Surgical treatment of thyrotoxicosis.

A retrospective study of thyrotoxic patients treated by subtotal thyroidectomy between 2 and 21 years ago in the north-east of Scotland showed that 20% of the patients could not be identified or traced at the time of the survey. The thyroid status of 40% of patients followed up was abnormal.It is now accepted that radioiodine treatment of thyrotoxicosis is followed by a significant incidence of late onset hypothyroidism, and life-long follow-up is regarded as obligatory. The findings in this study indicate that similar methods of aftercare are required for surgically treated patients and for all patients receiving thyroxine-replacement therapy.     

Pregnancy outcome after treatment with radioiodine for differentiated thyroid carcinoma

The aim of the study was to investigate the influence of radioiodine (RAI) therapy on pregnancies and the health status of children born to mothers who had received therapeutic doses of I-131 for differentiated thyroid carcinoma (DTC). Gestational histories of 76 women treated for DTC from 1971-2005 were retrospectively analyzed. The outcome of 49 pregnancies after RAI was: 35 children (72%), 5 (10%) miscarriages and 9 (18%) induced abortions. RAI did not adversely affect the rate of successful delivery and live birth demographics. Congenital malformation and first year mortality were not observed. The children's ages range from 1 month to 29 years (chi+/-SD=8.0+/-8.4). A higher therapeutic dose (>100 mCi) did not significantly alter the pregnancy outcome. There is no reason to discourage females treated with 1-131 from becoming pregnant. Patients should avoid pregnancy after RAI administration for 1 year.     

Severe euthyroid cardiac disease; technique for treatment with radioiodine

It is possible to safely lower the basal metabolism of patients suffering from severe cardiac disease by administering multiple small doses of radioiodine in order to achieve symptomatic relief. From the present study, multiple small doses of I(131) appeared to be as effective as single or multiple large doses of this material and complications such as thyroiditis, temporary thyrotoxicosis and bone marrow depression were almost always avoided. No damage to the parathyroid glands or the recurrent laryngeal nerve was observed. No radiation sickness developed after therapy.A scintigram of the thyroid gland was useful in determining the size, shape and function of the thyroid gland before and during radioiodine treatment and helped to determine the need for additional treatment. In order to prevent the distressing symptoms of the myxedema state, desiccated thyroid was administered when necessary. In the series of 278 euthyroid patients with severe cardiac disease who were treated with radioactive iodine, results were excellent in 35 per cent of cases and good in 44 per cent. In 21 per cent there was no improvement.     

Thyroidectomy as the last chance treatment for life threatening thyrotoxicosis. Case report

The case of 54-year old woman with severe Graves thyrotoxicosis and antithyroid drugs intolerance is presented. She was admitted to Endocrinology Department and therapy with propranolol, lithium, glucocorticoids, iodine contrast media was instituted. Then ablative dose of radioiodine was given; all these appeared to be ineffective. To avoid thyrotoxic storm thyroidectomy was undertaken. Surgical procedure was uneventful and successful. Surgical intervention should be considered in severe life-threatening cases of thyrotoxicosis.     

How often should patients be reviewed after treatment with iodine-131 for thyrotoxicosis?

Six to 18 years after treatment with iodine-131 for thyrotoxicosis 69 euthyroid patients with raised serum thyrotrophin (TSH) concentrations (mean 25.0 +/- SE 2.0 mU/l) and 61 with normal concentrations (mean 4.0 +/- 0.2 mU/l) were included in a prospective five-year follow-up study beginning in 1972. During this period 13 patients from the original group with raised serum TSH concentrations became hypothyroid. In contrast it was five years before hypothyroidism developed in a single patient from the group with normal serum TSH concentrations in 1972, although raised concentrations were recorded in 19 of these patients during the study.     

Apathetic thyrotoxicosis

Apathetic thyrotoxicosis is an atypical though not rare manifestation of hyperthyroidism. The cardinal features are apathy and depression, as opposed to hyperkinesis and mental alertness in the usual thyrotoxic patient, and are unassociated with the usual signs and symptoms of hyperthyroidism, making the diagnosis difficult. We report three cases of apathetic thyrotoxicosis seen during one year.     

一种消除转基因植物潜在风险的新技术

多年来,科学家们一直为寻求解决转基因植物安全性问题的有效工具而不懈努力。美国康涅狄格大学华人科学家李义教授领导的研究小组,经过6年多的深入研究,在此领域实现了重大突破,2007年发表了“外源基因清除”技术(Gene-deletor)。该技术整合了Cre/LoxP和FLP/FRT双重组系统,用器官或组织特异启动子驱动FLP/Cre,在外源基因发挥功能之后,可将其从转基因植物的花粉、果实和种子中彻底清除,可有效防止转基因植物的外源基因向非转基因植物或杂草的逃逸,从而消除公众对转基因植物生态和食品安全的担忧。 着重介绍了“外源基因清除”技术(Gene-deletor)的概念、作用机制及其潜在应用。