scholarly journals The Feasibility of High Dose Iodine 131 Treatment as an Alternative to Surgery in Patients with a Very Large Goiter: Effect on Thyroid Function and Size and Pulmonary Function*

1999 ◽  
Vol 84 (10) ◽  
pp. 3636-3641 ◽  
Author(s):  
Steen J. Bonnema ◽  
Henrik Bertelsen ◽  
Jesper Mortensen ◽  
Peter B. Andersen ◽  
Dorthe U. Knudsen ◽  
...  

Abstract Some patients with very large goiters (>150 mL) are not candidates for surgery. We evaluated the feasibility of high dose 131I in such patients. Twenty-three patients (2 men and 21 women; median age, 67 yr; range, 42–86 yr) with very large goiter (8 toxic) were treated with calculated high dose 131I [median, 2281 megabecquerels (61.6 mCi); range, 988-4620 megabecquerels (26.7–124.9 mCi)]. During the 12-month observation period, goiter reduction and tracheal anatomy were monitored by magnetic resonance imaging, and the respiratory capacity was monitored by pulmonary function tests. Five patients (22%) developed hypothyroidism. Thyroid volumes were at baseline, after 1 week, and after 1 yr [mean ± sem, 311 ± 28, 314 ± 26 (P = NS), and 215 ± 26 (P < 0.01) mL]. The relative changes 1 week after therapy ranged from −14.1% to 15.3%. After 1 yr the mean size was reduced by 33.9% (range, 13.5–61.4%). Only the initial goiter size showed a significant negative correlation to the percent reduction. The smallest cross-sectional area of the trachea decreased 9.2% within 1 week after treatment, but eventually emerged with a 17.9% larger area [mean ± sem, 84.3 ± 4.8, 75.5 ± 5.1 (P < 0.01), and 98.2 ± 6.0 (P < 0.01) mm2]. The inspiratory parameter, FIF50%, improved after an initial insignificant decline[ baseline therapy, after 1 week, after 3 months, and after 1 yr (mean ± sem), 2.37 ± 0.24, 2.20 ± 0.21 (P = NS), 2.51 ± 0.23 (P= NS), and 2.76 ± 0.25 (P = 0.01) L/s]. FIF50% correlated significantly with the smallest cross-sectional tracheal area (baseline, 1 week, and 1 yr: r = 0.74; P < 0.001, r = 0.63; P < 0.005, and r = 0.46; P < 0.05). Changes in tracheal anatomy did not correlate with changes in either lung dynamics or goiter size. In conclusion, very large goiters can be reduced by a third, on the average, with high dose 131I therapy without any initial clinically significant tracheal compression. Tracheal cross-sectional area as well as pulmonary inspiratory capacity improve. No serious adverse effects are seen.

1999 ◽  
Vol 46 (5) ◽  
pp. 628 ◽  
Author(s):  
Chan Ju Lee ◽  
Jae Ho Lee ◽  
Jae Woo Song ◽  
Chul Gyu Yoo ◽  
Young Whan Kim ◽  
...  

2014 ◽  
Vol 121 (3) ◽  
pp. 621-630 ◽  
Author(s):  
Naoya Matsuda ◽  
Hiroki Ohkuma ◽  
Masato Naraoka ◽  
Akira Munakata ◽  
Norihito Shimamura ◽  
...  

Object Cerebral vasospasm after subarachnoid hemorrhage (SAH) is a serious complication. Free radicals derived from subarachnoid clotting are recognized to play an important role. Oxidized low-density lipoprotein (ox-LDL) and lectin-like oxidized LDL receptor-1 (LOX-1) have been shown to be related to the pathogenesis of atherosclerosis and may increase in cerebral arteries after SAH, due to the action of free radicals derived from a subarachnoid clot. These molecules may also affect the pathogenesis of vasospasm, generating intracellular reactive oxygen species and downregulating the expression of endothelial NO synthase (eNOS). If so, apple polyphenol might be effective in the prevention of vasospasm due to an abundant content of procyanidins, which exhibit strong radical scavenging effects, and the ability to suppress ox-LDL and LOX-1. The purposes of this study were to investigate changes in levels of ox-LDL and LOX-1 after SAH and whether administering apple polyphenol can modify cerebral vasospasm. Methods Forty Japanese white rabbits were assigned randomly to 4 groups: an SAH group (n = 10); a shamoperation group (n = 10), which underwent intracisternal saline injection; a low-dose polyphenol group (n = 10) with SAH and oral administration of apple polyphenol at 10 mg/kg per day from Day 0 to Day 3; and a high-dose polyphenol group (n = 10) with SAH and oral administration of apple polyphenol at 50 mg/kg per day. At Day 4, the basilar artery and brain was excised from each rabbit. The degree of cerebral vasospasm was evaluated by measuring the cross-sectional area of each basilar artery, and the expression of ox-LDL, LOX-1, and eNOS was examined for each basilar artery by immunohistochemical staining and reverse transcriptase polymerase chain reaction. In addition, neuronal apoptosis in the cerebral cortex was evaluated by TUNEL. Results Compared with the sham group, the expression of ox-LDL and LOX-1 in the basilar arterial wall was significantly increased in the SAH group, the expression of eNOS was significantly decreased, and the cross-sectional area of basilar artery was significantly decreased. Compared with the SAH group, the cross-sectional area of basilar artery was increased in the polyphenol groups, together with the decreased expression of ox-LDL and LOX-1 and the increased expression of eNOS. In the high-dose polyphenol group, those changes were statistically significant compared with the SAH group. In the low-dose polyphenol group, those changes were smaller than in the high-dose polyphenol group. No apoptosis and no changes were seen in the cerebral cortex in all groups. Conclusions This is the first study suggesting that ox-LDL and LOX-1 increase due to SAH and that they may play a role in the pathogenesis of vasospasm. It is assumed that procyanidins in apple polyphenol may inhibit a vicious cycle of ox-LDL, LOX-1, and ROS in a dose-dependent manner. Apple polyphenol is a candidate for preventive treatment of cerebral vasospasm.


2006 ◽  
Vol 31 (5) ◽  
pp. 490-494 ◽  
Author(s):  
Andrea R. Campos ◽  
Luciano N. Serafini ◽  
Claudia Sobreira ◽  
Luciana G. Menezes ◽  
José A.B. Martinez

Myopathy is a well-known side effect of corticosteroid therapy. Creatine monohydrate (Cr) supplementation has been shown to increase fat-free mass and muscular function. This study aimed to investigate if Cr administration could offset the deleterious functional effects of high doses of steroids. Fifty-six male Syrian golden hamsters were randomized among 4 groups: GI (n = 10), subcutaneous (s.c.) and intraperitoneal (i.p.) saline; GII (n = 10), s.c. saline and i.p. Cr (600 mg·kg–1·d–1); GIII (n = 18), s.c. dexamethasone (7.5 mg·kg–1·d–1) and i.p. saline; and GIV (n = 18), s.c. dexamethasone and i.p. Cr. Daily voluntary running was measured using activity wheels for 18 d. At the end of the study, statistically significant differences in running were observed between all groups, except for GI versus GII (GI, 8878 ± 2737 m; GII, 9145 ± 2000 m; GIII, 4289 ± 2623 m; GIV, 6339 ± 2345 m). Dexamethasone led to a significant decrease in cross-sectional area of type II fibers of the medial gastrocnemius. The cross-sectional area of type I fibers was significantly larger in GIV than in GIII. In conclusion, Cr administration attenuated the impairment of daily spontaneous running of hamsters receiving a high dose of corticosteroids. Additional research is needed to clarify the clinical implications of this finding.


1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.


2020 ◽  
Vol 0 (4) ◽  
pp. 19-24
Author(s):  
I.M. UTYASHEV ◽  
◽  
A.A. AITBAEVA ◽  
A.A. YULMUKHAMETOV ◽  
◽  
...  

The paper presents solutions to the direct and inverse problems on longitudinal vibrations of a rod with a variable cross-sectional area. The law of variation of the cross-sectional area is modeled as an exponential function of a polynomial of degree n . The method for reconstructing this function is based on representing the fundamental system of solutions of the direct problem in the form of a Maclaurin series in the variables x and λ. Examples of solutions for various section functions and various boundary conditions are given. It is shown that to recover n unknown coefficients of a polynomial, n eigenvalues are required, and the solution is dual. An unambiguous solution was obtained only for the case of elastic fixation at one of the rod’s ends. The numerical estimation of the method error was made using input data noise. It is shown that the error in finding the variable crosssectional area is less than 1% with the error in the eigenvalues of longitudinal vibrations not exceeding 0.0001.


Author(s):  
S.Sh. Gammadaeva ◽  
M.I. Misirkhanova ◽  
A.Yu. Drobyshev

The study analyzed the functional parameters of nasal breathing, linear parameters of the nasal aperture, nasal cavity and nasopharynx, volumetric parameters of the upper airways in patients with II and III skeletal class of jaw anomalies before and after orthognathic surgery. The respiratory function of the nose was assessed using a rhinomanometric complex. According to rhinoresistometry data, nasal resistance and hydraulic diameter were assessed. According to the data of acoustic rhinometry, the minimum cross-sectional area along the internal valve, the minimum cross-sectional area on the head of the inferior turbinate and nasal septum and related parameters were estimated. According to the CBCT data, the state of the nasal septum, the inferior turbinates, the nasal aperture, the state of the nasal cavity, and the linear values of the upper respiratory tract (nasopharynx) were analyzed. The patients were divided into 4 groups according to the classification of the patency of the nasal passages by


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