Graves' Disease Associated with Histologic Hashimoto's Thyroiditis

1985 ◽  
Vol 93 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Stephen A. Falk ◽  
Eric A. Birken ◽  
A. H. Ronquillo

The microscopic slides of 16 patients who underwent bilateral subtotal thyroidectomy for hyperthyroid Graves' disease were reviewed and classified into three groups: I, Hashimoto's thyroiditis; II, Graves' disease; and III, both Hashimoto's thyroiditis and Graves' disease. Three patients were classified as group 1, 10 as group II, and three as group III. In 38% of the patients with clinical Graves' disease the histologic evidence of Hashimoto's thyroiditis could be found either alone or in combination with histologic evidence of Graves' disease (groups I and III). One patient in group I, four in group II, and three in group III had infiltrative ophthalmopathy (50% of total). Hyperthyroid Graves' disease, Graves' ophthalmopathy, and Hashimoto's thyroiditis can occur all together, in duads, or individually at a specific time in a patient's life.

2020 ◽  
Vol 6 (2) ◽  
pp. 3-10
Author(s):  
Anshul ◽  
Kaushal Kishor Jha

Aim: Teeth are constantly going through cycles of demineralization and remineralization. The ultimate goal of clinical intervention is the preservation of tooth structure and the prevention of lesion progression to the point where restoration is required. Thus promoting remineralization is the ultimate goal of clinical prevention of caries lesion. The present in vitro study aimed to investigate the efficacy of GC Tooth Mousse (CPP-ACP) and GC Tooth Mousse Plus (CPP-ACP)F  on artificial enamel caries in primary human teeth.   Methods and Material:    Sixty freshly extracted human primary anterior teeth were used in this study.      The root portion of 60 primary anterior teeth was separated from the crown portion at the cemento-enamel junction (CEJ)      Teeth samples were divided into 3 Groups (n=20 each). Group 1 as a control group, Group 2  GC Tooth Mousse, and Group 3 Tooth Mousse Plus containing dentifrices were used. Samples were subjected to 10 days of pH cycling protocol. The changes were analyzed using Vickers Hardness Testing Machine and SEM.    Pre and post groups were compared by paired t-test.  Independent groups were compared by one-way analysis of variance.   Result: Micro-morphological observations of the enamel surfaces with SEM :      Group 1 the enamel scanning showed shallow depressions and fine porosities within these depressions, Group 2 showed numerous granular particles and amorphous crystals which were arranged on the enamel surface. Smooth, homogeneous surface, and no irregularities were seen in Group 3. Surface Microhardness Evaluation   After treatment, the mean hardness Group III was the highest followed by  Group II and Group I (i.e. Group I < Group II < Group III).   Conclusion:  GC Tooth Mousse Plus showed a statistically significant amount of remineralization.


2011 ◽  
Vol 18 (04) ◽  
pp. 575-580
Author(s):  
IMRAN HUSAIN ◽  
MUHAMMAD MUZAMMIL TAHIR ◽  
SHAHZAD ASHRAF ◽  
Muhammad Usman Khan

Purpose: We compared postoperative outcome of conventional large bore percutaneous nephrolithotomy (PCNL) with small bore and tubeless percutaneous ephrolithotomy (PCNL). Study Design: prospective randomized trial. Period: August 2008-2009 Setting: Shaikh Zayed Hospital Lahore. Materials and Methods: The study included 90 patients randomized in three groups. Group. 1 included 30 patients who underwent conventional PCNL with large bore 16 fr nephrostomy tube, Group2 included 30 patients, PCNL with small bore 10 fr nephrostomy tube, and Group3 included 30 patients who had tubeless PCNL. Comparison was made in the terms of analgesia requirement, fever, duration of urinary leak and hospital stay. Results: In Group 1 analgesia requirement ranged from 40-70mg mean 50mg, in Group II, it was 30-60mg with mean 47.3mg while in Group III, The requirement of analgesia was 10-50mg with mean 21.1mg, p<0.005. Hospital stay was between 4 to 7days, mean 5.7days in group I while in group II, stay was between 3 to 5 days, mean 4.3days and in group III, it was between 1 to 4 days, mean 3.17days, p <0.005. Twelve patients had fever in group I, In group II, eleven patients while in group III, five patients developed fever, p <0.005. Leakage of urine from site of wound in group I was observed between 0 to 5 days while in group II leakage was between 0 to 4 days, and the leakage period reduced in group III from 0 to 2 days p <0.005. Conclusions: Tubeless PCNL is associated with the least postoperative pain. urinary leakage, fever and hospital stay, it’s a good option after an uncomplicated percutaneous renal procedure 


2020 ◽  
Vol 11 ◽  
pp. 204201882090701
Author(s):  
Hanaa Tarek El-Zawawy ◽  
Huda Fahmy Farag ◽  
Mona Mohamed Tolba ◽  
Hanaa Abdalbasit Abdalsamea

Background: Hashimoto’s thyroiditis (HT) is a common autoimmune disorder that causes significant morbidity. Interleukin (IL)-17 was identified as a major contributing factor in the pathogenesis of HT. Blastocystis hominis (BH) is a very common infection and has been shown to be associated with several diseases. Our aim was to determine serum IL-17 level in HT patients with and without BH infection and the effect of eradicating BH in patients with HT. Methods: A prospective cohort study was conducted on 20 HT patients not infected with BH (group I), 20 HT patients infected with BH (group II), and 20 healthy patients (group III). Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (anti-TPO), and IL-17 were performed by ELISA method and were repeated in group II after 6 weeks of eradication of BH. Results: Patients with HT showed a significantly higher serum IL-17 compared with controls. IL-17 was significantly higher in HT patients infected with BH compared with HT patients not BH infected (mean 6.93 ± 2.83 pg/ml versus 3.25 ± 1.55 pg/ml, p = 0.003). After BH eradication TSH, anti-TPO, and IL-17 were significantly decreased (mean 14.76 ± 11.11 µIU/ml versus 9.39 ± 7.11 µIU/ml, p < 0.001; mean 308 ± 175.6 IU/ml versus 295.4 ± 167.1 IU/ml, p = 0.006; and mean 6.93 ± 2.83 pg/ml versus 6.45 ± 2.48 pg/ml, p < 0.001), respectively. Multivariate analysis after treating BH infection showed that IL-17 was significantly negatively correlated with FT3 (adjusted p = 0.002) and significantly positively correlated with anti-TPO (adjusted p = 0.045). Conclusion: Treatment of BH infection ameliorates HT through reduction in IL-17, anti-TPO, and TSH. Clinical trial registration number: PACTR201909495111649


2019 ◽  
Vol 70 (2) ◽  
pp. 1461
Author(s):  
Ş DURSUN

The aim of this study was to investigate the efficacy of different short term synchronization protocols on estrus and pregnancy rates in merino ewes that had not become pregnant after at least three matings during the breeding season. Three different protocols were used as follows: Group I: Ewes (n=30) were inserted intravaginal progesterone sponge (florogestan asetate; 30 mg) for 6 days plus PGF2α (125 μg, i.m.) at the time of sponge removal, Group II: Ewes (40) were treated same as in group 1 plus eCG (250 IU, i.m.) at time of sponge removal, and Group III: Ewes (n=38) were only injected with PGF2α at the same time with the ewes in the other two groups. Estrus was detected by rams (n=4), 24 hours after PGF2α and ewes detected in estrus were mated. Ten rams were used for mating. Pregnancy was diagnosed 60 days after mating by ultrasonography. Estrus, conception and pregnancy rates were: for Group I 100%, 73.3% and 73.3%, for Group II 92.5%, 89.2% and 82.5% and for Group III 81.6%, 100% and 81%. In Group III, pregnancy loss after pregnancy diagnosis was significantly higher (35.4%) compared with the other groups (Group I: 13.6% and Group II: 15%).


Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.


1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.


2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.


2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>


2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


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