Untersuchungen zur effektiven Halbwertszeit des 131J bei der Radiojodbehandlung der Schilddrüsenautonomie

1991 ◽  
Vol 30 (03) ◽  
pp. 71-76
Author(s):  
R. Bares ◽  
U. Büll ◽  
B. Müller

In order to compute effective half-life of131I after application of therapeutic doses (Teff), the time course of whole-body radioactivity was evaluated retrospectively in 115 patients with benign thyroid diseases (multinodular autonomous adenoma, solitary autonomous adenoma or Graves’ disease). Because of a large overlap of Teff in the various diseases analyzed, courses of all patients who did (group Ts, 24 cases) or did not (group kTs, 91 cases) receive antithyroid drugs during therapy were summarized. In group Ts a mean Teff of 5.0 ± 0.9 d was found which was significantly (p <0.01) lower than the mean Teff of 6.3 ± 0.9 d in group kTs. We believe that the mean Teff is a practical alternative in radioiodine dosimetry if an exact determination of Teff cannot be performed because of shortage of time.

2004 ◽  
Vol 43 (06) ◽  
pp. 217-220 ◽  
Author(s):  
J. Dressler ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
Chr. Reiners ◽  
...  

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


2021 ◽  
Vol 92 (12) ◽  
pp. 980-986
Author(s):  
Edwin Hong-Teck Loh ◽  
Feng Wei Soh ◽  
Brian See ◽  
Benjamin Boon Chuan Tan

BACKGROUND: Graves’ Disease (GD) is a common cause of hyperthyroidism. Although definitive treatment with radioactive iodine (RAI) is preferred for military aircrew, there are cultural and individual differences in receptivity toward RAI, and clinical guidelines that recommend antithyroid drugs (ATD) as the first line therapy. We examined a case series of Republic of Singapore Air Force (RSAF) aviators with GD treated with ATD and the impact of their condition on aeromedical disposition.CASE SERIES: All RSAF aircrew diagnosed with GD and treated with ATD over a 15-yr period were retrospectively identified and analyzed to determine the impact on their fitness for flying duties. The mean age of the 13 aircrew was 33 ± 7.1 yr (range, 25–47 yr), with 11 (84.6%) being males. There were 10 (76.9%) who had ATD as the only treatment while 3 (23.1%) were initially treated with ATD but subsequently underwent RAI or surgery. Of the 10 treated with only ATD, 3 (30.0%) were returned to restricted flying, 6 (60.0%) were returned to unrestricted flying, and 1 (10.0%) is still undergoing ATD titration. There were 10 (76.9%) aircrew who were returned to some form of flying duties while on low doses of ATD.DISCUSSION: This case series suggests that ATD is a viable treatment modality in the aeromedical management of military aviators with GD and it is possible to return military aircrew on a stable maintenance dose of ATD to flying duties. A framework is proposed to support the aeromedical decision-making process for military aircrew in the treatment of GD.Loh EH-T, Soh FW, See B, Tan BBC. Aeromedical decision making for military aircrew with Graves’ disease. Aerosp Med Hum Perform. 2021; 92(12):980–986.


In all the experiments hitherto made to determine the gravitative attraction between two masses, the temperature has not varied more than a few degrees, and there are no results which would enable us to detect with certainty any dependence of attraction upon temperature even if such dependence exists. It is true, as Professor Hicks has pointed out, that Baily’s results for the Mean Density of the Earth, if arranged in the order of the temperature of the apparatus when they were obtained, show a fall in value as the temperature rises. But this is almost certainly some secondary effect, due to errors in the measurements of the apparatus, or to the seasons at which different attracted masses were used. The ideal experiment to find if temperature has an effect on gravitation would consist in one determination of the gravitative attraction between two masses at, say 15°C., and another determination at, say, the temperature of boiling liquid air. But the difficulties of exact determination at ordinary temperatures are not yet overcome, and at any very high or very low temperatures, they would be so much increased that the research seems at present hopeless.


2015 ◽  
Vol 54 (03) ◽  
pp. 131-136 ◽  
Author(s):  
F. F. Behrendt ◽  
A. Heinzel ◽  
B. Müller ◽  
F. M. Mottaghy ◽  
F. A. Verburg ◽  
...  

SummaryAim: To compare uptake measurements and different methods for the pretherapeutic determination of the effective thyroidal 131I half life (Teff) to the results of posttherapeutic dosimetric measurements. Patients, methods: Retrospective study of 1538 patients who received their first RIT in our department for autonomous thyroid nodules (ATN), autonomous multinodular goiter (AMG) or Graves' disease (GD) between November 1999 and January 2011. Pretherapeutic measurements were performed at any combination of 24 h, 48 h and 6 days after 131I administration. Post-therapy dosimetric measurements were performed in 12 h intervals until discharge. Teff was determined through monoexponential curve fitting. Results: Pretherapeutic Teff values based on measurements at 24 h and 48 h, 24 h and 6 d, 48 h and 6 d as well as on day 24 h, 48 h and 6 d yielded implausible (< 2 d or > 8 d) values for Teff, in 60.4%, 25.7%, 29.1 and 21.4% of available calculations, respectively. The plausible results showed significant, clinically relevant and sometimes considerable overestimations of Teff. Using empirically determined fixed disease specific Teff values resulted in a better congruence between the pre- and posttherapeutic dosimetry results. 24 h measurements were marginally more accurate than 48 h ones in AMG and GD whereas 48 h measurements were marginally more accurate in ATN; these differences are however not clinically relevant. 6 d measurements are clearly less accurate than those after 24 h or 48 h. Conclusion: In ATN, AMG and GD, pretherapeutic dosimetry can be performed by a single uptake measurement at 24 h or 48 h using a fixed, disease specific value for Teff. Additional later measurements do not yield a further clinically relevant contribution to accuracy of pretherapeutic dosimetry.


1992 ◽  
Vol 82 (2) ◽  
pp. 237-244 ◽  
Author(s):  
A. M. Peters ◽  
P. Allsop ◽  
A. W. J. Stuttle ◽  
R. N. Arnot ◽  
M. Gwilliam ◽  
...  

1. It is widely believed that the lung is an important site of granulocyte margination and releases most of the granulocytes of the peripheral neutrophilia of exercise. 2. We measured granulocyte margination in the lung in terms of the lung total blood granulocyte pool and the lung circulating granulocyte pool in eight patients without inflammatory disease or evidence of lung pathology by comparing the regional γ-camera lung count rate of 111In-labelled granulocytes with that of 111In-labelled erythrocytes. According to the respective 111In activities in peripheral blood samples taken between 5 and 40 min after granulocyte injection, the lung marginating granulocyte pool was 0.78 (sem 0.045) of the lung total blood granulocyte pool or 4.6 (0.92) of the lung circulating granulocyte pool 5 min after injection, decreasing to plateau values of 0.57 (0.053) and 1.53 (0.28) from 20 min after injection. This compared with corresponding whole-body ratios of about 0.6 and 1.5, respectively. 3. After 4 min of maximal exercise in four normal subjects given 111In-labelled granulocytes 60 min before exercise, the 111In-labelled granulocyte count rate over the lung increased to 1.23 (0.05) of the pre-exercise value with a time course that was essentially identical with the time course of the peripheral native neutrophilia. The spleen 111In signal decreased with the same time course, reaching a minimum of 0.63 (0.05) of the pre-exercise level at 5–10 min after the end of exercise. 4. In a further four normal subjects given 99mTc-labelled erythrocytes, exercise resulted in an increase in the lung 99mTc count rate to 1.11 (0.05) of the pre-exercise value. This increase was maximal immediately after the end of exercise. Based on changes in peripheral haemoglobin, total blood volume decreased in the eight normal subjects to 0.89 (0.01) of the pre-exercise value. 5. Using (a) the mean increases seen in lung 111In and 99mTc count rates in the normal subjects, (b) the mean haemoconcentration recorded in the normal subjects and (c) the mean baseline ratio of lung marginating granulocyte pool/lung total blood granulocyte pool measured in the patients, we calculated that the lung marginating granulocyte pool after exercise declined to only 0.94 of the pre-exercise value in the four normal subjects given 111In-labelled granulocytes. 6. We conclude (a) that although granulocytes marginate in the lung, they do not do so to an extent greater than the average for the whole body, and (b) that there is no significant release of granulocytes from the lungs as a result of exercise.


1869 ◽  
Vol 17 ◽  
pp. 426-427

The observations made by the author were of the three usual elements —the Dip, Declination, and Intensity of the Horizontal Component of the Force. They were taken with instruments supplied to the Colaba Observatory in the year 1867 through the Kew Committee of the British Association, after having been tested at the Kew Observatory. The dip-circle was made by Barrow of London, and is furnished with two needles; the other instrument, the unifilar magnetometer, which serves both for observations of declination and horizontal force, was made by Elliott Brothers of London. The results of the observations for dip only have as yet been received from the author. A complete observation consists of thirty-two readings, each end of the needle being read twice in each different position of the needle and circle; and the mean of the thirty-two is taken as the result of the observation. The observations were 178 in number, commencing on the 29th of April 1867, and extending to the 29th of December 1868. They were generally taken, with the two needles alternately, on particular days of the week. Up to August 17, 1867, the observations commenced with either end (A or B) of the needle dipping, and without remagnetizing the needle; i. e . the magnetization for the latter half of one observation was made to serve for the first half of the next observation with the same needle, the two needles having been kept during the interval with contrary poles adjacent in a zinc box; but after August 17, 1867, the needle was always remagnetized, so as to make the end A dip during the first half of the observation. The effect of this change of practice was to produce a marked increase in the accordance of successive observations. Tables are given containing every complete observation made up to the end of 1868, and showing, as well as the mean dip, the partial results in each position of the circle, and with each end of the needle dipping, and also the mean weekly and mean monthly values. The mean dip obtained for the months April to December 1867 was 19° 2'.00, and for the year 1868 was 19° 3'.87. The period embraced by the observations is too limited to allow of an exact determination of the rate of secular change; nevertheless the observations show distinctly that the dip is increasing. The author takes + l'.3 as the rate of annual change.


1988 ◽  
Vol 59 (1) ◽  
pp. 155-164 ◽  
Author(s):  
C. R. Krishnamurti ◽  
S. M. Janssens

1. Whole-body protein synthetic rates in non-pregnant ewes were determined by the continuous infusion of L-[15N]- and [1-13C]leucine and measuring the plasma enrichment of leucine, α-ketoisocaproate (α-KIC) and expired carbon dioxide by gas–liquid chromatography–mass spectrometry.2. The mean whole-body protein synthesis estimated from plasma leucine flux corrected for oxidation was 5·38 (SE 0·54) g/kg per d.3. Under the conditions of the present study leucine oxidation was 0·323 (SE 0·067) mmol/kg per d and accounted for 10·71 (SE 2·26) % of plasma [13C]leucine flux. Deamination of leucine was 0·55 (SE 0·035) mmol/kg per d and accounted for approximately 17% of plasma [15N]leucine flux.4. The rate of α-KIC reamination to leucine, calculated by subtracting 13C flux from 15N flux, was 0·228 (SE 0·101) mmol/kg per d.5. The rate of whole-body protein degradation was 4·49 (SE 0·54) g/kg per d and there was a net protein gain of 0·89 (SE 0·21) g/kg per d.


2012 ◽  
Vol 107 (02) ◽  
pp. 379-387 ◽  
Author(s):  
Genevieve Contant ◽  
Theodore Spiro ◽  
Elisabeth Perzborn ◽  
Céline Guinet ◽  
Yves Gourmelin ◽  
...  

SummaryRivaroxaban is an oral, direct factor Xa inhibitor. Routine coagulation monitoring is not required, but a quantitative determination of rivaroxaban concentrations might be useful in some clinical circumstances. This multicentre study assessed the suitability of the anti-factor Xa chromogenic assay for the measurement of rivaroxaban plasma concentrations (ng/ml) using rivaroxaban calibrators and controls, and the inter-laboratory precision of the measurement. Twenty-four centres in Europe and North America were provided with sets of rivaroxaban calibrators (0, 41, 209 and 422 ng/ml) and a set of rivaroxaban pooled human plasma controls (20, 199 and 662 ng/ml; the concentrations were unknown to the participating laboratories). The evaluation was carried out over 10 days by each laboratory using local anti-factor Xa reagents as well as the centrally provided reagent, a modified STA® Rotachrom® assay. A calibration curve was produced each day, and the day-to-day precision was evaluated by testing three human plasma controls. When using the local anti-factor Xa reagents, the mean rivaroxaban concentrations (measured/actual values) were: 17/20, 205/199 and 668/662 ng/ml, and the coefficient of variance (CV) was 37.0%, 13.7% and 14.1%, respectively. When the modified STA Rotachrom method was used, the measured/actual values were: 18/20, 199/199 and 656/662 ng/ml, and the CV was 19.1%, 10.9% and 10.0%, respectively. The results suggest that, by using rivaroxaban calibrators and controls, the anti-factor Xa chromogenic method is suitable for measuring a wide range of rivaroxaban plasma concentrations (20–660 ng/ml), which covers the expected rivaroxaban plasma levels after therapeutic doses.


2018 ◽  
Vol 31 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Fereidoun Azizi ◽  
Atieh Amouzegar

Abstract Background: Diffuse toxic goiter accounts for about 15% of all childhood thyroid diseases. There is great controversy over the management of Graves’ disease in children and adolescents. This article reports our experience in 304 children and juvenile patients with Graves’ disease. Methods: Between 1981 and 2015, 304 patients aged 5–19 years with diffuse toxic goiter were studied, of whom 296 patients were treated with antithyroid drugs (ATD) for 18 months. Patients with persistent or relapsed hyperthyroidism who refused ablative therapy with surgery or radioiodine were managed with continuous methimazole (MMI) treatment. Results: In 304 patients (245 females and 59 males), the mean age was 15.6±2.6 years. After 18 months of ATD therapy, 37 remained in remission and of the 128 who relapsed, two, 29 and 97 patients chose surgery, continuous ATD and radioiodine therapy, respectively. Of the 136 patients who received radioiodine, 66.2% became hypothyroid. Twenty-nine patients received continuous ATD therapy for 5.7±2.4 years. The mean MMI dose was 4.6±12 mg daily, no serious complications occurred and all of them remained euthyroid during the follow-up. Less abnormal thyroid-stimulating hormone (TSH) values were observed in these patients, as compared to patients who were on a maintenance dose of levothyroxine after radioiodine induced hypothyroidism. Conclusions: Original treatment with ATD and subsequent radioiodine therapy remain the mainstay of treatment for juvenile hyperthyroidism. Continuous ATD administration may be considered as another treatment modality for hyperthyroidism.


2012 ◽  
Vol 69 (5) ◽  
pp. 389-393 ◽  
Author(s):  
Snezana Djordjevic ◽  
Vesna Kilibarda ◽  
Slavica Vucinic ◽  
Tomislav Stojanovic ◽  
Biljana Antonijevic

Background/Aim. Saliva is a body fluid which, like serum, can be used for determination of concentrations of certain drugs, both in pharmacotherapy as well as in acute poisonings. The aim of this study was to determine carbamazepine concentrations in both saliva and serum in acute poisoning in order to show if there is a correlation between the obtained values, as well as to monitor toxicokinetics of carbamazepine in body fluides. Methods. Saliva and serum samples were obtained from 26 patients treated with carbamazepine and 20 patients acutely poisoned by the drug immediately after their admission in the Emergency Toxicology Unit. Determination of salivary and serum carbamazepine concentrations was performed by the validated high pressure liquid chromatographyultraviolet (HPLC-UV) method. Results. A significant correlation of salivary and serum carbamazepine concentrations in both therapeutic application and acute poisoning (r = 0.9481 and 0.9117, respectively) was confirmed. In acute poisonings the mean ratio between salivary and serum concentrations of carbamazepine (0.43) was similar to the mean ratio after its administration in therapeutic doses (0.39), but there were high inter-individual variations in carbamazepine concentrations in the acutely poisoned patients, as a consequence of different ingested doses of the drug. In acute poisoning the halftime of carbamazepine in saliva and serum was 12.57 h and 6.76 h, respectively. Conclusion. Our results suggest a possible use of saliva as an alternative biological material for determination of carbamazepine concentrations in therapeutic application and acute poisoning as well, and a possible extrapolation of the results obtained in saliva to serum concentrations of carbamazepine.


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