scholarly journals The usefulness of conventional and echo colour Doppler sonography in the differential diagnosis of toxic multinodular goitres

2000 ◽  
pp. 339-346 ◽  
Author(s):  
F Boi ◽  
M Loy ◽  
M Piga ◽  
A Serra ◽  
F Atzeni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Autoimmunity ◽  
Peak Systolic Velocity ◽  
Normal Subjects ◽  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma ◽  
Radionuclide Distribution ◽  
Group A ◽  
Group B

OBJECTIVE: To assess the potential role of conventional sonography and colour flow Doppler (CFD) sonography (CFDS) in the differential diagnosis of toxic multinodular goitres. SUBJECTS AND METHODS: We investigated 55 patients with untreated hyperthyroidism (24 with typical toxic diffuse goitre of Graves' disease (Group A); 26 with multinodular goitre (Group B); and five with single toxic adenoma (Group C); 22 euthyroid subjects (12 with non-toxic multinodular goitre (Group D) and ten normal subjects (Group E)) were included as controls. In all cases free thyroxine, free tri-iodothyronine, TSH, TSH receptor antibodies (TRAb), anti-thyroperoxidase antibody, anti-thyroglobulin antibodies and anti-thyroid microsomal antibodies were determined and a [(99m)Tc]pertechnetate thyroid scan was performed. RESULTS: Patients with toxic multinodular goitre displayed two different CFDS patterns: 18 patients (Group B-1) had nodules with normal vascularity surrounded by diffuse parenchymal hypoechogenicity with markedly increased CFD signal and maximal peak systolic velocity (PSV) (a pattern similar to Group A patients with Graves' disease); eight patients (Group B-2) had increased intra- and perinodular CFD signal and PSV with normal extranodular vascularity (a pattern similar to that found in Group C patients with single toxic adenoma). Patients of Group B-1 showed a proportion of clinically evident thyroid ophthalmopathy, positive TRAb and other thyroid autoantibodies similar to that observed in Group A patients, while no evidence of thyroid autoimmunity was found in Group B-2. Sixteen out of 18 (89%) patients from Group B-1 displayed a scintiscan pattern of diffuse uneven radionuclide distribution, while seven out of eight (87.5%) of those from Group B-2 had localized uptake in multiple discrete nodules. Taken together, these data strongly suggest that Group B-1 mostly represents patients with the multinodular variant of Graves' disease, while Group B-2 represents patients with non-autoimmune toxic multinodular goitre. CONCLUSIONS: This study shows that combined conventional sonography and CFDS may easily distinguish nodular variants of Graves' disease from non-autoimmune forms of toxic multinodular goitre and confirms the clinical usefulness of this technique in the first-line evaluation of hyperthyroid patients.

Type of operation for toxic adenoma, toxic multinodular goitre and Graves’ Disease

2015 ◽  
Vol 87 (1) ◽  
pp. 34-37 ◽  
Author(s):  
S. Lanitis ◽  
K. Karkoulias ◽  
G. Sourtse ◽  
V. Ganis
Keyword(s):  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma

scholarly journals Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases

2014 ◽  
Vol 86 (1) ◽  
pp. 9 ◽  
Author(s):  
Domenico Prezioso ◽  
Fabrizio Iacono ◽  
Umberto Russo ◽  
Giuseppe Romeo ◽  
Antonio Ruffo ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Carotid Artery ◽  
Doppler Ultrasound ◽  
Erectile Function ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Cavernosal Artery ◽  
Vascular Origin ◽  
Group A ◽  
Group B

Objective: A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved, although cavernous peak systolic velocity (PSV) is generally considered a major parameter. Nevertheless the penile dynamic color Doppler is invasive and linked to several complications. The intima-media thicknesses (IMT) of cavernosal artery would add to the predictive value of vasculogenic ED risk and outcomes. We also hypothesized the existence of a correlation between IMT cavernosal artery and IMT carotid arteries. This study seeks to evaluate these hypotheses with our experience, investigating the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic ED. Material and methods: A total of 59 subjects (32 vasculogenic ED patients - group A - and 27 no vasculogenic ED patients - group B) were evaluated in our andrological center from September 2012 to June 2013 and enrolled in the study. All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution dynamic color Doppler ultrasound evaluation of carotid and penile districts and valutation of IMT in both districts. Results: The values of cavernosal artery IMT in group A were higher than in group B (0,28 ± 0,06 mm vs 0,17 ± 0,07 mm). Even the values of carotid artery IMT in vasculogenic ED group were higher than in no vasculogenic ED group (0,74 ± 0,14 mm vs 0,59 ± 0,11 mm). The cavernosal IMT showed a moderate (r = 0.61) positive linear correlation (p < 0.001) with the carotid artery IMT. Conclusions: An increased cavernous IMT might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase.

Urinary excretion of glycated protein determined with a specific radioimmunoassay

1991 ◽  
Vol 37 (4) ◽  
pp. 504-507 ◽  
Author(s):  
Chizuko Ukita ◽  
Mitsushige Nishikawa ◽  
Akira Shouzu ◽  
Mitsuo Inada
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Mean Values ◽  
Specific Radioimmunoassay ◽  
Glycated Protein ◽  
Highly Sensitive ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract We developed a simple and highly sensitive RIA for glycated protein (GP), and used it to measure GP in serum and urine from 15 normal controls and 30 diabetics (14 with urinary excretion rate of albumin, Ualb less than 15 micrograms/min, group A; nine with 15 less than or equal to Ualb less than or equal to 150 micrograms/min, group B; and seven with Ualb greater than 150 micrograms/min, group C). The mean serum concentration of GP was above normal in all groups of diabetics, and the mean glycation ratios of serum protein (SGP) were higher in groups B and C than in normal subjects. Urinary concentrations of GP also were increased in groups B and C, although the glycation ratio of urinary protein (UGP) was decreased in group C. Consequently, the selectivity of urinary excretion of GP (UGP/SGP) was significantly decreased in group C. Moreover, there was a significant difference in the mean values of selectivity between groups of patients with various degrees of retinopathy. We suggest that measurements of serum and urinary GP are useful to evaluate the progression of diabetic complications.

Toxicity in Uremia 1. Correlation between PTH Levels and Depressed Cell Proliferation

1988 ◽  
Vol 11 (3) ◽  
pp. 155-158 ◽  
Author(s):  
R. Esposito ◽  
M. Manzo ◽  
M. Hohenegger ◽  
M. Pluvio ◽  
N. Lanzetti ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Normal Subjects ◽  
High Plasma ◽  
Depressing Effect ◽  
Group A ◽  
Uremic Patients ◽  
Group B

Cell proliferation is significantly depressed in uremia; to assess the influence of PTH on it, normal lymphocytes were cultured in presence of uremic patients’ serum with low or high plasma PTH levels (Group A; PTH < 2.5 ng/ml; Group B: PTH > 12 ng/ml), and serum of normal subjects (Group C). Cell proliferation was lowered by serum from both groups (p A vs C < 0.004; p B vs C < 0.001). However, the depressing effect was more evident when group B serum was employed (p A vs B< 0.002).

Fatty acid-independent inhibition of hepatic ketone body production by insulin in humans

1988 ◽  
Vol 254 (6) ◽  
pp. E694-E699 ◽  
Author(s):  
U. Keller ◽  
P. P. Gerber ◽  
W. Stauffacher
Keyword(s):  
Fatty Acid ◽  
Plasma Insulin ◽  
Ketone Body ◽  
Plasma Free Fatty Acid ◽  
Normal Subjects ◽  
Heparin Infusion ◽  
Group A ◽  
Plasma Ffa ◽  
Group B ◽  
Body Production

To investigate whether elevated plasma insulin or glucagon concentrations are capable of modifying hepatic ketogenesis independently of plasma free fatty acid (FFA) concentrations, ketone body production was determined by [3–14C]acetoacetate infusions in overnight-fasted normal subjects during exogenous supply of FFA (Intralipid and heparin infusion). When plasma FFA concentrations were elevated from 0.73 +/- 0.07 to 1.53 +/- 0.16 mmol/l during low insulin concentrations (approximately equal to 13 microU/ml) in group A (n = 7), total ketone body production increased from 3.6 +/- 0.6 to 8.2 +/- 1.0 mumol.kg-1.min-1 (P less than 0.001). When plasma FFA were similarly elevated during raised plasma insulin concentrations (approximately equal to 110 microU/ml) in group B (n = 5), total ketone body production was only 3.8 +/- 0.8 mumol.kg-1.min-1 (P less than 0.01 vs. group A). Low plasma FFA and low insulin concentrations resulted in total ketone body production of 0.70 +/- 0.18 mumol.kg-1.min-1 in group C (n = 7; P less than 0.01 vs. groups A and B). Elevation of plasma glucagon during Intralipid infusion in group D (n = 7) failed to affect ketogenesis, but the beta-hydroxybutyrate-to-acetoacetate concentration ratio decreased significantly (P less than 0.01). The data indicate that elevation of plasma insulin to high physiological concentrations restrains FFA-induced ketogenesis.

Effects of exogenous growth hormone pretreatment on the pituitary growth hormone response to growth hormone-releasing hormone alone or in combination with pyridostigmine in Type I diabetic patients

1991 ◽  
Vol 125 (5) ◽  
pp. 510-517 ◽  
Author(s):  
Andrea Giustina ◽  
Simonetta Bossoni ◽  
Corrado Bodini ◽  
Antonino Cimino ◽  
Giuseppe Pizzocolo ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Blood Glucose ◽  
Normal Subjects ◽  
Diabetic Patients ◽  
Type I ◽  
Gh Secretion ◽  
Glucose Levels ◽  
Group A ◽  
Group B ◽  
And Control

Abstract. We evaluated the effects of iv pretreatment with exogenous GH on the GH response to GHRH either alone or in combination with pyridostigmine in 14 Type I diabetic patients and 6 normal subjects. All the subjects received an iv bolus injection of biosynthetic human GH, 2 IU; 2 h later they received either a. pyridostigmine, 120 mg orally, or b. placebo, 2 tablets orally, followed 1 h later by iv injection of GHRH(1-29) NH2, 100 μg. In normal subjects the median GH peak after GH+GHRH was 1.8, range 1.2-6.9 μg/l. Pyridostigmine enhanced the GH response to GHRH in all subjects. The median GH peak after pyridostigmine+ GH+GHRH was 32.7, range 19.8-42.1 μg/l (p<0.001 vs GHRH alone). Seven diabetic subjects had median GH peaks after GH+GHRH >6.9 μg/l (the maximum GH peak after GH+GHRH in normal subjects) (group A: median GH peak 35.7, range 21.7-55 μg/l). The other diabetic subjects had GH peak lower than 6.9 μg/l (group B: median GH peak 4.4, range 2.1-6.5 μg/l). Pyridostigmine significantly increased the GH response to GHRH in group B patients (median GH peak 29.3, range 15.7-93.4 μg/l, p<0.001 vs GH+GHRH alone), but not in group A patients (median GH peak 39.9, range 21.9-64.9 μg/l). Group A diabetic patients were younger and had higher HbA1c and blood glucose levels than group B patients. In those diabetic patients with an exaggerated GH response to GH+GHRH, pyridostigmine failed to cause the increase in GH secretion observed in diabetic and control subjects with no responses to GH+GHRH. It can be suggested that elevated 24-h GH levels in some Type I diabetic patients may be due to decreased somatostatinergic tone which in turn causes altered autoregulation of GH secretion. We hypothesize that this finding is a consequence of a reset of the hypothalamic control of GH secretion caused by a chronically elevated blood glucose level in this subpopulation.

Circulating Cytokines as Biological Indicators for PE and Ceramics Articulations

2007 ◽  
Vol 361-363 ◽  
pp. 1323-1326
Author(s):  
Silvana Fiorito ◽  
Laura Magrini ◽  
Robert Streicher
Keyword(s):  
Hip Prosthesis ◽  
Ultrahigh Molecular Weight Polyethylene ◽  
Normal Subjects ◽  
Serum Levels ◽  
Biological Indicators ◽  
Tnf Α ◽  
Hip Prosthesis Implantation ◽  
Group A ◽  
Group B ◽  
Circulating Cytokines

We studied the role of cytokines (TNF-α, IL-6,IL-1β, TGF-β) as markers of osteolysis in patients who underwent to a hip prosthesis implantation subdivided in two groups: group A with an ultrahigh molecular weight polyethylene (UHMWPE) insert articulating against a metal ball head , and group B with an all alumina ceramic combination. Profibrogenic (TGF-β) and pro-inflammatory cytokines (TNF-α, IL-6,IL-1β) are secreted by the periprosthetic synovial-like fibrous membrane in hip artificial implants. They are secreted by inflammatory activated cells and trigger the cascade of biochemical events leading to the activation of osteoclasts and bone resorption. A statistically significant increase of TGF-β serum levels was observed between TGF-β values in implanted patients as compared to normal subjects and between TGF-β values after versus before implantation in Group A. A progressive decrease in TNF-α and IL-6 serum levels has been observed in both Groups, when compared with the initial values before the implantation. IL-1β levels decreased up to 60 months after the implantation Our data suggest that monitoring circulating cytokines could be a good indicator for the proliferation and activity of the periprosthetic synovial-like membrane and potential osteolysis. This could allow for an adequate early treatment.

scholarly journals Open angle glaucoma, glaucoma suspect and ocular hypertension in thyroid related immune orbitopathy and other thyroid diseases

2016 ◽  
Vol 8 (1) ◽  
pp. 50
Author(s):  
Saleha Sultana ◽  
Syed Abdul Wadud ◽  
Shabeena Huda ◽  
Sharfuddin Ahmed
Keyword(s):  
Ocular Hypertension ◽  
Multinodular Goiter ◽  
Open Angle Glaucoma ◽  
Thyroid Diseases ◽  
Graves Disease ◽  
Open Angle ◽  
Glaucoma Suspect ◽  
Toxic Multinodular Goiter ◽  
Group A ◽  
Group B

<p><strong>Background:</strong> The eye changes associated with thyroid disease are referred to as Thyroid related Orbitopathy. A well described association exist between open angle glaucoma and thyroid related orbitopathy, the possible relationship between open angle glaucoma and either hypothyroidism or hyperthyroidism without orbitopathy is variable.</p><p><strong>Objective:</strong> To observe the relation of open angle glaucoma (OAG), glaucoma suspect (GS) and ocular hypertension(OHT) between Thyroid related immune orbitopathy (TRIO) and other thyroid diseases (toxic multinodular goiter and hypothyroidism).</p><p><strong>Method:</strong> With purposive type of sampling technique 40 patients of Graves' disease disease in Group-A and 40 patients of other thyroid diseases in Group-B which was subdivided into 20 patients of toxic multinodular goiter in Group-B 1, 20 patients of hypothyroidism in Group-B2 were selected in Bangabandhu Sheikh Mujib Medical University (BSMMU) for this cross sectional study. The diagnosis of Graves' disease, toxic multinodular goiter and hypothyroidism were carried out by history, clinical examination and clinical test in endocrinology department. All the patients underwent complete ocular examinations, measuring of intraocular pressure (IOP), fundus examination, visual field analysis, gonioscopy and exophthalmometry.</p><p><strong>Result:</strong> The OAG, GS and OHT was 7.5% (3 cases), 5.0% (2 cases) and 17.5% (7 cases) respectively in Group-A. In contrast OAG, GS was 5% (lease), 5% (1 case) respectively in Group-Bl, only 5% (1 case) OAG in Group-B2. There was no incidence of OHT in Group-B (B1+B2). Although the occurrence of OAG and GS were higher in Group-A than Group-B, this difference was not statistically significant (p&gt;0.05). However OHT was more common in Group-A than Group-B and is statistically significant (p&lt;0.05). Among the 12 patients with OAG, GS and OHT in Group-A, 11 had ≥22mm exophthalmos. In Group-A, ≥22mm exophthalmos in 60% cases, in contrast none of Group-B have ≥22mm.</p><p><strong>Conclusion:</strong> The occurrence of OHT was higher in thyroid related immune orbitopathy than other thyroid diseases.</p>

scholarly journals Diagnostic performances and clinical usefulness of comprehensive non-commercial software for renogram analysis: Values of renal output efficiency and normalized residual activity in suspected kidney outflow obstruction

2021 ◽  
pp. 3-3
Author(s):  
Slobodanka Beatovic ◽  
Marija Radulovic ◽  
Otas Durutovic ◽  
Milos Veljkovic ◽  
Jelena Saponjski ◽  
...  
Keyword(s):  
Residual Activity ◽  
Area Under The Curve ◽  
Normal Subjects ◽  
Roc Curve Analysis ◽  
Output Efficiency ◽  
Group A ◽  
Group B ◽  
Sensitivity Specificity ◽  
Furosemide Test ◽  
One Way Anova

Introduction/Objective. Nuclear Medicine Section of IAEA has developed the software for dynamic renal scintigraphy, which allows calculation of advanced parameters of drainage: renal output efficiency (OE) and normalized residual activity (NORA). The aim of this study was to validate IAEA software by comparing results of parameters of renal drainage in normal subjects against their established reference values and to assess diagnostic accuracy of OE and NORA in distinguishing between obstruction/unobstruction. Methods. 55 patients with suspected obstruction and 36 kidney donors were investigated. Group A consisted of 24 obstructed kidneys, Group B of 37 kidneys with dilated urinary tract and Group C of 72 normal kidneys. 40min acquisition was applied. Furosemide was administered after 20min. Post-micturition image was acquired at 50min. Parameters analyzed were: OE at 20min (OE20) and at the end of furosemide test (OE40), NORA at 20min (NORA20) and after micturition (NORAPM). One-way ANOVA was used for evaluating differences between Groups. Ability of OE40 and NORAPM to distinguish between obstruction/unobstruction was determined by ROC curve analysis. The sensitivity, specificity, area under the curve and cutoff values were analyzed. Results. Excellent agreement of our results with established OE and NORA values was found. Difference between Groups was significant for OE20, OE40 NORA20 and NORAPM (p < 0.001). Cut-off values for obstruction were 82% and 0.11 for OE40 and NORAPM, respectively. Conclusion. IAEA software gives reliable analysis of diuretic renography and helps to better diagnose obstruction. IAEA should be encouraged to produce final version of the software and to release it through Web site.

scholarly journals Prospective evaluation of autoimmune and non-autoimmune subclinical hypothyroidism in Down syndrome children

2020 ◽  
Vol 182 (4) ◽  
pp. 385-392 ◽  
Author(s):  
Giorgia Pepe ◽  
Domenico Corica ◽  
Luisa De Sanctis ◽  
Mariacarolina Salerno ◽  
Maria Felicia Faienza ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Subclinical Hypothyroidism ◽  
Heart Defects ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Sh Group ◽  
History Of ◽  
Group A ◽  
Group B

Objective To evaluate the prevalence and natural course of autoimmune and non-autoimmune subclinical hypothyroidism (SH) in Down syndrome (DS) children and adolescents. Design Prospective multicenter study. Methods For the study, 101 DS patients with SH (TSH 5–10 mIU/L; FT4 12–22 pmol/L), aged 2–17 years at SH diagnosis were enrolled. Annual monitoring of TSH, FT4, BMI, height, and L-thyroxine dose was recorded for 5 years. Thyroid autoimmunity was tested at diagnosis and at the end of follow-up. Results Thirty-seven out of 101 patients displayed autoantibody positivity (group A); the remaining 64 were classified as non-autoimmune SH (group B). Group A was characterized by higher median age at SH diagnosis and by more frequent family history of thyroid disease (6.6 vs 4.7 years, P = 0.001; 32.4% vs 7.8%, P = 0.001 respectively), whereas congenital heart defects were more common in group B (65.6% vs 43.2%, P = 0.028). Gender, median BMI (SDS), height (SDS), FT4, and TSH were similar in both groups. At the end of follow-up: 35.1% of group A patients developed overt hypothyroidism (OH) vs 17.2% of group B (P = 0.041); 31.25% of group B vs 10.8% of group A became biochemically euthyroid (P = 0.02); and 37.8% of group A vs 51.5% of group B still had SH condition (P = 0.183). Logistic regression suggested autoimmunity (OR = 3.2) and baseline TSH values (OR = 1.13) as predictive factors of the evolution from SH to OH. Conclusions In DS children, non-autoimmune SH showed higher prevalence and earlier onset. The risk of thyroid function deterioration over time seems to be influenced by thyroid autoimmunity and higher baseline TSH values.

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