy Technology Data Exchange (ETDEWEB)

Liaukus, C.

2012-12-01

To better understand the informational needs of non energy-focused contractors, including what information they need to motivate them to become energy-focused, the BARA team studied the type of information provided by the national programs, trade associations, and manufacturers that were researched for the related technical report: Effective Communication of Energy Efficiency. While that report focused on the delivery method, format, and strategy of the information, this study examines the content being put forward.

Needs of Non-Energy Focused Contractors

Energy Technology Data Exchange (ETDEWEB)

Liakus, C. [Building Media and the Building America Retrofit Alliance (BARA), Wilmington, DE (United States)

2012-12-01

To better understand the informational needs of non-energy focused contractors, including what information they need to motivate them to become energy-focused, the BARA team studied the type of information provided by the national programs, trade associations, and manufacturers that were researched for the related technical report: Effective Communication of Energy Efficiency. While that report focused on the delivery method, format, and strategy of the information, this study examines the content being put forward.

Analysis and modeling of "focus" in context

DEFF Research Database (Denmark)

Hovy, Dirk; Anumanchipalli, Gopala; Parlikar, Alok

2013-01-01

This paper uses a crowd-sourced definition of a speech phenomenon we have called focus. Given sentences, text and speech, in isolation and in context, we asked annotators to identify what we term the focus word. We present their consistency in identifying the focused word, when presented with text...... or speech stimuli. We then build models to show how well we predict that focus word from lexical (and higher) level features. Also, using spectral and prosodic information, we show the differences in these focus words when spoken with and without context. Finally, we show how we can improve speech synthesis...

Five focus strategies to organize health care delivery.

Science.gov (United States)

Peltokorpi, Antti; Linna, Miika; Malmström, Tomi; Torkki, Paulus; Lillrank, Paul Martin

2016-01-01

The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators. Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.

EPIDEMIOLOGY OF THYROID LESIONS IN WARDHA DISTRICT OF CENTRAL INDIA

Directory of Open Access Journals (Sweden)

Samarth Shukla

2015-02-01

Full Text Available AIMS: To establish a significant predominance of thyroid lesions in and around Wardha district, and to establish specific etiological link for the predominance the thyroid lesions. MATERIALS AND METHOD S : This was a hospital based analytical prospective study, conducted in Acharya Vinobha Bhave Rural Hospital (A.V.B.R.H. involving 108 patients. The study was carried over a duration of 1 year January 2010 to December 2010. Patients attending endocrinological clinics and the newly detected cases of thyroid lesions, within set parameters of study, were the subjects of this study. OBSERVATION: Thyroid lesions which we came across in the course of the study were Thyrotoxicosis, Myxoedema, Thyroiditis, Diffuse goitre, Nodular Goitre and Carcinoma Thyroid . These were correlated with epidemiological factors like Age, Sex, Region, Diet and Iodine Intake. Significant relationship between thyroid function, age of patient, diet was seen in comparison to individual thyroid lesions. CONCLUSION : G oitre was the commest pathology encountered . Almost all of the thyroid lesions were of hypothyroid in their function with exception of thyrotoxicosis and carcinoma. Thyroid lesions were found predominantly in females, Age related lesion pathology was significant, and vegetarian and non - vegetarian diets along with low and high iodine salt uptake had obvious pathological effects on thyroid

Value of radioimmuno-assay of triiodothyronine and thyrotropic hormone in the diagnosis of thyroid disease

International Nuclear Information System (INIS)

Hesch, R.D.; Emrich, D.; Muehlen, A. von zur; Breuel, H.P.; Goettingen Univ.

1975-01-01

Results of a purely in-vitro test were compared with previously available methods in 425 patients. For triiodothyronine, a normal range must be differentiated from the so-called euthyroid range (0.8-2.0 ng/ml) for patients with euthyroid goitre. The accuracy for triiodothyronine is then more than 95% and in hyperthyroidism 97.5%. It is, therefore, superior to other in-vitro measurements. But a disadvantage is that it is easily influenced by thyroid and extrathyroid factors. Similar accuracy is obtained for the TRH function test (thyrotropine-releasing hormone). Notable is a 'negative' TRH test in 20% of patients with euthyroid goitre. The significance of triiodothyronine determination is decreased in autonomous adenoma, in which the TRH test has an accuracy of 96.5%. In rare diseases of the thyroid all diagnostic possibilities must be taken into account. In ordinary practice a stepwise course is suggested. RT 3 U, T 4 , T 3 and thyroid scan with sup(99m)Tc pertechnetate are useful as basic tests. PBI is still thought to be important. The second step involves the TRH test rather than 131 I function test. Triiodothyronine determination is best for therapeutic and follow-up purposes, a situation in which TRH test is of limited value. (orig.) [de

Subsurface contaminants focus area

International Nuclear Information System (INIS)

1996-08-01

The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites

Subsurface contaminants focus area

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-08-01

The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites.

Material focus

DEFF Research Database (Denmark)

Sokoler, Tomas; Vallgårda, Anna K. A.

2009-01-01

In this paper we build on the notion of computational composites, which hold a material perspective on computational technology. We argue that a focus on the material aspects of the technology could be a fruitful approach to achieve new expressions and to gain a new view on the technology's role...... in design. We study two of the computer's material properties: computed causality and connectability and through developing two computational composites that utilize these properties we begin to explore their potential expressions....

Self-focusing relativistic electron streams in plasmas

International Nuclear Information System (INIS)

Cox, J.L. Jr.

1975-01-01

A relativistic electron stream propagating through a dense plasma induces current and charge densities which determine how the stream can self-focus. Magnetic self-focusing is possible because stream-current neutralization, although extensive, is not complete. Electric self-focusing can occur because the stream charge becomes overneutralized when the net current is smaller than a critical value. Under some circumstances, the latter process can cause the stream to focus into a series of electron bunches

Focus On Photoshop Elements Focus on the Fundamentals

CERN Document Server

Asch, David

2011-01-01

Are you bewildered by the advanced editing options available in Photoshop Elements? Do you want to get the most out of your image without going bleary-eyed in front of a computer screen? This handy guide will explain the ins and outs of using Photoshop Elements, without having to spend hours staring at the screen. Using a fabulous combination of easy-to-follow advice and step-by-step instructions, Focus On Photoshop Elements gives great advice on setting up, storing and sharing your image library and teaches you the basics of RAW image processing and color correction, plus shows you how to edi

Focus groups: a useful tool for curriculum evaluation.

Science.gov (United States)

Frasier, P Y; Slatt, L; Kowlowitz, V; Kollisch, D O; Mintzer, M

1997-01-01

Focus group interviews have been used extensively in health services program planning, health education, and curriculum planning. However, with the exception of a few reports describing the use of focus groups for a basic science course evaluation and a clerkship's impact on medical students, the potential of focus groups as a tool for curriculum evaluation has not been explored. Focus groups are a valid stand-alone evaluation process, but they are most often used in combination with other quantitative and qualitative methods. Focus groups rely heavily on group interaction, combining elements of individual interviews and participant observation. This article compares the focus group interview with both quantitative and qualitative methods; discusses when to use focus group interviews; outlines a protocol for conducting focus groups, including a comparison of various styles of qualitative data analysis; and offers a case study, in which focus groups evaluated the effectiveness of a pilot preclinical curriculum.

Plasma Focus

International Nuclear Information System (INIS)

Bernard, Alain; Jolas, Alain; Garconnet, J.-P.; Mascureau, J. de; Nazet, Christian; Coudeville, Alain; Bekiarian, Andre.

1977-01-01

The present report is the edition of the lectures given in a conference on the Focus experiment held at the Centre d'etudes de Limeil, on Oct. 1975. After a survey of the early laboratories one will find the main results obtained in Limeil concerning interferometry, laser scattering, electric and magnetic-measurements, X-ray and neutron emission and also the possible use of explosive current generators instead of capacitor banks at high energy levels. The principal lines of future research are given in the conclusion [fr

Technology of a small plasma focus

International Nuclear Information System (INIS)

Lee, S.

1990-01-01

This paper reviews plasma focus technology, including the underlying dynamic and energy balance theory, scaling of the neutron yield, cost effectiveness of the design, as well as the main subsystems, e.g., capacitor bank, spark-gap switch and triggering electronics, the plasma focus tube, some simple diagnostics, and a high-voltage charger. It discusses the range of densities and temperatures available with a small plasma focus, and the type of experiments and applications that can be carried out with it. 61 refs, 21 figs

Accumulation of iodine-123 in thyroid and urinary excretion of iodine in an area of endemic goiter

Energy Technology Data Exchange (ETDEWEB)

Goebel, R; Leb, G; Passath, A; Knapp, G

1983-06-20

The thyroid radioiodine uptakes decreased from 52.4% (1982, 24-hours, /sup 131/I) to 30.5% (1981, /sup 123/I). The severity of scintigraphic findings decreased as well, although the incidence of nodules remains definitely high. The excretion of iodine was found to be 53.28 ..mu..g/g creatine and is low compared with the present uptakes. It characterizes an area of endemic goitre degree I, borderline to degree II.

Automatic focusing system of BSST in Antarctic

Science.gov (United States)

Tang, Peng-Yi; Liu, Jia-Jing; Zhang, Guang-yu; Wang, Jian

2015-10-01

Automatic focusing (AF) technology plays an important role in modern astronomical telescopes. Based on the focusing requirement of BSST (Bright Star Survey Telescope) in Antarctic, an AF system is set up. In this design, functions in OpenCV is used to find stars, the algorithm of area, HFD or FWHM are used to degree the focus metric by choosing. Curve fitting method is used to find focus position as the method of camera moving. All these design are suitable for unattended small telescope.

Instabilities in the plasma focus

International Nuclear Information System (INIS)

Kaeppeler, H.J.

1975-03-01

The plasma focus was studied by many research teams in view of a possible approach to controlled thermonuclear fusion. Though it is questionable whether the plasma focus will ever lead to a fusion reactor, it nevertheless constitutes a strong source of neutron, X- and gamma radiation for simulating fusion reactor conditions. Furthermore, the plasma focus yields very high temperatures (10 7 K) and densities (> 10 19 cm -3 ) and thus provides interesting conditions for the study of high density plasmas. This review paper starts with a description of the compression stage of the focussing plasma, using a snow-plough model. It is shown that sophisticated MHD calculations substantiate the snowplough theory, but are not suited to describe the phenomena in the final compressed stage. For this purpose, a particle-in-cell calculation is employed, yielding a beam-beam collision model for the neutron production. Experimental evidence indicates that neutron production is associated with the appearence of m = O instabilities and is the direct result of collisions between anomalously accelerated ions. One of the mechanisms of ion acceleration are strong local electric fields. Another possible mechanism can bee seen in beam-plasma instabilities caused by runaway electrons. The analytical derivation of the dispersion relation for plasma focus conditions including runaway effect is discussed (orig.) [de

A Very Rare Cause of Subglottic Stenosis: Non-Malignant Intratracheal Thyroid Tissue

Directory of Open Access Journals (Sweden)

Ümit Aydogmus

2014-08-01

Full Text Available We present a case of subglottic stenosis associated with benign thyroid tissue involvement due to relapse of multinodular goiter despite surgery 14 years ago.The patient had undergone bilateral subtotal thyroidectomy 14 years ago and the pathology report had been multinodular thyroid tissue at the time. The patient recently presented to an emergency service due to sudden development of respiratory distress and was then directed to our center. Cervical tomography showed bilateral thyroid tissue that narrowed the tracheal diameter by 80% by invading the trachea from the left wall at the level of the thyroid gland. The patient required urgent tracheostomy due to serious respiratory trouble. The trachea was incised vertically about 2.5 cm below the cricoid cartilage. A 2 cm endotracheal lesion with margins that could not be distinguished from the left vocal cord was observed and biopsies were taken from both this lesion and the tissue surrounding the trachea. A Montgomery T-tube extending from the subglottic area to the distal section was placed. Pathology evaluation revealed histopathological findings that matched normal thyroid tissue. Although infrequent, tracheal invasion associated with a thyroid cancer is known to occur. We present a case with postoperative intratracheal relapse due to a benign cause and the emergency treatment.

Line broadening by focusing

International Nuclear Information System (INIS)

Brito, A.L. de; Jabs, A.

1983-01-01

It is pointed out that the spectral width of a quasi-monochromatic light beam broadens when the beam is focused. A quantitative formula for this broadening is derived from classical wave theory. The effect is shown to explain some experiments on laser beams done by E. Panarella which that author has explained under the ad-hoc hypothesis that the frequency of the photons changes along with the intensity of the light beam. The line broadening by focusing might also contribute to gas ionization by incident light when the ionization potential is well above the mean photon energy. Some remarks are made on some direct applications of the Heisenberg relations in comparison with our treatment. (Author) [pt

A Feminist Critique of Solution-Focused Therapy.

Science.gov (United States)

Dermer, Shannon B.; Hemesath, Crystal Wilhite; Russell, Candyce S.

1998-01-01

Applying the feminist critique to solution-focused therapy highlights the strengths and weaknesses of this model from a feminist perspective. Although solution-focused therapy and feminist approaches share an emphasis on competence and strengths, solution-focused theory tends to overlook gender and power differences. In general, the model falls…

Particle Accelerator Focus Automation

Directory of Open Access Journals (Sweden)

Lopes José

2017-08-01

Full Text Available The Laboratório de Aceleradores e Tecnologias de Radiação (LATR at the Campus Tecnológico e Nuclear, of Instituto Superior Técnico (IST has a horizontal electrostatic particle accelerator based on the Van de Graaff machine which is used for research in the area of material characterization. This machine produces alfa (He+ and proton (H+ beams of some μA currents up to 2 MeV/q energies. Beam focusing is obtained using a cylindrical lens of the Einzel type, assembled near the high voltage terminal. This paper describes the developed system that automatically focuses the ion beam, using a personal computer running the LabVIEW software, a multifunction input/output board and signal conditioning circuits. The focusing procedure consists of a scanning method to find the lens bias voltage which maximizes the beam current measured on a beam stopper target, which is used as feedback for the scanning cycle. This system, as part of a wider start up and shut down automation system built for this particle accelerator, brings great advantages to the operation of the accelerator by turning it faster and easier to operate, requiring less human presence, and adding the possibility of total remote control in safe conditions.

Particle Accelerator Focus Automation

Science.gov (United States)

Lopes, José; Rocha, Jorge; Redondo, Luís; Cruz, João

2017-08-01

The Laboratório de Aceleradores e Tecnologias de Radiação (LATR) at the Campus Tecnológico e Nuclear, of Instituto Superior Técnico (IST) has a horizontal electrostatic particle accelerator based on the Van de Graaff machine which is used for research in the area of material characterization. This machine produces alfa (He+) and proton (H+) beams of some μA currents up to 2 MeV/q energies. Beam focusing is obtained using a cylindrical lens of the Einzel type, assembled near the high voltage terminal. This paper describes the developed system that automatically focuses the ion beam, using a personal computer running the LabVIEW software, a multifunction input/output board and signal conditioning circuits. The focusing procedure consists of a scanning method to find the lens bias voltage which maximizes the beam current measured on a beam stopper target, which is used as feedback for the scanning cycle. This system, as part of a wider start up and shut down automation system built for this particle accelerator, brings great advantages to the operation of the accelerator by turning it faster and easier to operate, requiring less human presence, and adding the possibility of total remote control in safe conditions.

The importance of the right focusing technique. At-a-glance information on focusing techniques in X-ray procedures

International Nuclear Information System (INIS)

Lichte-Wichmann, M.

1993-01-01

Sharp pictures providing all the information relevant to a particular case obviate repeat exposures, help to keep the radiation dose to a minimum and prevent false diagnoses. In her book, the author gives practical guidance on focusing techniques that is equally valuable to beginners and experienced investigators or medical X-ray assistants and physicians. A substantial part of the book is devoted to detailed instructions on how an object is brought into focus as well as on the criteria of proper focusing and the possibilities of identifying and avoiding false focusing techniques. The problems arising when uncommon X-ray pictures have to be taken are explained by diagrammatic representations. (orig.) [de

Plasma lenses for focusing relativistic electron beams

International Nuclear Information System (INIS)

Govil, R.; Wheeler, S.; Leemans, W.

1997-01-01

The next generation of colliders require tightly focused beams with high luminosity. To focus charged particle beams for such applications, a plasma focusing scheme has been proposed. Plasma lenses can be overdense (plasma density, n p much greater than electron beam density, n b ) or underdense (n p less than 2 n b ). In overdense lenses the space-charge force of the electron beam is canceled by the plasma and the remaining magnetic force causes the electron beam to self-pinch. The focusing gradient is nonlinear, resulting in spherical aberrations. In underdense lenses, the self-forces of the electron beam cancel, allowing the plasma ions to focus the beam. Although for a given beam density, a uniform underdense lens produces smaller focusing gradients than an overdense lens, it produces better beam quality since the focusing is done by plasma ions. The underdense lens can be improved by tapering the density of the plasma for optimal focusing. The underdense lens performance can be enhanced further by producing adiabatic plasma lenses to avoid the Oide limit on spot size due to synchrotron radiation by the electron beam. The plasma lens experiment at the Beam Test Facility (BTF) is designed to study the properties of plasma lenses in both overdense and underdense regimes. In particular, important issues such as electron beam matching, time response of the lens, lens aberrations and shot-to-shot reproducibility are being investigated

A matter of focus: Power-holders feel more responsible after adopting a cognitive other-focus, rather than a self-focus

NARCIS (Netherlands)

Scholl, Annika; Sassenberg, Kai; Scheepers, Daan; Ellemers, Naomi|info:eu-repo/dai/nl/086631276; de Wit, Frank

Social power implies responsibility. Yet, power-holders often follow only their own interests and overlook this responsibility. The present research illuminates how a previously adopted cognitive focus guides perceived responsibility when a person receives high (vs. low) power. In three experiments,

Design of a new type synchronous focusing mechanism

Science.gov (United States)

Zhang, Jintao; Tan, Ruijun; Chen, Zhou; Zhang, Yongqi; Fu, Panlong; Qu, Yachen

2018-05-01

Aiming at the dual channel telescopic imaging system composed of infrared imaging system, low-light-level imaging system and image fusion module, In the fusion of low-light-level images and infrared images, it is obvious that using clear source images is easier to obtain high definition fused images. When the target is imaged at 15m to infinity, focusing is needed to ensure the imaging quality of the dual channel imaging system; therefore, a new type of synchronous focusing mechanism is designed. The synchronous focusing mechanism realizes the focusing function through the synchronous translational imaging devices, mainly including the structure of the screw rod nut, the shaft hole coordination structure and the spring steel ball eliminating clearance structure, etc. Starting from the synchronous focusing function of two imaging devices, the structure characteristics of the synchronous focusing mechanism are introduced in detail, and the focusing range is analyzed. The experimental results show that the synchronous focusing mechanism has the advantages of ingenious design, high focusing accuracy and stable and reliable operation.

Investigation of a staged plasma-focus apparatus

International Nuclear Information System (INIS)

Lee, J.H.; McFarland, D.R.; Harries, W.L.

1978-01-01

A new staged plasma-focus geometry combining two Mather-type plasma-focus guns has been constructed, and the current-sheet dynamics investigated. The production of simultaneous pairs of plasma foci has been achieved. The intensities of X-ray and fusion-neutron emission were measured and found to agree with the scaling law for a plasma focus. Advantages of this new geometry include the possibility of using plasma-focus type pinches in multiple arrays at power levels beyond the validity regime of the current scaling law for a single gun. (author)

Tanks Focus Area annual report FY2000

International Nuclear Information System (INIS)

2000-01-01

The U.S. Department of Energy (DOE) continues to face a major radioactive waste tank remediation effort with tanks containing hazardous and radioactive waste resulting from the production of nuclear materials. With some 90 million gallons of waste in the form of solid, sludge, liquid, and gas stored in 287 tanks across the DOE complex, containing approximately 650 million curies, radioactive waste storage tank remediation is the nation's highest cleanup priority. Differing waste types and unique technical issues require specialized science and technology to achieve tank cleanup in an environmentally acceptable manner. Some of the waste has been stored for over 50 years in tanks that have exceeded their design lives. The challenge is to characterize and maintain these contents in a safe condition and continue to remediate and close each tank to minimize the risks of waste migration and exposure to workers, the public, and the environment. In 1994, the DOE's Office of Environmental Management (EM) created a group of integrated, multiorganizational teams focusing on specific areas of the EM cleanup mission. These teams have evolved into five focus areas managed within EM's Office of Science and Technology (OST): Tanks Focus Area (TFA); Deactivation and Decommissioning Focus Area; Nuclear Materials Focus Area; Subsurface Contaminants Focus Area; and Transuranic and Mixed Waste Focus Area

Spatial filters for focusing ultrasound images

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt; Gori, Paola

2001-01-01

, but the approach always yields point spread functions better or equal to a traditional dynamically focused image. Finally, the process was applied to in-vivo clinical images of the liver and right kidney from a 28 years old male. The data was obtained with a single element transducer focused at 100 mm....... A new method for making spatial matched filter focusing of RF ultrasound data is proposed based on the spatial impulse response description of the imaging. The response from a scatterer at any given point in space relative to the transducer can be calculated, and this gives the spatial matched filter...... for synthetic aperture imaging for single element transducers. It is evaluated using the Field II program. Data from a single 3 MHz transducer focused at a distance of 80 mm is processed. Far from the transducer focal region, the processing greatly improves the image resolution: the lateral slice...

Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

Science.gov (United States)

Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

2010-01-01

Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

Veselago focusing of anisotropic massless Dirac fermions

Science.gov (United States)

Zhang, Shu-Hui; Yang, Wen; Peeters, F. M.

2018-05-01

Massless Dirac fermions (MDFs) emerge as quasiparticles in various novel materials such as graphene and topological insulators, and they exhibit several intriguing properties, of which Veselago focusing is an outstanding example with a lot of possible applications. However, up to now Veselago focusing merely occurred in p-n junction devices based on the isotropic MDF, which lacks the tunability needed for realistic applications. Here, motivated by the emergence of novel Dirac materials, we investigate the propagation behaviors of anisotropic MDFs in such a p-n junction structure. By projecting the Hamiltonian of the anisotropic MDF to that of the isotropic MDF and deriving an exact analytical expression for the propagator, precise Veselago focusing is demonstrated without the need for mirror symmetry of the electron source and its focusing image. We show a tunable focusing position that can be used in a device to probe masked atom-scale defects. This study provides an innovative concept to realize Veselago focusing relevant for potential applications, and it paves the way for the design of novel electron optics devices by exploiting the anisotropic MDF.

The Relationship Between Personality Type And Leadership Focus

Directory of Open Access Journals (Sweden)

Grant Sieff

2006-11-01

Full Text Available Optimising focus is a key success driver for many organisation leaders. The relationship between personality type and leadership focus is examined. Personality type is assessed with Form M of the Myers-Briggs Type Indicator instrument, and leadership focus is explored through the development and application of a Leadership Focus Questionnaire. South African executives form the target population for this study. Both functionalist and interpretive approaches are applied. Three primary theoretical hypotheses about leadership focus, concerning (1 optimising the balance of focus between external and internal priorities, (2 the fit between the leadership personality type and the organisation type, and (3 the capacity to manage a multiple focus, are considered. Results show that Extraverted personality types are more comfortable with the challenges of focus in the leadership role than are Introverted types, and Extraverted, Sensing, Thinking and Judging types experience a greater degree of fit with their organisations than do Introverted, Intuitive, Feeling and Perceiving types.

Incidence of hypothyroidism more than twenty years after therapy in hyperthyroid patients treated with radioactive iodine

International Nuclear Information System (INIS)

Ronga, G.; Esposito, M.; Bschieri, I.; Fenzi, G.F.; Martino, E.; Pinchera, A.

1988-01-01

It is confirmed that delayed hypothyroidism is the major complication of I 131 therapy of the hyperthyroid syndromes of toxic diffuse or toxic multinodular goiter. In a homogeneous group of 94 patients taken from case histories of 454 subjects treated between 1957 and 1967, the annual increment of complications over the years appears significantly less than that found by other Authors and by us in prior review afeter a shorter interval of time

Radiodine treatment of hyperthyroidism with a simplified dosimetric approach. Clinical results; Terapia radiometabolica dell'ipertiroidismo con approccio dosimetrico semplificato. Risultati clinici

Energy Technology Data Exchange (ETDEWEB)

Giovanella, L.; De Palma, D.; Ceriani, L.; Garancini, S. [Azienda Ospedaliera Universitaria, Ospedale di Circolo e Fondazione Macchi, Dipt. di Diagnostica per Immagini e Radioterapia, Unita' Operativa di Medicina Nucleare, Varese (Italy); Vanoli, P.; Tordiglione, M. [Azienda Ospedaliera Universitaria, Ospedale di Circolo e Fondazione Macchi, Unita' Operativa di Radioterapia, Varese (Italy); Tarolo, G. L. [Milan Univ., Milan (Italy). Cattedra di Medicina Nucleare, Ist. di Scienze Radiologiche

2000-12-01

In this article is evaluated the clinical and effectiveness of a simplified dosimetric approach to the iodine-131 treatment of hyperthyroidism due to Graves' disease or uninodular and multinodular toxic goiter. 189 patients with biochemically confirmed hyperthyroidism and performed thyroid ultrasonography and scintigraphy obtaining the diagnosis of Graves' disease in 43 patients, uninodular toxic goiter in 57 patients and multinodular toxic goiter in 89 patients were enrolled in order to be examined. It was found in 28 patients cold thyroid nodules and performed fine-needle aspiration with negative cytology for thyroid malignancy in all cases. Antithyroid drugs were stopped 5 days till radioiodine administration and, if necessary, restored 15 days after the treatment. Radioiodine uptake test was performed in all patients and therapeutic activity calculated to obtain a minimal activity of 185 MBq in the thyroid 24 hours after administration. The minimal activity was adjusted based on clinical, biochemical and imaging data to obtain a maximal activity of 370 MBq after 24 hours. Biochemical and clinical tests were scheduled at 3 and 12 months posttreatment and thyroxine treatment was started when hypothyroidism occurred. In Graves' disease patients a mean activity of 370 MBq (distribution 259-555 MBq) was administered. Three months after treatment and at least 15 days after methimazole discontinuation 32 of 43 (74%) patients were hypothyroid , 5 of 43 (11%) euthyroid and 6 of 43 (15%) hyperthyroid. Three of the latter were immediately submitted to a new radioiodine administration while 32 hypothyroid patients received thyroxine treatment. One year after the radioiodine treatment no patient had hyperthyroidism; 38 of 43 (89%) were on a replacement treatment while 5 (11%) remained euthyroid. In uni-and multinodular toxic goiter a mean activity of 444 MBq (distribution 259-555 MBq) was administered. Three months posttreatment 134 of 146 (92%) patients were

Focus groups in organizational research

Directory of Open Access Journals (Sweden)

L. Kamfer

1989-05-01

Full Text Available Focus groups are commonly used in marketing research. In this article an application of the focus group technique within an organizational context is described. Nine focus groups were conducted during the planning stage of a survey intended to establish employee perceptions of advancement policies and practices in a major South African manufacturing company. Fourteen themes emerged from a content analysis of the discussions. Two of these reflected aspects requiring commitment decisions from management toward the survey. The others indicated areas of concern which should be included in the survey. In this way, the focus groups contributed useful information for the subsequent sample survey. Opsomming Fokusgroepe word algemeen in bemarkingsnavorsing aangewend. In hierdie studie word 'n toepassingvan die fokusgroeptegniek in die konteks van 'n opname binne 'n organisasie beskryf. Nege fokusgroepbesprekings is gevoer tydens die beplanningstadium van 'n opname wat binne 'n Suid-Afrikaanse vervaardigingsonderneming gedoen is. Die doel van die opname was om die persepsies van werknemers teenoor die bestaande personeel- en bestuursontwikkelingsbeleid en -praktyke van die maatskappy te bepaal. Veertien temas is deur middel van 'n inhoudontleding gei'dentifiseer. Twee hiervan het aspekte aangedui waaroor bestuur beginselbesluite t.o.v. die opname sou moes neem. Die ander het probleemareas aangedui wat by die ondersoek selfingesluit behoort te word. Sodoende het die fokusgroepe inligting verskafwat vir die latere vraelysopname belangrik was.

Identifying Information Focuses in Listening Comprehension

Science.gov (United States)

Zhang, Hong-yan

2011-01-01

The study explains the process of learners' listening comprehension within Halliday's information theory in functional grammar, including the skills of identifying focuses while listening in college English teaching. Identifying information focuses in listening is proved to improve the students' communicative listening ability by the means of a…

[Classification and etiology of hyperthyroidism].

Science.gov (United States)

Łacka, Katarzyna; Fraczek, Magdalena Maria

2014-03-01

The prevalence of hyperthyroidism in women is between 0.5-2% and it is 10 times less common in men. The most common causes are Graves' disease, toxic multinodular goiter, and autonomously functioning thyroid adenoma. Rare causes of hyperthyroidisms are as follow: pituitary adenoma, autoimmune thyroiditis (Hashitoxicosis), levothyroxine overdose, inadequate iodine supplementation (including amiodaron induced hyperthyroidism, iodine-based contrast media), hCG excess (pregnancy, gestational trophoblastic disease, germ-cell tumors), drug induced hyperthyroidism, differentiated thyroid carcinomas and/or their metastases, struma ovarii, and familial nonautoimmune hyperthyroidism. This article focuses on the current data of etiopathogenesis of hyperthyroidisms. Genetic factors (like HLA-DR3,CD40, CTLA-4, PTPN22, FOXP3 CD25) and thyroid specific genes (thyroglobulin, TSHR, G(s)alpha) and environmental and endogenous factors (such as age, iodine, selenium, emotional stress, smoking, gender, pregnancy, sex hormones, fetal microchimerism, fetal growth, bacterial infections, viral infections, allergies, drugs (alemtuzumab, interferon alpha, iplimumab/tremelimumab, tyrosine kinase inhibitors, denileukindiftitox, thalidomide/lenalidomide, exposition to fallout and radiotherapy) have been described.

Tanks Focus Area annual report FY2000

Energy Technology Data Exchange (ETDEWEB)

None

2000-12-01

The U.S. Department of Energy (DOE) continues to face a major radioactive waste tank remediation effort with tanks containing hazardous and radioactive waste resulting from the production of nuclear materials. With some 90 million gallons of waste in the form of solid, sludge, liquid, and gas stored in 287 tanks across the DOE complex, containing approximately 650 million curies, radioactive waste storage tank remediation is the nation's highest cleanup priority. Differing waste types and unique technical issues require specialized science and technology to achieve tank cleanup in an environmentally acceptable manner. Some of the waste has been stored for over 50 years in tanks that have exceeded their design lives. The challenge is to characterize and maintain these contents in a safe condition and continue to remediate and close each tank to minimize the risks of waste migration and exposure to workers, the public, and the environment. In 1994, the DOE's Office of Environmental Management (EM) created a group of integrated, multiorganizational teams focusing on specific areas of the EM cleanup mission. These teams have evolved into five focus areas managed within EM's Office of Science and Technology (OST): Tanks Focus Area (TFA); Deactivation and Decommissioning Focus Area; Nuclear Materials Focus Area; Subsurface Contaminants Focus Area; and Transuranic and Mixed Waste Focus Area.

Focus group report - part II

International Nuclear Information System (INIS)

1997-12-01

The Waste Policy Institute, through a cooperative agreement with the U.S. Department of Energy (DOE) Office of Science and Technology (OST) conducted a focus group with members of the Hanford Advisory Board (HAB), interviews with tribal government representatives, and a survey of Oak Ridge Local Oversight Committee (LOC) and Site Specific Advisory Board (SSAB) members. The purpose was to understand what members of the interested and involved public want to know about technology development and ways to get that information to them. These data collection activities were used as a follow-up to two previously held focus groups with the general public near Idaho National Engineering and Environmental Laboratory (INEEL) and the Savannah River Site (SRS). Most participants from the first two focus groups said they did not have time and/or were not interested in participating in technology decision-making. They said they would prefer to defer to members of their communities who are interested and want to be involved in technology decision-making

The sporting body: body image and eating disorder symptomatology among female athletes from leanness focused and nonleanness focused sports.

Science.gov (United States)

Kong, Peiling; Harris, Lynne M

2015-01-01

Female athletes experience pressure to conform to social and sporting norms concerning body weight. This study compared general and sporting body dissatisfaction and disordered eating symptomatology among 320 elite, recreational, and noncompetitive female athletes aged 17 to 30 years competing in leanness focused sports and nonleanness focused sports. Participants completed an online questionnaire including demographic questions, the Eating Attitudes Test, and the Figure Rating Scale. Athletes from leanness focused sports reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of participation level. Elite athletes reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of sport type, and differences between recreational and noncompetitive athletes were not found. More than 60% of elite athletes from leanness focused and nonleanness focused sports reported pressure from coaches concerning body shape. The findings have important implications for identifying risk factors for eating disorders among female athletes, where athletes who compete at elite level and those who compete in leanness focused sports at any level may be at higher risk for developing eating disorders.

Broadband and flexible acoustic focusing by metafiber bundles

Science.gov (United States)

Sun, Hong-Xiang; Chen, Jia-He; Ge, Yong; Yuan, Shou-Qi; Liu, Xiao-Jun

2018-06-01

We report a broadband and flexible acoustic focusing through metafiber bundles in air, in which each metafiber consists of eight circular and narrow rectangular cavities. The fractional bandwidth of the acoustic focusing could reach about 0.2, which arises from the eigenmodes of the metafiber structure. Besides, owing to the flexible characteristic of the metafibers, the focus position can be manipulated by bending the metafiber bundles, and the metafiber bundles could bypass rigid scatterers inside the lens structure. More interestingly, the acoustic propagation and focusing directions can be changed by using a designed right-angled direction converter fabricated by the metafibers, and a waveform converter and a focusing lens of the cylindrical acoustic source are realized based on the metafiber bundles. The proposed focusing lens has the advantages of broad bandwidth, flexible structure, and high focusing performance, showing great potentials in versatile applications.

Focus: Digital

DEFF Research Database (Denmark)

Technology has been an all-important and defining element within the arts throughout the 20th century, and it has fundamentally changed the ways in which we produce and consume music. With this Focus we investigate the latest developments in the digital domain – and their pervasiveness and rapid...... production and reception of contemporary music and sound art. With ‘Digital’ we present four composers' very different answers to how technology impact their work. To Juliana Hodkinson it has become an integral part of her sonic writing. Rudiger Meyer analyses the relationships between art and design and how...

Focus Group Guide

Science.gov (United States)

2017-07-01

home for the arrival of school- aged children. TIP: Do not conduct focus groups in a command conference room in the command group area. Doing so...organizational effectiveness and equal opportunity/equal employment opportunity/fair treatment and sexual assault and response factors (which are listed on the... Sexual Harassment (C) Sex Harassment Retaliation (D) Discrimination - Sex (E) Discrimination - Race (F) Discrimination - Disability (G

An elastic, low-background vertical focusing element for a doubly focusing neutron monochromator

International Nuclear Information System (INIS)

Smee, Stephen A.; Brand, Paul C.; Barry, Dwight D.; Broholm, Collin L.; Anand, Dave K.

2001-01-01

A novel, variable radius of curvature, device for the focusing of neutrons is presented. This elastic element consists of a thin variable thickness, constant width, aluminum blade to which diffracting crystals can be attached. When buckled, the blade assumes a circular focal shape, the radius of which is easily controlled by the relative displacement of supporting pivots. Precision electromechanical and optical measurements show that the slope of the buckled blade conforms to a circular arc to within 0.15 degree sign for radii in the range 900 mm< R<10 000 mm. This easily scalable, low mass mechanism is well suited for use in a focusing neutron monochromator, as the parasitic scattering typically associated with traditional lead screw and lever mechanisms is greatly reduced

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

Energy Technology Data Exchange (ETDEWEB)

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

2004-12-01

The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3{sup rd} version. (orig.) [German] Die Version 3 der Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen stellt im Wesentlichen eine redaktionelle Ueberarbeitung der Version 2 dar. Im Kapitel Indikation und Empfehlungen fuer eine Radioiodtherapie, eine Operation oder eine thyreostatische Therapie bei gutartigen Schilddruesenerkrankungen basiert die Leitlinie auf einem interdisziplinaer abgestimmten Konzept. Die Entscheidungskriterien sind multifaktoriell und beruecksichtigen die Art der Schilddruesenerkrankung (Autonomie, Morbus Basedow, Struma, Rezidivstruma

Focusing effects in laser-electron Thomson scattering

Directory of Open Access Journals (Sweden)

Chris Harvey

2016-09-01

Full Text Available We study the effects of laser pulse focusing on the spectral properties of Thomson scattered radiation. Modeling the laser as a paraxial beam we find that, in all but the most extreme cases of focusing, the temporal envelope has a much bigger effect on the spectrum than the focusing itself. For the case of ultrashort pulses, where the paraxial model is no longer valid, we adopt a subcycle vector beam description of the field. It is found that the emission harmonics are blue shifted and broaden out in frequency space as the pulse becomes shorter. Additionally the carrier envelope phase becomes important, resulting in an angular asymmetry in the spectrum. We then use the same model to study the effects of focusing beyond the limit where the paraxial expansion is valid. It is found that fields focussed to subwavelength spot sizes produce spectra that are qualitatively similar to those from subcycle pulses due to the shortening of the pulse with focusing. Finally, we study high-intensity fields and find that, in general, the focusing makes negligible difference to the spectra in the regime of radiation reaction.

Some optical diagnostics for the plasma focus

International Nuclear Information System (INIS)

Korzhavin, V.M.

1980-01-01

Some aspects of studying plasma focus dynamics are reported. Particular efforts were made to develop an infrared (IR) diagnostics. The plasma focus is formed in a discharge chamber, when shock waves and plasma sheath cumulate on the axis as a result of the break-down of filling gas by the application of high voltage. The current J was measured with a Rogovsky coil, and the voltage U was measured with a capacitor divider. The current derivative was measured with magnetic probes, and X-ray and neutron emission intensities were measured with a plastic scintillator. The total neutron yield were measured by the activation method. The time-integrated soft X-ray pictures of plasma focus were taken with a pin-hole camera. The formation and disruption of plasma focus were studied by multi-picture speed photography. Laser interferometry was used to study the time-space distribution of plasma density. For the study of turbulence phenomena in plasma focus, a new type IR detector was employed. The results of measurements suggest that there exists some superthermal radiation during the second compression of plasma focus, but it is not so strong. (Kato, T.)

Auto-focusing accelerating hyper-geometric laser beams

International Nuclear Information System (INIS)

Kovalev, A A; Kotlyar, V V; Porfirev, A P

2016-01-01

We derive a new solution to the paraxial wave equation that defines a two-parameter family of three-dimensional structurally stable vortex annular auto-focusing hyper-geometric (AH) beams, with their complex amplitude expressed via a degenerate hyper-geometric function. The AH beams are found to carry an orbital angular momentum and be auto-focusing, propagating on an accelerating path toward a focus, where the annular intensity pattern is ‘sharply’ reduced in diameter. An explicit expression for the complex amplitude of vortex annular auto-focusing hyper-geometric-Gaussian beams is derived. The experiment has been shown to be in good agreement with theory. (paper)

Focusing of electromagnetic waves

International Nuclear Information System (INIS)

Dhayalan, V.

1996-01-01

The focusing of electromagnetic waves inside a slab has been examined together with two special cases in which the slab is reduced to a single interface or a single medium. To that end the exact solutions for the fields inside a layered medium have been used, given in terms of the outside current source in order to obtain the solutions for the focused electric field inside a slab. Both exact and asymptotic solutions of the problem have been considered, and the validity of the latter has been discussed. The author has developed a numerical algorithm for evaluation of the diffraction integral with special emphasis on reducing the computing time. The numerical techniques in the paper can be readily applied to evaluate similar diffraction integrals occurring e.g. in microstrip antennas. 46 refs

Facility Focus: Food Service.

Science.gov (United States)

College Planning & Management, 2002

2002-01-01

Describes the Hawthorn Court Community Center at Iowa State University, Ames, and the HUB-Robeson Center at Pennsylvania State University. Focuses on the food service offered in these new student-life buildings. Includes photographs. (EV)

Focus group report, Part I

International Nuclear Information System (INIS)

1997-07-01

The Waste Policy Institute, through a cooperative agreement with the U.S. Department of Energy's (DOE) Office of Science and Technology (OST), conducted two focus groups with people who live or work near DOE sites. The purpose of the focus groups was to gain a better understanding of the general community's information needs about the development of innovative technologies that are used in the cleanup of the sites. The authors wanted to better understand of what role these people want to play in the development of new technologies, how OST communication products can help facilitate that role, and the usefulness of current OST communication products. WPI held the focus groups in communities near the Idaho National Engineering and Environmental Laboratory (INEEL) and the Savannah River Site (SRS) because they are among the DOE sites that cannot be cleaned up before 2006. To include many facets of the communities, WPI randomly selected participants from membership lists of organized groups in each community including: elected officials, school boards, unions, chambers of commerce, economic development organizations, environmental organizations, health and human service organizations, and area clergy. While in the communities, WPI also interviewed stakeholders such as tribal representatives and a Citizens Advisory Board (CAB) member. Qualitative data gathered during the focus group sessions give some indication of general stakeholder opinions. However, the authors caution readers not to make broad assumptions about the general stakeholder audience based on the opinions of a limited number of general community stakeholders

The perchlorate discharge test with {sup 123}I for the diagnosis of the Pendred syndrome in children; Der Depletionstest mit {sup 123}Iod zur Diagnose des Pendred-Syndroms bei Kindern

Energy Technology Data Exchange (ETDEWEB)

Hahn, K.; Fischer, S. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

2009-03-15

The method for the diagnosis of the Pendred Syndrome in children by the Perchlorate discharge test using {sup 123}I is described. The older child, who has the Pendred Syndrome and the obligatory hearing deficit, frequently has neither a goitre nor hypothyroidism, but other investigations (bone growth, scars and function tests) can also show changes. However a more certain diagnosis of this disorder in children is possible by the perchlorate discharge test using {sup 123}I. (orig.)

Phase analysis and focusing of synchrotron radiation

CERN Document Server

Chubar, O; Snigirev, A

1999-01-01

High accuracy calculations of synchrotron radiation (SR) emitted by a relativistic electron show that the phase of the frequency domain electric field of SR differs from the phase of radiation of a virtual point source. These differences may result in the reduction of focusing efficiency of diffraction-limited SR, if the focusing is performed by conventional optical components optimised for point sources. We show that by applying a phase correction locally, one may transform the phase of SR electric field at a desired polarisation to that of a point source. Such corrections are computed for undulator radiation (planar and helical) and bending magnet radiation (central part and edges). The focusing of the corrected SR wavefront can result in the increase of peak intensity in the focused spot up to several times compared to the focusing without correction. For non-diffraction-limited radiation, the effect of the phase corrections is reduced. Due to this reason, the use of the proposed phase corrections in exist...

Axial sheath dynamics in a plasma focus

International Nuclear Information System (INIS)

Soliman, H.M.; El-Khalafawy, T.A.; Masoud, M.M.

1990-01-01

This paper presents the result of investigation with a 10 kJ Mather type plasma focus. It is operated in hydrogen gas at ambient pressure of 0.15--1 torr and charging voltage of 8--11 kV. Radial distribution of the current sheath density with axial distance has been estimated. Plasma rotation in the expansion chamber in the absence of external magnetic field has been detected. A plasma flare from the plasma focus region propagating in the radial direction has been observed. Streak photography shows two plasma streams flowing simultaneously out of the muzzle. The mean energy of the electron beam ejected from the pinch region of the focused plasma, was measured by retarding field analyzer to be 0.32 keV. The electron temperature of the plasma focus at peak compression was determined by measuring the X-ray intensity as a function of absorber thickness at a distance of 62 cm from the focus. The electron temperature has been found to 3 keV

Target focusing configuration for X-ray laser experiments

International Nuclear Information System (INIS)

Seppala, L.G.

1985-01-01

X-ray laser experiments imposed a new demand on the Novette focusing optics. These optics had to provide highly uniform, double-sided illumination on a target region 1.0 cm long by 100 to 200 μm wide. This line focus requirement had to be achieved without degrading the diagnostic reflection from the last surface of the focus lens and without potential ghost focus problems. The only optical configuration that preserves the diagnostic reflection is shown. A negative focal length cylinder lens is placed between the focus lens and the debris shield, with the concave surface facing toward the focus lens. Any ghost reflections from the cylinder lens or debris shield are degraded by astigmatism, making them less hazardous. In practice, the uniformity of illumination is probably about the same for a positive or a negative cylinder lens. The minimum Novette focused spot was approximately 50 to 75 μm in diameter, and the fabrication errors in the 80-cm-diam precision cylinder lens produced a line focus 25 μm wide. a negative cylinder lens design was chosen, however, to optimize the illumination uniformity in the case of line widths of several hundred microns

The use of focused ethnography in nursing research.

Science.gov (United States)

Cruz, Edward Venzon; Higginbottom, Gina

2013-03-01

To provide an overview of the relevance and strengths of focused ethnography in nursing research. The paper provides descriptions of focused ethnography and discusses using exemplars to show how focused ethnographies can enhance and understand nursing practice. Orthodox ethnographic approaches may not always be suitable or desirable for research in diverse nursing contexts. Focused ethnography has emerged as a promising method for applying ethnography to a distinct issue or shared experience in cultures or sub-cultures and in specific settings, rather than throughout entire communities. Unfortunately, there is limited guidance on using focused ethnography, particularly as applied to nursing research. Research studies performed by nurses using focused ethnography are summarised to show how they fulfilled three main purposes of the genre in nursing research. Additional citations are provided to help demonstrate the versatility of focused ethnography in exploring distinct problems in a specific context in different populations and groups of people. The unique role that nurses play in health care, coupled with their skills in enquiry, can contribute to the further development of the discipline. Focused ethnography offers an opportunity to gain a better understanding and appreciation of nursing as a profession, and the role it plays in society. Focused ethnography has emerged as a relevant research methodology that can be used by nurse researchers to understand specific societal issues that affect different facets of nursing practice. As nurse researchers endeavour to understand experiences in light of their health and life situations, focused ethnography enables them to understand the interrelationship between people and their environments in the society in which they live.

Radioiodine 131 therapy in hyperthyroidism evaluation of French nuclear medicine practices

International Nuclear Information System (INIS)

Bernard, D.; Boin, C.; Desruet, M.; Roux, J.; Wolf, M.; Fagret, D.; Allenet, B.; Foroni, L.

2015-01-01

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

[The role of the autonomic nervous system on malfunction of gastric motor and myoelectric activity in patients with hyperthyroidism].

Science.gov (United States)

Barczyński, M; Thor, P J; Słowiaczek, M; Pitala, A

2000-01-01

The aim of this study was to determine both the type of gastric mioelectric and emptying disorders in correlation to degree of severity of hyperthyroidism (clinical and thyroid hormones' blood levels) and ANS function estimated in HRV analysis. The study was performed on a group of 50 patients (35 with multinodular toxic goitre and 15 with Graves' disease, 45 females and 5 males, mean age 39.6 years, mean BMI 23.72) with newly diagnosed and so far untreated hyperthyroidism. The control group were 50 healthy volunteers age-, sex-, and BMI-matched to the studied group. Patients were studied twice, within newly diagnosed thyreotoxicosis and after treatment (Metizol) and reaching stable euthyroid state. The study consisted of: a) percutaneous EGG analysis (Synectics): 30 minutes before and after a test meal (ENRICH Liquid 250 ml), b) HRV analysis (ECG POSTER 2002): 10 minutes at rest and during deep breathing test, c) ultrasound measurement of gastric emptying by Bolondi method. Statistical analysis of collected data was performed. In hyperthyroid patients significant both preprandial and postprandial dysrhythmia (33.01% of bradygastria and 16.49% of tachygastria) was found. In some patients decrease of amplitude of EGG signal was marked as a result of antral hypomotility with coexisting significantly prolonged gastric emptying (110 min). Among severe hyperthyroid patients both the antral food distribution (antrum 35% bigger than in a control group) and impaired proximal stomach relaxation were evident. The degree of gastric mioelectric activity and emptying disorders was proportional to the degree of both severity of clinical manifestation of hyperthyroidism in Zgliczynski scale (from I degree to III degrees) and free thyroid hormones' blood levels (positive correlation). In HRV analysis at rest in hyperthyroid patients comparing to a control group the decrease of both the heart rate variability and a total power was found particularly in HF component resulting in

Competitive mindsets, creativity, and the role of regulatory focus

NARCIS (Netherlands)

Bittner, Jenny; Heidemeier, Heike

2013-01-01

We examined how regulatory focus and intentions to compete rather than cooperate with group members relate to creativity. Study 1 showed that a promotion focus (i.e., a focus on ideals) activated a cooperative mindset, whereas a prevention focus (i.e., a focus on responsibilities) activated a

Different Approaches to Cross-Lingual Focus Groups

Directory of Open Access Journals (Sweden)

Maira Quintanilha

2015-12-01

Full Text Available Focus groups are a useful data-generation strategy in qualitative health research when it is important to understand how social contexts shape participants’ health. However, when cross-lingual focus groups are conducted across cultural groups, and in languages in which the researcher is not fluent, questions regarding the usefulness and rigor of the findings can be raised. In this article, we will discuss three different approaches to cross-lingual focus groups used in a community-based participatory research project with pregnant and postpartum, African immigrant women in Alberta, Canada. In two approaches, we moderated focus groups in women’s mother tongue with the support of real-time interpreters, but in the first approach, audio recording was used and in the second approach, audio recording was not used. In the third approach, a bilingual moderator facilitated focus groups in women’s mother tongue, with transcription and translation of audio-recorded data upon completion of data generation. We will describe each approach in detail, including their advantages and challenges, and recontextualize what we have learned within the known literature. We expect the lessons learned in this project may assist others in planning and implementing cross-lingual focus groups, especially in the context of community-based participatory research.

Final focus test beam

International Nuclear Information System (INIS)

1991-03-01

This report discusses the following: the Final Focus Test Beam Project; optical design; magnets; instrumentation; magnetic measurement and BPM calibration; mechanical alignment and stabilization; vacuum system; power supplies; control system; radiation shielding and personnel protection; infrastructure; and administration

Cryotherapy for conjunctival primary acquired melanosis and malignant melanoma. Experience with 62 cases.

Science.gov (United States)

Jakobiec, F A; Rini, F J; Fraunfelder, F T; Brownstein, S

1988-08-01

Sixty-two patients were treated by some combination of cryotherapy and surgery with an average follow-up of 3.3 years for one of the following diseases: focal or diffuse flat conjunctival primary acquired melanosis (PAM) with atypia but without a nodule of melanoma (10 cases); unifocal malignant melanoma with or without focal or diffuse PAM (30 cases); and multinodular/multicentric melanoma with and without PAM (22 cases). Of the ten patients who had PAM with atypia, invasive nodules of malignant melanoma did not develop. A second treatment was required to control the disease in four of the ten patients with extensive or diffuse lesions, and one has mild persistent disease. Of the 30 patients with unifocal nodules of malignant melanoma, 27 remained free of recurrence after one treatment, and 2 are asymptomatic after two treatments. One patient with a thick nodule at presentation required a parotidectomy and radical neck dissection for cervical metastases after recurrence in the conjunctival sac. In the group of 22 patients with multinodular malignant melanoma, only two did not have recurrent disease after one treatment. Of those who received multiple therapies, seven remained free of recurrence for at least 2 years after the last treatment; regional or distant metastases developed in nine; four required exenteration; and eight died. Conjunctival adjunctive cryotherapy avoids exenteration in extensive lesions of pure PAM and in unifocal melanoma, but even after multiple therapies, multinodular malignant melanoma had a 45% rate of metastasis. Metastasis was related to the presence of PAM sine pigmento in four patients (microscopically but not clinically detectable PAM); to the location of the nodules (9 of 10 patients who experienced metastases had forniceal, palpebral, and/or caruncular nodules); to the thickness or depth of invasion of the nodules (greater than 2 mm); and to the development of intralymphatic spread ("in-transit" local metastasis) within the

Structural Analysis of Extended Plasma Focus Chamber

International Nuclear Information System (INIS)

Mohd Azhar Ahmad; Abdul Halim Baijan; Siti Aiasah Hashim

2016-01-01

Accelerator Development Centre (ADC) of Nuclear Malaysia intends to upgrade the plasma focus device. It involves the extension part placed on top of the existing plasma focus vacuum chamber. This extended vacuum chamber purposely to give an extra space in conducting experiments on the existing plasma focus chamber. The aim of upgrading the plasma focus device is to solve the limitation in research and analysis of sample due to its done in an open system that cause analysis of samples is limited and less optimal. This extended chamber was design in considering the ease of fabrication as well as durability of its structural. Thus, this paper discusses the structural analysis in term of pressure loading effect in extended chamber. (author)

Plasma focus as a pulsed power source

International Nuclear Information System (INIS)

Sahlin, H.; McFarland, G.; Barlett, R.; Gullickson, R.

1975-01-01

The plasma focus is a remarkable natural phenomena that achieves significant space-time compression of both particle and field energy. Depending on the mode of operation, about 20 percent of the bank energy can be concentrated into the kinetic energy of a thin, dense, cylindrically convergent gas shell, or into a small-diameter, high-ν/γ relativistic electron burst and oppositely directed ion burst. The kinetic energy of the fast ions and electrons can exceed the applied voltage by a factor of greater than 100. The different modes of energy concentration by the plasma focus are presented and discussed both in terms of their role in the direct yield of the focus and for the case of a plasma focus supplemented by various fusionable targets

Suppression of radiation excitation in focusing environment

International Nuclear Information System (INIS)

Huang, Z.; Ruth, R.D.

1996-12-01

Radiation damping and quantum excitation in an electron damping ring and a straight focusing channel are reviewed. They are found to be the two limiting cases in the study of a general bending and focusing combined system. In the intermediate regime where the radiation formation length is comparable to the betatron wavelength, quantum excitation can be exponentially suppressed by focusing field. This new regime may have interesting applications in the generation of ultra-low emittance beams

Nova frequency conversion and focusing system

International Nuclear Information System (INIS)

Summers, M.A.; Seppala, L.G.; Williams, J.D.

1985-01-01

New developments in crystal array technology provided significant improvements in the mechanical design and optical performance of the Nova 2 omega/3 omega array hardware. The final Nova array configuration was tested on the Novette laser and on the first arm of Nova. Ten Nova 2 omega/3 omega crystal arrays were assembled and tested for crystal alignment and wave front distortion before installation on the Nova target chamber. Ten Nova focus lens positioners were assembled and tested last year. The positioning accuracy and repeatability of each assembly were evaluated before installation on the target chamber. A cylindrical focusing system was also developed for installation in the Nova lens positioner assembly. Finally, 10 completed frequency conversion and focusing systems were activated

Final Focus Systems in Linear Colliders

International Nuclear Information System (INIS)

Raubenheimer, Tor

1998-01-01

In colliding beam facilities, the ''final focus system'' must demagnify the beams to attain the very small spot sizes required at the interaction points. The first final focus system with local chromatic correction was developed for the Stanford Linear Collider where very large demagnifications were desired. This same conceptual design has been adopted by all the future linear collider designs as well as the SuperConducting Supercollider, the Stanford and KEK B-Factories, and the proposed Muon Collider. In this paper, the over-all layout, physics constraints, and optimization techniques relevant to the design of final focus systems for high-energy electron-positron linear colliders are reviewed. Finally, advanced concepts to avoid some of the limitations of these systems are discussed

Focus on Organic Conductors

Directory of Open Access Journals (Sweden)

Shinya Uji, Takehiko Mori and Toshihiro Takahashi

2009-01-01

Full Text Available Organic materials are usually thought of as electrical insulators. Progress in chemical synthesis, however, has brought us a rich variety of conducting organic materials, which can be classified into conducting polymers and molecular crystals. Researchers can realize highly conducting molecular crystals in charge-transfer complexes, where suitable combinations of organic electron donor or acceptor molecules with counter ions or other organic molecules provide charge carriers. By means of a kind of chemical doping, the charge-transfer complexes exhibit high electrical conductivity and, thanks to their highly crystalline nature, even superconductivity has been observed. This focus issue of Science and Technology of Advanced Materials is devoted to the research into such 'organic conductors'The first organic metal was (TTF(TCNQ, which was found in 1973 to have high conductivity at room temperature and a metal–insulator transition at low temperatures. The first organic superconductor was (TMTSF2PF6, whose superconductivity under high pressures was reported by J´erome in 1980. After these findings, the research on organic conductors exploded. Hundreds of organic conductors have been reported, among which more than one hundred exhibit superconductivity. Recently, a single-component organic conductor has been found with metallic conductivity down to low temperatures.In these organic conductors, in spite of their simple electronic structures, much new physics has arisen from the low dimensionality. Examples are charge and spin density waves, characteristic metal–insulator transitions, charge order, unconventional superconductivity, superconductor–insulator transitions, and zero-gap conductors with Dirac cones. The discovery of this new physics is undoubtedly derived from the development of many intriguing novel organic conductors. High quality single crystals are indispensable to the precise measurement of electronic states.This focus issue

Expanded studies of linear collider final focus systems at the Final Focus Test Beam

International Nuclear Information System (INIS)

Tenenbaum, P.G.

1995-12-01

In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research

Expanded studies of linear collider final focus systems at the Final Focus Test Beam

Energy Technology Data Exchange (ETDEWEB)

Tenenbaum, Peter Gregory [Stanford Univ., CA (United States)

1995-12-01

In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research.

Thyroid disorders in Multan, Pakistan, and hormone levels during Ramadan

International Nuclear Information System (INIS)

Khan, S.M.; Abbas, H.G.; Sabih, D.E.

1986-01-01

Patients with thyroid disorders were analyzed in 1984 with respect to their clinical state, thyroid hormone levels in the blood and the speciality of the referring clinician. There were 815 patients (304 men, 511 women) with ages from 3 months to 80 years. Analysis showed that 310 (38%) of the patients were euthyroid without goitre, the male:female ratio being 3:2; 260 (31.9%) of the patients were euthyroid with goitre, the male:female ratio being 1:5; 61 (7.5%) patients were hypothyroid, with a male:female ratio of 3:4; 175 (21.5%) were thyrotoxic, the ratio being 1:3; and 9 (1.1%) had thyroid carcinoma, the ratio being 1:2. Sources of referral were also taken into account. In June of the same year, another study was conducted to find the effect of fasting on various hormones during Ramadan. One female and 32 male volunteers without thyroid disorders, between 12 and 65 years of age, gave blood samples. Each volunteer gave two blood samples: the first was collected during fasting and the second after fasting. Serum T 3 , T 4 and prolactin (PRL) were measured using radioimmunoassay. Statistical analysis showed that variations in T 3 and T 4 were not significant but that there was a significant increase in PRL during fasting (p<0.05). (author)

Plasma-focused cyclic accelerators

International Nuclear Information System (INIS)

Mondelli, A.A.; Chernin, D.P.

1985-01-01

The use of ambient plasma to neutralize the transverse forces of an intense particle beam has been known for many years. Most recently, the so-called ion-focused regime (IFR) for beam propagation has been used as a means of focusing intense electron beams in linear accelerators and suggested for injecting an electron beam across magnetic field lines into a high-current cyclic accelerator. One technique for generating the required background plasma for IFR propagation is to use a laser to ionize ambient gas in the accelerator chamber. This paper discusses an alternative means of plasma production for IFR, viz. by using RF breakdown. For this approach the accelerator chamber acts as a waveguide. This technique is not limited to toroidal accelerators. It may be applied to any accelerator or recirculator geometry as well as for beam steering and for injection or extraction of beams in closed accelerator configurations

Night Vision Goggles Objectives Lens Focusing Methodology

National Research Council Canada - National Science Library

Pinkus, Alan; Task, H. L

2000-01-01

...: interpupillary distance, tilt, eye relief, height, eyepiece and objective lens focus. Currently, aircrew use a Hoffman 20/20 test unit to pre-focus their NVG objective lenses at optical infinity before boarding their aircraft...

Computational numerical modelling of plasma focus

International Nuclear Information System (INIS)

Brollo, Fabricio

2005-01-01

Several models for calculation of the dynamics of Plasma Focus have been developed. All of them begin from the same physic principle: the current sheet run down the anode length, ionizing and collecting the gas that finds in its way.This is known as snow-plow model.Concerning pinch's compression, a MHD model is proposed.The plasma is treated as a fluid , particularly as a high ionized gas.However, there are not many models that, taking into account thermal equilibrium inside the plasma, make approximated calculations of the maximum temperatures reached in the pinch.Besides, there are no models which use those temperatures to estimate the termofusion neutron yield for the Deuterium or Deuterium-Tritium gas filled cases.In the PLADEMA network (Dense Magnetized Plasmas) a code was developed with the objective of describe the plasma focus dynamics, in a conceptual engineering stage.The codes calculates the principal variables (currents, time to focus, etc) and estimates the neutron yield in Deuterium-filled plasma focus devices.It can be affirmed that the code's experimental validation, in its axial and radial stages, was very successfully. However, it was accepted that the compression stage should be formulated again, to find a solution for a large variation of a parameter related with velocity profiles for the particles trapped inside the pinch.The objectives of this work can be stated in the next way : - Check the compression's model hypothesis. Develop a new model .- Implement the new model in the code. Compare results against experimental data of Plasma Focus devices from all around the world [es

Synchrotron radiation focusing by a Bragg--Fresnel lens

International Nuclear Information System (INIS)

Aristov, V.V.; Basov, Y.A.; Snigirev, A.A.

1989-01-01

Since the discovery of x rays and until the present time the possibilities of their controlling and focusing have been widely discussed. In the hard spectrum region (λ∼1 A) the main focusing schemes are the following: geometrical focusing based on incoherent interaction of wave packets reflected by different regions of bending crystals and coherent (dynamic) focusing performed at the cost of the effect of refraction index angular dispersion near the exact Bragg angle value -θ B . A main disadvantage of geometrical focusing is low spatial resolution (∼0.1 mm) and temperature stability. In the case of coherent focusing a main disadvantage is a narrow angular aperture (∼10 sec. of arc) at spatial resolution (∼1--10 μm). Recently, advances in the development of diffraction physics and microstructuring technology open up possibilities for fabricating effective focusing x-ray optical elements---Bragg--Fresnel lenses (BFL)---with high spatial resolution (∼0.1 μm) at a wide angular aperture and high temperature stability. The present paper describes the main principles of Bragg--Fresnel optics (BFO). It presents the results on the synchrotron experiment and on observation of focusing. In this work the peculiarities of BFL diffraction contrast formation are investigated and image transmission using a BFL is performed. Possibilities of developing x-ray optical schemes of ultrahigh resolution on the basis of BFL elements are also discussed

Focusing of Shear Shock Waves

Science.gov (United States)

Giammarinaro, Bruno; Espíndola, David; Coulouvrat, François; Pinton, Gianmarco

2018-01-01

Focusing is a ubiquitous way to transform waves. Recently, a new type of shock wave has been observed experimentally with high-frame-rate ultrasound: shear shock waves in soft solids. These strongly nonlinear waves are characterized by a high Mach number, because the shear wave velocity is much slower, by 3 orders of magnitude, than the longitudinal wave velocity. Furthermore, these waves have a unique cubic nonlinearity which generates only odd harmonics. Unlike longitudinal waves for which only compressional shocks are possible, shear waves exhibit cubic nonlinearities which can generate positive and negative shocks. Here we present the experimental observation of shear shock wave focusing, generated by the vertical motion of a solid cylinder section embedded in a soft gelatin-graphite phantom to induce linearly vertically polarized motion. Raw ultrasound data from high-frame-rate (7692 images per second) acquisitions in combination with algorithms that are tuned to detect small displacements (approximately 1 μ m ) are used to generate quantitative movies of gel motion. The features of shear shock wave focusing are analyzed by comparing experimental observations with numerical simulations of a retarded-time elastodynamic equation with cubic nonlinearities and empirical attenuation laws for soft solids.

High efficiency focus neutron generator

Science.gov (United States)

Sadeghi, H.; Amrollahi, R.; Zare, M.; Fazelpour, S.

2017-12-01

In the present paper, the new idea to increase the neutron yield of plasma focus devices is investigated and the results are presented. Based on many studies, more than 90% of neutrons in plasma focus devices were produced by beam target interactions and only 10% of them were due to thermonuclear reactions. While propounding the new idea, the number of collisions between deuteron ions and deuterium gas atoms were increased remarkably well. The COMSOL Multiphysics 5.2 was used to study the given idea in the known 28 plasma focus devices. In this circumstance, the neutron yield of this system was also obtained and reported. Finally, it was found that in the ENEA device with 1 Hz working frequency, 1.1 × 109 and 1.1 × 1011 neutrons per second were produced by D-D and D-T reactions, respectively. In addition, in the NX2 device with 16 Hz working frequency, 1.34 × 1010 and 1.34 × 1012 neutrons per second were produced by D-D and D-T reactions, respectively. The results show that with regards to the sizes and energy of these devices, they can be used as the efficient neutron generators.

Finding beam focus errors automatically

International Nuclear Information System (INIS)

Lee, M.J.; Clearwater, S.H.; Kleban, S.D.

1987-01-01

An automated method for finding beam focus errors using an optimization program called COMFORT-PLUS. The steps involved in finding the correction factors using COMFORT-PLUS has been used to find the beam focus errors for two damping rings at the SLAC Linear Collider. The program is to be used as an off-line program to analyze actual measured data for any SLC system. A limitation on the application of this procedure is found to be that it depends on the magnitude of the machine errors. Another is that the program is not totally automated since the user must decide a priori where to look for errors

Focus on Form in task-based language teaching

NARCIS (Netherlands)

van de Guchte, M.

2015-01-01

This dissertation presents research on the way in which learners focus on grammar in task-based language teaching (TBLT). Such a focus on grammar during meaningful task performance is called a Focus on Form (FonF). For this PhD research project we conducted three experimental studies which

Autofocus system and autofocus method for focusing on a surface

Science.gov (United States)

O'Neill, Mary Morabito

2017-05-23

An autofocus system includes an imaging device, a lens system and a focus control actuator that is configured to change a focus position of the imaging device in relation to a stage. The electronic control unit is configured to control the focus control actuator to a plurality of predetermined focus positions, and activate the imaging device to obtain an image at predetermined positions and then apply a spatial filter to the obtained images. This generates a filtered image for the obtained images. The control unit determines a focus score for the filtered images such that the focus score corresponds to a degree of focus in the obtained images. The control unit identifies a best focus position by comparing the focus score of the filtered images, and controls the focus control actuator to the best focus position corresponding to the highest focus score.

Focusing procedures in time-of-flight mass spectrometry

International Nuclear Information System (INIS)

Ioanoviciu, D.

2002-01-01

Time-of-flight mass spectrometry is a fast growing field due to its ability to handle very fast processes and due to its theoretically unlimited mass range. The performances of the time-of-flight mass analysers are heavily dependent on the progress in ion optics, a periodically reviewed field. In this presentation the various focusing procedures in time-of-flight mass spectrometry are reviewed. For ions of the same charge and mass flight time differences result from different potentials at the location of formation and from the initial velocity spread. There is no simultaneous space and velocity focusing in time-of-flight mass spectrometry. Space focusing of first and second order can be reached in time-of-flight mass analysers having two homogeneous electric field ion sources followed by a field free space in front of the detector. Single and double stage homogeneous electric field mirrors can focus in time ions of different energies. These different energies result when ions leaving different initial sites and arriving simultaneously to an intermediate space focus. Convenient mass dispersion can be obtained by including a mirror. Initial velocity focusing is obtained by the delayed extraction procedure in drift space and mirror time-of-flight mass analysers. Post source pulse focusing aims at the same purpose. Ion source electrodes of hyperbolic shape, operated by high voltage pulses can bring major improvements of the resolution, especially at high masses. For each focusing procedure the geometric and/or electric conditions are given as well as the aberrations allowing the mass resolution determination. The various focusing procedures are compared and a prediction of their future performances was tempted. (author)

The final focus test beam project

International Nuclear Information System (INIS)

Burke, D.

1991-05-01

An overview is given of the Final Focus Test Beam (FFTB) that is being constructed as a prototype final focus system for a future electron-positron linear collider. This beam line will use as input the 50 GeV electron beam from the SLC linac, and is designed to reduce the transverse dimensions of the beam spot at the focal point to 1 μm. 5 refs., 2 figs., 1 tab

The Realization of Focus in Asturian Spanish

Directory of Open Access Journals (Sweden)

Covadonga Sánchez-Alvarado

2018-01-01

Full Text Available Spanish was classified as a language that only exploits syntactic mechanisms to mark focus. Recent experimental studies, nonetheless, have shown that speakers of different dialects are also able to use prosody to different degrees. This study aims to provide further understanding on the role played by prosody in the realization of focus in Spanish by looking at Asturian Spanish, a dialect in contact with another Romance language, Asturian. The data from a contextualized sentence completion task revealed that a phonological distinction between specific pitch categories (L+focus being elicited (i.e., informational/non-corrective vs. contrastive/corrective. Nonetheless, it also showed that speakers exploit different prosodic features (i.e., pitch range, alignment, and duration to mark focus constituents, although their use differs as a result of that constituents’ function. These findings provide further support for the consideration of languages and specific dialects in a continuum based on the degree to which they use prosody to mark focus and to explore more in detail the phonetic implementation of focal accents.

Dialogicality in Focus

DEFF Research Database (Denmark)

The phenomenon which dialogism addresses is human interaction. It enables us to conceptualise human interaction as intersubjective, symbolic, cultural, transformative and conflictual, in short, as complex. The complexity of human interaction is evident in all domains of human life, for example, i......, because rather than applying dialogism to this or that domain, the present volume focuses on dialogicality itself to interrogate the concepts and methods which are taken for granted in the burgeoning literature. (Imprint: Nova Press)...

CRISPR-FOCUS: A web server for designing focused CRISPR screening experiments

OpenAIRE

Cao, Qingyi; Ma, Jian; Chen, Chen-Hao; Xu, Han; Chen, Zhi; Li, Wei; Liu, X. Shirley

2017-01-01

The recently developed CRISPR screen technology, based on the CRISPR/Cas9 genome editing system, enables genome-wide interrogation of gene functions in an efficient and cost-effective manner. Although many computational algorithms and web servers have been developed to design single-guide RNAs (sgRNAs) with high specificity and efficiency, algorithms specifically designed for conducting CRISPR screens are still lacking. Here we present CRISPR-FOCUS, a web-based platform to search and prioriti...

Instructions to Adopt an External Focus Enhance Muscular Endurance

Science.gov (United States)

Marchant, David C.; Greig, Matt; Bullough, Jonathan; Hitchen, Daniel

2011-01-01

The influence of internal (movement focus) and external (outcome focus) attentional-focusing instructions on muscular endurance were investigated using three exercise protocols with experienced exercisers. Twenty-three participants completed a maximal repetition, assisted bench-press test on a Smith's machine. An external focus of attention…

Case report: An interesting case of large colloid goiter with dyspnea

Directory of Open Access Journals (Sweden)

Jaya Prakasha Mayya

2017-12-01

Full Text Available Benign nodular goitre is one of the most common endocrine disorder, especially in countries like Nepal where iodine deficiency is endemic. Case History: A 59 years old female presented with large thyroid swelling. Investigations showed it to be colloid goiter compressing the airway. Left hemithyroidectomy was done. Post operative period was uneventful.Discussion: Management of thyroid nodules depends upon assessment of thyroid function, fine needle aspiration cytology and imaging. Surgery is the common method of treatment.   

Technology of focus detection for 193nm projection lithographic tool

Science.gov (United States)

Di, Chengliang; Yan, Wei; Hu, Song; Xu, Feng; Li, Jinglong

2012-10-01

With the shortening printing wavelength and increasing numerical aperture of lithographic tool, the depth of focus(DOF) sees a rapidly drop down trend, reach a scale of several hundred nanometers while the repeatable accuracy of focusing and leveling must be one-tenth of DOF, approximately several dozen nanometers. For this feature, this article first introduces several focusing technology, Obtained the advantages and disadvantages of various methods by comparing. Then get the accuracy of dual-grating focusing method through theoretical calculation. And the dual-grating focusing method based on photoelastic modulation is divided into coarse focusing and precise focusing method to analyze, establishing image processing model of coarse focusing and photoelastic modulation model of accurate focusing. Finally, focusing algorithm is simulated with MATLAB. In conclusion dual-grating focusing method shows high precision, high efficiency and non-contact measurement of the focal plane, meeting the demands of focusing in 193nm projection lithography.

Prosodic Marking of Narrow Focus in Seoul Korean

Directory of Open Access Journals (Sweden)

Hae-Sung Jeon

2017-01-01

Full Text Available This paper explores prosodic marking of narrow (corrective focus in Seoul Korean. Korean lacks lexical stress and it has a phonologized association between the Accentual Phrase (AP initial segment and intonation. In the experiment, 4 speakers read sentences including a two-item list which were designed to elicit either an L or H AP-initial tone. The durational variations, the pitch events at prosodic boundaries, and 'F''0 'span in 32 sentences read neutrally and 64 sentences read with one of the items under focus were analyzed. The results show that the focused constituent consistently initiates a new prosodic phrase. In comparison to the neutrally spoken or defocused counterpart, the focused constituent was more likely to be realized as an Intonational Phrase (IP in some contexts. Bitonal IP boundary tones were more likely to occur under focus than monotonal tones. In addition, in focused constituents, durational expansion particularly at the phrase-edges, expansion in 'F''0 'span, and raising of the phrase-initial pitch were observed. On the other hand, defocused constituents were not phonetically reduced compared to the neutral counterparts. The results imply that the phonetic cues spreading over the focused constituent complement the exaggerated prosodic boundaries.

PREFACE: Focus section on Hadronic Physics Focus section on Hadronic Physics

Science.gov (United States)

Roberts, Craig; Swanson, Eric

2007-07-01

Hadronic physics is the study of strongly interacting matter and its underlying theory, Quantum Chromodynamics (QCD). The field had its beginnings after World War Two, when hadrons were discovered in ever increasing numbers. Today, it encompasses topics like the quark-gluon structure of hadrons at varying scales, the quark-gluon plasma and hadronic matter at extreme temperature and density; it also underpins nuclear physics and has significant impact on particle physics, astrophysics, and cosmology. Among the goals of hadronic physics are to determine the parameters of QCD, understand the origin and characteristics of confinement, understand the dynamics and consequences of dynamical chiral symmetry breaking, explore the role of quarks and gluons in nuclei and in matter under extreme conditions and understand the quark and gluon structure of hadrons. In general, the process is one of discerning the relevant degrees of freedom and relating these to the fundamental fields of QCD. The emphasis is on understanding QCD, rather than testing it. The papers gathered in this special focus section of Journal of Physics G: Nuclear and Particle Physics attempt to cover this broad range of subjects. Alkofer and Greensite examine the issue of quark and gluon confinement with the focus on models of the QCD vacuum, lattice gauge theory investigations, and the relationship to the AdS/CFT correspondence postulate. Arrington et al. review nucleon form factors and their role in determining quark orbital momentum, the strangeness content of the nucleon, meson cloud effects, and the transition from nonperturbative to perturbative QCD dynamics. The physics associated with hadronic matter at high temperature and density and at low Bjorken-x at the Relativistic Heavy Ion Collider (RHIC), the SPS at CERN, and at the future LHC is summarized by d'Enterria. The article of Lee and Smith examines experiment and theory associated with electromagnetic meson production from nucleons and

Two novel mutations in the sixth transmembrane segment of the thyrotropin receptor gene causing hyperfunctioning thyroid nodules.

Science.gov (United States)

Gozu, Hulya; Avsar, Melike; Bircan, Rifat; Claus, Maren; Sahin, Serap; Sezgin, Ozlem; Deyneli, Oguzhan; Paschke, Ralf; Cirakoglu, Beyazit; Akalin, Sema

2005-04-01

Autonomously functioning thyroid nodules (AFTNs) can present as hyperfunctioning adenomas or toxic multinodular goiters. In the last decade, a large number of activating mutations have been identified in the thyrotropin receptor (TSHR) gene in autonomously functioning thyroid nodules. Most have been situated close to, or within the sixth transmembrane segment and third intracellular loop of the TSHR where the receptor interacts with the Gs protein. In this study we describe two novel mutations in the sixth transmembrane segment of the TSHR causing hyperfunctioning thyroid nodules. Genomic DNAs were isolated from four hyperfunctioning thyroid nodules, normal tissues and peripheral leukocytes of two patients with toxic multinodular goiter. After amplifying the related regions, TSHR and G(s)alpha genes were analyzed by single-strand conformation polymorphism (SSCP) analysis. The precise localization of the mutations was identified by automatic DNA sequence analysis. Functional studies were done by site-directed mutagenesis and transfection of a mutant construct into COS-7 cells. We identified two novel TSHR mutations in two hyperfunctioning thyroid nodules: Phe631Val in the first patient and Iso630Met in the second patient. Both mutant receptors display an increase in constitutive stimulation of basal cyclic adenosine monophosphate (cAMP) levels compared to the wild-type receptor. This confirms that these mutant receptors cause hyperfunctioning thyroid nodules.

Final focus systems for linear colliders

International Nuclear Information System (INIS)

Helm, R.; Irwin, J.

1992-08-01

Final focus systems for linear colliders present many exacting challenges in beam optics, component design, and beam quality. Efforts to resolve these problems as they relate to a new generation of linear colliders are under way at several laboratories around the world. We will outline criteria for final focus systems and discuss the current state of understanding and resolution of the outstanding problems. We will discuss tolerances on alignment, field quality and stability for optical elements, and the implications for beam parameters such as emittance, energy spread, bunch length, and stability in position and energy. Beam-based correction procedures, which in principle can alleviate many of the tolerances, will be described. Preliminary results from the Final Focus Test Beam (FFTB) under construction at SLAC will be given. Finally, we mention conclusions from operating experience at the Stanford Linear Collider (SLC)

Final focus systems for linear colliders

International Nuclear Information System (INIS)

Helm, R.; Irwing, J.

1992-01-01

Final focus systems for linear colliders present many exacting challenges in beam optics, component design, and beam quality. Efforts to resolve these problems as they relate to a new generation of linear colliders are under way at several laboratories around the world. We outline criteria for final focus systems and discuss the current state of understanding and resolution of the outstanding problems. We discuss tolerances on alignment, field quality and stability for optical elements, and the implications for beam parameters such as emittance, energy spread , bunch length, and stability in position and energy. Beam-based correction procedures, which in principle can alleviate many of the tolerances, are described. Preliminary results from the Final Focus Test Beam (FFTB) under construction at SLAC are given. Finally, we mention conclusions from operating experience at the Stanford Linear Collider (SLC). (Author) 16 refs., 4 tabs., 6 figs

Radiation damping in focusing-dominated systems

International Nuclear Information System (INIS)

Huang, Zhirong; Chen, Pisin; Ruth, R.D.

1995-01-01

A quasi-classical method is developed to calculate the radiation damping of a relativistic particle in a straight, continuous focusing system. In one limiting case where the pitch angle of the particle θ p is much larger than the radiation opening angle 1/γ, the radiation power spectrum is similar to synchrotron radiation and the relative damping rate of the transverse action is proportional to the relative energy loss rate. In the other limiting case where θ p much-lt 1/γ, the radiation is dipole in nature and the relative damping rate of the transverse action is energy-independent and is much faster than the relative energy rate. Quantum excitation to the transverse action is absent in this focusing channel. These results can be extended to bent systems provided that the focusing field dominates over the bending field

Discrete and modal focusing effects: principles and applications

DEFF Research Database (Denmark)

Stamate, Eugen

2012-01-01

Charge flux distribution on the surface of biased electrodes of different geometries immersed in a plasma is investigated by three-dimensional simulations and experiments. It is demonstrated that the sheath surrounding the electrodes that interface insulators acts as an electrostatic lens, focusing...... the charges to distinct locations on the electrode surface depending on the entrance coordinates at the sheath edge. Two focusing effects are identified. Discrete focusing leads to the formation of a passive surface of no ion impact, near the edge of the electrodes interfacing insulators. Modal focusing...... results in the formation of certain ‘modal spots’ and/or ‘modal lines’. Several phenomenological aspects and potential applications are reviewed and further discussed, including charge focusing by a three-dimensional plasma–sheath–lens, ion dose uniformity during plasma immersion ion implantation, mass...

Focus Group Evidence: Implications for Design and Analysis

Science.gov (United States)

Ryan, Katherine E.; Gandha, Tysza; Culbertson, Michael J.; Carlson, Crystal

2014-01-01

In evaluation and applied social research, focus groups may be used to gather different kinds of evidence (e.g., opinion, tacit knowledge). In this article, we argue that making focus group design choices explicitly in relation to the type of evidence required would enhance the empirical value and rigor associated with focus group utilization. We…

Self-focusing Past and Present - Fundamentals and Prospects

CERN Document Server

Boyd, Robert W

2007-01-01

Self-focusing has been an area of active scientific investigation for years. From a practical point of view, self-focusing effects impose a limit on the power that can be transmitted through a material medium. This book presents a comprehensive treatment of this topic and reviews both theoretical and experimental investigations of self-focusing.

Adaptive photoacoustic imaging using the Mallart-Fink focusing factor

Science.gov (United States)

Li, Meng-Lin

2008-02-01

Focusing errors caused by sound velocity heterogeneities widen the mainlobe and elevate the sidelobes, thus degrading both spatial and contrast resolutions in photoacoustic imaging. We propose an adaptive array-based photoacoustic imaging technique that uses the Mallart-Fink (MF) focusing factor weighting to reduce the effect of such focusing errors. The definition of the MF focusing factor indicates that the MF focusing factor at the main lobe of the point-spread function is high (close to 1, without speckle noise being present, which is the case in photoacoustic imaging), whereas it is low at the sidelobes. Based on this property, the elevated sidelobes caused by sound velocity heterogeneities in the tissue can be suppressed after being multiplied by the corresponding map of the MF focusing factor on each imaging point; thus the focusing quality can be improved. This technique makes no assumption of sources of focusing errors and directly suppresses the unwanted sidelobe contributions. Numerical experiments with near field phase screen and displaced phase screen models were performed here to verify the proposed adaptive weighting technique. The effect of the signal-to-noise ratio on the MF focusing factor is also discussed.

PREFACE: Focus section on superconducting power systems Focus section on superconducting power systems

Science.gov (United States)

Cardwell, D. A.; Amemiya, N.; Fair, R.

2012-01-01

This focus section of Superconductor Science and Technology looks at the properties, technology and applications of (RE)BCO and MgB2 based superconductors for power engineering systems. Both bulk and conductor forms of material are addressed, including elements of materials fabrication and processing, and the measurement of their applied properties for various levels of system application. The areas of research include ac losses in type II materials in power devices, cables and coated conductors, the development of high current dc cables and the application of superconductors in levitation devices, motors and fault current limiters. This focus section presents a broad cross-section of contemporary issues, that represent state-of-the-art for power applications of superconductors, and highlights the areas that require further development if commercial applications of these rapidly emerging materials are to be realised. It contains papers from some of the major groups in the field, including contributions from Europe, the USA and Japan, and describes devices that are relatively close to market.

[THE ENVIRONMENTAL BASES AND MECHANISM FOR NATURAL OPISTHORCHIASIS FOCUS PULSATION IN THE COMBINED FOCUS OF OPISTHORCHIASIS AND TULAREMIA].

Science.gov (United States)

Ushakov, A V

2015-01-01

A cyclic change in the epizootic activity of a tularemia activity underlies the mechanism of natural opisthorchiasis focus pulsation in the combined focus of opisthorchiasis and tularemia in the ecosystem of the Konda River. This is due to mass breeding and depression in the water vole (Arvicola terrestris) population. The mass breeding is predetermined by high population reproduction constants. The rodents' potential fecundity occurs with the high capacity of lands, which is caused by the hydrological regime of rivers. The size depression is predetermined by the epizootics of tularemia. The water vole is a host of the pathogens of opisthorchiasis and tularemia. So the mass rodent breeding in the combined infection and invasion focus causes an increase in the number of real invasion sources. The epizootic of tularemia is responsible for elimination of these invasion sources and for decreases in the flow of invasion material, the infection rate of Codiella and hence the amount of their produced cercarae, the extensive and intensive indicators of fish contamination, and the intensity of an epizootic process in the opisthorchiasis focus.

Discrete and modal focusing effects: principles and applications

International Nuclear Information System (INIS)

Stamate, E

2012-01-01

Charge flux distribution on the surface of biased electrodes of different geometries immersed in a plasma is investigated by three-dimensional simulations and experiments. It is demonstrated that the sheath surrounding the electrodes that interface insulators acts as an electrostatic lens, focusing the charges to distinct locations on the electrode surface depending on the entrance coordinates at the sheath edge. Two focusing effects are identified. Discrete focusing leads to the formation of a passive surface of no ion impact, near the edge of the electrodes interfacing insulators. Modal focusing results in the formation of certain ‘modal spots’ and/or ‘modal lines’. Several phenomenological aspects and potential applications are reviewed and further discussed, including charge focusing by a three-dimensional plasma–sheath–lens, ion dose uniformity during plasma immersion ion implantation, mass spectrometry and plasma monitoring. (paper)

Task-focused modeling in automated agriculture

Science.gov (United States)

Vriesenga, Mark R.; Peleg, K.; Sklansky, Jack

1993-01-01

Machine vision systems analyze image data to carry out automation tasks. Our interest is in machine vision systems that rely on models to achieve their designed task. When the model is interrogated from an a priori menu of questions, the model need not be complete. Instead, the machine vision system can use a partial model that contains a large amount of information in regions of interest and less information elsewhere. We propose an adaptive modeling scheme for machine vision, called task-focused modeling, which constructs a model having just sufficient detail to carry out the specified task. The model is detailed in regions of interest to the task and is less detailed elsewhere. This focusing effect saves time and reduces the computational effort expended by the machine vision system. We illustrate task-focused modeling by an example involving real-time micropropagation of plants in automated agriculture.

Bringing customer focus to power generation

Energy Technology Data Exchange (ETDEWEB)

Mahoney, J.V. [USGen Power Services (United States)

1997-02-01

The restructuring of the power generation industry and the impact it will have on a company`s success was discussed. Some companies are following one of three distinct strategies for survival, the GENCO, MARKETCO and TRADECO. The GENCO focuses on aggregating low cost, kick butt generation assets that could be either regionally concentrated or geographically distributed. The TRADECO invests in few, or even no, assets. Its only objective is to maximize net income. The MARKETCO structure focuses on understanding and meeting customers` needs. The MARKETCO puts as much value in aggregating `load` as it does on assets. It was suggested that the MARKETCO was the quickest path to success in the restructured electric industry, since it is plainly evident that in the New Millenium the customer will be king, and companies will not survive unless they focus the majority of their efforts on the customer.

Applications of focused ion beams in microelectronics

International Nuclear Information System (INIS)

Broughton, C.; Beale, M.I.J.; Deshmukh, V.G.I.

1986-04-01

We present the conclusions of the RSRE programme on the application of focused ion beams in microelectronics and review the literature published in this field. We discuss the design and performance of focused beam implanters and the viability of their application to semiconductor device fabrication. Applications in the areas of lithography, direct implantation and micromachining are discussed in detail. Comparisons are made between the use of focused ion beams and existing techniques for these fabrication processes with a strong emphasis placed on the relative throughputs. We present results on a novel spot size measurement technique and the effect of beam heating on resist. We also present the results of studies into implantation passivation of resist to oxygen plasma attack as basis for a dry development lithography scheme. A novel lithography system employing flood electron exposure from a photocathode which is patterned by a focused ion beam which can also be used to repair mask defects is considered. (author)

Laser-nucleated acoustic cavitation in focused ultrasound.

Science.gov (United States)

Gerold, Bjoern; Kotopoulis, Spiros; McDougall, Craig; McGloin, David; Postema, Michiel; Prentice, Paul

2011-04-01

Acoustic cavitation can occur in therapeutic applications of high-amplitude focused ultrasound. Studying acoustic cavitation has been challenging, because the onset of nucleation is unpredictable. We hypothesized that acoustic cavitation can be forced to occur at a specific location using a laser to nucleate a microcavity in a pre-established ultrasound field. In this paper we describe a scientific instrument that is dedicated to this outcome, combining a focused ultrasound transducer with a pulsed laser. We present high-speed photographic observations of laser-induced cavitation and laser-nucleated acoustic cavitation, at frame rates of 0.5×10(6) frames per second, from laser pulses of energy above and below the optical breakdown threshold, respectively. Acoustic recordings demonstrated inertial cavitation can be controllably introduced to the ultrasound focus. This technique will contribute to the understanding of cavitation evolution in focused ultrasound including for potential therapeutic applications. © 2011 American Institute of Physics

CT-FC: more Comprehensive Traversal Focused Crawler

Directory of Open Access Journals (Sweden)

NFN Kuspriyanto

2012-03-01

Full Text Available In todays world, people depend more on the WWW information, including professionals who have to analyze the data according their domain to maintain and improve their business. A data analysis would require information that is comprehensive and relevant to their domain. Focused crawler as a topical based Web indexer agent is used to meet this applications information need. In order to increase the precision, focused crawler face the problem of low recall. The study on WWW hyperlink structure characteristics indicates that many Web documents are not strong connected but through co-citation & co-reference. Conventional focused crawler that uses forward crawling strategy could not visit the documents in these characteristics. This study proposes a more comprehensive traversal framework. As a proof, CT-FC (a focused crawler with the new traversal framework ran on DMOZ data that is representative to WWW characteristics. The results show that this strategy can increase the recall significantly.

NATIVE LANGUAGE INFLUENCE IN LEARNERS'. ASSESSMENT OF ENGLISH FOCUS

Directory of Open Access Journals (Sweden)

M. L. Garcia Lecumberri

2001-06-01

Full Text Available Accentual focus is a frequent linguistic device in English which may also be used in Spanish but less widely and less frequently. Given this disparity, it was expected that native language influence would manifest itself in FL leamers' focus assessrnents as cornpared to native English speakers. Other factors were also expected to account of listener perceptions, such as task type and linguistic competence. Two focus domains were used to test hypotheses: utterance initial and utterance medial focus. Focus identification was tested using two tasks which differed in their cognitive demands: multiple choice and open questions. Acceptability was estirnated by asking listeners to rate utterances on a five point scale. English NL listeners displayed better focus identification rates as cornpared to FL learners. This result may be understood both as an effect of native competence advantage and also as a reflection of native language influence. Both listener groups found utterance initial focus easier to identi@ and considered it to be more acceptable than medial focus. Both groups showed worse results in the open test, which is interpreted as a consequence of this task being more demanding on listeners' explicit knowledge. These trends were much more pronounced amongst FL leamers. It is suggested that the potential ambiguity of English medial focus is partly responsible for the bias against it. Additionally, Spanish listeners results show the their NL influence in this bias as well as in the good results for initial focus and acceptability estirnations.

Focus on Russia

International Nuclear Information System (INIS)

Van Koningsbrugge, H.

2008-01-01

A few articles in this magazine focus on the developments and policies in Russia. The titles of some of the articles are 'Between state power and liberal reform' on the task of the new Russian president to find a new balance between government interference and market economy; 'Green light for green energy' on the willingness of the Russian government to stimulate renewable energy; 'Russian power play' on the role of Gazprom in the liberalization of the Russian power market; 'Gazprom's risky strategy' on it's pricing strategy

Non-hydrodynamic model of plasma focus structure

International Nuclear Information System (INIS)

Imshennik, V.S.; Zueva, N.M.; Lokutsievskij, O.V.; Mikhajlova, M.S.

1985-01-01

Experimental and theoretical plasma focus study has resulted in the necessity of creating a non-hydrodynamic plasma focus structure model (MKHD model). This model describes the final stage of plasma focus, which starts immediately after maximum plasma compression. It is related to a very limited space near the neck of the sausage instability. The MKHD model is two-dimensional, axially symmetric and collisionless with respect to the ions and magnetohydrodynamic with respect to the electrons; it accounts for the pinch instability of the sausage type (m=0 mode). The MKHD model, first of all, explains the long time of the plasma focus existence and non-thermonuclear peculiarities in the neutron yield. The initial and boundary conditions are formulated in accordance with the experiments and the results of computations in the 2D MHD model. A non-stationary process of plasma focus dynamics is studied numerically for a relatively long time - about 20 ns; this time is, in principle, not restricted. The computations show that the external edge of the neck expands rather slowly (at a speed that is lower than the thermal ion velocity, by an order of magnitude), and the magnetic field energy is converted to the kinetic energy of the chaotic ion motion (which is doubled for the time of computation). A 'supra-thermal' tail (with the deuterium ion energy higher than 10 keV) forms slowly at the ion distribution function; this tail determines a substantial part of the total neutron yield. The formation of stable vortices, which actually determine the structure of the plasma flow during the developed non-hydrodynamic stage of the plasma focus, is also found in the computations. These properties of the development of the sausage instability, as found in the numerical experiment with the MKHD plasma focus model, are in qualitative agreement with the behaviour of an instability of the same type in the MHD models of the Z-pinch

Focal CT abnormality and epileptogenic focus

International Nuclear Information System (INIS)

Yagi, Kazuichi; Mihara, Tadahiro; Tottori, Takayasu; Matsuda, Kazumi; Watanabe, Yutaka; Seino, Masakazu

1989-01-01

In 31 patients with temporal lobe epilepsy, the precise site of epileptogenic focus was determined by means of a depth EEG recording as one of the presurgical evaluations. In 13 patients, a CT scan revealed focal lesions; 7 in the left temporal lobe and 6 in the right temporal lobe. In 5 of the 7 patients and in 5 of the 6 patients the epileptogenic foci were determined in the temporal lobe on the side of a CT lesion. However, in 2 of the patients with a CT lesion in the left temporal lobe, independent epileptogenic foci were found in both the temporal lobes, and in the other patient with a CT lesion in the right temporal lobe, they were found in the right frontal and left temporal lobes. Thus, the CT lesions agreed in lateralization and focality with the epileptogenic foci in 10 of the 13 patients (77%), but they disagreed in 3 (23%). A CT lesion disclosed in the temporal lobe does not necessarily indicate the side and/or site where the epileptogenic focus may be localized. Although exceptions may be made, spatial disagreement was exemplified between the CT lesion and epileptogenic focus. Therefore, extreme caution has to be taken on the side and/or site of the epileptogenic focus when functional surgical indication is to be made. (author)

Invited paper: Plasma focus in China

International Nuclear Information System (INIS)

Jinji, Y.

1983-01-01

Plasma focus research in China began in the seventies. There are now 3 devices in two institutions, Tsinghua University in Beijing and the Institute of Mining and Metallurgy in Changsha. The research works can be divided into two groups: the engineering problems related to plasma focus devices and the plasma phenomena and process of the focus. Under the first subject, insulation and plasma spark gaps are studied. By casting silicon rubber onto the ends of the transmission cable, the length of insulation can be appreciably reduced. With the method of simulating charges, the electric field distribution of a field distortion type spark gap was calculated. Comparison of the field distribution before and after triggering was represented. It shows that the electric field strength of the gap after triggering may reach 14-80 times as high as that before triggering. Thus the characteristic of the gap may be improved remarkably. In respect of the phenomena of the plasma focus, neutron emission and X-ray emission were measured. It was shown that the proportion of X-ray with higher energy depends upon the material of the inner electrode. Two kinds of stud materials, tungsten and molybendum, were adopted. Measured results of the distribution of X-ray energy were represented respectively for the two materials used. Evidently, the distribution changed with the inserted materials

Synthesis of focusing-and-deflection columns

International Nuclear Information System (INIS)

Szilagyi, M.; Mui, P.H.

1995-01-01

Szilagyi and Szep have demonstrated that focusing lenses of high performances can be constructed from a column of circular plate electrodes. Later, Szilagyi modified that system to include dipole, quadrupole, and octupole components by partitioning each plate into eight equal sectors. It has already been shown that the additional quadrupole components can indeed bring about substantial improvements in the focusing of charged particle beams. In this article, that design procedure is expanded to construct columns capable of both focusing and deflecting particle beams by just introducing additional dipole components. In this new design, the geometry of the system remains unchanged. The only extra complication is the demand for more individual controls of the sector voltages. Two sample designs, one for negative ions and one for electrons, are presented showing that in both cases a ±2.3 mrad diverging beam can be focused down to a spot of less than 50 nm in radius over a scanning circular area of radius 0.25 mm. The details of the two systems are given in Sec. IV along with the source conditions. The performance of the negative ion system is found to be comparable to the published data. For the relativistic electron system, the interaction of individual components to reduce various aberrations is investigated. copyright 1995 American Vacuum Society

Child-Focused and Context-Focused Behaviors of Physical and Occupational Therapists during Treatment of Young Children with Cerebral Palsy

NARCIS (Netherlands)

Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J.

2016-01-01

Aims: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. Method: Videos of 49 therapy sessions

Child-Focused and Context-Focused Behaviors of Physical and Occupational Therapists during Treatment of Young Children with Cerebral Palsy

NARCIS (Netherlands)

Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J

2016-01-01

AIMS: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. METHOD: Videos of 49 therapy sessions

Simultaneous spatio-temporal focusing for tissue manipulation

Directory of Open Access Journals (Sweden)

Squier J.

2013-11-01

Full Text Available Simultaneous spatiotemporal focusing (SSTF is applied to lens tissue and compared directly with standard femtosecond micromachining of the tissue at the same numerical aperture. Third harmonic generation imaging is used for spatio-temporal characterization of the processing conditions obtained with both a standard and SSTF focus.

HINS Linac front end focusing system R&D

Energy Technology Data Exchange (ETDEWEB)

Apollinari, G.; Carcagno, R.H.; Dimarco, J.; Huang, Y.; Kashikhin, V.V.; Orris, D.F.; Page, T.M.; Rabehl, R.; Sylvester, C.; Tartaglia, M.A.; Terechkine, I.; /Fermilab /Argonne

2008-08-01

This report summarizes current status of an R&D program to develop a focusing system for the front end of a superconducting RF linac. Superconducting solenoids will be used as focusing lenses in the low energy accelerating sections of the front end. The development of focusing lenses for the first accelerating section is in the production stage, and lens certification activities are in preparation at FNAL. The report contains information about the focusing lens design and performance, including solenoid, dipole corrector, and power leads, and about cryogenic system design and performance. It also describes the lens magnetic axis position measurement technique and discusses scope of an acceptance/certification process.

SKEW QUADRUPOLE FOCUSING LATTICES AND APPLICATIONS

International Nuclear Information System (INIS)

Parker, B.

2001-01-01

In this paper we revisit using skew quadrupole fields in place of traditional normal upright quadrupole fields to make beam focusing structures. We illustrate by example skew lattice decoupling, dispersion suppression and chromatic correction using the neutrino factory Study-II muon storage ring design. Ongoing BNL investigation of flat coil magnet structures that allow building a very compact muon storage ring arc and other flat coil configurations that might bring significant magnet cost reduction to a VLHC motivate our study of skew focusing

Ion beam generation and focusing

International Nuclear Information System (INIS)

Miller, P.A.; Mendel, C.W.; Swain, D.W.; Goldstein, S.A.

1975-01-01

Calculations have shown that efficiently generated and focused ion beams could have significant advantages over electron beams in achieving ignition of inertially-confined thermonuclear fuel. Efficient ion beam generation implies use of a good ion source and suppression of net electron current. Net electron flow can be reduced by allowing electrons to reflex through a highly transparent anode or by use of transverse magnetic fields (either beam self-fields or externally applied fields). Geometric focusing can be achieved if the beam is generated by appropriately shaped electrodes. Experimental results are presented which demonstrate ion beam generation in both reflexing and pinched-flow diodes. Spherically shaped electrodes are used to concentrate a proton beam, and target response to proton deposition is studied

Designing focusing solenoids for superconducting RF accelerators

Energy Technology Data Exchange (ETDEWEB)

Davis, G.; Kashikhin, V.V.; Page, T.; Terechkine, I.; Tompkins, J.; Wokas, T.; /Fermilab

2006-08-01

The design of a focusing solenoid for use in a superconducting RF linac requires resolving a range of problems with conflicting requirements. Providing the required focusing strength contradicts the goal of minimizing the stray field on the surfaces of adjacent superconducting RF cavities. The requirement of a compact solenoid, able to fit into a gap between cavities, contradicts the need of mechanical support necessary to restrain electromagnetic forces that can result in coil motion and subsequent quenching. In this report we will attempt to address these and other issues arising during the development of focusing solenoids. Some relevant test data will also be presented.

Focus Groups as Transformative Spiritual Encounters

Directory of Open Access Journals (Sweden)

Sharon Moloney PhD

2011-03-01

Full Text Available Focus groups are a valuable method for exploring the construction and negotiation of meanings. In her doctoral research the author explored how Australian women's experiences of menstruation, birth, and spirituality are invested with meaning and how that meaning influences and shapes those experiences. The focus group has been described as a potentially liminal space, which enables the discussion of taboo subjects by breaking the ice and giving people permission to comment. In addition, she discovered that the groups could be occasions of empowerment and transformation for both participants and researcher. In a way that far exceeded her expectations, the group format was ideally suited to feminist research and the organic inquiry methodology she used. Some groups became deeply spiritual encounters that were nourishing and transformative for all. This article explores how focus groups can be vehicles of spiritual transformation, examining one group in particular to highlight the points raised.

On the self-focusing of electric helicons

International Nuclear Information System (INIS)

Tsintadze, N.L.; El-Ashry, M.Y.; Garuchava, D.P.

1987-07-01

The present work is devoted to the investigation of the stationary self-focusing of circularly polarized helicons in a magnetized plasma in the case of ultra-relativistic intensities. It is shown that the larger intensity and effective width at the boundary is the much faster growing self-focusing. (author). 8 refs

Focus, accent, and argument structure: effects on language comprehension.

Science.gov (United States)

Birch, S; Clifton, C

1995-01-01

Four experiments investigated the effect of syntactic argument structure on the evaluation and comprehension of utterances with different patterns of pitch accents. Linguistic analyses of the relation between focus and prosody note that it is possible for certain accented constituents within a broadly focused phrase to project focus to the entire phrase. We manipulated focus requirements and accent in recorded question-answer pairs and asked listeners to make linguistic judgments of prosodic appropriateness (Experiments 1 and 3) or to make judgments based on meaningful comprehension (Experiments 2 and 4). Naive judgments of prosodic appropriateness were generally consistent with the linguistic analyses, showing preferences for utterances in which contextually new noun phrases received accent and old noun phrases did not, but suggested that an accented new argument NP was not fully effective in projecting broad focus to the entire VP. However, the comprehension experiments did demonstrate that comprehension of a sentence with broad VP focus was as efficient when only a lexical argument NP received accent as when both NP and verb received accent. Such focus projection did not occur when the argument NP was an "independent quantifier" such as nobody or everything. The results extend existing demonstrations that the ease of understanding spoken discourse depends on appropriate intonational marking of focus to cases where certain structurally-defined words can project focus-marking to an entire phrase.

[Aerodynamic focusing of particles and heavy molecules

International Nuclear Information System (INIS)

de la Mora, J.F.

1990-01-01

By accelerating a gas containing suspended particles or large molecules through a converging nozzle, the suspended species may be focused and therefore used to write fine lines on a surface. Our objective was to study the limits on how narrow this focal region could be as a function of particle size. We find that, for monodisperse particles with masses m p some 3.6 x 10 5 times larger than the molecular mass m of the carrier gas (diameters above some 100 angstrom), there is no fundamental obstacle to directly write submicron features. However, this conclusion has been verified experimentally only with particles larger than 0.1 μm. Experimental, theoretical and numerical studies on the defocusing role of Brownian motion for very small particles or heavy molecules have shown that high resolution (purely aerodynamic) focusing is impossible with volatile molecules whose masses are typically smaller than 1000 Dalton. For these, the minimal focal diameter after optimization appears to be 5√(m/m p ) times the nozzle diameter d n . But combinations of focused lasers and aerodynamic focusing appear as promising for direct writing with molecular precursors. Theoretical and numerical schemes capable of predicting the evolution of the focusing beam, including Brownian motion effects, have been developed, although further numerical work would be desirable. 11 refs

Does Varying Attentional Focus Affect Skill Acquisition in Children? A Comparison of Internal and External Focus Instructions and Feedback

Science.gov (United States)

Agar, Charles; Humphries, Charlotte A.; Naquin, Millie; Hebert, Edward; Wood, Ralph

2016-01-01

Recently, researchers have concluded that motor skill performance is enhanced when learners adopt an external attentional focus, compared to adopting an internal focus. We extended the line of inquiry to children and examined if skill learning in children was differentially affected by providing instructions and feedback that direct attentional…

Development of TPF-1 plasma focus for education

Science.gov (United States)

Picha, R.; Promping, J.; Channuie, J.; Poolyarat, N.; Sangaroon, S.; Traikool, T.

2017-09-01

The plasma focus is a device that uses high voltage and electromagnetic force to induce plasma generation and acceleration, in order to cause nuclear reactions. Radiation of various types (X-ray, gamma ray, electrons, ions, neutrons) can be generated using this method during the pinch phase, thus making the plasma focus able to serve as a radiation source. Material testing, modification, and identification are among the current applications of the plasma focus. Other than being an alternative option to isotopic sources, the plasma focus, which requires multidisciplinary team of personnel to design, operate, and troubleshoot, can also serve as an excellent learning device for physics and engineering students in the fields including, but not limited to, plasma physics, nuclear physics, electronics engineering, and mechanical engineering. This work describes the parameters and current status of Thai Plasma Focus 1 (TPF-1) and the characteristics of the plasma being produced in the machine using a Rogowski coil.

Consequences of Collective-Focused Leadership and Differentiated Individual-Focused Leadership : Development and Testing of an Organizational-Level Model

OpenAIRE

Kunze, Florian; de Jong, Simon Barend; Bruch, Heike

2016-01-01

Recent advances in leadership research suggest that collective-focused leadership climate and differentiated individual-focused leadership might simultaneously, yet oppositely, affect collective outcomes. The present study extends this literature by addressing open questions regarding theory, methods, statistics, and level of analysis. Therefore, a new and more parsimonious theoretical model is developed on the organizational-level of analysis. Drawing on the commitment literature, we argue f...

Focusing of atoms with spatially localized light pulses

International Nuclear Information System (INIS)

Helseth, Lars Egil

2002-01-01

We theoretically study the focusing of atoms using strongly localized light pulses. It is shown that when inhomogenously polarized light is focused at high angular apertures, one may obtain useful potentials for atom focusing. Here we analyze the case of pulsed light potentials for red- and blue-detuned focusings of atoms. In particular, we show that the atomic beam aperture must be stopped considerably down in order to reduce the sidelobes of the atomic density, which is similar to the situation often encountered in conventional optics. It is suggested that an annular aperture in front of the atomic beam could be useful for increasing the resolution, at the cost of a lower atomic density

Optimization of an electrostatic quadrupole doublet focusing systems

Energy Technology Data Exchange (ETDEWEB)

Hussein, Oday A., E-mail: oah@sc.nahrainuniv.edu.iq [Department of Physics, College of Science, Al-Nahrain University, Baghdad (Iraq); Sise, Omer [Department of Science Education, Faculty of Education, Suleyman Demirel University, Isparta (Turkey)

2017-05-15

Highlights: • The imaging properties of an electrostatic quadrupole doublet lens were analyzed with the aid of computer simulation. • The optimal electrode voltages which lead to stigmatic image in both planes of the quadrupole doublet lens with minimum spot size at position sensitive detector (PSD) were found for two operation modes: point-to-point focusing and parallel-to-point focusing. • The imaging properties of are very sensitive to the lunching angle of the electron-beam. - Abstract: The imaging properties of an electrostatic quadrupole doublet lens were analyzed with the aid of computer simulation. The optimal electrode voltages which lead to stigmatic image in both planes of the quadrupole doublet lens with minimum spot size at position sensitive detector (PSD) were found for two operation modes: point-to-point focusing and parallel-to-point focusing. The optical properties as: Magnifications, spot sizes in the image plane and aberration figures were discussed. The results showed that the focusing of the lens was strong in the xy-plane in comparison with the focusing in the xz-plane. The distortion of the image was greater when the image position will be close to the lens in comparison with object position. Also, the imaging properties were very sensitive to the lunching angle of the electron-beam.

The plasma focus - numerical experiments leading technology

International Nuclear Information System (INIS)

Saw, S.H.; Lee, S.

2013-01-01

Numerical experiments on the plasma focus are now used routinely to assist design and provide reference points for diagnostics. More importantly guidance has been given regarding the implementation of technology for new generations of plasma focus devices. For example intensive series of experiments have shown that it is of no use to reduce static bank inductance L0 below certain values because of the consistent loading effects of the plasma focus dynamics on the capacitor bank. Thus whilst it was thought that the PF1000 could receive major benefits by reducing its bank inductance L 0 , numerical experiments have shown to the contrary that its present L 0 of 30 nH is already optimum and that reducing L 0 would be a very expensive fruitless exercise. This knowledge gained from numerical experiments now acts as a general valuable guideline to all high performance (ie low inductance) plasma focus devices not to unnecessarily attempt to further lower the static inductance L 0 . The numerical experiments also show that the deterioration of the yield scaling law (e.g. the fusion neutron yield scaling with storage energy) is inevitable again due to the consistent loading effect of the plasma focus, which becomes more and more dominant as capacitor bank impedance reduces with increasing capacitance C 0 as storage energy is increased. This line of thinking has led to the suggestion of using higher voltages (as an alternative to increasing C 0 ) and to seeding of Deuterium with noble gases in order to enhance compression through thermodynamic mechanisms and through radiation cooling effects of strong line radiation. Circuit manipulation e.g. to enhance focus pinch compression by current-stepping is also being numerically experimented upon. Ultimately however systems have to be built, guided by numerical experiments, so that the predicted technology may be proven and realized. (author)

Iodine nutrition and risk of thyroid irradiation from nuclear accidents

International Nuclear Information System (INIS)

Delange, F.

1990-01-01

The objectives of this paper are to discuss the following aspects of physiopathology of iodine nutrition related to thyroid irradiation by nuclear accidents: (1) The cycle of iodine in nature, the dietary sources of iodine and the recommended dietary allowances for iodine. (2) The anomalies of thyroid metabolism induced by iodine deficiency. The caricatural situation as seen in endemic goitre will be used as mode. (3) The specific paediatric aspects of adaptation to iodine deficiency. (4) The present status of iodine nutrition in Europe. (author)

Atypical Manifestations of Hyperthyroidism

Science.gov (United States)

Boxall, E. A.; Lauener, R. W.; McIntosh, H. W.

1964-01-01

Patients with hyperthyroidism usually present with symptoms of hypermetabolism with or without goitre and/or eye signs. Occasionally, however, the chief complaints are not immediately suggestive of hyperthyroidism. Patients with hyperthyroidism are described who presented with such atypical manifestations as periodic muscular paralysis, myasthenia, myopathy, encephalopathy, psychosis, angina pectoris, atrial fibrillation, heart failure without underlying heart disease, skeletal demineralization, pretibial myxedema, unilateral eye signs, and pitting edema of the ankles. ImagesFig. 2Fig. 3Fig. 5Fig. 7Fig. 8Fig. 9Fig. 10 PMID:14178405

[Congenital hyperthyroidism in maternal Basedow disease].

Science.gov (United States)

Meden, H; Rath, W

1989-09-01

A case of congenital hyperthyroidism, after pregnancy complicated by Graves' disease is presented. Fetal tachycardia was the cardial symptom. Caesarean section was performed in the 29 years old patient with normal thyroid function in the 29th week of pregnancy. The neonate showed symptoms of a congenital hyperthyroidism with goitre. Antithyroid antibodies were found in the serum of both mother and child. At the age of ten weeks, after a short course of thyrostatic treatment, the infant was discharged with normal thyroid function following complicationfree progress.

Accelerating and focusing structures for PIGMI

International Nuclear Information System (INIS)

Swenson, D.A.; Bush, E.D. Jr.; Holsinger, R.F.; Manca, J.J.; Saito, N.; Stovall, J.E.

1977-01-01

The National Cancer Institute is supporting a program of accelerator development at the Los Alamos Scientific Laboratory aimed at the extension of proton linac technologies to produce the most suitable Pion Generator for Medical Irradiations (PIGMI). An optimized design of a pion generator suitable for a radiotherapy program at a major medical center has been established, consisting of a 250-keV injector, followed by a 35-meter-long drift-tube linac that accelerates the proton beam to 150 MeV, and an 85-meter-long coupled-cavity linac that accelerates the beam to its final energy of 650 MeV, where the average beam current of 100 microamperes impinges on one or more targets producing abundant quantities of π - mesons for radiotherapeutic applications. A number of extensions to proton linac technology are being pursued under the PIGMI program at LASL. A discussion is given of recent developments in three areas relevant to the acceleration and focusing of proton beams, namely, the alternating phase focused (APF) linac structure, the disk and washer linac structure, and small permanent magnet quadrupole lenses. The APF linac structure is being developed for the acceleration and focusing role from the injection energy of 250 keV to a few MeV, where a transition is made to a permanent magnet quadrupole focused linac structure. The disk and washer linac structure is under consideration for the high velocity portion of the design

MACS low-background doubly focusing neutron monochromator

CERN Document Server

Smee, S A; Scharfstein, G A; Qiu, Y; Brand, P C; Anand, D K; Broholm, C L

2002-01-01

A novel doubly focusing neutron monochromator has been developed as part of the Multi-Analyzer Crystal Spectrometer (MACS) at the NIST Center for Neutron Research. The instrument utilizes a unique vertical focusing element that enables active vertical and horizontal focusing with a large, 357-crystal (1428 cm sup 2), array. The design significantly reduces the amount of structural material in the beam path as compared to similar instruments. Optical measurements verify the excellent focal performance of the device. Analytical and Monte Carlo simulations predict that, when mounted at the NIST cold-neutron source, the device should produce a monochromatic beam (DELTA E=0.2 meV) with flux phi>10 sup 8 n/cm sup 2 s. (orig.)

Wayside Teaching: Focusing on Relationships

Science.gov (United States)

Powell, Sara Davis

2011-01-01

Wayside teaching focuses on building and maintaining positive relationships with students. Teachers can implement certain wayside teaching practices to end the year in a positive way and begin preparing for the next school year.

Foil focusing of relativistic electron beams

Energy Technology Data Exchange (ETDEWEB)

Ekdahl, Jr., Carl August [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-10-26

When an intense relativistic electron beams (IREB) passes through a grounded metal foil, the transverse electric field due to the beam space charge is locally shorted out, and the beam is focused by the magnetic field of its current. The effect can be treated as focusing by a thin lens with first order aberration. Expressions for the focal length and aberration coefficient of the equivalent thin lens are developed in this note. These are then applied to practical examples representative of IREB research at Los Alamos National Laboratory.

Focus measurement of electron linear accelerator

International Nuclear Information System (INIS)

Su Zhijun; Xin Jian; Jia Qinglong

2007-01-01

Many personal factors would influence the result of the focus measurement of linear accelerator using the conventional sandwich method. This paper presents a modified method which applies a film scanning meter to scan the X-ray image film got by sandwich method for obtaining a greyscale distribution, then the full width at half maximum value of greyscale distribution represents the focus size. The method can eliminates disadvantage influence from accelerator radiant field asymmetry by quadratic polynomial fitting and measures peak width at half height instead of stripe statistic. (authors)

Neutron emission from deuterium plasma focus

International Nuclear Information System (INIS)

Antanasijevic, R.; Banjanac, R.; Dragic, A.; Djordjevic, D.; Joksimovic, D.; Maric, Z.; Udovicic, V.; Vukovic, J.

1998-01-01

The anisotropy of emitted neutrons is investigated on a small 'Mather-type' plasma focus device (PF). This problem is of importance for determining the nature of the fusion reaction mechanisms. Mica detectors together with thick uranium foils were used for both detection and angular distribution measurements of the neutrons. Previously, the annealing of the detectors was done and measured after the irradiation with neutrons from Am-Be source. Also, annealing ability of H-plasma focus has been tested. Geometry of detectors in both experiments was the same. (authors)

Using Focus Group Research in Public Relations.

Science.gov (United States)

Grunig, Larissa A.

1990-01-01

Analyzes a recent instance of focus group research applied to a public relations case (rather than a marketing case). Reviews the advantages and disadvantages of this qualitative method, and describes the case of a county department of mental health relying on focus group research to help plan a program aimed at reducing the stigma of mental…

Open-access publishing for pharmacy-focused journals.

Science.gov (United States)

Clauson, Kevin A; Veronin, Michael A; Khanfar, Nile M; Lou, Jennie Q

2008-08-15

Pharmacy-focused journals that are available in open-access (OA), freely accessible, hybrid, or traditional formats were identified. Relevant journals were accessed from PubMed, International Pharmaceutical Abstracts, EMBASE, and the Pharmacology and Pharmacy category of Thomson Scientific Journal Citation Reports. Criteria were established to select journals that satisfied the definition of pharmacy focused. Journals were assessed based on accessibility, copyright transfer requirements, and restrictions. If tracked, the journal's impact factor (IF) was identified according to classification, and medians were calculated for each journal category. A total of 317 pharmacy-focused journals were identified. The majority of pharmacy-focused journals identified were traditional/non-OA (n = 240). A smaller number of journals were freely accessible/ non-OA (n = 37), freely accessible/non-OA with content restrictions (n = 20), or freely available/non-OA with date restrictions (n = 18). The fewest number of journals were completely OA (n = 2). The median IF for the 185 journals whose IF was tracked was 2.029. The median IF for freely accessible and hybrid journals (n = 42) was 2.550, whereas the median IF for traditional journals (n = 143) was 1.900. A very small number of pharmacy-focused journals adhere to the OA paradigm of access. However, journals that adopt some elements of the OA model, chiefly free accessibility, may be more likely to be cited than traditional journals. Pharmacy practitioners, educators, and researchers could benefit from the advantages that OA offers but should understand its financial disadvantages.