Graves' ophthalmopathy after total thyroidectomy for papillary carcinoma

We report the case of a 53-year-old woman who underwent two-phase total thyroidectomy (June and December 2001) for a multinodular goiter with incidental discovery at the first procedure of a multicentric papillary carcinoma of the right thyroid lobe. Thyroidectomy was followed by an ablative dose of 131-radioiodine because of the presence of residual tissue in the neck. The various elements of the follow-up are reassuring: no residual tissue was detected at the ultrasonography of the neck and thyroglobulin was undetectable in the absence of antithyroglobulin autoantibodies. In April 2006, the patient developed unilateral Graves’ ophthalmopathy with the appearance of antithyrotropin receptor autoantibodies (TRAb). Ophthalmopathy progressively improved, in parallel to the decrease of TRAb. The parallel trend of TRAb and the ophthalmopathy supports the major role of TRAb in the pathogenesis of thyroid-associated ophthalmopathy. This observation also shows the possibility of developing autoantibodies in the absence of detectable thyroid tissue.     

Gallbladder volume and contractility in term and preterm neonates: normal values and clinical applications in ultrasonography

The aim of this study was to establish the normal values and evaluate associated factors of gallbladder volume and contractility in term and preterm neonates by using ultrasonography. Sonographic measurement of gallbladder volume was performed by using the ellipsoid method in 50 preterm and 46 term infants. We collected data soon after delivery and at 6-h fasting, and at 3-h and 6-h fasting following regular milk feeding. Serial postprandial changes of gallbladder volume and contractility were collected at 15-min intervals for one hour. Gallbladder contraction index (C.I.) was determined as percentage decrement of postprandial size from initial size. Fasting gallbladder volume was larger in term group ( p < 0:05). Term neonates more readily showed significant contraction (C.I. > 50%; p < 0:05). In preterm infants significant contraction was clearly observed at postconceptional age > 31 weeks or body weight > 1300 g. The presence of hepatobiliary diseases might be detected by evaluating serial changes of gallbladder volume and contractility under ultrasonography in the neonatal stage.     

Consequences of analysing complex survey data using inappropriate analysis and software computing packages

In the analysis of complex survey data such as stratified multi-stage cluster samples, ignoring the design effects such as clustering and stratification usually will lead to erroneous conclusions. In this paper, we will demonstrate the consequences in the estimation of means and proportions by two examples from a stratified two-stage cluster sample. A brief review of methodology will be presented, and some suggestions on computational issues will be provided.     

Iodine status in vegans consuming a living food diet

The dietary intake and urinary output of iodine and the thyroid activity was measured in 12 living food eaters (people consuming uncooked, Lactobacilli rich vegan food) and omnivores. Seven day food record was used for calculating the dietary iodine intake, instrumental neutron activation analysis for measuring the urinary iodine output and RIA for determining of the thyroid hormones (TSH and FT4). The living food eaters were divided into two groups according to urinary iodine output: high iodine group (≥900 ug/d) and low iodine group (<200 ug/d). Thyroid activity in both groups was with in normal range. Dietary intake of iodine was dependent on the the use of seaweed. The highest amounts of dietary iodine observed in the present study, as assessed by the the urinary iodine output, can be harmful for susceptible subjects. On the other hand the calculated intake of iodine by living food eaters didn't fill the RDA. As an conclusion on a living food diet one has to ensure the sufficient intake of iodine by consuming seaweed or Kelp tablets daily. However the intake of these preparations needs to be kept at reasonble limits due to their possible high iodine content. More information of the iodine content of different seaweeds and seaweed products is needed.     

Effect on caries in mentally handicapped children of addition of fluoride and bicarbonate-phosphate to dietary sugar products

Abstract— Mentally handicapped children, aged 5–15 years and living in institutions, received fluoride supplement in several sugar products of their diet; in candies, marmalades, jams, fruit juices and in sweet desserts corresponding to 10 mg F as NaF per kg of the sugar (sucrose or glucose) of each product. To two of the four daily candies was also added a NaHCO₃+KH₂PO₄ mixture (mole ratio 9.8/1, resp.) to substitute for 2.5% of the sugar of the candy. The control children received the respective products without the additives. After stepwise exclusions of subjects for various reasons, e.g. for the absence of permanent teeth, low initial caries activity, strong medication, Down's syndrome, etc, the mean DMFS-increment in the remaining 48 control subjects was 4.5 and in the 41 test subjects 2.6 lesions/100 surfaces at risk, i.e. 42% reduction. Caries arrestment had occurred in these test subjects after the first year, while in the respective controls it was cantinuously increasing. Among numerous oral and body parameters. studied, only surface enamel fluoride in primary teeth was increased by the fluoride supplements and urinary phosphate and calcium excretion decreased.     

Prognostic significance of complement alleles Bf and C4 in early rheumatoid arthritis

Summary The prognostic significance of class III major histocompatibility complex complement components, factor B (Bf), C4A and C4B, were studied in a 3-year prospective study of 73 patients with early RA. Patients with C4B null allele had higher disease activity with more radiological progression than patients with C4A null allele or patients without null alleles. C4B null allele also associated with increased susceptibility to side effects from antirheumatic treatment. The Bf phenotypes did not associate with the severity of RA. C4B null allele may have prognostic significance in determining a special subgroup of RA patients with a more complicated course of the disease.     

Modulation of CYP1A1 activity by a Ginkgo biloba extract in the human intestinal Caco-2 cells

Ginkgo biloba is a widely consumed dietary supplement. Some dietary active compounds modulate the activity of biotransformation enzymes inside the enterocytes and more interestingly of cytochrome P-450 1A1 (CYP1A1). This enzyme is of a particular interest because of its implication in the metabolism of some exogenous pro-carcinogens or endogenous molecules. In the present work, we have used Caco-2 cells to study the effect of a standard reference material of a Ginkgo biloba extract (GBE) (10-400 μg/ml), as well as of its major individual active compounds (kaempferol, quercetin, isorhamnetin, ginkgolides and bilobalide), alone or in mixtures, at realistic intestinal concentrations, on the induction of CYP1A1 activity, in the presence or absence of benzo[a]pyrene (B[a]P) (0.1 μg/ml), a well-known CYP1A1 inducer. 3-O-rutinosides of kaempferol, quercetin and isorhamnetin were also tested. We have demonstrated a strong induction (p < 0.005) of CYP1A1 activity and a slight, but significant (p < 0.005), decrease of this activity in the presence of B[a]P by the GBE at the realistic exposure level of 100 μg/ml. The inductive effect was explained, in part, by quercetin and kaempferol after 24 h exposure while unknown compounds seem to be responsible for the strong CYP1A1 induction observed after 6 h exposure. The inhibitory potency of flavonols on CYP1A1 activity in presence of B[a]P was much stronger for the aglycones than for the 3-O-rutinosides, explaining the slight effect observed with the GBE, mainly composed of glycosylated flavonoids. These results indicate that GBEs may disturb intestinal CYP1A1 activity and, in turn, affect the metabolism of other compounds. The present paper thus highlights the necessity to take these side effects into account when administrating Ginkgo biloba herbal supplements.