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  1. Radioiodine therapy of thyroid autonomy

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    Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

    2002-08-01

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

  2. Endocrine ophthalmopathy and radioiodine therapy

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    Karlsson, F. Anders [Uppsala Univ. Hospital, Inst. of Medical Sciences (Sweden). Section of Endocrinology and Diabetes

    2006-12-15

    Endocrine ophthalmopathy is to some degree present in most patients with Graves' disease. In few cases, a severe form of the condition develops and in the majority of these cases, the course of the eye problems has been influenced by the treatment for thyrotoxicosis. In this regard, radioiodine therapy has been increasingly recognized as carrying a special risk. Here, the current understanding of endocrine ophthalmopathy and the risks associated with the development of severe eye disease are discussed. The results of a retrospective investigation of patients with severe eye disease in our hospital, and the experience with corticosteroid administration following radioiodine in order to reduce the risk of ophthalmopathy, are also presented.

  3. Radioiodine therapy of euthyroid multinodular goitres

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    Manders, Jeroen M.B.; Corstens, Frans H.M. [University Medical Center Nijmegen, 565 Department of Nuclear Medicine, Geert Grooteplein Zuid 8, 6525 GA Nijmegen (Netherlands)

    2002-08-01

    Euthyroid multinodular goitre is caused by excessive replication of thyroid epithelial cells, due to various stimuli. With time there is a gradual increase in size and in nodularity. The clinical manifestations arise solely from thyroid enlargement. Treatment of euthyroid multinodular goitre is indicated only when thyroid enlargement causes symptoms of obstruction, such as dysphagia and dyspnoea. Treatment options are radioiodine (iodine-131), surgery and TSH suppression therapy. In this review we compare these treatment modalities. In our opinion, radioiodine is the treatment of choice in elderly patients, in patients in whom surgery is contra-indicated and in patients who are unwilling to undergo surgery. The life-time risk of fatal and non-fatal cancer due to radioiodine is negligible in patients over 65 years of age, compared with the life-time risk of fatal cancer in the non-exposed population. (orig.)

  4. Radioiodine therapy in benign thyroid diseases

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    Radioiodine ((131)I) therapy of benign thyroid diseases was introduced 70 yr ago, and the patients treated since then are probably numbered in the millions. Fifty to 90% of hyperthyroid patients are cured within 1 yr after (131)I therapy. With longer follow-up, permanent hypothyroidism seems...... inevitable in Graves' disease, whereas this risk is much lower when treating toxic nodular goiter. The side effect causing most concern is the potential induction of ophthalmopathy in predisposed individuals. The response to (131)I therapy is to some extent related to the radiation dose. However, calculation...

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

    Directory of Open Access Journals (Sweden)

    Andrew Collier

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chatterjee S

    2015-08-01

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

  7. Does radioiodine therapy have disadvantageous effects in non-iodine accumulating differentiated thyroid carcinoma?

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    Schaap, J; Eustatia-Rutten, CFA; Stokkel, M; Links, TP; Diamant, M; Romijn, JA; Smit, JWA; van der Velde, E.A.

    2002-01-01

    BACKGROUND Although radioiodine therapy in differentiated thyroid carcinoma without radioiodine accumulation has not been considered harmful, increased thyrotrophin levels during thyroxine withdrawal without the benefit of radiotoxicity as well as the selection of de-differentiated cells may have di

  8. Dosage assessment for radioiodine therapy in benign thyroid disorders

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    Isselt, J.W. van

    2001-01-01

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

  9. Outcome of Radioiodine Therapy in a West African Population

    NARCIS (Netherlands)

    Onimode, Yetunde A; Ankrah, Alfred; Adedapo, Kayode S

    2016-01-01

    Hyperthyroidism continues to be a pressing public health concern in West Africa. Its prevalence in Africa has been quoted as 1.2%-9.9%, with Graves' disease as its most common cause. Radioiodine-131 (RAI) therapy of hyperthyroidism recently commenced in two government hospitals in Ghana and Nigeria.

  10. Dosage assessment for radioiodine therapy in benign thyroid disorders

    NARCIS (Netherlands)

    Isselt, J.W. van

    2001-01-01

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

  11. Predictors of the results of radioiodine therapy of Gagves’ disease

    Directory of Open Access Journals (Sweden)

    G V Shestakova

    2010-09-01

    Full Text Available The aim of this study was to investigate different clinical and laboratory predictors influence on radioiodine therapy results for Graves' disease. A 1-year prospective study was performed on 621 patients treated with empirical radioiodine therapy. Mean administered dose of 131I was 350 MBq. All patients were divided into two groups with small (<25 ml and large (>25 ml thyroid gland volume. One day before radioiodine therapy all patients were examined with fT4 measurement and radioiodine uptake test to determine percentage uptake at 2 h, 4 h, and 24 h after test dose of 131I administration. Unique universal method to estimate predictors influence for any classification task was presented and used for actual task of radioiodine therapy results estimation. For patients with small thyroid gland volume a set of 11 predictors that have an influence on therapy result was revealed and importance of each predictor from indicated set was determined. The most influential predictors were administered dose of 131I, thyroid gland volume, percentage uptake at 24 h after test dose of 131I administration, and patient age. For patients with large thyroid gland volume a set of 10 predictors was revealed. The most influential predictors were administered dose of 131I, thyroid gland volume, percentage uptake at 2 h after test dose of 131I administration, and patient age. Accounting all predictors from indicated sets for both patient groups allows constructing of classification system that provides therapy result estimation for any patient and any administered dose of 131I with accuracy above 90%.

  12. Radioiodine therapy and subsequent pregnancy; Gravidez apos radioiodoterapia

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

    2007-06-15

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    INTRODUCTION: The impact on tracheal anatomy and respiratory function of recombinant human (rh)TSH-stimulated (131)I therapy in patients with goiter is not clarified. METHODS: In a double-blinded design, patients (age 37-87 yr) with a large multinodular goiter (range, 99-440 ml) were randomized...... previously. In the placebo group, no significant changes in the lung function or SCAT were found throughout the study. In the rhTSH group, a slight decrease was observed in the forced vital capacity 1 wk after therapy, whereas the mean individual change in SCAT was significantly increased by 10.5% (95...

  14. [Advances in research on radioiodine therapy of carcinoma mediated by gene transfer technology].

    Science.gov (United States)

    Mu, Da; Kuang, Anren

    2010-10-01

    Radioiodine therapy of carcinoma could be mediated by transferring the genes which participate in the process of iodine metabolism in thyroid. The correlative genes are sodium/iodine symporter gene, thyroid peroxidase gene and the specific thyroid transcription factors, and others. The objective gene can specifically express in carcinoma by inserting the tissue-specific promoter/enhancer upstream of them, so radioiodine could be used to treat varied carcinomas. The radioiodine uptake in carcinoma cells was obviously increased and the radioiodine therapy of carcinoma was effective after those genes had expressed in carcinoma cells. The main problem was that the effective half-time of radioiodine in cells was too short to produce the ideal effect of radioiodine therapy. Moreover, 211At and 188Re could be transferred by sodium/iodine symporter and they could be used to treat the carcinoma that is capable of radioiodine uptake.

  15. Radioiodine therapy in Graves` disease; Radioiodtherapie der Immunhyperthyreose

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    Schuemichen, C. [Rostock Univ., Zentrum fuer Radiologie, Klinik und Poliklinik fuer Nuklearmedizin (Germany)

    1997-12-01

    Analogous to subtotal struma resection, stable long-term results are attained with radioiodine therapy of immunohyperthyreosis only with an ablative therapy concept. Hypothyreosis is thus no longer an undesired or unavoidable side effect of radioiodine therapy, but constitutes part of the treatment principle. In addition to the negligible theoretical low late risk of radiation effect, an increase in immunostimulation is induced in the majority of patients by means of increased antigen presentation. In a minority of patients, this has detrimental effects on the treatment results and leads to a requirement for relatively high focal doses (200-300 Gy) to achieve a generally satisfactory therapeutic result. In individual cases, endocrine orbitopathy may be exacerbated or elicited. It is therefore recommended that radioiodine therapy of immunohyperthyreosis should be undertaken with cortisone protection as a matter of principle. (orig.) [Deutsch] In Analogie zur subtotalen Strumaresektion werden auch mit der Radioiodtherapie der Immunhyperthyreose nur mit einem ablativen Therapiekonzept stabile Langzeitergebnisse erzielt. Die Hypothyreose ist somit nicht laenger unerwuenschte oder unvermeidliche Nebenwirkung der Radioiodtherapie, sondern Bestandteil des Behandlungsprinzips. Neben dem vernachlaessigbar geringen theoretischen Spaetrisiko durch Strahleneinwirkung wird bei einem Grossteil der Patienten durch eine vermehrte Antigenpraesentation eine Zunahme der Immunstimulation induziert, die bei einem kleineren Teil der Patienten das Behandlungsergebnis beeintraechtigt und dazu fuehrt, dass relativ hohe Herddosen (200-300 Gy) fuer ein insgesamt zufriedenstellendes Behandlungsergebnis erforderlich werden. In Einzelfaellen kann hierdurch auch eine endokrine Orbitopathie verschlechtert oder neu ausgeloest werden. Es wird daher empfohlen, die Radioiodtherapie der Immunhyperthyreose grundsaetzlich unter Kortisonschutz vorzunehmen. (orig.)

  16. Recent advances in radioiodine therapy for thyroid cancer

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    Bae, Sang Kyun [Inje University College of Medicine, Busan (Korea, Republic of)

    2006-04-15

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

  17. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

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    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

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

    DEFF Research Database (Denmark)

    Fast, S; Bonnema, S J; Hegedüs, L

    2011-01-01

    This review provides an update on recombinant human TSH (rh-TSH) augmented radioiodine (¹³¹I) therapy and outlines its potential role in the treatment of symptomatic benign multinodular non-toxic goitre. In some countries, ¹³¹I has been used for three decades to reduce the size of nodular goitres......-56% amplification of goitre reduction at one-year post radioiodine compared to conventional (without rh-TSH) ¹³¹I therapy. Although patient satisfaction is not improved at one-year, this approach facilitates tracheal decompression and is particularly promising in large goitres. The majority of multinodular non......-toxic goitre patients may not require amplified goitre reduction. But as an alternative strategy, rh-TSH allows up to 80% reduction of the therapeutic ¹³¹I activity while still achieving goitre reduction comparable to that of conventional ¹³¹I therapy and maintaining high patient satisfaction. The dose...

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

    Science.gov (United States)

    Gurgul, Edyta; Sowinski, Jerzy

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Objective: The objective of the study was to evaluate the long-term outcome of recombinant human TSH (rhTSH)-augmented radioiodine ((131)I) therapy for benign multinodular nontoxic goiter. Patients and Methods: Between 2002 and 2005, 86 patients with a multinodular nontoxic goiter were treated...... scale. Results: In both groups, thyroid volume was further reduced from 1 yr to final FU (71 months). The mean goiter volume reductions obtained at 1 yr and final FU [59.2 ± 2.4% (sem) and 69.7 ± 3.1%, respectively] in the rhTSH group were significantly greater than those obtained in the (131)I......-alone group (43.2 ± 3.7 and 56.2 ± 3.6%, respectively, P = 0.001 and P = 0.006), corresponding to a gain of 24% at final FU. At last FU the mean reduction in compression visual analog scale score was significantly greater in patients receiving rhTSH (P = 0.049). Additional therapy (thyroid surgery or (131)I...

  1. 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

  2. Radioiodine therapy of benign thyroid disease; Radioiodbehandling af benign thyreoideasygdom

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    Krogh Rasmussen, Aa.; Jarloev, A.E.; Faber, J

    2000-01-01

    The aim of the study was to evaluate differences in the use of radioactive iodine in the treatment of benigh thyroid disease in Denmark. A questionnaire was distributed to all departments in Denmark which administer radioiodine in the treatment of benign thyroid disease (n=20). Radioiodine is used for patients with toxic nodular goitre and for patients with relapse of toxic diffuse goitre. Four departments did not use radioiodine for volume reduction in non-toxic goitre. Patient information's included very different recommendations regarding cautions in relation to radioiodine treatment. Radioiodine is widely used in the treatment of benign thyroid disease. We recommend a national standardization of the cautions in relation to radioiodine treatment. (au)

  3. 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

    PURPOSE: To evaluate the importance of 24 h radioiodine uptake (24 h RIU) for the outcome of radioiodine treatment of hyperthyroidism. METHODS: Retrospective analysis of 72 patients who underwent radioiodine treatment for toxic goiter at our outpatient clinic [29 diffuse goiters (DG), 30 toxic...... multinodular goiters (TMG) and 13 toxic adenomas (TA)]. Thyroid status was determined by TSH, fT3 and fT4 levels, and outcome was rendered successful when hyperthyroidism was absent. Relation between low 24 h RIU (below median) or high 24 h RIU (above or equal to median) and outcome was evaluated. RESULTS......: Of patients with DG and low 24 h RIU, 15% remained hyperthyroid, as opposed to 56% of patients with DG and high 24 h RIU (Phyperthyroid, as opposed to 44% of patients with TMG and high 24 h RIU (P

  4. Glycididazole sodium combined with radioiodine therapy for patients with differentiated thyroid carcinoma (DTC).

    Science.gov (United States)

    Wen, Qiang; Ma, Qingjie; Bai, Lin; Wang, Tongtong; Han, Yuping; Zhang, Haishan

    2015-01-01

    The aim of the present study was to evaluate efficacy and side effects of glycididazole sodium (CMNa) combined with radioiodine therapy for patients with DTC cervical metastases. 53 patients of DTC cervical lymph node metastasis were randomly divided into 2 groups, where 24 cases were treated with 4.44 GBq of (131)I alone, 29 cases were treated with 800 mg/m(2) of CMNa combined with 4.44 GBq of (131)I. Peripheral blood samples were collected before and after treatment to perform measurements of routine blood test, liver function, renal function, parathyroid hormone (PTH), lymphocyte micronucleus rates and chromosome mutation. The results showed that rates of complete response (CR) in CMNa combined with radioiodine group (65.5%) were significantly higher than that in radioiodine monotherapy group (37.5%). Furthermore, CMNa combined with adioiodine treatment significantly increased the percentage of thyroglobulin (Tg) reduction at 12 weeks after treatment (P0.05). These results indicate 4.44 GBq of (131)I treatment combined with 800 mg/m(2) of CMNa could significantly improve clinical efficacy of DTC patients without increasing side effects.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

  6. Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Andersen, Ulrik Bjørn; Sørensen, Christian Hjort

    2016-01-01

    of cerebrovascular events has been reported after radioiodine therapy. This study aimed to examine whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. METHOD: Patients treated for benign thyroid disorders (nontoxic goiter, adenoma, and hyperthyroidism) were examined...... with ultrasound for the main outcome, carotid intima media thickness (CIMT), and for plaque presence (plaque presence only in late damage). Signs of early damage from radioiodine were studied in 39 radioiodine-treated patients, who were examined before treatment and at 1, 3, 6, and 12 months after treatment. Late...... were adjusted for age, sex, cholesterol, smoking status, known atherosclerotic disease, and body mass index. RESULTS: No changes in CIMT were found in the patients followed prospectively for one year after treatment with radioactive iodine for benign thyroid disease (p = 0.58). In the study on late...

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

    NARCIS (Netherlands)

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

    2003-01-01

    BACKGROUND: Justification for adjuvant radio-iodine (I-131) therapy in differentiated thyroid cancer (DTC) is purely based on retrospective data. This is true for ablative therapy and even more so for high-dosage adjuvant schedules. Randomized trials on the latter application are considered impossib

  8. Strategies of radioiodine therapy for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Lind, P. [Department of Nuclear Medicine and Endocrinology, PET Center Klagenfurt, LKH Klagenfurt (Austria)

    2002-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

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

    Directory of Open Access Journals (Sweden)

    A Dreval

    2007-09-01

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

  11. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

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

  13. Value of recombinant human thyrotropin in high-dose radioiodine therapy: a case report.

    Science.gov (United States)

    Müller, Vika; Bohuslavizki, Karl H; Klutmann, Susanne; Clausen, Malte

    2002-12-01

    We report on a high-dose radioiodine therapy after injection of recombinant human thyrotropin (rhTSH) in a 61-y-old woman with compression of the spinal cord caused by metastasis of a follicular thyroid carcinoma. Fourteen years ago, the patient underwent subtotal thyroidectomy because of multinodular goiter without any histologic evidence for malignant disease, and the patient was put on thyroxine substitution (100 micro g/d). In April 2000, she developed paralysis of the right leg. Morphologic imaging revealed spinal compression caused by a space-occupying lesion within the thoracic spine. Subsequent biopsy and histology demonstrated metastasis of a follicular thyroid carcinoma. Therefore, high-dose radioiodine therapy was scheduled after 4 wk of hormone withdrawal. Within a few days of being off thyroxine, the patient's paralytic symptoms worsened rapidly. The patient was again put on thyroxine, 100 micro g/d, and high-dose radioiodine therapy under stimulation with rhTSH was performed without any side effects. The second high-dose radioiodine therapy 3 mo later, again performed under stimulation with rhTSH, showed significantly less iodine avidity, and thyroglobulin levels fell from 1,024 micro g/L to 361 micro g/L, thereby demonstrating therapeutic efficacy. Thus, rhTSH might be used as a tool not only in the diagnostic application but also in the therapeutic application of (131)I.

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Martin A. [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland); University Hospital Basel, Division of Endocrinology, Diabetology and Clinical Nutrition, Basel (Switzerland); Christ-Crain, Mirjam; Mueller, Beat [University Hospital Basel, Division of Endocrinology, Diabetology and Clinical Nutrition, Basel (Switzerland); Schindler, Christian [University Hospital Basel, Institute of Social and Preventive Medicine, Basel (Switzerland); Mueller-Brand, Jan [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland)

    2006-06-15

    Carbimazole ameliorates hyperthyroidism but reduces radioiodine uptake and adversely affects the outcome of simultaneous radioiodine therapy. We explored whether withdrawal of carbimazole for 3 days can restore the outcome of radioiodine treatment without concurrent exacerbation of hyperthyroidism. By generating three groups with comparable radioiodine uptake, we also investigated whether the effect of carbimazole depends on the radioiodine uptake. Stratified by a radioiodine uptake >30%, 227 consecutive adult patients were prospectively assigned to radioiodine therapy (target dose 200 Gy) without, on or 3 days off carbimazole. Patients were clinically (Crooks-Wayne score) and biochemically (T{sub 3}, fT{sub 4}, TSH) followed up after 3, 6 and 12 months. Primary endpoint was outcome 12 months after radioiodine therapy. A total of 207 patients completed follow-up (toxic nodular goitre, n=117; Graves' disease, n=90). The overall success rate was 71.5%. Patients without and 3 days off carbimazole had similar biochemical (81.4% and 83.3%, respectively; p=0.82) and clinical outcomes [median (range) Crooks-Wayne score 0 (0-16) and 1 (0-10), respectively; p=0.73], which were both higher than in patients on carbimazole [42.6%, p<0.001; Crooks-Wayne score 3 (0-30), p<0.03]. Time to achieve cure was delayed on carbimazole. No changes in thyroid hormone levels occurred after 3 days' discontinuation of carbimazole. Logistic regression revealed that all observed cure rates were independent of entity, sex, age, thyroid volume, radioiodine uptake, radioiodine half-life, fT{sub 4}, T{sub 3} and TSH. (orig.)

  17. The role of radioiodine therapy in benign nodular goitre.

    Science.gov (United States)

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

    2014-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Tülay Kaçar Güvel

    2014-10-01

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

  19. Effectiveness of radioiodine therapy in treatment of hyperthyroidism.

    Science.gov (United States)

    Alam, M N; Chakrabarty, R K; Akhter, M; Nahar, N; Swapan, M K; Alam, M M; Nahar, R; Sultana, N; Hallaz, M M; Alam, M M; Uddin, M M; Hossain, M A; Yasmin, S; Islam, M R

    2013-10-01

    The present non randomized clinical trial was conducted in the Center for Nuclear Medicine and Ultrasound, Mymensingh, Bangladesh for duration of one year. Total 30 patients with hyperthyroidism diagnosed by clinical and biochemical profile were included in the study. All patients received radioiodine treatment and regular follow up at 1st month, 3rd month, 6th month & 9th month were done to evaluate clinical and biochemical status and complications. Data were analyzed by computer with SPSS programme using 't' test and chi-square test. In the present study, out of 30 respondents more than three fourth of the respondents (76.6%) were in the age group of 31-50 years followed by less than 30 years are group (16.7%) and rest of respondents were in the age group of more than 50 years (06.7%). Mean±SD and range of age of the respondents were 39.80±10.02 years and 17-65 years respectively. Among the 30 respondents 11(36.7%) were male and 19(63.3%) were female. Male to female ratio was 1:1.73. Out of 30 patients 26(86.7%) presented with goiter and among them 21(80.8%) has diffused goiter and five (19.2%) had nodular goiter. Baseline mean±SD, median, range of serum T₃ level were 5.24±3.62, 4.34, 1.48-14.65nmol/L respectively. Base line mean±SD, median range of serum T₄ level were 192.25±99.17, 201.77, 1.75-336.25nmol/L respectively. Baseline mean±SD, median range of serum TSH level were 6.33±23.93, 0.15-0.07, 130.46nmol/L respectively. In the present study serum T₃, T₄ level among the respondents sharply decrease from baseline to 2nd follow up then gradually decrease from 2nd to 4th follow up. Serum TSH level gradually increases from baseline to 3rd follow up and then gradually decreases from 3rd to 4th follow up. The result showed radioiodine is an effective option for the treatment of thyrotoxicosis.

  20. 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.)

  1. Long-term impairment of the lacrimal glands after radioiodine therapy: a cross-sectional study

    Energy Technology Data Exchange (ETDEWEB)

    Zettinig, Georg; Fueger, Barbara J.; Pirich, Christian; Dudczak, Robert [Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Wien (Austria); Ludwig Boltzmann Institute for Nuclear Medicine, University of Vienna (Austria); Hanselmayer, Georg; Nepp, Johannes [Department of Ophthalmology, University of Vienna (Austria); Hofmann, Andrea [Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Wien (Austria)

    2002-11-01

    Impairment of the lacrimal glands after external radiation has been well documented, but there are only a few reports on the effects of radioiodine therapy on the lacrimal glands. Long-term effects of high-dose radioiodine therapy on tear secretion have not previously been studied. We investigated 175 eyes of 88 patients with a history of radioiodine therapy for thyroid carcinoma (68 females, 20 males; mean age 55{+-}16 years, range 17-81 years) and compared them with a sex- and age-matched control group (n=39). All patients had been given at least 2.96 GBq iodine-131 (maximal administered activity 22.3 GBq {sup 131}I). An ophthalmological investigation was performed 64{+-}71 months (range 3-317 months) after initial radioiodine therapy by a single ophthalmologist. Lacrimal gland function was evaluated with three different function tests. External eye morphology was considered, and detailed ophthalmological history-taking was performed. Patients with factors known to affect lacrimal gland function (contact lenses, autoimmune disorders, history of additional radiation exposure) were excluded from the study. A total of 81 patients (92%) had at least one abnormal function test indicating impaired lacrimal gland function. Schirmer's tear test was decreased (<10 mm/5 min) in 47 of the 88 patients and definitely abnormal (<5 mm/5 min) in 35 patients. A tear film break-up time of <10 s was found in 78 patients, and 62 patients had a definitely abnormal break-up time of <5 s. The lacrimal lipid layer was impaired in 43 patients. The function tests were all significantly altered in the study group as compared with the controls (P<0.005, P<0.001, P<0.001, respectively). Both subjective symptoms of dry eye (P<0.01) and changes in the external eye morphology (P<0.001) were significantly more prevalent in the study group. Our findings suggest that in the majority of patients, lacrimal gland function may be permanently impaired after high-dose radioiodine therapy. All three

  2. 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.)

  3. Improved radioiodination of 1,2-dipalmitoyl-3-IPPA via a tributyltin intermediate

    Energy Technology Data Exchange (ETDEWEB)

    McPherson, D.W. E-mail: phm@oml.gov; Luo, H.; Kropp, J.; Knapp, F.F

    1999-10-01

    1,2-Palmitoyl-3-[15-(4-iodophenyl)pentadecan-3-oyl]-rac-glyceroI (MIPAG) is a new agent for the clinical evaluation of pancreatic lipase activity and has demonstrated promise in preliminary clinical studies with patients affected with pancreatic insufficiency. Iodine-131-MIPAG was initially prepared via thallium-iodide displacement. Because of the need for a simple method which is amendable for the routine clinical use of MIPAG we have investigated the preparation and radioiodination of MIPAG utilizing the tributyltin precursor, 1,2-palmitoyl-3-[15-(-4-tributylstannylphenyl)pentadecan-3-oyl] -rac-glyceroI (TBT-MIPAG, 2). Compound 2 was prepared via the condensation of 1,2-palmitoyl-rac-glycerol with 15-(4-tributylstannylphenyl)pentadecanoic acid (TBT-PPA) prepared from 4-bromophenylacetylene. Electrophilic radioiodination using peracetic acid with sodium iodide-125 in ethanol at 80 deg. C for 60 min afforded I-125-MIPAG in 65.9% ({+-}11.5%) yield and radiochemical purity of 94% ({+-}3.0%) after C-18 Sep-Pak purification (n=6). This improved method for radioiodination utilizing TBT-MIPAG now provides radioiodinated MIPAG for routine clinical evaluation.

  4. Influencing factors of radioiodine therapy in hyperthyroidism in adults

    Institute of Scientific and Technical Information of China (English)

    XU Jiehua; ZHANG Zikang; CHENG Muhua; WANG Ping; WU Chunxing; SHAN Hong

    2007-01-01

    The study was to evaluate factors affecting outcome of 131I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131I treatment from July 2003 to July 2005 in our department were retrospectively analyzed. Factors possibly contributing to the outcome of the 131I therapy were analyzed, including gender, age, history of antithyroid drug, thyroid volume, duration of disease and radioactive iodine uptake rate. Multivariate analysis was done. The rates of euthyroidism and hypothyroidism were 69% and 8.5%, respectively, after one time 131I therapy. Multivariate analysis of the patients showed no statistically significant factors affecting the outcome of 131I therapy. The study showed that 131I dose can be directly calculated, and this simplifies the dose-determined method and individualizes the therapy.

  5. Radioiodine-131 therapy improves sex hormones and sexual function in male patients with Graves'disease%131I治疗Graves甲亢对男性患者性激素及性功能的影响

    Institute of Scientific and Technical Information of China (English)

    王世俊; 晋建华; 徐计秀; 武志芳; 陆克义; 李聪革; 雷智莉; 李思进

    2012-01-01

    目的:观察放射性131I治疗男性Graves甲亢患者早期血清性激素和性功能的变化. 方法:男性Graves甲亢患者34例,年龄21~40(32.3±6.7)岁,给予131I治疗剂量为111-407(237.8±51.8)MBq,在131I治疗前及治疗后3、6个月分别检测血清甲状腺激素及性激素,同时对患者进行勃起功能问卷评分(IIEF-5)调查.用同期体检的健康男性20例作为对照,年龄25 ~37(31±3.1)岁. 结果:男性Graves甲亢患者雌激素、睾酮、促黄体生成素水平分别为(132.5±40.4)pmol/L、(21.6±4.6)nmol/L、(10.1±4.4)IU/L,明显高于健康对照组的(80.4±31.2)pmol/L、(14.5 ±4.2)nmol/L、(6.2±1.9)IU/L(P<0.05).131I治疗3个月后血清雌激素、睾酮水平为(110.2±20.6)pmol/L、(17.7±5.5)nmol/L,较治疗前明显下降(P<O.05).治疗6个月后雌激素、睾酮、促黄体生成素水平为(82.6±30.1)pmol/L、(13.8±3.4)nmol/L、(6.6±1.5)IU/L,与健康对照组相比无差别(P>0.05).男性Graves甲亢患者IIEF-5评分为5~25(15.5±3.5)分,明显低于对照组的19 ~25(24.5±0.5)分(P<0.05).131I治疗后6个月组为10 ~25(23.5±1.5)分,明显高于3个月组的8~25(19.5±1.0)分(P<0.05).结论:男性Graves甲亢患者雌激素、睾酮、促黄体生成素水平明显增高,性功能评分(IIEF-5)明显降低.使用131I治疗6个月后,患者血清睾酮、促黄体生成素,雌激素水平以及IIEF-5评分基本恢复正常.Graves甲亢患者使用131I治疗可明显改善其性功能.%Objective: To observe the changes of sex hormones and sexual function in male patients with Graves'disease (CD) after Radioiodine-131 (1-131) therapy. Methods-. Thirty-four male GD patients, aged 21 -40 (32.3 ±6.7) years, were treated with 1-131 at the dose of 111 -407 (237.8 ±51.8) MBq. The levels of serum sex hormones were measured, and the patients'scores on erectile function (IIEF-5) were obtained before and 3 and 6 months after the treatment. Another 20 healthy men aged 25-37 (31 ±3

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Spesshardt, K. (Sankt-Vincentius-Krankenhaeuser, Karlsruhe (Germany, F.R.). Radiologische Abt. mit Strahlentherapie und Nuklearmedizin)

    1980-10-15

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

  8. Gastrointestinal Side Effects of the Radioiodine Therapy for the Patients with Differentiated Thyroid Carcinoma Two Days after Prescription

    Science.gov (United States)

    Pashnehsaz, Mehran; Takavar, Abbas; Izadyar, Sina; Zakariaee, Seyed Salman; Mahmoudi, Mahmoud; Paydar, Reza; Geramifar, Parham

    2016-01-01

    Iodine-131 (I-131) therapy is one of the conventional approaches in the treatment of patients with differentiated thyroid carcinoma (DTC). The radioiodine agents also accumulate in the other organs that cause pain and damage to the patients. Radioiodine therapy is associated with various gastrointestinal (GI) toxicities. In this study, GI side effects of the radioiodine therapy were investigated. GI toxicities of the radioiodine therapy were studied in 137 patients with histologically proven DTC in Jun-Nov 2014. All the patients were treated by radioiodine agents in the research institute of Shariati Hospital, Tehran, Iran. The patients were examined 48 h after prescription (before discharge) and their GI side effects were registered. Correlation of the age, gender, administered dose, administered dose per body weight as the independent factors, and GI side effects were analyzed using the Pearson correlation test with Statistical Package for the Social Sciences (SPSS) version 20. Regression coefficients and linearity of the variable were investigated by MATLAB software. Line fitting was performed using MATLAB curve-fitting toolbox. From the subjects, 38 patients had GI complaints (30.4%). Significant factors influencing GI side effects were dose per body weight and administered doses. There was no significant correlation between age and gender as the independent parameters and GI complaints. The most prevalent GI side effect was nausea that occurs in 26.4% of the patients. From the results, it could be concluded that the GI side effects could be prevented by administering a safe radioiodine dose value less than 5,550 MBq. PMID:27651737

  9. Radiation protection measures for the reduction of incorporation for personnel during radioiodine therapy; Strahlenschutzmassnahmen zur Verringerung der Inkorporation beim Personal waehrend der Radiojodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Petzold, J. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Alborzi, H.; Keller, A.; Lincke, T.; Meyer, K.; Petzold, L.; Sabri, O.; Schoenmuth, T.

    2008-07-01

    As a result of extensive measurements of Radioiodine concentration in the room air and in the breathing air of the patients in a Radioiodine therapy station, simple radiation-hygenic measures are developed and described that lead to a considerable reduction of Iodine incorporation and with it of the effective dose for the nursing personnel. (orig.)

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    Context and Objective: Stimulation with recombinant human TSH (rhTSH) before radioiodine ((131)I) therapy augments goiter volume reduction (GVR). Observations indicate that rhTSH has a preconditioning effect beyond increasing thyroid (131)I uptake. We test the hypothesis that an equivalent GVR...

  11. Radiation protection of patients and staff during radioiodine therapy; Strahlenschutz von Patient und Personal bei der Radiojodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Baldauf, D.; Schueler, W.; Winkler, B. [STEP Sensortechnik und Elektronik Pockau GmbH, Pockau (Germany); Petzold, J.; Lincke, T.; Sabri, O.; Sattler, B.; Seese, A. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2008-07-01

    A measuring system for continuous assessment of local dose rate in the environment of radioiodine therapy patients is presented that allows statements on doses reached in the target area with high statistical reliability. Furthermore, this kind of measurement leads to a noticeable reduction of external radiation exposure for the group of medical personnel involved. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Wojciech Barud

    2014-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-02-15

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

  15. Telomerase reverse transcriptase promoter-driven expression of iodine pump genes for targeted radioiodine therapy of malignant glioma cells

    Institute of Scientific and Technical Information of China (English)

    Jian Tan; Wei Li; Peng Wang

    2011-01-01

    Radioiodine is a routine therapy for differentiated thyroid cancers. Non-thyroid cancers can intake radioiodine after transfection of the human sodium iodide symporter (hNIS) gene. The human telomerase reverse transcriptase (hTERT) promoter, an excellent tumor-specific promoter, has potential value for targeted gene therapy of glioma. We used the hTERT promoter to drive the expression of the hNIS and human thyroid peroxidase (hTPO) gene as a primary step for testing the effects of radioiodine therapy on malignant glioma. The U87 and U251 cells were co-transfected with two adenoviral vectors, in which the hNIS gene had been coupled to the hTERT promoter and the hTPO gene had been coupled to the CMV promoter, respectively. Then, we performed Western blot, 135l intake and efflux assays, and clonogenic assay with cancer cells. We also did 99mTc tumor imaging of nude mice models. After co-transfection with Ad-hTERT-hNIS and Ad-CMV-hTPO, glioma cells showed the 125l intake almost 1.5 times higher than cells transfected with Ad-hTERT-hNIS alone. Western blots revealed bands of approximately 70 kDa and 110 kDa, consistent with the hNIS and hTPO proteins. In clonogenic assay, approximately 90% of co transfected cells were killed, compared to 50% of control cells after incubated with 37 MBq of 131I. These results demonstrated that radioiodine therapy was effective in treating malignant glioma cell lines following induction of tumor-specific iodide intake by the hTERT promoter-directed hNIS expression in vitro. Co transfected hNIS and hTPO genes can result in increased intake and longer retention of radioiodine. Nude mice harboring xenografts transfected with Ad-hTERT-NIS can take 99mTc scans.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-15

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

  17. Radioiodine therapy of benign thyroid diseases: Graves' disease - current aspects; Radioiodtherapie gutartiger Schilddruesenerkrankungen: Morbus Basedow - aktuelle Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, M.J. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Bonn (Germany)

    2005-06-01

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

  18. Radioiodine therapy in patients with Graves' disease; Radioiodoterapia em pacientes com doenca de Basedow-Graves

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Margarida Maria Galvao; Blum, Bernardo; Pellegrini, Paulo Martins [Instituto Brasileiro de Medicina Nuclear, Rio de Janeiro, RJ (Brazil); Corbo, Rossana [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Rebello, Ana Maria de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    2000-04-01

    We studied retrospectively 104 patients with Graves' disease who underwent radioiodine therapy between 1983 and 1993. The administered dose varied from 2.0 to 9.0 mCi (74 to 333 MBq). In 1994 and 1998 the patients were asked to answer a questionnaire and were considered to have hypothyroidism when receiving T4 therapy. The importance of radioiodine therapy, its indications and the different methods of calculating the administered activity were studied. The results were compared with the literature. At the end of the evaluation, 62,4% of the patients presented hypothyroidism and 37,6% euthyroidism. There was no significant difference regarding the development of hypothyroidism when sex, number of doses, total activity (mCi), effective radiation ({mu}Ci per gram of tissue) and use of antithyroid drugs were considered. In conclusion, the period of time of post-radioiodine therapy is the most important factor in the analysis of the results, which may interfere with the development of hypothyroidism. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-06-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

  2. Cytogenetic effects of radioiodine therapy: a 20-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, Gordon K. [Oak Ridge Institute for Science and Education, Radiation Emergency Assistance Center/Training Site, Oak Ridge, TN (United States); Khvostunov, Igor K. [Medical Radiological Research Center, Obninsk, Kaluga Region (Russian Federation); Gregoire, Eric [Institut de Radioprotection et de Surete Nucleaire, PRP-HOM/SRBE/LDB, BP 17, Fontenay aux roses Cedex (France); Barquinero, Joan-Francesc [Universtitat Autonoma de Barcelona, Facultat de Biociencies, Cerdanyola del Valles (Spain); Shi, Lin; Tashiro, Satoshi [Hiroshima University, Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima (Japan)

    2016-05-15

    The purpose of this study was to compare cytogenetic data in a patient before and after treatment with radioiodine to evaluate the assays in the context of biological dosimetry. We studied a 34-year-old male patient who underwent a total thyroidectomy followed by ablation therapy with {sup 131}I (19.28 GBq) for a papillary thyroid carcinoma. The patient provided blood samples before treatment and then serial samples at monthly intervals during the first year period and quarterly intervals for 5 years and finally 20 years after treatment. A micronucleus assay, dicentric assay, FISH method and G-banding were used to detect and measure DNA damage in circulating peripheral blood lymphocytes of the patient. The results showed that radiation-induced cytogenetic effects persisted for many years after treatment as shown by elevated micronuclei and chromosome aberrations as a result of exposure to {sup 131}I. At 5 years after treatment, the micronucleus count was tenfold higher than the pre-exposure frequency. Shortly after the treatment, micronucleus counts produced a dose estimate of 0.47 ± 0.09 Gy. The dose to the patient evaluated retrospectively using FISH-measured translocations was 0.70 ± 0.16 Gy. Overall, our results show that the micronucleus assay is a retrospective biomarker of low-dose radiation exposure. However, this method is not able to determine local dose to the target tissue which in this case was any residual thyroid cells plus metastases of thyroidal origin. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

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

  5. Parathyroid gland function after radioiodine ((131)I) therapy for toxic and non-toxic goitre.

    Science.gov (United States)

    Szumowski, Piotr; Abdelrazek, Saeid; Mojsak, Małgorzata; Rogowski, Franciszek; Kociura-Sawicka, Agnieszka; Myśliwiec, Janusz

    2013-01-01

    The therapeutic effect of radioactive iodine ((131)I) on benign goitre consists of the emission of tissue-destructive beta-radiation. Since the range of beta (131)I radiation in tissue can reach 2.4 mm, it can affect the adjacent parathyroid glands. The purpose of this paper is to assess parathyroid function in patients with toxic and non-toxic goitres, up to five years following (131)I therapy. The study sample consisted of 325 patients with benign goitres (220 with toxic nodular goitre (TNG), 25 with non-toxic nodular goitre (NTNG), and 80 with Graves' disease (GD) treated with (131)I. The therapeutic activity of (131)I for each patient was calculated using Marinelli's formula. The serum levels of fT3, fT4, TSH, iPTH and Ca(2+), Ca and phosphates were determined one week before (131)I administration, as well as every two months up to a year following the therapy, and then after three and five years post-treatment. After two months following the administration of (131)I, all the treated patients showed a statistically significant above normal increase in iPTH concentrations (amounting to a value almost twice the norm in patients with TNG), which remained stable up to ten months after treatment, to return to normal level in the following months. In all the patients, Ca(2+), Ca, phosphates concentration remained within normal range throughout the course of the study. The concentrations of fT3 and fT4 quickly returned to normal after (131)I administration, and remained within normal range until the completion of the study. Radioiodine treatment of benign thyroid disorders results in transient (up to ten months after (131)I administration) hyperparathyroidism. The condition does not influence the level of calcium and phosphates concentration in any significant way.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  7. Improvement of goiter volume reduction after 0.3 mg recombinant human thyrotropin-stimulated radioiodine therapy in patients with a very large goiter: a double-blinded, randomized trial

    DEFF Research Database (Denmark)

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

    2007-01-01

    INTRODUCTION: The effect of (131)I therapy amplification by recombinant human (rh) TSH prestimulation in very large goiters has not been evaluated in a double-blinded, placebo-controlled study. METHODS: Twenty-nine patients (22 females; age range 37-87 yr) with a large multinodular goiter (median...... the reduction of very large goiters by more than 50%, compared with (131)I therapy alone, but at the expense of more adverse effects after therapy. Our data suggest that rhTSH stimulation may work through mechanisms that go beyond the increase in thyroid (131)I uptake...

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

    Energy Technology Data Exchange (ETDEWEB)

    Joensson, Helene

    2003-10-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    to radiation and is capable of inducing atherosclerosis. The objective of the study was to elucidate whether ionizing radiation from radioiodine might contribute to cerebrovascular morbidity. METHODS: In a retrospective register cohort study, 4000 hyperthyroid and 1022 euthyroid goitre patients treated...

  10. Embolization in combination with radioiodine therapy for bone metastases from differentiated thyroid carcinoma

    NARCIS (Netherlands)

    van Tol, KM; Hew, JM; Jager, PL; Vermey, A; Dullaart, RPF; Links, TP

    2000-01-01

    BACKGROUND The outcome for patients with bone metastases from differentiated thyroid carcinoma is worse compared to the overall prognosis of patients with differentiated thyroid carcinoma. The aim of this study is to evaluate the effect of embolization with concomitant radioiodine treatment on the s

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-02-01

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

  14. Survival outcome of radioiodine therapy in post thyroidectomy thyroid carcinoma patients: Outcome of long term follow up

    Science.gov (United States)

    Haque, F.; Nahar, N.; Sultana, S.; Nasreen, F.; Jabin, Z.; Alam, A. S. M. M.

    2016-03-01

    The overall prognosis of patients with thyroid carcinoma is excellent whenever managed following best practice guidelines. Objective: To calculate sex and age group affected by thyroid cancer; to compare between single or multiple dose of radio ablation needed after thyroidectomy and to determine the percentage of patients become disease free during their follow up. Methods: This was a retrospective study done in NINMAS, Bangladesh on 687 patients from 1984 to 2004. In all cases total or near total thyroidectomy was done before commencing radioiodine therapy. Patients TG level, neck ultrasonography, thyroid scan, whole body I131 scans, neck examination were done every six monthly/yearly. Results: Among 687 patients, female were more sufferers (68.1%) and female to male ratio was 2:1. Age group 19-40 years was mostly affected (57.8%). Most common type seen was papillary carcinoma (81.8%). After ablation 100 patients did not follow-up. Total 237 patients discontinued within 4 years. Remaining 450 patients undergone regular follow-up for 5 years and more, 394 were disease free (87.6%). Total recurrence of metastasis was 23 and 12 patients expired at different times. Conclusions: Long-term regular follow-up is necessary after radioiodine ablation to become free of disease.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

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

    Directory of Open Access Journals (Sweden)

    Nalini Sindy Perumal

    2010-03-01

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

  18. Prognostic Value of Tc99m-Pertechnetate Thyroid Scintigraphy in Radioiodine Therapy in a Cohort of Chinese Graves’ Disease Patients: A Pilot Clinical Study

    Directory of Open Access Journals (Sweden)

    Haifeng Hou

    2015-01-01

    Full Text Available Objectives. This study is to assess the prognostic value of Tc99m-pertechnetate thyroid scintigraphy for predicting the outcomes of fixed low dose of radioiodine therapy (RIT in a cohort of Chinese Graves’ disease (GD patients. Materials and Methods. This is a retrospective study of GD patients who received RIT with a single dose of radioiodine (5 mCi. All the patients received Tc99m-pertechnetate thyroid scintigraphy prior to RIT. Thyroid mass, Tc99m-pertechnetate uptake, gender, age at diagnosis, duration of the disease, ophthalmopathy, and serum levels of FT4, FT3, TT4, and TT3 prior to RIT were analyzed as potential interference factors for outcomes of RIT. Results. One hundred and eighteen GD patients who completed RIT were followed up for 12 months. The outcomes (euthyroidism, hypothyroidism, and hyperthyroidism were found to be significantly associated with thyroid mass and Tc99m-pertechnetate uptake. Patients with thyroid mass ≤ 40.1 g or Tc99m-pertechnetate uptake ≤ 15.2% had higher treatment success. Conclusions. A fixed low dose of 5 mCi radioiodine seems to be practical and effective for the treatment of Chinese GD patients with thyroid mass ≤ 40.1 g and Tc99m-pertechnetate uptake ≤ 15.2%. This study demonstrates Tc99m-pertechnetate thyroid scintigraphy is an important prognostic factor for predicting the outcomes of RIT.

  19. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    Science.gov (United States)

    Wartofsky, L

    1997-04-01

    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

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

    Science.gov (United States)

    Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Hegedüs, Laszlo

    2009-01-01

    PURPOSE OF REVIEW: There is no consensus on the ideal treatment of patients with a benign nontoxic multinodular goiter. In some European countries, (131)I therapy has replaced surgery as the treatment of choice in these patients. Recombinant human thyrotropin (rhTSH) is a very potent stimulator o...... effective than (131)I therapy without rhTSH. However, no trial has yet compared (131)I therapy and surgery head-to-head, and future trials should include evaluation of quality of life and cost....

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Rivkees ScottA

    2010-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-05-01

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

  6. Dry Distillation of Radioiodine from TeO2 Targets

    OpenAIRE

    Jacek Koziorowski; Jesper Fonslet

    2013-01-01

    As medical cyclotrons are becoming more abundant, 123I and 124I are getting more attention as alternatives to 131I for diagnostics of thyroid disease. Both 123I and 124I provide better diagnostics, deliver less dose to patients and both reduce the risk of thyroid stunning, facilitating subsequent therapy. Dry distillation of radioiodine from tellurium dioxide targets has become the standard approach to producing these radioiodines. Setting up such a production of radioiodine is associated wit...

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

    Energy Technology Data Exchange (ETDEWEB)

    Calegaro, Jose Ulisses Manzzini; Teixeira, Sandra Mara Pessano [Hospital de Base do Distrito Federal, Brasilia, DF (Brazil). Centro de Medicina Nuclear]. E-mail: jcalegaro@uol.com.br

    2007-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

    Science.gov (United States)

    Papastavrou, Evridiki; Frangos, Savvas; Tamana, Panayiota

    2016-01-01

    Purpose. To systematically review clinical studies examining the effectiveness of nonpharmacological methods to prevent/minimize salivary gland damage due to radioiodine treatment of differentiated thyroid carcinoma (DTC). Methods. Reports on relevant trials were identified by searching the PubMed, CINHAL, Cochrane, and Scopus electronic databases covering the period 01/2000–10/2015. Inclusion/exclusion criteria were prespecified. Search yielded eight studies that were reviewed by four of the present authors. Results. Nonpharmacological methods used in trials may reduce salivary gland damage induced by radioiodine. Sialogogues such as lemon candy, vitamin E, lemon juice, and lemon slice reduced such damage significantly (p DTC. However, the studies retrieved were limited in number, sample size, strength of evidence, and generalizability. More randomized controlled trials of these methods with multicenter scope and larger sample sizes will provide more systematic and reliable results allowing more definitive conclusions. PMID:27446226

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

    OpenAIRE

    Bin Long; Linfa Li; Lifang Yao; Shoucong Chen; Heqing Yi; Xuemei Ye; Dong Xu; Peng Wu

    2015-01-01

    Purpose: To determine whether postoperative radioiodine (RAI) combined with radiofrequency ablation (RFA) is an effective, safe, and feasible method for elimination of excessive postsurgical thyroid remnant for differentiated thyroid carcinoma (DTC). Materials and Methods: We took a prospective study and treated 12 DTC patients (4 males, 8 females, age 20–78 years) who underwent thyroidectomy for RFA followed by 131 I ablation. The pretreatment requires iodine-free diet and thyroid hormone...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-04-01

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

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

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedus, Laszlo; Pacini, Furio

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-01

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

  14. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of {sup 99m}Tc-pertechnetate thyroid uptake

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger [Department of Nuclear Medicine, University Hospital Bonn (Germany); Joe, Alexius; Zimmerlin, Martina [Department of Nuclear Medicine, University Hospital Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

    2002-04-01

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

  15. Radioiodine treatment for non-toxic goitre

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla

    2009-01-01

    There is no ideal treatment for benign multinodular goitre. Besides surgery, which is recommended for large goitres or when malignancy cannot be excluded, the non-surgical treatment options are levothyroxine therapy and radioiodine ((131)I) therapy. Conventional (131)I therapy [without recombinant...... human thyroid-stimulating hormone (rhTSH)] has been used for more than a decade in symptomatic non-toxic multinodular goitre, and although it does lead to significant thyroid volume reduction, relatively high activities of radioiodine are needed because of a frequent finding of a low thyroid radioiodine...... in multinodular goitre, aspects of this association, such as the cost-benefit and optimum rhTSH dose and safety, will have to be sufficiently clarified....

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    OBJECTIVE: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules. DESIGN: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized...... at inclusion and at 1, 3 and 6 months after treatment. RESULTS: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the (131)I group (P=0.0025). In the ILP group, mean thyroid nodule volume reduction was 44+/-5% (s.e.m.; P

  17. Cost-effectiveness-analysis: radioiodine or antithyroid drugs as first-line therapy of hyperthyroidism due to Graves` disease; Kosten-Effektivitaets-Analyse: Radioiod oder thyreostatische Medikation bei der Primaerbehandlung der Immunhyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Moka, D.; Dederichs, B.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hunsche, E.; Lauterbach, K.W. [Koeln Univ. (Germany). Inst. fuer Gesundheitsoekonomie, Medizin und Gesellschaft

    1999-06-01

    Aim: As first-line therapy of hyperthyroidism caused by Graves` disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. Method: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq I-131 residual activity. Result: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. Conclusion: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake). (orig.) [Deutsch] Ziel: Die Erstmanifestation einer Immunhyperthyreose wird in Europa ueberwiegend thyreostatisch, in den USA mehrheitlich mit Radioiod definitiv behandelt. Diese beiden Alternativen wurden auf dem Hintergrund neuer nationaler Entlassungsrichtwerte nach einer Radioiodtherapie (RITh) verglichen. Methode: Aus Sicht der Gesellschaft entscheiden einerseits die langfristigen Rezidivraten, andererseits die Menge medizinischer Leistungen, der Versicherungsstatus und der Produktivitaetsausfall des Patienten (Fehlzeiten, Einkommen) sowie die zeitliche Verteilung der Kosten (Diskontierung) ueber die Kosten

  18. Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of {sup 99m}Tc-pertechnetate: applicability to unifocal thyroid autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Joe, Alexius Y. [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Wissmeyer, Michael [Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland); Juengling, Freimut D.; Krause, Thomas M. [University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland)

    2006-05-15

    The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on {sup 99m}Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1{+-}10.3 years) with unifocal thyroid autonomy were treated at three different centres with {sup 131}I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU{sub s} (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36{+-}19% and 38{+-}20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28{+-}16%; p<0.01). A dose strategy based on the TcTU{sub s} can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

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

    Directory of Open Access Journals (Sweden)

    N V Severskaya

    2013-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Byoung Kuk; Lee, You La; Lee, Yong Jin [School of Medicine, Kyungpook National University, Daegu (Korea, Republic of)] (and others)

    2008-10-15

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

  1. Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs; Radioiodtherapie des Morbus Basedow - dosimetrischer Vergleich verschiedener Therapieregime bezueglich der Thyreostatikabgabe

    Energy Technology Data Exchange (ETDEWEB)

    Urbannek, V.; Voth, E.; Moka, D.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Medizinische Einrichtungen der Univ. zu Koeln (Germany)

    2001-08-01

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

  2. Effective method of measuring the radioactivity of [131I]-capsule prior to radioiodine therapy with significant reduction of the radiation exposure to the medical staff.

    Science.gov (United States)

    Lützen, Ulf; Zhao, Yi; Marx, Malies; Imme, Thea; Assam, Isong; Siebert, Frank-Andre; Culman, Juaraj; Zuhayra, Maaz

    2016-01-01

    Radiation Protection in Radiology, Nuclear Medicine and Radio Oncology is of the utmost importance. Radioiodine therapy is a frequently used and effective method for the treatment of thyroid disease. Prior to each therapy the radioactivity of the [131I]-capsule must be determined to prevent misadministration. This leads to a significant radiation exposure to the staff. We describe an alternative method, allowing a considerable reduction of the radiation exposure. Two [131I]-capsules (A01 = 2818.5; A02 = 7355.0 MBq) were measured multiple times in their own delivery lead containers - that is to say, [131I]-capsules remain inside the containers during the measurements (shielded measurement) using a dose calibrator and a well-type and a thyroid uptake probe. The results of the shielded measurements were correlated linearly with the [131I]-capsules radioactivity to create calibration curves for the used devices. Additional radioactivity measurements of 50 [131I]-capsules of different radioactivities were done to validate the shielded measuring method. The personal skin dose rate (HP(0.07)) was determined using calibrated thermo luminescent dosimeters. The determination coefficients for the calibration curves were R2 > 0.9980 for all devices. The relative uncertainty of the shielded measurement was radioactivity.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jentzen, Walter; Schmitz, Jochen; Freudenberg, Lutz; Eising, Ernst; Bockisch, Andreas; Stahl, Alexander [Universitaet Duisburg-Essen, Klinik fuer Nuklearmedizin, Essen (Germany); Balschuweit, Dorothee; Hilbel, Thomas [Fachhochschule Gelsenkirchen, Fachbereich Physikalische Technik, Gelsenkirchen (Germany)

    2010-12-15

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

  4. Extrathyroidal Radioiodine Accumulation in a Fibroadenoma of the Breast.

    Science.gov (United States)

    Kim, Myoung Hyoun; Kim, Hun Soo; Park, Soon-Ah

    2017-02-01

    A 45-year-old woman with a differentiated thyroid carcinoma received adjuvant radioiodine therapy following total thyroidectomy and left modified radical neck dissection. A posttherapy planar radioiodine scan showed multifocal uptake in the thyroid bed and left chest. SPECT/CT revealed a fibroadenoma in the left breast. Six months later, an I scan showed no iodine avidity in the breast fibroadenoma, whereas ultrasonography showed no significant change in the size of the fibroadenoma. Altered radioiodine uptake of a breast fibroadenoma can be observed on follow-up scans after cytotoxic radioiodide treatment in patients with differentiated thyroid carcinoma.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

    suggests that RAI therapy might improve the general clinical outcome in this patient group. (orig.)

  6. Radioiodinated branched carbohydrates

    Science.gov (United States)

    Goodman, Mark M.; Knapp, Jr., Furn F.

    1989-01-01

    A radioiodinated branched carbohydrate for tissue imaging. Iodine-123 is stabilized in the compound by attaching it to a vinyl functional group that is on the carbohydrate. The compound exhibits good uptake and retention and is promising in the development of radiopharmaceuticals for brain, heart and tumor imaging.

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

    Directory of Open Access Journals (Sweden)

    Bin Long

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Little is known about the whole body oxidative stress burden following radioactive iodine ((131)I) therapy of thyroid diseases. METHODS: We studied 17 patients with benign nodular goiter treated with (131)I therapy. The targeted thyroid dose was 50 Gy in 11 patients pretreated with 0....... in the thyroid gland, but the study supports that (131)I therapy of benign nodular goiter carries no or only a minute risk of developing subsequent malignancies. It remains to be explored whether our findings also apply to hyperthyroid disorders.......BACKGROUND: Little is known about the whole body oxidative stress burden following radioactive iodine ((131)I) therapy of thyroid diseases. METHODS: We studied 17 patients with benign nodular goiter treated with (131)I therapy. The targeted thyroid dose was 50 Gy in 11 patients pretreated with 0.......1 mg of recombinant human TSH (rhTSH). In 6 patients, the applied thyroid dose was 100 Gy without rhTSH prestimulation. Well-established biomarkers of oxidative stress to RNA (8-oxo-7,8-dihydroguanosine; 8-oxoGuo) and DNA (8-oxo-7,8-dihydro-2'-deoxyguanosine; 8-oxodG) were measured in freshly voided...

  10. Efeitos agudos laringológicos e vocais da radioiodoterapia em pacientes com hipertireoidismo por doença de Basedow Graves Acute effects of radioiodine therapy on the voice and larynx of Basedow-Graves patients

    Directory of Open Access Journals (Sweden)

    Roberta Werlang Isolan-Cury

    2008-04-01

    Full Text Available A Doença de Graves constitui a forma mais comum de hipertireoidismo e três abordagens terapêuticas são atualmente utilizadas: uso de medicamentos antitireoideanos, cirurgia e iodo radioativo (I 131. Os efeitos do o I 131 e a indução precoce de hipotireoidismo são conseqüências da destruição induzida do I131 sobre o parênquima tireoideano. São poucos relatos encontrados na literatura acerca dos efeitos da radioioterapia sobre a laringe e conseqüentemente na produção vocal. OBJETIVO: Avaliar os efeitos agudos sobre a voz da radioiodoterapia em pacientes com hipertireoidismo por Doença de Basedow Graves. MATERIAL E MÉTODO: Estudo de corte contemporâneo longitudinal, prospectivo. Procedimentos: Investigação vocal, mensuração do tempo máximo fonatório de /a/ e relação s/z, análise freqüência fundamental (Software Praat, laringoscopia e análise perceptivo-auditiva em três momentos: pré-dose, 4 dias e 20 dias pós dose. Momentos baseados no perfil inflamatório do tecido tireoideano. RESULTADOS: Não houve mudanças estatisticamente significantes nos aspectos vocais e laringológicos nos três momentos avaliados. CONCLUSÃO: A radioiodoterapia não afeta a qualidade vocal.Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131. There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim and the AIM: os this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. MATERIAL AND METHOD: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/ and the s/z ratio, fundamental frequency analysis (Praat software, laringoscopy and (perceptive-auditory analysis in three different conditions: pre-treatment, 4 days, and

  11. Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma - A systematic review

    NARCIS (Netherlands)

    Clement, S. C.; Peeters, R. P.; Ronckers, C. M.; Links, T. P.; van den Heuvel-Eibrink, M. M.; van Dijkum, E. J. M. Nieveen; van Rijn, R. R.; van der Pal, H. J. H.; Neggers, S. J.; Kremer, L. C. M.; van Eck-Smit, B. L. F.; van Santen, H. M.

    2015-01-01

    Background: Treatment of differentiated thyroid carcinoma (DTC) often involves administration of radioactive iodine (I-131) for remnant ablation or adjuvant therapy. As DTC has favorable outcome and the incidence is increasing, concerns have been raised about the possible adverse effects of I-131 th

  12. Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma - A systematic review

    NARCIS (Netherlands)

    Clement, S C; Peeters, R P; Ronckers, C M; Links, T P; van den Heuvel-Eibrink, M M; Nieveen van Dijkum, E J M; van Rijn, R R; van der Pal, H J H; Neggers, S J; Kremer, L C M; van Eck-Smit, B L F; van Santen, H M

    2015-01-01

    BACKGROUND: Treatment of differentiated thyroid carcinoma (DTC) often involves administration of radioactive iodine (I-131) for remnant ablation or adjuvant therapy. As DTC has favorable outcome and the incidence is increasing, concerns have been raised about the possible adverse effects of I-131 th

  13. Procedure guideline for radioiodine therapy and {sup 131}iodine whole-body scintigraphy in paediatric patients with differentiated thyroid cancer; Verfahrensanweisung zur Radioiodtherapie und {sup 131}I-Ganzkoerperszintigraphie bei differenzierten Schilddruesenkarzinomen im Kindes- und Jugendalter

    Energy Technology Data Exchange (ETDEWEB)

    Franzius, C.; Schober, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dietlein, M. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Biermann, M. [Haukeland University Hospital, Bergen (Norway). Nuclear Medicine and PET-Center; Bergen Univ. (Norway). Dept. of Surgical Sciences; Fruehwald, M.; Linden, T. [Universitaetsklinikum Muenster (Germany). Klinik und Poliklinik fuer Kinderheilkunde; Bucsky, P. [Luebeck Univ. (Germany). Haematologie, Onkologie und Immunologie der Klinik fuer Kinder- und Jugendmedizin; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    The procedure guideline for radioiodine ({sup 131}I) therapy and {sup 131}I whole-body scintigraphy of differentiated thyroid cancer in paediatric patients is the counterpart to the procedure guidelines (version 3) for adult patients and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Characteristics of thyroid cancer in children are the higher aggressiveness of papillary thyroid cancer, the higher frequency of extrathyroidal extension and of disseminated pulmonary metastases as well as the high risk of local recurrences. Radioiodine therapy is generally recommended in children, the {sup 131}I activity depends on the children's body weight. Radioiodine ablation in children with small papillary cancer ({<=}1 cm) should be considered. TSH stimulation is reached two weeks (children) or three weeks (adolescents) after withdrawal of thyroid hormones. Anti-emetic drugs are highly recommended. CT of the chest and examination of pulmonary function are clearly indicated if there is any suspicion on metastases. 3-6 months after {sup 131}I ablation, the {sup 131}I whole-body scintigraphy is highly recommended as lymph node metastases are frequently detected in paediatric patients. Follow-up care should be arranged in shorter intervals than in adults to test the compliance and to adapt dosage of thyroid hormones to the children's body weight. Reference values of fT3 are higher in children than in adults. Evidence is insufficient to describe in which constellation the TSH may be kept within the low normal level. Therefore, TSH suppression is generally recommended. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-10-15

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

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part; Radioiodtherapie bei kombinierter Schilddruesenautonomie. Ergebnisse nach Korrektur fuer disseminierte Anteile

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J. [Klinik fuer Nuklearmedizin, Klinikum Augsburg (Germany); Wengenmair, H.; Kopp, J. [Medizinische Physik und Strahlenschutz, Klinikum Augsburg (Germany)

    2006-07-01

    Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

  19. Novel radioiodinated neuroreceptor ligands

    Energy Technology Data Exchange (ETDEWEB)

    Musachio, J.L.

    1993-01-01

    Since many bioactive compounds do not readily undergo direct labeling with radioisotopes of iodine, the novel prosthetic groups, p-toluenesulfonate esters of (E)- and (Z)-3-(tri-n-butylstannyl)prop-2-en-1-ol, were designed to complement existing methods for radioiodine incorporation. The preparation and synthetic utility of these bifunctional reagents are described. These vinylstannylated alkylating agents were coupled with nucleophilic functionalities (amide nitrogen, secondary amine, tertiary alcohol) in acceptable to excellent yields. Regio- and stereospecific radioiododestannylation with retention of configuration occurred under mild, no-carrier-added conditions to give the corresponding radiolabeled N- or O-iodoallyl analogs in good radiochemical yields with high specific radioactivities. The methodology is versatile and well-suited to selective labeling of small molecules with radioisotopes of iodine. Of particular importance are the N-iodoallyl analogs of spiperone and the O-iodoallyl analog of diprenorphine for in vitro and in vivo studies of dopamine D[sub 2] and opioid receptors. For in vivo studies of central serotonin 5-HT[sub 2] receptors via single photon emission computed tomography (SPECT), novel radioiodinated N1-alkyl-2-iodo-LSD derivatives were synthesized. These target radioligands were prepared in moderate radiochemical yields. D-(+)-N1-ethyl-2-iodo-LSD, EIL, was identified as the most promising candidate of this series. [[sup 125]I]-EIL binds to central 5-HT[sub 2] receptors with high affinity and selectivity in vitro and labels 5-HT[sub 2] receptors in vivo with high specificity. For preparation of EIL labeled with [sup 123]I, an optimized procedure was developed that gave [[sup 123]I]-EIL in acceptable yields. This radioligand allowed visualization of serotonin 5-HT[sub 2] sites in living baboon brain via SPECT. [[sup 123]I]-EIL may serve as an agent for tomographic studies of human cerebral 5-HT[sub 2] receptors in normal and disease states.

  20. Radioiodination of chicken luteinizing hormone without affecting receptor binding potency

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, M.; Ishii, S. (Waseda Univ., Tokyo (Japan))

    1989-12-01

    By improving the currently used lactoperoxidase method, we were able to obtain radioiodinated chicken luteinizing hormone (LH) that shows high specific binding and low nonspecific binding to a crude plasma membrane fraction of testicular cells of the domestic fowl and the Japanese quail, and to the ovarian granulosa cells of the Japanese quail. The change we made from the original method consisted of (1) using chicken LH for radioiodination that was not only highly purified but also retained a high receptor binding potency; (2) controlling the level of incorporation of radioiodine into chicken LH molecules by employing a short reaction time and low temperature; and (3) fractionating radioiodinated chicken LH further by gel filtration using high-performance liquid chromatography. Specific radioactivity of the final {sup 125}I-labeled chicken LH preparation was 14 microCi/micrograms. When specific binding was 12-16%, nonspecific binding was as low as 2-4% in the gonadal receptors. {sup 125}I-Labeled chicken LH was displaced by chicken LH and ovine LH but not by chicken follicle-stimulating hormone. The equilibrium association constant of quail testicular receptor was 3.6 x 10(9) M-1. We concluded that chicken LH radioiodinated by the present method is useful for studies of avian LH receptors.

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

    Directory of Open Access Journals (Sweden)

    Carmen Dolores Gonçalves Brandão

    2004-02-01

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

  2. Potential of the drug-regulation iodide uptake in patients for prevention of radioiodine-refractory papillary thyroid cancer

    Directory of Open Access Journals (Sweden)

    Dmitriy Kirillovich Fomin

    2014-11-01

    Full Text Available ObjectiveTo evaluate the efficacy and feasibility of retinoic acid derivatives and lithium salts for radioiodine-refractory prevention in patients with differentiated thyroid cancer during multistage radioiodine therapy.Materials and methodsThe retrospective analysis was performed using the diagnostic and treatment results of 40 patients with differentiated thyroid cancer that underwent 131I therapy, which on the basis of posttherapy whole-body scan had direct indications for subsequent course of radioiodine therapy. The patients were divided into two groups:the control group (20 patients, which conducted a second course of radioiodine therapy on the standard template and without special training$the main group (20 patients, who were administered Sedalia (900 mg per day for 8 days, p.o. and isotretinoin (1.2 mg/kg body weight for 60 days, p.o. to prevention of the 131I resistance.To evaluate the effectiveness of a repeated course of radioiodine therapy following parameters were used: the thyroglobulin (Tg and antibodies to thyroglobulin (Tg-Ab level in the serum, the posttherapy whole body scan in combination with SPECT-CT.ResultsWe have found, that radioactive iodine treatment was effective in 75% of the main group and 90% of patients in the control group. The remission was observed in 10% and 40% in the main and control group, respectively. The partial regression was considered as Tg and TG-Ab reduction, and was observed more in the study group. The resistance to 131I therapy was found in 20% and 10% in the main and control group, respectively, which was based on the fact of permanent Tg/Tg-Ab serum level and absence of the pathological foci iodine uptake on the whole-body scans. The disease progress was found in one patient in the main group.ConclusionThe use of retinoic acid derivatives and lithium salts, in an effort to prevent the resistance to 131I-theraphy pretend to be unjustified, because it does not lead to significant

  3. Reduced radioiodine uptake at increased iodine intake and {sup 131}I-induced release of ''cold'' iodine stored in the thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Meller, B.; Haase, A.; Richter, E.; Baehre, M. [Dept. of Radiotherapy and Nuclear Medicine, Univ. of Luebeck (Germany); Seyfarth, M. [Inst. of Clinical Chemistry, Univ. of Luebeck (Germany); Wenzel, B.E. [Clinic of Internal Medicine I, Univ. of Luebeck (Germany)

    2005-07-01

    Aim: the extent of urinary iodine excretion (UIE) provides information about iodine supply and release. In the present study we investigated correlations between UIE and radioiodine uptake (RIU) as well as effects of radioiodine therapy on UIE in patients with autonomous goitre. Patients, methods: In 197 consecutive patients with thyroid autonomy, UIE was measured twice during radioiodine test (RITe) and correlated with RIU. In 98 of these patients, thyroglobulin and thyroid volume (V) were determined prior to therapy. Individual changes in urinary iodine excretion ({delta}UIE) and TG ({delta}TG) could be investigated four weeks (4W) and six months (6M) after radioiodine therapy. Additionally, {delta}V was determined 6M after therapy. {delta}UIE, {delta}TG and {delta}V were correlated with target dose and target volume. Results: patients with higher iodine excretion exhibited significantly lower thyroidal radioiodine uptake values. Twofold increased UIE prior to therapy decreased radioiodine uptake by 25%. Compared with pretherapeutic values, UIE and TG were significantly increased four weeks after radioiodine therapy (p < 0.001). Median values of both parameters were found to be doubled. The product of target dose and target volume was not only correlated with a decrease of thyroid volume 6M after therapy, but also with an increase of UIE and TG in the early phase after therapy. Conclusions: it was confirmed that UIE during RITe is a measure for iodine intake and can be used to investigate the competition between stable iodine and radioiodine. The increase of UIE and TG four weeks after therapeutic administration of radioiodine can be explained by disintegrated thyroid follicles. The therapy-induced iodine release may be one important cause for the development of hyperthyroidism in some patients during the first weeks after radioiodine therapy. It may contribute to the known decrease of radioiodine uptake after preapplications of {sup 131}I in various thyroid

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    There is no consensus regarding the optimum treatment of benign non-toxic goitre. L-thyroxine suppressive therapy is widely used, but there is poor evidence of its efficacy, and it may have serious adverse effects on health. Surgery is first choice in large goitres or if malignancy is suspected....... 131I therapy results in a one-year goitre reduction of around 40% in multinodular goitres, usually with a high degree of patient satisfaction and improvement of the inspiratory capacity. The effect is attenuated with increasing goitre size. The risk of hypothyroidism is 22-58% within 5-8 years...... intrathyroidal isotope distribution. Pre-stimulation with even a small dose of rhTSH seems to allow a reduction of the 131I activity while still achieving a mean goitre reduction of approximately 40% within a year. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged 131...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-15

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

  6. Investigation of biokinetics of radioiodine with a population kinetics approach.

    Science.gov (United States)

    Janzen, T; Giussani, A; Canzi, C; Gerundini, P; Oeh, U; Hoeschen, C

    2010-01-01

    The dosimetric studies required for planning individually tailored radioiodine therapy of benign thyroid pathologies may be too complex and time-demanding for many ordinary nuclear medicine departments. In this work, a preliminary population kinetics approach was applied to a model structure for iodine biokinetics in order to identify those model features that actually need to be individually investigated, in order to simplify the protocol for data collection in patients. Data from 29 patients undergoing radioiodine therapy for the treatment of the autonomous nodule syndrome were used in the analysis. The greatest inter-individual variations were observed in the parameters describing the transformation of iodide into organic iodine in the thyroid and in the kinetics of the organic form.

  7. 224例分化型甲状腺癌放射性碘治疗分析%Experience of 224 patients with differentiated thyroid carcinoma by radioiodine therapy

    Institute of Scientific and Technical Information of China (English)

    郭一玲; 陈佐伟; 张英男; 冯程; 辛镇祓

    2011-01-01

    目的:对在我科8年来治疗的分化型甲状腺癌(DTC)患者进行回顾性分析,了解DTC发病规律,并证明131碘治疗DTC的疗效.方法:2002至2010年确诊为DTC并有颈部淋巴结转移的患者,进行甲状腺近全切除,并进行颈部淋巴结清扫,术后131碘治疗.131碘治疗后,每半年随访一次.随访指标:颈部超声检查;血清TSH、FT4、FT3;血清Tg、TgAb检查;全身放射性碘扫描;胸部CT或MRI.疗效判定:当血清Tg、TgAb阴性,颈部超声未见肿大淋巴结,全身放射性碘扫描未见放射性浓聚时,为DTC治愈.当上述指标为阳性时,则进行再次131碘治疗.用SPSS软件进行统计学处理.结果:DTC患者数逐年明显增加;乳头癌与滤泡癌的比例约为12(207):1(17),女性患者远多于男性,男:女患者患病比例约为1(57):3(167);DTC在20-55岁之间为高发年龄段,峰值在25-35岁之间;131碘治疗对DTC治愈率约达90%,近10%的顽固性DTC患者多次131碘治疗效果欠佳.结论:分化型甲状腺癌患病率有明显增加趋势,25-35岁为高发年龄,女性多于男性,早期诊断及早期治疗是关键.手术切除甲状腺后进行131碘治疗对DTC治愈率达90%.近10%的患者131碘治疗效果欠佳,需寻求更好的治疗方法.%Objective: To study the incidence of differentiated thyroid carcinoma ( DTC ) and the outcome of 131 Iodine therapy for DTC, we summarized retrospectively data of patients with DTC who were managed by 131 Iodine therapy in our department in past 8 years. Methods :Patients with DTC and neck lymph nodes metastasis were diagnosed and near - total thyroidectomy were performed, and neck metastatic lymph nodes were excised. After operation they were treated by radioiodine. Patients were followed up once every half of year after 131 Iodine therapy . To observe the following ired: neck ultrasound test , serum TSH, FT4, FT3 test, serum Tg, TgAb test, radioiodine whole body scan,chest CT or MRI. Assessment of outcome of 131 Iodine

  8. Treatment of hyperthyroidism with radioiodine targeted activity: A comparison between two dosimetric methods.

    Science.gov (United States)

    Amato, Ernesto; Campennì, Alfredo; Leotta, Salvatore; Ruggeri, Rosaria M; Baldari, Sergio

    2016-06-01

    Radioiodine therapy is an effective and safe treatment of hyperthyroidism due to Graves' disease, toxic adenoma, toxic multinodular goiter. We compared the outcomes of a traditional calculation method based on an analytical fit of the uptake curve and subsequent dose calculation with the MIRD approach, and an alternative computation approach based on a formulation implemented in a public-access website, searching for the best timing of radioiodine uptake measurements in pre-therapeutic dosimetry. We report about sixty-nine hyperthyroid patients that were treated after performing a pre-therapeutic dosimetry calculated by fitting a six-point uptake curve (3-168h). In order to evaluate the results of the radioiodine treatment, patients were followed up to sixty-four months after treatment (mean 47.4±16.9). Patient dosimetry was then retrospectively recalculated with the two above-mentioned methods. Several time schedules for uptake measurements were considered, with different timings and total number of points. Early time schedules, sampling uptake up to 48h, do not allow to set-up an accurate treatment plan, while schedules including the measurement at one week give significantly better results. The analytical fit procedure applied to the three-point time schedule 3(6)-24-168h gave results significantly more accurate than the website approach exploiting either the same schedule, or the single measurement at 168h. Consequently, the best strategy among the ones considered is to sample the uptake at 3(6)-24-168h, and carry out an analytical fit of the curve, while extra measurements at 48 and 72h lead only marginal improvements in the accuracy of therapeutic activity determination.

  9. Subjective perception of radioactivity. No change post successful treatment with radioiodine; Strahlen bleiben boese. Keine Aenderung der subjektiven Konzepte von Radioaktivitaet nach erfolgreicher Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, L.S.; Mueller, S.P.; Beyer, T.; Bockisch, A. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2009-07-01

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

  10. Radioactive Iodine Therapy of Differentiated Thyroid Carcinoma: Redesigning the Paradigm

    Science.gov (United States)

    Goldsmith, Stanley J.

    2017-01-01

    Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma. Guidelines have proliferated and they have become more detailed and complex. This trend is likely to continue as the science and technology involved increases in sophistication and efficacy. PMID:28117291

  11. Radioactive Iodine Therapy of Differentiated Thyroid Carcinoma: Redesigning the Paradigm

    Directory of Open Access Journals (Sweden)

    Stanley J. Goldsmith

    2017-02-01

    Full Text Available Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma. Guidelines have proliferated and they have become more detailed and complex. This trend is likely to continue as the science and technology involved increases in sophistication and efficacy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-09-01

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

  14. Outpatient management of patients with large multinodular goitres treated with fractionated radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.M.; Thomas, P.A.; Allen, L.W.; Akerman, R.; Lan, L. [Department of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW (Australia); Epstein, M.T. [Department of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia)

    1997-12-01

    The efficacy of fractionated out-patient radioiodine therapy in 38 patients with compressive symptoms due to long-standing large multinodular goitres was assessed. The diagnosis was established by clinical assessment in addition to technetium-99m pertechnetate thyroid scan or computed tomography scan of the thyroid and mediastinum. Oral iodine-131 therapy was administered as a 2.22 GBq (60 mCi) cumulative dose over 4 months (555 MBq per month). All patients were monitored with serum thyroid-stimulating hormone and free thyroxine ({+-} free tri-iodothyronine) assays before the treatment and after each dose fraction. Clinical and biochemical follow-up was performed on all patients and ranged from 6 to 45 months after therapy. The patients consisted of 35 female and three male patients with a median age of 59 years (range 37-87 years). Prior to treatment 20 patients were biochemically hyperthyroid and 18 were euthyroid. Overall, 71% of patients reported a subjective improvement in compressive symptoms and 29% reported no change. Clinically assessed reduction in goitre size occurred in 92% of patients while there was no change in 8%. At 3 months of follow-up, 31% of patients had become hypothyroid and at 18 months 66% were hypothyroid. Seven hyperthyroid patients (35%) became euthyroid and 13 hyperthyroid patients (65%) became hypothyroid. Three patients who became hypothyroid experienced neck soreness (transient in one patient, persistent in two patients). There were no differences in outcome between patients who were hyperthyroid and those who were euthyroid prior to treatment. Fractionated out-patient radioiodine therapy showed excellent short- and medium-term safety, was very well tolerated and offered a satisfactory alternative treatment to surgery. (orig.) With 1 fig., 3 tabs., 23 refs.

  15. Dry Distillation of Radioiodine from TeO2 Targets

    Directory of Open Access Journals (Sweden)

    Jacek Koziorowski

    2013-10-01

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

  16. Radioiodine uptake in inactive pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Bakheet, S.M.; Powe, J.; Al Suhaibani, H. [Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Hammami, M.M.; Bazarbashi, M. [Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1999-06-01

    Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.) With 4 figs., 1 tab., 9 refs.

  17. Radioiodine in the Savannah River Site environment

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-01-15

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

  18. Radioiodine in the Savannah River Site environment

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-01-15

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

  19. Treatment of medulloblastoma using an oncolytic measles virus encoding the thyroidal sodium iodide symporter shows enhanced efficacy with radioiodine

    Directory of Open Access Journals (Sweden)

    Hutzen Brian

    2012-11-01

    Full Text Available Abstract Background Medulloblastoma is the most common malignant brain tumor of childhood. Although the clinical outcome for medulloblastoma patients has improved significantly, children afflicted with the disease frequently suffer from debilitating side effects related to the aggressive nature of currently available therapy. Alternative means for treating medulloblastoma are desperately needed. We have previously shown that oncolytic measles virus (MV can selectively target and destroy medulloblastoma tumor cells in localized and disseminated models of the disease. MV-NIS, an oncolytic measles virus that encodes the human thyroidal sodium iodide symporter (NIS, has the potential to deliver targeted radiotherapy to the tumor site and promote a localized bystander effect above and beyond that achieved by MV alone. Methods We evaluated the efficacy of MV-NIS against medulloblastoma cells in vitro and examined their ability to incorporate radioiodine at various timepoints, finding peak uptake at 48 hours post infection. The effects of MV-NIS were also evaluated in mouse xenograft models of localized and disseminated medulloblastoma. Athymic nude mice were injected with D283med-Luc medulloblastoma cells in the caudate putamen (localized disease or right lateral ventricle (disseminated disease and subsequently treated with MV-NIS. Subsets of these mice were given a dose of 131I at 24, 48 or 72 hours later. Results MV-NIS treatment, both by itself and in combination with 131I, elicited tumor stabilization and regression in the treated mice and significantly extended their survival times. Mice given 131I were found to concentrate radioiodine at the site of their tumor implantations. In addition, mice with localized tumors that were given 131I either 24 or 48 hours after MV-NIS treatment exhibited a significant survival advantage over mice given MV-NIS alone. Conclusions These data suggest MV-NIS plus radioiodine may be a potentially useful therapy for

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  1. Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative.

    Science.gov (United States)

    Espinosa-Muñoz, E; Ramírez-Ocaña, D; Martín-García, A M; Ruiz-García, F J; Puentes-Zarzuela, C

    The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with (131)I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with (131)I at this age, makes this case unique. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  3. Effects of Radioiodine Treatment on Salivary Gland Function in Patients with Differentiated Thyroid Carcinoma: A Prospective Study.

    Science.gov (United States)

    Klein Hesselink, Esther N; Brouwers, Adrienne H; de Jong, Johan R; van der Horst-Schrivers, Anouk N A; Coppes, Rob P; Lefrandt, Joop D; Jager, Piet L; Vissink, Arjan; Links, Thera P

    2016-11-01

    Complaints of a dry mouth (xerostomia) and sialoadenitis are frequent side effects of radioiodine treatment in differentiated thyroid cancer (DTC) patients. However, detailed prospective data on alterations in salivary gland functioning after radioiodine treatment ((131)I) are scarce. Therefore, the primary aim of this study was to prospectively assess the effect of high-activity radioiodine treatment on stimulated whole saliva flow rate. Secondary aims were to study unstimulated whole and stimulated glandular (i.e., parotid and submandibular) saliva flow rate and composition alterations, development of xerostomia, characteristics of patients at risk for salivary gland dysfunction, and whether radioiodine uptake in salivary glands on diagnostic scans correlates to flow rate alterations. In a multicenter prospective study, whole and glandular saliva were collected both before and 5 mo after radioiodine treatment. Furthermore, patients completed the validated xerostomia inventory. Alterations in salivary flow rate, composition, and xerostomia inventory score were analyzed. Salivary gland radioiodine uptake on diagnostic scans was correlated with saliva flow rate changes after radioiodine treatment. Sixty-seven patients (mean age ± SD, 48 ± 17 y; 63% women, 84% underwent ablation therapy) completed both study visits. Stimulated whole saliva flow rate decreased after ablation therapy (from 0.92 [interquartile range, 0.74-1.25] to 0.80 [interquartile range, 0.58-1.18] mL/min, P = 0.003), as well as unstimulated whole- and stimulated glandular flow rates (P subjective feeling of dry mouth increased (P = 0.001). Alterations in saliva flow rate were not associated with semiquantitatively assessed radioiodine uptake in salivary glands on diagnostic scans. For the small cohort of patients undergoing repeated radioiodine therapy, we could not demonstrate alterations in salivary parameters. We prospectively showed that salivary gland function is affected after high

  4. Variants and pitfalls on radioiodine scans in pediatric patients with differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, Mohamed; Vali, Reza; Chan, Jeffrey; Omarkhail, Yusuaf; Shammas, Amer [University of Toronto, Nuclear Medicine Division, Department of Medical Imaging, The Hospital for Sick Children, Toronto, Ontario (Canada)

    2016-10-15

    Potentially false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma can mimic functioning thyroid tissue and functioning thyroid carcinomatous tissue. Such false-positive findings comprise variants and pitfalls that can vary slightly in children as compared with adults. To determine the patterns and frequency of these potential false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma. We reviewed a total of 223 radioiodine scans from 53 pediatric patients (mean age 13.3 years, 37 girls) with differentiated thyroid carcinoma. Focal or regional activity that likely did not represent functioning thyroid tissue or functioning thyroid carcinomatous tissue were categorized as variants or pitfalls. The final diagnosis was confirmed by reviewing the concurrent and follow-up clinical data, correlative ultrasonography, CT scanning, serum thyroglobulin and antithyroglobulin antibody levels. We calculated the frequency of these variants and pitfalls from diagnostic and post-therapy radioiodine scans. The most common variant on the radioiodine scans was the thymic activity (24/223, 10.8%) followed by the cardiac activity (8/223, 3.6%). Salivary contamination and star artifact, caused by prominent thyroid remnant, were the most important observed pitfalls. Variants and pitfalls that mimic functioning thyroid tissue or functioning thyroid carcinomatous tissue on radioiodine scan in children with differentiated thyroid carcinoma are not infrequent, but they decrease in frequency on successive radioiodine scans. Potential false-positive findings can be minimized with proper knowledge of the common variants and pitfalls in children and correlation with clinical, laboratory and imaging data. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Ash Gargya

    2012-01-01

    Full Text Available Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions. Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis. Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma. Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

  6. Personalized Medicine Based on Theranostic Radioiodine Molecular Imaging for Differentiated Thyroid Cancer.

    Science.gov (United States)

    Ahn, Byeong-Cheol

    2016-01-01

    Molecular imaging based personalized therapy has been a fascinating concept for individualized therapeutic strategy, which is able to attain the highest efficacy and reduce adverse effects in certain patients. Theranostics, which integrates diagnostic testing to detect molecular targets for particular therapeutic modalities, is one of the key technologies that contribute to the success of personalized medicine. Although the term "theranostics" was used after the second millennium, its basic principle was applied more than 70 years ago in the field of thyroidology with radioiodine molecular imaging. Differentiated thyroid cancer, which arises from follicular cells in the thyroid, is the most common endocrine malignancy, and theranostic radioiodine has been successfully applied to diagnose and treat differentiated thyroid cancer, the applications of which were included in the guidelines published by various thyroid or nuclear medicine societies. Through better pathophysiologic understanding of thyroid cancer and advancements in nuclear technologies, theranostic radioiodine contributes more to modern tailored personalized management by providing high therapeutic effect and by avoiding significant adverse effects in differentiated thyroid cancer. This review details the inception of theranostic radioiodine and recent radioiodine applications for differentiated thyroid cancer management as a prototype of personalized medicine based on molecular imaging.

  7. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  8. Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Maria Eduarda; Flamini, Rodrigo C.; Corbo, Rossana; Mamede, Marcelo [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear], e-mail: mamede@inca.gov.br

    2009-10-15

    The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy. (author)

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  10. Clinical research of juvenile hyperthyroidism treatment with radioiodine%131I治療青少年及兒童甲亢臨床應用研究

    Institute of Scientific and Technical Information of China (English)

    邱陵; 張春銀; 陳躍

    2001-01-01

    Objective To evaluate the effects and side effects in the radioiodine management of juvenile hyperthyroidism. Methods 80 patients with poor effects using anti-thyroid drug were assigned to receive 131Itherapy. The follows of therapy outcome were assessed 1, 3, 6 and 12 months after the start of treatment. One follows up per 1-3 years. Results Among 80 patients followed by 6 months, clinical response was excellent in 65patients (81%), good in 15 (19 % ). There were 12 patients with hypothyroidism followed 4 years, and with no other side effects, Conclusion The good therapeutic effect was obtained in radioiodine treatment for juvenile hyperthyroidism. Radioiodine was effective to juvenile hyperthyroidism.

  11. Preparation of radioiodine labelled thiouracil derivatives

    Energy Technology Data Exchange (ETDEWEB)

    Visser, T.J.; Klootwijk, W. (Erasmus Univ., Rotterdam (Netherlands))

    1981-05-01

    2-Thiouracil and 6-propyl-2-thiouracil are radioiodinated with high yield using the chloramine-T method at low pH to prevent oxidation of the sulfur. The radioiodine-labelled derivatives are purified by adsorption chromatography on Sephadex G-10. The identity and purity of the products obtained are demonstrated by both normal- and reversed-phase high pressure liquid chromatography. The specific activity of the tracers amounts to approximately 1750 Ci mmol/sup -1/. Conditions for storage are described as well. These radioactive compounds may be used in the investigation of the mechanism of action of thyroid peroxidase as well as of iodothyronine deiodinases.

  12. Radioiodine concentrated in a wetland.

    Science.gov (United States)

    Kaplan, Daniel I; Zhang, Saijin; Roberts, Kimberly A; Schwehr, Kathy; Xu, Chen; Creeley, Danielle; Ho, Yi-Fang; Li, Hsiu-Ping; Yeager, Chris M; Santschi, Peter H

    2014-05-01

    Most subsurface environmental radioactivity contamination is expected to eventually resurface in riparian zones, or wetlands. There are a number of extremely sharp biogeochemical interfaces in wetlands that could alter radionuclide speciation and promote accumulation. The objective of this study was to determine if a wetland concentrated (129)I emanating from a former waste disposal basin located on the Savannah River Site (SRS) in South Carolina, USA. Additionally, studies were conducted to evaluate the role of sediment organic matter in immobilizing the radioiodine. Groundwater samples were collected along a 0.7-km transect away from the seepage basin and in the downstream wetlands. The samples were analyzed for (129)I speciation (iodide (I(-)), iodate (IO3(-)), and organo-I). Groundwater (129)I concentrations in many locations in the wetlands (as high as 59.9 Bq L(-1)(129)I) were greatly elevated with respect to the source term (5.9 Bq L(-1)(129)I). (129)I concentration profiles in sediment cores were closely correlated to organic matter concentrations (r(2) = 0.992; n = 5). While the sediment organic matter promoted the uptake of (129)I to the wetland sediment, it also promoted the formation of a soluble organic fraction: 74% of the wetland groundwater (129)I could pass through a 1 kDa (wetlands may be highly effective at immobilizing aqueous (129)I, they may also promote the formation of a low-molecular-weight organic species that does not partition to sediments. This study provides a rare example of radioactivity concentrations increasing rather than decreasing as it migrates from a point source and brings into question assumptions in risk models regarding continuous dilution of released contaminants.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

  14. Benefits of automated surface decontamination of a radioiodine ward.

    Science.gov (United States)

    Westcott, Eliza; Broadhurst, Alicia; Crossley, Steven; Lee, Lloyd; Phan, Xuyen; Scharli, Rainer; Xu, Yan

    2012-02-01

    A floor-washing robot has been acquired to assist physicists with decontamination of radioiodine therapy ward rooms after discharge of the patient at Sir Charles Gairdner Hospital. The effectiveness of the robot in decontaminating the ward has been evaluated. A controlled experiment was performed by deliberately contaminating a polyvinyl chloride flooring offcut with 131I followed by automated decontamination with the robot. The extent of fixed and removable contamination was assessed before and after decontamination by two methods: (1) direct Geiger-Mueller counting and (2) beta-counting wipe tests. Surface contamination was also assessed in situ on the ward by Geiger-Mueller counting and wipe testing. Contamination maps confirmed that contamination was removed rather than spread around by the robot. Wipe testing revealed that the robot was successful in clearing approximately 60-80% of removable contamination. The robotic floor-washing device was considered suitable to provide effective automated decontamination of the radioiodine ward. In addition, the robot affords other benefits: the time spent by the physicists decontaminating the room is greatly reduced offering financial and occupational safety and health benefits. The robot has also found utility in other decontamination applications in the healthcare environment.

  15. Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer.

    Science.gov (United States)

    Oluwasanjo, Adetokunbo; Pathak, Ranjan; Ukaigwe, Anene; Alese, Olatunji

    2016-01-01

    Therapy-related acute myeloid leukemia (t-AML) associated with radioiodine treatment (RAI) is emerging as an important clinical entity with the rise in incidence of thyroid cancer. We conducted an electronic search of MEDLINE and EMBASE, and also searched reference lists of articles and abstracts from conference proceedings for case reports and review articles on t-AML following radioiodine therapy. A total of 37 patients with acute myeloid neoplasms following radioiodine treatment were analyzed. The median RAI dose was 324 mCi, and median age was 47.5 years with M/F ratio of 1:3. Latency period was 1-4 years, and the median time from RAI exposure to diagnosis of t-AML was 2.9 years. FAB M2 and M3 were the two most common t-AML subtypes reported. Seventy-one percent of the cases that reported cytogenetic abnormalities were classified as unfavorable. The most commonly reported abnormalities were del 5q and t(15:17). Survival outcomes were not reported due to lack of patient-level data. T-AML following radioiodine therapy for thyroid cancer appears to have a shorter latency period than other types of t-AML, which is an important consideration for post-therapy surveillance. Reporting of cases and outcomes will help provide data for further research. Identifying biomarkers that help risk-stratify patients prior to therapy and specific genetic-guided therapies may help improve outcomes.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  17. Mammary radioiodine accumulation due to functional sodium iodide symporter expression in a benign fibroadenoma.

    Science.gov (United States)

    Berger, F; Unterholzner, S; Diebold, J; Knesewitsch, P; Hahn, K; Spitzweg, C

    2006-11-03

    The sodium iodide symporter (NIS) has been characterized to mediate the active transport of iodide not only in the thyroid gland but also in various non-thyroidal tissues, including lactating mammary gland and the majority of breast cancers, thereby offering the possibility of diagnostic and therapeutic radioiodine application in breast cancer. In this report, we present a 57-year-old patient with multifocal papillary thyroid carcinoma, who showed focal radioiodine accumulation in a lesion in the right breast on a posttherapy (131)I scan following radioiodine therapy. CT and MR-mammography showed a focal solid lesion in the right breast suggestive of a fibroadenoma, which was confirmed by histological examination. Immunostaining of paraffin-embedded tumor tissue sections using a human NIS antibody demonstrated NIS-specific immunoreactivity confined to epithelial cells of mammary ducts. In conclusion, in a thyroid cancer patient we identified a benign fibroadenoma of the breast expressing high levels of functionally active NIS protein as underlying cause of focal mammary radioiodine accumulation on a posttherapy (131)I scan. These data show for the first time that functional NIS expression is not restricted to lactating mammary gland and malignant breast tissue, but can also be detected in benign breast lesions, such as fibroadenomata of the breast.

  18. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Seo, Ye Young [Dept. of Nuclear Medicine, College of Medicine, The Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of); Ryu, Ji Young [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-12-15

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

  19. Radioiodine treatment for malignant thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-15

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

  20. Synthesis and biodistribution of radioiodinated nicotine analogs

    Energy Technology Data Exchange (ETDEWEB)

    Chan, S.M.; Basmadjian, G.P.; Marten, D.F.; Sadek, S.; Magarian, R.A.; Grunder, J.R.; Ice, R.D.

    1984-01-01

    The authors reported previously on the synthesis and biodistribution of radioiodinated 5-iodonicotine. In their continuous effort to search for a potential brain as well as adrenal medulla imaging agent, the authors synthesized four radioiodinated nicotine analogs. The labeled compounds were prepared by brominating nicotinic acid, and reacting the acylated product with the appropriate amines to give the respective amides which were then reduced with diborane to the amines. I-125 labeling was done by halogen exchange. Biodistribution studies performed in female Sprague-Dawley rats showed that all these compounds were taken up rapidly by the brain and the adrenal. The highest uptake of all these compounds in both organs occurred at 2 minutes after tail vein injections. The organ:blood ratios at 2 minutes and the T/sub 1/3/ (min.) of radioactivity in these organs were compared.

  1. Radioiodinated metaiodobenzylguanidine (MIBG): radiochemistry, biology, and pharmacology.

    Science.gov (United States)

    Vallabhajosula, Shankar; Nikolopoulou, Anastasia

    2011-09-01

    As an analogue of adrenergic neurotransmitter norepinephrine (NE), metaiodobenzylguanidine (MIBG) demonstrates high uptake both in normal sympathetically innervated tissues, such as the heart and salivary glands, and in tumors that express the NE transporter (NET), specifically those of neural crest and neuroendocrine origin. In 1994, (131)I-MIBG, also known as iobenguane I-131 intravenous, received Food and Drug Administration (FDA) approval as an imaging agent. In 2008, (123)I-MIBG was also approved by FDA as a tumor imaging agent. Commercial formulations of radioiodinated MIBG are prepared on the basis of radioiodide exchange reaction with unlabeled MIBG as a precursor and contain large mass amounts of unlabeled MIBG, or "cold carrier," molecules. Because the cold MIBG molecules competitively inhibit the uptake of radiolabeled MIBG molecules by adrenergic and neuroendocrine cells expressing NET, no-carrier-added (n.c.a.), high specific activity (SA) radioiodinated MIBG preparations have been developed on the basis of electrophilic radioiodination reaction and solid-phase technology by using dibutylstanyl benzylguanidine precursor linked to polymers. On the basis of n.c.a. synthetic procedures, therapeutic doses of [(131)I]MIBG can be administered with very high SA (1600 mCi/μmol or 5734 mCi/mg). The very high SA of n.c.a. [(131)I]MIBG drug would increase the specific cellular uptake of adrenergic neurons and neuroendocrine tumor cells expressing NET.

  2. Radioiodine therapy of differentiated thyroid cancer: radiologic impact of out-patient treatment with 100 to 150 mCi Iodine-131 activities; Radioiodoterapia do carcinoma diferenciado da tireoide: impacto radiologico da liberacao hospitalar de pacientes com atividades entre 100 e 150 mCi de iodo-131

    Energy Technology Data Exchange (ETDEWEB)

    Sapienza, Marcelo Tatit; Willegaignon, Jose; Ono, Carla Rachel; Watanabe, Tomoco; Guimaraes, Maria Ines Calil Cury; Buchpiguel, Carlos Alberto [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Servico de Medicina Nuclear; Gutterres, Ricardo Fraga; Marechal, Maria Helena da Hora [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2009-07-01

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

  3. Improving adherence with inhaler therapy in COPD

    Directory of Open Access Journals (Sweden)

    Suzanne C Lareau

    2010-11-01

    Full Text Available Suzanne C Lareau1, Barbara P Yawn21College of Nursing, University of Colorado Denver, Aurora, Colorado; 2Department of Research, Olmsted Medical Center, Rochester, Minnesota, USAAbstract: Chronic obstructive pulmonary disease (COPD is a major public health problem, associated with considerable morbidity and health care costs. The global burden of COPD morbidity is predicted to rise substantially in the coming decade, but could be moderated by better use of existing management strategies. Smoking cessation, medication therapy, and pulmonary rehabilitation have all been shown to diminish morbidity and improve patient outcomes. But each of these strategies requires adherence. Adherence is crucial for optimizing clinical outcomes in COPD, with nonadherence resulting in a significant health and economic burden. Suboptimal medication adherence is common among COPD patients, due to a number of factors that involve the medication, the delivery device, the patient, and the health professionals caring for the patient. Lack of medication adherence needs to be identified and addressed by using simplified treatment regimens, increasing patient knowledge about self-management, and enhancing provider skills in patient education, communication, and adherence counseling. This article reports some of the challenges of medication nonadherence faced by the clinician in the management of COPD, and suggests ways to evaluate and improve adherence effectively in primary care.Keywords: chronic obstructive pulmonary disease, adherence, clinician

  4. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity,

  5. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity, c

  6. Improving the quality of oral anticoagulant therapy

    NARCIS (Netherlands)

    Gadisseur, Alain Peter Anton

    2006-01-01

    Oral anticoagulant therapy has changed little since the development of the coumarin drugs after the Second World War. The basic nature of the therapy, i.e. the balancing between thrombosis and haemorrhage, makes it a therapy difficult to manage. Add to this the many influences from co-morbidity, c

  7. 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.)

  8. Microbial copper reduction method to scavenge anthropogenic radioiodine

    Science.gov (United States)

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

    2016-06-01

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

  9. An alternative and expedient synthesis of radioiodinated 4-iodophenylalanine

    Energy Technology Data Exchange (ETDEWEB)

    Vaidyanathan, Ganesan, E-mail: ganesan.v@duke.edu [Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC 27710 (United States); McDougald, Darryl; Grasfeder, Linda; Zalutsky, Michael R.; Chin, Bennett [Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC 27710 (United States)

    2011-10-15

    Radiolabeled amino acids have been used extensively in oncology both as diagnostic and therapeutic agents. In our pursuit to develop radiopharmaceuticals to target breast cancer, we were interested in determining the uptake of radioiodinated 4-iodophenylalanine, among other labeled amino acids, in breast cancer cells. In this work, we have developed an alternative method for the synthesis of this agent. The novel tin precursor, (S)-tert-butyl 2-(tert-butoxycarbonylamino)-3-(4-(tributylstannyl)phenyl)propanoate (3) was synthesized from the known, corresponding iodo derivative. Initially, the labeled 4-iodophenylalanine was synthesized from the above tin precursor in two steps with radiochemical yields of 91.6{+-}2.7% and 83.7{+-}1.7% (n=5), for the radioiodination (first) and deprotection (second) step, respectively. Subsequently, it was synthesized in a single step with an average radiochemical yield of 94.8{+-}3.4% (n=5). After incubation with MCF-7 breast cancer cells for 60 min, an uptake of up to 49.0{+-}0.7% of the input dose was seen; in comparison, the uptake of [{sup 14}C]phenylalanine under the same conditions was 55.9{+-}0.5%. Furthermore, the uptake of both tracers was inhibited to a similar degree in a concentration-dependent manner by both unlabeled phenylalanine and 4-iodophenylalanine. With [{sup 14}C]phenylalanine as the tracer, IC{sub 50} values of 1.45 and 2.50 mM were obtained for Phe and I-Phe, respectively, and these values for [{sup 125}I]I-Phe inhibition were 1.3 and 1.0 mM. In conclusion, an improved and convenient method for the synthesis of no-carrier-added 4-[{sup *}I]phenylalanine was developed and the radiotracer prepared by this route demonstrated an amino acid transporter-mediated uptake in MCF-7 breast cancer cells in vitro that was comparable to that of [{sup 14}C]phenylalanine. - Highlights: > A new method to synthesize radioiodinated 4-iodophenylalanine. > Acid-labile protecting groups containing tin precursor. > Efficient removal

  10. Stem Cell Therapy to Improve Burn Wound Healing

    Science.gov (United States)

    2017-03-01

    Award Number: W81XWH-13-2-0024 TITLE: Stem Cell Therapy to Improve Burn Wound Healing PRINCIPAL INVESTIGATOR: Carl Schulman, MD, PhD, MSPH...NUMBER Stem Cell Therapy to Improve Burn Wound Healing 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Carl Schulman, MD, PhD, MSPH...chronic wounds with significant improvement in healing and scarring. Application of mesenchymal stem cell (MSC) therapy to severe burn wounds

  11. Guidelines for radioiodinated MIBG scintigraphy in children.

    Science.gov (United States)

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

    2003-05-01

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

  12. Psoriasis: improving adherence to topical therapy.

    NARCIS (Netherlands)

    Feldman, S.R.; Horn, E.J.; Balkrishnan, R.; Basra, M.K.; Finlay, A.Y.; McCoy, D.; Menter, A.; Kerkhof, P.C.M. van de

    2008-01-01

    Topical therapy has an important role in psoriasis treatment. It is efficacious and has a favorable safety profile as demonstrated in clinical trials. However, poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of the medication. The Internati

  13. Technical solutions to improve cardiac regenerative therapy

    NARCIS (Netherlands)

    van Slochteren, F.J.

    2014-01-01

    The therapeutic options for patients suffering from ischemic heart disease (IHD) are limited, and worldwide 23 million patients suffer from heart failure (HF). Therefore there is a strong need for alternative therapies for IHD. Since cardiac regenerative therapies have shown promising results in bas

  14. A dose-effect correlation for radioiodine ablation in differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Flux, Glenn D.; Chittenden, Sarah J.; Buckley, Susan; Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Department of Physics, Sutton, Surrey (United Kingdom); Haq, Masud; Newbold, Kate; Harmer, Clive L. [Royal Marsden NHS Foundation Trust, Thyroid Unit, Sutton, Surrey (United Kingdom)

    2010-02-15

    The aim of this study was to determine the range of absorbed doses delivered to thyroid remnants, blood, and red marrow from fixed administrations of radioiodine and to ascertain whether the success of ablation is more dependent on these absorbed doses than on the administered activity. Twenty-three patients received 3,000 MBq radioiodine following near-total thyroidectomy. The maximum absorbed dose to remnants was calculated from subsequent single photon emission tomography scans. Absorbed doses delivered to blood and red marrow were calculated from blood samples and from whole-body retention measurements. The protein bound iodine (PBI) was also calculated. Maximum absorbed doses to thyroid remnants ranged from 7 to 570 Gy. Eighteen of the 23 patients had a successful ablation. A significant difference was seen between the absorbed doses delivered to thyroid remnants, blood, and red marrow for those patients that had a successful ablation compared to those with a failed ablation (p = 0.030, p = 0.043 and p = 0.048, respectively). The difference between the PBI values acquired at day 1 and day 6 were also indicative of response (p = 0.074). A successful ablation is strongly dependent on the absorbed dose to the thyroid remnant. Dosimetry-based personalized treatment can prevent both sub-optimal administrations, which entails further radioiodine therapy, and excessive administration of radioactivity, which increases the potential for radiation toxicity. (orig.)

  15. Dosimetry of radioiodine for embryo and fetus

    Energy Technology Data Exchange (ETDEWEB)

    Berkovski, V.; Eckerman, K.F.; Phipps, A.W.; Nosske, D

    2003-07-01

    This paper discusses the biokinetic and dosimetric models adopted in ICRP Publication 88 for the evaluation of fetal doses resulting from maternal intakes of radioiodine. The biokinetic model is used to simulate the behaviour of iodine in both the mother and the fetus. Such simulations provide the basis for the estimation of the dose to the embryo and determine the distribution of maternal iodine at the beginning of the fetal period. The model considers iodine to accumulate in the fetal thyroid from the 11th week. The dose to the fetus delivered following birth is evaluated with the biokinetic and dosimetric models described in ICRP Publication 67. Although a substantial fraction of the emitted energy of electrons and photons is less than 10 keV, conventionally assumed to be non-penetrating radiation, these emissions can escape the small fetal thyroid. Absorbed fractions for both self-dose and crossfire were evaluated for the requirements of radioiodine dosimetry in ICRP Publication 88. (author)

  16. Radioiodine treatment of Grave's disease; Radiojodtherapie des Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Heidenreich, P.; Vogt, H.; Dorn, R.; Graf, G.; Kopp, J. [Klinik fuer Nuklearmedizin, Zentralklinikum Augsburg (Germany)

    2001-09-01

    In Germany radioiodine therapy of Grave's disease is performed in patients older than 20 years, after at least one year of unsuccessful antithyroid therapy, intolerance against antithyroid medication, recurrences after surgical interventions and small goiters. Hyperthyroidism is eliminated with an ablative dose concept (300 Gy) in more than 90% associated with rate of hypothyroidism in the outcome of also more than 90%. Adverse prognostic factors are an insufficient dose to the thyroid and/or concomitant antithyreoid medication. Radioiodine therapy in Germany must be an inpatient single time approach due to quality assurance and radiation protection reasons. The mean hospitalization is only 3-4 days with the patient being discharged at an annual dose of less than 1 mSv at 2 m distance (dose rate at discharge < 3,5 {mu}Sv/h at 2 m). An adjuvant treatment with cortisone is recommended in a simultaneous endocrine ophthalmopathy to prevent from deterioration. Radioiodine therapy of Grave's disease is cost effective with a low probability of side-effects and is not associated with an increased genetic or somatic risk. Therapy control and life span follow up has to be carried out by the expert physician legally responsible for the radioiodine therapy. (orig.) [German] Die Radiojodtherapie des Morbus Basedow wird in Deutschland, bei Patienten aelter als 20 Jahre, erst nach mindestens einjaehriger, erfolgloser thyreostatischer Therapie, bei Thyreostatikaunvertraeglichkeit, Rezidiven nach Operation und kleinen Strumen durchgefuehrt. Die Beseitigung der Hyperthyreose wird mit einem ablativen Dosiskonzept (300 Gy) in > 90%, verbunden mit einer Hypothyreoserate von ebenfalls > 90% erreicht. Prognostisch unguenstige Einflussfaktoren sind eine zu niedrig gewaehlte Herddosis und/oder eine begleitende Thyreostase. Aus Gruenden der Qualitaetssicherung und des Strahlenschutzes muss in Deutschland die Radiojodtherapie stationaer als Einzeittherapie durchgefuehrt werden. Die

  17. RADIOIODINE GEOCHEMISTRY IN THE SRS SUBSURFACE ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, D.; Emerson, H.; Powell, B.; Roberts, K.; Zhang, S.; Xu, C.; Schwer, K.; Li, H.; Ho, Y.; Denham, M.; Yeager, C.; Santschi, P.

    2013-05-16

    Iodine-129 is one of the key risk drivers for several Savannah River Site (SRS) performance assessments (PA), including that for the Low-Level Waste Disposal Facility in E-Area. In an effort to reduce the uncertainty associated with the conceptual model and the input values used in PA, several studies have recently been conducted dealing with radioiodine geochemistry at the SRS. The objective of this report was to review these recent studies and evaluate their implications on SRS PA calculations. For the first time, these studies measured iodine speciation in SRS groundwater and provided technical justification for assuming the presence of more strongly sorbing species (iodate and organo-iodine), and measured greater iodine sediment sorption when experiments included these newly identified species; specifically they measured greater sorption coefficients (K{sub d} values: the concentration ratio of iodine on the solid phase divided by the concentration in the aqueous phase). Based on these recent studies, new best estimates were proposed for future PA calculations. The new K{sub d} values are greater than previous recommended values. These proposed K{sub d} values reflect a better understanding of iodine geochemistry in the SRS subsurface environment, which permits reducing the associated conservatism included in the original estimates to account for uncertainty. Among the key contributing discoveries supporting the contention that the K{sub d} values should be increased are that: 1) not only iodide (I{sup -}), but also the more strongly sorbing iodate (IO{sub 3}{sup -}) species exists in SRS groundwater (average total iodine = 15% iodide, 42% iodate, and 43% organoiodine), 2) when iodine was added as iodate, the measured K{sub d} values were 2 to 6 times greater than when the iodine was added as iodide, and perhaps most importantly, 3) higher desorption (10 to 20 mL/g) than (ad)sorption (all previous studies) K{sub d} values were measured. The implications of this

  18. Synthesis and radioiodination of analogues of substance P for the building up of a radioimmunoassay

    Energy Technology Data Exchange (ETDEWEB)

    Bienert, M.; Schmidt, H.E.; Ehrlich, A.; Forner, K.; Klauschenz, E.; Furkert, J.; Rathsack, R.; Niedrich, H. (Akademie der Wissenschaften der DDR, Berlin. Inst. fuer Wirkstofforschung; Akademie der Wissenschaften der DDR, Berlin-Buch. Zentralinstitut fuer Isotopen- und Strahlenforschung)

    1984-02-01

    The substance P (SP) analogs (Lys(MSOC)/sup 3/)-SP, (Tyr/sup 8/)-SP, (Tyr/sup 8/,Nle/sup 11/)-SP and (p-HPA/sup 1/)-SP have been synthesized by classical methods of peptide synthesis as well as by the liquid phase peptide synthesis (LPPS) to allow conjugation with protein in the N..cap alpha..-position and radioiodination. (Tyr/sup 8/)-SP and (p-HPA-Arg/sup 1/)-SP have been radioiodinated by the chloramine T- and the lactoperoxidase method. A complete S-oxidation of SP was observed, when the chloramine T procedure was used, but this modification does not disturb the assay. The introduction of the (/sup 125/I-pHPA-Arg/sup 1/)-SP-tracer led to considerable improvements of our SP-radioimmunoassay.

  19. Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

    DEFF Research Database (Denmark)

    Vestergaard, P; Hermann, A P; Gram, J

    1997-01-01

    To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

  20. Mitochondria-targeting for improved photodynamic therapy

    Science.gov (United States)

    Ngen, Ethel J.

    Photodynamic therapy (PDT) is an emerging cancer therapeutic modality, with great potential to selectively treat surface cancers, thus minimizing systemic side effects. In this dissertation, two approaches to deliver photosensitizers to mitochondria were investigated: 1) Reducing photosensitizer sizes to improve endocytosis and lysosomal localization. Upon irradiation the photosensitizers would then produce singlet oxygen which could rupture the lysosomal membrane releasing the lysosomally trapped photosensitizers to the cytosol, from where they could relocalize to mitochondria by passive diffusion (photochemical internalization). 2) Using delocalized lipophilic cationic dyes (DLCs) to exploit membrane potential differences between the cytoplasm and mitochondria in delivering photosensitizers to mitochondria. To investigate the effects of steric hindrance on mitochondrial localization and photodynamic response, a series of eight thiaporphyrins were studied. Two new thiaporphyrin analogues 6 and 8 with reduced steric hindrance at the 10- and 15- meso positions were studied in comparison to 5,20-diphenyl-10,15-bis[4 (carboxymethyleneoxy)-phenyl]-21,23-dithiaporphyrin 1, previously validated as a potential second generation photosensitizer. Although 6 showed an extraordinarily high uptake (7.6 times higher than 1), it was less potent than 1 (IC 50 = 0.18 muM versus 0.13 muM) even though they both showed similar sub-cellular localization patterns. This low potency was attributed to its high aggregation tendency in aqueous media (4 times higher than 1), which might have affected its ability to generate singlet oxygen in vitro . 8 on the other hand showed an even lower potency than 6 (2.28 vs 0.18 muM). However this was attributed to its low cellular uptake (20 times less than 6) and inefficient generation of singlet oxygen. Overall, although the structural modifications did improve the cellular uptake of 6, 6 was still less potent than the lead photosensitizers 1. Thus

  1. Specific activity of radioiodine-labelled human chorionic gonadotropin ligand

    Energy Technology Data Exchange (ETDEWEB)

    Crespi, M. (South African Inst. for Medical Research, Sandringham. National Inst. for Virology); Kay, G.W.; Van der Walt, L.A. (South African Inst. for Medical Research, Johannesburg. Dept. of Pathology)

    1983-10-01

    The article deals with the determination of the specific activity of radioiodine-labelled human chorionic gonadotropin ligand. The iodiation of human chorionic gonadotropin and the counting efficiency of /sup 125/I are discussed.

  2. Can Shockwave Therapy Improve Tendon Metabolism?

    NARCIS (Netherlands)

    Zwerver, Johannes; Waugh, Charlotte; van der Worp, Henk; Scott, Alex; Ackermann, PW; Hart, DA

    2016-01-01

    Shockwave treatments are commonly used in the management of tendon injuries and there is increasing evidence for its clinical effectiveness. There is a paucity of fundamental (in vivo) studies investigating the biological action of shockwave therapy. Destruction of calcifications, pain relief and me

  3. Can shockwave therapy improve tendon metabolism?

    NARCIS (Netherlands)

    Zwerver, Johannes; Waugh, Charlotte; van der Worp, Henk; Scott, Alex

    2016-01-01

    Shockwave treatments are commonly used in the management of tendon injuries and there is increasing evidence for its clinical effectiveness. There is a paucity of fundamental (in vivo) studies investigating the biological action of shockwave therapy. Destruction of calcifications, pain relief and me

  4. Can Shockwave Therapy Improve Tendon Metabolism?

    NARCIS (Netherlands)

    Zwerver, Johannes; Waugh, Charlotte; van der Worp, Henk; Scott, Alex; Ackermann, PW; Hart, DA

    2016-01-01

    Shockwave treatments are commonly used in the management of tendon injuries and there is increasing evidence for its clinical effectiveness. There is a paucity of fundamental (in vivo) studies investigating the biological action of shockwave therapy. Destruction of calcifications, pain relief and

  5. Can shockwave therapy improve tendon metabolism?

    NARCIS (Netherlands)

    Zwerver, Johannes; Waugh, Charlotte; van der Worp, Henk; Scott, Alex

    2016-01-01

    Shockwave treatments are commonly used in the management of tendon injuries and there is increasing evidence for its clinical effectiveness. There is a paucity of fundamental (in vivo) studies investigating the biological action of shockwave therapy. Destruction of calcifications, pain relief and me

  6. Kit preparation of radioiodinated o-iodohippuran

    Energy Technology Data Exchange (ETDEWEB)

    Hinkle, G.H.; Basmadjian, G.P.; Kirschner, A.S.; Ice, R.D.

    1981-03-01

    The purpose of this study was to evaluate a kit preparation for radioiodinated o-iodohippuran (I). All ingredients, excluding the radionuclide, were packaged in a ready-to-use kit for easy, quick formulation. Electrophoresis was utilized to evaluate the radiochemical purity of the labeled product and indicated that the radiolabeling technique provided a product with greater than 95% radiochemical purity. Biodistribution studies in rats and rabbits provided an indication of the tissue distribution and localization of the radiopharmaceutical. Computer-generated renogram curves plotted from gamma-camera images of rabbits showed the equivalency of the 131I-labeled I and 123I-labeled I to the commercially available radiopharmaceutical.

  7. Metal organic framework MIL-101 for radioiodine capture and storage

    Science.gov (United States)

    Assaad, Thaer; Assfour, Bassem

    2017-09-01

    we report on the use of metal organic frameworks(MOFs) for radioiodine recovery and storage. One MOF (namely MIL-101) was prepared and investigated in detail to demonstrate the iodine removal efficiency and capacity of MOFs. The typical sorption kinetics and uptake isotherms were measured using radioactive iodine (123 I) for the first time. Our measurements indicate that MOFs can capture and store radioiodine in very high efficiency and fast kinetics.

  8. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ross, D.S.; Nussbaum, S.R.

    1989-06-01

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status.

  9. Patterns of radioiodine uptake by the lactating breast

    Energy Technology Data Exchange (ETDEWEB)

    Bakheet, S.M. (Dept. of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)); Hammami, M.M. (Dept. of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia))

    1994-07-01

    Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: ''full'', ''focal'', ''crescent'' and ''irregular''. The uptake was asymmetric in 60% (left>right in 45%, right>left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis. (orig.)

  10. Does Music Therapy Improve Anxiety and Depression in Alzheimer's Patients?

    Science.gov (United States)

    de la Rubia Ortí, José Enrique; García-Pardo, María Pilar; Cabañés Iranzo, Carmen; Cerón Madrigal, José Joaquin; Castillo, Sandra Sancho; Julián Rochina, Mariano; Prado Gascó, Vicente Javier

    2017-07-17

    To evaluate the effectiveness of the implementation of a short protocol of music therapy as a tool to reduce stress and improve the emotional state in patients with mild Alzheimer's disease. A sample of 25 patients with mild Alzheimer's received therapy based on the application of a music therapy session lasting 60 min. Before and after the therapy, patient saliva was collected to quantify the level of salivary cortisol using the Enzyme-Linked ImmunoSorbent Assay (ELISA) immunoassay technique and a questionnaire was completed to measure anxiety and depression (Hospital Anxiety and Depression Scale). The results show that the application of this therapy lowers the level of stress and decreases significantly depression and anxiety, establishing a linear correlation between the variation of these variables and the variation of cortisol. A short protocol of music therapy can be an alternative medicine to improve emotional variables in Alzheimer patients.

  11. Radioiodination and biodistribution of quantum dots using Bolton-Hunter reagent

    Energy Technology Data Exchange (ETDEWEB)

    Jun Park, Jae [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706 (Korea, Republic of); Sup Lee, Tae, E-mail: nobelcow@kirams.re.k [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706 (Korea, Republic of); Hyun Kang, Joo [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706 (Korea, Republic of); Song, Rita [Nano/Bio Chemistry Group, Institut Pasteur Korea (IP-Korea), Seongnam 463-400 (Korea, Republic of); Jeong Cheon, Gi, E-mail: larry@kirams.re.k [Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706 (Korea, Republic of)

    2011-01-15

    In this study, the radioiodination and biodistribution of quantum dots (QDs) using Bolton-Hunter reagent were investigated. Radioiodination yield was 33.4{+-}2.0%. Fluorescent intensity of radioiodinated QDs decreased to 75.4% of the maximum prior to radioiodination. In biodistribution and ex vivo fluorescence imaging, radioiodinated QDs were highly accumulated in reticuloendothelial system (liver and spleen) and had low level bone uptakes and slow clearance from body. These results suggest that the radioiodination method of nanoparticles using Bolton-Hunter reagent could be easily used in the biodistribution and quantification of nanoparticles in vivo.

  12. Improve T Cell Therapy in Neuroblastoma

    Science.gov (United States)

    2014-07-01

    compared with the other c- chain cytokines. Since systemic administration of recombi - nant IL-7 is well-tolerated (167), we and other investigators are...alternative vector systems that retain significant genomic integration capacity, but are based on DNA plasmids such as the transposon/transposes system which...mutagenesis by DNA transposons in gene therapy. Transl Res 2013;161:265–283. 197. Nakazawa Y, et al. PiggyBac-mediated cancer immunotherapy using EBV

  13. [Thyroid cancer metastasis to the lumbar spine successfully treated by embolization and radioiodine. A case report].

    Science.gov (United States)

    Sumimura, J; Nakagawa, K; Kawamura, J; Tayama, M; Takahashi, E; Moritomo, T; Miyata, M

    1990-07-01

    A 82-year-old woman suffered from a metastatic lesion of follicular carcinoma of the thyroid to the fourth lumbar spine, which compressed the spinal nerves and caused lumbar pain and paresthesis of the lower limb. External irradiation, 5200 RAD, was carried out. Total thyroidectomy was done for the preparation of radioiodine(131I) therapy. Two weeks later, embolization of lumbar arteries was performed to prevent the progression of the spinal cord damage during a period waiting for 131I administration. The size of the lumbar lesion decreased, and lumbal pain and spinal cord symptoms disappeared. After administration of 131I, the metastatic lesion became further smaller.

  14. Radiation exposure of persons exposed occupationally or in the vicinity of patients treated with unsealed radionuclides as for example with radioiodine; Strahlenexposition von beruflich exponierten Personen und Personen aus der Umgebung des Patienten bei der Therapie mit offenen radioaktiven Stoffen am Beispiel der Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-07-01

    In Germany, more than 30,000 patients per year are treated with radioiodine for thyroid diseases. The activity used in a treatment ward with 14 beds ranges typically between 1-2 TBq {sup 131}I annually. The mean applied activity in a patient with benign thyroid diseases is 550 MBq and in patients with thyroid cancer 4.3 GBq {sup 131}I. In patients with benign thyroid diseases the mean hospitalisation time ranges between three days (Graves' disease) and five days (toxic goitre), in patients with thyroid cancer it is approximately three days. Regular thyroid monitoring of the therapy ward staff with a semiconductor detector in a shielded whole body counter showed {sup 131}I activities of up to 300 Bq (mean 50 Bq). Assuming a constant {sup 131}I content of 50 Bq over 365 days results in a thyroid dose of 2 mSv and an effective dose of 0.1 mSv. The external exposure controlled by film badges showed a maximum dose per year of 3 mSv and a mean dose of 0.55 mSv. To reduce the exposure of persons close to the patient after dismissal from radioiodine therapy, special guidelines should be followed for approximately one week. Under this condition exposures exceeding the limit of 1 mSv for the general population according to the New German Radiation Protection Ordinance can be avoided. (orig.) [German] Jaehrlich werden in der Bundesrepublik mehr als 30.000 Radioiodbehandlungen von Schilddruesenerkrankungen durchgefuehrt. Der Radioiod-Verbrauch auf einer Therapiestation mit 14 Betten betraegt jaehrlich typischerweise 1-2 TBq {sup 131}I. Die durchschnittlich verabreichte Aktivitaet bei Patienten mit gutartigen Schilddruesenerkrankungen liegt bei 550 MBq, bei Patienten mit Schilddruesenkarzinomen bei 4,3 GBq {sup 131}I. Die mittlere Dauer des stationaeren Aufenthalts bewegt sich bei Patienten mit gutartigen Schilddruesenerkrankungen zwischen drei Tagen (Morbus Basedow) und fuenf Tagen (funktionelle Autonomie), bei Patienten mit Schilddruesenkarzinomen liegt sie bei ca. drei

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

    Institute of Scientific and Technical Information of China (English)

    李俊红; 韦智晓; 李亚范

    2011-01-01

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

  16. Uninhibited thyroidal uptake of radioiodine despite iodine excess in amiodarone-induced hypothyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Wiersinga, W.M.; Touber, J.L.; Trip, M.D.; van Royen, E.A.

    1986-08-01

    Iodine excess is associated with a low thyroidal radioiodine uptake due to dilution of the radioisotope by the increased stable iodide pool. We studied thyroidal uptake of radioisotopes in cardiac patients with iodine excess due to amiodarone treatment. /sup 99m/Tc-pertechnetate scintigraphy was performed in 13 patients receiving long term amiodarone therapy. Five patients had a clearly visible thyroid gland, and 8 patients had no or a very faint thyroid image. All patients with positive scans had an increased plasma TSH level, whereas all patients with negative scans had a normal or absent TSH response to TRH. Thyroidal uptake and discharge of 123I were studied in 30 other patients. Group I (n = 11) had normal plasma TSH responses to TRH and no iodine excess, group II (n = 7) had normal TSH responses to TRH and excess iodine from metrizoate angiography in the previous month, group III (n = 7) had normal or decreased TSH responses to TRH while receiving long term amiodarone therapy, and group IV (n = 5) had increased TSH responses to TRH while receiving long term amiodarone therapy. The mean radioiodine uptake value in group I (5.4 +/- 0.8% (+/- SE) at 60 min) was higher than those in group II (2.3 +/- 0.7%; P = 0.009) and group III (0.8 +/- 0.3%; P = 0.0005), but not different from that in group IV (5.3 +/- 1.2%; P = NS). Radioiodine discharge after perchlorate (expressed as a percentage of the 60 min uptake) in group I (10.1 +/- 2.2%) was lower than those in group II (24.9 +/- 10.6%; P = 0.05) and group III (28.8 +/- 5.3%; P less than 0.005), whereas discharge in group IV (58.0 +/- 6.1%) was greater than those in group II (P less than 0.05) and group III (P less than 0.01). In conclusion, 1) thyroid visualization by /sup 99m/Tc-pertechnetate and thyroid radioiodine uptake during iodine excess are decreased in euthyroid and hyperthyroid patients, but preserved in hypothyroid patients.

  17. Hyperbaric oxygen therapy improves colorectal anastomotic healing

    NARCIS (Netherlands)

    G.S.A. Boersema (Geesien); Z. Wu (Zhouqiao); L.F. Kroese; S. Vennix (Sandra); Y.M. Bastiaansen-Jenniskens (Yvonne); J.W. van Neck (Han); K.H. Lam; G.J. Kleinrensink (Gert Jan); J. Jeekel (Johannes); J.F. Lange (Johan F.)

    2016-01-01

    textabstractPurpose: Hyperbaric oxygen treatment (HBOT) has been found to improve the healing of poorly oxygenated tissues. This study aimed to investigate the influence of HBOT on the healing in ischemic colorectal anastomosis. Methods: Forty Wistar rats were randomly divided into a treatment group

  18. Can convective therapies improve dialysis outcomes?

    Science.gov (United States)

    Locatelli, Francesco; Manzoni, Celestina; Cavalli, Andrea; Di Filippo, Salvatore

    2009-11-01

    Convective treatments are characterized by enhanced removal of middle and large molecular weight solutes, important in the genesis of many complications of hemodialysis, compared with conventional low-flux hemodialysis. The availability of these techniques represented an intriguing innovation and a possible means to improve the still poor prognosis of hemodialysis patients. In this study we will critically review the most important published studies evaluating the impact of convective treatments on dialysis outcomes. The Hemodialysis (HEMO) study showed that greater urea removal nonsignificantly reduces the relative risk of mortality and that also high-flux hemodialysis was associated with a nonsignificant reduction, although a secondary analysis pointed to an advantage for high-flux membranes in subgroups of patients. More recently, the Membrane Permeability Outcome (MPO) study found that survival could be improved by use of high-flux membranes compared with low-flux dialysis in high-risk patients as identified by serum albumin Dialysis Outcomes and Practice Patterns (DOPPS) studies are supporting rationales for the use of convective treatments to improve survival and delay long-term complications of hemodialysis patients.

  19. Hyperbaric oxygen therapy improves cognitive functioning after brain injury

    Institute of Scientific and Technical Information of China (English)

    Su Liu; Guangyu Shen; Shukun Deng; Xiubin Wang; Qinfeng Wu; Aisong Guo

    2013-01-01

    Hyperbaric oxygen therapy has been widely applied and recognized in the treatment of brain injury;however, the correlation between the protective effect of hyperbaric oxygen therapy and changes of metabolites in the brain remains unclear. To investigate the effect and potential mechanism of hyperbaric oxygen therapy on cognitive functioning in rats, we established traumatic brain injury models using Feeney’s free fal ing method. We treated rat models with hyperbaric oxygen therapy at 0.2 MPa for 60 minutes per day. The Morris water maze test for spatial navigation showed that the average escape latency was significantly prolonged and cognitive function decreased in rats with brain injury. After treatment with hyperbaric oxygen therapy for 1 and 2 weeks, the rats’ spatial learning and memory abilities were improved. Hydrogen proton magnetic resonance spectroscopy analysis showed that the N-acetylaspartate/creatine ratio in the hippocampal CA3 region was sig-nificantly increased at 1 week, and the N-acetylaspartate/choline ratio was significantly increased at 2 weeks after hyperbaric oxygen therapy. Nissl staining and immunohistochemical staining showed that the number of nerve cells and Nissl bodies in the hippocampal CA3 region was significantly increased, and glial fibril ary acidic protein positive cells were decreased after a 2-week hyperbaric oxygen therapy treatment. Our findings indicate that hyperbaric oxygen therapy significantly im-proves cognitive functioning in rats with traumatic brain injury, and the potential mechanism is me-diated by metabolic changes and nerve cellrestoration in the hippocampal CA3 region.

  20. Hyperbaric oxygen therapy improves cognitive functioning after brain injury.

    Science.gov (United States)

    Liu, Su; Shen, Guangyu; Deng, Shukun; Wang, Xiubin; Wu, Qinfeng; Guo, Aisong

    2013-12-15

    Hyperbaric oxygen therapy has been widely applied and recognized in the treatment of brain injury; however, the correlation between the protective effect of hyperbaric oxygen therapy and changes of metabolites in the brain remains unclear. To investigate the effect and potential mechanism of hyperbaric oxygen therapy on cognitive functioning in rats, we established traumatic brain injury models using Feeney's free falling method. We treated rat models with hyperbaric oxygen therapy at 0.2 MPa for 60 minutes per day. The Morris water maze test for spatial navigation showed that the average escape latency was significantly prolonged and cognitive function decreased in rats with brain injury. After treatment with hyperbaric oxygen therapy for 1 and 2 weeks, the rats' spatial learning and memory abilities were improved. Hydrogen proton magnetic resonance spectroscopy analysis showed that the N-acetylaspartate/creatine ratio in the hippocampal CA3 region was significantly increased at 1 week, and the N-acetylaspartate/choline ratio was significantly increased at 2 weeks after hyperbaric oxygen therapy. Nissl staining and immunohistochemical staining showed that the number of nerve cells and Nissl bodies in the hippocampal CA3 region was significantly increased, and glial fibrillary acidic protein positive cells were decreased after a 2-week hyperbaric oxygen therapy treatment. Our findings indicate that hyperbaric oxygen therapy significantly improves cognitive functioning in rats with traumatic brain injury, and the potential mechanism is mediated by metabolic changes and nerve cell restoration in the hippocampal CA3 region.

  1. Improving Islet Engraftment by Gene Therapy

    Directory of Open Access Journals (Sweden)

    Xiaojie Wang

    2011-01-01

    Full Text Available Islet cell transplantation is currently the only feasible long-term treatment option for patients with type 1 diabetes. However, the majority of transplanted islets experience damage and apoptosis during the isolation process, a blood-mediated inflammatory microenvironment in the portal vein upon islet infusion, hypoxia induced by the low oxygenated milieu, and poor-revascularization-mediated lack of nutrients, and impaired hormone modulation in the local transplanted site. Strategies using genetic modification methods through overexpression or silencing of those proteins involved in promoting new formation of blood vessels or inhibition of apoptosis may overcome these hurdles and improve islet engraftment outcomes.

  2. In contrast to matrix metalloproteinases, serum adiponectin concentrations increase after radioiodine treatment of thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Lewiński A

    2012-10-01

    Full Text Available Abstract Background Matrix metalloproteinases (MMPs, together with their tissue inhibitors (TIMPs, remodel extracellular matrix under physiological and pathological conditions and are implicated in pathogenesis of cardiovascular diseases, cancer and in chronic inflammation. We have endeavoured to assess whether concentrations of MMPs, TIMPs, and anti-inflammatory adiponectin are altered by pharmacological treatment of acute thyrotoxicosis or by radioiodine therapy (RIT. Material and methods We measured serum concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, and adiponectin, TSH, free T4 (FT4 and free T3 (FT3 in 15 patients (4 males, age (years 51.8±15.3 (mean±SD with hyperthyroidism treated with thiamazole (Group 1 and in 20 subjects (2 males, treated for thyrotoxicosis with radioiodine, age 52.3±12.4 (Group 2, where blood samples were taken before RIT, visit 1 (V1, seven days post RIT, visit 2 (V2, and two to three months post RIT, visit 3 (V3. Results In Group 1 there was no significant change in concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2 or adiponectin, despite a fall in FT4 and FT3 (8.74±4.79 pg/ml vs 3.54±2.40 pg/ml, for FT3, and 4.48 ±2.21 ng/ml vs 1.02±1.07 ng/ml, for FT4, p4 and FT3 from 24.4±15.4 pmol/l (V1 to 14.7±10.6 pmol/l (V3, and from 10.0±5.65 (V1 to 6.1±4.8 pmol/l (V2, p4 and FT3, respectively. Conclusions Radioiodine therapy of thyrotoxicosis does not alter serum MMP-2, MMP-9 or TIMP-1 concentrations either acutely or after about three months of observation. An increase in serum adiponectin might reflect favourable effects of radioiodine administration on cardiovascular risk factors, while an increase in TIMP-2 (principal MMP-2 inhibitor might lead to a decrease in free MMP-2 concentrations.

  3. Synthesis and biodistribution of radioiodinated nicotine analogs

    Energy Technology Data Exchange (ETDEWEB)

    Chan, S.M.; Basmadjian, G.P.; Sadek, S.A.; Magarian, R.A.; Grunder, J.R.; Marten, D.F.

    1986-06-01

    Four /sup 125/I-labelled nicotine analogs were synthesized: 3-(methylpropylaminomethyl)-, 3-(diethylaminomethyl)-, 3-(isopropylaminomethyl)-, and 3-(diisopropylaminomethyl)-5-(/sup 125/I)-iodopyridines. 5-Bromonicotinic acid was acylated with thionyl chloride and then reacted with the appropriate primary and secondary amines to give the corresponding amides which were reduced with diborane to the desirable amines. Radioiodination was done by halogen exchange. Biodistribution studies in rats, showed that all four labelled compounds were rapidly taken up by the brain and the adrenal gland. This was followed by rapid washout of the compounds from these organs. The most promising of these compounds, 3-(diisopropylaminomethyl)-5-(/sup 125/I)-iodopyridine, showed a brain-to-blood ratio of 6.0:1 and an adrenal-to-blood ratio of 35.9:1 at 2 minutes post administration. In vitro correlation studies showed that brain uptake of these compounds depends on both protein binding and lipophilicity, whereas adrenal uptake depends only on lipophilicity.

  4. Proton radiography to improve proton therapy treatment

    Science.gov (United States)

    Takatsu, J.; van der Graaf, E. R.; Van Goethem, M.-J.; van Beuzekom, M.; Klaver, T.; Visser, J.; Brandenburg, S.; Biegun, A. K.

    2016-01-01

    The quality of cancer treatment with protons critically depends on an accurate prediction of the proton stopping powers for the tissues traversed by the protons. Today, treatment planning in proton radiotherapy is based on stopping power calculations from densities of X-ray Computed Tomography (CT) images. This causes systematic uncertainties in the calculated proton range in a patient of typically 3-4%, but can become even 10% in bone regions [1,2,3,4,5,6,7,8]. This may lead to no dose in parts of the tumor and too high dose in healthy tissues [1]. A direct measurement of proton stopping powers with high-energy protons will allow reducing these uncertainties and will improve the quality of the treatment. Several studies have shown that a sufficiently accurate radiograph can be obtained by tracking individual protons traversing a phantom (patient) [4,6,10]. Our studies benefit from the gas-filled time projection chambers based on GridPix technology [2], developed at Nikhef, capable of tracking a single proton. A BaF2 crystal measuring the residual energy of protons was used. Proton radiographs of phantom consisting of different tissue-like materials were measured with a 30×30 mm2 150 MeV proton beam. Measurements were simulated with the Geant4 toolkit.First experimental and simulated energy radiographs are in very good agreement [3]. In this paper we focus on simulation studies of the proton scattering angle as it affects the position resolution of the proton energy loss radiograph. By selecting protons with a small scattering angle, the image quality can be improved significantly.

  5. Stem cell therapy and coordination dynamics therapy to improve spinal cord injury.

    Science.gov (United States)

    Schalow, G

    2008-01-01

    During competition a motocross athlete suffered a clinically complete spinal cord injury (SCI) at the Thoracic 11/12 levels according to MRIs (magnetic resonance imaging). Six weeks after the accident the subject began intensive Coordination Dynamics Therapy (CDT) at an up-to-date therapy centre. After 6 months of therapy, when further improvements were only marginal, the patient opted for haematopoietic stem cell therapy in addition to ongoing CDT. During two years of stem cell therapy, including 4 sessions of stem cell application, and ongoing coordination dynamics therapy, improvement remained marginal--no more than what would have been achieved with continuing only CDT. It is concluded that this haematopoietic stem cell therapy did not have any beneficial effect on the repair of the spinal cord in this patient. Differences in the regeneration capacity between commonly used laboratory animals and human are addressed. On the basis of a frog model for regeneration, cell communication, and neural control, it is discussed why complete SCI in human are difficult to improve and why for stem cell therapies more proper human knowledge is needed to induce structural repair and direct it to the injured sites of the neuronal networks. Further research is needed to improve and justify the clinical application of stem cell therapy. A thoughtful combination of stem cell therapy and CDT may have a chance of structural repair even in complete SCI. However, objective measures are needed to quantify improvement in MRI (anatomic measure), EMG (measuring of motor programs by sEMG, electrophysiologic measure), and measurements of coordination dynamics (kinesiologic measure).

  6. Spa adjuvant therapy improves diabetic lower extremity arterial disease.

    Science.gov (United States)

    Qiu, Yongbin; Zhu, Yi; Jia, Wei; Chen, Songhua; Meng, Qingzhou

    2014-08-01

    To investigate the effect of spa adjuvant therapy on diabetic lower extremity arterial disease (LEAD). 128 patients with type II diabetes were separated into three groups according to the degree of lower extremity vascular stenosis. Patients within each group were then randomly divided to receive no treatment (control) or spa adjuvant therapy (treatment). Clinical symptoms, blood pressure and hemodynamic analyses were compared between control and treatment groups by Chi square or t-test. After adjuvant therapy with spa, patients' pain, numbness, and cold sensation were significantly improved compared with control groups (PSpa adjuvant therapy also significantly increased the dorsalis pedis pulse and systolic peak velocity ratio of patients with mild lower extremity vascular stenosis compared with control groups (P0.05). Both in the spa and control groups, there were no significant differences before and after medication for fasting, 2-h postprandial blood glucose and glycosylated hemoglobin (HbA1C) analyses (P>0.05). Spa adjuvant therapy can significantly alleviate lower extremity pain, numbness, and cold sensory symptoms in diabetic LEAD patients with stenosis. Moreover, in LEAD patients with mild stenosis, spa adjuvant therapy also improves the dorsalis pedis pulse and systolic peak velocity ratio, suggesting a potential role for spa therapy as an early intervention strategy to treat the initial stages of disease. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Metabolomics has the potential to improve drug therapy

    DEFF Research Database (Denmark)

    Stage, Claus; Jürgens, Gesche; Dalhoff, Kim Peder

    2014-01-01

    Until now drug therapy has primarily been controlled by dose titration on the basis of effects and side effects. However, a lot of people being treated with a drug experience too little effect or too many side effects. Therefore it will be advantageous to improve drug therapy and make it even mor...... "individualized". In this chase metabolomics is a hot topic. The aim of this paper is to review the concepts of metabolomics and the possible applications in regard to drug development, drug therapy and diagnosis, prognosis and monitoring of diseases....

  8. Animal-Assisted Therapy for Improving Human Health

    Directory of Open Access Journals (Sweden)

    Sibel Cevizci

    2009-06-01

    Full Text Available ABSTRACT Animal Assisted Therapy (AAT or Pet Therapy is an adjunctive therapy by taking advantage of human and animal interaction, activate the physiological and psychological mechanisms, initiate positive changes improving health in metabolism. In recent years, this interaction are in use to treat psychological and psychiatric disorders such as stress, depression, loneliness, pervasive developmental disorders affect negatively to human health. Furthermore, AAT has been increasingly used to improve quality of life, hypertension, cardiovascular diseases, chronic illnesses such as cancer and AIDS. The aim of this paper is to identify AAT by reviewing human and animal interaction, evaluate how AAT has a scientific background from past to now. Also, we aim to give some information about the risks, institutional applications, some factors referring AAT’s mechanism of action and chronic diseases, psychological and physical improvements provided with animal assisted therapies. The therapy results will be evaluated more advisable providing AAT is being applied with public health specialist, veterinarian, physician, psychologist, psychiatrist and veterinary public health experts who are monitor applications. Especially, the psychosomatic effects result from physical, emotional and play mechanism of action of HDT can be used for improving quality of life in individuals with chronic diseases. In Turkey, there is no any investigation which have been performed in this scientific field. It is quitely important to evaluate the benefits of this therapy accurately and to select various methods proper to diseases. Consequently, it is obvious that AAT will be considered by the healthcare services as a supportive therapy process for improving human health in Turkey and needs further studies. [TAF Prev Med Bull 2009; 8(3.000: 263-272

  9. Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids - early effect

    Directory of Open Access Journals (Sweden)

    Makarewicz Jacek

    2010-10-01

    Full Text Available Abstract Introduction Radioiodine (131I therapy is widely accepted as an essential part of therapeutic regimens in many cases of differentiated thyroid cancer. Radiation-induced oxidative damage to macromolecules is a well known phenomenon. Frequently examined process to evaluate oxidative damage to macromolecules is lipid peroxidation (LPO, resulting from oxidative damage to membrane lipids. The aim of the study was to examine serum LPO level in hypothyroid (after total thyroidectomy cancer patients subjected to ablative activities of 131I. Materials and methods The study was carried out in 21 patients (18 females and 3 males, average age 52.4 ± 16.5 years after total thyroidectomy for papillary (17 patients or follicular (4 patients thyroid carcinoma. Hypothyroidism was confirmed by increased TSH blood concentration (BRAHMS, Germany, measured before 131I therapy. Activity of 2.8 - 6.9 GBq of 131I was administered to the patients orally as sodium iodide (OBRI, Poland. Concentrations of malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA, as an index of LPO (LPO-586 kit, Calbiochem, USA, were measured in blood serum just before 131I administration (day "0" and on the days 1-4 after 131I therapy. Sera from 23 euthyroid patients served as controls. Correlations between LPO and TSH or 131I activity were calculated. Results Expectedly, serum LPO level, when measured before 131I therapy, was several times higher (p 131I therapy. LPO did not correlate with TSH concentration. In turn, negative correlation was found between 131I activity and LPO level on the day "2" after radioiodine treatment. Conclusions Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids, at least early, after therapy.

  10. Radioiodinated agents for imaging multidrug resistant tumors.

    Science.gov (United States)

    Kortylewicz, Zbigniew P; Augustine, Ann M; Nearman, Jessica; McGarry, Jonathon; Baranowska-Kortylewicz, Janina

    2009-03-01

    Diagnostic agents enabling characterization of multidrug resistance (MDR) in tumors can aid in the selection of chemotherapy regimens. We report here synthesis and evaluation of radiopharmaceuticals based on the second-generation MDR-reversing drug MS-209. 5-[3-{4-(2-Phenyl-2-(4'-[(125)I]iodo-phenyl)acetyl)piperazin-1-yl}-2-hydroxypropoxy]quino-line (17) was prepared from the 4'-tributylstannyl precursor (16) in >95% radiochemical yield. (16) was synthesized in a six-step process with the overall yield of 25%. In vitro studies were conducted in MES-SA (drug-sensitive) and MES-SA/Dx5 (MDR) human uterine sarcoma cell lines. In vivo studies were performed in athymic mice bearing MES-SA and MES-SA/Dx5 xenografts. The uptake of (17) is higher in MES-SA than MES-SA/Dx5 cells. The uptake and efflux of (17) depend on temperature and concentration, and indicate active transport mechanism(s). Incubation of drug sensitive MES-SA cells with verapamil or (15), a nonradioactive analog of (17), alters the cellular retention of radioactivity only marginally. However, MES-SA/Dx5 cells retain approximately 12% more of (17) when incubated with 10 muM verapamil. The addition of (15) or high concentrations of (17) also increase the uptake of (17) in MES-SA/Dx5 up to 200%, depending on the concentration and temperature. The dependence of (17) uptake on the MDR status is also evident in the ex vivo binding studies. In vivo tests in mice xenografted simultaneously with both tumor cell lines indicate distinct pharmacokinetics for each tumor. The absorption half-life in MES-SA/Dx5 xenograft is approximately 10x shorter and the mean residence time approximately 50% shorter compared to MES-SA xenograft in the same mouse. Radioiodinated derivatives of MS-209 appear to be good indicators of multidrug resistance.

  11. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine.

    Science.gov (United States)

    Boelaert, Kristien; Maisonneuve, Patrick; Torlinska, Barbara; Franklyn, Jayne A

    2013-05-01

    Hyperthyroidism is common, but opinions regarding optimal therapy with antithyroid drugs or radioiodine (131-I) differ. There are no randomized trials comparing these options in terms of mortality. The aim of the study was to determine whether mortality associated with hyperthyroidism varies with treatment administered or other factors. We conducted a prospective observational population-based study of 1036 subjects aged ≥ 40 years presenting to a single specialist clinic from 1989-2003 with a first episode of hyperthyroidism who were followed until June 2012. Antithyroid drugs or radioiodine (131-I) were administered. We compared causes of death with age-, sex-, and period-specific mortality in England and Wales and used within-cohort analysis of influence of treatment modality, outcome, disease etiology, severity and control, and comorbidities. In 12 868 person-years of follow-up, 334 died vs 290.6 expected (standardized mortality ratio [SMR], 1.15 [95% confidence interval (CI),1.03-1.28]; P = .01). Increased all-cause mortality largely reflected increased circulatory deaths (SMR, 1.20 [95% CI, 1.01-1.43]; P = .04). All-cause mortality was increased for the person-years accumulated during thionamide treatment (SMR, 1.30 [95% CI, 1.05-1.61]; P = .02) and after 131-I not associated with hypothyroidism (SMR, 1.24 [95% CI, 1.04-1.46]; P = .01) but not during T₄ replacement for 131-I-induced hypothyroidism (SMR, 0.98 [95% CI, 0.82-1.18]; P = .85). Within-cohort analysis comparing mortality during thionamide treatment showed a similar hazard ratio (HR) for all-cause mortality when 131-I did not result in hypothyroidism (HR, 0.95 [95% CI, 0.70-1.29]), but reduced mortality with 131-I-induced hypothyroidism (HR, 0.70 [95% CI, 0.51-0.96]). Reduced mortality associated with hypothyroidism was seen only in those without significant comorbidities and not in those with other serious diseases. Atrial fibrillation at presentation (P = .02) and an increment of 10 pmol/L in

  12. A survey of owners' perceptions and experiences of radioiodine treatment of feline hyperthyroidism in the UK.

    Science.gov (United States)

    Boland, Lara A; Murray, Jane K; Bovens, Catherine Pv; Hibbert, Angie

    2014-08-01

    The efficacy of radioiodine treatment of feline hyperthyroidism is well established; however, limited information is known about owners' perceptions or experiences of radioiodine. This study aimed to examine factors that influence owner treatment choices and their opinions following radioiodine. Surveys were sent to owners of cats referred for radioiodine treatment between 2002 and 2011 (radioiodine group; 264 cats) and owners of non-radioiodine-treated hyperthyroid cats seen at first-opinion practices (control group; 199 cats). The response rate was 67.0% (310 returned: 175 radioiodine, 135 control). Of 135 controls, 72 (53.3%) were unaware of radioiodine as a treatment option. Owners of cats ⩾15 years old and uninsured cats were less likely to pursue radioiodine. Cost of treatment, travel distance, potential human or animal health risks and waiting periods for radioiodine had a low impact on owners' treatment choice. Owners reported a moderate level of concern about treatment hospitalisation length, which included (158 respondents) the possibility of the cat being unhappy 130 (82.3%), owner missing the cat 102 (64.6%), inappetence 50 (31.6%), other pets missing the cat 32 (20.3%), development of co-morbid disease 28 (17.7%) and side effects 25 (15.8%). Owners assessed their cat's quality of life on a scale of 1 (very poor) to 10 (excellent), as 4 (4) (median [interquartile range]) pre-radioiodine (134 respondents) and 9 (2) post-radioiodine (131 respondents). Of 132 respondents, 121 (91.7%) were happy with their decision to choose radioiodine. The results of this questionnaire may assist veterinarians in addressing common owner concerns when discussing radioiodine as a treatment option for hyperthyroidism.

  13. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2003-12-01

    Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainty and debate. Early side effects are uncommon and readily manageable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

  14. Improving proton therapy by metal-containing nanoparticles : nanoscale insights

    NARCIS (Netherlands)

    Schlathölter, Thomas; Eustache, Pierre; Porcel, Erika; Salado, Daniela; Stefancikova, Lenka; Tillement, Olivier; Lux, Francois; Mowat, Pierre; Biegun, Aleksandra; van Goethem, Marc-Jan; Remita, Hynd; Lacombe, Sandrine

    2016-01-01

    The use of nanoparticles to enhance the effect of radiation-based cancer treatments is a growing field of study and recently, even nanoparticle-induced improvement of proton therapy performance has been investigated. Aiming at a clinical implementation of this approach, it is essential to

  15. Improving proton therapy by metal-containing nanoparticles : nanoscale insights

    NARCIS (Netherlands)

    Schlathölter, Thomas; Eustache, Pierre; Porcel, Erika; Salado, Daniela; Stefancikova, Lenka; Tillement, Olivier; Lux, Francois; Mowat, Pierre; Biegun, Aleksandra; van Goethem, Marc-Jan; Remita, Hynd; Lacombe, Sandrine

    2016-01-01

    The use of nanoparticles to enhance the effect of radiation-based cancer treatments is a growing field of study and recently, even nanoparticle-induced improvement of proton therapy performance has been investigated. Aiming at a clinical implementation of this approach, it is essential to characteri

  16. Improving proton therapy by metal-containing nanoparticles : nanoscale insights

    NARCIS (Netherlands)

    Schlathölter, Thomas; Eustache, Pierre; Porcel, Erika; Salado, Daniela; Stefancikova, Lenka; Tillement, Olivier; Lux, Francois; Mowat, Pierre; Biegun, Aleksandra; van Goethem, Marc-Jan; Remita, Hynd; Lacombe, Sandrine

    2016-01-01

    The use of nanoparticles to enhance the effect of radiation-based cancer treatments is a growing field of study and recently, even nanoparticle-induced improvement of proton therapy performance has been investigated. Aiming at a clinical implementation of this approach, it is essential to characteri

  17. Direct and indirect radioiodination of protein: comparative study of chemotactic peptide labeling; Radioiodacao de proteina por via direta e indireta: estudo comparativo da marcacao de peptideo quimiotatico

    Energy Technology Data Exchange (ETDEWEB)

    Lavinas, Tatiana

    2004-07-01

    The development of simple methods for protein radioiodination have stimulated the use of radioiodinated peptides in vivo. There are two basic methods for labeling proteins with radioiodine: direct labeling, reaction of an electrophilic radioiodine with functional activated groups on protein, like the phenol ring in the tyrosine residue, and the conjugation of a previously radioiodinated molecule to the protein, referred as indirect method. The great problem related to the direct radioiodination of proteins is the in vivo dehalogenation. This problem can be minimized if a non-phenolic prosthetic group is used in the indirect radioiodination of the peptide. The ATE prosthetic group, N-succinimidyl 3-(tri-n-butylstannyl) benzoate, when radioiodinated by electrophilic iododestannilation produces N-succinimidyl 3-[{sup 123}l/{sup 131}l] iodine benzoate (SIB) that is subsequently conjugated to the protein by the acylation of the lysine group. There are many radiopharmaceuticals employed in scintigraphic images of infection and inflammation used with some limitations. These limitations stimulated the improvement of a new class of radiopharmaceuticals, the receptor-specific related labeled peptides, as the mediators of the inflammatory response, that presents high affinity by receptors expressed in the inflammation process, and fast clearance from blood and non-target tissues. One of these molecules is the synthetic chemotactic peptide fNleLFNIeYK that presents potent chemotaxis for leukocytes, with high affinity by the receptors presented in polymorphonuclear leukocytes and mononuclear phagocytes. The objective of this work included the synthesis of ATE prosthetic group and comparative radioiodination of the chemotactic peptide fNleLFNIeYK by direct and indirect methods, with radiochemical purity determination and evaluation of in vivo and in vitro stability of the compounds. This work presented an original contribution in the comparative biological distribution studies

  18. Mirror therapy for improving motor function after stroke.

    Science.gov (United States)

    Thieme, Holm; Mehrholz, Jan; Pohl, Marcus; Behrens, Johann; Dohle, Christian

    2012-03-14

    Mirror therapy is used to improve motor function after stroke. During mirror therapy, a mirror is placed in the patient's midsagittal plane, thus reflecting movements of the non-paretic side as if it were the affected side. To summarise the effectiveness of mirror therapy for improving motor function, activities of daily living, pain and visuospatial neglect in patients after stroke. We searched the Cochrane Stroke Group's Trials Register (June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1950 to June 2011), EMBASE (1980 to June 2011), CINAHL (1982 to June 2011), AMED (1985 to June 2011), PsycINFO (1806 to June 2011) and PEDro (June 2011). We also handsearched relevant conference proceedings, trials and research registers, checked reference lists and contacted trialists, researchers and experts in our field of study. We included randomised controlled trials (RCTs) and randomised cross-over trials comparing mirror therapy with any control intervention for patients after stroke. Two review authors independently selected trials based on the inclusion criteria, documented the methodological quality of studies and extracted data. We analysed the results as standardised mean differences (SMDs) for continuous variables. We included 14 studies with a total of 567 participants that compared mirror therapy with other interventions. When compared with all other interventions, mirror therapy may have a significant effect on motor function (post-intervention data: SMD 0.61; 95% confidence interval (CI) 0.22 to 1.0; P = 0.002; change scores: SMD 1.04; 95% CI 0.57 to 1.51; P < 0.0001). However, effects on motor function are influenced by the type of control intervention. Additionally, mirror therapy may improve activities of daily living (SMD 0.33; 95% CI 0.05 to 0.60; P = 0.02). We found a significant positive effect on pain (SMD -1.10; 95% CI -2.10 to -0.09; P = 0.03) which is influenced by patient population

  19. Improving translation success of cell-based therapies in orthopaedics.

    Science.gov (United States)

    Bara, Jennifer J; Herrmann, Marietta; Evans, Christopher H; Miclau, Theodore; Ratcliffe, Anthony; Richards, R Geoff

    2016-01-01

    There is a clear discrepancy between the growth of cell therapy and tissue engineering research in orthopaedics over the last two decades and the number of approved clinical therapies and products available to patients. At the 2015 annual meeting of the Orthopaedic Research Society, a workshop was held to highlight important considerations from the perspectives of an academic scientist, clinical researcher, and industry representative with the aim of helping researchers to successfully translate their ideas into clinical and commercial reality. Survey data acquired from workshop participants indicated an overall positive opinion on the future potential of cell-based therapies to make a significant contribution to orthopaedic medicine. The survey also indicated an agreement on areas requiring improvement in the development of new therapies, specifically; increased support for fundamental research and education and improved transparency of regulatory processes. This perspectives article summarises the content and conclusions of the workshop and puts forward suggestions on how translational success of cell-based therapies in orthopaedics may be achieved. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  20. Limits of fetal thyroid risk from radioiodine exposure

    Energy Technology Data Exchange (ETDEWEB)

    Lloyd, R.D.; Tripp, D.A.; Kerber, R.A. [Univ. of Utah School of Medicine, Salt Lake City, UT (United States)

    1996-04-01

    An incident in which a young women became pregnant soon after being treated with 444 MBq {sup 131}I for Graves disease prompted us to search local records for the occurrence of thyroid abnormalities among people exposed in utero to fallout radioiodine. The data base from the Utah Fallout Study indicated that there had been 480 cohort subjects for whom dose to thyroid from fallout radioiodine had been calculated and who could have received any thyroid dose before birth (2473 subjects had been re-examined in 1985-86 of the 4818 examined in 1965-70). Of these 480 subjects in this category, 403 of them could be located in the 1980`s and were examined for abnormalities. Although nodules, thyroiditis, hypothyroidism and goiter were seen among the 375 persons with in utero thyroid doses from fallout radioiodine below 0.42 Gy, no thyroid abnormalities of any kind occurred in the 4 persons with in utero thyroid doses of 0.5 to 2.6 Gy. In addition, no neoplasia was found in any of the 403 subjects examined about 3 decades after in utero fallout exposure. These limited data do not indicate that the fetal thyroid is more sensitive than the postnatal thyroid by more than about a factor of about 4 when thyroid dose is considered and by not much more than unity when the comparison is based on dose equivalent (x-ray vs. radioiodine). 21 refs., 1 tab.

  1. Radioiodinated glucose analogues for use as imaging agents

    Science.gov (United States)

    Goodman, Mark M.; Knapp, Jr., Furn F.

    1988-01-01

    A radioiodinated branched carbohydrate for tissue imaging. Iodine-123 is stabilized in the compound by attaching it to a vinyl functional group that is on the carbohydrate. The compound exhibits good uptake and retention and is promising in the development of radiopharmaceuticals for brain, heart and tumor imaging.

  2. Disparity of radioiodine and radiothallium concentrations in chronic thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Shimaoka, K.; Parthasarathy, K.L.; Friedman, M.; Rao, U.

    1980-01-01

    Three cases of chronic thyroiditis (Hashimoto's disease) presented with thyroid nodules, showed disparate uptakes of radioiodine and radiothallium. All patients were clinically euthyroid and had positive antithyroid antibody titers. On cytological and/or pathological examinations, they were consistent with chronic thyroiditis.

  3. A New Technology Developed to Remove Aqueous Radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Yeop; Baik, Min Hoon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Radioiodine is considered as a critical radionuclide by the International Commission on Radiological Protection(ICRP) in terms of the radiation and radiotoxicity risks to nature and human health. In addition, there were reports about great increases of thyroid cancer in children in Belarus from 1990. In natural environments, there were several reports for the unusual increase of radioactive iodine ratios in most environmental samples (i.e. soils, vegetables, and seafoods). Iodine usually exists as iodide, iodate, and organic iodine in the environment. Iodide is considered as the most difficult form among the iodine species to treat by the conventional adsorption-based technology. This is why urgent new technology is needed to suppress such a progressive accumulation of radioiodine in natural environments. The conventional methods based on the anion-exchange and adsorption techniques have been difficult to manage the growing release of radioiodine for decades. Here we suggest a new solution that uses a biostimulant way to isolate radioiodine. We discovered that natural SRB can play an important intermediary role to get anionic iodide and cationic copper combined strongly as perfect counterions by enzymatic Cu-reduction.

  4. Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

    Energy Technology Data Exchange (ETDEWEB)

    Li, Luchuan; Lv, Bin; Chen, Bo [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Guan, Ming [Department of General Surgery, Qihe People' s Hospital, Qihe, Shandong 251100 (China); Sun, Yongfeng [Department of General Surgery, Licheng District People' s Hospital, Jinan, Shandong 250115 (China); Li, Haipeng [Department of General Surgery, Caoxian People' s Hospital, Caoxian, Shandong 274400 (China); Zhang, Binbin; Ding, Changyuan; He, Shan [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Zeng, Qingdong, E-mail: qingdz0201@163.com [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China)

    2015-07-10

    Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na{sup +}/I{sup −} symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells.

  5. The Effectiveness of Gestalt Therapy and Cognitive Therapy on Improvement of Life Quality of War Veterans

    Directory of Open Access Journals (Sweden)

    S Sadeghi

    2012-02-01

    Full Text Available Background & Aim: The imposed war burdened a lot of problems on the society of Iran during the past few years. In this course, veterans didn’t immune from its harmful effects. The aim of the present study was to determine the effectiveness of integrated group gestalt therapy and cognitive therapy on improvement of quality of life of veterans of city of Jahrom, Iran. Methods: The present clinical trial study was conducted on thirty veterans of Jahrom in 2010. The subjects included all the war veterans of Jahrom, 820 with 25-69 percent physical damage. Random sampling was executed and the world Health Organization life quality questionnaire (WHOQOL-BREF was given to 150 of them. Fifteen people in each group were replaced by another fifteen people. The test group received eight sessions of group consultation in Gestalt therapy and cognition therapy ways, but the control group received no therapy. The gathered data was analyzed using ANOVA test. Results: The result of this study showed that-there is a significant difference between the life quality dimensions (physical health, mental health, life environment and social relations between the test and control group (p=0.001. Conclusion: The results of this study showed that the integrated of group counseling by gestalt therapy and cognitive therapy had an influence on increasing the veteran’s life qualifications in aspects of physical health, mental health, life environment and social relations.

  6. Modulation of the tumor vasculature and oxygenation to improve therapy

    DEFF Research Database (Denmark)

    Siemann, Dietmar W; Horsman, Michael R

    2015-01-01

    , and extracellular molecules which together are essential for the initiation, progression and spread of tumor cells. The physical conditions that arise are imposing and manifold, and include elevated interstitial pressure, localized extracellular acidity, and regions of oxygen and nutrient deprivation. No less...... that create a significant hindrance to the control of cancers by conventional anticancer therapies. However, the aberrant nature of the tumor microenvironments also offers unique therapeutic opportunities. Particularly interventions that seek to improve tumor physiology and alleviate tumor hypoxia...

  7. Investigation of a Potential Scintigraphic Tracer for Imaging Apoptosis: Radioiodinated Annexin V-Kunitz Protease Inhibitor Fusion Protein

    Directory of Open Access Journals (Sweden)

    Mei-Hsiu Liao

    2011-01-01

    Full Text Available Radiolabeled annexin V (ANV has been widely used for imaging cell apoptosis. Recently, a novel ANV-Kunitz-type protease inhibitor fusion protein, ANV-6L15, was found to be a promising probe for improved apoptosis detection based on its higher affinity to phosphatidylserine (PS compared to native ANV. The present paper investigates the feasibility of apoptosis detection using radioiodinated ANV-6L15. Native ANV and ANV-6L15 were labeled with iodine-123 and iodine-125 using Iodogen method. The binding between the radioiodinated proteins and erythrocyte ghosts or chemical-induced apoptotic cells was examined. ANV-6L15 can be radioiodinated with high yield (40%−60% and excellent radiochemical purity (>95%. 123I-ANV-6L15 exhibited a higher binding ratio to erythrocyte ghosts and apoptotic cells compared to 123I-ANV. The biodistribution of 123I-ANV-6L15 in mice was also characterized. 123I-ANV-6L15 was rapidly cleared from the blood. High uptake in the liver and the kidneys may limit the evaluation of apoptosis in abdominal regions. Our data suggest that radiolabled ANV-6L15 may be a better scintigraphic tracer than native ANV for apoptosis detection.

  8. Improved drug therapy: triangulating phenomics with genomics and metabolomics

    Science.gov (United States)

    2014-01-01

    Embracing the complexity of biological systems has a greater likelihood to improve prediction of clinical drug response. Here we discuss limitations of a singular focus on genomics, epigenomics, proteomics, transcriptomics, metabolomics, or phenomics—highlighting the strengths and weaknesses of each individual technique. In contrast, ‘systems biology’ is proposed to allow clinicians and scientists to extract benefits from each technique, while limiting associated weaknesses by supplementing with other techniques when appropriate. Perfect predictive modeling is not possible, whereas modeling of intertwined phenomic responses using genomic stratification with metabolomic modifications may greatly improve predictive values for drug therapy. We thus propose a novel-integrated approach to personalized medicine that begins with phenomic data, is stratified by genomics, and ultimately refined by metabolomic pathway data. Whereas perfect prediction of efficacy and safety of drug therapy is not possible, improvements can be achieved by embracing the complexity of the biological system. Starting with phenomics, the combination of linking metabolomics to identify common biologic pathways and then stratifying by genomic architecture, might increase predictive values. This systems biology approach has the potential, in specific subsets of patients, to avoid drug therapy that will be either ineffective or unsafe. PMID:25181945

  9. Therapies to improve the cosmetic symptoms of rosacea.

    Science.gov (United States)

    Lanoue, Julien; Goldenberg, Gary

    2015-07-01

    Rosacea is a commonly encountered chronic inflammatory skin disease with a predilection for highly visible areas of the skin such as the face. The cosmetic symptoms of rosacea can be substantial and may greatly reduce a patient's quality of life. Although there is no definitive cure for rosacea, effective treatment of symptoms can mitigate the deleterious effects of this condition and improve quality of life. In this article, we review both existing and emerging cosmetic treatments for rosacea, including topical medications, systemic pharmacologic therapies, light-based modalities, and procedural interventions, and assess their ability to improve the cosmetic symptoms of rosacea.

  10. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    Science.gov (United States)

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

  11. IMPROVING FUNCTIONAL INDEPENDENCE OF PATIENTS WITH MULTIPLE SCLEROSIS BY PHYSICAL THERAPY AND OCCUPATIONAL THERAPY

    Directory of Open Access Journals (Sweden)

    Ana-Maria Ticărat

    2011-06-01

    Full Text Available Introduction. Patients with multiple sclerosis can have a normal life despite of their real or possible disability and of the progressive nature of it. Scope. Patients who follow physical therapy and occupational therapy will have an increased quality of life and a greater functional independence.Methods. The randomized study was made on 7 patients with multiple sclerosis, from Oradea Day Centre, 3 times/week, ages between 35 – 55 years, functional level between mild and sever. Assessment and rehabilitation methods: inspection, BARTHEL Index. Frenkel method, brething exercises, weights exercises, gait exercises, writind exercises and games were used in the rehabilitation process. Group therapies: sociotherapy, arttherapy, music therapy. Results analysis consisted of the comparison of baseline and final means.Results. By analizing baseline and final means for Barthel Index for each functon separately, it was shown a mild improvement of functional independence for almost assessed functions, with at least 1-1,5 points.Conclusions. Persons with multiple sclerosis who follow physical therapy and occupational therapy presents a better functional independence after the treatment.

  12. Radioiodine therapy in skeletal metastases from well-differentiated ...

    African Journals Online (AJOL)

    with skeletal metastases from well-differentiated thyroid carcinoma ... pathology reports from resected tumours, 9 were papillary and 15 were follicular cancers. ... The diagnosis of thyroid cancer was based on lobectomy in a single subject.

  13. ORIGINAL ARTICLE ORI ORI Radioiodine therapy in skeletal ...

    African Journals Online (AJOL)

    follicular thyroid cancer, and severely reduce quality of life, causing pain, .... the skull (9 patients), followed by spinal regions (9 patients), and the .... not done; BS = bone scan; CT = computed tomography; FNA = fine needle aspiration; MRI =.

  14. Improving access to tuberculosis preventive therapy and treatment for children

    Directory of Open Access Journals (Sweden)

    Ben J. Marais

    2017-03-01

    Full Text Available Children suffer a huge burden of disease in tuberculosis (TB endemic countries. This disease burden was largely invisible when TB control programmes focused exclusively on adults with sputum smear-positive disease. High-level advocacy and better data have improved visibility, but the establishment of functional paediatric TB programmes remains challenging. The key issues that limit children's access to TB preventive therapy and treatment in endemic areas are briefly discussed. Barriers to preventive therapy include (1 the perceived inability to rule out active disease, (2 fear of creating drug resistance, (3 non-implementation of existing guidelines in the absence of adequate monitoring, and (4 poor adherence with long preventive therapy courses. Barriers to TB treatment include (1 perceived diagnostic difficulties, (2 non-availability of chest radiography, (3 young children presenting to unprepared maternal and child health (MCH services, and (4 the absence of child-friendly formulations. With drug-resistant disease there is currently no guidance on the use of preventive therapy and treatment is usually restricted to cases with bacteriologically confirmed disease, which excludes most young children from care, even if their likely source case has documented drug-resistant TB.

  15. Improving access to tuberculosis preventive therapy and treatment for children.

    Science.gov (United States)

    Marais, Ben J

    2017-03-01

    Children suffer a huge burden of disease in tuberculosis (TB) endemic countries. This disease burden was largely invisible when TB control programmes focused exclusively on adults with sputum smear-positive disease. High-level advocacy and better data have improved visibility, but the establishment of functional paediatric TB programmes remains challenging. The key issues that limit children's access to TB preventive therapy and treatment in endemic areas are briefly discussed. Barriers to preventive therapy include (1) the perceived inability to rule out active disease, (2) fear of creating drug resistance, (3) non-implementation of existing guidelines in the absence of adequate monitoring, and (4) poor adherence with long preventive therapy courses. Barriers to TB treatment include (1) perceived diagnostic difficulties, (2) non-availability of chest radiography, (3) young children presenting to unprepared maternal and child health (MCH) services, and (4) the absence of child-friendly formulations. With drug-resistant disease there is currently no guidance on the use of preventive therapy and treatment is usually restricted to cases with bacteriologically confirmed disease, which excludes most young children from care, even if their likely source case has documented drug-resistant TB. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  16. Differentiated thyroid cancer. New concept of radioiodine ablation; Differenziertes Schilddruesenkarzinom. Fortschritte bei der Radioiodablation

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Kobe, C. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Universitaetsklinikum Koeln (Germany), Zentrum fuer Integrierte Onkologie Koeln-Bonn; Luster, M. [Universitaetsklinikum Ulm (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    Ablative radioiodine therapy is the treatment of choice in patients with differentiated thyroid cancer, the only exception being the unifocal, very small papillary thyroid cancer. The TSH-stimulation can be achieved by a waiting period for 2-3 weeks after thyroidectomy without medication or by the use of recombinant human TSH (rhTSH). Both options lead to high success rates. 'Single dose cure' using activities between 1.85 and 3.7 GBq {sup 131}I is standard. Since 2010 rhTSH is approved by the EMA for the indications pT1-4, N0-1, cM0. Survey studies did not find any inferiority of ablation with rhTSH or iatrogenic hypothyroidism in the high-risk patient group. Renal clearance is not reduced after rhTSH administration, thus the {sup 131}I blood dose and the whole body doses are lower in patients under rhTSH. Comparing identical {sup 131}I activities after endogeneous or exogeneous stimulation, rhTSH will minimize the acute adverse effects of {sup 131}I. A short-term withdrawal of levothyroxine some days before rhTSH-injection lowers the iodine plasma level, which may be advantageous for the ablation success if lower 131I activities are used. A rhTSH-based diagnostic {sup 131}I whole-body scintigraphy 3-6 months after ablation is standard for therapy control. At this time, the rhTSH-stimulated thyroglobulin-level is essential for a personalized risk stratification. Tg-measurements by a second generation assay should be used for follow-up care. Metaanalyses have shown that radioiodine ablation lowers the mortality rate, the risk of locoregional recurrences and the risk of late metastasizing. Therefore, ablation has shown a clear benefit. (orig.)

  17. Extracorporeal shock wave therapy does not improve hypertensive nephropathy.

    Science.gov (United States)

    Caron, Jonathan; Michel, Pierre-Antoine; Dussaule, Jean-Claude; Chatziantoniou, Christos; Ronco, Pierre; Boffa, Jean-Jacques

    2016-06-01

    Low-energy extracorporeal shock wave therapy (SWT) has been shown to improve myocardial dysfunction, hind limb ischemia, erectile function, and to facilitate cell therapy and healing process. These therapeutic effects were mainly due to promoting angiogenesis. Since chronic kidney diseases are characterized by renal fibrosis and capillaries rarefaction, they may benefit from a proangiogenic treatment. The objective of our study was to determine whether SWT could ameliorate renal repair and favor angiogenesis in L-NAME-induced hypertensive nephropathy in rats. SWT was started when proteinuria exceeded 1 g/mmol of creatinine and 1 week after L-NAME removal. SWT consisted of implying 0.09 mJ/mm(2) (400 shots), 3 times per week. After 4 weeks of SWT, blood pressure, renal function and urinary protein excretion did not differ between treated (LN + SWT) and untreated rats (LN). Histological lesions including glomerulosclerosis and arteriolosclerosis scores, tubular dilatation and interstitial fibrosis were similar in both groups. In addition, peritubular capillaries and eNOS, VEGF, VEGF-R, SDF-1 gene expressions did not increase in SWT-treated compared to untreated animals. No procedural complications or adverse effects were observed in control (C + SWT) and hypertensive rats (LN + SWT). These results suggest that extracorporeal kidney shock wave therapy does not induce angiogenesis and does not improve renal function and structure, at least in the model of hypertensive nephropathy although the treatment is well tolerated.

  18. Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Yang Wang; Shuquan Zhang; Min Luo; Yajun Li

    2014-01-01

    Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modiifcation of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve ifbers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our ifndings indicate that hyperbaric oxygen therapy reduces apop-tosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury.

  19. Opportunities for improving, adapting and introducing emollient therapy and improved newborn skin care practices in Africa.

    Science.gov (United States)

    Duffy, Jean L; Ferguson, Rebecca M; Darmstadt, Gary L

    2012-04-01

    Infections and complications from prematurity cause a majority of global neonatal deaths. Recent evidence has demonstrated the life-saving ability of topical emollient therapy in resource-poor settings. With the potential to reduce infection and neonatal mortality by 41 and 26%, respectively, emollient therapy is a promising option for improving newborn care. While application of oil to the newborn is nearly universal in South Asia, little is known about this behavior in Africa. This article draws on literature regarding neonatal skin care in Africa to describe behaviors, motivations and potential for introducing topical emollients. Oil massage does not appear to be universal. When oil massage occurs, substances of unknown toxicity and possibly damaging massage practices are used; thus, there is scope for introduction of improved therapeutic practices. Overall, more research is needed to develop the evidence base of current neonatal skin care behaviors in Africa, and to determine emollient therapy effectiveness there.

  20. Determination of the optimal minimum radioiodine dose in patients with Graves' disease: a clinical outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.; Tan, P.; Booker, J. [Pacific Medical Imaging, Newcastle, NSW (Australia); Epstein, M. [Dept. of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia); Lan, L. [High-Dependency Unit, St. George Hospital, Sydney, NSW (Australia)

    2001-10-01

    The study was performed under the auspices of the International Atomic Energy Commission, Vienna, Austria, with the aim of determining the optimal minimum therapeutic dose of iodine-131 for Graves' disease. The study was designed as a single-blinded randomised prospective outcome trial. Fifty-eight patients were enrolled, consisting of 50 females and 8 males aged from 17 to 75 years. Each patient was investigated by clinical assessment, biochemical and immunological assessment, thyroid ultrasound, technetium-99m thyroid scintigraphy and 24-h thyroid {sup 131}I uptake. Patients were then randomised into two treatment groups, one receiving 60 Gy and the other receiving 90 Gy thyroid tissue absorbed dose of radioiodine. The end-point markers were clinical and biochemical response to treatment. The median follow-up period was 37.5 months (range, 24-48 months). Among the 57 patients who completed final follow-up, a euthyroid state was achieved in 26 patients (46%), 27 patients (47%) were rendered hypothyroid and four patients (7%) remained hyperthyroid. Thirty-four patients (60%) remained hyperthyroid at 6 months after the initial radioiodine dose (median dose 126 MBq), and a total of 21 patients required additional radioiodine therapy (median total dose 640 MBq; range 370-1,485 MBq). At 6-month follow-up, of the 29 patients who received a thyroid tissue dose of 90 Gy, 17 (59%) remained hyperthyroid. By comparison, of the 28 patients who received a thyroid tissue dose of 60 Gy, 17 (61%) remained hyperthyroid. No significant difference in treatment response was found (P=0.881). At 6 months, five patients in the 90-Gy group were hypothyroid, compared to two patients in the 60-Gy group (P=0.246). Overall at 6 months, non-responders to low-dose therapy had a significantly larger thyroid gland mass (respective means: 35.9 ml vs 21.9 ml) and significantly higher levels of serum thyroglobulin (respective means: 597.6 {mu}g/l vs 96.9 {mu}g/l). Where low-dose radioiodine

  1. Effects of Radioiodine Treatment on Salivary Gland Function in Patients with Differentiated Thyroid Carcinoma : A Prospective Study

    NARCIS (Netherlands)

    Klein Hesselink, Esther; Brouwers, Adrienne H.; Jong, de Johan R.; van der Horst-Schrivers, Anouk N. A.; Coppes, Rob P.; Lefrandt, Joop D.; Jager, Piet L.; Vissink, Arjan; Links, Thera P.

    2016-01-01

    Complaints of a dry mouth (xerostomia) and sialoadenitis are frequent side effects of radioiodine treatment in differentiated thyroid cancer (DTC) patients. However, detailed prospective data on alterations in salivary gland functioning after radioiodine treatment (I-131) are scarce. Therefore, the

  2. Improvement of different vaccine delivery systems for cancer therapy

    Directory of Open Access Journals (Sweden)

    Safaiyan Shima

    2011-01-01

    Full Text Available Abstract Cancer vaccines are the promising tools in the hands of the clinical oncologist. Many tumor-associated antigens are excellent targets for immune therapy and vaccine design. Optimally designed cancer vaccines should combine the best tumor antigens with the most effective immunotherapy agents and/or delivery strategies to achieve positive clinical results. Various vaccine delivery systems such as different routes of immunization and physical/chemical delivery methods have been used in cancer therapy with the goal to induce immunity against tumor-associated antigens. Two basic delivery approaches including physical delivery to achieve higher levels of antigen production and formulation with microparticles to target antigen-presenting cells (APCs have demonstrated to be effective in animal models. New developments in vaccine delivery systems will improve the efficiency of clinical trials in the near future. Among them, nanoparticles (NPs such as dendrimers, polymeric NPs, metallic NPs, magnetic NPs and quantum dots have emerged as effective vaccine adjuvants for infectious diseases and cancer therapy. Furthermore, cell-penetrating peptides (CPP have been known as attractive carrier having applications in drug delivery, gene transfer and DNA vaccination. This review will focus on the utilization of different vaccine delivery systems for prevention or treatment of cancer. We will discuss their clinical applications and the future prospects for cancer vaccine development.

  3. Evaluation of a continuous quality improvement program in anticoagulant therapy

    Science.gov (United States)

    Cantin, Ariane; Lahaie, Alexandre; Odobasic, Bojan; Tremblay, Marie-Philip; Wazzan, Dana; Caron, Stéphanie; Leblanc, Caroline; Martineau, Josée; Lalonde, Lyne

    2016-01-01

    Background: The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. Objective: To evaluate the participants’ appreciation for the various activities of the program. Methods: Participants had access to training activities, including an audit with feedback, online training activities (OTA), clinical tools and support from facilitators. Cognitive behavioural learning determinants were evaluated before and 5 months after the beginning of the program. Participants’ satisfaction and perception were documented via online questionnaires and a semistructured interview. Results: Of the 52 pharmacists in the ACO Program, 47 participated in this evaluation. Seventy-seven percent of the participants completed at least 1 OTA and 6% published on the forum. The feeling of personal effectiveness rose from 8.01 (7.67-8.35) to 8.62 (8.24-8.99). The audit and feedback, as well as the high-quality OTA and their lecturers, were the most appreciated elements. Discussion: There was a high OTA participation rate. The facilitators seemed to play a key role in the CQIP. The low level of participation in the forum reflects the known phenomenon of social loafing. Technical difficulties affecting the platform and data collection for the audit with feedback constituted limitations. Conclusion: The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness. PMID:27829859

  4. Optimizing insulin pump therapy: a quality improvement project.

    Science.gov (United States)

    Meade, Lisa T; Rushton, Wanda E

    2013-01-01

    The purpose of the study was to assess insulin pump use and provide ongoing education. A quality improvement project using a pump assessment questionnaire was implemented at an endocrinology office in the southeastern United States. The questionnaire was designed to evaluate all aspects of insulin pump therapy, including pump operations, infusion set failure, management of acute complications, and usage of advanced device features. Eighty-nine patients (80% with type 1 diabetes and 20% with type 2 diabetes) completed the questionnaire at the endocrinology practice. A certified diabetes educator reviewed the questions with each patient, identifying deficiencies and training opportunities. The most common areas of deficiency identified after implementation of the assessment form included the following: expired or no basal insulin prescription in the event of pump failure or removal, no mupirocin (Bactroban®, GlaxoSmithKline, Research Triangle Park, North Carolina) prescription for suspected site infections, lack of insulin syringe if pump stopped working, failure to check urine ketones, no antiemetic prescription for sick day intervention, using manual bolus instead of bolus calculator, and lack of in-date glucagon kit. Use of a pump assessment questionnaire allows for focused discussion concerning patient behaviors related to pump operations, troubleshooting, and self-management. Incorporating use of a pump assessment questionnaire into routine practice may result in improved patient education and avoidance of adverse events specific to insulin pump therapy.

  5. Mapping and monitoring of ablative thermal therapy for improved results

    Science.gov (United States)

    Gustafson, David E.; Nadadur, Desikachari; Dalmadge, Gary W.; Nields, Morgan

    2007-02-01

    We demonstrate a method which incorporates state-of-the-art x-ray imaging with novel thermal therapy monitoring to enable improved minimally invasive thermal-therapy delivery for benign or malignant tumors. Thermal ablative techniques including RFA, microwave, and laser ablation are gaining acceptance. Incomplete treatments are common since there is no reliable method to monitor treatment zones during ablation. Treatment that doesn't encompass the entire tumor results in recurrence usually within one year. We describe a method to monitor tumor ablation zones during ablations performed under CT image guidance. This method allows the operator to predict necrosis while avoiding injury to critical structures. We validated the model using tissue and animal experiments. We also report on initial clinical results from patients receiving RFA treatments for primary or metastatic lesions. Following CT image-guidance to position RFA devices in a patient's tumor, intraprocedural CT data was acquired and processed offline. In this paper we describe the methods to monitor and provide feedback on the ablation during the study. By demonstrating the creation of accurate thermal maps in tissue and animal models, and extending this in preliminary treatment of tumors in patients, we hope to encourage the broader adoption of these methods by improving both safety and efficacy.

  6. Long-term results of two schedules of radioiodine treatment for toxic multinodular goitre

    Energy Technology Data Exchange (ETDEWEB)

    Huysmans, D.A.K.C. (Dept. of Nuclear Medicine, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Hermus, A.R.M.M. (Dept. of Medicine, Div. of Endocrinology, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Corstens, F.H.M. (Dept. of Nuclear Medicine, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Kloppenborg, P.W.C. (Dept. of Medicine, Div. of Endocrinology, Univ. Hospital Nijmegen St. Radboud (Netherlands))

    1993-11-01

    The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85-3.70 MBq/g) and radioactive iodine uptake. Follow-up (mean[+-]SEM) was 4.3[+-]0.2 years and 5.2[+-]0.3 years, respectively (P0.1). At the end of follow-up, hyperthyroidism was succesfully reversed in 73% (group A) and 88% (group B). In each group, hypothyroidism was present in 7%. The total dose per gram of thyroid tissue was not significantly different in groups A and B (2.1[+-]0.2 vs 2.7[+-]0.2 MBq/g). However, for patients treated with calculated doses the number of [sup 131]I administrations was significantly lower (1.3[+-]0.1) than for patients treated with low doses (2.2[+-]0.2), and the percentage of patients who were adequately treated with a single dose was more than twice as high (66% in group B versus 27% in group A). Euthyroidism was reached within a significantly shorter time after treatment with calculated doses (media time 0.6 years in group BVS 1.5 years in group A; life table analysis). It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a low risk of post-treatment hypothyroidism and that calculated (higher) doses appear to be preferable to low doses. (orig.)

  7. Dosimetrically determined doses of radioiodine for the treatment of metastatic thyroid carcinoma.

    Science.gov (United States)

    Van Nostrand, Douglas; Atkins, Frank; Yeganeh, Fred; Acio, Elmo; Bursaw, Randy; Wartofsky, Leonard

    2002-02-01

    In the absence of definitive studies relating radioiodine dose to outcomes, selection of a dose of radioiodine to treat metastatic thyroid carcinoma is problematic, and several approaches have been used. These include empiric fixed doses and doses used on dosimetric approaches specific for each patient. This paper is a review of the rationale and technique for dosimetrically-determined doses of radioiodine for the treatment of metastatic thyroid carcinoma. This review (1) discusses the alternatives for selection of a dose, (2) discusses the two major approaches for determining radioiodine doses dosimetrically, (3) briefly reviews several modifications of these approaches, (4) reviews the literature regarding the results, (5) discusses the side effects of these different approaches, and (6) concludes with recommendations for patient management and future research. This review does not address use of dosimetrically-determined doses of radioiodine for the initial ablation of thyroid tissue postoperatively.

  8. Mitochondrial therapy improves limb perfusion and myopathy following hindlimb ischemia.

    Science.gov (United States)

    Ryan, Terence E; Schmidt, Cameron A; Alleman, Rick J; Tsang, Alvin M; Green, Thomas D; Neufer, P Darrell; Brown, David A; McClung, Joseph M

    2016-08-01

    Critical limb ischemia is a devastating manifestation of peripheral arterial disease with no effective strategies for improving morbidity and mortality outcomes. We tested the hypothesis that cellular mitochondrial function is a key component of limb pathology and that improving mitochondrial function represents a novel paradigm for therapy. BALB/c mice were treated with a therapeutic mitochondrial-targeting peptide (MTP-131) and subjected to limb ischemia (HLI). Compared to vehicle control, MTP-131 rescued limb muscle capillary density and blood flow (64.7±11% of contralateral vs. 39.9±4%), and improved muscle regeneration. MTP-131 also increased electron transport system flux across all conditions at HLI day-7. In vitro, primary muscle cells exposed to experimental ischemia demonstrated markedly reduced (~75%) cellular respiration, which was rescued by MTP-131 during a recovery period. Compared to muscle cells, endothelial cell (HUVEC) respiration was inherently protected from ischemia (~30% reduction), but was also enhanced by MTP-131. These findings demonstrate an important link between ischemic tissue bioenergetics and limb blood flow and indicate that the mitochondria may be a pharmaceutical target for therapeutic intervention during critical limb ischemia. Copyright © 2016. Published by Elsevier Ltd.

  9. Methods to Improve Adoptive T-Cell Therapy for Melanoma

    DEFF Research Database (Denmark)

    Donia, Marco; Hansen, Morten; Sendrup, Sarah L

    2013-01-01

    Further development of adoptive T-cell therapy (ACT) with autologous tumor-infiltrating lymphocytes (TILs) has the potential to markedly change the long-term prognosis of patients with metastatic melanoma, and modifications of the original protocol that can improve its clinical efficacy are highly...... desirable. In this study, we demonstrated that a high in vitro tumor reactivity of infusion products was associated with clinical responses upon adoptive transfer. In addition, we systematically characterized the responses of a series of TIL products to relevant autologous short term-cultured melanoma cell...... lines from 12 patients. We provide evidence that antitumor reactivity of both CD8(+) and CD4(+) T cells could be enhanced in most TIL products by autologous melanoma sensitization by pretreatment with low-dose IFN-γ. IFN-γ selectively enhanced responses to tumor-associated antigens other than melanoma...

  10. [Therapy resistant diabetes mellitus and lipodystrophy: leptin therapy leads to improvement].

    Science.gov (United States)

    Jazet, Ingrid M; Jonker, Jacqueline T; Wijngaarden, Marjolein A; Lamb, Hildo; Smelt, August H M

    2013-01-01

    Lipodystrophy is a congenital or acquired disorder characterized by complete or partial absence of subcutaneous fat tissue, often accompanied by insulin resistance, diabetes mellitus (DM), hypertriglyceridemia and hepatic steatosis. A decrease in both number and function of adipocytes leads to ectopic fat depositions and decreased production of adipokines such as leptin. We present 2 patients with inadequately regulated DM, hypertriglyceridemia and hepatic steatosis who were eventually diagnosed with lipodystrophy: 1 with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) and 1 with congenital partial lipodystrophy (Dunnigan syndrome). Both received recombinant human leptin therapy (methionylleptin, available on a compassionate-use basis). This resulted in improved plasma levels of triglyceride, glucose and HbA1c and a decrease in liver size. In addition, hepatic triglyceride content decreased from 19.3% to 1.3% in the first patient and from 20.6% to 12.4% in the second. Leptin therapy is an effective and safe treatment for therapy-resistant diabetes and hypertriglyceridemia in patients with congenital lipodystrophy.

  11. Antioxidant status in hyperthyroid cats before and after radioiodine treatment.

    Science.gov (United States)

    Branter, E; Drescher, N; Padilla, M; Trepanier, L A

    2012-01-01

    Reversible antioxidant depletion is found in hyperthyroid humans, and antioxidant depletion increases the risk of methimazole toxicosis in rats. To determine whether abnormalities in concentrations of blood antioxidants or urinary isoprostanes were present in hyperthyroid cats, and were reversible after radioiodine treatment. To determine whether or not antioxidant abnormalities were associated with idiosyncratic methimazole toxicosis. Hyperthyroid cats presented for radioiodine treatment (n = 44) and healthy mature adult control cats (n = 37). Prospective, controlled, observational study. Red blood cell glutathione (GSH), plasma ascorbate (AA), plasma free retinol (vitamin A), α-tocopherol (vitamin E), and urinary free 8-isoprostanes in hyperthyroid cats were compared to healthy cats and to hyperthyroid cats 2 months after treatment. Blood antioxidants were not significantly different in hyperthyroid cats (mean GSH 1.6 ± 0.3 mM; AA 12.8 ± 4.9 μM, and vitamin E, 25 ± 14 μg/mL) compared to controls (GSH 1.4 ± 0.4 mM; AA 15.0 ± 6.6 μM, and vitamin E, 25 ± 17 μg/mL). Urinary isoprostanes were increased in hyperthyroid cats (292 ± 211 pg/mg creatinine) compared to controls (169 ± 82 pg/mg; P = .006), particularly in hyperthyroid cats with a USG cats (0.54 ± 0.28 μg/mL versus 0.38 ± 0.21 in controls; P = .007). Both abnormalities normalized after radioiodine treatment. No association was found between oxidative status and prior idiosyncratic methimazole toxicosis. Increased urinary isoprostane could reflect reversible renal oxidative stress induced by hyperthyroidism, and this requires additional evaluation. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  12. Procedure for the radioiodination of a ganglioside derivative

    Energy Technology Data Exchange (ETDEWEB)

    Klemm, N.; Su, S.N.; Harnacker, B.; Jeng, I. (Missouri Univ., Columbia (USA))

    1982-08-01

    A procedure for the preparation of a radioiodinated derivative of ganglioside GM/sub 1/ has been devised. Carbon 6 of the terminal galactosyl residue of GM/sub 1/ was converted to an aldehyde by galactose oxidase. The adduct formed by this oxidation product of GM/sub 1/ with tyramine was reduced with sodium cyanoborohydride. The tyramine moiety covalently attached to GM/sub 1/ was then labelled by the conventional iodine chloride procedure. The technique described herein is simple and economical for the preparation of a highly radioactive GM/sub 1/ derivative.

  13. Radioiodine treatment of feline hyperthyroidism in Germany; Radioiodtherapie bei Katzen mit Hyperthyreose in Deutschland

    Energy Technology Data Exchange (ETDEWEB)

    Puille, M.; Bauer, R. [Klinik fuer Nuklearmedizin der Justus-Liebig-Univ. Giessen (Germany); Knietsch, M.; Spillmann, T.; Gruenbaum, E.G. [Medizinische und Gerichtliche Veterinaerklinik I, Innere Krankheiten der Kleintiere der Justus-Liebig-Univ. Giessen (Germany)

    2002-12-01

    Aim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with {sup 131}I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German ''Strahlenschutzverordnung''. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT{sub 3} and FT{sub 4} were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 {+-} 10%, effective halflife 2.5 {+-} 0.7 days. Whole body activity <1 MBq was reached 13 {+-} 4 days after application of {sup 131}I. Radiation exposure of cat owners was estimated as 1.97 {mu}Sv/MBq for adults. Conclusion: Radioiodine therapy of feline hyperthyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are highly desirable. (orig.) [German] Ziel: Etablierung der Radioiodtherapie als veterinaermedizinische Routinetherapie der felinen Hyperthyreose in Uebereinstimmung mit der deutschen Strahlenschutzverordnung. Patienten und Methoden: 35 Katzen mit gesicherter Hyperthyreose wurden in einen Kontrollbereich stationaer mit Iod-131 behandelt. Uptake und effektive Halbwertszeit wurden mittels Kameradosimetrie ermittelt. Der Behandlungserfolg wurde labor-chemisch geprueft. Die Entlassung

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. Improving proton therapy by metal-containing nanoparticles: nanoscale insights

    Science.gov (United States)

    Schlathölter, Thomas; Eustache, Pierre; Porcel, Erika; Salado, Daniela; Stefancikova, Lenka; Tillement, Olivier; Lux, Francois; Mowat, Pierre; Biegun, Aleksandra K; van Goethem, Marc-Jan; Remita, Hynd; Lacombe, Sandrine

    2016-01-01

    The use of nanoparticles to enhance the effect of radiation-based cancer treatments is a growing field of study and recently, even nanoparticle-induced improvement of proton therapy performance has been investigated. Aiming at a clinical implementation of this approach, it is essential to characterize the mechanisms underlying the synergistic effects of nanoparticles combined with proton irradiation. In this study, we investigated the effect of platinum- and gadolinium-based nanoparticles on the nanoscale damage induced by a proton beam of therapeutically relevant energy (150 MeV) using plasmid DNA molecular probe. Two conditions of irradiation (0.44 and 3.6 keV/μm) were considered to mimic the beam properties at the entrance and at the end of the proton track. We demonstrate that the two metal-containing nanoparticles amplify, in particular, the induction of nanosize damages (>2 nm) which are most lethal for cells. More importantly, this effect is even more pronounced at the end of the proton track. This work gives a new insight into the underlying mechanisms on the nanoscale and indicates that the addition of metal-based nanoparticles is a promising strategy not only to increase the cell killing action of fast protons, but also to improve tumor targeting. PMID:27143877

  16. Improving cultural diversity awareness of physical therapy educators.

    Science.gov (United States)

    Lazaro, Rolando T; Umphred, Darcy A

    2007-01-01

    In a climate of increasing diversity in the population of patients requiring physical therapy (PT) services, PT educators must prepare students and future clinicians to work competently in culturally diverse environments. To be able to achieve this goal, PT educators must be culturally competent as well. The purposes of the study were to develop a valid and reliable instrument to assess cultural diversity awareness and to develop an educational workshop to improve cultural diversity awareness of PT academic and clinical educators. Phase 1 of the study involved the development of an instrument to assess cultural diversity awareness. The Cultural Diversity Awareness Questionnaire (CDAQ) was developed, validated for content, analyzed for reliability, and field and pilot tested. Results indicated that the CDAQ has favorable psychometric properties. Phase 2 of the study involved the development and implementation of the Cultural Diversity Workshop (CDW). The seminar contents and class materials were developed, validated, and implemented as a one-day cultural diversity awareness seminar. A one-group, pretest-posttest experimental design was used, with participants who completed the CDAQ before and after the workshop. Results indicated that the workshop was effective in improving cultural diversity awareness of the participants. Results of the workshop evaluation affirmed the achievement of objectives and effectiveness of the facilitator. This study provided a solid initial foundation upon which a comprehensive cultural competence program can be developed.

  17. Photodynamic therapy improves the ultraviolet-irradiated hairless mice skin

    Science.gov (United States)

    Jorge, Ana Elisa S.; Hamblin, Michael R.; Parizotto, Nivaldo A.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2014-03-01

    Chronic exposure to ultraviolet (UV) sunlight causes premature skin aging. In light of this fact, photodynamic therapy (PDT) is an emerging modality for treating cancer and other skin conditions, however its response on photoaged skin has not been fully illustrated by means of histopathology. For this reason, the aim of this study was analyze whether PDT can play a role on a mouse model of photoaging. Hence, SKH-1 hairless mice were randomly allocated in two groups, UV and UV/PDT. The mice were daily exposed to an UV light source (280-400 nm: peak at 350 nm) for 8 weeks followed by a single PDT session using 20% 5-aminolevulinic acid (ALA) topically. After the proper photosensitizer accumulation within the tissue, a non-coherent red (635 nm) light was performed and, after 14 days, skin samples were excised and processed for light microscopy, and their sections were stained with hematoxylin-eosin (HE) and Masson's Trichrome. As a result, we observed a substantial epidermal thickening and an improvement in dermal collagen density by deposition of new collagen fibers on UV/PDT group. These findings strongly indicate epidermal and dermal restoration, and consequently skin restoration. In conclusion, this study provides suitable evidences that PDT improves the UV-irradiated hairless mice skin, supporting this technique as an efficient treatment for photoaged skin.

  18. Case of buerger's disease Improve by Gi-Chim Treatment (Leech Therapy)

    OpenAIRE

    2009-01-01

    Objective : The purpose of this case is to show a case of buerger's disease improved by leech therapy. Methods : The patient received Leech Therapy and Oreintal medical therapy(acupunture and herb medicine). Result : We evaluate through visual analog scale(VAS), neurophatic total symptom score(TSS), fontaine grade and picture of patient's foot. Conclusion : Leech therapy and Oriental medical therapy had a good effect on buerger's disease.

  19. Case of buerger's disease Improve by Gi-Chim Treatment (Leech Therapy

    Directory of Open Access Journals (Sweden)

    Kwak Byung-min

    2009-06-01

    Full Text Available Objective : The purpose of this case is to show a case of buerger's disease improved by leech therapy. Methods : The patient received Leech Therapy and Oreintal medical therapy(acupunture and herb medicine. Result : We evaluate through visual analog scale(VAS, neurophatic total symptom score(TSS, fontaine grade and picture of patient's foot. Conclusion : Leech therapy and Oriental medical therapy had a good effect on buerger's disease.

  20. Cognitive behavioral therapy in combination with systemic family therapy improves mild to moderate postpartum depression

    Directory of Open Access Journals (Sweden)

    Yongmei Hou

    2014-03-01

    Full Text Available Objective: To explore the effect of cognitive behavioral therapy (CBT in combination with systemic family therapy (SFT on mild to moderate postpartum depression and sleep quality. Methods: 249 primiparous women with mild to moderate postpartum depression were recruited and randomly assigned to a control group (n=128, which received conventional postpartum care, or to a psychological intervention group (n=121, which received conventional postpartum care combined with psychological intervention. The Edinburgh Postnatal Depression Scale (EPDS and Pittsburgh Sleep Quality Index (PSQI were employed to evaluate depression and sleep quality, respectively. Results: 104 patients in the intervention group and 109 in the control group completed the study. After intervention, the EPDS score, PSQI score, sleep quality score, sleep latency score, sleep duration score, habitual sleep efficiency score, sleep disturbance score, and daytime dysfunction score were significantly lower in the intervention group than in the control group. The EPDS and PSQI scores of each group at different time points after intervention were markedly decreased compared with those before intervention, and the reduction in the intervention group was more evident than that in the control group. Conclusion: CBT in combination with SFT can improve depression and sleep quality in patients with mild to moderate postpartum depression.

  1. Astym therapy improves function and range of motion following mastectomy

    Directory of Open Access Journals (Sweden)

    Davies CC

    2016-03-01

    Full Text Available Claire C Davies,1 Dorothy Brockopp,2 Krista Moe2 1Baptist Health Rehabilitation, 2Research Department, Baptist Health Lexington, Lexington, KY, USA Abstract: Hypersensitive scar tissue formation along the incision line and drain site is a common side effect following mastectomy. If this scar tissue is not addressed, it can lead to decreased flexibility and function in the involved upper quadrant. Astym® treatment is a new approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy. Keywords: breast cancer, quality of life, scar tissue treatment, physical therapy

  2. Improving live attenuated bacterial carriers for vaccination and therapy.

    Science.gov (United States)

    Loessner, Holger; Endmann, Anne; Leschner, Sara; Bauer, Heike; Zelmer, Andrea; zur Lage, Susanne; Westphal, Kathrin; Weiss, Siegfried

    2008-01-01

    Live attenuated bacteria are well established as vaccines. Thus, their use as carriers for prophylactic and therapeutic macromolecules is a logical consequence. Here we describe several experimental applications of bacteria to carry heterologous macromolecules into the murine host. First, Listeria monocytogenes are described that are able to transfer eukaryotic expression plasmids into host cells for gene therapy. High multiplicities of infection are still required for efficient gene transfer and we point out some of the bottlenecks that counteract a more efficient transfer and application in vivo. Then, we describe Salmonella enterica serovar Typhimurium (S. typhimurium) as an expression plasmid transfer vehicle for oral DNA vaccination of mice. We demonstrate that the stabilization of the plasmid transformants results in an improved immune response. Stabilization was achieved by replacing the origin of replication of the original high-copy-number plasmid by a low-copy-number origin. Finally, we describe Salmonella carriers for the improved expression of heterologous proteins. We introduce a system in which the plasmid is carried as a single copy during cultivation but is amplified several fold upon infection of the host. Using the same in vivo inducible promoter for both protein expression and plasmid amplification, a substantial increase in antigen expression in vivo can be achieved. A modification of this approach is the introduction of inducible gene expression in vivo with a low-molecular-weight compound. Using P(BAD) promoter and L-arabinose as inducer we were able to deliberately activate genes in the bacterial carrier. No background activity could be observed with P(BAD) such that an inducible suicide gene could be introduced. This is adding an important safety feature to such live attenuated carrier bacteria.

  3. Improved animal models for testing gene therapy for atherosclerosis.

    Science.gov (United States)

    Du, Liang; Zhang, Jingwan; De Meyer, Guido R Y; Flynn, Rowan; Dichek, David A

    2014-04-01

    Gene therapy delivered to the blood vessel wall could augment current therapies for atherosclerosis, including systemic drug therapy and stenting. However, identification of clinically useful vectors and effective therapeutic transgenes remains at the preclinical stage. Identification of effective vectors and transgenes would be accelerated by availability of animal models that allow practical and expeditious testing of vessel-wall-directed gene therapy. Such models would include humanlike lesions that develop rapidly in vessels that are amenable to efficient gene delivery. Moreover, because human atherosclerosis develops in normal vessels, gene therapy that prevents atherosclerosis is most logically tested in relatively normal arteries. Similarly, gene therapy that causes atherosclerosis regression requires gene delivery to an existing lesion. Here we report development of three new rabbit models for testing vessel-wall-directed gene therapy that either prevents or reverses atherosclerosis. Carotid artery intimal lesions in these new models develop within 2-7 months after initiation of a high-fat diet and are 20-80 times larger than lesions in a model we described previously. Individual models allow generation of lesions that are relatively rich in either macrophages or smooth muscle cells, permitting testing of gene therapy strategies targeted at either cell type. Two of the models include gene delivery to essentially normal arteries and will be useful for identifying strategies that prevent lesion development. The third model generates lesions rapidly in vector-naïve animals and can be used for testing gene therapy that promotes lesion regression. These models are optimized for testing helper-dependent adenovirus (HDAd)-mediated gene therapy; however, they could be easily adapted for testing of other vectors or of different types of molecular therapies, delivered directly to the blood vessel wall. Our data also supports the promise of HDAd to deliver long

  4. Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes.

    Science.gov (United States)

    Vromans, Lynette P; Schweitzer, Robert D

    2011-01-01

    This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder.

  5. Incidental findings of intense radioiodine uptake in struma ovarii and bilateral nonlactating breasts simultaneously on postablation {sup 131}I SPECT/CT for papillary thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Hye Kyung; Kim, Mi Ra [Haeundae Paik HospitalUniversity of Inje, College of Medicine, Busan (Korea, Republic of)

    2016-12-15

    A 52-year-old woman diagnosed with papillary thyroid carcinoma was referred for {sup 131}I therapy following total thyroidectomy. She was given 4,810 MBq (130 mCi) of {sup 131}I following 4 weeks of thyroid hormone withdrawal. A post therapy scan showed intense, focal activity in the pelvis and intense, diffuse activity on both sides of the chest, which was localized to the right ovary and both breasts on SPECT/CT examination. She had bilateral nipple pain and a history of antidopaminergic drugs as combination medication for her rheumatoid arthritis and prokinetics during radioiodine therapy. On a {sup 123}I whole-body scan 9 months later after stopping the drugs, bilateral breast uptake was not visible; however, right ovarian focal uptake was still visualized. Bilateral salpingo-oophorectomy was performed, and revealed struma ovarii with substantial internal necrosis due to radioiodine therapy. This case is interesting as two rare entities, {sup 131}I therapy-related struma ovarii and drug-related breast uptake, were simultaneously visualized.

  6. Pharmacological Interventions for Improving Adenovirus Usage in Gene Therapy

    NARCIS (Netherlands)

    Haisma, Hidde J.; Bellu, Anna Rita

    2011-01-01

    Gene therapy may be an innovative and promising new treatment strategy for cancer but is limited due to a low efficiency and specificity of gene delivery to the target cells. Adenovirus is the preferred gene therapy vector for systemic delivery because of its unparalleled in vivo transduction effici

  7. Pharmacological Interventions for Improving Adenovirus Usage in Gene Therapy

    NARCIS (Netherlands)

    Haisma, Hidde J.; Bellu, Anna Rita

    2011-01-01

    Gene therapy may be an innovative and promising new treatment strategy for cancer but is limited due to a low efficiency and specificity of gene delivery to the target cells. Adenovirus is the preferred gene therapy vector for systemic delivery because of its unparalleled in vivo transduction

  8. Improving Computer Based Speech Therapy Using a Fuzzy Expert System

    OpenAIRE

    Ovidiu Andrei Schipor; Stefan Gheorghe Pentiuc; Maria Doina Schipor

    2012-01-01

    In this paper we present our work about Computer Based Speech Therapy systems optimization. We focus especially on using a fuzzy expert system in order to determine specific parameters of personalized therapy, i.e. the number, length and content of training sessions. The efficiency of this new approach was tested during an experiment performed with our CBST, named LOGOMON.

  9. Circuit class therapy for improving mobility after stroke.

    Science.gov (United States)

    English, Coralie; Hillier, Susan L; Lynch, Elizabeth A

    2017-06-02

    participants, MD -3.62 seconds, 95% CI -6.09 to -1.16; Activities of Balance Confidence scale: two studies, 103 participants, MD 7.76, 95% CI 0.66 to 14.87). Two other pooled balance measures failed to demonstrate superior effects (Berg Blance Scale and Step Test). Independent mobility, as measured by the Stroke Impact Scale, Functional Ambulation Classification and the Rivermead Mobility Index, also improved more in CCT interventions compared with others. Length of stay showed a non-significant effect in favour of CCT (two trials, 217 participants, MD -16.35, 95% CI -37.69 to 4.99). Eight trials (815 participants) measured adverse events (falls during therapy): there was a non-significant effect of greater risk of falls in the CCT groups (RD 0.03, 95% CI -0.02 to 0.08, GRADE: very low). Time after stroke did not make a difference to the positive outcomes, nor did the quality or size of the trials. Heterogeneity was generally low; risk of bias was variable across the studies with poor reporting of study conduct in several of the trials. There is moderate evidence that CCT is effective in improving mobility for people after stroke - they may be able to walk further, faster, with more independence and confidence in their balance. The effects may be greater later after the stroke, and are of clinical significance. Further high-quality research is required, investigating quality of life, participation and cost-benefits, that compares CCT with standard care and that also investigates the influence of factors such as stroke severity and age. The potential risk of increased falls during CCT needs to be monitored.

  10. Acceptance and commitment therapy improves exercise tolerance in sedentary women.

    Science.gov (United States)

    Ivanova, Elena; Jensen, Dennis; Cassoff, Jamie; Gu, Fei; Knäuper, Bärbel

    2015-06-01

    To test the efficacy of an acute intervention derived from acceptance and commitment therapy (ACT) for increasing high-intensity constant work rate (CWR) cycle exercise tolerance in a group of low-active women age 18-45 yr. The secondary goals were to examine whether ACT would reduce perceived effort and improve in-task affect during exercise and increase postexercise enjoyment. In a randomized controlled trial, 39 women were randomized to either the experimental (using ACT-based cognitive techniques and listening to music during the CWR exercise tests) or a control group (listening to music during the CWR exercise tests). Before (CWR-1) and after the intervention (CWR-2), participants completed a CWR cycle exercise test at 80% of maximal incremental work rate (Wmax) until volitional exhaustion. On average, ACT (n = 18) and control (n = 21) groups were matched for age, body mass index, weekly leisure activity scores, and Wmax (all P > 0.05). Exercise tolerance time (ETT) increased by 15% from CWR-1 to CWR-2 for the ACT group (392.05 ± 146.4 vs 459.39 ± 209.3 s; mean ± SD) and decreased by 8% (384.71 ± 120.1 vs 353.86 ± 127.9 s) for the control group (P = 0.008). RPE were lower (e.g., by 1.5 Borg 6-20 scale units at 55% of ETT, P ≤ 0.01) during CWR-2 in the ACT versus that in the control group. By contrast, ACT had no effect on in-task affect. Exercise enjoyment was higher after CWR-2 in the ACT group versus that in the control group (P effective intervention for enhancing the established health benefits of high-intensity exercise need to be provided.

  11. A facile synthesis of radioiodinated (Z)-vinyl iodides via vinylboronates

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, George W. E-mail: Kabalka@utk.edu; Akula, Murthy R.; Zhang, Jinhua

    2003-05-01

    A direct radioiodination of (Z)-vinylboronic acid esters to the corresponding vinyl iodides using Na{sup 123}I and chloramine-T is described. The boronates were prepared from vinyl iodides via palladium coupling reactions.

  12. Characterization and restoration of performance of {open_quotes}aged{close_quotes} radioiodine removing activated carbons

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, W.P. [NUCON International, Inc., Columbus, OH (United States)

    1997-08-01

    The degradation of radioiodine removal performance for impregnated activated carbons because of ageing is well established. However, the causes for this degradation remain unclear. One theory is that this reduction in performance from the ageing process results from an oxidation of the surface of the carbon. Radioiodine removing activated carbons that failed radioiodine removal tests showed an oxidized surface that had become hydrophilic compared with new carbons. We attempted to restore the performance of these {open_quotes}failed{close_quotes} carbons with a combination of thermal and chemical treatment. The results of these investigations are presented and discussed with the view of extending the life of radioiodine removing activated carbons. 4 refs., 2 tabs.

  13. Iodine-131 therapy for parotid oncocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Kosuda, S.; Ishikawa, M.; Tamura, K.; Mukai, M.; Kubo, A.; Hashimoto, S.

    1988-06-01

    We present a rare case of a patient with coexisting parotid oncocytoma and chronic thyroiditis who received two therapeutic doses of (/sup 131/I)iodide for a recurrent oncocytoma (oxyphilic granular cell adenoma), resulting in a definite reduction in tumor volume. We suggest that radioiodine therapy for a recurrent oncocytoma is an effective form of tumor therapy.

  14. Separation of radioiodinated angiotensins by chromatofocusing in minicolumns.

    Science.gov (United States)

    Sernia, C

    1984-05-01

    Angiotensins I, II, and III (AI, AII, AIII) and Saralasin (Sar1-Ala8-AII) were labeled with 125I and separated from the nonlabeled forms on minicolumns (a Pasteur pipet ) of chromatofocusing medium. At low ionic strength, 125I-labeled angiotensins could be eluted with Polybuffer or a piperazine-histidine buffer at their approximate isoelectric points, while nonlabeled angiotensins remained adsorbed to the column and required 1 mol X liter-1 NaCl for elution. The 125I-labeled angiotensins prepared by this method were bound by antibodies (AI) and adrenal receptors (AII, Saralasin) to an extent similar to angiotensins prepared by DEAE-Sephadex A-25 chromatography. This new method of preparing radioiodinated angiotensins is rapid (15 min), inexpensive, and requires no fraction-collecting equipment.

  15. Thyroid cell irradiation by radioiodines: a new Monte Carlo electron track-structure code

    OpenAIRE

    Christophe Champion; Mouhamad Elbast; Ting-Di Wu; Nicole Colas-Linhart

    2007-01-01

    The most significant impact of the Chernobyl accident is the increased incidence of thyroid cancer among children who were exposed to short-lived radioiodines and 131-iodine. In order to accurately estimate the radiation dose provided by these radioiodines, it is necessary to know where iodine is incorporated. To do that, the distribution at the cellular level of newly organified iodine in the immature rat thyroid was performed using secondary ion mass microscopy (NanoSIMS50). Actual dosimetr...

  16. Toxoplasma gondii: demonstration of intrinsic peroxidase activity during lacto-peroxidase mediated radioiodination of tachyzoites

    Energy Technology Data Exchange (ETDEWEB)

    Gallois, Y.; Tricaud, A.; Foussard, F.; Hodbert, J.; Girault, A.; Mauras, G.; Dubremetz, J.F.

    1986-01-01

    Tachyzoites of Toxoplasma gondii have been radioiodinated under various conditions with or without lactoperoxidase, with glucose oxidase being used to generate hydrogen peroxide. Erythrocytes were iodinated simultaneously as a control. In our conditions, tachyzoites were more intensely labelled in the absence of lactoperoxidase. This result can be explained by the existence of an intrinsic peroxidase activity which interfere with the exogenously added enzyme during surface radioiodination.

  17. Adjunctive Phosphodiesterase-4 Inhibitor Therapy Improves Antibiotic Response to Pulmonary Tuberculosis in a Rabbit Model

    Directory of Open Access Journals (Sweden)

    Selvakumar Subbian

    2016-02-01

    Conclusions: Adjunctive CC-11050 therapy significantly improves the response of rabbits with experimental pulmonary TB to INH treatment. We propose that CC-11050 may be a promising candidate for host directed therapy of patients with pulmonary TB, reducing the duration and improving clinical outcome of antibiotic treatment.

  18. Novel strategies to improve the endocrine therapy of breast cancer

    Directory of Open Access Journals (Sweden)

    Aurelio Bartolome Castrellon

    2017-05-01

    Full Text Available Endocrine therapy (ET constitutes the usual first-line of therapy for patients in the treatment of metastatic hormone receptorpositive breast cancer. Unfortunately, not all patients respond to first-line endocrine treatment due to intrinsic resistance, while others may initially respond but eventually progress with secondary acquired resistance leading to disease progression. Mechanisms of resistance to anti-estrogen therapy include, loss of expression for estrogen or progesterone receptor, upregulation of epidermal receptor growth factor 2, increased receptor tyrosine kinase signaling, leading to activation of various intracellular pathways that are involved in signal transduction such as PI3K/AKT/mammalian target of rapamycin, and others. Growing understanding of the signal cascade of estrogen receptors and the signaling pathways that interact with estrogen receptors has revealed the complex role of these receptors in cell growth and proliferation, and on the mechanism in development of resistance. These insights have led to the development of targeted therapies that may prove to be effective options for the treatment of breast cancer and may overcome hormone therapy resistance. In this review we summarize some of the mechanisms of endocrine resistance, selected clinical trials of ET and targeted therapies, which might interfere with estrogen receptor pathways and might reduce or reverse resistance to traditional, sequential, single-agent ET.

  19. Selective mono-radioiodination and characterization of a cell-penetrating peptide. L-Tyr-maurocalcine

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadi, Mitra; Bacot, Sandrine; Perret, Pascale; Riou, Laurent; Ghezzi, Catherine [Universite Joseph Fourier, Grenoble (France); INSERM U1039, Grenoble (France). Radiopharmaceutiques Biocliniques; Poillot, Cathy; Cestele, Sandrine [INSERM U836, Grenoble (France). Grenoble Inst. of Neuroscience; Universite Joseph Fourier, Grenoble (France); Desruet, Marie-Dominique [INSERM U1039, Grenoble (France). Radiopharmaceutiques Biocliniques; Couvet, Morgane; Bourgoin, Sandrine; Seve, Michel [CRI-INSERM U823, Grenoble (France). Inst. of Albert Bonniot; Universite Joseph Fourier, Grenoble (France); Waard, Michel de [INSERM U836, Grenoble (France). Grenoble Inst. of Neuroscience; Universite Joseph Fourier, Grenoble (France); Smartox Biotechnologies, Grenoble (France)

    2014-07-01

    Mono-and poly-iodinated peptides form frequently during radioiodination procedures. However, the formation of a single species in its mono-iodinated form is essential for quantitative studies such as determination of tissue concentration or image quantification. Therefore, the aim of the present study was to define the optimal experimental conditions in order to exclusively obtain the mono-iodinated form of L-maurocalcine (L-MCa). L-MCa is an animal venom toxin which was shown to act as a cell-penetrating peptide. In order to apply the current direct radioiodination technique using oxidative agents including chloramine T, Iodo-Gen {sup registered} or lactoperoxidase, an analogue of this peptide containing a tyrosine residue (Tyr-L-MCa) was synthesized and was shown to fold/oxidize properly. The enzymatic approach using lactoperoxidase/H{sub 2}O{sub 2} was found to be the best method for radioiodination of Tyr-L-MCa. MALDI-TOF mass spectrometry analyses were then used for identification of the chromatographic eluting components of the reaction mixtures. We observed that the production of different radioiodinated species depended upon the reaction conditions. Our results successfully described the experimental conditions of peptide radioiodination allowing the exclusive production of the mono-iodinated form with high radiochemical purity and without the need for a purification step. Mono-radioiodination of L-Tyr-MCa will be crucial for future quantitative studies, investigating the mechanism of cell penetration and in vivo biodistribution.

  20. Analysis of risk factors of rapid thyroidal radioiodine-131 turnover in Graves' disease patients.

    Science.gov (United States)

    Zhang, Ruiguo; Tan, Jian; Wang, Renfei; Zhang, Guizhi; Jia, Qiang; Meng, Zhaowei; Zhang, Yueqian

    2017-08-15

    Rapid iodine-131((131)I) turnover in the thyroid gland is an important feature of Graves' disease (GD) and also a strong predictor of radioiodine therapy failure. The aim of this study was to explore the predictors of rapid (131)I turnover. The clinical data on 2543 patients were retrospectively reviewed. Patients were divided into 2 groups depending on present or absent with rapid (131)I turnover defined as a 4-hour to 24-hour (131)I uptake ratio of ≥1. Overall, 590 cases (23.2%) had a rapid (131)I turnover. In the univariate analysis, gender, age, FT3/FT4 concentration, disease duration, with or without antithyroid drugs (ATD), time of ATD, thyroid weight and thyroid textures displayed significant differences. Cutoff values of age, FT3 and thyroid weight to predict rapid (131)I turnover were 38 years, 35 pmol/l and 56 g by receiver operating characteristic curves. Binary logistic regression analysis further revealed higher probability of rapid (131)I turnover in patients with thyroid weight ≥56 g (odds ratio [OR]:3.7, 95% confidence interval [CI]: 3.032-4.559), age rapid (131)I turnover in GD patients.

  1. Evil radioactivity. Subjective perception of radioactivity in patients with thyroid disease prior to treatment with radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, L.S. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin; Radiologisch-Nuklearmedizinische Gemeinschaftspraxis, Grevenbroich (Germany); Beyer, T.; Mueller, S.P.; Goerges, R.; Bockisch, A. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin; Hopfenbach, A. [Radiologisch-Nuklearmedizinische Gemeinschaftspraxis, Grevenbroich (Germany)

    2006-07-01

    Aim: We assess the perspective of patients with thyroid disease towards radiation and radioactivity by means of a cultural-anthropological approach based on qualitative measures and quantitative scores. From the interviews with the patients we evaluate as to how much radioactivity is accepted as an abstract term or as a benefit within the medical context. Patients, methods: 68 patients with autonomously functioning thyroid lesions (35 women, 33 men, 32-81 years) were included in this study. All patients were interviewed in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1=positive, 5=negative) to quantify their attitudes. Results: The responses of all patients towards radioactivity in general were heterogeneous with most responses reflecting a negative perception. Many patients expressed their associated fears about atomic energy, malignant diseases and radioactive contamination. The scoring system reflected a mostly negative opinion base. However, patients became more positive once they assumed an immediate benefit of radioactivity for the treatment of their own disease (p=0.01). Conclusions: Knowing about significant differences in patient's perception about radioactivity in general or in the clinical context may help to optimise and tailor the initial, pre-therapeutical interview towards the patient. (orig.)

  2. Improvement with ongoing Enzyme Replacement Therapy in advanced late-onset Pompe disease: a case study.

    Science.gov (United States)

    Case, Laura E; Koeberl, Dwight D; Young, Sarah P; Bali, Deeksha; DeArmey, Stephanie M; Mackey, Joanne; Kishnani, Priya S

    2008-12-01

    Benefits of enzyme replacement therapy with Myozyme (alglucosidase alfa), anecdotally reported in late-onset Pompe disease, range from motor and pulmonary improvement in less severely affected patients, to stabilization with minimal improvement in those with advanced disease. We report a case of a 63-year-old patient with significant morbidity who made notable motor and pulmonary function gains after two years on therapy. Thus, improvements in those with advanced disease may be possible after long-term treatment.

  3. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction?

    DEFF Research Database (Denmark)

    Olsen, Anne B; Persiani, Marie; Boie, Sidsel

    2015-01-01

    OBJECTIVE: The aim of this study was to investigate whether low-intensity extracorporeal shockwave therapy (LI-ESWT) can be used as a treatment for men with erectile dysfunction of organic origin. MATERIALS AND METHODS: This prospective, randomized, blinded, placebo-controlled study included 112 ...... are needed. KEYWORDS: Erectile dysfunction; extracorporeal shockwave; penis...

  4. Improvement of disfiguring skin conditions by laser therapy

    NARCIS (Netherlands)

    van Drooge, A.M.

    2014-01-01

    Since their introduction in dermatology, lasers became a welcome addition to the therapeutic armentarium for disfiguring skin conditions. In this thesis, we evaluated laser therapy for the treatment of scars, of benign dermal tumours, and of port-wine stains. For scars, many different laser devices

  5. Improvement of disfiguring skin conditions by laser therapy

    NARCIS (Netherlands)

    van Drooge, A.M.

    2014-01-01

    Since their introduction in dermatology, lasers became a welcome addition to the therapeutic armentarium for disfiguring skin conditions. In this thesis, we evaluated laser therapy for the treatment of scars, of benign dermal tumours, and of port-wine stains. For scars, many different laser devices

  6. Radioiodine scan index: A simplified, quantitative treatment response parameter for metastatic thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong Ryool; Ahn, Byeong Cheol; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae [Dept. of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, Daegu (Korea, Republic of)

    2015-09-15

    We aimed to develop and validate a simplified, novel quantification method for radioiodine whole-body scans (WBSs) as a predictor for the treatment response in differentiated thyroid carcinoma (DTC) patients with distant metastasis. We retrospectively reviewed serial WBSs after radioiodine treatment from 2008 to 2011 in patients with metastatic DTC. For standardization of TSH simulation, only a subset of patients whose TSH level was fully enhanced (TSH > 80 mU/l) was enrolled. The radioiodine scan index (RSI) was calculated by the ratio of tumor-to-brain uptake. We compared correlations between the RSI and TSH-stimulated serum thyroglobulin (TSH{sub sT}g) level and between the RSI and Tg reduction rate of consecutive radioiodine treatments. A total of 30 rounds of radioiodine treatment for 15 patients were eligible. Tumor histology was 11 papillary and 4 follicular subtypes. The TSH{sub sT}g level was mean 980 ng/ml (range, 0.5–11,244). The Tg reduction rate after treatment was a mean of −7 % (range, −90 %–210 %). Mean RSI was 3.02 (range, 0.40–10.97). RSI was positively correlated with the TSH{sub sT}g level (R2 = 0.3084, p = 0.001) and negatively correlated with the Tg reduction rate (R2 = 0.2993, p = 0.037). The regression equation to predict treatment response was as follows: Tg reduction rate = −14.581 × RSI + 51.183. Use of the radioiodine scan index derived from conventional WBS is feasible to reflect the serum Tg level in patients with metastatic DTC, and it may be useful for predicting the biologic treatment response after radioiodine treatment.

  7. Motor function improvement with mirror therapy in stroke patients: a CAT

    Directory of Open Access Journals (Sweden)

    Raúl Aguilera Eguía

    2013-12-01

    Full Text Available Introduction Stroke comprises several conditions characterized by sudden, non-convulsive loss of neurological function. A large percentage of individuals who survive stroke will have limb motor sequelae. Aim To assess the validity and applicability of the results regarding the effectiveness of mirror therapy in patients with stroke and answer the following question: In stroke subjects, can mirror therapy improve motor function? Method We analyzed the article "Mirror therapy for improving motor function after stroke," Cochrane Systematic Review [Thieme 20121]. Results Mirror therapy may increase motor function between the second and sixth week of intervention, with a standardized mean difference (SMD of 0.61 (95% CI 0.22-1.00. Conclusion Despite methodological limitations of the primary studies included in the systematic review, we found that mirror therapy is a reasonable adjunct to standard therapy by physiotherapists.

  8. Comparison of 18F-FDG PET/CT, 99mTc-methy-isobutyl-isonitrile(MIBI) scan and radioiodine diagnostic whole body scan with I-131 post-therapeutic whole body scan in papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chung Ho; Park, Young Ha; Yoo, Ie Ryung; Kim, Sung Hoon; Chung, Soo Kyo [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-07-01

    To evaluate the usefulness of 18F-FDG PET/CT and 99mTc-MIBI scan in the detection of remnant thyroid tissue, recurrence or metastasis before high dose I-131 ablation therapy. Twenty-four patients (20 female, 4 male, age=52.913.2), who received 99mTc-MIBI scan, radioiodine diagnostic whole body scan (WBS) and 18F-FDG PET/CT within a week before high dose I-131 ablation therapy from May 2004 to September 2007 were retrospectively reviewed. All patients thyroid stimulating hormone, thyroglobulin (Tg) and anti-thyroglobulin level were checked before administering I-123 or I-131 for diagnostic WBS. TSH level were higher than 30 mIU/L in all patients. The radioiodine diagnostic WBS, 99mTc-MIBI scan and 18F-FDG PET/CT were compared with the post-therapeutic WBS obtain 7 days after administration of I-131 (=150 mCi). Post-therapeutic WBS of 4 patients showed distant metastases, commonly in lung, all 4 were positive on 18F-FDG PET/CT, 1 on 99mTc-MIBI scan, but none of them were detectable on radioiodine diagnostic WBS. 7 patients with cervical or supraclavicular lymph node metastases on post-therapeutic WBS, 5 were positive on 18F-FDG PET/CT, 4 on radioiodine diagnostic WBS, and 3 on 99mTc-MIBI scan. 9 patients with remnant thyroid tissue only in thyroid bed, 7 were positive on radioiodine diagnostic WBS, 5 on 18F-FDG PET/CT and 3 on 99mTc-MIBI scan. One case with high Tg level (>10ng/mI) was positive only on post-therapeutic WBS scan. 3 patients with high Tg level, all of diagnostic scans and post-therapeutic scan were negative. Compared to the post-therapeutic WBS with radioiodine diagnostic WBS, 99mTc-MIBI scan, 18F-FDG PET/CT, none of the studies were perfectly matched with post-therapeutic WBS, but can compensate each other. 18F-FDG PET/CT might be helpful, when lymph node or lung metastasis is suspected. Further evaluation with larger population is necessary.

  9. Optokinetic therapy improves text reading in patients with hemianopic alexia: a controlled trial

    Science.gov (United States)

    Spitzyna, G.A.; Wise, R.J.S.; McDonald, S.A.; Plant, G.T.; Kidd, D.; Crewes, H.; Leff, A.P.

    2009-01-01

    Objective An acquired right-sided homonymous hemianopia can result in slowed left-to-right text reading, so-called hemianopic alexia (HA). Patients with HA lack essential visual information to help guide ensuing reading fixations. We tested two hypotheses: firstly, that practice with a visual rehabilitation method that induced small-field optokinetic nystagmus (OKN) would improve reading speeds in patients with HA when compared to a sham visual rehabilitation therapy; secondly, that this therapy would preferentially affect reading saccades into the blind field. Methods 19 patients with HA were entered into a two-armed study with two therapy blocks in each arm: one group practiced reading moving text (MT) that scrolled from right-to-left, daily for two four week blocks (group1), while the other had sham therapy (spot-the-difference) for the first block and then crossed-over to MT for the second. Results Group 1 showed significant improvements in static text reading speed over both therapy blocks (18% improvement), while group 2 did not significantly improve over the first block (5% improvement) but did when they crossed-over to the MT block (23% improvement). MT therapy was associated with a direction-specific effect on saccadic amplitude for rightward but not leftward reading saccades. Conclusion OKN inducing therapy preferentially affects reading saccades in the direction of the induced (involuntary) saccadic component. This is the first study to demonstrate the effectiveness of a specific eye movement based therapy in patients with HA in the context of a therapy-controlled trial. A free web-based version of the therapy used in this study is available online to suitable patients with HA. PMID:17536049

  10. Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study

    OpenAIRE

    2012-01-01

    Abstract Background Cognitive processing in Bipolar Disorder is characterized by a number of attentional abnormalities. Mindfulness Based Cognitive Therapy combines mindfulness meditation, a form of attentional training, along with aspects of cognitive therapy, and may improve attentional dysfunction in bipolar disorder patients. Methods 12 euthymic BD patients and 9 control participants underwent record of electroencephalography (EEG, band frequency analysis) during resting states (eyes open...

  11. Rapid improvement of calcinosis in juvenile dermatomyositis with alendronate therapy.

    Science.gov (United States)

    Ambler, Geoffrey R; Chaitow, Jeffrey; Rogers, Maureen; McDonald, David W; Ouvrier, Robert A

    2005-09-01

    A 6-year-old boy with improving juvenile dermatomyositis (JDM) developed severe and debilitating calcinosis, unresponsive to diltiazem and probenecid. Alendronate produced dramatic improvement within 1 month and by 12 months calcinosis had virtually resolved. The response was followed by bone mineral content measurements.

  12. Influence of valency and labelling chemistry on in vivo targeting using radioiodinated HER2-binding Affibody molecules

    Energy Technology Data Exchange (ETDEWEB)

    Tolmachev, Vladimir [Uppsala University, Unit of Biomedical Radiation Sciences, Rudbeck Laboratory, Uppsala (Sweden); Bromma (Sweden); Uppsala University, Unit of Nuclear Medicine, Department of Medical Sciences, Uppsala (Sweden); Mume, Eskender; Sjoeberg, Stefan [Uppsala University, Department of Biochemistry and Organic Chemistry, Uppsala (Sweden); Frejd, Fredrik Y.; Orlova, Anna [Uppsala University, Unit of Biomedical Radiation Sciences, Rudbeck Laboratory, Uppsala (Sweden); Bromma (Sweden)

    2009-04-15

    HER2 is a transmembrane tyrosine kinase, which is overexpressed in a number of carcinomas. The Affibody molecule Z{sub HER2:342} is a small (7 kDa) affinity protein binding to HER2 with an affinity of 22 pM. The goal of this study was to evaluate the use of ((4-hydroxyphenyl)ethyl)maleimide (HPEM) for radioiodination of Z{sub HER2:342} and to compare the targeting properties of monomeric and dimeric forms of Z{sub HER2:342}. The biodistribution of different radioiodinated derivatives of Z{sub HER2:342} was studied in BALB/C nu/nu mice bearing HER2-expressing SKOV-3 xenografts. Biodistributions of {sup 125}I-PIB-Z{sub HER2:342} and site-specifically labelled {sup 125}I-HPEM-Z{sub HER2:342}-C were compared. Biodistributions of monomeric {sup 131}I-HPEM-Z{sub HER2:342}-C and dimeric {sup 125}I-HPEM-(Z{sub HER2:342}){sub 2}-C were evaluated using a paired-label method. {sup 125}I-HPEM-Z{sub HER2:342}-C had the same level of tumour accumulation as {sup 125}I-PIB-Z{sub HER2:342}, but fourfold lower renal retention of radioactivity. The monomeric form of Z{sub HER2:342} provided better tumour targeting than the dimeric form. Favourable biodistribution of {sup 131}I-HPEM-Z{sub HER2:342}-C makes it a promising candidate for radionuclide therapy. (orig.)

  13. Implantable defibrillators improve survival in patients with mildly symptomatic heart failure receiving cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Gold, Michael R; Daubert, Jean-Claude; Abraham, William T;

    2013-01-01

    Cardiac resynchronization therapy (CRT) decreases mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure. These benefits have been noted with both CRT-pacemakers as well as those devices with defibrillator backup (CRT...

  14. Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia

    NARCIS (Netherlands)

    Spillekom-van Koulil, S.; Lankveld, W.G.J.M. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Donders, A.R.T.; Wirken, L.; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.M.

    2011-01-01

    OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physica

  15. [Nursing experience helping a client with schizophrenia improve her family relationships: application of reality therapy].

    Science.gov (United States)

    Yu, Chin-Hsing; Yang, Pei-Yi; Lu, Shu-Chin; Ma, Da-Yuan

    2012-12-01

    Reality therapy has been demonstrated to be an effective strategy in achieving behavioral change. This case study used reality therapy as a therapeutic communication tool to help improve the family relationships of a client with schizophrenia. We used a four-tiered questioning technique to address, respectively, the aspects of "want," "doing/direction," "evaluation" and "plan" (WDEP). Nursing interventions were held between October 21st and November 19th, 2010. The authors used the reality therapy framework and WDEP system to guide the client to explore her inner needs, review problems objectively, and determine where efforts could be focused most effectively. Better appreciation of her abilities and strengths and encouragement of effective actions helped improve client relationships with her family members. This study introduced reality therapy and shared clinical experiences in order to help readers better understand reality therapy as an alternative framework of communication in nursing care.

  16. [Improvement of parodontitis therapy of patients with HIV-infection].

    Science.gov (United States)

    Soboleva, L A; Oseeva, A O; Shul'diakov, A A; Bulkina, N V

    2010-01-01

    For the purpose to determine the clinic-pathogenetic efficacy of cycloferon liniment in the combined therapy of periodontitis of patients with subclinical stage of HIV-infection medical examination and treatment of 40 patients was carried out. It was established that use of liniment cycloferon in the combined treatment of patients with subclinical stage of HIV-infection allowed to accelerate process of normalization of lipid peroxidation parameters and antioxidant potential of blood, to decrease infection load (herpes symplex virus I, Candida albicans, Staphylococcus aureus) in parodontal recess and evidence of local inflammation with reduction of activity of the tumours necrosis factor and interleukin 1beta, what provided acceleration of recuperation processes, lowering the frequency of parodontitis relapses.

  17. Cost-effectiveness of using recombinant human thyroid-stimulating hormone before radioiodine ablation for thyroid cancer treatment in Spanish hospitals.

    Science.gov (United States)

    Vallejo, J A; Muros, M A

    2017-05-20

    In thyroid cancer treatment, the thyroid-stimulating hormone (TSH) must be elevated before radioiodine ablation, either by exogenous (with recombinant human thyrotropin [rhTSH]) or endogenous stimulation by thyroid hormone withdrawal (THW). The use of rhTSH avoids hypothyroidism and favours the subsequent elimination of radioiodine, but involves the cost of the product. For this reason, a cost-effectiveness analysis was performed, taking into account all costs involved and the benefits associated with the use of this therapy. Using a Markov modelling with two analysis arms (rhTSH and THW), stratified into high (100mCi/3700 MBq) and low (30mCi/1110 MBq) radioiodine doses, and using 17 weekly cycles, the incremental cost per quality-adjusted life-year (QALY) related to the use of rhTSH was determined. The clinical inputs included in the model were based on published studies and in a treatment survey conducted in Spain. Radioablation preparation with rhTSH is superior to THW, showing additional benefits (0.048 AVAC), as well as cost savings (-€614.16), with an incremental cost-effectiveness rate (ICER) of -€12,795/QALY. The univariate and multivariate sensitivity analyses showed the result to be robust. The use of rhTSH previous to radioablation in Spain has cost savings, as well as a series of health benefits for the patient, making it highly cost-effective. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  18. The Hypothalamic-Pituitary-Thyroid Axis in Infants and Children: Protection from Radioiodines

    Directory of Open Access Journals (Sweden)

    Jeffrey Fisher

    2014-01-01

    Full Text Available Potassium iodide (KI is recommended as an emergency treatment for exposure to radioiodines, most commonly associated with nuclear detonation or mishaps at nuclear power plants. Protecting the thyroid gland of infants and children remains a priority because of increased incidence of thyroid cancer in the young exposed to radioiodines (such as 131I and 133I. There is a lack of clinical studies for KI and radioiodines in children or infants to draw definitive conclusions about the effectiveness and safety of KI administration in the young. In this paper, we compare functional aspects of the hypothalamic-pituitary-thyroid (HPT axis in the young and adults and review the limited studies of KI in children. The HPT axis in the infant and child is hyperactive and therefore will respond less effectively to KI treatment compared to adults. Research on the safety and efficacy of KI in infants and children is needed.

  19. Procedure guideline for radioiodine test (version 3); Verfahrensanweisung zum Radioiodtest (Version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Eschner, W. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Lassmann, M. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany). Abt. fuer Nuklearmedizin; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

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

  20. Three dimensional conformal radiation therapy may improve the therapeutic ratio of radiation therapy after pneumonectomy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Trouette, R.; Causse, N.; Elkhadri, M.; Caudry, M.; Maire, J.P.; Houlard, J.P.; Racaldini, L.; Demeaux, H.

    1995-12-01

    Three dimensional conformal radiation therapy would allow to decrease the normal tissue dose while maintaining the same target dose as standard treatment. To evaluate the feasibility of normal tissue dose reduction for ten patients with pneumonectomy for lung cancer, we determined the dose distribution to the normal tissue with 3-dimensional conformal radiation therapy (3-DCRT) and conventional treatment planning (CTP). Dose-volume histograms for target and normal tissue (lung, heart) were used for comparison of the different treatment planning. The mean percentages of lung and heart volumes which received 40 Gy with 3-DCRT were respectively 63% and 37% of the mean percentage of lung and volumes which received the same dose with CTP. These preliminary results suggest that conformal therapy may improve the therapeutic ratio by reducing risk to normal tissue.

  1. Cognitive behavioral therapy for suicidal behaviors: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Mewton L

    2016-03-01

    Full Text Available Louise Mewton,1 Gavin Andrews2 1National Health and Medical Research Council Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 2Clinical Research Unit for Anxiety and Depression (CRUfAD, St Vincent's Hospital, Sydney, NSW, Australia Abstract: This systematic review provides an overview of the effectiveness of cognitive behavioral therapy (CBT in reducing suicidal cognitions and behavior in the adult population. We identified 15 randomized controlled trials of CBT for adults (aged 18 years and older that included suicide-related cognitions or behaviors as an outcome measure. The studies were identified from PsycINFO searches, reference lists, and a publicly available database of psychosocial interventions for suicidal behaviors. This review identified some evidence of the use of CBT in the reduction of both suicidal cognitions and behaviors. There was not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. On the other hand, CBT focusing on suicidal cognitions and behaviors was found to be effective. Given the current evidence, clinicians should be trained in CBT techniques focusing on suicidal cognitions and behaviors that are independent of the treatment of mental illness. Keywords: suicidal behaviors, suicidal cognitions, CBT

  2. Speciation of Radiocesium and Radioiodine in Aerosols from Tsukuba after the Fukushima Nuclear Accident

    DEFF Research Database (Denmark)

    Xu, Sheng; Zhang, Luyuan; Freeman, Stewart P. H. T.

    2015-01-01

    Aerosol samples were collected from Tsukuba, Japan, soon after the 2011 Fukushima nuclear accident and analyzed for speciation of radiocesium and radioiodine to explore their chemical behavior and isotopic ratios after the release. Most Cs-134 and Cs-137 were bound in organic matter (53-91%) and ......Aerosol samples were collected from Tsukuba, Japan, soon after the 2011 Fukushima nuclear accident and analyzed for speciation of radiocesium and radioiodine to explore their chemical behavior and isotopic ratios after the release. Most Cs-134 and Cs-137 were bound in organic matter (53...

  3. Effectiveness of Radioiodine Treatment for Toxic Nodular Goiter

    Directory of Open Access Journals (Sweden)

    Hatice Şakı

    2015-10-01

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

  4. Improved bioresorbable microporous intravascular stents for gene therapy.

    Science.gov (United States)

    Ye, Y W; Landau, C; Meidell, R S; Willard, J E; Moskowitz, A; Aziz, S; Carlisle, E; Nelson, K; Eberhart, R C

    1996-01-01

    Drug imbibing microporous stents are under development at a number of centers to enhance healing of the arterial wall after balloon coronary angioplasty procedures. The authors improved the mechanical strength and reservoir properties of a biodegradable microporous stent reported to this Society in 1994. A combined tubular/helical coil stent is readily fabricated by flotation/precipitation and casting/ winding techniques. A two stage solvent swelling technique allows precise adjustment of the surface hydrophilic/hydrophobic balance. These developments permit seven-fold improvement in drug capacity without significantly altering mechanical properties. Stents modified in this manner retain tensile and compressive strength and are suitable for remote deployment. Elution kinetics of these modified stents suggest they are suitable for gene delivery. Successful gene transfer and transmural expression have been demonstrated after implantation of stents impregnated with a recombinant adenovirus carrying a nuclear localizing beta-galactosidase reporter gene into rabbit carotid arteries. These studies suggest that surface modified, bioresorbable polymer stents ultimately may be useful adjunctive devices for gene transfer during percutaneous transluminal revascularization.

  5. Health education improves effectively therapy of inpatients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Xiang Gu; Chunzhi Shi; Yibai Feng; Xianggui Wang; Hongbin Nie; Yongming Zhou; Yeqiang Liu; Xiangdong Xu

    2006-01-01

    Objective: Low rate of medication usage and blood pressure (BP) control, bad lifestyle, poor cognition to hypertension, have been obstacles in prevention from hypertensive disease and complication in Chinese cohort. Health education appears to be an impendent measure to improve this situation. To study the effect of health education on the rate of medication usage and BP control, the lifestyle, and the incidence of complication among patients with hypertension. Methods: 284 hypertensive inpatients were divided randomly into two groups: the control group was intervened with routine medication; the education group was intervened with routine medication in combination with intensive health education according to the investigation on the risk factors of cardiocerebrovascular diseases and cognitive levels of hypertensivedisease. During 12.16 ± 1.95 months of following up,the status of lifestyle, the rate of medication usage and BP control, and incidence of complications between two groups were analyzed. Results: In education group, the rate of smoking, alcohol intake, lower-salt ingesting, exercise, medication usage and BP control were improved after intervention and significantly different from those before intervention (P < 0.01). After intervention,the incidence of complications in education group and control group was 10.9% and 30.5% respectively (P < 0.01 ). Conclusion:Intensive health education is an important measure in preventing from hypertension.

  6. Improving plan quality for prostate volumetric-modulated arc therapy.

    Science.gov (United States)

    Wright, Katrina; Ferrari-Anderson, Janet; Barry, Tamara; Bernard, Anne; Brown, Elizabeth; Lehman, Margot; Pryor, David

    2017-08-04

    We critically evaluated the quality and consistency of volumetric-modulated arc therapy (VMAT) prostate planning at a single institution to quantify objective measures for plan quality and establish clear guidelines for plan evaluation and quality assurance. A retrospective analysis was conducted on 34 plans generated on the Pinnacle(3) version 9.4 and 9.8 treatment planning system to deliver 78 Gy in 39 fractions to the prostate only using VMAT. Data were collected on contoured structure volumes, overlaps and expansions, planning target volume (PTV) and organs at risk volumes and relationship, dose volume histogram, plan conformity, plan homogeneity, low-dose wash, and beam parameters. Standard descriptive statistics were used to describe the data. Despite a standardized planning protocol, we found variability was present in all steps of the planning process. Deviations from protocol contours by radiation oncologists and radiation therapists occurred in 12% and 50% of cases, respectively, and the number of optimization parameters ranged from 12 to 27 (median 17). This contributed to conflicts within the optimization process reflected by the mean composite objective value of 0.07 (range 0.01 to 0.44). Methods used to control low-intermediate dose wash were inconsistent. At the PTV rectum interface, the dose-gradient distance from the 74.1 Gy to 40 Gy isodose ranged from 0.6 cm to 2.0 cm (median 1.0 cm). Increasing collimator angle was associated with a decrease in monitor units and a single full 6 MV arc was sufficient for the majority of plans. A significant relationship was found between clinical target volume-rectum distance and rectal tolerances achieved. A linear relationship was determined between the PTV volume and volume of 40 Gy isodose. Objective values and composite objective values were useful in determining plan quality. Anatomic geometry and overlap of structures has a measurable impact on the plan quality achieved for prostate patients

  7. Graves' ophthalmopathy and {sup 1}31{sup I} therapy

    Energy Technology Data Exchange (ETDEWEB)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell' Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A. [Pisa Univ. of Pisa, Pisa (Italy). Dept. of Endocrinology and Metabolism

    1999-12-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: (i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; (ii) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; (iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between

  8. Astym therapy improves function and range of motion following mastectomy.

    Science.gov (United States)

    Davies, Claire C; Brockopp, Dorothy; Moe, Krista

    2016-01-01

    Hypersensitive scar tissue formation along the incision line and drain site is a common side effect following mastectomy. If this scar tissue is not addressed, it can lead to decreased flexibility and function in the involved upper quadrant. Astym(®) treatment is a new approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy.

  9. [Individual reminiscence therapy improves self-esteem for Japanese community-dwelling older adults].

    Science.gov (United States)

    Nomura, Nobutake

    2009-04-01

    This study examined the effects of individual reminiscence therapy in Japanese community-dwelling older adults without dementia. Participants (twenty three men and fifty seven women, mean age = 82.6 yrs) were recruited from a community day-care center. They were randomly assigned to a reminiscence therapy group or a control group. Participants in the reminiscence group completed five or six weekly sessions (30-60 minutes) of individual reminiscence therapy. Participant's depression, life satisfaction, and self-esteem were assessed before and after the sessions. The results showed that the reminiscence group had a significant improvement in self-esteem. Thus individual reminiscence therapy can be a tool to maintain or improve self-esteem for Japanese older adults without dementia.

  10. Reducing dysfunctional beliefs about sleep does not significantly improve insomnia in cognitive behavioral therapy.

    Science.gov (United States)

    Okajima, Isa; Nakajima, Shun; Ochi, Moeko; Inoue, Yuichi

    2014-01-01

    The present study examined to examine whether improvement of insomnia is mediated by a reduction in sleep-related dysfunctional beliefs through cognitive behavioral therapy for insomnia. In total, 64 patients with chronic insomnia received cognitive behavioral therapy for insomnia consisting of 6 biweekly individual treatment sessions of 50 minutes in length. Participants were asked to complete the Athens Insomnia Scale and the Dysfunctional Beliefs and Attitudes about Sleep scale both at the baseline and at the end of treatment. The results showed that although cognitive behavioral therapy for insomnia greatly reduced individuals' scores on both scales, the decrease in dysfunctional beliefs and attitudes about sleep with treatment did not seem to mediate improvement in insomnia. The findings suggest that sleep-related dysfunctional beliefs endorsed by patients with chronic insomnia may be attenuated by cognitive behavioral therapy for insomnia, but changes in such beliefs are not likely to play a crucial role in reducing the severity of insomnia.

  11. Electrophoretic purification of radioiodinated follicle-stimulating hormone for radioligand receptor assay and radioimmunoassay

    Energy Technology Data Exchange (ETDEWEB)

    Schneyer, A.L.; Sluss, P.M.; Bosukonda, D.; Reichert, L.E. Jr.

    1986-10-01

    A method is described for electrophoretic purification of (/sup 125/I)human (h) FSH after radioiodination that improves radioligand binding to FSH membrane receptors. Lactoperoxidase-iodinated hFSH was separated from reaction products by electrophoresis on 7.5% polyacrylamide tube gels (PAGE). Material eluted from 3-mm gel slices was analyzed for incorporation of /sup 125/I and binding to antibody (RIA) or receptor (RRA), and by sodium dodecyl sulfate-PAGE for protein composition. Sodium dodecyl sulfate-PAGE analysis of individual PAGE fractions demonstrated that iodinated proteins, both higher and lower in apparent mol wt than intact FSH, were separated by PAGE, but not by gel filtration chromatography (Sephadex G-25). PAGE purification of radioligand resulted in significantly greater (compared to gel filtration) RRA sensitivity and specificity. Maximum binding of PAGE-purified (/sup 125/I)hFSH to excess calf tests membrane receptors was 45%, with a specific activity of approximately 26 microCi/micrograms, as determined by the method of self-displacement. Maximum binding to excess hFSH antisera (NIH anti-hFSH 4) was 80-85%. This allowed a useful final dilution of 1:120,000, thereby facilitating development of a sensitive and specific RIA with this antiserum. These data indicate that PAGE separation of intact (/sup 125/I)hFSH from other iodinated proteins results in improved radioligand binding, assay sensitivity, and assay specificity. In addition, PAGE-purified lactoperoxidase-iodinated hFSH is suitable for use in both RIA and RRA.

  12. Mesenchymal stem cell therapy promotes the improvement and recovery of renal function in a preclinical model

    Directory of Open Access Journals (Sweden)

    Antônio Urt Filho

    2016-01-01

    Full Text Available Abstract Acute renal failure (ARF is an extremely important public health issue in need of novel therapies. The present study aimed to evaluate the capacity of mesenchymal stem cell (MSC therapy to promote the improvement and recovery of renal function in a preclinical model. Wistar rats were used as the experimental model, and our results show that cisplatin (5mg/kg can efficiently induce ARF, as measured by changes in biochemical (urea and creatinine and histological parameters. MSC therapy performed 24h after the administration of chemotherapy resulted in normalized plasma urea and creatinine levels 30 and 45d after the onset of kidney disease. Furthermore, MSC therapy significantly reduced histological changes (intratubular cast formation in protein overload nephropathy and tubular hydropic degeneration in this ARF model. Thus, considering that current therapies for ARF are merely palliative and that MSC therapy can promote the improvement and recovery of renal function in this model system, we suggest that innovative/alternative therapies involving MSCs should be considered for clinical studies in humans to treat ARF.

  13. Antifungal Therapy for Systemic Mycosis and the Nanobiotechnology Era: Improving Efficacy, Biodistribution and Toxicity

    Science.gov (United States)

    Souza, Ana C. O.; Amaral, Andre C.

    2017-01-01

    Fungal diseases have been emerging as an important public health problem worldwide with the increase in host predisposition factors due to immunological dysregulations, immunosuppressive and/or anticancer therapy. Antifungal therapy for systemic mycosis is limited, most of times expensive and causes important toxic effects. Nanotechnology has become an interesting strategy to improve efficacy of traditional antifungal drugs, which allows lower toxicity, better biodistribution, and drug targeting, with promising results in vitro and in vivo. In this review, we provide a discussion about conventional antifungal and nanoantifungal therapies for systemic mycosis. PMID:28326065

  14. Bispecific Antibody Pretargeting for Improving Cancer Imaging and Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sharkey, Robert M.

    2005-02-04

    The main objective of this project was to evaluate pretargeting systems that use a bispecific antibody (bsMAb) to improve the detection and treatment of cancer. A bsMAb has specificity to a tumor antigen, which is used to bind the tumor, while the other specificity is to a peptide that can be radiolabeled. Pretargeting is the process by which the unlabeled bsMAb is given first, and after a sufficient time (1-2 days) is given for it to localize in the tumor and clear from the blood, a small molecular weight radiolabeled peptide is given. According to a dynamic imaging study using a 99mTc-labeled peptide, the radiolabeled peptide localizes in the tumor in less than 1 hour, with > 80% of it clearing from the blood and body within this same time. Tumor/nontumor targeting ratios that are nearly 50 times better than that with a directly radiolabeled Fab fragment have been observed (Sharkey et al., ''Signal amplification in molecular imaging by a multivalent bispecific nanobody'' submitted). The bsMAbs used in this project have been composed of 3 antibodies that will target antigens found in colorectal and pancreatic cancers (CEA, CSAp, and MUC1). For the ''peptide binding moiety'' of the bsMAb, we initially examined an antibody directed to DOTA, but subsequently focused on another antibody directed against a novel compound, HSG (histamine-succinyl-glycine).

  15. Integrated yoga therapy for improving mental health in managers

    Directory of Open Access Journals (Sweden)

    Tikhe Sham Ganpat

    2011-01-01

    Full Text Available Background: Managers′ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to "Excessive Tension" and consequent deterioration in "Executive Efficiency." Objective: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET program. Materials and Methods: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre-post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program. Results: The data analysis showed 68.25% decrease (P<0.001 in somatic symptoms, 66.29% decrease (P<0.001 in anxiety and insomnia, 65.00% decrease (P<0.001 in social dysfunction, 87.08% decrease (P<0.001 in severe depression, and 71.47% decrease (P<0.001 in all medical complaints. Conclusion: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for "Executive Efficiency."

  16. Functional electrical stimulation therapy improves grasping in chronic cervical spinal cord injury: Two case studies

    Directory of Open Access Journals (Sweden)

    Miller Rosalynn C.

    2008-01-01

    Full Text Available OBJECTIVE AND IMPORTANCE: To present case studies of two individuals with chronic cervical spinal cord injury (SCI who participated in functional electrical stimulation (FES therapy with the objective to restore voluntary grasp function. CLINICAL PRESENTATION: Both individuals (right hand dominant males, age 24 and 31 had a sustained a cervical SCI (C6 and C4-5, respectively at least 8 years prior to participation in this study. INTERVENTION: Both individuals participated in an individualized FES therapy program for 6 weeks. FES therapy was administered through a regimen of three, one-hour sessions, per week for three months. A single arm of each participant (n = 2 was treated. FES therapy is an integrative intervention strategy combining muscle strengthening, functional movement training and stretching. The participant's hand movement abilities were assessed pre and post FES therapy using the Manual Muscle Test (MMT, a modified Sollerman Hand Function Test (mSHFT, and the Reach, Grasp, Transport and Release Task (RGTR. DISCUSSION: As the injuries of participants in the current study were chronic and thus neurologically stable, no spontaneous improvements/recovery in hand function was expected. However, FES as part of an integrated therapeutic approach affected restoration and improvement of hand function in both participants. CONCLUSION: The concurrent improvement in strength, integrated motor function and object contact following FES therapy, demonstrated that there is potential for affecting change in hand function of individuals with chronic SCI.

  17. Vocal improvement after voice therapy in the treatment of benign vocal fold lesions.

    Science.gov (United States)

    Schindler, A; Mozzanica, F; Ginocchio, D; Maruzzi, P; Atac, M; Ottaviani, F

    2012-10-01

    Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after voice therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 voice therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of voice therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of voice quality can be achieved after voice therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If voice therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of voice therapy in the management of benign vocal fold

  18. Speech and language therapies to improve pragmatics and discourse skills in patients with schizophrenia.

    Science.gov (United States)

    Joyal, Marilyne; Bonneau, Audrey; Fecteau, Shirley

    2016-06-30

    Individuals with schizophrenia display speech and language impairments that greatly impact their integration to the society. The aim of this systematic review was to identify the importance of speech and language therapy (SLT) as part of rehabilitation curriculums for patients with schizophrenia emphasizing on the speech and language abilities assessed, the therapy setting and the therapeutic approach. This article reviewed 18 studies testing the effects of language therapy or training in 433 adults diagnosed with schizophrenia. Results showed that 14 studies out of 18 lead to improvements in language and/or speech abilities. Most of these studies comprised pragmatic or expressive discursive skills being the only aim of the therapy or part of it. The therapy settings vary widely ranging from twice daily individual therapy to once weekly group therapy. The therapeutic approach was mainly operant conditioning. Although the evidence tends to show that certain areas of language are treatable through therapy, it remains difficult to state the type of approach that should be favoured and implemented to treat language impairments in schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Anodyne therapy versus exercise therapy in improving the healing rates of venous leg ulcer

    Directory of Open Access Journals (Sweden)

    Emad T. Ahmed

    2013-06-01

    Full Text Available Objective: The purpose of this study was to determine the best physical therapy program to increase wound healing rates in patients suffering from venous leg ulcer. Methods: Forty patients who had venous leg ulcer for more than 4 weeks and not respondent well to medical treatment. Patients were classified into 4 equal groups 10 of each, Group (1: received 40 minute of monochromatic infrared energy (MIRE, Group (2: received 40 minutes of exercise program consisted of stretching and resisted exercise (RE, Group (3: received 20 minutes of exercise in addition to 20 minutes of resisted exercise (MIRE/RE, and group (4: control group which received conventional therapy of the ulcer. All groups received treatment 5days per week for 12days. Measurements of ulcer surface area and PUSH scale were conducted before treatment, post 6 days of treatment, and after 12 days of treatment. Results: The one way analysis of variance was used to compare ulcer surface area and PUSH score which revealed that both treatment groups (MIRE and RE had significant (P< 0.05 decrease in ulcer surface area and PUSH scale after 6 and 12days post application of treatment. On the other hand, the combination of MIRE and RE showed a highly significant decrease in ulcer surface area and PUSH score when compared with control or with individual treatment. Conclusion: The results of this study suggest that combination of MIRE to RE is more effective than individual treatment to enhance the healing rate of venous ulcer of the leg. [Int J Res Med Sci 2013; 1(3.000: 198-203

  20. Active Music Therapy and Physical Improvements From Rehabilitation for Neurological Conditions.

    Science.gov (United States)

    Kogutek, Demian Leandro; Holmes, Jeffrey David; Grahn, Jessica Adrienne; Lutz, Sara G; Ready, Emily

    2016-01-01

    Context • A variety of rehabilitation-based interventions are currently available for individuals with physical impairments resulting from neurological conditions, including physiotherapy, occupational therapy, and speech language pathology. Many individuals find participation in those therapies to be challenging. Alternative therapies have emerged as beneficial adjunctive treatments for individuals undergoing neurological rehabilitation, including music therapy (MT). Objective • The study intended to identify and collate systematically the evidence on MT interventions that address physical improvements in a rehabilitative setting. Design • The research team performed a literature review, searching electronic databases from their inception to April 2014, including Embase, CINAHL, PubMed, Scopus, and ProQuest. The review included original studies that examined the use of active MT as an intervention that promotes physical improvements for adults >18 y of age. Articles were excluded if the studies focused primarily on psychosocial, emotional, or spiritual therapeutic goals. The review identified the studies' outcome measures for different populations and the MT approaches and interventions and obtained a general description of the clinical sessions, such as the frequency and duration of the therapy, interventions performed, sessions designs, populations, equipment used, and credentials of the therapists. Results • Eleven studies identified 2 major categories for the delivery of MT sessions: individual and group. One study included group sessions, and 10 studies included individual sessions. The studies included a total of 290 participants, 32 in the group MT, and 258 in the individual MT. The one study that used group therapy was based on active MT improvisation. For the individual therapy, 2 studies had investigated therapeutic instrument music performance and 8 used music-supported therapy. Conclusions • The findings of the review suggested that active MT

  1. In vivo image of radioiodinated IVDU and IVFRU in HSV-TK gene tranduced hepatocellular carcinoma bearing buffalo rat

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Sup; Choi, T. H.; Ahn, S. H.; Woo, K. S.; Chung, W. S.; Lee, S. J.; Choi, C. W. [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2000-07-01

    The extent of gene delivery and expression in gene therapy with suicide genes such as herpes simplex virus thymidine kinase (HSV-tk) is assessed with measurement of selective localization of radioiodinated HSV-tk substrates in HSV-tk expressing tumor. We compared n vitro uptake of {sup 125}I-IVDU, IVFRU and in vivo image of HSV-tk gene tranduced hepatocellular carcinoma model. Using H{sub 2}O{sub 2}(hydrogen peroxide), IVDU and IVFRU was radiolabeled as carrier free form. The uptake of {sup 125}I-IVDU IVFRU was determined with increasing incubation periods in MCA-tk and MCA cell line (1X10{sup 6}cell/flask). The cell harvested and counted after incubation of 15, 30, 60, 120, 240, 480 minutes. For estimating accumulation of radiolabelled IVDU, IVFRU in HSV-tk expressing tumor, MCA-tk cells (1 X 10{sup 6}/100 {mu}l) injected intramuscularly into right thigh of buffalo rats. To determine selective localization of radiolabelled IVDU, IVFRU in HSV-tk expressing hepatocellular carcinoma bearing buffalo rats, MCA-tk cells (1X 10{sup 7} cell/100 {mu}l) were injected subcutaneously into both shoulders of buffalo rats. Established tumor mass implanted into liver of buffalo rats using intra-hepatic tumor injection. Two weeks later, {sup 123}I labelled IVDU, IVFRU(7.4 X 10{sup 7}Bq/200 {mu}l) injected intravenously into tail veins of each buffalo rats. Gamma camera used as revealing localization of {sup 123}I-IVDU, IVFRU in MCA-tk cells grafts rats and in vivo image was taken 2 hrs, 24 hrs after injection. radioiodinated IVDU, IVFRU were radiolabeled with {sup 123}I as labeling yield 70%, {sup 125}I as 84%. Two compounds showed minimal uptake in MCA cell line, but in MCA-tk cell line, increased uptake was observed. The ratio of MCA-tk to MCA was up to 116-fold in {sup 125}I-IVDU, up to 37-fold in {sup 125}I-IVFRU at 480 min. The uptake of IVDU was 4 times higher than IVFRU in MCA-tk cells. Gamma camera images of HSV-tk gene tranduced MCA tumor showed accumulation of {sup 123}I

  2. The potential for nanotechnology to improve delivery of therapy to the acute ischemic heart.

    Science.gov (United States)

    Evans, Cameron W; Iyer, K Swaminathan; Hool, Livia C

    2016-04-01

    Treatment of acute cardiac ischemia remains an area in which there are opportunities for therapeutic improvement. Despite significant advances, many patients still progress to cardiac hypertrophy and heart failure. Timely reperfusion is critical in rescuing vulnerable ischemic tissue and is directly related to patient outcome, but reperfusion of the ischemic myocardium also contributes to damage. Overproduction of reactive oxygen species, initiation of an inflammatory response and deregulation of calcium homeostasis all contribute to injury, and difficulties in delivering a sufficient quantity of drug to the affected tissue in a controlled manner is a limitation of current therapies. Nanotechnology may offer significant improvements in this respect. Here, we review recent examples of how nanoparticles can be used to improve delivery to the ischemic myocardium, and suggest some approaches that may lead to improved therapies for acute cardiac ischemia.

  3. Successful Phenotype Improvement following Gene Therapy for Severe Hemophilia A in Privately Owned Dogs.

    Science.gov (United States)

    Callan, Mary Beth; Haskins, Mark E; Wang, Ping; Zhou, Shangzhen; High, Katherine A; Arruda, Valder R

    2016-01-01

    Severe hemophilia A (HA) is an inherited bleeding disorder characterized by gene therapy using adeno-associated viral (AAV) vectors, the canine model has been one of the best predictors of the therapeutic dose tested in clinical trials for hemophilia B (factor IX deficiency) and other genetic diseases, such as congenital blindness. Here we report our experience with liver gene therapy with AAV-FVIII in two outbred, privately owned dogs with severe HA that resulted in sustained expression of 1-2% of normal FVIII levels and prevented 90% of expected bleeding episodes. A Thr62Met mutation in the F8 gene was identified in one dog. These data recapitulate the improvement of the disease phenotype in research animals, and in humans, with AAV liver gene therapy for hemophilia B. Our experience is a novel example of the benefits of a relevant preclinical canine model to facilitate both translational studies in humans and improved welfare of privately owned dogs.

  4. Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation.

    Science.gov (United States)

    Teoh Bing Fei, Joni; Yee, Anne; Habil, Mohamad Hussain Bin; Danaee, Mahmoud

    2016-10-01

    Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk-taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Twenty-five years after Chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma.

    Science.gov (United States)

    Reiners, Christoph; Biko, Johannes; Haenscheid, Heribert; Hebestreit, Helge; Kirinjuk, Stalina; Baranowski, Oleg; Marlowe, Robert J; Demidchik, Ewgeni; Drozd, Valentina; Demidchik, Yuri

    2013-07-01

    After severe reactor emergencies with release of radioactive iodine, elevated thyroid cancer risk in children and adolescents is considered the main health consequence for the population exposed. We studied thyroid cancer outcome after 11.3 years' median follow-up in a selected, very high-risk cohort, 234 Chernobyl-exposed Belarusian children and adolescents undergoing postsurgical radioiodine therapy (RIT) in Germany. Cumulatively 100 children with or (without; n = 134) distant metastasis received a median 4 (2) RITs and 16.9 (6.6) GBq, corresponding to 368 (141) MBq/kg iodine-131. Outcomes were response to therapy and disease status, mortality, and treatment toxicity. Of 229 patients evaluable for outcome, 147 (64.2%) attained complete remission [negative iodine-131 whole-body scan and TSH-stimulated serum thyroglobulin (Tg) 10 μg/L, decrease from baseline in radioiodine uptake intensity in ≥ 1 focus, in tumor volume or in Tg). Except for 2 recurrences (0.9%) after partial remission, no recurrences, progression, or disease-specific mortality were noted. One patient died of lung fibrosis 17.5 years after therapy, 2 of apparently thyroid cancer-unrelated causes. The only RIT side effect observed was pulmonary fibrosis in 5 of 69 patients (7.2%) with disseminated lung metastases undergoing intensive pulmonary surveillance. Experience of a large, very high-risk pediatric cohort with radiation-induced differentiated thyroid carcinoma suggests that even when such disease is advanced and initially suboptimally treated, response to subsequent RIT and final outcomes are mostly favorable.

  6. The impact of improved glycaemic control with GLP-1 receptor agonist therapy on diabetic retinopathy.

    Science.gov (United States)

    Varadhan, Lakshminarayanan; Humphreys, Tracy; Walker, Adrian B; Varughese, George I

    2014-03-01

    Rapid improvement in glycaemic control with GLP-1 receptor agonist (RA) therapy has been reported to be associated with significant progression of diabetic retinopathy. This deterioration is transient, and continuing GLP-1 RA treatment is associated with reversal of this phenomenon. Pre-existent maculopathy, higher grade of retinopathy and longer duration of diabetes may be risk factors for persistent deterioration.

  7. TSL Family Therapy Followed by Improved Marital Quality and Reduced Oxidative Stress

    Science.gov (United States)

    Kim, Jae Yop; Kim, Dong Goo; Nam, Seok In

    2012-01-01

    Objectives: The current study evaluated the effectiveness of a form of family therapy developed in Korea. The "Thank you--Sorry--Love" (TSL) model was applied to a group of elderly retired men to improve the quality of their marriage and to reduce their stress. Methods: Thirty married retired Korean men were assigned to three groups.…

  8. Improving breast cancer outcome by preoperative systemic therapy and image-guided surgery

    NARCIS (Netherlands)

    Mieog, Jan Sven David

    2011-01-01

    This thesis consists of two parts. In part I, we have demonstrated that preoperatively administrated systemic (neoadjuvant) therapy is a feasible treatment strategy in early stage breast cancer to achieve improved surgical options and to assess tumor response. We also demonstrated that overexpressio

  9. TSL Family Therapy Followed by Improved Marital Quality and Reduced Oxidative Stress

    Science.gov (United States)

    Kim, Jae Yop; Kim, Dong Goo; Nam, Seok In

    2012-01-01

    Objectives: The current study evaluated the effectiveness of a form of family therapy developed in Korea. The "Thank you--Sorry--Love" (TSL) model was applied to a group of elderly retired men to improve the quality of their marriage and to reduce their stress. Methods: Thirty married retired Korean men were assigned to three groups. Group 1…

  10. Improvement of erythrocyte deformability by cholesterol-lowering therapy with pravastatin in hypercholesterolemic patients.

    Science.gov (United States)

    Kohno, M; Murakawa, K; Yasunari, K; Yokokawa, K; Horio, T; Kano, H; Minami, M; Yoshikawa, J

    1997-03-01

    Erythrocyte deformation is an important regulatory factor of the microcirculation. The present study was designed to examine whether erythrocyte deformability is altered in hypercholesterolemic patients and, if so, whether cholesterol-lowering therapy affects this parameter in these patients. The erythrocyte deformability of 37 hypercholesterolemic patients was evaluated before and after 1 year of therapy with pravastatin, an inhibitor of hepatic hydroxymethyl glutaryl coenzyme A reductase, under various shear stresses (4.7, 9.5, 23.6, 47.3, 118.1, and 236.2 dyne/cm2) using laser diffractometry. At study entry, erythrocyte deformability under 4.7 and 9.5 dyne/cm2 shear stress, which is actually observed in human vessels, was reduced compared with that in 20 age-matched normocholesterolemic subjects and was inversely correlated with serum cholesterol and low-density lipoprotein (LDL) cholesterol. Pravastatin therapy for 1 year, which reduced serum cholesterol from 288 +/- 28 to 223 +/- 20 mg/dL, significantly improved erythrocyte deformability by approximately 20%. There was a significant relation between the improvement of erythrocyte deformability and the reduction of serum cholesterol or LDL cholesterol. The results suggest that erythrocyte deformability is reduced in hypercholesterolemic patients, and that long-term cholesterol-lowering therapy can improve reduced erythrocyte deformability, which may contribute to the improvement of organ perfusion.

  11. Leukocytapheresis Therapy Improved Cholestasis in a Patient Suffering from Primary Sclerosing Cholangitis with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Minoru Itou

    2009-04-01

    Full Text Available Primary sclerosing cholangitis (PSC is an autoimmune disease of the hepatobiliary system for which effective therapy has not been established. Leukocytapheresis (LCAP therapy is known to effective in patients with ulcerative colitis (UC. In addition, effects of LCAP therapy were reported on some autoimmune diseases such as Crohn’s disease, rheumatoid arthritis and rapidly progressive glomerulonephritis. Here we report the case of a 29-year-old man with PSC associated with UC who was treated with LCAP therapy. He had a 16-year history of UC and a 12-year history of PSC. Although he was under treatment with prednisolone and ursodeoxycholic acid, exacerbation of UC and PSC-associated cholestasis were seen. Since he showed side effects of prednisolone, he was treated with LCAP. Not only improvement of UC, but also decreased serum alkaline phosphatase, γ-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP. Our experience with this case suggests that LCAP therapy could be a new effective therapeutic strategy for patients with PSC associated with UC.

  12. Biologic therapy improves psoriasis by decreasing the activity of monocytes and neutrophils.

    Science.gov (United States)

    Yamanaka, Keiichi; Umezawa, Yoshinori; Yamagiwa, Akisa; Saeki, Hidehisa; Kondo, Makoto; Gabazza, Esteban C; Nakagawa, Hidemi; Mizutani, Hitoshi

    2014-08-01

    Therapy with monoclonal antibodies to tumor necrosis factor (TNF)-α and the interleukin (IL)-12/23 p40 subunit has significantly improved the clinical outcome of patients with psoriasis. These antibodies inhibit the effects of the target cytokines and thus the major concern during their use is the induction of excessive immunosuppression. Recent studies evaluating the long-term efficacy and safety of biologic therapy in psoriasis have shown no significant appearance of serious adverse effects including infections and malignancies. However, the immunological consequence and the mechanism by which the blockade of a single cytokine by biologics can successfully control the activity of psoriasis remain unclear. In the current study, we investigated the effect of biologic therapy on cytokine production of various lymphocytes and on the activity of monocytes and neutrophils in psoriatic patients. Neutrophils, monocytes and T cells were purified from heparinized peripheral venous blood by Ficoll density gradient centrifugation, and γ-interferon, TNF-α and IL-17 production from lymphocytes was measured by flow cytometer. The activation maker of neutrophils and the activated subsets of monocytes were also analyzed. Biologic therapy induced no significant changes in the cytokine production by lymphocytes from the skin and gut-homing T cells. However, neutrophil activity and the ratio of activated monocyte population increased in severely psoriatic patients were normalized in psoriatic patients receiving biologic therapy. The present study showed that biologic therapy ameliorates clinical symptoms and controls the immune response in patients with psoriasis.

  13. Integrated insulin pump therapy with continuous glucose monitoring for improved adherence: technology update

    Directory of Open Access Journals (Sweden)

    Tumminia A

    2015-09-01

    Full Text Available Andrea Tumminia,1 Laura Sciacca,1 Lucia Frittitta,1 Sebastiano Squatrito,1 Riccardo Vigneri,2 Rosario Le Moli,1 Letizia Tomaselli2 1Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy; 2Endocrinology, Garibaldi-Nesima Hospital, Catania, Italy Abstract: Insulin pump therapy combined with real-time continuous glucose monitoring, known as sensor-augmented pump (SAP therapy, has been shown to improve metabolic control and to reduce the rate of hypoglycemia in adults with type 1 diabetes compared to multiple daily injections or standard continuous subcutaneous insulin infusion. Glycemic variability is also reduced in patients on SAP therapy. This approach allows patients to monitor their glucose levels being informed of glycemic concentration and trend. Trained diabetic patients, therefore, can appropriately modify insulin infusion and/or carbohydrate intake in order to prevent hypo- or hyperglycemia. For these reasons, SAP therapy is now considered the gold standard for type 1 diabetes treatment. To be clinically effective, however, devices and techniques using advanced technology should not only have the potential to theoretically ameliorate metabolic control, but also be well accepted by patients in terms of satisfaction and health-related quality of life, because these factors will improve treatment adherence and consequently overall outcome. SAP therapy is generally well tolerated by patients; however, many clinical trials have identified significant noncompliance in the use of this device, most notably in the pediatric and adolescent populations. In this review we aim to analyze the main reasons for good or poor adherence to SAP therapy and to provide useful tips in order to fully benefit from this kind of novel therapeutic approach. Keywords: sensor-augmented insulin pump therapy, type 1 diabetes, quality of life, patient adherence, continuous subcutaneous insulin

  14. Designing the future of talking therapy: Using digital health to improve outcomes in psychosis

    Directory of Open Access Journals (Sweden)

    Amy Hardy

    2016-01-01

    We initiated the first UK collaboration of healthcare design researchers, digital health experts and clinician academics to develop a digital design solution to improve therapy outcomes in psychosis. Our user-centred inclusive design approach was informed by the Design Council’s (2005 double diamond method consisting of discover, define, develop and deliver phases (see Figure One. As an inclusive design project, stakeholders (service users, clinicians and researchers were involved from the outset, with interviews iteratively conducted to generate and validate hypotheses regarding possible design solutions. In the 'discover' phase our research included literature review, observing therapy sessions, system mapping of the contexts in which therapy was delivered, together with research into behaviour change models and new technologies. Workshops were held at the 'define' phase to synthesise the research insights, from which the area for achieving maximum impact on outcomes and the aim of the eventual design brief were defined. The insights highlighted the need to improve the efficiency of the in-session process, for service users to feel more supported outside of sessions, and to improve the enjoyment of the therapy experience, whilst reducing information processing demands. We therefore aimed to explore the potential for mobile technologies to support the delivery of the therapy. In the 'develop' phase, during collaborative ideation workshops, we generated over 60 concepts. Working closely with service users and clinicians, we gradually distilled them and developed three concepts: bubbles, where thoughts are visualised as bubbles that can be influenced by our actions; journey, where therapy is a journey with incremental progress, challenges and achievements; and interaction, which focuses

  15. The use of discrete-event simulation modelling to improve radiation therapy planning processes.

    Science.gov (United States)

    Werker, Greg; Sauré, Antoine; French, John; Shechter, Steven

    2009-07-01

    The planning portion of the radiation therapy treatment process at the British Columbia Cancer Agency is efficient but nevertheless contains room for improvement. The purpose of this study is to show how a discrete-event simulation (DES) model can be used to represent this complex process and to suggest improvements that may reduce the planning time and ultimately reduce overall waiting times. A simulation model of the radiation therapy (RT) planning process was constructed using the Arena simulation software, representing the complexities of the system. Several types of inputs feed into the model; these inputs come from historical data, a staff survey, and interviews with planners. The simulation model was validated against historical data and then used to test various scenarios to identify and quantify potential improvements to the RT planning process. Simulation modelling is an attractive tool for describing complex systems, and can be used to identify improvements to the processes involved. It is possible to use this technique in the area of radiation therapy planning with the intent of reducing process times and subsequent delays for patient treatment. In this particular system, reducing the variability and length of oncologist-related delays contributes most to improving the planning time.

  16. Strategies to improve homing of mesenchymal stem cells for greater efficacy in stem cell therapy.

    Science.gov (United States)

    Naderi-Meshkin, Hojjat; Bahrami, Ahmad Reza; Bidkhori, Hamid Reza; Mirahmadi, Mahdi; Ahmadiankia, Naghmeh

    2015-01-01

    Stem/progenitor cell-based therapeutic approach in clinical practice has been an elusive dream in medical sciences, and improvement of stem cell homing is one of major challenges in cell therapy programs. Stem/progenitor cells have a homing response to injured tissues/organs, mediated by interactions of chemokine receptors expressed on the cells and chemokines secreted by the injured tissue. For improvement of directed homing of the cells, many techniques have been developed either to engineer stem/progenitor cells with higher amount of chemokine receptors (stem cell-based strategies) or to modulate the target tissues to release higher level of the corresponding chemokines (target tissue-based strategies). This review discusses both of these strategies involved in the improvement of stem cell homing focusing on mesenchymal stem cells as most frequent studied model in cellular therapies.

  17. Reducing the Human Burden of Breast Cancer: Advanced Radiation Therapy Yields Improved Treatment Outcomes.

    Science.gov (United States)

    Currey, Adam D; Bergom, Carmen; Kelly, Tracy R; Wilson, J Frank

    2015-01-01

    Radiation therapy is an important modality in the treatment of patients with breast cancer. While its efficacy in the treatment of breast cancer was known shortly after the discovery of x-rays, significant advances in radiation delivery over the past 20 years have resulted in improved patient outcomes. With the development of improved systemic therapy, optimizing local control has become increasingly important and has been shown to improve survival. Better understanding of the magnitude of treatment benefit, as well as patient and biological factors that confer an increased recurrence risk, have allowed radiation oncologists to better tailor treatment decisions to individual patients. Furthermore, significant technological advances have occurred that have reduced the acute and long-term toxicity of radiation treatment. These advances continue to reduce the human burden of breast cancer. It is important for radiation oncologists and nonradiation oncologists to understand these advances, so that patients are appropriately educated about the risks and benefits of this important treatment modality.

  18. Targeted Radionuclide Therapy of Melanoma.

    Science.gov (United States)

    Norain, Abdullah; Dadachova, Ekaterina

    2016-05-01

    An estimated 60,000 individuals in the United States and 132,000 worldwide are yearly diagnosed with melanoma. Until recently, treatment options for patients with stages III-IV metastatic disease were limited and offered marginal, if any, improvement in overall survival. The situation changed with the introduction of B-RAF inhibitors and anti-cytotoxic T-lymphocyte antigen 4 and anti-programmed cell death protein 1 immunotherapies into the clinical practice. With only some patients responding well to the immune therapies and with very serious side effects and high costs of immunotherapy, there is still room for other approaches for the treatment of metastatic melanoma. Targeted radionuclide therapy of melanoma could be divided into the domains of radioimmunotherapy (RIT), radiolabeled peptides, and radiolabeled small molecules. RIT of melanoma is currently experiencing a renaissance with the clinical trials of alpha-emitter (213)Bi-labeled and beta-emitter (188)Rhenium-labeled monoclonal antibodies in patients with metastatic melanoma producing encouraging results. The investigation of the mechanism of efficacy of melanoma RIT points at killing of melanoma stem cells by RIT and involvement of immune system such as complement-dependent cytotoxicity. The domain of radiolabeled peptides for targeted melanoma therapy has been preclinical so far, with work concentrated on radiolabeled peptide analogues of melanocyte-stimulating hormone receptor and on melanin-binding peptides. The field of radiolabeled small molecule produced radioiodinated benzamides that cross the cellular membrane and bind to the intracellular melanin. The recent clinical trial demonstrated measurable antitumor effects and no acute or midterm toxicities. We are hopeful that the targeted radionuclide therapy of metastatic melanoma would become a clinical reality as a stand-alone therapy or in combination with the immunotherapies such as anti-PD1 programmed cell death protein 1 monoclonal antibodies

  19. Electroconvulsive therapy in a terminally ill patient: when every day of improvement counts.

    Science.gov (United States)

    Mulder, Marlies E; Verwey, Bastiaan; van Waarde, Jeroen A

    2012-03-01

    Electroconvulsive therapy (ECT) is seldom used in a palliative setting. Although literature on the application of ECT in terminally ill patients is sparse, ECT may be useful to rapidly improve the quality of life in these patients. We present the case of a 71-year-old man with metastasized pancreas carcinoma complicated by severe depression. After 3 ECT sessions, the communication between the patient and his family in the last moments of his life improved. We conclude that ECT should be considered to treat mood disorders in terminally ill patients when every day of improvement counts.

  20. Radioiodinated MIBG in paraganglioma and pheochromocytoma: previous results and early experiences using no-carrier-added MIBG

    Energy Technology Data Exchange (ETDEWEB)

    James, Olga [Duke University Medical Center, Box 3949, Durham, NC 27710 (United States)], E-mail: olga.g.james@duke.edu; Coleman, R. Edward [Duke University Medical Center, Box 3949, Durham, NC 27710 (United States)], E-mail: colem010@mc.duke.edu

    2008-08-15

    The majority of pheochromocytomas and paragangliomas are benign, with malignancy occurring in approximately 10% of pheochromocytoma patients. The malignancy rate among paragangliomas is 15-35% or higher if associated with succinate dehydrogenase B gene mutations. The 5-year mortality rate in malignant pheochromocytoma and paraganglioma is nearly 50%. Malignancy of both pheochromocytoma and paraganglioma is determined by the existence of metastasis or local invasion and not by the cellular characteristics. There are no known clinical, biochemical or histopathological differences between pheochromocytoma and paraganglioma. Metaiodobenzylguanidine (MIBG) radiolabeled with either {sup 123}I or {sup 131}I has been used to diagnose neuroendocrine tumors such as paraganglioma and pheochromocytoma, and {sup 131}I-MIBG has been used to treat these tumors. The role of radioiodinated MIBG in treating neuroendocrine tumors is still being evaluated. More recently, no-carrier-added (nca) MIBG has become available, and the advantages of nca MIBG over ca MIBG are being demonstrated. This article reviews the biology of paragangliomas and pheochromocytomas, the role of MIBG imaging in the diagnosis of these tumors and the role of both ca and nca {sup 131}I-MIBG in the treatment of these tumors. New data on nca {sup 131}I-MIBG in the therapy of these tumors are included.

  1. Effects of the restriction of food and water intake on the distribution and retention of radioiodine in mice

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Sentaro; Sato, Hiroshi; Kubota, Yoshihisa; Sun, Xuezhi [National Inst. of Radiological Sciences, Chiba (Japan); Dao Thi Bich Thuy; Chandrasekharan, N.V.

    2000-09-01

    The effects of the restriction of food and water intakes on gastrointestinal absorption, distribution to organs and excretion of {sup 131}I were investigated in C3H/He mice. The animals were divided into four groups and administered orally 37 kBq carrier-free Na {sup 131}I in 0.25 ml normal saline. One group of animals was given food and water ad libitum throughout the experimental period. Food and water to the remaining groups were restricted before and/or after the administration of {sup 131}I. The animals in each group were sacrificed 4 h and 24 h after administration, and the activity of {sup 131}I in thyroid, blood, liver, kidney, gastrointestinal tract, urine, feces, and carcass was measured. There was a significant increase in the retention of {sup 131}I in the thyroid and the concentration of {sup 131}I in the blood due to the restriction of food and water after the administration of {sup 131}I. In contrast, a significant decrease in the urinary excretion was observed in these animals. In those animals, which fasted before administration only, the retention of {sup 131}I in the thyroid and other organs were decreased. Therefore, for an accurate diagnosis and effective therapy with radioiodine as well as effective radiation protection, the intake of food and water should be taken into account. (author)

  2. FDG PET in non-pharmacological therapy in Alzheimer's disease; cerebral metabolic increase correlates with clinical improvement after cognitive therapy

    Energy Technology Data Exchange (ETDEWEB)

    Na, Hae Ri; Kim, Yu Kyeong; Park, Seong Min; Lee, Seung Hyun; Park, Eun Kyung; Lee, Jung Seok; Kim, Sang Yun; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    In management of AD, pharmacological treatment alone using acetylcholinesterase inhibitor (AChEI) is general consensus, and provides beneficial effect to prolong their progression. Combined non-pharmacological therapy, especially cognitive therapy is recently having attention with expectation of improvement in cognitive ability. This study examined the effect of combined cognitive therapy in AD patients who were maintaining AChEI using FDG PET. Four patients (689 yrs) who diagnosed as probable Alzheimer's disease based on the NINCDS-ADRDA criteria participated in this study. 12-week cognitive therapy comprised seven fields to enhance orientation, memory, recall, visuo-motor organization, categorization and behavior modification/sequencing. They received 45-minute sessions twice per week with maintaining their previous medication. Clinical improvement was assessed by comprehensive neuropsychological tests. Two FDG PET studies were performed before cognitive therapy and in the middle of the therapy, and compared to evaluate the effect of cognitive therapy to cerebral metabolism. Two of 4 patients whose initial cognitive impairment was milder had clinical improvement after 12 weeks, the rest who were more severely impaired failed to have clinical improvement. Regional cerebral hypometabolism on initial PET was correlated with their functional status. Follow up PET of two responders demonstrated the increases in regional metabolism in the temporal and/or frontal cortex, which was associated their functional improvement. Cerebral metabolism in poor responders were minimally increased or no changed. This preliminary data suggests that cognitive therapy is potentially useful to stabilize or improve cognitive and functional performance in AD patients with relatively mild cognitive dysfunction. And FDG PET could demonstrate possible candidates for cognitive therapy and the effect of the therapy.

  3. Medication monitoring and optimization : a targeted pharmacist program for effective and cost-effective improvement of chronic therapy adherence

    NARCIS (Netherlands)

    van Boven, Job F.M.; Stuurman-Bieze, Ada G.G.; Hiddink, Eric G.; Postma, Maarten J.; Vegter, Stefan

    2014-01-01

    BACKGROUND: Community pharmacies provide a promising platform for monitoring and improving therapy adherence and providing pharmaceutical care. Structured methods and appropriate software are important tools to increase pharmacist effectiveness and improve health outcomes. In 2006, the Medication Mo

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  5. Withholding or withdrawing therapy in intensive care units: improving interdisciplinary cooperation

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Ammentorp, Jette; Ørding, Helle

    and profit of the audits were evaluated in writing at the end of the sessions and by a short questionnaire three months later. RESULTS. In all three audits the discussions were engaged. In the immediate evaluation 61% assessed this type of audit as “To a great extent” usable to promote interdisciplinary......INTRODUCTION. Decisions regarding withholding or withdrawing therapy are common in the intensive care units. The health care professionals involved in the decision-making process do not always assess the situation identically, leading to potential conflicts. Studies have suggested that improving......) where withholding and withdrawing therapy decisions had been made. The participants were first asked to assess the cases and subsequently, based on the discussions, to formulate quality goals for withholding and withdrawing therapy decision-making, cooperation and care for patients and relatives. Form...

  6. Postural Stability in Parkinson's Disease Patients Is Improved after Stochastic Resonance Therapy.

    Science.gov (United States)

    Kaut, Oliver; Brenig, Daniel; Marek, Milena; Allert, Niels; Wüllner, Ullrich

    2016-01-01

    Background. Postural instability in Parkinson's disease (PD) increases the risk of falls and is not improved by pharmacological therapy. Objective. We performed a double-blind, randomized sham-controlled study to test the effects of stochastic resonance (whole body vibration) therapy on postural stability in PD. Methods. Fifty-six PD participants were allocated to either experimental or sham groups. The experimental group received four series of vibration over eight days, with each series consisting of six stimulus trains of 60-second duration using a randomized whole body vibration. Participants allocated to the control group received a sham treatment. Results. Within-group analysis revealed that postural stability in the experimental group improved by 17.5% (p = 0.005) comparing experimental and sham groups. The between-group analysis of change after treatment comparing both groups also showed a significant improvement of postural stability (p = 0.03). Only in the within-group analysis several items were improved after Bonferroni correction, too, rigor 41.6% (p = 0.001), bradykinesia 23.7% (p = 0.001), tremor 30.8% (p = 0.006), and UPDRSIII sum score 23.9% (p = 0.000), but did not reach the level of significance in the between-group analysis. Conclusions. Stochastic resonance therapy significantly enhanced postural stability even in individuals with increased risk of falling. Thus it offers a potential supplementation to canonical treatments of PD.

  7. Postural Stability in Parkinson’s Disease Patients Is Improved after Stochastic Resonance Therapy

    Directory of Open Access Journals (Sweden)

    Oliver Kaut

    2016-01-01

    Full Text Available Background. Postural instability in Parkinson’s disease (PD increases the risk of falls and is not improved by pharmacological therapy. Objective. We performed a double-blind, randomized sham-controlled study to test the effects of stochastic resonance (whole body vibration therapy on postural stability in PD. Methods. Fifty-six PD participants were allocated to either experimental or sham groups. The experimental group received four series of vibration over eight days, with each series consisting of six stimulus trains of 60-second duration using a randomized whole body vibration. Participants allocated to the control group received a sham treatment. Results. Within-group analysis revealed that postural stability in the experimental group improved by 17.5% (p=0.005 comparing experimental and sham groups. The between-group analysis of change after treatment comparing both groups also showed a significant improvement of postural stability (p=0.03. Only in the within-group analysis several items were improved after Bonferroni correction, too, rigor 41.6% (p=0.001, bradykinesia 23.7% (p=0.001, tremor 30.8% (p=0.006, and UPDRSIII sum score 23.9% (p=0.000, but did not reach the level of significance in the between-group analysis. Conclusions. Stochastic resonance therapy significantly enhanced postural stability even in individuals with increased risk of falling. Thus it offers a potential supplementation to canonical treatments of PD.

  8. Group mindfulness-based therapy significantly improves sexual desire in women.

    Science.gov (United States)

    Brotto, Lori A; Basson, Rosemary

    2014-06-01

    At least a third of women across reproductive ages experience low sexual desire and impaired arousal. There is increasing evidence that mindfulness, defined as non-judgmental present moment awareness, may improve women's sexual functioning. The goal of this study was to test the effectiveness of mindfulness-based therapy, either immediately or after a 3-month waiting period, in women seeking treatment for low sexual desire and arousal. Women participated in four 90-min group sessions that included mindfulness meditation, cognitive therapy, and education. A total of 117 women were assigned to either the immediate treatment (n = 68, mean age 40.8 yrs) or delayed treatment (n = 49, mean age 42.2 yrs) group, in which women had two pre-treatment baseline assessments followed by treatment. A total of 95 women completed assessments through to the 6-month follow-up period. Compared to the delayed treatment control group, treatment significantly improved sexual desire, sexual arousal, lubrication, sexual satisfaction, and overall sexual functioning. Sex-related distress significantly decreased in both conditions, regardless of treatment, as did orgasmic difficulties and depressive symptoms. Increases in mindfulness and a reduction in depressive symptoms predicted improvements in sexual desire. Mindfulness-based group therapy significantly improved sexual desire and other indices of sexual response, and should be considered in the treatment of women's sexual dysfunction.

  9. Cardiac resynchronization therapy improves psycho-cognitive performance in patients with heart failure.

    Science.gov (United States)

    Duncker, David; Friedel, Katrin; König, Thorben; Schreyer, Hendrik; Lüsebrink, Ulrich; Duncker, Mareke; Oswald, Hanno; Klein, Gunnar; Gardiwal, Ajmal

    2015-09-01

    Reduced cognitive performance and high prevalence of depression have been reported in patients with congestive heart failure (CHF) and severe left ventricular dysfunction. However, effects of contemporary device therapy on cognitive performance and depression symptoms have not been studied thoroughly. Seventy-four consecutive CHF patients-45 receiving a biventricular defibrillator (CRT-D) and 29 receiving an implantable single or dual-chamber defibrillator (ICD) as a control group-were enrolled in this investigator-initiated, prospective, controlled, and investigator-blinded study. A set of neuropsychological tests (mini-mental state examination, DemTect, age-concentration test, and Beck depression inventory) was performed before, at 3 and at 6 months after device implantation. DemTect-score improved significantly (F = 7.8; P = 0.007) after CRT-D-implantation compared with ICD. Age-concentration test revealed better concentration ability after CRT-D-implantation (F = 8.3; P = 0.005) compared with ICD. Under CRT-D mini-mental state examination showed a significant improvement (F = 4.2; P = 0.043). CRT with defibrillator therapy also improved depression revealed by beck depression inventory (F = 14.7; Pcognitive improvement by resynchronization therapy in CHF patients with severe left ventricular dysfunction. In contrast to ICD therapy, the beneficial effect of CRT-D on psycho-cognitive performance might be attributed to improved cardiac function and haemodynamics. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  10. Statin therapy is associated with improved pathologic response to neoadjuvant chemoradiation in rectal cancer.

    Science.gov (United States)

    Mace, Adam G; Gantt, Gerald A; Skacel, Marek; Pai, Rish; Hammel, Jeff P; Kalady, Matthew F

    2013-11-01

    Achieving a pathologic complete response to neoadjuvant chemoradiation improves prognosis in rectal cancer. Statin therapy has been shown to enhance the impact of treatment in several malignancies, but little is known regarding the impact on rectal cancer response to neoadjuvant chemoradiation. The purpose of this study was to determine whether statin use during neoadjuvant chemoradiation improves pathologic response in rectal cancer. This was a retrospective cohort study based on data from a prospectively maintained colorectal cancer database. The 2 cohorts were defined by statin use during neoadjuvant chemoradiation. This study was performed at a single tertiary referral center. Four hundred seven patients with primary rectal adenocarcinoma who underwent neoadjuvant therapy then proctectomy between 2000 and 2012 were included. Ninety-nine patients (24.3%) took a statin throughout the entire course of neoadjuvant therapy. The primary outcome measure was pathologic response to neoadjuvant chemoradiotherapy as defined by the American Joint Committee on Cancer tumor regression grading system, grades 0 to 3. Patients in the statin cohort had a lower median regression grade (1 vs 2, p = 0.01) and were more likely to have a better response (grades 0-1 vs 2-3) than those not taking a statin (65.7% vs 48.7%, p = 0.004). Statin use remained a significant predictor of an American Joint Committee on Cancer grade 0 to 1 (OR, 2.25; 95% CI, 1.33-3.82) in multivariate analyses. Although statin use itself did not significantly improve oncologic outcomes, an American Joint Committee on Cancer grade 0 to 1 response was associated with statistically significant improvements in overall survival, disease-free survival, cancer-specific mortality, and local recurrence. This was a retrospective study and subject to nonrandomization of patients and incorporated patients on variable statin agents and doses. Statin therapy is associated with an improved response of rectal cancer to

  11. Radioiodinated methyl-branched fatty acids: Evaluation of catabolites formed in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, F.F. Jr.; Reske, S.N.; Kirsch, G.; Ambrose, K.R.; Blystone, S.L.; Goodman, M.M.

    1987-01-01

    Radioiodinated terminal iodophenyl-substituted long-chain fatty acids containing either racemic mono-methyl or geminal dimethyl-branching in the alkyl chain have been shown to exhibit delayed myocardial clearance properties which make these agents useful for the SPECT evaluation of myocardial fatty acid uptake patterns. Although the myocardial clearance rate of 15-(p-iodophenyl)-3-R,S- methylpentadecanoic acid (BMIPP) is considerably delayed, in comparison with the IPPA straight-chain analogue, analysis of the radioiodinated lipids present in the outflow tract of isolated rat hearts administered BMIPP have clearly demonstrated the presence of a polar metabolite. The synthesis of ..beta..-hydroxy fatty acids has been developed to allow investigation of the possible formation of ..beta..-hydroxy catabolites in vivo. The preparation of ..beta..-hydroxy BMIPP and ..beta..-hydroxy IPPA are described, and the possible significance of their formation in vivo discussed. 4 figs.

  12. [Prognosis improvements in children with acute myelocytic leucemia after more intensive induction therapy (author's transl)].

    Science.gov (United States)

    Scheer, U; Schellong, G; Riehm, H

    1979-03-01

    Between October 1974 and October 1978 23 children with acute myelocytic leucemia (AML) received intensive therapy in the Univ.-Kinderklinik Münster: 4 children were treated according to the ALGB-protocol consisting of 5-7 day courses of ARA-C-infusion and 3 DNR-injections. 19 patients received the West-Berlin-protocol: The first 7 the original ALL protocol, 11 the modified form of AML, which will be presented here as AML-therapy-study BFM 78. 4 of the 23 patients died with early acute cerebral bleeding. 2 patients were nonresponders. 17 children went into remission. One girl died in remission of septicemic aspergillosis. 4 children had a relapse. In November 1978 there were still 12 patients in continuous complete remission, 3 of them already without therapy. 13 of the 19 patients, who were treated with the West-Berlin-protocol went into remission. 1 had a relapse. At present there are 11 patients in continuous complete remission. The above results and those found in the literature could signify that the long term prognosis of children with AML will be improved. To coordinate efforts toward this goal a cooperative AML-therapy-study in the "Deutsche Arbeitsgemeinschaft für Leukämieforschung" (BFM-group) using the here presented therapy protocol was formed in November 1978.

  13. [DIETARY SUPPLEMENT REKECEN IMPROVES SAFETY AND EFFICACY OF CHRONIC PROSTATITIS ANTIBACTERIAL THERAPY].

    Science.gov (United States)

    Kuznetsov, V F; Davidov, M I; Sokolov, A P; Kuznetsov, S V

    2015-01-01

    This randomized comparative study was carried out to estimate efficacy and safety of the natural complex of fermented food fibers and short chain fatty acids (dietary supplement rekicen-RD®) in antibacterial therapy of 64 patients with chronic infectious prostatitis. 32 patients of the treatment group received 8 week standard antibacterial therapy for chronic prostatitis in combination with dietary supplement rekicen-RD® and 32 patients of the control group were treated only with antibacterial therapy. Short-term and long-term results were estimated after 8 weeks and 6 months follow-up, respectively. It was found, that addition of dietary supplement rekicen- RD® to antibacterial therapy resulted in statistically significant improvement of the treatment efficacy. Compared to patients of the control group, patients of the treatment group had more pronounced positive changes of all indicators of treatment efficacy (NIH-CPSI total score, quality of life, echo-structure of prostate, the number of leukocytes in prostatic secretions). Long-term (after 6 months) clinical efficacy of the combination of antibacterial therapy with dietary supplement rekicen-RD® was 96,9%, bacteriological efficacy after 8 weeks - 87,5%, after 6 months - 81%. Notably, there was 4,5-fold reduction in the rate of antibiotics adverse side effects in the treatment group patients without a single gastro-intestinal side effect.

  14. Specific inhibition of the ABCG2 transporter could improve the efficacy of photodynamic therapy.

    Science.gov (United States)

    Bebes, Attila; Nagy, Tünde; Bata-Csörgo, Zsuzsanna; Kemény, Lajos; Dobozy, Attila; Széll, Márta

    2011-11-01

    Photodynamic therapy is based on the selective accumulation of a photosensitizer in tumors, followed by destruction of the target tissue by a light source. Protoporphyrin IX, a well-known photosensitizer, was recently reported as an endogenous substrate for the multidrug transporter ABCG2. We investigated the role of ABCG2 protein in the porphyrin extrusion ability of keratinocytes, with regard to the impact of the specific inhibition of ABCG2 by a non-toxic fumitremorgin C analog, Ko-134, on photodynamic therapy efficacy. We studied the level of porphyrin accumulation in response to delta-aminolevulinic acid pretreatment in proliferating and highly differentiated HaCaT keratinocytes. An in vitro model of photodynamic therapy on HaCaT cells was established with a therapeutically approved narrow-bandwidth red-light source. The porphyrin extrusion ability of HaCaT cells proved to correlate with their ABCG2 expression which was higher in proliferating cells than in differentiated cells. Moreover, the specific inhibition of ABCG2 by Ko-134 enhanced the sensitivity of keratinocytes to photodynamic therapy in vitro. These results suggest that ABCG2 may serve as a target molecule via which to improve the photodynamic therapy of skin lesions: its inhibition by the non-toxic Ko-134 is a promising therapeutic modality.

  15. Indacaterol add-on therapy improves lung function, exercise capacity and life quality of COPD patients.

    Science.gov (United States)

    Mroz, R M; Minarowski, L; Chyczewska, E

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive, inflammatory condition, involving airways and lung parenchyma. The disease leads to airflow limitation, and pulmonary hyperinflation, resulting in dyspnea, decreased exercise tolerance, and impaired quality of life. COPD pharmacotherapy guidelines are based on a combination of long-acting beta2-agonists (LABA), long-acting antimuscarinic agents (LAMA) and methyloxantins. Recently, indacaterol, ultralong acting beta2-agonist, has been introduced. The aim of our study was to assess the impact of indacaterol add-on therapy on lung function, exercise tolerance and quality of life of COPD patients. Thirty four COPD patients, receiving stable bronchodilator therapy were randomly allocated into two arms of add-on treatment (1:1 - indacaterol:placebo) for 3 months. Indacaterol replaced LABA in all patients receiving LABA. Spirometry, lung volumes, DLCO, St George's Respiratory Questionnaire (SGRQ) and 6 min Walk Distance (6MWD) were performed before and after therapy. We found that in the indacaterol group FEV1 did not changed significantly. However, there were significant improvements in ERV, 6MWD, and 6MWD-related dyspnea score. We also found that the degree of desaturation before and after 6MWD, and fatigue levels significantly improved in the indacaterol group. The patients' quality of life also changed favorably in the indacaterol treatment arm. We conclude that the add-on therapy with indacaterol exerts positive effects in COPD patients.

  16. Survival benefit and phenotypic improvement by hamartin gene therapy in a tuberous sclerosis mouse brain model.

    Science.gov (United States)

    Prabhakar, Shilpa; Zhang, Xuan; Goto, June; Han, Sangyeul; Lai, Charles; Bronson, Roderick; Sena-Esteves, Miguel; Ramesh, Vijaya; Stemmer-Rachamimov, Anat; Kwiatkowski, David J; Breakefield, Xandra O

    2015-10-01

    We examined the potential benefit of gene therapy in a mouse model of tuberous sclerosis complex (TSC) in which there is embryonic loss of Tsc1 (hamartin) in brain neurons. An adeno-associated virus (AAV) vector (serotype rh8) expressing a tagged form of hamartin was injected into the cerebral ventricles of newborn pups with the genotype Tsc1(cc) (homozygous for a conditional floxed Tsc1 allele) SynI-cre(+), in which Tsc1 is lost selectively in neurons starting at embryonic day 12. Vector-treated Tsc1(cc)SynIcre(+) mice showed a marked improvement in survival from a mean of 22 days in non-injected mice to 52 days in AAV hamartin vector-injected mice, with improved weight gain and motor behavior in the latter. Pathologic studies showed normalization of neuron size and a decrease in markers of mTOR activation in treated as compared to untreated mutant littermates. Hence, we show that gene replacement in the brain is an effective therapeutic approach in this mouse model of TSC1. Our strategy for gene therapy has the advantages that therapy can be achieved from a single application, as compared to repeated treatment with drugs, and that AAV vectors have been found to have minimal to no toxicity in clinical trials for other neurologic conditions. Although there are many additional issues to be addressed, our studies support gene therapy as a useful approach in TSC patients.

  17. Therapies with Emerging Evidence of Efficacy: Avotermin for the Improvement of Scarring

    Directory of Open Access Journals (Sweden)

    Jim Bush

    2010-01-01

    Full Text Available Many patients are dissatisfied with scars on both visible and non-visible body sites and would value any opportunity to improve or minimise scarring following surgery. Approximately 44 million procedures in the US and 42 million procedures in the EU per annum could benefit from scar reduction therapy. A wide range of non-invasive and invasive techniques have been used in an attempt to improve scarring although robust, prospective clinical trials to support the efficacy of these therapies are lacking. Differences in wound healing and scar outcome between early fetal and adult wounds led to interest in the role of the TGFβ family of cytokines in scar formation and the identification of TGFβ3 (avotermin as a potential therapeutic agent for the improvement of scar appearance. Extensive pre-clinical and human Phase I and II clinical trial programmes have confirmed the scar improving efficacy of avotermin which produces macroscopic and histological improvements in scar architecture, with improved restitution of the epidermis and an organisation of dermal extracellular matrix that more closely resembles normal skin. Avotermin is safe and well tolerated and is currently in Phase III of clinical development, with the first study, in patients undergoing scar revision surgery, fully recruited.

  18. Nickel-mediated radioiodination of aryl and heteroaryl bromides: rapid synthesis of tracers for SPECT imaging.

    Science.gov (United States)

    Cant, Alastair A; Champion, Sue; Bhalla, Rajiv; Pimlott, Sally L; Sutherland, Andrew

    2013-07-22

    Rapid and efficient radioiodination of aryl and heteroaryl bromides has been achieved using a nickel(0)-mediated halogen-exchange reaction. This transformation gives direct access to [(123)I]- and [(125)I]-imaging agents for single photon emission computed tomography (SPECT), such as 5-[(123)I]-A85380 (see scheme, Boc = tert-butyloxycarbonyl, cod = 1,5-cyclooctadiene, TFA = trifluoroacetic acid). Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Synthesis and evaluation of a radioiodinated lumiracoxib derivative for the imaging of cyclooxygenase-2 expression

    Energy Technology Data Exchange (ETDEWEB)

    Kuge, Yuji [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Department of Tracer Kinetics and Bioanalysis, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638 (Japan)], E-mail: kuge@med.hokudai.ac.jp; Obokata, Naoyuki; Kimura, Hiroyuki; Katada, Yumiko; Temma, Takashi [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Sugimoto, Yukihiko [Department of Physiological Chemistry, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Aita, Kazuki [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Central Institute of Isotope Science, Hokkaido University, Sapporo 060-8638 (Japan); Seki, Koh-ichi [Central Institute of Isotope Science, Hokkaido University, Sapporo 060-8638 (Japan); Tamaki, Nagara [Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638 (Japan); Saji, Hideo [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan)

    2009-11-15

    Introduction: Despite extensive attempts to develop cyclooxygenase (COX)-2 imaging radiotracers, no suitable positron emission tomography (PET)/single photon emission computed tomography (SPECT) tracers are currently available for in vivo imaging of COX-2 expression. The aims of this study were to synthesize and evaluate a radioiodinated derivative of lumiracoxib, 2-[(2-fluoro-6-iodophenyl)-amino]-5-methylphenylacetic acid (FIMA), which is structurally distinct from other drugs in the class and has weakly acidic properties, as a SPECT tracer for imaging COX-2 expression. Methods: The COX inhibitory potency was assessed by measuring COX-catalyzed oxidation with hydrogen peroxide. Cell uptake characteristics of {sup 125}I-FIMA were assessed in control and linterfero/interferon-{gamma}-stimulated macrophages. The biodistribution of {sup 125}I-FIMA was determined by the ex vivo tissue counting method in rats. Results: The COX-2 inhibitory potency of FIMA (IC{sub 50}=2.46 {mu}M) was higher than that of indomethacin (IC{sub 50}=20.9 {mu}M) and was comparable to lumiracoxib (IC{sub 50}=0.77 {mu}M) and diclofenac (IC{sub 50}=0.98 {mu}M). The IC{sub 50} ratio (COX-1/COX-2=182) indicated FIMA has a high isoform selectivity for COX-2. {sup 125}I-FIMA showed a significantly higher accumulation in COX-2 induced macrophages than in control macrophages, which decreased with nonradioactive FIMA in a concentration dependent manner. The biodistribution study showed rapid clearance of {sup 125}I-FIMA from the blood and most organs including the liver and kidneys. No significant in vivo deiodination was observed with radioiodinated FIMA. Conclusions: FIMA showed high inhibitory potency and selectivity for COX-2. Radioiodinated FIMA showed specific accumulation into COX-2 induced macrophages, no significant in vivo deiodination and rapid blood clearance. Radioiodinated FIMA deserves further investigation as a SPECT radiopharmaceutical for imaging COX-2 expression.

  20. Does radioiodine cause the ophthalmopathy of Graves' disease; Editorial

    Energy Technology Data Exchange (ETDEWEB)

    McDougall, I.R. (Stanford Univ., CA (United States). Medical Center)

    1993-02-01

    This editorial briefly reviews studies which might answer the question as to whether radioiodine treatment causes the ophthalmopathy of Graves' disease. However, the data do not allow any conclusion one way or the other. Other possible causal factors are discussed. Further studies are required to define whether treatment of hyperthyroidism aggravates the ophthalmopathy and whether one thereby is worse than the others and by how much. (UK).

  1. Does motivational interviewing improve retention or outcome in cognitive behaviour therapy for overweight and obese adolescents?

    Science.gov (United States)

    Brennan, Leah

    2016-01-01

    This study aimed to determine whether motivational interviewing improved retention and/or outcome in cognitive behaviour therapy for overweight and obese adolescents (M=14.4, SD=2.0; 52% female). The first 23 participants were allocated to a standard semi-structure assessment interview, the remaining 19 to a motivational interview, prior to commencing the intervention. The groups did not differ at baseline or on anthropometric (weight, BMI, BMI-z-score, waist circumference, waist-hip or waist-height ratio), body composition (percent body fat, fat mass, lean mass) or attrition measures post-treatment or post-maintenance (p>.01). MI did not improve retention or outcome of cognitive behaviour therapy for adolescent overweight and obesity.

  2. Heavy charged particle radiobiology: using enhanced biological effectiveness and improved beam focusing to advance cancer therapy.

    Science.gov (United States)

    Allen, Christopher; Borak, Thomas B; Tsujii, Hirohiko; Nickoloff, Jac A

    2011-06-03

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation.

  3. The role of music therapy in rehabilitation: improving aphasia and beyond.

    Science.gov (United States)

    Leonardi, Simona; Cacciola, Alberto; De Luca, Rosaria; Aragona, Bianca; Andronaco, Veronica; Milardi, Demetrio; Bramanti, Placido; Calabrò, Rocco Salvatore

    2017-08-08

    Music is part of the human nature, and it is also philogenically relevant to language evolution. Language and music are bound together in the enhancement of important social functions, such as communication, cooperation and social cohesion. In the last few years, there has been growing evidence that music and music therapy may improve communication skills (but not only) in different neurological disorders. One of the plausible reasons concerning the rational use of sound and music in neurorehabilitation is the possibility to stimulate brain areas involved in emotional processing and motor control, such as the fronto-parietal network. In this narrative review, we are going to describe the role of music therapy in improving aphasia and other neurological disorders, underlying the reasons why this tool could be effective in rehabilitative settings, especially in individuals affected by stroke.

  4. Clinical applications of newer radionuclide therapies.

    NARCIS (Netherlands)

    Brans, B.; Linden, O.; Giammarile, F.; Tennvall, J.; Punt, C.J.A.

    2006-01-01

    When radio-iodine was first used in the treatment of metastasized thyroid carcinoma in 1943, its success in terms of tumour response, quality of life improvement and survival was considered a 'miracle', as in those days metastatic cancer was generally fatal. Inspired by this, many efforts have been

  5. Epicardial shock-wave therapy improves ventricular function in a porcine model of ischaemic heart disease.

    Science.gov (United States)

    Holfeld, Johannes; Zimpfer, Daniel; Albrecht-Schgoer, Karin; Stojadinovic, Alexander; Paulus, Patrick; Dumfarth, Julia; Thomas, Anita; Lobenwein, Daniela; Tepeköylü, Can; Rosenhek, Raphael; Schaden, Wolfgang; Kirchmair, Rudolf; Aharinejad, Seyedhossein; Grimm, Michael

    2016-12-01

    Previously we have shown that epicardial shock-wave therapy improves left ventricular ejection fraction (LVEF) in a rat model of myocardial infarction. In the present experiments we aimed to address the safety and efficacy of epicardial shock-wave therapy in a preclinical large animal model and to further evaluate mechanisms of action of this novel therapy. Four weeks after left anterior descending (LAD) artery ligation in pigs, the animals underwent re-thoracotomy with (shock-wave group, n = 6) or without (control group, n = 5) epicardial shock waves (300 impulses at 0.38 mJ/mm(2) ) applied to the infarcted anterior wall. Efficacy endpoints were improvement of LVEF and induction of angiogenesis 6 weeks after shock-wave therapy. Safety endpoints were haemodynamic stability during treatment and myocardial damage. Four weeks after LAD ligation, LVEF decreased in both the shock-wave (43 ± 3%, p wave animals 6 weeks after treatment (62 ± 9%, p = 0.006); no improvement was observed in controls (41 ± 4%, p = 0.36), yielding a significant difference. Quantitative histology revealed significant angiogenesis 6 weeks after treatment (controls 2 ± 0.4 arterioles/high-power field vs treatment group 9 ± 3; p = 0.004). No acute or chronic adverse effects were observed. As a potential mechanism of action in vitro experiments showed stimulation of VEGF receptors after shock-wave treatment in human coronary artery endothelial cells. Epicardial shock-wave treatment in a large animal model of ischaemic heart failure exerted a positive effect on LVEF improvement and did not show any adverse effects. Angiogenesis was induced by stimulation of VEGF receptors. Copyright © 2014 John Wiley & Sons, Ltd.

  6. High versus low radioiodine activity in patients with differentiated thyroid cancer - A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Valachis, Antonis [Dept. of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala,, (Sweden)], e-mail: Valachis@hotmail.com, Antonis.Valachis@akademiska.uu.se; Nearchou, Andreas [Dept, of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala., Uppsala (Sweden)

    2013-08-15

    Background: The purpose of the meta-analysis was to estimate the effectiveness and toxicity of low activity radioiodine ablation versus high activity in patients with differentiated thyroid cancer (DTC). Design: A systematic review and meta-analysis was performed by including all randomized trials of low activity versus high activity radioiodine ablation after thyroidectomy. Standard meta-analytic procedures were used to analyze the study outcomes. Results: Ten trials were considered eligible and were further analyzed. The pooled risk ratio (RR) of having a successful ablation for an activity of 1100 MBq versus 3700 MBq (seven trials, 1772 patients) was 0.94 (95% CI 0.85 - 1.04, p-value 0.21). The RR for successful ablation when only thyroid hormone withdrawal was used (five trials, 1116 patients) was 0.87 (95% CI 0.72 - 1.06, p-value 0.17) and it was comparable to RR when only recombinant-human TSH (rec-hTSH) (two trials, 812 patients) was used (1.00, 95% CI 0.93 - 1.07, p-value 0.92). Salivary dysfunction, nausea, and neck pain were significantly more frequent among patients with higher dose for ablation. Conclusion: Our meta-analysis provides some evidence from randomized trials that a lower activity of radioiodine ablation is as effective as higher dose after surgery in patients with DTC with lower toxicity.

  7. Transfer factors of radioiodine from volcanic-ash soil (Andosol) to crops

    Energy Technology Data Exchange (ETDEWEB)

    Ban-Nai, Tadaaki; Muramatsu, Yasuyuki [National Inst. of Radiological Sciences, Chiba (Japan). Environmental and Toxicological Sciences Research Group

    2003-03-01

    In order to obtain soil-to-plant transfer factors (TFs) of radioiodine from volcanic-ash soil to agricultural crops, we carried out radiotracer experiments. The mean values of TFs (on a wet weight basis) of radioiodine from Andosol to edible parts of crops were as follows: water dropwort, 0.24; lettuce, 0.00098; onion, 0.0011; radish, 0.0044; turnip, 0.0013 and eggplant, 0.00010. The mean value of the TFs of radioiodine for edible parts of wheat (on a dry weight basis) was 0.00015. We also studied the distributions of iodine in crops. There was a tendency for the TFs of leaves to be higher than those of tubers, fruits and grains. A very high TF was found for water dropwort, because this plant was cultivated under a waterlogged condition, in which iodine desorbed from soil into soil solution with a drop in the Eh value. The data obtained in this study should be helpful to assess the long-lived {sup 129}I (half life: 1.57 x l0{sup 7} yr) pathway related to the fuel cycle. (author)

  8. Investigation of public exposure resulted from the radioiodine delay tank facility of nuclear medicine department

    Science.gov (United States)

    Yusof, Mohd Fahmi Mohd; Ali, Abdul Muhaimin Mat; Abdullah, Reduan; Idris, Abdullah Waidi

    2016-01-01

    The study is carried out to assess the exposure rate that could contribute to public exposure in a radioiodine ward delay tank facility of Radiotherapy, Oncology and Nuclear Medicine, Department, Hospital Universiti Sains Malaysia (HUSM). The exposure rate at several locations including the delay tank room, doorway and at the public walking route was measured using Victoreen 415P-RYR survey meter. The radioactive level of the 131I waste was measured using Captus 3000 well counting system. The results showed that exposure rate and total count of the delay tank sample increased when the radioiodine ward was fully occupied with patient and reduced when the ward was vacant. Occupancy of radioiodine ward for two consecutive weeks had dramatically increased the exposure rate around the delay tank and radioactive level of 131I waste. The highest exposure rate and radioactive level was recorded when the ward was occupied for two consecutive weeks with 177.00 µR/h and 58.36 kcpm respectively. The exposure rate decreased 15.76 % when the door of the delay tank room was closed. The exposure rate at public walking route decreased between 15.58 % and 36.92 % as the distance increased between 1 and 3 m.

  9. Stereoselective synthesis of an iodinated resveratrol analog: Preliminary bioevaluation studies of the radioiodinated species

    Energy Technology Data Exchange (ETDEWEB)

    Dhyani, Manish V.; Kameswaran, Mythili; Korde, Aruna G.; Pandey, Usha [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Chattopadhyay, Subrata [Bio-Organic Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Banerjee, Sharmila, E-mail: sharmila@barc.gov.i [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085 (India)

    2011-07-15

    Stereoselective synthesis of an E-hydroxystilbene has been carried out using the McMurry reaction. Synthesis of a monoiodinated hydroxystilbene has been carried out by a McMurry cross-coupling reaction. For the purpose of biological evaluation, the facile electrophilic substitution route has been attempted to radioiodinate it with {sup 125}I. The HPLC pattern of the radioiodinated hydroxystilbene, which could be obtained in >90% radiochemical purity, was found to be identical to that of its non-radioactive analog that has been independently prepared using the McMurry cross-coupling route. In vitro cell uptake studies were carried out in breast cancer cells MCF7, overexpressing estrogen receptors. In vivo biodistribution studies in female Swiss mice show a uterine uptake of 0.85{+-}0.4% ID/g at 3 h.p.i. with a uterus to muscle ratio of 2.83. Uptake in the thyroid was insignificant indicating good in vivo stability of the radioiodinated hydroxystilbene.

  10. Investigation of public exposure resulted from the radioiodine delay tank facility of nuclear medicine department

    Energy Technology Data Exchange (ETDEWEB)

    Yusof, Mohd Fahmi Mohd, E-mail: mfahmi@usm.my; Ali, Abdul Muhaimin Mat; Abdullah, Reduan; Idris, Abdullah Waidi [School of Health Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan (Malaysia)

    2016-01-22

    The study is carried out to assess the exposure rate that could contribute to public exposure in a radioiodine ward delay tank facility of Radiotherapy, Oncology and Nuclear Medicine, Department, Hospital Universiti Sains Malaysia (HUSM). The exposure rate at several locations including the delay tank room, doorway and at the public walking route was measured using Victoreen 415P-RYR survey meter. The radioactive level of the {sup 131}I waste was measured using Captus 3000 well counting system. The results showed that exposure rate and total count of the delay tank sample increased when the radioiodine ward was fully occupied with patient and reduced when the ward was vacant. Occupancy of radioiodine ward for two consecutive weeks had dramatically increased the exposure rate around the delay tank and radioactive level of {sup 131}I waste. The highest exposure rate and radioactive level was recorded when the ward was occupied for two consecutive weeks with 177.00 µR/h and 58.36 kcpm respectively. The exposure rate decreased 15.76 % when the door of the delay tank room was closed. The exposure rate at public walking route decreased between 15.58 % and 36.92 % as the distance increased between 1 and 3 m.

  11. Culture-inappropriate antibiotic therapy decreases quality of life improvement after sinus surgery.

    Science.gov (United States)

    Zhang, Zi; Palmer, James N; Morales, Knashawn H; Howland, Timothy J; Doghramji, Laurel J; Adappa, Nithin D; Chiu, Alexander G; Cohen, Noam A; Lautenbach, Ebbing

    2014-05-01

    Despite their widespread use, antibiotics have not been shown to improve chronic rhinosinusitis (CRS) outcomes. We aimed to determine whether culture-inappropriate postoperative antibiotic therapy was associated with less quality-of-life (QOL) improvement following functional endoscopic sinus surgery (FESS). This retrospective cohort study recruited 376 adult CRS patients undergoing FESS between October 1, 2007 to December 31, 2011. Patient demographics, comorbidities and medications were collected at baseline. Trimethoprim-sulfamethoxazole and clindamycin were administered for 2 weeks postoperatively. The antibiotic appropriateness was determined based on bacterial resistance profile of organisms identified during intraoperative culture. The QOL outcome was defined as change of 22-item Sinonasal Outcome Test scores from preoperative visit to 1-month, 3-month, and 6-month post-FESS. Clinically significant difference was defined as at least 0.5 standard deviations (SD) of baseline QOL score in the reference group. Mixed-effects regression models were performed. Seven percent of patients (n = 27) had culture-inappropriate antibiotic therapy, and additional 5% (n = 19) had culture-specific antibiotic adjustment. Compared to patients with culture-appropriate antibiotics, patients with culture-inappropriate antibiotics had significantly less improvement of QOL from baseline to postoperative 1-month and 3-month follow-up where the difference became clinically significant; patients with antibiotic adjustment had more QOL improvement from baseline to 1-month follow-up, but their QOL worsened at 3-month follow-up, and these changes were not clinically significant. However, all effects washed out at 6-month follow-up with no significant differences. Culture-inappropriate postoperative antibiotic therapy decreased short-term QOL improvement to a clinically meaningful level after FESS. Culture guided selection of antibiotics may improve short-term FESS outcome. © 2014 ARS

  12. Action Plan to Improve State Examination Results. Physical Therapy and Rehabilitation Program. Cienfuegos, 2008-2012

    Directory of Open Access Journals (Sweden)

    María Cristina Núñez Martínez

    2014-04-01

    Full Text Available Background: the analysis of the state examination results in the 21 programs of the Health Technology undergraduate studies in the province of Cienfuegos during the 2008-2010 academic years showed four programs with largest number of failing students. Among them, Physical Therapy and Rehabilitation had the highest failure rates in the 2009-2010 academic year. Objective: to implement an action plan to improve academic performance of Physical Therapy and Rehabilitation students on the theoretical exercise of the state examination. Methods: a before-after intervention study was conducted from September 2008 to July 2012. It included 52 students who failed the written state examination and 100% of the students who took the exam in the 2010-2011 and 2011-2012 academic years to whom the plan was applied. Results: an improvement plan validated by experts was developed. It included actions that had an impact on low academic performance on the theoretical exercise of the state examination, as well as on the shortcomings of the design and implementation of the evaluation system. The quality of results on state examinations improved after putting the action plan into practice. Conclusion: this action plan allowed changing the unfavorable performance on state examinations in the Physical Therapy and Rehabilitation program during the 2008-2010 period.

  13. Combined transcranial direct current stimulation and robotic upper limb therapy improves upper limb function in an adult with cerebral palsy.

    Science.gov (United States)

    Friel, Kathleen M; Lee, Peter; Soles, Lindsey V; Smorenburg, Ana R P; Kuo, Hsing-Ching; Gupta, Disha; Edwards, Dylan J

    2017-01-01

    Robotic therapy can improve upper limb function in hemiparesis. Excitatory transcranial direct current stimulation (tDCS) can prime brain motor circuits before therapy. We tested safety and efficacy of tDCS plus robotic therapy in an adult with unilateral spastic cerebral palsy (USCP). In each of 36 sessions, anodal tDCS (2 mA, 20 min) was applied over the motor map of the affected hand. Immediately after tDCS, the participant completed robotic therapy, using the shoulder, elbow, and wrist (MIT Manus). The participant sat in a padded chair with affected arm abducted, forearm supported, and hand grasping the robot handle. The participant controlled the robot arm with his affected arm to move a cursor from the center of a circle to each of eight targets (960 movements). Motor function was tested before, after, and six months after therapy with the Wolf Motor Function Test (WMFT) and Fugl-Meyer (FM). Reaching accuracy on the robot task improved significantly after therapy. The WMFT and FM improved clinically meaningful amounts after therapy. The motor map of the affected hand expanded after therapy. Improvements were maintained six months after therapy. Combined tDCS and robotics safely improved upper limb function in an adult with USCP.

  14. Improvement of asthma therapy by a novel formoterol multidose dry powder inhaler.

    Science.gov (United States)

    Moeller, Manfred; Grimmbacher, Stefanie; Munzel, Ullrich

    2008-01-01

    The objective of this post-marketing surveillance (PMS) was the evaluation of efficacy, tolerability, and acceptance of the advanced formoterol (CAS 73573-87-2) multidose dry powder inhaler (MDPI) Formatris 6 microg/12 microg Novolizer (FN) in asthmatic patients (n = 5219) in a real-life setting. A total of 2727 patients (52%) received concomitant anti-inflammatory treatment exclusively via a budesonide Novolizer (BN). Efficacy of the FN was assessed by measurement of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) before and after 4 weeks of therapy. The severity of cough, wheezing, diurnal dyspnea, nocturnal dyspnea and dyspnea on physical effort were assessed on a four-point scale, and a severity sum score was calculated. The patients' satisfaction with the multiple feedback mechanisms, handling and safety of the FN was also assessed. The physicians judged the patient compliance and any improved inhalation reassurance due to FN control mechanisms in comparison with other inhalation systems. FN use (n = 2727) was associated with improved lung function. After 4 weeks, PEF increased by 26% (from 270 L/min to 340 L/min) and the median FEV1 increased by 24% (from 2.1 L to 2.6 L). The median severity sum score decreased from 8.0 before therapy to 3.0 after therapy. Most patients assessed the control mechanisms and safety functions of the FN as 'very good' or 'good'. 96% of patients were satisfied with the optical control mechanism, 92% with the acoustic mechanism, 70% with the taste feedback, 89% with the dose counter and 76% with the overdose prevention. The majority of patients (95%) confirmed that the multiple feedback mechanisms reassured correct drug intake, with 83% rating the FN as 'much better' or 'better' than previously used inhalers. The physicians confirmed that in contrast to previously used inhalers the FN ensured correct inhalation in 87% of all patients. The physicians were satisfied with the patients' compliance in 95% of

  15. Improvement of quality of life following 6 months of methadone maintenance therapy in Malaysia

    Directory of Open Access Journals (Sweden)

    Baharom Nizam

    2012-08-01

    Full Text Available Abstract Background Methadone Maintenance Therapy (MMT is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients’ quality of life. This study aims to identify the impact of MMT programme on clients’ quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. Methods In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF, at baseline and 6 months after therapy were collected and converted to 0–100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. Results There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 ± 20.81. Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. Conclusions There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.

  16. Synthesis and evaluation of radioiodinated cyclooxygenase-2 inhibitors as potential SPECT tracers for cyclooxygenase-2 expression

    Energy Technology Data Exchange (ETDEWEB)

    Kuge, Yuji [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan)]. E-mail: kuge@pharm.kyoto-u.ac.jp; Katada, Yumiko [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Shimonaka, Sayaka [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Temma, Takashi [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Kimura, Hiroyuki [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Kiyono, Yasushi [Radioisotopes Research Laboratory, Kyoto University Hospital, Faculty of Medicine, Kyoto University, Kyoto 606-8507 (Japan); Yokota, Chiaki [Cerebrovascular Laboratory, National Cardiovascular Center Research Institute, Osaka 565-8565 (Japan); Minematsu, Kazuo [Cerebrovascular Division, Department of Medicine, National Cardiovascular Center Research Institute, Osaka 565-8565 (Japan); Seki, Koh-ichi [Central Institute of Isotope Science, Hokkaido University, Hokkaido 060-8638 (Japan); Tamaki, Nagara [Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, Hokkaido 060-8638 (Japan); Ohkura, Kazue [Department of Radiopharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Hokkaido 061-0293 (Japan); Saji, Hideo [Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan)

    2006-01-15

    Although several COX-2 inhibitors have recently been radiolabeled, their potential for imaging COX-2 expression remains unclear. In particular, the sulfonamide moiety of COX-2 inhibitors may cause slow blood clearance of the radiotracer, due to its affinity for carbonic anhydrase (Canada) in erythrocytes. Thus, we designed a methyl sulfone-type analogue, 5-(4-iodophenyl)-1-[4-(methylsulfonyl)phenyl]-3-trifluoromethyl-1H-pyrazole (IMTP). In this study, the potential of radioiodinated IMTP was assessed in comparison with a {sup 125}I-labeled celecoxib analogue with a sulfonamide moiety ({sup 125}I-IATP). Methods: The COX inhibitory potency was assessed by measuring COX-catalyzed oxidation by hydrogen peroxide. The biodistribution of {sup 125}I-IMTP and {sup 125}I-IATP was determined by the ex vivo tissue counting method in rats. Distribution of the labeled compounds to rat blood cells was measured. Results: The COX-2 inhibitory potency of IMTP (IC{sub 5}=5.16 {mu}M) and IATP (IC{sub 5}=8.20 {mu}M) was higher than that of meloxicam (IC{sub 5}=29.0 {mu}M) and comparable to that of SC-58125 (IC{sub 5}=1.36 {mu}M). The IC{sub 5} ratios (COX-1/COX-2) indicated the high isoform selectivity of IMTP and IATP for COX-2. Significant levels of {sup 125}I-IMTP and {sup 125}I-IATP were observed in the kidneys and the brain (organs known to express COX-2). The blood clearance of {sup 125}I-IMTP was much faster than that of {sup 125}I-IATP. Distribution of {sup 125}I-IATP to blood cells (88.0%) was markedly higher than that of {sup 125}I-IMTP (18.1%), which was decreased by CA inhibitors. Conclusions: Our results showed a high inhibitory potency and selectivity of IMTP for COX-2. The substitution of a sulfonamide moiety to a methyl sulfone moiety effectively improved the blood clearance of the compound, indicating the loss of the cross reactivity with CA in {sup 125}I-IMTP. {sup 123}I-IMTP may be a potential SPECT radiopharmaceutical for COX-2 expression.

  17. Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Scanlon ML

    2013-01-01

    Full Text Available Michael L Scanlon,1,2 Rachel C Vreeman1,21Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA; 2USAID, Academic Model Providing Access to Healthcare (AMPATH Partnership, Eldoret, KenyaAbstract: The rollout of antiretroviral therapy (ART significantly reduced human immunodeficiency virus (HIV-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world’s HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a

  18. Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Yi-Qi Du; Tun Su; Jian-Gao Fan; Yu-Xia Lu; Ping Zheng; Xing-Hua Li; Chuan-Yong Guo

    2012-01-01

    AIM:To investigate whether the addition of probiotics can improve the eradication effect of triple therapy for Helicobacter pylori (H.pylori) infection.METHODS:This open randomized trial recruited 234 H.pylori positive gastritis patients from seven local centers.The patients were randomized to one-week standard triple therapy (omeprazole 20 mg bid,clarithromycin 500 mg bid,and amoxicillin 1000 mg bid; OCA group,n =79); two weeks of pre-treatment with probiotics,containing 3 × 107 Lactobacillus acidophilus per day,prior to one week of triple therapy (POCA group,n =78); or one week of triple therapy followed by two weeks of the same probiotics (OCAP group,n =77).Successful eradication was defined as a negative C13 or C14 urease breath test four weeks after triple therapy.Patients were asked to report associated symptoms at baseline and during follow-up,and side effects related to therapy were recorded.Data were analyzed by both intention-to-treat (ITT) and per-protocol (PP) methods.RESULTS:PP analysis involved 228 patients,78 in the OCA,76 in the POCA and 74 in the OCAP group.Successful eradication was observed in 171 patients; by PP analysis,the eradication rates were significantly higher (P =0.007 each) in the POCA (62/76; 81.6%,95%CI 72.8%-90.4%) and OCAP (61/74; 82.4%,95% CI 73.6%-91.2%) groups than in the OCA group (48/78;61.5%,95% CI 50.6%-72.4%).ITT analysis also showed that eradication rates were significantly higher in the POCA (62/78; 79.5%,95% CI 70.4%-88.6%)and OCAP (61/77; 79.2%,95% CI 70%-88.4%)groups than in the OCA group (48/79; 60.8%,95% CI 49.9%-71.7%),(P =0.014 and P =0.015).The symptom relieving rates in the POCA,OCAP and OCA groups were 85.5%,89.2% and 87.2%,respectively.Only one of the 228 patients experienced an adverse reaction.CONCLUSION:Administration of probiotics before or after standard triple therapy may improve H.pylori eradication rates.

  19. THE APPLICATION OF BEHAVIOR THERAPY MODEL FOR THE IMPROVEMENT OF SPEAKING ABILITY OF DYSARTHRIA PATIENTS

    Directory of Open Access Journals (Sweden)

    Gusdi Sastra

    2016-02-01

    Full Text Available Research on behavior therapy has been conducted on patients with dysarthria, a disorder of articulation due to impairment of the central nervous system, which directly controls the activity of the muscles that play a role in the process of articulation in the pronunciation production. This study discusses three issues: lingual form made by people with dysarthria before getting behavior therapy, emotional influences on lexical and semantic knowledge of the patient, and the achievement of the model of behavior therapy applied to patients with dysarthria speech impairment. The theory used in this study was from Prins (2004 and the method of analysis applied is the method from Nunan (1992combined with Sudaryanto (1993.The research found that there is an increased ability of patient to talk: nearly 40 percent of the index lingual knowledge or information, 20 percent of semantics, and 40 percent of feeling. Lingual index is significant as a means of therapy for patients with dysarthria. An increase in the speech ability improves confidence in facing social life.

  20. Negative symptom improvement during cognitive rehabilitation: results from a 2-year trial of Cognitive Enhancement Therapy.

    Science.gov (United States)

    Eack, Shaun M; Mesholam-Gately, Raquelle I; Greenwald, Deborah P; Hogarty, Susan S; Keshavan, Matcheri S

    2013-08-30

    Cognitive rehabilitation has shown beneficial effects on cognition in patients with schizophrenia, which may also help to improve negative symptoms due to overlapping pathophysiology between these two domains. To better understand the possible relationship between these areas, we conducted an exploratory analysis of the effects of Cognitive Enhancement Therapy (CET) on negative symptoms. Early course schizophrenia outpatients (n=58) were randomized to 2 years of CET or an Enriched Supportive Therapy (EST) control condition. Results revealed significant and medium-sized (d=0.61) differential improvements favoring CET in overall negative symptoms, particularly social withdrawal, affective flattening, and motor retardation. Neurocognitive improvement was associated with reduced negative symptoms in CET, but not EST patients. No relationships were observed between improvements in emotion processing aspects of social cognition, as measured by the Mayer-Salovey-Caruso Emotional Intelligence Test, and negative symptoms. CET represents an effective cognitive rehabilitation intervention for schizophrenia that may also have benefits to negative symptoms. Future studies specifically designed to examine negative symptoms during the course of cognitive rehabilitation are needed.

  1. Aerobic Exercise as an Adjunct Therapy for Improving Cognitive Function in Heart Failure

    Directory of Open Access Journals (Sweden)

    Rebecca A. Gary

    2014-01-01

    Full Text Available Persons with heart failure (HF are typically older and are at a much higher risk for developing cognitive impairment (CI than persons without HF. Increasingly, CI is recognized as a significant, independent predictor of worse clinical outcomes, more frequent hospital readmissions, and higher mortality rates in persons with HF. CI can have devastating effects on ability to carry out HF effective self-care behaviors. If CI occurs, however, there are currently no evidence based guidelines on how to manage or improve cognitive function in this population. Improvement in cognition has been reported following some therapies in HF and is thought to be the consequence of enhanced cerebral perfusion and oxygenation, suggesting that CI may be amenable to intervention. Because there is substantial neuronal loss with dementia and no effective restorative therapies, interventions that slow, reverse, or prevent cognitive decline are essential. Aerobic exercise is documented to increase cerebral perfusion and oxygenation by promoting neuroplasticity and neurogenesis and, in turn, cognitive functioning. Few studies have examined exercise as a potential adjunct therapy for attenuating or alleviating cognitive decline in HF. In this review, the potential benefit of aerobic exercise on cognitive functioning in HF is presented along with future research directions.

  2. The Effectiveness of Integrative Group Therapy on Improving Problem-Solving

    Directory of Open Access Journals (Sweden)

    Raheleh Maddah-Shoorcheh

    2014-05-01

    Full Text Available Background: Today, the psychological and behavioral science experts pay attention to the problem-solving skill as a basic skill. Improving the problem-solving skill is better done through psychological trainings in the form of a group in which communication is the most important issue. Therefore, the purpose of the present study is to investigate the effectiveness of integrative group therapy on the problem-solving skill. Materials and Methods: This study is an experimental study with pretest-posttest approach. Thirty clients who were referring to the Counseling and Psychological Services Center of Ferdowsi University of Mashhad were chosen based on screening method. In addition, they were randomly divided into two equal groups: experimental and control groups (13 participants each. Problem-solving questionnaire was used to collect data as well as the experimental intervention was integrative group therapy that was administrated during 8 weekly two-hour sessions. Mean and standard deviation were used for data analysis in the descriptive level and covariate method was used at the inference level (ANCOVA. Results: The results suggest that the problem-solving skills in the experimental group were significantly increased. Moreover, the significant difference was observed in subscales closeness, control, confidence and creative. Conclusion: Integrative group therapy could be an effective intervention for improving problem-solving skills.

  3. Successful Phenotype Improvement following Gene Therapy for Severe Hemophilia A in Privately Owned Dogs.

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    Mary Beth Callan

    Full Text Available Severe hemophilia A (HA is an inherited bleeding disorder characterized by <1% of residual factor VIII (FVIII clotting activity. The disease affects several mammals including dogs, and, like humans, is associated with high morbidity and mortality. In gene therapy using adeno-associated viral (AAV vectors, the canine model has been one of the best predictors of the therapeutic dose tested in clinical trials for hemophilia B (factor IX deficiency and other genetic diseases, such as congenital blindness. Here we report our experience with liver gene therapy with AAV-FVIII in two outbred, privately owned dogs with severe HA that resulted in sustained expression of 1-2% of normal FVIII levels and prevented 90% of expected bleeding episodes. A Thr62Met mutation in the F8 gene was identified in one dog. These data recapitulate the improvement of the disease phenotype in research animals, and in humans, with AAV liver gene therapy for hemophilia B. Our experience is a novel example of the benefits of a relevant preclinical canine model to facilitate both translational studies in humans and improved welfare of privately owned dogs.

  4. Electric stimulation and decimeter wave therapy improve the recovery of injured sciatic nerves

    Institute of Scientific and Technical Information of China (English)

    Feng Zhao; Wei He; Yingze Zhang; Dehu Tian; Hongfang Zhao; Kunlun Yu; Jiangbo Bai

    2013-01-01

    Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackin-non’s model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histo-logical observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, al eviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for rege-neration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.

  5. Interactive rehabilitation system for improvement of balance therapies in people with cerebral palsy.

    Science.gov (United States)

    Jaume-i-Capó, Antoni; Martínez-Bueso, Pau; Moyà-Alcover, Biel; Varona, Javier

    2014-03-01

    The present study covers a new experimental system, designed to improve the balance and postural control of adults with cerebral palsy. This system is based on a serious game for balance rehabilitation therapy, designed using the prototype development paradigm and features for rehabilitation with serious games: feedback, adaptability, motivational elements, and monitoring. In addition, the employed interaction technology is based on computer vision because motor rehabilitation consists of body movements that can be recorded, and because vision capture technology is noninvasive and can be used for clients who have difficulties in holding physical devices. Previous research has indicated that serious games help to motivate clients in therapy sessions; however, there remains a paucity of clinical evidence involving functionality. We rigorously evaluated the effects of physiotherapy treatment on balance and gait function of adult subjects with cerebral palsy undergoing our experimental system. A 24-week physiotherapy intervention program was conducted with nine adults from a cerebral palsy center who exercised weekly in 20-min sessions. Findings demonstrated a significant increase in balance and gait function scores resulting in indicators of greater independence for our participating adults. Scores improved from 16 to 21 points in a scale of 28, according to the Tinetti Scale for risk of falls, moving from high fall risk to moderate fall risk. Our promising results indicate that our experimental system is feasible for balance rehabilitation therapy.

  6. The peer review system (PRS) for quality assurance and treatment improvement in radiation therapy

    Science.gov (United States)

    Le, Anh H. T.; Kapoor, Rishabh; Palta, Jatinder R.

    2012-02-01

    Peer reviews are needed across all disciplines of medicine to address complex medical challenges in disease care, medical safety, insurance coverage handling, and public safety. Radiation therapy utilizes technologically advanced imaging for treatment planning, often with excellent efficacy. Since planning data requirements are substantial, patients are at risk for repeat diagnostic procedures or suboptimal therapeutic intervention due to a lack of knowledge regarding previous treatments. The Peer Review System (PRS) will make this critical radiation therapy information readily available on demand via Web technology. The PRS system has been developed with current Web technology, .NET framework, and in-house DICOM library. With the advantages of Web server-client architecture, including IIS web server, SOAP Web Services and Silverlight for the client side, the patient data can be visualized through web browser and distributed across multiple locations by the local area network and Internet. This PRS will significantly improve the quality, safety, and accessibility, of treatment plans in cancer therapy. Furthermore, the secure Web-based PRS with DICOM-RT compliance will provide flexible utilities for organization, sorting, and retrieval of imaging studies and treatment plans to optimize the patient treatment and ultimately improve patient safety and treatment quality.

  7. Effectiveness of Cognitive and Transactional Analysis Group Therapy on Improving Conflict-Solving Skill

    Directory of Open Access Journals (Sweden)

    Bahram A. Ghanbari-Hashemabadi

    2012-03-01

    Full Text Available Background: Today, learning the communication skills such as conflict solving is very important. The purpose of the present study was to investigate the efficiency of cognitive and transactional analysis group therapy on improving the conflict-solving skill.Materials and Method: This study is an experimental study with pretest-posttest and control group. Forty-five clients who were referring to the counseling and psychological services center of Ferdowsi University of Mashhad were chosen based on screening method. In addition, they were randomly divided into three equal groups: control group (15 participants, cognitive experimental group (15 participants and transactional analysis group (15 participants. Conflict-solving questionnaire was used to collect data and the intervention methods were cognitive and transactional analysis group therapy that was administrated during 8 weekly two-hour sessions. Mean and standard deviation were used for data analysis in the descriptive level and One-Way ANOVA method was used at the inference level.Results: The results of the study suggest that the conflict-solving skills in the two experimental groups were significantly increased. Conclusion: The finding of this research is indicative of the fact that both cognitive and transactional analysis group therapy could be an effective intervention for improving conflict-solving skills

  8. Using interprofessional simulation to improve collaborative competences for nursing, physiotherapy, and respiratory therapy students.

    Science.gov (United States)

    King, Judy; Beanlands, Sarah; Fiset, Valerie; Chartrand, Louise; Clarke, Shelley; Findlay, Tarra; Morley, Michelle; Summers, Ian

    2016-09-01

    Within the care of people living with respiratory conditions, nursing, physiotherapy, and respiratory therapy healthcare professionals routinely work in interprofessional teams. To help students prepare for their future professional roles, there is a need for them to be involved in interprofessional education. The purpose of this project was to compare two different methods of patient simulation in improving interprofessional competencies for students in nursing, physiotherapy, and respiratory therapy programmes. The Canadian Interprofessional Health Collaborative competencies of communication, collaboration, conflict resolution patient/family-centred care, roles and responsibilities, and team functioning were measured. Using a quasi-experimental pre-post intervention approach two different interprofessional workshops were compared: the combination of standardised and simulated patients, and exclusively standardised patients. Students from nursing, physiotherapy, and respiratory therapy programmes worked together in these simulation-based activities to plan and implement care for a patient with a respiratory condition. Key results were that participants in both years improved in their self-reported interprofessional competencies as measured by the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). Participants indicated that they found their interprofessional teams did well with communication and collaboration. But the participants felt they could have better involved the patients and their family members in the patient's care. Regardless of method of patient simulation used, mannequin or standardised patients, students found the experience beneficial and appreciated the opportunity to better understand the roles of other healthcare professionals in working together to help patients living with respiratory conditions.

  9. Electric stimulation and decimeter wave therapy improve the recovery of injured sciatic nerves.

    Science.gov (United States)

    Zhao, Feng; He, Wei; Zhang, Yingze; Tian, Dehu; Zhao, Hongfang; Yu, Kunlun; Bai, Jiangbo

    2013-07-25

    Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackinnon's model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histological observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, alleviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for regeneration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.

  10. Human retinal gene therapy for Leber congenital amaurosis shows advancing retinal degeneration despite enduring visual improvement.

    Science.gov (United States)

    Cideciyan, Artur V; Jacobson, Samuel G; Beltran, William A; Sumaroka, Alexander; Swider, Malgorzata; Iwabe, Simone; Roman, Alejandro J; Olivares, Melani B; Schwartz, Sharon B; Komáromy, András M; Hauswirth, William W; Aguirre, Gustavo D

    2013-02-05

    Leber congenital amaurosis (LCA) associated with retinal pigment epithelium-specific protein 65 kDa (RPE65) mutations is a severe hereditary blindness resulting from both dysfunction and degeneration of photoreceptors. Clinical trials with gene augmentation therapy have shown partial reversal of the dysfunction, but the effects on the degeneration are not known. We evaluated the consequences of gene therapy on retinal degeneration in patients with RPE65-LCA and its canine model. In untreated RPE65-LCA patients, there was dysfunction and degeneration of photoreceptors, even at the earliest ages. Examined serially over years, the outer photoreceptor nuclear layer showed progressive thinning. Treated RPE65-LCA showed substantial visual improvement in the short term and no detectable decline from this new level over the long term. However, retinal degeneration continued to progress unabated. In RPE65-mutant dogs, the first one-quarter of their lifespan showed only dysfunction, and there was normal outer photoreceptor nuclear layer thickness retina-wide. Dogs treated during the earlier dysfunction-only stage showed improved visual function and dramatic protection of treated photoreceptors from degeneration when measured 5-11 y later. Dogs treated later during the combined dysfunction and degeneration stage also showed visual function improvement, but photoreceptor loss continued unabated, the same as in human RPE65-LCA. The results suggest that, in RPE65 disease treatment, protection from visual function deterioration cannot be assumed to imply protection from degeneration. The effects of gene augmentation therapy are complex and suggest a need for a combinatorial strategy in RPE65-LCA to not only improve function in the short term but also slow retinal degeneration in the long term.

  11. Behavior and awareness of thyroid cancer patients in Korea having non-hospitalized low-dose radioiodine treatment with regard to radiation safety

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seog Gyun; Paeng, Jin Chul; Eo, Jae Seon; Shim, Hye Kyung; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2010-12-15

    With the recent increase in incidence of thyroid cancer, non-hospitalized low-dose (NH-LD) radioiodine treatment (RIT) has also increased rapidly. The radioactivity limit that is allowed to be administered without hospitalization depends on individual calculation, based partly on patients' behavior. In this study, Korean patients' behavior in relation to radiation safety in NHLD RIT was surveyed. A total of 218 patients who underwent NH-LD RIT of 1.1 GBq {sup 131}I in a single center were surveyed. The patients underwent RIT with a standard protocol and the survey was performed by interview when they visited subsequently for a whole-body scan. The survey questionnaire included three parts of questions: general information, behavior relating to isolation during RIT, and awareness of radiation safety. After administration of radioiodine, 40% of patients who returned home used mass transportation, and another 47% went home by taxi or in car driven by another person. Isolation at home was generally sufficient. However, 7% of patients did not stay in a separate room. Among the 218 patients, 34% did not go home and chose self-isolation away from home, mostly due to concerns about radiation safety of family members. However, the places were mostly public places, including hotels, resorts, and hospitals. About half of the patients replied that access to radiation safety information was not easy and their awareness of radiation safety was not satisfactory. As a result, 45% of patients wanted hospitalized RIT. In many countries, including Korea, RIT is continuously increasing. Considering the radiation safety of patients' family members or the public and the convenience of patients, the pretreatment education of patients should be enhanced. In addition, the hospitalization of patients having low-dose therapy is recommended to be seriously considered and expanded, with the expansion of dedicated treatment facilities

  12. Expression and function of the novel proto-oncogene PBF in thyroid cancer: a new target for augmenting radioiodine uptake.

    Science.gov (United States)

    Smith, Vicki E; Franklyn, Jayne A; McCabe, Christopher J

    2011-08-01

    Pituitary tumor-transforming gene (PTTG)-binding factor (PBF; PTTG1IP) was initially identified through its interaction with the human securin, PTTG. Like PTTG, PBF is upregulated in multiple endocrine tumours including thyroid cancer. PBF is believed to induce the translocation of PTTG into the cell nucleus where it can drive tumourigenesis via a number of different mechanisms. However, an independent transforming ability has been demonstrated both in vitro and in vivo, suggesting that PBF is itself a proto-oncogene. Studied in only a limited number of publications to date, PBF is emerging as a protein with a growing repertoire of roles. Recent data suggest that PBF possesses a complex multifunctionality in an increasing number of tumour settings. For example, PBF is upregulated by oestrogen and mediates oestrogen-stimulated cell invasion in breast cancer cells. In addition to a possible role in the induction of thyroid tumourigenesis, PBF overexpression in thyroid cancers inhibits iodide uptake. PBF has been shown to repress sodium iodide symporter (NIS) activity by transcriptional regulation of NIS expression through the human NIS upstream enhancer and further inhibits iodide uptake via a post-translational mechanism of NIS governing subcellular localisation. This review discusses the current data describing PBF expression and function in thyroid cancer and highlights PBF as a novel target for improving radioiodine uptake and thus prognosis in thyroid cancer.

  13. Selective androgen receptor modulators as improved androgen therapy for advanced breast cancer.

    Science.gov (United States)

    Coss, Christopher C; Jones, Amanda; Dalton, James T

    2014-11-01

    Androgens were at one time a therapeutic mainstay in the treatment of advanced breast cancer. Despite comparable efficacy, SERMs and aromatase inhibitors eventually became the therapies of choice due to in part to preferred side-effect profiles. Molecular characterization of breast tumors has revealed an abundance of androgen receptor expression but the choice of an appropriate androgen receptor ligand (agonist or antagonist) has been confounded by multiple conflicting reports concerning the role of the receptor in the disease. Modern clinical efforts have almost exclusively utilized antagonists. However, the recent clinical development of selective androgen receptor modulators with greatly improved side-effect profiles has renewed interest in androgen agonist therapy for advanced breast cancer.

  14. Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury

    Science.gov (United States)

    Wenger, Nikolaus; Moraud, Eduardo Martin; Gandar, Jerome; Musienko, Pavel; Capogrosso, Marco; Baud, Laetitia; Le Goff, Camille G.; Barraud, Quentin; Pavlova, Natalia; Dominici, Nadia; Minev, Ivan R.; Asboth, Leonie; Hirsch, Arthur; Duis, Simone; Kreider, Julie; Mortera, Andrea; Haverbeck, Oliver; Kraus, Silvio; Schmitz, Felix; DiGiovanna, Jack; van den Brand, Rubia; Bloch, Jocelyne; Detemple, Peter; Lacour, Stéphanie P.; Bézard, Erwan; Micera, Silvestro; Courtine, Grégoire

    2016-01-01

    Electrical neuromodulation of lumbar segments improves motor control after spinal cord injury in animal models and humans. However, the physiological principles underlying the effect of this intervention remain poorly understood, which has limited this therapeutic approach to continuous stimulation applied to restricted spinal cord locations. Here, we developed novel stimulation protocols that reproduce the natural dynamics of motoneuron activation during locomotion. For this, we computed the spatiotemporal activation pattern of muscle synergies during locomotion in healthy rats. Computer simulations identified optimal electrode locations to target each synergy through the recruitment of proprioceptive feedback circuits. This framework steered the design of spatially selective spinal implants and real–time control software that modulate extensor versus flexor synergies with precise temporal resolution. Spatiotemporal neuromodulation therapies improved gait quality, weight–bearing capacities, endurance and skilled locomotion in multiple rodent models of spinal cord injury. These new concepts are directly translatable to strategies to improve motor control in humans. PMID:26779815

  15. INTEGRATION BETWEEN MRI AND PHYSICAL THERAPY TO IMPROVE TREATMENT OF PATIENTS WITH SHOULDER PAIN

    Directory of Open Access Journals (Sweden)

    Awad Mohamed Elkhadir

    2016-08-01

    Full Text Available Background: Shoulder pain is the second most common musculoskeletal disorder treated by physical therapists. The cause for the shoulder pain is multifactorial. However, a specific diagnosis is crucial in the right management of shoulder dysfunction. Therefore, the aim of this study was to find out the efficacy of integrating the MRI for the accurate diagnosis and impact of this on rendering the effective physical therapy interventions in shoulder dysfunction patients. Methods: A retrospective study conducted on 14 patients who undergone an MRI with a 1.5 T unit MAGNETOM Symphony (Siemens, for their shoulder pain, where the diagnosis might be Muscle tears like, subscapularis, infraspinatus,supraspinatus and teres minor muscles; subacromial or subdeltoid bursitis and labral tears were included. All the subjects were then continued with usual physical therapy treatments for four weeks depending on their diagnosis which includes; advice, stretching, mobilization and strengthening exercises, manual therapy, massage, strapping, and electrotherapy . The outcome measures documented from the case sheet were; Visual Analogue Scale grade and passive range of motion of shoulder external / internal rotation and abduction. Results: Paired t test was used to compare the PROM between pre rehabilitation and post rehabilitation testing and the non parametric test, Mann Whitney U test was used for the comparison of VAS. All patients showed a significant improvement in VAS and PROM of abduction, internal and external rotation following physical therapy (P≤ 0.05. Conclusion: MRI is found to be a reliable method of diagnostic procedure for the shoulder pain and the integration of MRI and physical therapy to treat shoulder dysfunction leads to a better outcome.

  16. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review.

    Science.gov (United States)

    De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

    2017-08-01

    The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  17. Improving access to psychological therapies (IAPT) and treatment outcomes: epistemological assumptions and controversies.

    Science.gov (United States)

    Williams, C H J

    2015-06-01

    Cognitive behaviour therapy (CBT) is recommended as a primary treatment choice in England, for anxiety and depression, by the National Institute for Health and Care Excellence (NICE). It has been argued that CBT has enjoyed political and cultural dominance and this has arguably led to maintained government investment in England for the cognitive and behavioural treatment of mental health problems. The government programme 'Improving Access to Psychological Therapies' (IAPT) aims to improve the availability of CBT. The criticism of the NICE evidence-based guidelines supporting the IAPT programme, has been the dominance of the gold standard randomized controlled trial methodology, with a focus on numerical outcome data, rather than a focus on a recovery narrative. RCT-based research is influenced by a philosophical paradigm called positivism. The IAPT culture is arguably influenced by one research paradigm and such an influence can skew services only towards numerical outcome data as the only truth of 'recovery'. An interpretative paradigm could assist in shaping service-based cultures, alter how services are evaluated and improve the richness of CBT research. This paper explores the theory of knowledge (epistemology) that underpins the evidence-based perspective of CBT and how this influences service delivery. The paper argues that the inclusion of service user narrative (qualitative data) can assist the evaluation of CBT from the user's perspective and can understand the context in which people live and how they access services. A qualitative perspective is discussed as a research strategy, capturing the lived experience of under-represented groups, such as sexual, gender and ethnic minorities. Cognitive behaviour therapy (CBT) has enjoyed political and cultural dominance within mental healthcare, with renewed government investment in England for the'Improving Access to Psychological Therapies' (IAPT) programme. The criticism of the evidence-based guidelines

  18. Synthesis of radioiodinated cis- and trans- 1,2-diphenyl-3,3-dichloro-cyclopropanes: potential radiopharmaceuticals for estrogen dependent

    Energy Technology Data Exchange (ETDEWEB)

    Basmadjian, G.P.; Gilliland, D.L.; Magarian, R.A.; Ice, R.D. (Oklahoma Univ., Oklahoma City (USA). Health Sciences Center); Marchand, A.P. (Oklahoma Univ., Norman (USA). Dept. of Chemistry)

    Two non-steroidal compounds labelled with radioiodine, for breast cancer screening, have been developed. They are cis-trans-cyclopropyl analogs of cis- and trans-stilbene. Radioiodination with /sup 125/I or /sup 131/I was carried out by 1) exchange labelling 2) melt labelling 3) diazotization and 4) thallium iodination 5) triazine hydrolysis. The last two methods were the most efficient.

  19. Comparing uni-modal and multi-modal therapies for improving writing in acquired dysgraphia after stroke.

    Science.gov (United States)

    Thiel, Lindsey; Sage, Karen; Conroy, Paul

    2016-01-01

    Writing therapy studies have been predominantly uni-modal in nature; i.e., their central therapy task has typically been either writing to dictation or copying and recalling words. There has not yet been a study that has compared the effects of a uni-modal to a multi-modal writing therapy in terms of improvements to spelling accuracy. A multiple-case study with eight participants aimed to compare the effects of a uni-modal and a multi-modal therapy on the spelling accuracy of treated and untreated target words at immediate and follow-up assessment points. A cross-over design was used and within each therapy a matched set of words was targeted. These words and a matched control set were assessed before as well as immediately after each therapy and six weeks following therapy. The two approaches did not differ in their effects on spelling accuracy of treated or untreated items or degree of maintenance. All participants made significant improvements on treated and control items; however, not all improvements were maintained at follow-up. The findings suggested that multi-modal therapy did not have an advantage over uni-modal therapy for the participants in this study. Performance differences were instead driven by participant variables.

  20. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials.

    Science.gov (United States)

    In, Taesung; Lee, Kyeongjin; Song, Changho

    2016-10-28

    BACKGROUND Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. MATERIAL AND METHODS Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. RESULTS There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). CONCLUSIONS Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training.

  1. Anti-tachycardia therapy can improve altered cardiac adrenergic function in tachycardia-induced cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ohkusu, Yasuo; Takahashi, Nobukazu; Ishikawa, Toshiyuki [Yokohama City Univ. (Japan). School of Medicine] [and others

    2002-11-01

    We investigated whether anti-tachycardia therapy might improve the altered cardiac adrenergic and systolic function in tachycardia-induced cardiomyopathy (TC) in contrast to dilated cardiomyopathy (DCM). The subjects were 23 patients with heart failure, consisting of 8 patients with TC (43.6{+-}10.0 yrs) and 15 with DCM (45.3{+-}8.2 yrs). TC was determined as impairment of left ventricular function secondary to chronic or very frequent arrhythmia during more than 10% of the day. All patients were receiving anti-tachycardia treatment. Cardiac {sup 123}I-MIBG uptake was assessed as the heart/mediastinum activity ratio (H/M) before and after treatment. Left ventricular ejection fraction (LVEF) was also assessed. In the baseline study, H/M and LVEF showed no difference between TC and DCM (2.21{+-}0.44 vs. 2.10{+-}0.42, 35.3{+-}13.1 vs. 36.0{+-}10.9%, respectively). After treatment, the degree of change in H/M and LVEF differed significantly (0.41{+-}0.34 vs. 0.08{+-}0.20, 20.5{+-}14.4 vs. -2.1{+-}9.6%, p<0.01). In TC, heart failure improved after a shorter duration of treatment (p<0.05). In conclusion, anti-tachycardia therapy can improve altered cardiac adrenergic function and systolic function in patients with TC over a shorter period than in those with DCM. (author)

  2. Triple antibiotic combination therapy may improve but not resolve granuloma annulare.

    Science.gov (United States)

    Simpson, Brenda; Foster, Shannon; Ku, Jennifer H; Simpson, Eric L; Ehst, Benjamin D

    2014-01-01

    Granuloma annulare is a fairly common entity yet lacks reliable treatment options especially when multiple lesions or dissemination exists. A recent case series suggests that a regimen of three oral antibiotics may prove to be an effective treatment. Our objective is to evaluate the efficacy of once monthly triple antibiotic therapy for granuloma annulare. We conducted an open-label prospective study of subjects with at least five lesions of granuloma annulare who received once monthly rifampin, ofloxacin, and minocycline for 6 months. Improvement was measured with a novel objective Granuloma Annulare Severity Index (GASI) scoring system. Twenty-one subjects enrolled. Ten subjects (48%) achieved at least a 50% reduction in their GASI, including three subjects (14%) who reached 75% improvement and one subject (5%) whose skin cleared. Six subjects (29%) had no change or worsening of their granuloma annulare. Median GASI scores decreased significantly by 15 points (p antibiotic use may improve but not clear granuloma annulare over 6 months. Randomized trials may be warranted to further assess this therapy.

  3. Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study

    Directory of Open Access Journals (Sweden)

    Howells Fleur M

    2012-02-01

    Full Text Available Abstract Background Cognitive processing in Bipolar Disorder is characterized by a number of attentional abnormalities. Mindfulness Based Cognitive Therapy combines mindfulness meditation, a form of attentional training, along with aspects of cognitive therapy, and may improve attentional dysfunction in bipolar disorder patients. Methods 12 euthymic BD patients and 9 control participants underwent record of electroencephalography (EEG, band frequency analysis during resting states (eyes open, eyes closed and during the completion of a continuous performance task (A-X version, EEG event-related potential (ERP wave component analysis. The individuals with BD completed an 8-week MBCT intervention and record of EEG was repeated. Results (1 Brain activity, individuals with BD showed significantly decreased theta band power, increased beta band power, and decreased theta/beta ratios during the resting state, eyes closed, for frontal and cingulate cortices. Post MBCT intervention improvement over the right frontal cortex was seen in the individuals with BD, as beta band power decreased. (2 Brain activation, individuals with BD showed a significant P300-like wave form over the frontal cortex during the cue. Post MBCT intervention the P300-like waveform was significantly attenuated over the frontal cortex. Conclusions Individuals with BD show decreased attentional readiness and activation of non-relevant information processing during attentional processes. These data are the first that show, MBCT in BD improved attentional readiness, and attenuated activation of non-relevant information processing during attentional processes.

  4. Group play therapy for improving mental coping ability in children with asthma

    Directory of Open Access Journals (Sweden)

    Qian WANG

    2012-08-01

    Full Text Available Objective To explore the role of group play therapy in the improvement of mental coping ability in children with asthma. Methods Forty-four asthmatic children with behavior problems were randomly divided into experimental group (n=25 and control group (n=19. All children received two tests. The tools in this research were Achenbach Child Behavior Checklist (CBCL and Coping with a Disease Questionnaire (CODI. Before intervention, both groups received pretest. Members from the experimental group were provided with counseling for 3 months, once every two weeks for a total of 6 times, while during this period the members of the control group had not any experimental intervention.After intervention, the two groups received posttest. Five patients dropped out, and 39 went through this research (20 in experimental group and 19 in control group. The effects of group play therapy on behavior problems and coping strategy of children with asthma were evaluated. Results There was no statistically significant differences in the general information (age, sex, education, parents' marriage status and family structure and basic score of CBCL and CODI between the two groups (P > 0.05. After intervention, the scores of social problems, social withdrawal, depression, compulsive behavior, aggressive behavior and immature and total behavior problem score dropped significantly in experimental group (P < 0.05 while there were no significant changes in control group. And the scores of acceptance, avoidance and emotional reaction increased significantly in experimental group (P < 0.05 while there were no significant changes in control group. Conclusions Group play therapy can improve the children's confidence and interpersonal adaptability and emotion management capacity, thus correcting deviant behavior, ameliorate coping strategy, improving mental coping capability, and promote the development of mental health in children with asthma.

  5. Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, J; Hornstrup, Therese; Schmidt, Jakob Friis

    2014-01-01

    Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months.......7%; 95%CI 1.3-0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT....

  6. Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

    Science.gov (United States)

    Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

    2017-06-29

    Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017. Published by Elsevier Inc.

  7. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States); Roeske, John C., E-mail: jroeske@lumc.edu [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States)

    2012-08-01

    Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose

  8. Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

    Science.gov (United States)

    Scheer, Nicole A.; Alstat, Lucas R.; Van Zant, Robert S.

    2016-01-01

    PURPOSE The purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy. CASE DESCRIPTION An eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program. The patient underwent a total of 11 physical therapy treatment sessions. OUTCOMES At the conclusion of treatment, the patient demonstrated improved resting muscle tone in bilateral lower extremities with active 90/90 hamstring flexibility measured at 165° and ankle dorsiflexion active range of motion of 5° without pain at 0° and 90° knee flexion. The patient exhibited an improved gait pattern with even stride length and diminished genu recurvatum, decreased pain with standing and walking, discontinued use of ankle–foot orthoses, and improved activity tolerance and overall function for daily activities. DISCUSSION The results of this case report indicate that physical therapy rehabilitation utilizing an Astym therapy protocol can successfully achieve gains in flexibility and strength and allow for improved function of bilateral lower extremities in a patient with cerebral palsy. CONCLUSION Based on the findings of this case report, clinicians should consider the use of Astym therapy in treating musculoskeletal soft tissue dysfunction in pediatric patients with cerebral palsy.

  9. Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study.

    LENUS (Irish Health Repository)

    2011-04-01

    Statins improve infarct volume and neurological outcome in animal stroke models. We investigated the relationship between statin therapy and ischemic stroke outcome in the North Dublin Population Stroke Study.

  10. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement

  11. Development and optimization of targeted radionuclide tumor therapy using folate based radiopharmaceuticals

    CERN Document Server

    Reber, Josefine Astrid

    The folate receptor (FR) has been used for a quarter of a century as a tumor-associated target for selective delivery of drugs and imaging agents to cancer cells. While several folic acid radioconjugates have been successfully employed for imaging purposes in (pre)clinical studies, a therapeutic application of folic acid radioconjugates has not yet reached the critical stage which would allow a clinical translation. Due to a substantial expression of the FR in the proximal tubule cells, radiofolates accumulate in the kidneys which are at risk of damage by particle-radiation. To improve this situation, we aimed to develop and evaluate strategies for the performance of FR-targeted radionuclide therapy by decreasing the renal uptake of radiofolates and thereby reducing potential nephrotoxic effects. Two different strategies were investigated. First, the combination of radiofolates with chemotherapeutic agents such as pemetrexed (PMX) and 5-fluorouracil (5-FU) and secondly, an approach based on radioiodinated fol...

  12. Tumor Microenvironment Modulation by Cyclopamine Improved Photothermal Therapy of Biomimetic Gold Nanorods for Pancreatic Ductal Adenocarcinomas.

    Science.gov (United States)

    Jiang, Ting; Zhang, Bo; Shen, Shun; Tuo, Yanyan; Luo, Zimiao; Hu, Yu; Pang, Zhiqing; Jiang, Xinguo

    2017-09-20

    Due to the rich stroma content and poor blood perfusion, pancreatic ductal adenocarcinoma (PDA) is a tough cancer that can hardly be effectively treated by chemotherapeutic drugs. Tumor microenvironment modulation or advanced design of nanomedicine to achieve better therapeutic benefits for PDA treatment was widely advocated by many reviews. In the present study, a new photothermal therapy strategy of PDA was developed by combination of tumor microenvironment modulation and advanced design of biomimetic gold nanorods. On one hand, biomimetic gold nanorods were developed by coating gold nanorods (GNRs) with erythrocyte membrane (MGNRs). It was shown that MGNRs exhibited significantly higher colloidal stability in vitro, stronger photothermal therapeutic efficacy in vitro, and longer circulation in vivo than GNRs. On the other hand, tumor microenvironment modulation by cyclopamine treatment successfully disrupted the extracellular matrix of PDA and improved tumor blood perfusion. Moreover, cyclopamine treatment significantly increased the accumulation of MGNRs in tumors by 1.8-fold and therefore produced higher photothermal efficiency in vivo than the control group. Finally, cyclopamine treatment combined with photothermal MGNRs achieved the most significant shrinkage of Capan-2 tumor xenografts among all the treatment groups. Therefore, with the integrated advantages of tumor microenvironment regulation and long-circulation biomimetic MGNRs, effective photothermal therapy of PDA was achieved. In general, this new strategy of combining tumor microenvironment modulation and advanced design of biomimetic nanoparticles might have great potential in PDA therapy.

  13. Improving current immunoglobulin therapy for patients with primary immunodeficiency: quality of life and views on treatment.

    Science.gov (United States)

    Espanol, Teresa; Prevot, Johan; Drabwell, Jose; Sondhi, Seema; Olding, Laurence

    2014-01-01

    Subcutaneous or intravenous immunoglobulin replacement is the mainstay of treatment for most patients with primary immunodeficiency disease (PID). The purpose of this study was to gain an understanding of how existing PID therapies affect patient lives and to identify desired improvements to immunoglobulin treatments. An online questionnaire was made available through the International Patient Organisation for Primary Immunodeficiencies to patients with PID and their caregivers regarding current treatment satisfaction, living with PID, and patient preferences using a conjoint approach. Health-related quality of life was canvassed via questionnaires using the Short Form 12 Health Survey and EuroQoL 5 Dimensions. A total of 300 responded to the survey (72% patients with PID and 28% caregivers) from across 21 countries, mostly the UK, Sweden, Canada, France, Germany, and Spain. Fifty-three percent and 45% of patients received intravenous and subcutaneous therapy, respectively. Most respondents (76%) were satisfied with their current treatment, reflecting the benefits that immunoglobulin therapy provides for patient health and well-being. However, patients remained below the physical and mental well-being norms for health-related quality of life as determined by the questionnaire. All respondents expressed a desire for 4-weekly infusions, the ability to administer these at home, self-administration, shorter duration of administration, and fewer needle sticks. The results of this survey highlight the importance of providing access to different treatment options and modes of administration to ensure individual patient needs are best met.

  14. An improved Monte Carlo (MC) dose simulation for charged particle cancer therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ying, C. K. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang, Malaysia and School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu (Malaysia); Kamil, W. A. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang, Malaysia and Radiology Department, Hospital USM, Kota Bharu (Malaysia); Shuaib, I. L. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang (Malaysia); Matsufuji, Naruhiro [Research Centre of Charged Particle Therapy, National Institute of Radiological Sciences, NIRS, Chiba (Japan)

    2014-02-12

    Heavy-particle therapy such as carbon ion therapy are more popular nowadays because of the nature characteristics of charged particle and almost no side effect to patients. An effective treatment is achieved with high precision of dose calculation, in this research work, Geant4 based Monte Carlo simulation method has been used to calculate the radiation transport and dose distribution. The simulation have the same setting with the treatment room in Heavy Ion Medical Accelerator, HIMAC. The carbon ion beam at the isocentric gantry nozzle for the therapeutic energy of 290 MeV/u was simulated, experimental work was carried out in National Institute of Radiological Sciences, NIRS, Chiba, Japan by using the HIMAC to confirm the accuracy and qualities dose distribution by MC methods. The Geant4 based simulated dose distribution were verified with measurements for Bragg peak and spread out Bragg peak (SOBP) respectively. The verification of results shows that the Bragg peak depth-dose and SOBP distributions in simulation has good agreement with measurements. In overall, the study showed that Geant4 based can be fully applied in the heavy-ion therapy field for simulation, further works need to be carry on to refine and improve the Geant4 MC simulations.

  15. An improved Monte Carlo (MC) dose simulation for charged particle cancer therapy

    Science.gov (United States)

    Ying, C. K.; Kamil, W. A.; Shuaib, I. L.; Matsufuji, Naruhiro

    2014-02-01

    Heavy-particle therapy such as carbon ion therapy are more popular nowadays because of the nature characteristics of charged particle and almost no side effect to patients. An effective treatment is achieved with high precision of dose calculation, in this research work, Geant4 based Monte Carlo simulation method has been used to calculate the radiation transport and dose distribution. The simulation have the same setting with the treatment room in Heavy Ion Medical Accelerator, HIMAC. The carbon ion beam at the isocentric gantry nozzle for the therapeutic energy of 290 MeV/u was simulated, experimental work was carried out in National Institute of Radiological Sciences, NIRS, Chiba, Japan by using the HIMAC to confirm the accuracy and qualities dose distribution by MC methods. The Geant4 based simulated dose distribution were verified with measurements for Bragg peak and spread out Bragg peak (SOBP) respectively. The verification of results shows that the Bragg peak depth-dose and SOBP distributions in simulation has good agreement with measurements. In overall, the study showed that Geant4 based can be fully applied in the heavy-ion therapy field for simulation, further works need to be carry on to refine and improve the Geant4 MC simulations.

  16. A Mirror Therapy-Based Action Observation Protocol to Improve Motor Learning After Stroke.

    Science.gov (United States)

    Harmsen, Wouter J; Bussmann, Johannes B J; Selles, Ruud W; Hurkmans, Henri L P; Ribbers, Gerard M

    2015-07-01

    Mirror therapy is a priming technique to improve motor function of the affected arm after stroke. To investigate whether a mirror therapy-based action observation (AO) protocol contributes to motor learning of the affected arm after stroke. A total of 37 participants in the chronic stage after stroke were randomly allocated to the AO or control observation (CO) group. Participants were instructed to perform an upper-arm reaching task as fast and as fluently as possible. All participants trained the upper-arm reaching task with their affected arm alternated with either AO or CO. Participants in the AO group observed mirrored video tapes of reaching movements performed by their unaffected arm, whereas participants in the CO group observed static photographs of landscapes. The experimental condition effect was investigated by evaluating the primary outcome measure: movement time (in seconds) of the reaching movement, measured by accelerometry. Movement time decreased significantly in both groups: 18.3% in the AO and 9.1% in the CO group. Decrease in movement time was significantly more in the AO compared with the CO group (mean difference = 0.14 s; 95% confidence interval = 0.02, 0.26; P = .026). The present study showed that a mirror therapy-based AO protocol contributes to motor learning after stroke. © The Author(s) 2014.

  17. Improving cancer therapies by targeting the physical and chemical hallmarks of the tumor microenvironment.

    Science.gov (United States)

    Ivey, Jill W; Bonakdar, Mohammad; Kanitkar, Akanksha; Davalos, Rafael V; Verbridge, Scott S

    2016-09-28

    Tumors are highly heterogeneous at the patient, tissue, cellular, and molecular levels. This multi-scale heterogeneity poses significant challenges for effective therapies, which ideally must not only distinguish between tumorous and healthy tissue, but also fully address the wide variety of tumorous sub-clones. Commonly used therapies either leverage a biological phenotype of cancer cells (e.g. high rate of proliferation) or indiscriminately kill all the cells present in a targeted volume. Tumor microenvironment (TME) targeting represents a promising therapeutic direction, because a number of TME hallmarks are conserved across different tumor types, despite the underlying genetic heterogeneity. Historically, TME targeting has largely focused on the cells that support tumor growth (e.g. vascular endothelial cells). However, by viewing the intrinsic physical and chemical alterations in the TME as additional therapeutic opportunities rather than barriers, a new class of TME-inspired treatments has great promise to complement or replace existing therapeutic strategies. In this review we summarize the physical and chemical hallmarks of the TME, and discuss how these tumor characteristics either currently are, or may ultimately be targeted to improve cancer therapies.

  18. Dance/movement therapy for improving psychological and physical outcomes in cancer patients.

    Science.gov (United States)

    Bradt, Joke; Shim, Minjung; Goodill, Sherry W

    2015-01-07

    Current cancer care increasingly incorporates psychosocial interventions. Cancer patients use dance/movement therapy to learn to accept and reconnect with their bodies, build new self-confidence, enhance self-expression, address feelings of isolation, depression, anger and fear and to strengthen personal resources. To update the previously published review that examined the effects of dance/movement therapy and standard care versus standard care alone or standard care and other interventions on psychological and physical outcomes in patients with cancer. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 6), MEDLINE (OvidSP, 1950 to June week 4, 2014), EMBASE (OvidSP, 1980 to 2014 week 26), CINAHL (EBSCOhost, 1982 to July 15 2014), PsycINFO (EBSCOhost, 1806 to July 15 2014), LILACS (Virual Health Library, 1982 to July 15 2014), Science Citation Index (ISI, 1974 to July 15 2014), CancerLit (1983 to 2003), International Bibliography of Theatre and Dance (1989 to July 15 2014), the National Research Register (2000 to September 2007), Proquest Digital Dissertations, ClinicalTrials.gov, and Current Controlled Trials (all to July 15 2014). We handsearched dance/movement therapy and related topics journals, reviewed reference lists and contacted experts. There was no language restriction. We included all randomized and quasi-randomized controlled trials of dance/movement therapy interventions for improving psychological and physical outcomes in patients with cancer. We considered studies only if dance/movement therapy was provided by a formally trained dance/movement therapist or by trainees in a formal dance/movement therapy program. Two review authors independently extracted the data and assessed the methodological quality, seeking additional information from the trial researchers when necessary. Results were presented using standardized mean differences. We identified one new trial for inclusion in this update. In

  19. Radioiodinated O{sup 6}-Benzylguanine derivatives containing an azido function

    Energy Technology Data Exchange (ETDEWEB)

    Vaidyanathan, Ganesan, E-mail: ganesan.v@duke.edu; White, Benjamin; Affleck, Donna J.; McDougald, Darryl; Zalutsky, Michael R.

    2011-01-15

    Introduction: Drug resistance to alkylator chemotherapy has been primarily attributed to the DNA repair protein alkylguanine-DNA alkyltransferase (AGT); thus, personalizing chemotherapy could be facilitated if tumor AGT content could be quantified prior to administering chemotherapy. We have been investigating the use of radiolabeled O{sup 6}-benzylguanine (BG) analogues to label and quantify AGT in vivo. BG derivatives containing an azido function were sought to potentially enhance the targeting of these analogues to AGT, which is primarily present in the cell nucleus, either by conjugating them to nuclear localization sequence (NLS) peptides or by pretargeting via bio-orthogonal approaches. Methods: Two O{sup 6}-(3-iodobenzyl)guanine (IBG) derivatives containing an azido moiety-O{sup 6}-(4-azidohexyloxymethyl-3-iodobenzyl)guanine (AHOMIBG) and O{sup 6}-(4-azido-3-iodobenzyl)guanine (AIBG) - and their tin precursors were synthesized in multiple steps and the tin precursors were converted to radioiodinated AHOMIBG and AIBG, respectively. Both unlabeled and radioiodinated AHOMIBG analogues were conjugated to alkyne-derivatized NLS peptide heptynoyl-PK{sub 3}RKV. The ability of these radioiodinated compounds to bind to AGT was determined by a trichloroacetic acid precipitation assay and gel electrophoresis/phosphor imaging. Labeling of an AGT-AIBG conjugate via Staudinger ligation using the {sup 131}I-labeled phosphine ligand, 2-(diphenylphosphino)phenyl 4-[{sup 131}I]iodobenzoate, also was investigated. Results: [{sup 131}I]AHOMIBG was synthesized in two steps from its tin precursor in 52.2{+-}7.5% (n=5) radiochemical yield and conjugated to the NLS peptide via click reaction in 50.7{+-}4.9% (n=6) yield. The protected tin precursor of AIBG was radioiodinated in an average radiochemical yield of 69.6{+-}4.5% (n=7); deprotection of the intermediate gave [{sup 131}I]AIBG in 17.8{+-}4.2% (n=9) yield. While both [{sup 131}I]AHOMIBG and its NLS conjugate bound to AGT pure

  20. Improving postoperative pain management in children by providing regular training and an updated pain therapy concept.

    Science.gov (United States)

    Heinrich, M; Mechea, A; Hoffmann, F

    2016-04-01

    In recent years, children's hospitals have increasingly implemented postoperative pain management protocols to reduce postoperative pain and improve patient satisfaction. The effectiveness and long-term sustainability of such protocols have rarely been studied. Therefore, we conducted a prospective intervention study to assess the impact of regular training and improvement of clinical processes on the quality of postoperative pain management. We conducted an initial assessment of the status quo of postoperative pain management (Audit 1) followed by repeated training and improvement of clinical processes (analgesic pocket card, parents' brochure, modification of the patient chart, bimonthly advanced trainings sessions) and a follow-up review after 3 years (Audit 2). We used a data entry form, a patient survey, and an anonymous questionnaire for the nursing staff as measurement tools. Our analysis included a total of 93 and 85 patients in the initial and final audits. The return rates of the nursing staff questionnaire were 83% (Audit 1) and 77% (Audit 2). The training and process improvements resulted in significant improvement in the administration of analgesics for pain requiring treatment, the control of pain measurement after the administration of analgesics and the use of non-pharmacological pain therapies. The patients reported faster administration of analgesics for acute pain and improved pain relief following the intervention. Repeated training and improvement of clinical processes can significantly improve the long-term quality of postoperative pain management in children with a tolerable amount of effort on the part of health care professionals and institutions. © 2015 European Pain Federation - EFIC®

  1. WT1-specific T cell receptor gene therapy: improving TCR function in transduced T cells.

    Science.gov (United States)

    Stauss, Hans J; Thomas, Sharyn; Cesco-Gaspere, Michela; Hart, Daniel P; Xue, Shao-An; Holler, Angelika; King, Judy; Wright, Graham; Perro, Mario; Pospori, Constantina; Morris, Emma

    2008-01-01

    Adoptive transfer of antigen-specific T lymphocytes is an attractive form of immunotherapy for haematological malignancies and cancer. The difficulty of isolating antigen-specific T lymphocytes for individual patients limits the more widespread use of adoptive T cell therapy. The demonstration that cloned T cell receptor (TCR) genes can be used to produce T lymphocyte populations of desired specificity offers new opportunities for antigen-specific T cell therapy. The first trial in humans demonstrated that TCR gene-modified T cells persisted for an extended time period and reduced tumor burden in some patients. The WT1 protein is an attractive target for immunotherapy of leukemia and solid cancer since elevated expression has been demonstrated in AML, CML, MDS and in breast, colon and ovarian cancer. In the past, we have isolated high avidity CTL specific for a WT1-derived peptide presented by HLA-A2 and cloned the TCR alpha and beta genes of a WT1-specific CTL line. The genes were inserted into retroviral vectors for transduction of human peripheral blood T lymphocytes of leukemia patients and normal donors. The treatment of leukemia-bearing NOD/SCID mice with T cells transduced with the WT1-specific TCR eliminated leukemia cells in the bone marrow of most mice, while treatment with T cells transduced with a TCR of irrelevant specificity did not diminish the leukemia burden. In order to improve the safety and efficacy of TCR gene therapy, we have developed lentiviral TCR gene transfer. In addition, we employed strategies to enhance TCR expression while avoiding TCR mis-pairing. It may be possible to generate dominant TCR constructs that can suppress the expression of the endogenous TCR on the surface of transduced T cells. The development of new TCR gene constructs holds great promise for the safe and effective delivery of TCR gene therapy for the treatment of malignancies.

  2. Improvement of dose distribution by central beam shielding in boron neutron capture therapy

    Science.gov (United States)

    Sakurai, Yoshinori; Ono, Koji

    2007-12-01

    Since boron neutron capture therapy (BNCT) with epithermal neutron beams started at the Kyoto University Reactor (KUR) in June 2002, nearly 200 BNCT treatments have been carried out. The epithermal neutron irradiation significantly improves the dose distribution, compared with the previous irradiation mainly using thermal neutrons. However, the treatable depth limit still remains. One effective technique to improve the limit is the central shield method. Simulations were performed for the incident neutron energies and the annular components of the neutron source. It was clear that thermal neutron flux distribution could be improved by decreasing the lower energy neutron component and the inner annular component of the incident beam. It was found that a central shield of 4-6 cm diameter and 10 mm thickness is effective for the 12 cm diameter irradiation field. In BNCT at KUR, the depth dose distribution can be much improved by the central shield method, resulting in a relative increase of the dose at 8 cm depth by about 30%. In addition to the depth dose distribution, the depth dose profile is also improved. As the dose rate in the central area is reduced by the additional shielding, the necessary irradiation time, however, increases by about 30% compared to normal treatment.

  3. Improvement in the accuracy of respiratory-gated radiation therapy using a respiratory guiding system

    Science.gov (United States)

    Kang, Seong-Hee; Kim, Dong-Su; Kim, Tae-Ho; Suh, Tae-Suk; Yoon, Jai-Woong

    2013-01-01

    The accuracy of respiratory-gated radiation therapy (RGRT) depends on the respiratory regularity because external respiratory signals are used for gating the radiation beam at particular phases. Many studies have applied a respiratory guiding system to improve the respiratory regularity. This study aims to evaluate the effect of an in-house-developed respiratory guiding system to improve the respiratory regularity for RGRT. To verify the effectiveness of this system, we acquired respiratory signals from five volunteers. The improvement in respiratory regularity was analyzed by comparing the standard deviations of the amplitudes and the periods between free and guided breathing. The reduction in residual motion at each phase was analyzed by comparing the standard deviations of sorted data within each corresponding phase bin as obtained from free and guided breathing. The results indicate that the respiratory guiding system improves the respiratory regularity, and that most of the volunteers showed significantly less average residual motion at each phase. The average residual motion measured at phases of 40, 50, and 60%, which showed lower variation than other phases, were, respectively, reduced by 41, 45, and 44% during guided breathing. The results show that the accuracy of RGRT can be improved by using the in-house-developed respiratory guiding system. Furthermore, this system should reduce artifacts caused by respiratory motion in 4D CT imaging.

  4. Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC

    Directory of Open Access Journals (Sweden)

    Rahul Deshpande

    2011-01-01

    Full Text Available With rising incidence and emergence of effective treatment options, the management of hepatocellular carcinoma (HCC is a complex multidisciplinary process. There is still little consensus and uniformity about clinicopathological staging systems. Resection and liver transplantation have been the cornerstone of curative surgical treatments with recent emergence of ablative techniques. Improvements in diagnostics, surgical techniques, and postoperative care have lead to dramatically improved results over the years. The most appropriate treatment plan has to be individualised and depends on a variety of patient and tumour-related factors. Very small HCCs discovered on surveillance have the best outcomes. Patients with advanced cirrhosis and tumours within Milan criteria should be offered transplantation. Resection is best for small solitary tumours with preserved liver function. Ablative techniques are suitable for low volume tumours in patients unfit for either resection or transplantation. The role of downstaging and bridging therapy is not clearly established.

  5. Improved highly accurate localized motion imaging for monitoring high-intensity focused ultrasound therapy

    Science.gov (United States)

    Qu, Xiaolei; Azuma, Takashi; Sugiyama, Ryusuke; Kanazawa, Kengo; Seki, Mika; Sasaki, Akira; Takeuchi, Hideki; Fujiwara, Keisuke; Itani, Kazunori; Tamano, Satoshi; Takagi, Shu; Sakuma, Ichiro; Matsumoto, Yoichiro

    2016-07-01

    Visualizing an area subjected to high-intensity focused ultrasound (HIFU) therapy is necessary for controlling the amount of HIFU exposure. One of the promising monitoring methods is localized motion imaging (LMI), which estimates coagulation length by detecting the change in stiffness. In this study, we improved the accuracy of our previous LMI by dynamic cross-correlation window (DCCW) and maximum vibration amount (MVA) methods. The DCCW method was used to increase the accuracy of estimating vibration amplitude, and the MVA method was employed to increase signal-noise ratio of the decrease ratio at the coagulated area. The qualitative comparison of results indicated that the two proposed methods could suppress the effect of noise. Regarding the results of the quantitative comparison, coagulation length was estimated with higher accuracy by the improved LMI method, and the root-mean-square error (RMSE) was reduced from 2.51 to 1.69 mm.

  6. Improved low-power semiconductor diode lasers for photodynamic therapy in veterinary medicine

    Science.gov (United States)

    Lee, Susanne M.; Mueller, Eduard K.; Van de Workeen, Brian C.; Mueller, Otward M.

    2001-05-01

    Cryogenically cooling semiconductor diode lasers provides higher power output, longer device lifetime, and greater monochromaticity. While these effects are well known, such improvements have not been quantified, and thus cryogenically operated semiconductor lasers have not been utilized in photodynamic therapy (PDT). We report quantification of these results from laser power meter and photospectrometer data. The emission wavelengths of these low power multiple quantum well semiconductor lasers were found to decrease and become more monochromatic with decreasing temperature. Significant power output improvements also were obtained at cryogenic temperatures. In addition, the threshold current, i.e. the current at which lasing begins, decreased with decreasing temperature. This lower threshold current combined with the increased power output produced dramatically higher device efficiencies. It is proposed that cryogenic operation of semiconductor diode lasers will reduce the number of devices needed to produce the requisite output for many veterinary and medical applications, permitting significant cost reductions.

  7. Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation.

    Science.gov (United States)

    Thaut, Michael H; Gardiner, James C; Holmberg, Dawn; Horwitz, Javan; Kent, Luanne; Andrews, Garrett; Donelan, Beth; McIntosh, Gerald R

    2009-07-01

    This study examined the immediate effects of neurologic music therapy (NMT) on cognitive functioning and emotional adjustment with brain-injured persons. Four treatment sessions were held, during which participants were given a pre-test, participated in 30 min of NMT that focused on one aspect of rehabilitation (attention, memory, executive function, or emotional adjustment), which was followed by post-testing. Control participants engaged in a pre-test, 30 min of rest, and then a post-test. Treatment participants showed improvement in executive function and overall emotional adjustment, and lessening of depression, sensation seeking, and anxiety. Control participants improved in emotional adjustment and lessening of hostility, but showed decreases in measures of memory, positive affect, and sensation seeking.

  8. Curative effect of Tai Chi exercise in combination with auricular plaster therapy on improving obesity patient with secondary hyperlipidemia.

    Science.gov (United States)

    Song, Qinghua; Yuan, Yandong; Jiao, Chun; Zhu, Ximei

    2015-01-01

    Observe the effect of Tai Chi in combination with auricular plaster therapy on treating obesity patient with secondary hyperlipidemia. Select 45 patients who suffer from simple obesity and secondary hyperlipidemia and then adopt random digital table to divide them into a Tai Chi group, an auricular plaster therapy group and a combination group. Each group consists of 15 patients. The patients in Tai Chi group are trained with Tai Chi twice a day, while those in auricular plaster therapy are treated with auricular plaster therapy 3-5 times a day and those in the combination group are trained with Tai Chi and auricular plaster therapy twice a day. BMI, body fat percentage and blood lipid indexes are respectively detected for the selected patients in the three groups before treatment and after 180 days' treatment. After 180 days' treatment, BMI index and body fat percentage of Tai Chi group are significantly improved in comparison with those before treatment (Pplaster therapy group are not improved obviously in comparison with those before the treatment (P>0.05) but the blood lipid index is improved significantly (Pplaster therapy can show the obvious synergistic therapeutic effect and thus the combined curative effect is obviously superior to that of the single therapy method.

  9. Recognition of Radiological Protection of Ward Staff after Brachytherapy for Malignant Tumor with Radioiodine Seeds

    Directory of Open Access Journals (Sweden)

    HU Shu

    2016-02-01

    Full Text Available Through radiation measurement of the patients after brachytherapy with radioiodine seeds for malignant tumor at different distances and shielding condition, the importance, optimization and individualization of the radiological protection are well recognized. The 35 patients were randomly selected in the minimally invasive interventional ward of Peking University Shenzhen Hospital who underwent brachytherapy for malignant tumor with radioiodine seeds. Within 2 hours after the brachytherapy, the radiation of the patients without shielding, with 0.25 mmPb and 0.5 mmPb shielding were detected by an x-γ ray detector at different distances (equivalent dose rate. The results were analysed by SPSS19.0 t test. Annual equivalent dose was calculated by the average close contact time (two hours everyone per day. The average annual equivalent dose of the 35 patients without shielding was below 20 mSv at 0.5 meter, close to the public limit 1 mSv at 2 meters and equivalent to the background at 4 meters. Under 0.25 mmPb shielding, 6 patients’ radiation was still above the pubic limit, although the average radiation of the 35 patients was below the pubic limit; under 0.5 mmPb shielding, all patients’ radiation was nearly equivalent to the background at 0 meter. The results showed that among the time, distance and shielded protection, the individual radiological protection was especially important. The 0.25 mmPb lead cushion was the most commonly used shield. The 0.5 mmPb lead cushion also should be used in case of the large number of radioiodine seeds implantation and/or more superficial implant site, so as to ensure the individualization and optimization in radiological protection.

  10. Pulmonary fibrosis in youth treated with radioiodine for juvenile thyroid cancer and lung metastases after Chernobyl

    Energy Technology Data Exchange (ETDEWEB)

    Hebestreit, Helge; Burkhardt, Antje [University Children' s Hospital, Wuerzburg (Germany); Biko, Johannes; Reiners, Christoph [University Hospital, Department of Nuclear Medicine, Wuerzburg (Germany); Drozd, Valentina [International Belarussian-German Foundation, Minsk (Belarus); Demidchik, Yuri [Thyroid Cancer Centre, Minsk (Belarus); Trusen, Andreas [Klinik fuer Radiologie, Johanniter-Krankenhaus, Genthin-Stendal gGmbH, Stendal (Germany); Beer, Meinrad [University Hospital, Department of Radiology, Wuerzburg (Germany)

    2011-09-15

    The objective of this project was to systematically determine the prevalence and consequences of pulmonary fibrosis in youth with thyroid carcinoma and lung metastases from Belarus who were treated with radioiodine ({sup 131}I). A total of 69 patients treated for juvenile thyroid carcinoma and lung metastasis with {sup 131}I were assessed. A group of 29 patients without lung metastases and prior {sup 131}I treatment served as controls. The assessments included a CT scan of the lungs, extensive pulmonary function testing and an incremental cycle test to volitional fatigue with measurements of oxygen uptake (V. O{sub 2}), oxygen saturation and alveolar-arterial difference in oxygen partial pressure ({delta}aaO{sub 2}). Five patients with lung metastases showed advanced pulmonary fibrosis on CT scans and also had poorer lung functions compared with the 62 patients with none or minor signs of fibrosis and the 29 controls. Furthermore, these five patients showed lower peak V.O{sub 2}, lower oxygen saturation at peak exercise and higher exercise {delta}aaO{sub 2}. They were younger at the time of cancer diagnosis and had received chemotherapy more frequently than youth with pulmonary metastases who did not develop fibrosis. One of the five patients subsequently died from pulmonary fibrosis. Following the Chernobyl catastrophe, about 7% of children treated with radioiodine for thyroid carcinoma and lung metastases displayed pulmonary fibrosis which was associated with functional impairments. Based on the characteristics of affected individuals, the number of radioiodine courses may have to be limited, especially in young children, and chemotherapy should be avoided. (orig.)

  11. Evaluation of iodovinyl antibody conjugates: Comparison with a p-iodobenzoyl conjugate and direct radioiodination

    Energy Technology Data Exchange (ETDEWEB)

    Hadley, S.W.; Wilbur, D.S. (NeoRx Corporation, Seattle, WA (USA))

    1990-03-01

    The preparations and conjugations of 2,3,5,6-tetrafluorophenyl 5-(125I/131I)iodo-4-pentenoate (7a) and 2,3,5,6-tetrafluorophenyl 3,3-dimethyl-5-(125I/131I)iodo-4-pentenoate (7b) to monoclonal antibodies are reported. Reagents 7a and 7b were prepared in high radiochemical yield by iododestannylation of their corresponding 5-tri-n-butylstannyl precursors. Radioiodinated antibody conjugates were prepared by reaction of 7a or 7b with the protein at basic pH. Evaluation of these conjugates by several in vitro procedures demonstrated that the radiolabel was attached to the antibody in a stable manner and that the conjugates maintained immunoreactivity. Comparative dual-isotope biodistribution studies of a monoclonal antibody Fab fragment conjugate of 7a and 7b with the same Fab fragment labeled with N-succinimidyl p-(131I)iodobenzoate (PIB, p-iodobenzoate, 2) or directly radioiodinated have been carried out in tumor-bearing nude mice. Coinjection of the Fab conjugate of 7a with the Fab conjugate of 2 demonstrated that the biodistributions were similar in most organs, except the neck tissue (thyroid-containing) and the stomach, which contained substantially increased levels of the 7a label. Coinjection of the Fab conjugate of 7a with the Fab fragment radioiodinated by using the chloramine-T method demonstrated that the biodistributions were remarkably similar, suggesting roughly equivalent in vivo deiodination of these labeled antibody fragments. Coinjection of the Fab conjugate of 7a with the Fab conjugate of 7b indicated that there was {approximately} a 2-fold reduction in the amount of in vivo deiodination of the 7b conjugate as compared to the 7a conjugate.

  12. Radioiodine-labeled disulfide: a novel radiotracer for evaluation of tumor uptake

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, E. K.; Choi, Y. S.; Byun, S. S.; Baek, J. Y.; Lee, K. H.; Kim, S. E.; Choi, Y.; Kim, B. T. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    Diallyl disulfide found in garlic has been known to inhibit the growth of various cancer cells. In this study, iodine-substituted disulfides were synthesized and their growth inhibitory effects on cancer cells (SUN C5 and MCF-7) were investigated. Dibenzyl disulfide was labeled with {sup 123}I/{sup 125}I for evaluation of tumor uptake. Halogen-substituted disulfides were synthesized using 2,2'-dithiobis(benzothiazole) and one equivalent each of the corresponding thiols. Growth inhibition studies were performed on cancer cells that were grown at 37 .deg. C for 48 hr prior to exposure to the disulfides. Radioiodine-labeled disulfide was prepared by halogen exchange reaction on the 4-bromodibenzyl disulfide in the presence of Na{sup 123}I/{sup 125}I and CuCl at 150 .deg. C for 60 min, followed by HPLC purification. Uptake of the radioactivity to SUN C5 cells was measured as a function of time, and inhibition studies were performed in the presence of either S-methyl methanethiosulfonate (MMTS) or diallyl disulfide. Disulfides were synthesized in the high yields (90%). Tumor growth inhibition studies by the 3 iododisulfides showed the inhibition (>95%) comparable to diallyl disulfide (100%). Cu(I)-assisted radioiodination gave 4-{sup 123}I/{sup 125}I-iododibenzyl disulfide in overall 30-40% radiochemical yield and with high specific activity. Cell uptake studies of the radiolabeled disulfide showed a time-dependent increase of the uptake (4-fold increase from 15 min to 2 hr). Both MMTS, a glutathione depleting agent, and diallyl disulfide reduced the uptake of the radioactivity in a dose-dependent manner. Inhibition studies suggest that uptake of disulfide to the tumor cells could be mediated by thiol-disulfide exchange. This study demonstrates that radioiodine-labeled dibenzyl disulfide may be useful for evaluation of tumor uptake.

  13. Amrubicin therapy improves patients with refractory small-cell lung cancer: A single-arm confirmatory Chinese clinical study

    Directory of Open Access Journals (Sweden)

    Mengli Zheng

    2016-09-01

    Full Text Available Our objective was to evaluate an open-label, multicenter, single-arm study to appraise whether amrubicin therapy improves patients with refractory small-cell lung cancer in Chinese clinical study. Patients (n=95 with refractory small-cell lung cancer received 3 consecutive days amrubicin therapy for 21 days. Overall response rate of response to amrubicin was 39%. Anemia, febrile neutropenia, thrombocytopenia, hyperglycemia, hyponatremia, infection, elevated serum transaminases levels were appeared, but the incidences of adverse events were very few. Our results suggest amrubicin therapy can improve patients with refractory small-cell lung cancer and may be an effective and safe treatment option.

  14. Active music therapy improves cognition and behaviour in chronic vascular encephalopathy: a case report.

    Science.gov (United States)

    Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo

    2014-02-01

    This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Evaluation of a continuous quality improvement program in anticoagulant therapy: Feasibility, satisfaction and perception.

    Science.gov (United States)

    Cantin, Ariane; Lahaie, Alexandre; Odobasic, Bojan; Tremblay, Marie-Philip; Wazzan, Dana; Caron, Stéphanie; Leblanc, Caroline; Martineau, Josée; Lalonde, Lyne

    2016-11-01

    The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. To evaluate the participants' appreciation for the various activities of the program. Participants had access to training activities, including an audit with feedback, online training activities (OTA), clinical tools and support from facilitators. Cognitive behavioural learning determinants were evaluated before and 5 months after the beginning of the program. Participants' satisfaction and perception were documented via online questionnaires and a semistructured interview. Of the 52 pharmacists in the ACO Program, 47 participated in this evaluation. Seventy-seven percent of the participants completed at least 1 OTA and 6% published on the forum. The feeling of personal effectiveness rose from 8.01 (7.67-8.35) to 8.62 (8.24-8.99). The audit and feedback, as well as the high-quality OTA and their lecturers, were the most appreciated elements. There was a high OTA participation rate. The facilitators seemed to play a key role in the CQIP. The low level of participation in the forum reflects the known phenomenon of social loafing. Technical difficulties affecting the platform and data collection for the audit with feedback constituted limitations. The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness.

  16. Improving intermittent androgen deprivation therapy: lessons learned from basic and translational research

    Directory of Open Access Journals (Sweden)

    Rahul A Parikh

    2014-08-01

    Full Text Available Intermittent androgen deprivation therapy (IADT is an alternative to continuous androgen deprivation therapy (ADT in prostate cancer patients with nonmetastatic disease. ADT is associated with numerous side effects such as hot flashes, sexual dysfunction, anemia, fatigue, loss of muscle mass, osteoporosis, metabolic syndrome and premature cardiovascular disease. IADT was developed with the intention of improving the quality of life and to delay progression of prostate cancer to castration resistance. The benefits of slightly improved quality of life by IADT compared to ADT were demonstrated in multiple clinical trials. IADT was noted to be noninferior to ADT in patients with biochemical recurrence of prostate cancer but in studies performed in patients with metastatic prostate cancer, the results were inconclusive. Our recent studies suggested that the administration of 5 alpha-reductase inhibitors during the off-cycle of IADT can significantly prolong the survival of mice bearing androgen-sensitive prostate tumors when off-cycle duration was short. This review discusses the survival benefit of 5 alpha-reductase inhibition in IADT in animal models and the potential translation of this finding into clinic.

  17. Improvement in verbal memory performance in depressed in-patients after treatment with electroconvulsive therapy.

    Science.gov (United States)

    Biedermann, S V; Bumb, J M; Demirakca, T; Ende, G; Sartorius, A

    2016-12-01

    Electroconvulsive therapy (ECT) is a highly effective and well-tolerated therapy for severe and treatment-resistant depression. Cognitive side-effects are still feared by some patients and clinicians. Importantly, cognitive impairments are among the most disabling symptoms of depression itself. Patients suffering from a severe episode of depression were treated with either ECT or treatment as usual (TAU) in an in-patient setting. Matched healthy participants served as controls (HC). Verbal memory was tested with the California Verbal Learning Test (CVLT) before the specific treatment started (ECT = 15, TAU = 16, HC = 31) and 2 months after the last ECT session or 2 months after discharge respectively. Before the specific treatment started, depressed patients performed substantially worse compared with HC in total, short- and long-delay recall in the CVLT, while the ECT group showed the worst performance. More severely depressed patients showed worse performances in these measures. Intriguingly, verbal memory showed a significant improvement in ECT-treated patients, but not in the other groups. No differences between the groups were found at follow-up. Contrary to the widely feared assumption that ECT has long-term impact on memory functions, we found evidence that ECT is superior to TAU in improving verbal memory in depressed patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Improvements in performance following optometric vision therapy in a child with dyspraxia.

    Science.gov (United States)

    Hurst, Caroline M F; Van de Weyer, Sarah; Smith, Claire; Adler, Paul M

    2006-03-01

    SS, an 8-year-old boy with dyspraxia, presented for behavioural optometry assessment. He had been diagnosed with a subtle form of dyspraxia by his paediatric occupational therapist, based on poor proprioception, delayed bilateral integration and poor visual perception. A full visual assessment was carried out. SS was given a programme of reflex inhibition exercises for 3 months. Then, a programme of optometric vision therapy (OVT) exercises was prescribed at home and in practice for a period of 8 months. SS was assessed using a battery of occupational therapy Sensory Integration and Praxis Tests (SIPT) before optometric intervention, and after OVT. There were significant improvements in fusional reserves, accommodative facility and oculomotor control of pursuit and saccadic eye movements. His reading level had changed by 4 years in 11 months. The SIPT results showed improvements in the visual and motor/visual perception subtests, confirming the significant changes in visual perceptual performance. Consideration is given to treatment modalities for dyspraxia, and the studies confirming their effectivity of approach. This case study provides evidence supporting the use of OVT eye exercises in dyspraxia, ocular motility, accommodative dysfunction, learning difficulties and sports performance. The need for further research and inter-professional working is discussed.

  19. Radiation exposure of the families of outpatients treated with radioiodine (iodine-131) for hyperthyroidism.

    Science.gov (United States)

    Barrington, S F; O'Doherty, M J; Kettle, A G; Thomson, W H; Mountford, P J; Burrell, D N; Farrell, R J; Batchelor, S; Seed, P; Harding, L K

    1999-07-01

    Patients who receive radioiodine (iodine-131) treatment for hyperthyroidism (195-800 MBq) emit radiation and represent a potential hazard to other individuals. Critical groups amongst the public are fellow travellers on the patient's journey home from hospital and members of the patient's family, particularly young children. The dose which members of the public are allowed to receive as a result of a patient's treatment has been reduced in Europe following recently revised recommendations from ICRP. The annual public dose limit is 1 mSv, though adult members of the patient's family are allowed to receive higher doses, with the proviso that a limit of 5 mSv should not be exceeded over 5 years. Unless the doses received during out-patient administration of radioiodine can be demonstrated to comply with these new limits, hospitalisation of patients will be necessary. The radiation doses received by family members (35 adults and 87 children) of patients treated with radioiodine at five UK hospitals were measured using thermoluminescent dosimeters mounted in wrist bands. Families were given advice (according to current practice) from their treatment centre about limiting close contact with the patient for a period of time after treatment. Doses measured over 3-6 weeks were adjusted to give an estimate of values which might have been expected if the dosimeters had been worn indefinitely. Thirty-five passengers accompanying patients home after treatment also recorded the dose received during the journey using electronic (digital) personal dosimeters. For the "adjusted" doses to infinity, 97% of adults complied with a 5-mSv dose limit (range:0.2-5.8 mSv) and 89% of children with a 1-mSv limit (range: 0.2-7.2 mSv). However 6 of 17 children aged 3 years or less had an adjusted dose which exceeded this 1 mSv limit. The dose received by adults during travel was small in comparison with the total dose received. The median travel dose was 0.03 mSv for 1 h travel (range: 2 micro

  20. Radioiodination of advenovirus-associated virus external structural proteins. [/sup 125/I

    Energy Technology Data Exchange (ETDEWEB)

    Lubeck, M.D.; Johnson, F.B.

    1977-12-01

    The three structural polypeptides of adenovirus-associated virus type 3 (AAV-3) were examined to determine their orientation in the viral capsid. Sepharose-bound lactoperoxidase was used to label both dense-band and major-band AAV-3 virions. All three capsid proteins (VP1, VP2, and VP3) were found to be radioiodinated by solid-state lactoperoxidase in both dense-band and major-band virus particles. These findings indicate that the three polypeptides possess sequences that are externally oriented in the virion and that, therefore, no one of the three polypeptides can be considered an exclusively internally core protein.

  1. Radioiodine in the atmosphere after the Fukushima Dai-ichi nuclear accident.

    Science.gov (United States)

    Lebel, Luke S; Dickson, Raymond S; Glowa, Glenn A

    2016-01-01

    About 160 PBq of (131)I was released into the atmosphere during the accident at the Fukushima Dai-ichi Nuclear Power Plant. The chemistry of radioiodine is complicated, and it can be released in several different forms. In addition, the different physical forms, like molecular iodine, aerosol-form iodine, or organic iodine, would have all behaved differently once in the atmosphere, and would have been removed at different rates. These releases were detected by monitoring stations throughout Japan, and from these measurements, key insights can be made about the different chemical forms that were released, as well as the persistence of each in the environment.

  2. Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review

    Directory of Open Access Journals (Sweden)

    Hsiu-Ching Chiu

    2016-07-01

    Full Text Available Questions: Does constraint-induced movement therapy improve activity and participation in children with hemiplegic cerebral palsy? Does it improve activity and participation more than the same dose of upper limb therapy without restraint? Is the effect of constraint-induced movement therapy related to the duration of intervention or the age of the children? Design: Systematic review of randomised trials with meta-analysis. Participants: Children with hemiplegic cerebral palsy with any level of motor disability. Intervention: The experimental group received constraint-induced movement therapy (defined as restraint of the less affected upper limb during supervised activity practice of the more affected upper limb. The control group received no intervention, sham intervention, or the same dose of upper limb therapy. Outcome measures: Measures of upper limb activity and participation were used in the analysis. Results: Constraint-induced movement therapy was more effective than no/sham intervention in terms of upper limb activity (SMD 0.63, 95% CI 0.20 to 1.06 and participation (SMD 1.21, 95% CI 0.41 to 2.02. However, constraint-induced movement therapy was no better than the same dose of upper limb therapy without restraint either in terms of upper limb activity (SMD 0.05, 95% CI –0.21 to 0.32 or participation (SMD –0.02, 95% CI –0.34 to 0.31. The effect of constraint-induced movement therapy was not related to the duration of intervention or the age of the children. Conclusions: This review suggests that constraint-induced movement therapy is more effective than no intervention, but no more effective than the same dose of upper limb practice without restraint. Registration: PROSPERO CRD42015024665. [Chiu H-C, Ada L (2016 Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of Physiotherapy 62: 130–137

  3. Use of a risk assessment method to improve the safety of negative pressure wound therapy.

    Science.gov (United States)

    Lelong, Anne-Sophie; Martelli, Nicolas; Bonan, Brigitte; Prognon, Patrice; Pineau, Judith

    2014-06-01

    To conduct a risk analysis of the negative pressure wound therapy (NPWT) care process and to improve the safety of NPWT, a working group of nurses, hospital pharmacists, physicians and hospital managers performed a risk analysis for the process of NPWT care. The failure modes, effects and criticality analysis (FMECA) method was used for this analysis. Failure modes and their consequences were defined and classified as a function of their criticality to identify priority actions for improvement. By contrast to classical FMECA, the criticality index (CI) of each consequence was calculated by multiplying occurrence, severity and detection scores. We identified 13 failure modes, leading to 20 different consequences. The CI of consequences was initially 712, falling to 357 after corrective measures were implemented. The major improvements proposed included the establishment of 6-monthly training cycles for nurses, physicians and surgeons and the introduction of computerised prescription for NPWT. The FMECA method also made it possible to prioritise actions as a function of the criticality ranking of consequences and was easily understood and used by the working group. This study is, to our knowledge, the first to use the FMECA method to improve the safety of NPWT.

  4. Long-term pioglitazone therapy improves arterial stiffness in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Harashima, Keiichiro; Hayashi, Junichi; Miwa, Takashi; Tsunoda, Tooru

    2009-06-01

    Pioglitazone, a peroxisome proliferator-activated receptor gamma agonist, not only improves insulin resistance and glycemic control, but may also have additional beneficial vascular effects in patients with type 2 diabetes mellitus. We investigated whether pioglitazone had an influence on arterial stiffness, which is an independent predictor of cardiovascular events, in 204 patients with type 2 diabetes mellitus. A prospective, nonrandomized, open-label trial was performed that involved 41 patients treated with pioglitazone, 46 patients receiving sulfonylureas, 67 patients on insulin, and 50 patients on diet/exercise only. The follow-up period was 56 +/- 3 months. Arterial stiffness was evaluated by using the arterial stiffness index (ASI), which was based on analysis of the pulse wave amplitude pattern obtained during automated blood pressure measurement in the upper limb. The 4 groups had a similar baseline ASI, which was greater than the reference range in each group. Although antidiabetic therapies improved hemoglobin A(1c) and low-density lipoprotein cholesterol, ASI only decreased significantly in the pioglitazone group. Thus, pioglitazone improved abnormal arterial stiffness in patients with type 2 diabetes mellitus via a mechanism beyond the metabolic improvement. These findings may have important clinical implications in the use of pioglitazone in patients with type 2 diabetes mellitus.

  5. Long-term survival in advanced melanoma patients using repeated therapies: successive immunomodulation improving the odds?

    Directory of Open Access Journals (Sweden)

    Coventry BJ

    2015-04-01

    had died. Published studies of melanoma therapies were tabled for comparison. Conclusion: The fact that 18 cases of exceptional survival in advanced melanoma were identified is remarkable in itself. Even with recent therapies, the factors for improved survival remain enigmatic; however, one apparent common denominator in most cases was the persistent use of repeated therapies to reduce tumor bulk, induce tumor necrosis, and/or cause immunostimulation. These cases are instructive, suggesting manipulation of an established, endogenous, existing immune response. These observations provide practical evidence that the course for any patient with advanced melanoma at the outset should be considered unpredictable, open to immunomanipulation, and thus not uniformly fatal. The findings were compared and interpreted with reported newer immunotherapeutic approaches. Keywords: advanced melanoma, clinical responses, immunotherapy, prolonged survival

  6. Use of peers to improve adherence to antiretroviral therapy: a global network meta-analysis

    Science.gov (United States)

    Kanters, Steve; Park, Jay JH; Chan, Keith; Ford, Nathan; Forrest, Jamie; Thorlund, Kristian; Nachega, Jean B; Mills, Edward J

    2016-01-01

    Introduction It is unclear whether using peers can improve adherence to antiretroviral therapy (ART). To construct the World Health Organization's global guidance on adherence interventions, we conducted a systematic review and network meta-analysis to determine the effectiveness of using peers for achieving adequate adherence and viral suppression. Methods We searched for randomized clinical trials of peer-based interventions to promote adherence to ART in HIV populations. We searched six electronic databases from inception to July 2015 and major conference abstracts within the last three years. We examined the outcomes of adherence and viral suppression among trials done worldwide and those specific to low- and middle-income countries (LMIC) using pairwise and network meta-analyses. Results and discussion Twenty-two trials met the inclusion criteria. We found similar results between pairwise and network meta-analyses, and between the global and LMIC settings. Peer supporter+Telephone was superior in improving adherence than standard-of-care in both the global network (odds-ratio [OR]=4.79, 95% credible intervals [CrI]: 1.02, 23.57) and the LMIC settings (OR=4.83, 95% CrI: 1.88, 13.55). Peer support alone, however, did not lead to improvement in ART adherence in both settings. For viral suppression, we found no difference of effects among interventions due to limited trials. Conclusions Our analysis showed that peer support leads to modest improvement in adherence. These modest effects may be due to the fact that in many settings, particularly in LMICs, programmes already include peer supporters, adherence clubs and family disclosures for treatment support. Rather than introducing new interventions, a focus on improving the quality in the delivery of existing services may be a more practical and effective way to improve adherence to ART. PMID:27914185

  7. Children with Down Syndrome Improved in Motor Functioning and Muscle Tone Following Massage Therapy

    Science.gov (United States)

    Hernandez-Reif, Maria; Field, Tiffany; Largie, Shay; Mora, Dana; Bornstein, Joan; Waldman, Ronnie

    2006-01-01

    Twenty-one moderate to high functioning young children (mean age, two years) with Down syndrome receiving early intervention (physical therapy, occupational therapy and speech therapy) were randomly assigned to additionally receive two 0.5-hour massage therapy or reading sessions (control group) per week for two months. On the first and last day…

  8. Children with Down Syndrome Improved in Motor Functioning and Muscle Tone Following Massage Therapy

    Science.gov (United States)

    Hernandez-Reif, Maria; Field, Tiffany; Largie, Shay; Mora, Dana; Bornstein, Joan; Waldman, Ronnie

    2006-01-01

    Twenty-one moderate to high functioning young children (mean age, two years) with Down syndrome receiving early intervention (physical therapy, occupational therapy and speech therapy) were randomly assigned to additionally receive two 0.5-hour massage therapy or reading sessions (control group) per week for two months. On the first and last day…

  9. Evaluation of the Prognosis of Graves ’ Disease after Radioiodine Treatment and the Effects of Radioiodine on A-TPO,TRAb and IL-17%131I治疗Graves病的预后评估及对A-TPO、TRAb和IL-17水平的影响

    Institute of Scientific and Technical Information of China (English)

    徐金娥; 彭秋菊; 邓波; 李裕明

    2015-01-01

    of the thyroid ,radioactive iodine uptake ,serum TRAb levels before treatment with the treatment efficacy. The impact of radioiodine treatment on the levels of A‐TPO ,TRAb and IL‐17 was examined as well.Results The weight of the thyroid and serum TRAb levels before radioiodine treatment were independent risk factors for the efficacy of radioiodine treatment (OR:1.108 and 8.917 ,P=0.009 4 and 0.041 1 ,respectively).After 6‐month treatment ,the titers of A‐TPO were increased signifi‐cantly in the hypothyroid group(P 0.05).The titers of TRAb were increased significantly in the hyperthyroid group and the hypothyroid group (P0.05). The titers of IL‐17 had no significant changes after the treatment in all three groups.Conclusion The higher TRAb levels and the greater thyroid weigh before radioiodine treatment are associated with a relative resistance to the therapy.Patients with high levels of A‐TPO after radioiodine treatment for six months tend to develop hypothyroidism.The association of the levels of TRAb and IL‐17 with prognosis is undetermined.

  10. Multimodality therapy including radiotherapy and chemotherapy improves event-free survival in stage C esthesioneuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Eich, H.T.; Staar, S.; Mueller, R.P. [Dept. of Radiotherapy, Univ. of Cologne (Germany); Hero, B.; Berthold, F. [Dept. of Pediatric Oncology, Children' s Hospital, Univ. of Cologne (Germany); Micke, O. [Dept. of Radiotherapy, Univ. of Muenster (Germany); Seegenschmiedt, H. [Dept. of Radiotherapy, Alfried Krupp Hospital, Essen (Germany); Mattke, A. [Children' s Hospital, Olgaspital, Stuttgart (Germany)

    2003-04-01

    Background: To evaluate the efficacy of multimodality therapy in patients with esthesioneuroblastoma (ENB). Patients and Methods: From 01/1979 through 08/2001, 47 patients with ENB (20 men, 27 women, age 5-81 years), were registered from 18 oncologic centers. There were 14 tumors stage B and 33 stage C according to the Kadish classification. Initial treatment included surgery alone in seven patients, radiotherapy (RT) with or without chemotherapy (CTX) in twelve, surgery plus postoperative RT in 15, and multimodality therapy (surgery plus pre- or postoperative CTX plus postoperative RT) in 13. Results: The 5-year overall survival (OS) for the whole group was 64 {+-} 8% and the 5-year event-free survival (EFS) 50 {+-} 8%. Patients with multimodality treatment had a significantly better 5-year EFS (74 {+-} 13%) compared to the other patients (41 {+-} 9%; p = 0.05), while the 5-year OS was not significantly different between the treatment groups (p = 0.39). For patients with Kadish stage C, multimodality therapy (n = 11) resulted in superior 5-year EFS (72 {+-} 14% vs 17 {+-} 9%; p = 0.01). These patients tended to have an improved OS (69 {+-} 15% vs 47 {+-} 12%; p = 0.19) compared to the other treatment groups. None of the patients with multimodality treatment had a metastatic relapse. Conclusion: Multimodality treatment (surgery plus pre- or postoperative CTX plus postoperative RT) appears to be highly efficient in preventing local and systemic relapse in patients with advanced ENB. Timing and optimal agents of CTX need to be further evaluated. (orig.)

  11. The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

    Science.gov (United States)

    Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

    2015-11-01

    [Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.

  12. New radioiodinated carboxylic and hydroxamic matrix metalloproteinase inhibitor tracers as potential tumor imaging agents

    Energy Technology Data Exchange (ETDEWEB)

    Oltenfreiter, Ruth E-mail: ruth.oltenfreiter@rug.ac.be; Staelens, Ludovicus; Lejeune, Annabelle; Dumont, Filip; Frankenne, Francis; Foidart, Jean-Michel; Slegers, Guido

    2004-05-01

    Several studies have demonstrated a positive correlation between tumor progression and expression of extracellular proteinases such as matrix metalloproteinases (MMPs). MMP-2 and MMP-9 have become attractive targets for cancer research because of their increased expression in human malignant tumor tissues of various organs, providing a target for medical imaging techniques. Radioiodinated carboxylic and hydroxamic MMP inhibitors 2-(4'-[{sup 123}I]iodo-biphenyl-4-sulfonylamino)-3-(1H-indol-3-yl)-propionic acid (9) and 2-(4'-[{sup 123}I]iodo-biphenyl-4-sulfonylamino)-3-(1H-indol-3-yl)-propionamide (11) were synthesized by electrophilic aromatic substitution of the tributylstannyl derivatives and resulted in radiochemical yields of 60% {+-} 5% (n = 3) and 70% {+-} 5% (n = 6), respectively. In vitro zymography and enzyme assays showed high inhibition capacities of the inhibitors on gelatinases. In vivo biodistribution showed no long-term accumulation in organs and the possibility to accumulate in the tumor. These results warrant further studies of radioiodinated carboxylic and hydroxamic MMP inhibitor tracers as potential SPECT tumor imaging agents.

  13. Preparation, purification and primary bioevaluation of radioiodinated ofloxacin. An imaging agent

    Energy Technology Data Exchange (ETDEWEB)

    Kandil, Shaban; Seddik, Usama; Hussien, Hiba; Shaltot, Mohamed [Atomic Energy Authority, Cairo (Egypt). Cyclotron Project; El-Tabl, Abdou [Monofia Univ. (Egypt). Faculty of Science

    2015-07-01

    The broad-spectrum antibiotic agents have been demonstrated as promising diagnostic tools for early detection of infectious lesions. We set out ofloxacin (Oflo), a second-generation fluoroquinolone, for the radioiodination process. In particular, this was carried out with {sup 125}I via an electrophilic substitution reaction. The radiochemical yield was influenced by different factors; drug concentration, different oxidizing agents, e.g. chloramine-T, iodogen and n-bromosuccinimide, pH of medium, reaction time, temperature and different organic media. These parameters were studied to optimize the best conditions for labeling with ofloxacin. We found that radiolabeling in ethanol medium showed a 70% radiochemical yield of {sup 125}I-ofloxacin. The radioiodination was determined by means of TLC and HPLC. The cold labeled Oflo ({sup 127}I-Oflo) was prepared and controlled by HPLC. The cold labeled Oflo was also confirmed by NMR and MS techniques. Furthermore, biodistribution studies for labeled {sup 125}I-Oflo were examined in two independent groups (3 mice in each one); control and E. Coli-injected (inflamed). The radiotracer showed a good localization in muscle of thigh for inflamed group as compared to control. In conclusion, ofloxacine might be a promising target as an anti-inflammatory imaging agent.

  14. Radioiodine uptake and thyroid hormone levels on or off simultaneous carbimazole medication. A prospective paired comparison

    Energy Technology Data Exchange (ETDEWEB)

    Walter, M.A.; Mueller-Brand, J. [Inst. of Nuclear Medicine, Univ. Hospital Basel (Switzerland); Christ-Crain, M.; Mueller, B. [Div. of Endocrinology, Univ. Hospital Basel (Switzerland)

    2005-02-01

    Aim: To allow radioiodine (RAI) treatment in patients with need for anti-thyroid drug medication and low RAI uptakes we investigated the feasibility of discontinuing carbimazole for 3 days to enhance the RAI uptake without concurrent exacerbation of hyperthyroidism. Methods: We prospectively investigated RAI dynamics and thyroid hormone concentration in 12 patients with low RAI uptake (<30%) under simultaneous carbimazole medication and 3 days after discontinuation. At both time points fT{sub 4}, T{sub 3} and TSH were monitored. Results: Discontinuation of carbimazole for 3 days led to a significant increase of RAI uptake in all patients. We found an enhancement up to 4.9-fold compared to the measurement on carbimazole. The mean RAI uptake increased from 15.2{+-}4.4% to 50.1{+-}15.5% (p<0.001). The intrapersonal radioiodine half-life increased from 4.2{+-}1.6 days to 5.4{+-}0.7 days (p=0.13). Mean thyroid hormone concentration was not affected by the three day withdrawal of anti-thyroid drugs and no patient suffered from an aggravation of biochemical hyperthyroidism. Conclusion: A withdrawal of carbimazole for 3 days is long enough to provide sufficiently high RAI uptakes for RAI treatment in patients with low RAI uptakes and short enough to avoid the risk of exacerbation of hyperthyroidism. (orig.)

  15. Thyroid cell irradiation by radioiodines: a new Monte Carlo electron track-structure code

    Energy Technology Data Exchange (ETDEWEB)

    Champion, Christophe [Universite Paul Verlaine-Metz (France). Lab. de Physique Moleculaire et des Collisions]. E-mail: champion@univ-metz.fr; Elbast, Mouhamad; Colas-Linhart, Nicole [Universite Paris 7 (France). Faculte de Medecine. Lab. de Biophysique; Ting-Di Wu [INSERM U759, Orsay (France). Institut Curie Recherche. Imagerie Integrative

    2007-09-15

    The most significant impact of the Chernobyl accident is the increased incidence of thyroid cancer among children who were exposed to short-lived radioiodines and 131-iodine. In order to accurately estimate the radiation dose provided by these radioiodines, it is necessary to know where iodine is incorporated. To do that, the distribution at the cellular level of newly organified iodine in the immature rat thyroid was performed using secondary ion mass microscopy (NanoSIMS{sup 50}). Actual dosimetric models take only into account the averaged energy and range of beta particles of the radio-elements and may, therefore, imperfectly describe the real distribution of dose deposit at the microscopic level around the point sources. Our approach is radically different since based on a track-structure Monte Carlo code allowing following-up of electrons down to low energies ({approx}= 10 eV) what permits a nanometric description of the irradiation physics. The numerical simulations were then performed by modelling the complete disintegrations of the short-lived iodine isotopes as well as of {sup 131}I in new born rat thyroids in order to take into account accurate histological and biological data for the thyroid gland. (author)

  16. The effect of tanespimycin (17-AAG) on radioiodine accumulation in sodium iodide symporter expressing cells

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Kyoung Hyun; Youn, Hyewon; Song, Myung Geun; Lee, Dong Soo; Chung, June Key [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    The heat shock protein 90 inhibitor, tanespimycin, is an anticancer agent known to increase iodine accumulation in normal and cancerous thyroid cells. Iodine accumulation is regulated by membrane proteins such as sodium iodide sym porter (NIS) and pendrin (PDS), and thus we attempted to characterize the effects of tanespimycin on those genes. Cells were incubated with tanespimycin in order to evaluate {sup 125}I accumulation and efflux ability. Radioiodine uptake and efflux were measured by a gamma counter and normalized by protein amount. RT PCR were performed to measure the level of gene expression. After tanespimycin treatment, {sup 125}uptake was in creased by {approx}2.5 fold in FRTL 5, hNIS ARO. and hNIS MDA MB 231 cells, but no changes were detected in the hNIS HeLa cells. Tanespimycin significantly reduced the radioiodine efflux rate only in the FRTL 5 cell. in the FRTL 5 and hNIS ARO cells, PDS mRNA levels were markedly reduced; the only other observed alteration in the levels of NIS mRNA after tanespimtycin treatment was an observed increase in the h hNIS ARO cells. These results indicate that cellular responses against tanespimycin treatment differed between the normal rat thyroid cells and human cancer cells, and the reduction in the {sup 125I} efflux rate by tanespimycin in the normal rat thyroid cells might be attributable to reduced PDS gene expression.

  17. Detection of HCV-RNA by Reverse Transcription Polymerase Chain Reaction Using Biotinylated and Radioiodinated Primers

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jin Sook; Moon, Dae Hyuk; Cheon, Jun Hong; Chung, Yoon Young; Park, Hung Dong; Chung, Young Hwa; Lee, Young Sang [Asan Medical Center, University of Ulsan, Seoul (Korea, Republic of)

    1994-07-15

    This study was performed to evaluate the clinical applicability of the reverse transcription polymerase chain reaction (RT-PCR) kit of HCV-RNA using biotinylated and radioiodinated primers. Study subjects were 118 patients with positive anti-HCV. HCV-RNA in patients serum was extracted by guanidium thiocyanate method. After first amplification, the product was reamplified by primers labelled with biotin and I-125. The final amplification product was detected by counting the radioactivity after incubation in avidin coated tubes. In 51 samples, the test was repeated for evaluation of reproducibility. This new method was also compared with conventional RT-PCR methods in 34 samples from patients with chronic liver disease. The results were as follows, 1) HCV-RNA was positive in 85(97%)of 88 patients with chronic liver disease, and in 23 (73%) of 30 patients with normal liver function. 2) In comparison with conventional method, HCV-RNA was detected in 32(94%) of 34 patients with new method, whereas in 27(79% ) of the same group with conventional method 3) Repeated test with new method in 52 samples demonstrated 82% of concordant result. In conclusion, new method with biotinylated and radioiodinated primers was more sensitive than conventional method. However, great care must be taken for quality control because there were considerable interassay variation and possibility of false positivity and false negativity.

  18. Identification of frog photoreceptor plasma and disk membrane proteins by radioiodination

    Energy Technology Data Exchange (ETDEWEB)

    Witt, P.L.; Bownds, M.D.

    1987-03-24

    Several functions have been identified for the plasma membrane of the rod outer segment, including control of light-dependent changes in sodium conductance and a sodium-calcium exchange mechanism. However, little is known about its constituent proteins. Intact rod outer segments substantially free of contaminants were prepared in the dark and purified on a density gradient of Percoll. Surface proteins were then labeled by lactoperoxidase-catalyzed radioiodination, and intact rod outer segments were reisolated. Membrane proteins were identified by polyacrylamide gel electrophoresis and autoradiography. The surface proteins labeled included rhodopsin, the major membrane protein, and 12 other proteins. To compare the protein composition of plasma membrane with that of the internal disk membrane, purified rod outer segments were lysed by hypotonic disruption or freeze-thawing, and plasma plus disk membranes were radioiodinated. In these membrane preparations, rhodopsin was the major iodinated constituent, with 12 other proteins also labeled. Autoradiographic evidence indicated some differences in protein composition between disk and plasma membranes. A quantitative comparison of the two samples showed that labeling of two proteins, 24 kilodaltons (kDa) and 13 kDa, was enriched in the plasma membrane, while labeling of a 220-kDa protein was enriched in the disk membrane. These plasma membrane proteins may be associated with important functions such as the light-sensitive conductance and the sodium-calcium exchanger.

  19. Tumor Microenvironment Targeting and Responsive Peptide-Based Nanoformulations for Improved Tumor Therapy.

    Science.gov (United States)

    Qin, Hao; Ding, Yanping; Mujeeb, Ayeesha; Zhao, Ying; Nie, Guangjun

    2017-09-01

    The tumor microenvironment participates in all stages of tumor progression and has emerged as a promising therapeutic target for cancer therapy. Rapid progress in the field of molecular self-assembly using various biologic molecules has resulted in the fabrication of nanoformulations that specifically target and regulate microenvironment components to inhibit tumor growth. This inhibition process is based on differentiating between biophysicochemical cues guiding tumor and normal tissue microenvironments. Peptides and peptide derivatives, owing to their biocompatibility, chemical versatility, bioactivity, environmental sensitivity, and biologic recognition abilities, have been widely used as building blocks to construct multifunctional nanostructures for targeted drug delivery and controlled release. Several groups of peptides have been identified as having the ability to penetrate plasma membranes, regulate the essential signaling pathways of angiogenesis and immune reactions, and recognize key components in the tumor microenvironment (such as vascular systems, stromal cells, and abnormal tumor biophysicochemical features). Thus, using different modules, various functional peptides, and their derivatives can be integrated into nanoformulations specifically targeting the tumor microenvironment with increased selectivity, on-demand response, elevated cellular uptake, and improved tumor therapy. In this review, we introduce several groups of functional peptides and highlight peptide-based nanoformulations that specifically target the tumor microenvironment. We also provide our perspective on the development of smart drug-delivery systems with enhanced therapeutic efficacy. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

  20. Colloidal gold nanorings for improved photodynamic therapy through field-enhanced generation of reactive oxygen species

    Science.gov (United States)

    Hu, Yue; Yang, Yamin; Wang, Hongjun; Du, Henry

    2013-02-01

    Au nanostructures that exhibit strong localized surface plasmon resonance (SPR) have excellent potential for photo-medicine, among a host of other applications. Here, we report the synthesis and use of colloidal gold nanorings (GNRs) with potential for enhanced photodynamic therapy of cancer. The GNRs were fabricated via galvanic replacement reaction of sacrificial Co nanoparticles in gold salt solution with low molecular weight (Mw = 2,500) poly(vinylpyrrolidone) (PVP) as a stabilizing agent. The size and the opening of the GNRs were controlled by the size of the starting Co particles and the concentration of the gold salt. UV-Vis absorption measurements indicated the tunability of the SPR of the GNRs from 560 nm to 780 nm. MTT assay showed that GNRs were non-toxic and biocompatible when incubated with breast cancer cells as well as the healthy counterpart cells. GNRs conjugated with 5-aminolevulinic acid (5-ALA) photosensitizer precursor led to elevated formation of reactive oxygen species and improved efficacy of photodynamic therapy of breast cancer cells under light irradiation compared to 5-ALA alone. These results can be attributed to significantly enhance localized electromagnetic field of the GNRs.

  1. Can pharmacogenomics help to improve therapy in patients with high-grade osteosarcoma?

    Science.gov (United States)

    Kager, Leo; Diakos, Christopher; Bielack, Stefan

    2015-07-01

    Current standard treatment of patients with high-grade osteosarcoma (HGOS) includes complete surgical resection of the tumor and chemotherapy, most often with high-dose methotrexate, doxorubicin and cisplatin. With this approach > 60% of patients can be cured. However, conventional anticancer drugs have a narrow therapeutic index, and efficacy and toxicity vary considerably among patients. Pharmacogenomics aim to identify key genomic factors for drug effects (either desired or adverse) in normal host cells (germ-line variants) and cancer cells (somatic variants), and if an association between a genotype and a drug phenotype has been identified, validated and demonstrated to have a large effect size, these genotypes may be used to tailor therapy. In addition, pharmacogenomic models can be used to identify novel therapeutic targets. For example, germ-line variants in genes which potentially influence the disposition of methotrexate and cardiotoxicity of doxorubicin have recently been identified. Moreover, next-generation sequencing combined with several analytical methods has identified the phosphatidylinositol 3-kinase/mammalian target of rapamycin (PI3K/mTOR) pathway as a potential therapeutic target in HGOS. Herein, we discuss whether and how these novel pharmacogenomic insights may help to improve future therapy in HGOS.

  2. A Multidisciplinary Approach with Hyperbaric Oxygen Therapy Improve Outcome in Snake Bite Injuries.

    Science.gov (United States)

    Korambayil, Pradeoth Mukundan; Ambookan, Prashanth Varkey; Abraham, Siju Varghese; Ambalakat, Ajay

    2015-01-01

    Snakebite injuries are common in tropical India among those who are involved in outdoor activities. These injuries results in cellulitis, gangrene at the bite area, bleeding manifestations, compartment syndrome, regional lymphadenopathy, septicemia, hypotension, and disseminated intravascular coagulation (DIC) resulting in significant morbidity and mortality. The purpose of this study is to share our experience of multidisciplinary approach in the management of snakebite injuries of the extremities with various treatment modalities including hyperbaric oxygen (HBO) therapy, surgical debridement, and soft tissue reconstruction to provide an effective treatment for snake bite injuries. The study was conducted in the Department of Plastic Surgery, during the period October 2012-December 2014, wherein all the patients who were admitted with snakebite injuries were enrolled and the patients treated in plastic surgery department were included into the study. Out of total 766 patients, there were 323 patients treated with anti snake venom (ASV) and 29 died among the treated patients; 205 patients belonged to pediatric age group. Out of 112 patients referred to Department of Plastic Surgery, 50 cases presented with cellulitis, 24 patients with compartment syndrome, and 38 patients were referred for the management of soft tissue cover over the extremities. Among 112 patients, 77 involved the lower extremity and 35 the upper extremity. Multidisciplinary approach including hyperbaric oxygen (HBO) therapy improves outcome in the management of snakebite injuries of the extremities.

  3. Cytogenetic in thyroid carcinoma and therapy with 131{sup I}; Citogenetica en cancer de tiroides y terapia con 131''I

    Energy Technology Data Exchange (ETDEWEB)

    Popova, L.; Hadjidekova, V.; Christova, R.; Agova, S.; Grudeva, V.; Hadjieva, T.; Dominguez, I.

    2007-07-01

    In order to assess the genotoxic risk of the therapy with radioiodine-131(''131I), the production of micronuclei (MN) and chromosome aberrations (CA) were analyzed in the peripheral blood lymphocytes of group of 26 patients undergoing therapy with this radionuclide for differentiated thyroid carcinoma (DTC). Blood samples were taken immediately before ''131 I administration and 1 month later. The patients underwent radioiodine ablation (RIA) or radioiodine therapy (RIT) after radical thyroidectomy. The amount of orally administered ''131I activity varied from 3330 to 4030 MBq according to the king of therapy (RIA or RIT). results show that after radioiodine therapy there is a significant increase in the frequency of MN and CA. The mean frequencies of MN {+-} Sd before and after the therapy were 10.72 % {+-} 5.84 % and 25.28 %{+-} 12.6% respectively. For CA, the mean frequencies obtained were 1.16% {+-} 0.36% before and 2.3% {+-} 0.87% after the therapy. These findings indicate a genotoxic activity of ''131I therapy estimated after a period of one month. (Author) 38 refs.

  4. Improving therapist psychological flexibility while training acceptance and commitment therapy: a pilot study.

    Science.gov (United States)

    Luoma, Jason B; Vilardaga, Jennifer Plumb

    2013-01-01

    Acceptance and Commitment Therapy (ACT) training often includes experiential elements aimed at improving therapist psychological flexibility, yet the effects of ACT training on therapist psychological flexibility have yet to be evaluated. This pilot study examines the effects of experiential phone consultation as an adjunct to a standard continuing education workshop on psychological flexibility and burnout among therapists learning ACT. In this study, counselors taking a 2-day ACT workshop were randomly assigned to either six 30-min phone consultation sessions (n = 10) or no additional contact (n = 10). The results show that those in the consultation condition reported higher psychological flexibility at the 3-month follow-up compared to the workshop-only condition. Improvements in ACT knowledge, overall burnout, and personal accomplishment were found in both groups, independent of whether they received phone consultation, and this increase was maintained over time. In conclusion, ACT phone consultation contributed to counselor psychological flexibility above the workshop alone and appears to be feasible as a means to improve counselor psychological flexibility.

  5. High-dose therapy improved the bone remodelling compartment canopy and bone formation in multiple myeloma

    DEFF Research Database (Denmark)

    Hinge, Maja; Delaissé, Jean-Marie; Plesner, Torben;

    2015-01-01

    . Loss of this canopy has been associated with bone loss. This study addresses whether the bone remodelling in MM is improved by high-dose therapy. Bone marrow biopsies obtained from 20 MM patients, before and after first-line treatment with high-dose melphalan followed by autologous stem cell...... transplantation, and from 20 control patients with monoclonal gammopathy of undetermined significance were histomorphometrically investigated. This investigation confirmed that MM patients exhibited uncoupled bone formation to resorption and reduced canopy coverage. More importantly, this study revealed......Bone loss in multiple myeloma (MM) is caused by an uncoupling of bone formation to resorption trigged by malignant plasma cells. Increasing evidence indicates that the bone remodelling compartment (BRC) canopy, which normally covers the remodelling sites, is important for coupled bone remodelling...

  6. Dance movement therapy