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  1. Grave Markers.

    ERIC Educational Resources Information Center

    DeMuro, Ted

    1985-01-01

    Junior high school students studied the cultural uses, symbolic meanings, and general physical forms of tombs and tombstones and then used basic slab building techniques to construct large clay grave markers. (RM)

  2. [Graves' ophthalmopathy].

    PubMed

    Eckstein, A; Dekowski, D; Führer-Sakel, D; Berchner-Pfannschmidt, U; Esser, J

    2016-04-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.

  3. Graves disease (image)

    MedlinePlus

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

  4. Modeling Graves' Orbitopathy in Experimental Graves' Disease.

    PubMed

    Banga, J P; Moshkelgosha, S; Berchner-Pfannschmidt, U; Eckstein, A

    2015-09-01

    Graves' orbitopathy (GO), also known as thyroid eye disease is an inflammatory disease of the orbital tissue of the eye that arises as a consequence of autoimmune thyroid disease. The central feature of the disease is the production of antibodies to the thyrotropin hormone receptor (TSHR) that modulate the function of the receptor leading to autoimmune hyperthyroidism and GO. Over the years, all viable preclinical models of Graves' disease have been incomplete and singularly failed to progress in the treatment of orbital complications. A new mouse model of GO based upon immunogenic presentation of human TSHR A-subunit plasmid by close field electroporation is shown to lead to induction of prolonged functional antibodies to TSHR resulting in chronic disease with subsequent progression to GO. The stable preclinical GO model exhibited pathologies reminiscent of human disease characterized by orbital remodeling by inflammation and adipogenesis. Inflammatory lesions characterized by CD3+ T cells and macrophages were localized in the orbital muscle tissue. This was accompanied by extensive adipogenesis of orbital fat in some immune animals. Surprisingly, other signs of orbital involvement were reminiscent of eyelid inflammation involving chemosis, with dilated and congested orbital blood vessels. More recently, the model is replicated in the author's independent laboratories. The pre-clinical model will provide the basis to study the pathogenic and regulatory roles of immune T and B cells and their subpopulations to understand the initiation, pathophysiology, and progression of GO.

  5. Don Graves Remembered

    ERIC Educational Resources Information Center

    Romano, Tom

    2011-01-01

    Don Graves died Tuesday, September 28, 2010. In the early 1980s, Don blew open the door to teaching children to write. His qualitative research and subsequent 26 books transformed the teaching of writing in elementary schools. He showed how much could be learned by the simple, powerful strategy of sitting beside children and asking them about…

  6. Determination of grave disability.

    PubMed

    Wilbert, D E; Jorstad, V; Loren, J D; Wirrer, B

    1976-01-01

    There is a historical dilemma concerning the civil rights of psychiatric patients who are believed to need a protected status because of incompetency. California's Lanterman-Petris-Short Act provides a mechanism for putting the patient under the care of a conservator if the patient is unable to provide for his own personal needs of food, clothing, and shelter. If successful, this legislation will likely be the model for the country. Fifty-one patients for whom the clinical staff desired to initiate conservatorship proceedings were given a test consisting of behavioral tasks specifically designed to be appropriate to the legal definition of grave disability. The natural groupings were: chronic organic brain syndrome, chronic schizophrenia, and other. We found that the grave disability of the organic brain syndrome patients was fairly predictable from their mental status examination, while the grave disability of the chronic schizophrenic patients was unpredictable from their mental status examination and required the application of the behavioral test for an appropriate determination of their ability to perform the functions specified in the law: The Lanterman-Petris-Short Act to provide for personal needs of food, clothing, and shelter. When the method or the proceedings were applied to patients of other diagnostic categories, they were found to be inappropriate. At this writing, our method of evaluation is being recognized and requested by public and legal agencies in our area. It has been used as evidence in court. The procedure is clear, relevant, and easily taught to new workers. The results, given in plain English and in essay form, are readily understood by physician, social worker, judge, and jury alike. We began our study with vexation, ambiguous criteria, and a chronic medical and legal problem; we conclude with a practical and relevant answer.

  7. Prevention of Graves' ophthalmopathy.

    PubMed

    Bartalena, Luigi

    2012-06-01

    Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. PMID:22632372

  8. Graves Opthalmopathy and Psychoendocrinopathies

    PubMed Central

    Ghanem, Asaad A.; Amr, Mostafa A.; Araafa, Lamiaa F.

    2010-01-01

    Purpose: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO). Design: A prospective, controlled, University Hospital based study Subjects and Methods: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup. Psychiatric changes were assessed with the Middlesex Hospital Questionnaire (MHQ). Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone (TSH) concentrations, TSH receptor antibody (TRAb) activity and anti-thyroglobulin particle agglutination (TGPA) and antithyroid microsomal particle agglutination (MCPA). Results: The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group (P<0.0001). The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group (P<0.05). The scale scores of depression and phobia showed a positive correlation with scores of anxiety (P<0.0001). The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria (P<0.0001). Conclusion: The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO. PMID:20616926

  9. The pathogenesis of Graves' disease.

    PubMed

    Gossage, A A; Munro, D S

    1985-05-01

    The abnormally increased thyroid activity that is characteristic of Graves' disease is caused by immunoglobulins which specifically interact with the thyroid cell and stimulate it. Increases and decreases in thyroid activity in Graves' disease can be clearly related to rise and fall of these immunoglobulin-mediated activities. The level of immunoglobulin stimulatory activity can be used for prediction of the likelihood of neonatal Graves' disease and of recurrence of disease after cessation of treatment with antithyroid drugs. Investigation of patients with Graves' disease and their families has led to identification of particular human leukocyte antigens and genetically linked markers on immunoglobulins which both appear to incur increased susceptibility to certain autoimmune diseases. Differences in immune function, when compared with control populations, have been found in patients with these genetically linked markers. Protection against autoimmune disease is maintained by purposeful inhibition of any self-directed activity within each function of the immune system and by the controlling interaction of other immune functions. No single deficiency of immune function can be selected as giving the major risk of autoimmune disease, but rather a sum of relative defects resulting in an increased risk. In some patients with Graves' disease the self-protection mechanisms regain sufficient control of the immune functions to reduce the activity of the autoimmune disease, and the patient may achieve clinical remission. Often, however, there is evidence that abnormal immune activity directed against thyroid tissue has persisted with liability to recurrence of the Graves' disease.

  10. Digging your own grave: OSL signatures in experimental graves.

    PubMed

    Kemp, Justine; Pietsch, Timothy J; Olley, Jon

    2014-11-01

    Excavation of mock graves in sediments of aeolian and fluvial origin were conducted to test the bleaching efficiency of grave digging in materials that commonly host ancient burials in Australia. Grave-size pits were dug into Pleistocene aeolian sediments at Willandra Lakes and younger fluvial sediments on the Lachlan River, backfilled, and re-excavated. Samples for optical dating were taken from sediment infilling the mock graves and from the adjacent, undisturbed substrate, and analysed using the single aliquot-regenerative dose (SAR) protocol applied to single quartz grains. The resulting equivalent dose (De) distributions revealed that ≤1% of grains had been fully zeroed in both settings, and an additional 1-6% of poorly bleached grains were apparent in the fluvial sediments. Insufficient and heterogeneous bleaching of sediments during excavation and backfilling produced a decrease in the central dose of between 3 and 6 Gy, and an increase in over-dispersion values of between 5 and 10%. These differences were insufficient to clearly distinguish the disturbance event from the effects of bioturbation, biological mixing, or other sources of De variation. The use of the Minimum Age Model substantially over-estimated the burial age (zero years) in both depositional environments, with the degree of over-estimation increasing with the age of the host sediments. These results suggest that optically stimulated luminescence (OSL) techniques will not produce accurate ages for grave infill in a number of forensic and archaeological settings. Further study of the bleaching susceptibility of grains within grave infills, as well as the effectiveness of grave-digging as a bleaching mechanism is required. In other archaeological and geomorphological applications of OSL dating we recommend routine checks on the effective zeroing of sediments in modern equivalent situations. PMID:24953668

  11. [Orbital decompression for Graves' ophthalmopathy].

    PubMed

    Boulétreau, P; Breton, P; Freidel, M

    2005-04-01

    Graves' ophthalmopathy is a complex orbital condition with a controversial pathogenesis. It is the clinical expression of a discordance between the inextensible orbit and hypertrophic muscular and fatty elements within the orbit responding to immunological stimulation. The relationship between the orbital and its content can be improved by surgical expansion which increases the useful volume of the orbit. This procedure can be combined with lipectomy to decrease the volume of the orbital contents. We briefly recall the history of surgical decompression techniques and present our experience with Graves' ophthalmopathy patients.

  12. Euthyroid Graves' ophthalmopathy with negative autoantibodies.

    PubMed Central

    Cakir, Mehtap

    2005-01-01

    Graves' disease is an autoimmune-based hyperthyroidism in which a number of different antibodies directed against thyroid tissue plays a role. Graves' ophthalmopathy is thought to be a consequence of this autoimmune basis and occurs in some patients with Graves' disease. On occasional cases, the disease may present only with ophthalmopathy without hyperthyroidism. A 32-year-old woman with euthyroid Graves' ophthalmopathy and negative thyroid autoantibodies, including TSH receptor antibody, is presented here. Images Figure 1 Figure 2 PMID:16334503

  13. Antepartal nursing management of Grave's disease.

    PubMed

    Karacic, B

    1986-01-01

    The signs and symptoms of Grave's disease may be difficult to distinguish from the normal thyroid changes that occur in pregnancy. A brief review of thyroid physiology, thyroid changes during pregnancy, the effect of Grave's disease during pregnancy on the woman and fetus, and an assessment tool for use during the antepartal period is presented. Recommendations of specific areas of need seen in the pregnant Grave's patient during the antepartal period are also outlined. PMID:3635591

  14. Antiphospholipid antibody syndrome complicated by Grave's disease.

    PubMed

    Takahashi, Ayumi; Tamura, Atsushi; Ishikawa, Osamu

    2002-12-01

    The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity. PMID:12532043

  15. Radiation therapy for Graves' disease

    SciTech Connect

    Brennan, M.W.; Leone, C.R. Jr.; Janaki, L.

    1983-08-01

    We used radiation therapy (a total of 2,000 rads) to treat 14 patients (three men and 11 women, ranging in age from 27 to 72 years) with Graves' disease. Three of these patients had refused to take corticosteroids and the other 11 had failed to respond to them, had experienced side effects, or had other contraindications to their use. After follow-up periods ranging from six months to three years, soft-tissue inflammation was reduced in 13 of the 14 patients. All but two patients showed a decrease in proptosis of 1 to 3 mm. Myopathy showed the least improvement. Although we noted transient eyelid erythema, there were no permanent sequelae and none of the patients has had a recurrence of the inflammation.

  16. Current treatment of Graves' disease

    SciTech Connect

    Harada, T.; Shimaoka, K.; Mimura, T.; Ito, K.

    1987-04-01

    In this review we have described the rationale for the appropriate treatment of patients with Graves' disease. Because the etiology of this disorder remains obscure, its management remains controversial. Since antithyroid drugs and radioiodine became readily available in the early 1950s, they have been widely used for the treatment of thyrotoxicosis, and the number of cases treated surgically has markedly decreased. However, almost four decades of experience have disclosed an unexpectedly high incidence of delayed hypothyroidism after radioiodine treatment and a low remission rate after antithyroid therapy. As a result, surgery is again being advocated as the treatment of choice. The three modalities of treatment have different advantages and disadvantages, and selection of treatment is of importance. In principle, we believe that for most patients a subtotal thyroidectomy should be performed after the patient has been rendered euthyroid by antithyroid drugs. We attempt to leave a thyroid remnant of 6 to 8 gm.36 references.

  17. [Differential diagnosis of Graves' orbitopathy. Case report].

    PubMed

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  18. [Differential diagnosis of Graves' orbitopathy. Case report].

    PubMed

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures. PMID:26876268

  19. Medical Treatment of Graves' Orbitopathy.

    PubMed

    Salvi, M; Campi, I

    2015-09-01

    The medical treatment of Graves' orbitopathy (GO) is usually reserved to moderate to severe disease. Steroids have been widely employed and possess anti-inflammatory activity, but about 20-30% of patients are not responsive and about 20% present with disease recurrence. Immunosuppressive therapy alternative to corticosteroids may target the different antigens involved in pathogenic mechanisms of GO. Some have already been employed in clinical studies and showed interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the TSH receptor and the IGF-1 receptor on the fibroblasts, inflammatory cytokines, B and T cells. Most promising results are obtained by interacting with the PIK3/mTORC1 signaling cascades for adipogenesis and the anti-IGF-1R with the monoclonal antibody teprotumumab. A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials. Clinical practice will greatly benefit from the use of disease modifying agents in GO, as compared to steroids, currently standard treatment for GO. Among these, rituximab may be useful, especially in patients resistant to steroid or with contraindications to steroids. However, larger randomized controlled trials are needed for definitive data on the potential disease-modifying role of rituximab in GO. Direct targeting of the orbital fibroblast via immunosuppression or nonimmunosuppressive drugs is emerging as a promising alternative. PMID:26361263

  20. Bilateral carpal tunnel syndrome in Graves' disease.

    PubMed

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  1. Finding the Heartbeat: Applying Donald Graves's Approaches and Theories

    ERIC Educational Resources Information Center

    Koshewa, Allen

    2011-01-01

    Donald Graves's early professional books inspired Koshewa to look more deeply into student writing during the 1980s, and to value all phases of the writing process. Graves's perspective on uncovering and celebrating voice elevated Koshewa's writing instruction to a new plane. In this article, he writes about the impact that Donald Graves's work…

  2. Severe eyelid oedema in Graves' ophthalmopathy.

    PubMed

    Anagnostis, Panagiotis; Adamidou, Fotini; Poulasouchidou, Maria; Karras, Spyridon

    2013-07-13

    We report a case of severe eyelid oedema due to Graves' ophthalmopathy (GO). The aim was to present a case report and review of the literature about eyelid oedema due to GO. The case report includes a history of patient data and literature review. The patient was offered intravenous methylprednisolone and gave consent. A dosage of 500 mg intravenous methylprednisolone once weekly for 6 weeks, followed by 250 mg intravenous methylprednisolone once weekly for 6 weeks, with a total treatment period of 12 weeks was given. Up to day, minor improvement has been observed. Severe eyelid oedema due to GO is a rare manifestation of Graves' disease. In cases of active and moderate-to-severe disease, treatment with intravenous glucorticoids is recommended alone or with orbital radiotherapy, followed by rehabilitative surgery.

  3. Infrared thermographic detection of buried grave sites

    NASA Astrophysics Data System (ADS)

    Weil, Gary J.; Graf, Richard J.

    1992-04-01

    Since time began, people have been born and people have died. For a variety of reasons grave sites have had to be located and investigated. These reasons have included legal, criminal, religious, construction and even simple curiosity problems. Destructive testing methods such as shovels and backhoes, have traditionally been used to determine grave site locations in fields, under pavements, and behind hidden locations. These existing techniques are slow, inconvenient, dirty, destructive, visually obtrusive, irritating to relatives, explosive to the media and expensive. A new, nondestructive, non-contact technique, infrared thermography has been developed to address these problems. This paper will describe how infrared thermography works and will be illustrated by several case histories.

  4. Graves' disease. Manifestations and therapeutic options

    SciTech Connect

    McFarland, K.F.; Saleeby, G.

    1988-03-01

    Graves' disease is the most common cause of hyperthyroidism. Clinical features include thyroid enlargement, eye signs, tachycardia, heat intolerance, emotional lability, weight loss, and hyperkinesis. Three modes of therapy are available. The preferences of the patient and physician are usually prime considerations in devising the therapeutic plan. Radioactive iodine is the most frequently used and safest method of treatment for adults. Antithyroid drugs are preferred for children and pregnant women. Surgery is usually reserved for patients in whom the other forms of treatment are not acceptable. Considerable patient education during the decision-making process enhances the success of the therapeutic plan.

  5. [Graves’ orbitopathy in pediatrics].

    PubMed

    Mendoza F, Carolina; Lacourt R, Patricia

    2015-08-01

    Graves’ orbitopathy (GO) is rare in pediatric patients, however is the most common extrathyroid manifestation of Graves’ disease (GD), being present in 30-67% of patients. GO is an autoimmune inflammatory disorder involving orbital connective and fatty tissues as well as the extraocular muscles. In children, GO is less common and less severe than in adults. The most common symptoms are upper eyelid retraction, conjunctival injection, and proptosis and periorbital edema. Severe complications include dysthyroid optic neuropathy, corneal ulceration and eyeball subluxation. The diagnosis is established by clinical, laboratory and imaging findings. There are no management guidelines for GO in children but adult recommendations include the assessment of clinical activity and its severity, to implement the best treatment. Supportive therapies are intended to relieve symptoms and prevent corneal damage in mild cases. Tobacco exposure should also be avoided. The first line of treatment is systemic administration of corticosteroids in active and severe cases. Other options as somatostatin use and retrobulbar radiation have not been used in children, therefore their use is not recommended. PMID:26436933

  6. Graves Disease Is Associated With Endometriosis

    PubMed Central

    Yuk, Jin-Sung; Park, Eun-Ju; Seo, Yong-Soo; Kim, Hee Jin; Kwon, Seon-Young; Park, Won I.

    2016-01-01

    Abstract The aim of this cross-sectional study was to compare the prevalence of thyroid diseases between women with and without endometriosis. We established the endometriosis group according to diagnosis codes, surgery codes, and gonadotropin-releasing hormone agonist codes using the Korean Health Insurance Review and Assessment Service—National Inpatients Sample (HIRA-NIS) from 2009 to 2011. Four controls were randomly matched to each endometriosis case. Thyroid disease cases were selected using the thyroid disease diagnosis code (E0X). Among the 1,843,451 women sampled, 5615 had endometriosis; 22,460 controls were matched to the endometriosis cases. After adjustment for age and sampling year, Graves disease was associated with endometriosis (odds ratio [OR]: 2.52; 95% CI: 1.30–4.88; P < 0.01), while hypothyroidism was not (OR: 1.17; 95% CI: 0.90–1.52; P = 0.25). Autoimmune hypothyroidism was also not associated with endometriosis (OR: 1.61; 95% CI: 0.88–2.94; P = 0.12). This study revealed an association between Graves disease and endometriosis. PMID:26962803

  7. 75 FR 65030 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for two members of the Native American Graves Protection and Repatriation Review Committee....

  8. YARD NO. 3 BASINS (GRAVING DOCKS), VIEW TO EASTNORTHEAST AT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    YARD NO. 3 BASINS (GRAVING DOCKS), VIEW TO EAST-NORTHEAST AT THE SOUTH END OF THE CRANEWAY AND GALLERY BETWEEN BASINS NO. 1 AND 2, LOOKING ACROSS SOUTH END OF BASIN NO. 1 (THE WESTERN-MOST BASIN) - Rosie the Riveter National Historical Park, Graving Docks, Shipyard No. 3, Richmond, Contra Costa County, CA

  9. Donald Graves in Australia--"Children Want to Write ..."

    ERIC Educational Resources Information Center

    Walshe, R. D., Ed.

    The articles in this collection are intended to present a detailed picture of the work of Donald Graves and his associates at the Writing Process Laboratory (WPL) of the University of New Hampshire. The introduction provides an overview of the work of Graves and examines his views of beginning writing, writing conferences, revision, audience, and…

  10. Current insights into animal models of Graves' disease and orbitopathy.

    PubMed

    Wiesweg, B; Johnson, K T M; Eckstein, A K; Berchner-Pfannschmidt, U

    2013-08-01

    Graves' disease (GD) is a systemic autoimmune disease that is characterized by hyperthyroidism, orbitopathy and in rare cases dermopathy. Graves' orbitopathy (GO) is an inflammatory disease of eye and orbit which occurs in about 30-60% of patients. Hyperthyroidism occurs due to the presence of stimulating TSHR-autoantibodies (TRAbs) leading to increased serum levels of thyroid hormones. Attempts to induce Graves' disease in mice by immunization against the hTSHR or its variants have resulted in production of TRAbs that stimulate thyroid follicular cells to increase thyroid hormone secretion. Graves' like orbital changes, such as inflammation, adipogenesis and muscle fibrosis are more difficult to induce. In this review we summarize different methods used to induce murine Graves'-like disease and their impact on murine orbits.

  11. Orbital decompression for Graves' orbitopathy in England

    PubMed Central

    Perros, P; Chandler, T; Dayan, C M; Dickinson, A J; Foley, P; Hickey, J; MacEwen, C J; Lazarus, J H; McLaren, J; Rose, G E; Uddin, J M; Vaidya, B

    2012-01-01

    Aims The purpose of this study was to obtain data on orbital decompression procedures performed in England, classed by hospital and locality, to evaluate regional variation in care. Methods Data on orbital decompression taking place in England over a 2-year period between 2007 and 2009 were derived from CHKS Ltd and analysed by the hospital and primary care trust. Results and conclusions In all, 44% of these operations took place in hospitals with an annual workload of 10 or fewer procedures. Analysis of the same data by primary care trust suggests an almost 30-fold variance in the rates of decompression performed per unit population. Expertise available to patients with Graves' orbitopathy and rates of referral for specialist care in England appears to vary significantly by geographic location. These data, along with other outcome measures, will provide a baseline by which progress can be judged. PMID:22157920

  12. Predictive Factors of Development of Graves' Ophthalmopathy for Patients with Juvenile Graves' Disease

    PubMed Central

    Verkauskiene, Rasa; Jasinskas, Vytautas; Jankauskiene, Jurate

    2016-01-01

    Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO. PMID:27413373

  13. Predictive Factors of Development of Graves' Ophthalmopathy for Patients with Juvenile Graves' Disease.

    PubMed

    Jarusaitiene, Dalia; Verkauskiene, Rasa; Jasinskas, Vytautas; Jankauskiene, Jurate

    2016-01-01

    Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002-2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4-29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.

  14. Graves disease with ophthalmopathy following radiotherapy for Hodgkin's disease

    SciTech Connect

    Jacobson, D.R.; Fleming, B.J.

    1984-12-01

    The number of patients achieving long-term survival following neck irradiation for Hodgkin's disease and other malignancies is increasing. Paralleling this increase in survivors is the development of late complications of the therapy itself. Eleven patients have previously been reported who developed Graves ophthalmopathy 18 months to seven years after receiving neck radiotherapy for nonthyroidal malignancies. The seven patients who had HLA typing were all HLA-B8 negative, despite the reported association of the HLA-B8 antigen with Graves disease. A patient who is HLA-B8 positive who developed Graves ophthalmopathy and hyperthyroidism nine years after receiving mantle radiotherapy for Hodgkin's disease is reported. It is recommended that Graves disease be included among the thyroid diseases that receive consideration during follow-up of patients who have received mantle radiotherapy.

  15. 1. OVERVIEW WITH WILLIAM MORRIS GRAVE MONUMENT, THE INSCRIPTION ON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. OVERVIEW WITH WILLIAM MORRIS GRAVE MONUMENT, THE INSCRIPTION ON WHICH READS: 'GOD'S FINGER TOUCHED HIM AND HE SLEPT.' - Pratt Mines, Fraternal Cemetery, Crest of Sheridan Road, Irish Hill, Birmingham, Jefferson County, AL

  16. Successful treatment of Graves disease in pregnancy with Lugol's iodine.

    PubMed

    Jamieson, A; Semple, C G

    2000-02-01

    We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention. PMID:10765530

  17. Development of Graves' disease following radiation therapy in Hodgkin's disease

    SciTech Connect

    Loeffler, J.S.; Tarbell, N.J.; Garber, J.R.; Mauch, P.

    1988-01-01

    Radiation-related thyroid dysfunction is a common occurrence in patients with Hodgkin's disease treated with mantle field radiation. Although chemical and clinical hypothyroidism are most commonly seen, Graves' disease has also been described. We have examined the records of 437 surgically staged patients who received mantle field irradiation between April 1969 and December 1980 to ascertain the frequency of manifestations of Graves' disease. Within this group, seven patients developed hyperthyroidism accompanied by ophthalmic findings typical of those seen in Graves' disease. The actuarial risk of developing Graves' disease at 10 years following mantle irradiation for Hodgkin's disease was 3.3% in female patients and 1% in male patients in this study. The observed/expected ratios were 5.9 and 5.1 for female and male patients, respectively. This observed risk significantly exceeded that seen in the general population.

  18. Delineation of graves using electrical resistivity tomography

    NASA Astrophysics Data System (ADS)

    Nero, Callistus; Aning, Akwasi Acheampong; Danuor, Sylvester K.; Noye, Reginald M.

    2016-03-01

    A suspected old royal cemetery has been surveyed at the Kwame Nkrumah University of Science and Technology (KNUST) campus, Kumasi, Ghana using Electrical Resistivity Tomography (ERT) with the objective of detecting graves in order to make informed decisions with regard to the future use of the area. The survey was conducted on a 10,000 m2 area. Continuous Vertical Electrical Sounding (CVES) was combined with the roll along technique for 51 profiles with 1 m probe separation separated by 2 m. Inverted data results indicated wide resistivity variations ranging between 9.34 Ωm and 600 Ωm in the near surface. Such heterogeneity suggests a disturbance of the soil at this level. Both high (≥ 600 Ωm) and low resistivity (≤ 74.7 Ωm) anomalies, relative to background levels, were identified within the first 4 m of the subsurface. These were suspected to be burial tombs because of their rectangular geometries and resistivity contrasts. The results were validated with forward numerical modeling results. The study area is therefore an old cemetery and should be preserved as a cultural heritage site.

  19. Fly Ash: From Cradle to Grave

    USGS Publications Warehouse

    Ellis, Margaret S.; Affolter, Ronald H.

    2007-01-01

    The Energy Resources Program of the U.S. Geological Survey promotes and supports coal research to improve the understanding of the coal endowment of the United States. This results in geologically based, non-biased energy information products for policy and decision makers, land and resource managers, other federal and state agencies, the domestic energy industry, foreign governments, nongovernmental groups, academia, and other scientists. A more integrated approach to our coal quality work involves what we call a 'cradle to grave' approach. These types of studies focus not on just one aspect of the coal but rather on how or where different quality parameters form and (or) occur and what happens to them through the mining, production, transport, utilization and waste disposal process. An extensive suite of coal quality analyses, mineralogical, petrology, and leaching investigations are determined on samples taken from the different phases of the coal utilization process. This report consists of a tutorial that was given on June 10, 2007 at the 32nd International Technical Conference on Coal Utilization & Fuel Systems, The Power of Coal, Clearwater Coal Conference in Clearwater, Florida, USA. This tutorial covers how these studies are conducted and the importance of providing improved, comprehensive, science-based data sets for policy and decision makers.

  20. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    PubMed

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility.

  1. Hyperparathyroidism after radioactive iodine therapy for Graves disease

    SciTech Connect

    Esselstyn, C.B. Jr.; Schumacher, O.P.; Eversman, J.; Sheeler, L.; Levy, W.J.

    1982-11-01

    The association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been documented in recent years. This also has been demonstrated experimentally in animals. Despite the numbers of patients with Graves disease who have been treated with radioactive iodine, there are no reports in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves disease. This report describes the operative and pathologic findings in four patients with hyperparathyroidism. These patients had previously been treated with radioactive iodine for Graves disease. The pathologic findings at surgery included in three cases a single enlarged hyperplastic gland consistent with a parathyroid adenoma. One patient had hyperplasia of all four glands. The two largest glands and halves of the two remaining glands were removed. In a long-term follow-up of children and adolescents treated with radioactive iodine for Graves disease, Levy and Schumacher found calcium elevations in 10 of 159 patients. The increased incidence of hyperparathyroidism following radioactive iodine treatment for Graves disease in children and adolescents would seem several times higher than normal. Whether adults who have radioactive iodine treatment for Graves disease have a similar increase incidence is not known. Meanwhile it would seem reasonable to suggest that patients whose hyperthyroidism is treated with radioactive iodine should have their serum calcium levels determined at 5-year intervals.

  2. Preclinical models of Graves' disease and associated secondary complications.

    PubMed

    Moshkelgosha, Sajad; So, Po-Wah; Diaz-Cano, Salvador; Banga, J Paul

    2015-01-01

    Autoimmune thyroid disease is the most common organ-specific autoimmune disorder which consists of two opposing clinical syndromes, Hashimoto's thyroiditis and Graves' (hyperthyroidism) disease. Graves' disease is characterized by goiter, hyperthyroidism, and the orbital complication known as Graves' orbitopathy (GO), or thyroid eye disease. The hyperthyroidism in Graves' disease is caused by stimulation of function of thyrotropin hormone receptor (TSHR), resulting from the production of agonist antibodies to the receptor. A variety of induced mouse models of Graves' disease have been developed over the past two decades, with some reproducible models leading to high disease incidence of autoimmune hyperthyroidism. However, none of the models show any signs of the orbital manifestation of GO. We have recently developed an experimental mouse model of GO induced by immunization of the plasmid encoded ligand binding domain of human TSHR cDNA by close field electroporation that recapitulates the orbital pathology in GO. As in human GO patients, immune mice with hyperthyroid or hypothyroid disease induced by anti-TSHR antibodies exhibited orbital pathology and chemosis, characterized by inflammation of orbital muscles and extensive adipogenesis leading to expansion of the orbital retrobulbar space. Magnetic resonance imaging of the head region in immune mice showed a significant expansion of the orbital space, concurrent with proptosis. This review discusses the different strategies for developing mouse models in Graves' disease, with a particular focus on GO. Furthermore, it outlines how this new model will facilitate molecular investigations into pathophysiology of the orbital disease and evaluation of new therapeutic interventions.

  3. Increased risk of Graves' disease after pregnancy.

    PubMed

    Benhaim Rochester, Dana; Davies, Terry F

    2005-11-01

    The improvement in autoimmune thyroid disease during pregnancy and the subsequent exacerbation postpartum is secondary to immune system changes necessary to a normal pregnancy. Prior studies have shown that a clinically significant number of women develop Graves' disease (GD) in the postpartum period. The aim of this study was to examine the risk of post pregnancy GD and define patient characteristics that may impact the diagnosis and treatment strategies for this group. We performed a retrospective review of 152 consecutive women, aged 18-39 years when diagnosed with GD, to examine the relation between disease diagnosis and prior pregnancy. Differences in patient characteristics and treatment outcomes of women were analyzed. New York City population data were used to estimate a relative risk for the development of postpartum GD. We found that in parous women, 45% were diagnosed with GD in the postpartum period and 55% had an onset in subsequent years. No significant differences were noted in patient characteristics or treatment outcomes. We found that the risk of women developing post pregnancy GD was greatest in the older patients (35-39 years), with 56% developing GD compared to 42% of nulliparous women. These data, therefore, suggest an increased risk for older women. We were able to calculate the increase in estimated relative risk for postpartum disease by using control population data. The risk maximized at 5.6 for the age group 35-39 years when compared to the control population. These data support earlier studies that showed that a clinically significant number of women develop GD after childbirth compared to nulliparous women and extends this risk for many years. The mechanism of this long-standing increased susceptibility requires further delineation.

  4. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    PubMed

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M

    1988-04-01

    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  5. Human T lymphotropic virus type 1 uveitis after Graves' disease.

    PubMed Central

    Yamaguchi, K; Mochizuki, M; Watanabe, T; Yoshimura, K; Shirao, M; Araki, S; Miyata, N; Mori, S; Kiyokawa, T; Takatsuki, K

    1994-01-01

    A distinct clinical entity of uveitis associated with human T lymphotropic virus type 1 (HTLV-I) has been reported previously. During the period between January 1989 and April 1992, 93 patients were observed with HTLV-I uveitis and a significant correlation was found between Graves' disease and HTLV-I uveitis. Sixteen of the 93 patients with HTLV-I uveitis (17.2%) had a previous history of Graves' disease. Fifteen patients were female (15/60, 25.0%) and one was male (1/33, 3.0%). Interestingly, uveitis occurred after the onset of Graves' disease in all cases. On the other hand, none of 222 patients with idiopathic uveitis who were seronegative to HTLV-I had a history of Graves' disease. Although the mechanisms by which HTLV-I causes the correlation between uveitis and Graves' disease are unknown, the present data suggest that immune mediated or autoimmune mechanisms are involved in HTLV-I uveitis. Images PMID:8148330

  6. [Radioiodine versus surgery in the treatment of Graves' hyperthyroidism].

    PubMed

    Jukić, Tomislav; Stanicić, Josip; Petric, Vlado; Kusić, Zvonko

    2010-01-01

    The most common etiologic cause of thyrotoxicosis in children and adults is autoimmune Graves' (Basedow's) disease. Antithyroid medications, surgery and radioactive iodine have been used in the treatment of Graves' hyperthyroidism for more than six decades. The use of antithyroid drugs is the most common therapeutic approach. However, long-term remission with antithyroid drugs can be expected in 20-50% of adults and 20-30% of children. The methods for definitive treatment of Graves' hyperthyroidism are iodine-131 (radioiodine) and surgery. Both treatment modalities have benefits and risks and the decision is made according to the age, patient preference and the presence of other co-morbidities, individual characteristics of patients and the availability of certain treatment modality. Radioiodine is simple, safe, effective and economic procedure for definitive treatment of Graves' hyperthyroidism. It is administered ambulatory and can be given to the patient in thyrotoxicosis. Due to many benefits, radioiodine is preferred in most of the adult patients with Graves' hyperthyroidism while only small proportion of patients is sent to surgery. Radioiodine is especially the treatment of choice in elderly patients and patients with heart disease. In these patients radioiodine is indicated immediately after reaching euthyroidism with antithyroid drugs. Surgery is mainly indicated in younger patients, in the case of patient preference or in special indications. Clear indications for surgical treatment of Graves' hyperthyroidism are: suspected or confirmed malignancy, coexisting pathology that demands surgical treatment, pregnancy and breastfeeding, large goiter (> 80 grams) or goiter with symptoms and signs of compression, severe toxic side effects of antithyroid medications, requirement for immediate control of disease, age younger than 5 years and active ophtalmopathy. The risk of surgical treatment is negatively correlated with the surgeon's experience and nowadays

  7. Graves' Disease Pharmacotherapy in Women of Reproductive Age.

    PubMed

    Prunty, Jeremy J; Heise, Crystal D; Chaffin, David G

    2016-01-01

    Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence

  8. 77 FR 12875 - Proposed Information Collection; Native American Graves Protection and Repatriation Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-02

    ... National Park Service Proposed Information Collection; Native American Graves Protection and Repatriation... Number ``1024- 0144, Native American Graves Protection and Repatriation Regulations'' in the subject line... entire ICR package free of charge. SUPPLEMENTARY INFORMATION: I. Abstract The Native American...

  9. 77 FR 65407 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Notice of Nomination Solicitation... American Graves Protection and Repatriation Review Committee, National NAGPRA Program, National...

  10. 75 FR 13140 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination... Repatriation Review Committee; Notice of Nomination Solicitation. The National Park Service is soliciting nominations for one member of the Native American Graves Protection and Repatriation Review Committee....

  11. Premature twins of a mother with Graves' disease with discordant thyroid function: a case report.

    PubMed

    O'Connor, M J; Paget-Brown, A O; Clarke, W L

    2007-06-01

    Thyroid dysfunction is recognized in the newborns of mothers affected by Graves' disease during pregnancy. We describe the development of concurrent hyperthyroidism and hypothyroidism in the twin infants of a mother with Graves' disease diagnosed during pregnancy.

  12. [The treatment of Graves' disease: current views and controversies].

    PubMed

    Orgiazzi, Jacques

    2011-12-01

    One of the more prevalent among the organ-specific autoimmune diseases, Graves' disease share their chronic evolution and lack of immunomodulatory treatment. Treatment strategy has to consider as opposite options as medical conservatory or ablative approach which requires much expertise and attention to patients' wish. Whatever treatment option, it is mandatory to prevent any risk of iatrogenic hypothyroidism, especially a rise of TSH above normal limit. The long-lasting benefit-risk ratio of treatment options is of primordial importance in this usually benign but enduring disease. Occurrence of Graves' orbitopathy, a significant complication, requires a special multidisciplinary management; the same is true in the case of a current or planned pregnancy. Overall quality-of-life is often markedly affected by Graves' disease; this should not be overlooked. Smoking increases relapse risk after a course of antithyroid drug; it also increases the risk and severity of Graves' orbitopathy. Patients must be made aware of these deleterious effects and encouraged to quit smoking.

  13. 1. OVERVIEW, LOOKING WEST, TOMBSTONES, STATUES AND GRAVE PLOTS OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. OVERVIEW, LOOKING WEST, TOMBSTONES, STATUES AND GRAVE PLOTS OF THE DUCHOCK, MOSKO, BENKO AND OTHER FAMILIES OF THIS FORMER COAL MINING AREA SETTLED BY CZECH AND SLAVIC MINERS IN THE 1880S AND 1890S - St. Michael's Cemetery, Brookside Road, Brookside, Jefferson County, AL

  14. 77 FR 23196 - Native American Graves Protection and Repatriation Act Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... Office of the Secretary 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection and Repatriation... Secretary of the Interior (Secretary) is responsible for implementation of the Native American Graves... implementing the Native American ] Graves Protection and Repatriation Act for purposes of factual accuracy...

  15. 78 FR 21410 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves...

  16. The possible etiological role of psychological disturbances in Graves' disease.

    PubMed

    Harsch, I; Paschke, R; Usadel, K H

    1992-01-01

    In the discussion of possible factors in the etiology of Graves' disease, stress has always played a major role. We investigated the possible influence of present depression (depressivity scale DS) and anxiety (State Trait Angstinventar STAI X1) on peripheral lymphocyte subpopulations in 10 patients with Graves' disease. The tests were done in hyperthyroidism and after 2-4 months in stable euthyroidism. Parallel to the psychometric testing, peripheral lymphocyte subpopulations were investigated. Elevated anxiety as a constant personality trait was investigated with the State Trait Angstinventar STAI X2 in 19 hyperthyroid patients with Graves' disease. 5 of the 10 patients had a pathological T4:T8 ratio and very high raw values for present anxiety (mean = 53,8; STAI X1), as well as a a high percentile for depression (median 93,1; DS). The other 5 patients with a normal T4:T8 ratio had much lower values for anxiety (mean = 37,8; STAI X1) and depression (median 78,4; DS). In those patients, the T4:T8 ratio remained normal in stable euthyroidism, while the values for anxiety and depression decreased. This also happened in the patients with a formerly pathologic T4:T8 ratio. However, the pathologic T4:T8 ratio persisted in those patients. The STAI X2 percentage ranking for the 19 hyperthyroid patients was 76,5. The value for healthy people is 55,5. Therefore a significantly elevated anxiety--representing a constantly elevated internal psychological stress--seems to be present in patients with Graves' disease. Since psychological stress is known to influence the immune system, such a constant personality trait could be a predisposing factor for Graves' disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    PubMed

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C

    2015-09-01

    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  18. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    SciTech Connect

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  19. Drug-induced graves disease from CTLA-4 receptor suppression.

    PubMed

    Borodic, Gary; Hinkle, David M; Cia, Yihong

    2011-01-01

    Monoclonal antibody, ipilimumab, useful for treatment of metastatic melanoma, blocks CTLA-4 mediated T-cell suppression and can also cause a Graves ophthalmopathy like syndrome. Epidemiologic study has linked variant polymorphisms of CTLA-4 receptor gene to the presence of thyroid eye disease. The combination of these observations suggests CTLA-4 mediated T-cell functions are important to the pathogenesis of thyroid-associated eye disease. PMID:21242854

  20. Immunization with thyroglobulin induces Graves'-like disease in mice

    PubMed Central

    Endo, Toyoshi; Kobayashi, Tetsuro

    2009-01-01

    We immunized AKR/N mice with bovine thyroglobulin (Tg) once every 2 weeks and monitored their time-dependent changes in 125I uptake activity in the thyroid glands. After 3 months, anti-Tg antibody was positive in all sera from the immunized mice. Serum free tri-iodothyronine (T3) and free thyroxine (T4) levels in the immunized mice (n=6) were significantly higher than those in the saline injected (control) mice (n=6). Neck counts as well as scintigraphy of the thyroid glands revealed that iodide uptake activity of the immunized mice was not suppressed, but was instead higher than that of the control mice. Two of the six immunized mice showed extremely high iodide uptake activity. The thyroid glands of these two mice were diffusely enlarged and the height of the epithelial cells was also increased. In addition, two mice with high iodide uptake activity produced a high titer of thyroid-stimulating antibody. Additional experiments showed that 4 out of 11 AKR/N mice and 3 out of 10 C57BL6 mice immunized with Tg had high serum free T3/free T4 levels, high 125I uptake activity of the thyroid, and positive thyroid-stimulating antibody activity. Diffuse goiter, thyrotoxicosis, high iodide uptake activity, and positive thyroid-stimulating antibody are the characteristics of Graves' disease. Thus, these mice exhibit the symptoms of Graves' disease. These results suggest that immunization with Tg induces Graves'-like disease in mice and that our methods will provide a new animal model of Graves' disease. PMID:19491147

  1. Immunization with thyroglobulin induces Graves'-like disease in mice.

    PubMed

    Endo, Toyoshi; Kobayashi, Tetsuro

    2009-08-01

    We immunized AKR/N mice with bovine thyroglobulin (Tg) once every 2 weeks and monitored their time-dependent changes in (125)I uptake activity in the thyroid glands. After 3 months, anti-Tg antibody was positive in all sera from the immunized mice. Serum free tri-iodothyronine (T(3)) and free thyroxine (T(4)) levels in the immunized mice (n=6) were significantly higher than those in the saline injected (control) mice (n=6). Neck counts as well as scintigraphy of the thyroid glands revealed that iodide uptake activity of the immunized mice was not suppressed, but was instead higher than that of the control mice. Two of the six immunized mice showed extremely high iodide uptake activity. The thyroid glands of these two mice were diffusely enlarged and the height of the epithelial cells was also increased. In addition, two mice with high iodide uptake activity produced a high titer of thyroid-stimulating antibody. Additional experiments showed that 4 out of 11 AKR/N mice and 3 out of 10 C57BL6 mice immunized with Tg had high serum free T(3)/free T(4) levels, high (125)I uptake activity of the thyroid, and positive thyroid-stimulating antibody activity. Diffuse goiter, thyrotoxicosis, high iodide uptake activity, and positive thyroid-stimulating antibody are the characteristics of Graves' disease. Thus, these mice exhibit the symptoms of Graves' disease. These results suggest that immunization with Tg induces Graves'-like disease in mice and that our methods will provide a new animal model of Graves' disease. PMID:19491147

  2. Drug-induced graves disease from CTLA-4 receptor suppression.

    PubMed

    Borodic, Gary; Hinkle, David M; Cia, Yihong

    2011-01-01

    Monoclonal antibody, ipilimumab, useful for treatment of metastatic melanoma, blocks CTLA-4 mediated T-cell suppression and can also cause a Graves ophthalmopathy like syndrome. Epidemiologic study has linked variant polymorphisms of CTLA-4 receptor gene to the presence of thyroid eye disease. The combination of these observations suggests CTLA-4 mediated T-cell functions are important to the pathogenesis of thyroid-associated eye disease.

  3. Graves' disease in a dialysis dependent chronic renal failure patient

    PubMed Central

    Nair, C. G.; Jacob, P.; Menon, R.; Babu, M. J. C.

    2014-01-01

    Thyroid hormone level may be altered in chronic renal failure patients. Low levels of thyroxine protect the body from excess protein loss by minimizing catabolism. Hyperthyroidism is rarely encountered in end-stage dialysis dependent patients. Less than 10 well-documented cases of Graves' disease (GD) are reported in literature so far. We report a case of GD in a patient on dialysis. PMID:25484538

  4. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    SciTech Connect

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  5. Palivizumab outcomes registry data from Spain: Infección Respiratoria Infantil por Virus Respiratorio Sincitial (IRIS) Study Group.

    PubMed

    Carbonell-Estrany, Xavier

    2003-02-01

    Respiratory syncytial virus (RSV) is the leading cause of lower respiratory illness in children <2 years of age. Severe RSV infection requiring hospitalization is linked to gestational age, chronic cardiopulmonary conditions and immunosuppression. The Infección Respiratoria Infantil por Virus Respiratorio Sincitial (IRIS) Study group in Spain conducted two pivotal epidemiologic studies establishing that serious RSV illness among premature infants was responsible for high rehospitalization rates (approximately 13%). RSV lower respiratory tract illness also correlated with prolonged hospital stay and more intensive care unit admissions. In Europe recent availability of palivizumab, a humanized monoclonal antibody to RSV, is a major therapeutic advancement directed against prevention of lower respiratory tract infection secondary to this viral pathogen. To ensure proper and optimal usage of palivizumab, the IRIS group, in conjunction with the Spanish Neonatology Group, developed prophylaxis guidelines for neonates. Palivizumab prophylaxis is strongly recommended in premature infants < or =28 weeks gestation or those affected with chronic lung disease. Additionally, palivizumab is recommended for infants with a gestational age of 29 to 32 weeks, without evidence of chronic lung disease and who are <6 months old at the onset of the RSV season. It was thought that slightly older premature infants (33 to 35 weeks gestational age) should be assessed on an individual basis to determine whether prophylaxis is warranted. The IRIS Study Group is currently determining the effectiveness of these recommendations by measuring the incidence of RSV-related hospital admissions in infants born at < or =32 weeks gestational age who are receiving palivizumab prophylaxis.

  6. Grave's Disease and Primary Biliary Cirrhosis-An Unusual and Challenging Association.

    PubMed

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2014-03-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  7. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    PubMed Central

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  8. Thyroid carcinoma in patients with Graves' disease: an institutional experience.

    PubMed

    Wei, Shuanzeng; Baloch, Zubair W; LiVolsi, Virginia A

    2015-03-01

    Graves' disease (GD) is an autoimmune disorder characterized by diffuse hyperplasia and excessive production of thyroid hormone. The association between thyroid carcinoma and GD is controversial. The prevalence of thyroid carcinoma was investigated in patients with GD who underwent thyroidectomy for thyroid nodular lesions or GD from 1994 to 2013 at our institution. Three hundred and forty-seven patients were placed into two groups: Graves' disease with nodular lesions group (group GN) included 85 patients who had thyroidectomy for nodular lesion, and Graves' disease group (group G) included 262 patients who had thyroidectomy for hyperthyroidism. There were 59 patients with thyroid carcinomas in the 85 patients (69 %) of group GN, including 3 follicular carcinomas (5 %), 1 poorly differentiated carcinoma (2 %), and 55 papillary thyroid carcinomas (93 %). Among the 55 papillary thyroid carcinomas, 19 cases were papillary thyroid microcarcinomas (34 %); and 5 cases of tall cell variant (9 %) were identified. There were 8 cases with lymph node metastasis (14 %), 6 cases with lymphovascular invasion (10 %), and 12 cases with extrathyroidal invasion (20 %). In addition, 24 carcinomas showed multiple foci of tumor (41 %). In contrast, 51 patients (19 %) of 262 patients in group G had carcinoma, including 2 follicular carcinomas (4 %) and 49 papillary thyroid carcinomas (96 %). In the 49 cases of papillary thyroid carcinomas, 47 cases were microcarcinomas (96 %); and 2 cases of tall cell variant (4 %) were found. There were no lymph node metastasis or lymphovascular and extrathyroidal invasion, but 11 cases (22 %) demonstrated multiple carcinoma foci. In conclusion, thyroid nodular lesions in patients with GD should raise a high suspicion of carcinoma, and these lesions are frequently clinically significant tumors. Incidental thyroid carcinomas in patients with GD are not uncommon, but most of them are low-risk papillary thyroid microcarcinoma without lymph node

  9. Detection of single graves by airborne hyperspectral imaging.

    PubMed

    Leblanc, G; Kalacska, M; Soffer, R

    2014-12-01

    Airborne hyperspectral imaging (HSI) was assessed as a potential tool to locate single grave sites. While airborne HSI has shown to be useful to locate mass graves, it is expected the location of single graves would be an order of magnitude more difficult due to the smaller size and reduced mass of the targets. Two clearings were evaluated (through a blind test) as potential sites for containing at least one set of buried remains. At no time prior to submitting the locations of the potential burial sites from the HSI were the actual locations of the sites released or shared with anyone from the analysis team. The two HSI sensors onboard the aircraft span the range of 408-2524nm. A range of indicators that exploit the narrow spectral and spatial resolutions of the two complimentary HSI sensors onboard the aircraft were calculated. Based on the co-occurrence of anomalous pixels within the expected range of the indicators three potential areas conforming to our underlying assumptions of the expected spectral responses (and spatial area) were determined. After submission of the predicted burial locations it was revealed that two of the targets were located within GPS error (10m) of the true burial locations. Furthermore, due to the history of the TPOF site for burial work, investigation of the third target is being considered in the near future. The results clearly demonstrate promise for hyperspectral imaging to aid in the detection of buried remains, however further work is required before these results can justifiably be used in routine scenarios. PMID:25447169

  10. Detection of single graves by airborne hyperspectral imaging.

    PubMed

    Leblanc, G; Kalacska, M; Soffer, R

    2014-12-01

    Airborne hyperspectral imaging (HSI) was assessed as a potential tool to locate single grave sites. While airborne HSI has shown to be useful to locate mass graves, it is expected the location of single graves would be an order of magnitude more difficult due to the smaller size and reduced mass of the targets. Two clearings were evaluated (through a blind test) as potential sites for containing at least one set of buried remains. At no time prior to submitting the locations of the potential burial sites from the HSI were the actual locations of the sites released or shared with anyone from the analysis team. The two HSI sensors onboard the aircraft span the range of 408-2524nm. A range of indicators that exploit the narrow spectral and spatial resolutions of the two complimentary HSI sensors onboard the aircraft were calculated. Based on the co-occurrence of anomalous pixels within the expected range of the indicators three potential areas conforming to our underlying assumptions of the expected spectral responses (and spatial area) were determined. After submission of the predicted burial locations it was revealed that two of the targets were located within GPS error (10m) of the true burial locations. Furthermore, due to the history of the TPOF site for burial work, investigation of the third target is being considered in the near future. The results clearly demonstrate promise for hyperspectral imaging to aid in the detection of buried remains, however further work is required before these results can justifiably be used in routine scenarios.

  11. Investigation of clandestine graves resulting from human rights abuses.

    PubMed

    Vanezis, P

    1999-12-01

    The role of the forensic scientist in the investigation of clandestine graves resulting from human rights abuses is discussed. Individuals buried in such circumstances have perished following abuse by persons in authority or by other political factions. Such persons have been classed by the abusers as dissidents or political opponents, or have been killed simply for belonging to a particular racial or religious grouping. Guidelines for investigation and the general approach by the scientist are suggested and examples of exhumations are cited in which the author has had personal involvement. These include exhumations carried out in the former Yugoslavia, Rwanda and Chile.

  12. Neonatal Cholestasis Caused by Undiagnosed Maternal Graves' Disease

    PubMed Central

    Jensen, M. Kyle; Adams, Christa J.; Book, Linda S.

    2014-01-01

    Neonatal cholestasis results from a variety of etiologies, including anatomic, infectious, and metabolic abnormalities. Hyperthyroidism, in contrast to hypothyroidism, is infrequently associated with neonatal cholestasis. Newborn screening is an important tool to detect newborn metabolic disorders, including thyroid dysfunction. However, one must exercise caution when interpreting these reports; typically only high thyroid stimulating hormone (TSH) levels are flagged as abnormal, while low or undetectable levels may not be. We present a unique case of cholestasis in a hyperthyroid neonate of an untreated, undiagnosed mother with Graves' disease; the infant's metabolic screen was not flagged as abnormal. PMID:26157908

  13. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management.

    PubMed

    Barrio-Barrio, Jesús; Sabater, Alfonso L; Bonet-Farriol, Elvira; Velázquez-Villoria, Álvaro; Galofré, Juan C

    2015-01-01

    Graves' ophthalmopathy (GO) is an autoimmune inflammatory disorder associated with thyroid disease which affects ocular and orbital tissues. GO follows a biphasic course in which an initial active phase of progression is followed by a subsequent partial regression and a static inactive phase. Although the majority of GO patients have a mild, self-limiting, and nonprogressive ocular involvement, about 3-7% of GO patients exhibit a severe sight-threatening form of the disease due to corneal exposure or compressive optic neuropathy. An appropriate assessment of both severity and activity of the disease warrants an adequate treatment. The VISA (vision, inflammation, strabismus, and appearance), and the European Group of Graves' Orbitopathy (EUGOGO) classifications are the two widely used grading systems conceived to assess the activity and severity of GO and guide the therapeutic decision making. A critical analysis of classification, assessment, and management systems is reported. A simplified "GO activity assessment checklist" for routine clinical practice is proposed. Current treatments are reviewed and management guidelines according to the severity and activity of the disease are provided. New treatment modalities such as specific monoclonal antibodies, TSH-R antagonists, and other immunomodulatory agents show a promising outcome for GO patients.

  14. Imaging studies for diagnosing Graves' orbitopathy and dysthyroid optic neuropathy

    PubMed Central

    Gonçalves, Allan C. Pieroni; Gebrim, Eloísa M. M. S.; Monteiro, Mário L. R.

    2012-01-01

    Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies, such as computed tomography, magnetic resonance imaging, ultrasound and color Doppler imaging, play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss. In this paper, we review the imaging modalities that aid in the diagnosis and management of Graves' orbitopathy, with special emphasis on the diagnosis of optic nerve dysfunction in this condition. PMID:23184212

  15. Cradle to grave design of polymers for packaging

    SciTech Connect

    Narayan, R.

    1993-12-31

    Today`s polymeric materials are designed with little consideration for their ultimate disposability or recyclability. This has resulted in mounting worldwide concerns over the environmental consequences of such materials when they enter the waste stream after their intended uses. Of particular concern are polymers used in single use, disposable packaging applications. In the U.S., about 30% of synthetic polymers, totaling 16.5 billion pounds annually is used for packaging applications. Therefore, there is an urgent need to redesign and engineer new polymers that have the needed performance characteristics of the plastics, but can be transformed in appropriate waste disposal infrastructures to products that are compatible with the environment or recycled to the same or other products -- a {open_quotes}cradle to grave{close_quotes} design concept for materials. A {open_quotes}Cradle to Grave{close_quotes} design, use and disposal of new biodegradable polymers used in fast-food packaging will be presented. Integration of the biodegradable materials production with waste disposal infrastructures, specifically composting, will be discussed.

  16. Is Recombinant Human TSH a Trigger for Graves' Orbitopathy?

    PubMed Central

    Daumerie, C.; Boschi, A.; Perros, P.

    2012-01-01

    The pathogenesis of Graves' orbitopathy (GO) remains unknown. The hypothesis of a causal relationship between autoimmunity against the TSH receptor (TSHR) and GO is supported by clinical studies. Radioiodine treatment is associated with worsening or new onset of GO, possibly via antigen shedding or by inducing hypothyroidism. The coexistence of thyroid cancer with Graves' disease (GD) and GO is rare. Here we report 3 cases of reactivation of GO in patients who underwent treatment with recombinant human TSH (rhTSH) and radioiodine ablation. In each case, a thyroidectomy was performed to treat the GD, and an incidental thyroid cancer was discovered. In all 3 cases, reactivation of GO was observed 3–6 weeks after administration of rhTSH, despite maintaining euthyroidism, which was unaccompanied by a rise in serum TSHR antibodies after radioiodine and despite steroids in 1 of the 3 patients. These observations suggest that binding of either TSH or TSHR antibodies to the TSHR, independently of thyroid status, may be causally related to deterioration of GO. Clinicians should be aware of a possible association between rhTSH administration and reactivation of GO, which should be taken into account before prescribing rhTSH in patients with GO. Prophylactic steroids may need to be considered for patients at high risk of exacerbation of GO. PMID:24783004

  17. Is Recombinant Human TSH a Trigger for Graves' Orbitopathy?

    PubMed

    Daumerie, C; Boschi, A; Perros, P

    2012-07-01

    The pathogenesis of Graves' orbitopathy (GO) remains unknown. The hypothesis of a causal relationship between autoimmunity against the TSH receptor (TSHR) and GO is supported by clinical studies. Radioiodine treatment is associated with worsening or new onset of GO, possibly via antigen shedding or by inducing hypothyroidism. The coexistence of thyroid cancer with Graves' disease (GD) and GO is rare. Here we report 3 cases of reactivation of GO in patients who underwent treatment with recombinant human TSH (rhTSH) and radioiodine ablation. In each case, a thyroidectomy was performed to treat the GD, and an incidental thyroid cancer was discovered. In all 3 cases, reactivation of GO was observed 3-6 weeks after administration of rhTSH, despite maintaining euthyroidism, which was unaccompanied by a rise in serum TSHR antibodies after radioiodine and despite steroids in 1 of the 3 patients. These observations suggest that binding of either TSH or TSHR antibodies to the TSHR, independently of thyroid status, may be causally related to deterioration of GO. Clinicians should be aware of a possible association between rhTSH administration and reactivation of GO, which should be taken into account before prescribing rhTSH in patients with GO. Prophylactic steroids may need to be considered for patients at high risk of exacerbation of GO. PMID:24783004

  18. Radioiodine-induced hypothyroidism in Graves' disease: factors associated

    SciTech Connect

    Cunnien, A.J.; Hay, I.D.; Gorman, C.A.; Offord, K.P.; Scanlon, P.W.

    1982-11-01

    A retrospective analysis was done of the records of 454 patients who received their first /sup 131/I treatment for Graves' disease during six periods covering 1951 to 1978. In the earliest group, 3% of patients were hypothyroid 3 mo after /sup 131/I use, and 40% were hypothyroid at 1 yr. In the most recent group, 36% of patients were hypothyroid at 3 mo and 91% were myxedematous at 1 yr. Although no obvious trends were noted, whether in the number of patients pretreated with thionamide drugs, in the mean 24-hr /sup 131/I uptake, or in the calculated dose of /sup 131/I (muCi/estimated gram of thyroid tissue) during the years of the study, the initial mean dose of /sup 131/I administered increased from 8.1 mCi in the earliest group to 13.8 mCi in the latest group. Concurrently, estimates of gland size increased from a mean of 26 g in the first group to 43 g in the last. If, in patients with Graves' disease, the thyroid gland size did not truly increase during the years of the study, the increasing occurrence of early hypothyroidism seen after /sup 131/I use may reflect the conscious or unconscious decision to use larger doses of /sup 131/I calculated on the basis of inflated estimates of thyroid gland weight.

  19. Cytokines, Graves' Disease, and Thyroid-Associated Ophthalmopathy

    PubMed Central

    Khadavi, Nicole; Smith, Terry J.

    2008-01-01

    Graves' disease, an autoimmune process associated with thyroid dysfunction, can also manifest as remodeling of orbital connective tissue. Affected tissues exhibit immune responses that appear to be orchestrated by resident cells and those recruited from the bone marrow through their expression and release of cytokines and surface display of cytokine receptors. Cytokines are small molecules produced by many types of cells, including those of the “professional” immune system. Aberrant cytokine expression appears to play an important role in the pathogenesis of many human diseases, including thyroid autoimmunity. The skewed pattern of cytokine expression in the thyroid, including the T helper cell bias, may condition the response to apoptotic signals and determine the characteristics of an autoimmune reaction. Furthermore, chemoattractant cytokines, including IL16, RANTES, and CXCL10, elaborated by resident cells in the thyroid and orbit may provoke mononuclear cell infiltration. Other cytokines may drive cell activation and tissue remodeling. Thus cytokines and the signaling pathways they activate represent attractive therapeutic targets. Interruption of these might alter the natural course of Graves' disease and its orbital manifestations. PMID:18713026

  20. Cytokines, Graves' disease, and thyroid-associated ophthalmopathy.

    PubMed

    Gianoukakis, Andrew G; Khadavi, Nicole; Smith, Terry J

    2008-09-01

    Graves' disease, an autoimmune process associated with thyroid dysfunction, can also manifest as remodeling of orbital connective tissue. Affected tissues exhibit immune responses that appear to be orchestrated by resident cells and those recruited from the bone marrow through their expression and release of cytokines and surface display of cytokine receptors. Cytokines are small molecules produced by many types of cells, including those of the "professional" immune system. Aberrant cytokine expression appears to play an important role in the pathogenesis of many human diseases, including thyroid autoimmunity. The skewed pattern of cytokine expression in the thyroid, including the T helper cell bias, may condition the response to apoptotic signals and determine the characteristics of an autoimmune reaction. Furthermore, chemoattractant cytokines, including IL16, RANTES, and CXCL10, elaborated by resident cells in the thyroid and orbit may provoke mononuclear cell infiltration. Other cytokines may drive cell activation and tissue remodeling. Thus cytokines and the signaling pathways they activate represent attractive therapeutic targets. Interruption of these might alter the natural course of Graves' disease and its orbital manifestations. PMID:18713026

  1. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

    PubMed Central

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J.; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M.; Adamidou, Fotini; Anagnostis, Panagiotis; Ayvaz, Goksun; Azzolini, Claudio; Boschi, Antonella; Bournaud, Claire; Clarke, Lucy; Currò, Nicola; Daumerie, Chantal; Dayan, Colin; Fuhrer, Dagmar; Konuk, Onur; Marinò, Michele; Morris, Daniel; Nardi, Marco; Pearce, Simon; Pitz, Susanne; Rudovsky, Gottfried; Vannucchi, Guia; Vardanian, Christine; von Arx, Georg

    2016-01-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment. PMID:27099835

  2. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy.

    PubMed

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M

    2016-03-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment. PMID:27099835

  3. 76 FR 12132 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... the Interior, as required by law, in order to effect the agreed-upon disposition of Native...

  4. 77 FR 7180 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves Protection... of Native American human remains determined to be culturally unidentifiable; presentations by...

  5. 76 FR 69282 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-08

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... effect the agreed-upon disposition of Native American human remains determined to be...

  6. 48 CFR 352.242-72 - Native American Graves Protection and Repatriation Act.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Native American Graves... and Clauses 352.242-72 Native American Graves Protection and Repatriation Act. As prescribed in 342.302(c)(4), the Contracting Officer shall insert the following clause: Native American...

  7. 75 FR 9429 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of three meetings of the Native American Graves... agreement, of Native American human remains determined to be culturally unidentifiable; and presentations...

  8. Radioiodine thyroid ablation in graves' hyperthyroidism: merits and pitfalls.

    PubMed

    Nwatsock, J F; Taieb, D; Tessonnier, L; Mancini, J; Dong-A-Zok, F; Mundler, O

    2012-01-01

    Ablative approaches using radioiodine are increasingly proposed for the treatment of Graves' disease (GD) but their ophthalmologic and biological autoimmune responses remain controversial and data concerning clinical and biochemical outcomes are limited. The aim of this study was to evaluate thyroid function, TSH-receptor antibodies (TRAb) and Graves' ophthalmopathy (GO) occurrence after radioiodine thyroid ablation in GD. We reviewed 162 patients treated for GD by iodine-131 ((131)I) with doses ranging from 370 to 740 MBq, adjusted to thyroid uptake and sex, over a 6-year period in a tertiary referral center. Collected data were compared for outcomes, including effectiveness of radioiodine therapy (RIT) as primary endpoint, evolution of TRAb, and occurrence of GO as secondary endpoints. The success rate was 88.3% within the first 6 months after the treatment. The RIT failure was increased in the presence of goiter (adjusted odds ratio = 4.1, 95% confidence interval 1.4-12.0, P = 0.010). The TRAb values regressed with time (r = -0.147; P = 0.042) and patients with a favorable outcome had a lower TRAb value (6.5 ± 16.4 U/L) than those with treatment failure (23.7 ± 24.2 U/L, P < 0.001). At the final status, 48.1% of patients achieved normalization of serum TRAb. GO occurred for the first time in 5 patients (3.7%) who were successfully cured for hyperthyroidism but developed early and prolonged period of hypothyroidism in the context of antithyroid drugs (ATD) intolerance (P = 0.003) and high TRAb level (P = 0.012). On the basis the results of this study we conclude that ablative RIT is effective in eradicating Graves' hyperthyroidism but may be accompanied by GO occurrence, particularly in patients with early hypothyroidism and high pretreatment TRAb and/or ATD intolerance. In these patients, we recommend an early introduction of LT4 to reduce the duration and the degree of the radioiodine-induced hypothyroidism. PMID:22942775

  9. Monitoring controlled graves representing common burial scenarios with ground penetrating radar

    NASA Astrophysics Data System (ADS)

    Schultz, John J.; Martin, Michael M.

    2012-08-01

    Implementing controlled geophysical research is imperative to understand the variables affecting detection of clandestine graves during real-life forensic searches. This study focused on monitoring two empty control graves (shallow and deep) and six burials containing a small pig carcass (Sus scrofa) representing different burial forensic scenarios: a shallow buried naked carcass, a deep buried naked carcass, a deep buried carcass covered by a layer of rocks, a deep buried carcass covered by a layer of lime, a deep buried carcass wrapped in an impermeable tarpaulin and a deep buried carcass wrapped in a cotton blanket. Multi-frequency, ground penetrating radar (GPR) data were collected monthly over a 12-month monitoring period. The research site was a cleared field within a wooded area in a humid subtropical environment, and the soil consisted of a Spodosol, a common soil type in Florida. This study compared 2D GPR reflection profiles and horizontal time slices obtained with both 250 and 500 MHz dominant frequency antennae to determine the utility of both antennae for grave detection in this environment over time. Overall, a combination of both antennae frequencies provided optimal detection of the targets. Better images were noted for deep graves, compared to shallow graves. The 250 MHz antenna provided better images for detecting deep graves, as less non-target anomalies were produced with lower radar frequencies. The 250 MHz antenna also provided better images detecting the disturbed ground. Conversely, the 500 MHz antenna provided better images when detecting the shallow pig grave. The graves that contained a pig carcass with associated grave items provided the best results, particularly the carcass covered with rocks and the carcass wrapped in a tarpaulin. Finally, during periods of increased soil moisture levels, there was increased detection of graves that was most likely related to conductive decompositional fluid from the carcasses.

  10. Management plan and delivery of care in Graves' ophthalmopathy patients.

    PubMed

    Yang, Morgan; Perros, Petros

    2012-06-01

    Most patients with Graves' orbitopathy have mild disease that requires no or minimal intervention. For the minority of patients with moderate or severe disease, multiple medical and surgical treatments may be required at different stages. It is crucial that such patients are monitored closely and treatments applied with care in the right sequence. Medical treatments should be used as early as possible and only during the active phase of the disease. Rehabilitative surgery is indicated in the inactive phase of the disease and should follow the sequence: surgical decompression followed by eye muscle surgery, followed by lid surgery. Delivery of care in a coordinated fashion that makes use of best available expertise is important and best implemented through a Combined Thyroid Eye clinic. PMID:22632367

  11. [The necklace from the 660 grave in Megara Iblea].

    PubMed

    Verger, Stéphane

    2011-01-01

    The article analyzes the 660 grave in Megara Iblea, a Greek colony in Sicily, in which a woman has been buried. On her breast a magnificent neckless was found, made of amulets recalling the travel of the sun during the summer solstice. Some objects allude to solar cults (a cock; round pendants), others seem to came from Gallia and Macedonia (summer far West and East), others recall archeological contexts such as tombs in Marvinci, in the Vardar Valley, and allude to relations with female practices of medicine and magic and to female roles characterized by extraordinary powers, due to being descendants of the Sun god. These solar symbols, joint with the discovery of many little objects, typical of children burials, allow to hypotize a relation with the cult of Mater Matuta and seem to point out a difficult or anomalous pregnancy or birth. PMID:21941988

  12. THERAPY OF ENDOCRINE DISEASE: Endocrine dilemma: management of Graves' orbitopathy.

    PubMed

    Campi, Irene; Vannucchi, Guia; Salvi, Mario

    2016-09-01

    Management of Graves' orbitopathy (GO) must be based on the correct assessment of activity and severity of the disease. Activity is usually assessed with the Clinical Activity Score, whereas severity is classified according to a European Group On Graves' Orbitopathy (EUGOGO) consensus statement as mild, moderate-to-severe, and sight-threatening. Myopathic and chronic congestive forms are uncommon clinical presentations of GO. Restoration and maintenance of stable euthyroidism are recommended in the presence of GO.In moderate-to-severe disease, steroids have been widely employed and have shown to possess an anti-inflammatory activity, but about 20-30% of patients are not responsive and present recurrence. Some novel immunosuppressors have already been employed in clinical studies and have shown interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the thyroid-stimulating hormone and the insulin-like growth factor 1 receptor on the fibroblasts, inflammatory cytokines, B and T cells, and the PIK3/mTORC1 signaling cascades for adipogenesis. A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials.As the main goal of treatment is the well-being of the patient, the therapeutic strategy should be addressed to better suit the patient needs, more than improving one or more biological parameters. The increasing availability of new therapies will expand the therapeutic options for GO patients and allow the clinician to really personalize the treatment to better suit the patients' personal needs. PMID:27032693

  13. Association between Polymorphisms in the TSHR Gene and Graves' Orbitopathy

    PubMed Central

    Jurecka-Lubieniecka, Beata; Ploski, Rafal; Kula, Dorota; Szymanski, Konrad; Bednarczuk, Tomasz; Ambroziak, Urszula; Hasse-Lazar, Kornelia; Hyla-Klekot, Lidia; Tukiendorf, Andrzej; Kolosza, Zofia; Jarzab, Barbara

    2014-01-01

    Background Graves' orbitopathy (GO) as well as Graves' disease (GD) hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR). GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age), for whom environmental effects had less time to influence outcomes than in adults. Methods 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2). Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4) and lymphoid protein tyrosine phosphatase (PTPN22). Results The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. Conclusions Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients. PMID:25061884

  14. Total thyroidectomy as primary definitive treatment for Graves' hyperthyroidism.

    PubMed

    Snyder, Samuel; Govednik, Cara; Lairmore, Terry; Jiang, Da-Shu; Song, Juhee

    2013-12-01

    The objective of this study was to compare the results of total thyroidectomy (TT) for hyperthyroidism secondary to Graves' disease (GD) with TT for other benign thyroid diseases to determine if TT should be considered more often as first-line therapy for GD. Seven hundred eighty patients underwent TT for benign disease: 203 for GD, 56 for other hyperthyroidisms, and 521 for other benign diseases from March 1, 2003, to December 31, 2009. The perioperative results of these three groups were compared for demographics, blood loss, operative time, complications, and hospitalization. There were no significant differences among the three groups except the patients with GD were more likely to be younger (42 vs 56 vs 57 years; P < 0.001), have more blood loss (154 vs 99 vs 110 mL; P = 0.05), and were more likely to develop permanent hypoparathyroidism (1.0 vs 1.8 vs 0%; P = 0.03) when compared with other causes of hyperthyroidism and other benign thyroid diseases. Permanent recurrent laryngeal nerve injury did not occur in the GD group (0 vs 0 vs 0.4% nerves at risk; P = 0.69) with transient recurrent laryngeal nerve injury occurring in 1.7 versus 2.7 versus 3.1 per cent nerves at risk (P = 0.35). The lack of a euthyroid state preoperatively had no influence on surgical outcomes or complications. Eighty percent of the TTs for GD were done as same-day outpatient procedures. TT offers a safe, low-risk, and rapid cure for GD to justifiably be considered as a reasonable first-line therapy in selected patients with Graves' hyperthyroidism. PMID:24351357

  15. Thyroid-stimulating antibody (TSAb) of Graves' disease.

    PubMed

    Zakarija, M; McKenzie, J M

    The current knowledge of thyroid-stimulating antibody (TSAb) and its significance in Graves' disease is reviewed under 4 headings. 1) Methods of assay; these are categorized as thyroid-stimulation or thyrotropin-receptor-modulation type methods. The latter are convenient but non-specific and the former are inconvenient but specific. The use of guinea pig fat cell membranes as a source of receptor for thyrotropin may improve the specificity of the thyrotropin-binding inhibition (TBI) system. 2) Immunochemistry of TSAb; evidence for the restricted heterogeneity, or oligoclonality, of the antibody as it occurs in some sera, viz. selected for the very high titer, includes a relatively constant pI on isoelectric focussing, restriction to IgG1 and having only lambda or k as the light chain. 3) Are antibodies other than TSAb pathogenic in hyperthyroidism? data are provided indicating the presence in one serum of an antibody that inhibits the action of TSAb in vitro. Clinically this novel antibody caused delayed onset of neonatal hyperthyroidism in 2 children. The prevalence of the antibody and its general clinical significance are unknown, but ways of testing for its presence are reviewed. 4) Clinical significance of the assay of TSAb; TSAb occurs in at least 90% of patients but should not be necessary for the diagnosis of Graves' disease. Its persistence at the end of a course of antithyroid drugs predicates relapse; a high level on first diagnosis may forecast such persistence and be an indication for ablative therapy for hyperthyroidism. A high level of TSAb in the third trimester of pregnancy is a reliable index of neonatal hyperthyroidism. It should be recognized that there is a marked tendency for TSAb values to fall throughout the course of pregnancy.

  16. 76 FR 39007 - Native American Graves Protection and Repatriation Act Regulations- Definition of “Indian Tribe”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD98 Native American Graves Protection... regulations implementing the Native American Graves Protection and Repatriation Act (NAGPRA) removes the... implementation of the Native American Graves Protection and Repatriation Act, including the issuance...

  17. Graves' Patient with Thymic Expression of Thyrotropin Receptors and Dynamic Changes in Thymic Hyperplasia Proportional to Graves' Disease Activity

    PubMed Central

    Song, Young Shin; Won, Jae-Kyung; Kim, Mi Jeong; Lee, Ji Hyun; Kim, Dong-Wan; Chung, June-Key; Park, Do Joon

    2016-01-01

    Thymic hyperplasia is frequently observed in Graves' disease. However, detectable massive enlargement of the thymus is rare, and the mechanism of its formation has remained elusive. This case showed dynamic changes in thymic hyperplasia on serial computed tomography images consistent with changes in serum thyrotropin receptor (TSH-R) antibodies and thyroid hormone levels. Furthermore, the patient's thymic tissues underwent immunohistochemical staining for TSH-R, which demonstrated the presence of thymic TSH-R. The correlation between serum TSH-R antibody levels and thymic hyperplasia sizes and the presence of TSH-R in her thymus suggest that TSH-R antibodies could have a pathogenic role in thymic hyperplasia. PMID:26996584

  18. Nitrous oxide, methane and carbon dioxide dynamics from experimental pig graves.

    PubMed

    Dalva, M; Moore, T R; Kalacska, M; Leblanc, G; Costopoulos, A

    2015-02-01

    Twelve pig carcasses were buried in single, shallow and deep (30 and 90 cm, respectively) graves at an experimental site near Ottawa, Ontario, Canada, with three shallow and three deep wrapped in black plastic garbage bags. An additional six carcasses were left at the surface to decompose, three of which were bagged. Six reference pits without remains were also dug. The objective of this three-year study was to examine the biogeochemistry and utility of nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) in grave detection and whether grave depth or cadaver condition (bagged versus bare) affected soil pore air concentrations and emission of the three gases. Graves showed significantly higher (α=0.05) concentrations and surface fluxes of N2O and CO2 than reference pits, but there was no difference in CH4 between graves and reference pits. While CH4 decreased with depth in the soil profiles, N2O and CO2 showed a large increase compared to reference pits. Shallow graves showed significantly higher emissions and pore air concentrations of N2O and CO2 than deep graves, as did bare versus bagged carcasses.

  19. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    PubMed Central

    Žarković, Miloš

    2012-01-01

    Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs) are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS). Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1) involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo. PMID:22175033

  20. Nitrous oxide, methane and carbon dioxide dynamics from experimental pig graves.

    PubMed

    Dalva, M; Moore, T R; Kalacska, M; Leblanc, G; Costopoulos, A

    2015-02-01

    Twelve pig carcasses were buried in single, shallow and deep (30 and 90 cm, respectively) graves at an experimental site near Ottawa, Ontario, Canada, with three shallow and three deep wrapped in black plastic garbage bags. An additional six carcasses were left at the surface to decompose, three of which were bagged. Six reference pits without remains were also dug. The objective of this three-year study was to examine the biogeochemistry and utility of nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) in grave detection and whether grave depth or cadaver condition (bagged versus bare) affected soil pore air concentrations and emission of the three gases. Graves showed significantly higher (α=0.05) concentrations and surface fluxes of N2O and CO2 than reference pits, but there was no difference in CH4 between graves and reference pits. While CH4 decreased with depth in the soil profiles, N2O and CO2 showed a large increase compared to reference pits. Shallow graves showed significantly higher emissions and pore air concentrations of N2O and CO2 than deep graves, as did bare versus bagged carcasses. PMID:25544693

  1. Experiments to Detect Clandestine Graves from Interpreted High Resolution Geophysical Anomalies

    NASA Astrophysics Data System (ADS)

    Molina, C. M.; Hernandez, O.; Pringle, J.

    2013-05-01

    This project refers to the search for clandestine sites where possibly missing people have been buried based on interpreted near surface high resolution geophysical anomalies. Nowadays, there are thousands of missing people around the world that could have been tortured and killed and buried in clandestine graves. This is a huge problem for their families and governments that are responsible to warranty the human rights for everybody. These people need to be found and the related crime cases need to be resolved. This work proposes to construct a series of graves where all the conditions of the grave, human remains and related objects are known. It is expected to detect contrasting physical properties of soil to identify the known human remains and objects. The proposed geophysical methods will include electrical tomography, magnetic and ground penetrating radar, among others. Two geographical sites will be selected to located and build standard graves with contrasting weather, soil, vegetation, geographic and geologic conditions. Forward and inverse modeling will be applied to locate and enhance the geophysical response of the known graves and to validate the methodology. As a result, an integrated geophysical program will be provided to support the search for clandestine graves helping to find missing people that have been illegally buried. Optionally, the methodology will be tested to search for real clandestine graves.

  2. Mapping anthropogenic fill with GPR for unmarked grave detection: a case study from a possible location of Mokare's grave, Albany, Western Australia

    NASA Astrophysics Data System (ADS)

    Bladon, Paul; Moffat, Ian; Guilfoyle, David; Beale, Alice; Milani, Jennifer

    2011-11-01

    Geophysical techniques are a commonly used, non-invasive method for the location of unmarked graves. Contrary to popular perception, most studies rely not on directly imaging skeletal material but instead on locating the subsurface disturbance created by grave digging. This approach is effective only when sufficient contrast exists between detectable properties (such as structure, mineralogy or porosity) of the grave fill and the surrounding sediment. Resolving these features can be particularly problematic in disturbed areas where other anthropogenic fill is in place, as it is often complex in character and lacks a natural stratigraphy. In many cultural heritage projects, it is often more important to ensure that burials are not disturbed rather than to specifically locate them. Under these circumstances, ground penetrating radar (GPR) can be used to locate modern anthropogenic fill. This may show which areas of the site are younger than the targeted graves and therefore of no archaeological interest. This approach is trialled on a site thought to contain the grave of Mokare, a significant historical figure in the colonial settlement of the Albany area in Western Australia. The delineation of a package of modern fill in the shallow subsurface in the context of the probable history of earthworks on the site demonstrates that Mokare is not buried in the surveyed location. This approach, applied to suitable sites, could contribute to culturally sensitive non-invasive investigation of burial sites in other locations.

  3. Radioiodine treatment of Graves' disease. An assessment of its potential risks

    SciTech Connect

    Graham, G.D.; Burman, K.D.

    1986-12-01

    Concern about the side effects of radiation exposure has deterred physicians from using radioiodine treatment for Graves' disease, although the efficacy and safety of this treatment have been established in the 35 years since its introduction. In that time, no significant side effects have been discovered. We believe iodine-131 should be considered the treatment of choice in most patients with Graves' disease. This article reviews the current understanding of the risks in radioiodine treatment of Graves' disease, including the risks for teratogenicity, genetic damage, carcinogenesis, and cellular dysfunction.

  4. 77 FR 65406 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Notice of nomination solicitation... Protection and Repatriation Review Committee, National NAGPRA Program, National Park Service, 1201 Eye...

  5. VIEW OF FLAT GRAVE MARKERS AL0NG SAINT MIHIEL AVENUE, WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW OF FLAT GRAVE MARKERS AL0NG SAINT MIHIEL AVENUE, WITH UPRIGHT MARKERS IN BACKGROUND. VIEW TO NORTHWEST. - Los Angeles National Cemetery, 950 South Sepulveda Boulevard, Los Angeles, Los Angeles County, CA

  6. Dilated cardiomyopathy with Graves disease in a young child.

    PubMed

    Choi, Yu Jung; Jang, Jun Ho; Park, So Hyun; Oh, Jin-Hee; Koh, Dae Kyun

    2016-06-01

    Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP. PMID:27462586

  7. Dilated cardiomyopathy with Graves disease in a young child

    PubMed Central

    Choi, Yu Jung; Jang, Jun Ho; Oh, Jin-Hee; Koh, Dae Kyun

    2016-01-01

    Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP. PMID:27462586

  8. Odontological identification of human remains from mass graves in Croatia.

    PubMed

    Brkic, H; Strinovic, D; Kubat, M; Petrovecki, V

    2000-01-01

    This paper reports the results and methods of dental identification of 1000 human remains exhumed from mass graves in Croatia up to July 1998. Personal identification of the victims was performed at the Department of Forensic Medicine and Criminology at the School of Medicine in Zagreb. A forensic odontologist participated in the identification process by carrying out the dental identification. A total of 824 victims were positively identified, while 176 victims remained unidentified. Dental identification based on available dental antemortem data was achieved in 25% of the cases. Dental identification based on dental charts was achieved in 35%, on x-rays in 15%, on photographs of teeth in 22%, on interviews in 18%, and on confirmation by odontologists in 10% of the cases. Teeth, in combination with anthropological parameters, age, sex and height, as well as other specific characteristics such as tattoos, personal identification cards, clothes, jewellery and DNA, were helpful for identification of 64% of the victims, but the significance for the identification was not dominant. Only in 11% of the cases was identification achieved by other relevant means and teeth not used at all. Identification procedures in Croatia will continue until another 1700 people who are still missing or kept as prisoners of war since the aggression on Croatia in 1991 are found and/or identified. PMID:11197622

  9. A case of autoimmune hepatitis combined with Graves' disease.

    PubMed

    Jhee, Jong Hyun; Kim, Hyun Ju; Kang, Wonseok; Kim, Sewha; Kim, Do Young

    2015-01-01

    A 25-year-old woman presented with jaundice, palpitation, and weight loss of 5 kg during a period of 2 weeks. Laboratory tests showed elevated levels of liver enzymes (AST 1,282 IU/L, ALT 1,119 IU/L) and total bilirubin (6.4 mg/dL); negative for hepatitis virus infection; elevated serum levels of triiodothyronine (T3, 3.60 ng/dL), free thyroxine (fT4, 3.82 ng/dL), and lowered serum level of thyroid stimulating hormone (TSH, <0.025 μIU/mL); and positive for thyroid stimulating antibody and anti-mitochondrial antibody (AMA). The liver biopsy findings were consistent with autoimmune hepatitis (AIH). Accordingly, oral steroid therapy was started with 60 mg of prednisolone under the impression of AIH associated with Graves' disease. After a week of steroid therapy, the clinical manifestation showed significant improvement, with normalization of both liver and thyroid functions. Diagnosis of the liver condition of patients who present with hyperthyroidism and liver dysfunction is important, so that appropriate therapy can be promptly initiated. PMID:25603854

  10. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    PubMed

    Messina, G; Viceconti, N; Trinti, B

    1997-11-01

    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  11. Cradle-to-Grave Logistic Technologies for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Broyan, James L.; Ewert, Michael K.; Shull, Sarah

    2013-01-01

    Human exploration missions under study are very limited by the launch mass capacity of exiting and planned vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Consequently, crew item logistical mass is typically competing with vehicle systems for mass allocation. NASA is Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing four logistics technologies guided by a systems engineering cradle-to-grave approach to enable used crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion supply gases. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as the mission duration increases. This paper provides a description, benefits, and challenges of the four technologies under development and a status of progress at the mid ]point of the three year AES project.

  12. An unusual presenting symptom of graves' disease: myalgia.

    PubMed

    Papanikolaou, N; Perros, P

    2013-01-01

    A 50-year-old female patient presented with severe myalgia involving her proximal muscles for 3-4 weeks. She also reported mild thyrotoxic symptoms over the same time period. Examination revealed mild thyrotoxicosis, a moderate diffuse goiter and no eye signs. The clinical picture was dominated by muscle pain and tenderness involving mainly her proximal arms and legs, her calves and her fingers, requiring opiate analgesia. Muscle power and tendon reflexes were normal. Laboratory evaluation revealed undetectable serum thyroid stimulating hormone (TSH) with raised FT4, FT3 and positive TSH receptor antibodies. Treatment with carbimazole was started. Additional laboratory investigations were negative (inflammatory markers, creatine kinase and antibodies to antinuclear antibodies, gastric parietal cell, smooth muscle, mitochondrial, dsDNA, centromere, extractable nuclear antigen (ENA) ribonucleoprotein, ENA Sm, ENA Ro, ENA Anti-La, ENA Scl70, ENA Jo-1, anti-CCP and rheumatoid factor). Further assessment in the rheumatology clinic confirmed there was no small joint tenderness or loss of range of movement of her limbs, but widespread and profound muscle tenderness of the common extensors of the forearms, biceps, trapezius, calves and thighs. She was treated symptomatically with analgesic medication and continued on carbimazole. A month later she was euthyroid and her myalgia had resolved. Hyperthyroidism has a profound effect on skeletal muscle and often leads to myopathy. Severe myalgia in association with Graves' disease is rare and resolves with the restoration of euthyroidism. PMID:24783030

  13. [Management of Graves' disease and hypothyroidism in pregnancy].

    PubMed

    Momotani, Naoko; Iwama, Saika

    2012-11-01

    In the treatment of pregnant patients with Graves' disease, propylthiouracil is preferred over methimazole in early pregnancy because of a possible teratogenicity of methimazole. Methimazole is preferable to propylthiouracil in other time of pregnancy on the basis of severe liver dysfunction occasionally caused by propylthiouracil. Fetal hypothyroidism can be avoided when maternal free T4 levels are maintained at or above the upper normal limit for non-pregnant subjects. However, maternal free T4 should be kept normal for pregnant reference range when pregnancy complications develop. Fetal hypothyroidism in this setting will not affect the infant's development as long as mothers are euthyroid and the infants recover from hypothyroid state within a short time after birth. In hypothyroid women, 1-T4 dose often needs to be increased in pregnancy. Maternal T4 deficiency in early pregnancy has been suggested to affect normal brain development in the offspring. However, it has recently been shown in iodine rich area that no adverse effect on neuropsychological development was seen irrespective of the severity of maternal T4 deficiency. Insufficient iodine intake in the mother can cause low T4 in pregnancy and also inadequate production of T4 in breast-fed infants when sufficient T4 is essential for normal brain development.

  14. Clinical efficacy of Yingliu treatment for Graves disease

    PubMed Central

    Yang, Hua; Bi, Xiaojuan; Tang, Hong; Zeng, Juanhua; Cong, Yilei; Wu, Tengfei; Chen, Qiuye

    2015-01-01

    Objective: To observe the clinical efficacy and safety of the traditional Chinese medicine (TCM) mixture Yingliu combined with methimazole medication for the treatment of Graves disease (GD). Method: In a randomized, paralleled control study, 92 GD patients were randomized into a Yingliu mixture treatment and a control treatment group, both receiving methimazole. Both treatments lasted for 12 weeks and outcome parameter were thyroid function, thyroid autoantibodies, TCM symptome scores and safety indicators. Results: The clinical efficiency of the Yingliu mixture-methimazole combination was 92.5% vs. 82.5% (P < 0.05) of the solely methimazole medication group. After 12 weeks treatments the Yingliu mixture in combination with methimazole improved free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) receptor antibody (TRAb) and thyroglobulin antibody (TGAb) values significantly more than methimazole alone and TCM symptome scores were significant lower after 12 week treatment in the Yingliu mixture- methimazole group (P < 0.05). The thyroid enlargement (21 vs. 10, P < 0.05), fatigue (39 vs. 30, P < 0.01) and dry mouth symptoms (37 vs. 29, P < 0.05) were superior improved in the Yingliu than in the control medication group, respectively. There was no significant difference regarding safety evaluations between both treatment groups (P = 0.499). Conclusion: Yingliu mixture as combined medication with methimazole can significantly improve the outcome of a solely methimazole application for GD treatments. PMID:26131218

  15. Optimal iodine-131 dose for eliminating hyperthyroidism in Graves' disease

    SciTech Connect

    Nordyke, R.A.; Gilbert, F.I. Jr. )

    1991-03-01

    Since hypothyroidism is commonplace after treatment of Graves' disease with radioiodine, the goal should be cure of hyperthyroidism rather than avoidance of hypothyroidism. To find the optimal dose to accomplish cure, we treated 605 patients with stepwise increasing doses of 3, 4, 5, 6, 8, and 10 mCi, analyzing the relationship of dose, age, sex, gland weight, and thyroidal uptake to cure. Estimates of cure at doses above 10 mCi were made from the literature. Cure was directly related to dose between 5 and 10 mCi. There was no significant relationship between cure and age (chi-square, p = 0.74), sex (chi-square, p = 0.12), and 24-hr uptake if over 30% (chi-square for slope, p greater than 0.10). Cure and gland weight had an inverse relationship (chi-square for slope, 0.01 less than p less than 0.02). We concluded that the optimal 131I dose for curing hyperthyroidism is approximated by starting with 10 mCi and increasing it for unusually large glands or for special patient circumstances.

  16. Prenatal diagnosis and management of fetal goiter caused by maternal Grave's disease.

    PubMed

    Hadi, H A; Strickland, D

    1995-07-01

    We present a case of maternal Grave's disease associated with fetal goitrous hyperthyroidism. Fetal goiter was diagnosed by ultrasound and diagnosis of fetal hyperthyroidism was established by umbilical blood sampling. Fetus was successfully treated by increasing maternal propylthiouracil dosage. Fetal thyroid status was normal at birth. Role of sonography and umbilical blood sampling in management of fetal goiter complicated with maternal Grave's disease is discussed. PMID:7575824

  17. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    PubMed

    Wartofsky, L

    1997-04-01

    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

  18. Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy

    PubMed Central

    Yang, Yeoree; Hwang, Seawon; Kim, Minji; Lim, Yejee; Kim, Min-Hee; Lee, Sohee; Kang, Moo-Il; Cha, Bong-Yun

    2015-01-01

    The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies. PMID:26394731

  19. [Pulmonary carcinomatous lymphangitis: presentation as acute pneumopathy. Report of two cases].

    PubMed

    Ré, D P; Cazaux, A; Cambursano, V H; Zaya, A; Cortez, J R

    2013-01-01

    Introducción: La linfangitis carcinomatosa(LC) representa el 6-8% de las metástasis pulmonares. Existe evidencia de que puede ser una condición oncológicamente tratable, con impacto sobre la progresión de la disnea y lesiones radiológicas, con mejoría de la sobrevida. Se describen dos casos con el objetivo de inducir la sospecha de esta entidad ante un paciente con datos de neumopatía aguda. Métodos: Caso 1: mujer 32 años, disnea progresiva y tos de dos semanas de evolución sin respuesta a antibióticos. Taquipnea, aumento del trabajo respiratorio, crepitantes bibasales. Insuficiencia respiratoria. Radiografía: radiopacidadalvéolointersticialbibasal. Se inicia tratamiento para neumonía grave de la comunidad. Evoluciona desfavorablemente con requerimiento de ARM y desenlace fatal. Caso 2: mujer 46 años, disnea progresiva y tos de una semana de evolución. Taquipnea, subcrepitantes difusos.Insuficiencia respiratoria. Radiografía: radiopacidadintersticionodulillar difusa, con imagen radiopaca homogénea en vértice derecho.

  20. Lithium as an Alternative Option in Graves Thyrotoxicosis

    PubMed Central

    Prakash, Ishita; Nylen, Eric Sixtus; Sen, Sabyasachi

    2015-01-01

    A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was >6.99 ng/dL (0.7–1.8); FT3 was 18 pg/mL (3–5); TSI was 658% (0–139). Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis. PMID:26425375

  1. Predicting relapse following medical therapy for Graves' disease

    SciTech Connect

    McKillop, J.H.; Wilson, R.; Pearson, D.W.; Cuthbert, G.F.; Jenkins, C.; Caine, S.; Thomson, J.A.

    1984-01-01

    In 40 patients with Graves' disease (35 female, 5 male; mean age at presentation = 38 yrs) the authors examined the ability of thyroidal /sup 99m/Tc uptake and serum thyroid stimulating immunoglobins (TSI) to identify patients who would relapse after a course of medical therapy. Serum TSI and 20 minute thyroidal /sup 99m/Tc uptake were estimated every 3 months during a 12 month course of carbimazole and tri iodothyronine. TSI levels were estimated by inhibition of receptor binding and expressed as an index (normal value <25). 17 patients (Group 1) remained biochemically euthyroid for at least 1 year after cessation of therapy. 23 (Group II) developed recurrent thyrotoxicosis. Thyroid hormone level did not differ between Groups I and II at presentation. /sup 99m/Tc uptake did not differ significantly in the two groups at presentation and overlap of values persisted throughout therapy. 3 patients had undetectable TSI levels at presentation and throughout follow-up. In the remaining 37, TSI levels at presentation were significantly higher in Group II and all 7 patients with initial values >80 relapsed. After 12 months therapy a TSI level of >25 was present in 1 Group I patient and 16 Group II patients who had detectable TSI at presentation. /sup 99m/Tc uptake was a poor predictor of relapse of thyrotoxicosis. A very high TSI level at presentation (>80) was associated with relapse. An abnormal TSI on completion of 12 months medical therapy had a sensitivity of 86% and a specificity of 94% for prediction of relapse of thyrotoxicosis in the subsequent year.

  2. Prognostic factors in the radiotherapy of Graves' ophthalmopathy

    SciTech Connect

    Petersen, I.A.; Kriss, J.P.; McDougall, I.R.; Donaldson, S.S. )

    1990-08-01

    Between April 1968 and February 1988, 311 patients with symptomatic and progressive Graves' ophthalmopathy were treated with megavoltage orbital radiotherapy. The patients were divided into three groups: I treated with 20 Gy/2 weeks; II treated with 30 Gy/3 weeks, and III received 20 Gy/2 weeks. The degree of eye involvement was evaluated numerically before and after therapy for each of five parameters: soft tissue signs, proptosis, eye muscle impairment, corneal involvement, and sight loss. Pre-treatment and current thyroid diagnosis and status were also noted. To evaluate the effects of radiotherapy alone, follow-up was terminated at the time any eye surgery was done; for those not treated surgically the minimum follow-up was 12 months. Because there were significant demographic differences between the patient groups, the results of each group were analyzed separately. A stepwise linear regression analysis was performed to determine if there were any significant variables affecting outcome. Based on these data formulae were derived which enable outcome to be predicted in any patient. Before therapy more than 90% of patients in all groups had soft tissue and eye muscle involvement, whereas 65-75% had proptosis and about half 50% had some degree of sight loss. Radiotherapy arrested progression of ophthalmic parameters in all but 1-6% of the patients. Objective and symptomatic improvement was noted for all parameters assessed, but there was marked individual variability. The best responses were noted for soft tissue, corneal involvement, and sight loss; however over half the patients had some improvement in eye muscle function and proptosis. Factors which resulted in less favorable outcome included male gender, advanced age, need for concurrent therapy for hyperthyroidism, and no history of hyperthyroidism. No complications have been observed.

  3. Thyrotropin Receptor Epitope and Human Leukocyte Antigen in Graves' Disease.

    PubMed

    Inaba, Hidefumi; De Groot, Leslie J; Akamizu, Takashi

    2016-01-01

    Graves' disease (GD) is an organ-specific autoimmune disease, and thyrotropin (TSH) receptor (TSHR) is a major autoantigen in this condition. Since the extracellular domain of human TSHR (TSHR-ECD) is shed into the circulation, TSHR-ECD is a preferentially immunogenic portion of TSHR. Both genetic factors and environmental factors contribute to development of GD. Inheritance of human leukocyte antigen (HLA) genes, especially HLA-DR3, is associated with GD. TSHR-ECD protein is endocytosed into antigen-presenting cells (APCs), and processed to TSHR-ECD peptides. These peptide epitopes bind to HLA-class II molecules, and subsequently the complex of HLA-class II and TSHR-ECD epitope is presented to CD4+ T cells. The activated CD4+ T cells secrete cytokines/chemokines that stimulate B-cells to produce TSAb, and in turn hyperthyroidism occurs. Numerous studies have been done to identify T- and B-cell epitopes in TSHR-ECD, including (1) in silico, (2) in vitro, (3) in vivo, and (4) clinical experiments. Murine models of GD and HLA-transgenic mice have played a pivotal role in elucidating the immunological mechanisms. To date, linear or conformational epitopes of TSHR-ECD, as well as the molecular structure of the epitope-binding groove in HLA-DR, were reported to be related to the pathogenesis in GD. Dysfunction of central tolerance in the thymus, or in peripheral tolerance, such as regulatory T cells, could allow development of GD. Novel treatments using TSHR antagonists or mutated TSHR peptides have been reported to be effective. We review and update the role of immunogenic TSHR epitopes and HLA in GD, and offer perspectives on TSHR epitope specific treatments. PMID:27602020

  4. Spontaneous Improvement of Untreated Mild Graves' Ophthalmopathy: Rundle's Curve Revisited

    PubMed Central

    Menconi, Francesca; Profilo, Maria Antonietta; Leo, Marenza; Sisti, Eleonora; Altea, Maria Antonietta; Rocchi, Roberto; Latrofa, Francesco; Nardi, Marco; Vitti, Paolo; Marcocci, Claudio

    2014-01-01

    Background: According to Rundle's curve, Graves' ophthalmopathy (GO) worsens during an initial phase up to a peak of maximum severity, then improves and reaches a static plateau, with the activity curve preceding the severity curve by a few months. To our knowledge, no studies have tried to replicate Rundle's curve, and very few have investigated the natural history of GO. Here, we studied GO natural history retrospectively and tried to identify factors that may affect it. Methods: A total of 65 patients with untreated GO underwent an eye assessment after a median of seven months after the appearance of GO and then after a median of 40 months. The primary endpoints were the variation of the single GO features and of the NOSPECS score, as well as the overall outcome of GO. The secondary endpoint was the influence of several variables (age, sex, smoking, GO and thyroid disease duration, thyroid treatment, thyroid status, thyroid volume, anti-TSH receptor autoantibodies) on the outcome of GO. Results: The majority of patients had mild, minimally active GO, and only five had a Clinical Activity Score (CAS) >3. There was a significant reduction of CAS (p<0.0001) and NOSPECS (p=0.01) between the first and last observation, with a timing pattern resembling Rundle's curve. This difference was confirmed even when patients with a CAS >3 at first observation were excluded. At the last observation, 50.8% of patients had improved, 33.8% had remained stable, and 15.4% had worsened moderately or substantially. The overall outcome of GO was not affected by any of the variables under examination. Conclusions: In confirmation of Rundle's observations, untreated GO improves spontaneously with time in the majority of patients, with an activity peak between 13 and 24 months, which may have implications in determining the proper timing of GO treatments. PMID:23980907

  5. Current trends in the management of Graves' disease

    SciTech Connect

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. )

    1990-06-01

    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  6. Prise en charge des traumatismes graves du rein

    PubMed Central

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  7. Genetic associations of the thyroid stimulating hormone receptor gene with Graves diseases and Graves ophthalmopathy: A meta-analysis

    PubMed Central

    Xiong, Haibo; Wu, Mingxing; Yi, Hong; Wang, Xiuqing; Wang, Qian; Nadirshina, Sophia; Zhou, Xiyuan; Liu, Xueqin

    2016-01-01

    Graves’ disease (GD) is a common thyroid disease, and Graves ophthalmopathy(GO) is the most common extra-thyroidal manifestation of GD. Genetic associations of the thyroid stimulating hormone receptor (TSHR) gene with GD and GO have been studied in different population groups for a long time. We aimed to obtain a more precise estimation of the effects of TSHR single nucleotide polymorphisms (SNPs) on GD/GO using a meta-analysis. Publications were searched on Pub Med and EMBASE up to December 30, 2015. Eight studies involving three SNPs (rs179247, rs12101255, and rs2268458), which included 4790 cases and 5350 controls, met the selection criteria. The pooled odds ratios (OR) and the 95% confidence intervals (CI) were estimated. SNPs rs179247 (dominant model [GG + GA vs. AA]: OR = 0.66, 95%CI: 0.61–0.73, P = 0.000, I2 = 0%) and rs12101255 (dominant model [TT + TC vs. CC]: OR = 1.67, 95%CI: 1.53–1.83, P = 0.000, I2 = 0%) were significantly associated with GD in all of the genetic models. TSHR rs12101255 and rs2268458 polymorphisms had no association between GO and GD (GD without GO). The results indicate that rs179247 and rs12101255 are likely to be genetic biomarkers for GD. Further studies with different population groups and larger sample sizes are needed to confirm the genetic associations of the TSHR gene with GD/GO. PMID:27456991

  8. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    NASA Astrophysics Data System (ADS)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  9. Triiodothyronine, Thyroxine, and Iodine in Purified Thyroglobulin from Patients with Graves' Disease

    PubMed Central

    Izumi, M.; Larsen, P. Reed

    1977-01-01

    Previous studies have suggested that there is an overproduction of triiodothyronine (T3) relative to thyroxine (T4) in patients with thyrotoxicosis associated with Graves' disease. To evaluate whether or not an increased ratio of T3 to T4 in thyroidal secretion could be contributing to this relative T3 hyperproduction, T3, T4, and iodine were measured in thyroglobulin (Tg) from controls and patients with Graves' disease who had been treated either with propranolol only or with antithyroid drugs plus iodide before surgery. To avoid possible artifacts associated with pulse labeling and chromatography, T3 and T4 were determined by radioimmunoassay of Pronase hydrolysates of purified Tg. Results of analyses of Tg from six control patients and seven with Graves' disease, not receiving thiourea drugs or iodide, showed that the iodine content of Graves' disease Tg was not different from normal. Both contained 3.4 residues of T4/molecule Tg, but there was 0.39±0.08 (mean±SD) residue of T3/molecule Tg in Graves' Tg as opposed to 0.23±0.07 residue T3 molecule Tg in controls matched for iodine content (P < 0.01). This difference resulted in a significantly lower T4/T3 molar ratio (9±2) in Graves' Tg as opposed to control (15±2, P < 0.001). In Tg from patients with treated Graves' disease, iodine, T3, and T4 were reduced, but the reduction in the latter was more substantial, resulting in a T4/T3 molar ratio of 3.4±1. Fractionation of Tg from all groups by RbCl density gradient ultracentrifugation indicated that at physiological levels of Tg iodination, the molar ratio of T3/Tg was consistently higher in Graves' disease. The specific mechanism for this difference is not known, but it is not due to iodine deficiency. If T3 and T4 are secreted in this altered ratio in patients with Graves' disease, the magnitude of the difference could explain the relative T3 hyperproduction which is characteristic of this state. PMID:577211

  10. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland.

    PubMed

    Smith, D M; Dutta, S; Ahmed, F; Thaha, M A

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The "Scottish automated follow-up register" (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ (2) test and ANOVA using SPSS v15.0. A p value of < 0.05 was considered significant. Results. Altogether, 3737 patients were diagnosed with Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p < 0.001). The dose of RAI has increased (p < 0.001) and there has been a reduction in recurrence rate with higher dose of RAI. Surgical intervention rates decreased from 55.3% to 12.3% (p < 0.001) over time. Conclusions. Analysis of a large dataset of patients with Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates. PMID:27313946

  11. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland

    PubMed Central

    Smith, D. M.; Dutta, S.; Ahmed, F.; Thaha, M. A.

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The “Scottish automated follow-up register” (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ2 test and ANOVA using SPSS v15.0. A p value of < 0.05 was considered significant. Results. Altogether, 3737 patients were diagnosed with Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p < 0.001). The dose of RAI has increased (p < 0.001) and there has been a reduction in recurrence rate with higher dose of RAI. Surgical intervention rates decreased from 55.3% to 12.3% (p < 0.001) over time. Conclusions. Analysis of a large dataset of patients with Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates. PMID:27313946

  12. A study of human leukocyte D locus related antigens in Graves' disease.

    PubMed

    Farid, N R; Sampson, L; Noel, E P; Barnard, J M; Mandeville, R; Larsen, B; Marshall, W H; Carter, N D

    1979-01-01

    An association between Graves' disease and the human leukocyte antigen (HLA) system has previously been reported. The disease was more strongly associated with the HLA D locus antigen Dw3 than with HLA B8. Products of the HLA D locus are determined by the interaction of test cells with standard typing lymphocytes, a technically difficult procedure. Recently, it has been possible to type serologically for D locus related (DRw) specificities on peripheral bone marrow-derived (B) lymphocytes. Blood B lymphocytes from 50 unrelated controls and 41 patients with Graves' disease were typed for seven HLA DRw specificities. 28 patients with Graves' disease (68%) were positive for DRw3, in contrast to 14 controls (28%); whereas only 21 patients (50%) were HLA B8 positive, compared with 13 (26%) controls. Thus, positivity for DRw3 afforded a relative risk for Graves' disease of 5.5, whereas that for HLA B8 amounted to 3.0. Additionally, a family with multiple cases of Graves' disease in which the disease was previously shown to be inherited with the haplotype, was linked to DRw2, which suggests that the susceptibility to the disease was inherited in association with that antigen. Two HLA B/glyoxalase recombination events were observed in this family; in both instances HLA DRw followed HLA B. This study thus demonstrates that the disease susceptibility gene for Graves' disease is in strong linkage disequilibrium with DRw3; however, it may be associated with other DRw specificities and inherited within family units in association with them.

  13. Ocular Changes and Approaches of Ophthalmopathy in Basedow – Graves- Parry- Flajani Disease

    PubMed Central

    SARACI, George; TRETA, Anamaria

    2011-01-01

    ABSTRACT Basedow-Graves disease is an autoimmune condition with multiple local and systemic aspects. Among these, oculopathy has a major impact on patient's life from both functional and esthetic point of view. Basedow-Graves oculopathy requires an appropriate positive and differential diagnosis using clinical and imagistic approaches. Treatment is always required in moderate or severe forms and it begins with simple general points and continues with medical and surgical therapies. Current article stresses upon the most characteristic clinical signs of thyroidian ophthalmopathy and the required current therapeutic approaches. PMID:22205899

  14. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    PubMed

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice. PMID:27319009

  15. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    PubMed

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

  16. Isolated Adrenocorticotropin Deficiency Concomitant with Graves' Disease: A Case Report and Literature Review.

    PubMed

    Ohara, Nobumasa; Kaneko, Masanori; Kuriyama, Hideyuki; Sato, Kazuhiro; Katakami, Hideki; Oki, Yutaka; Kaneko, Kenzo; Kamoi, Kyuzi

    2016-01-01

    A 73-year-old Japanese woman with untreated Graves' hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves' disease, especially in older patients. PMID:27629962

  17. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    SciTech Connect

    Eckel, R.H.; Green, W.L.

    1980-04-11

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  18. "Why Didn't I Know about This Book When I Started?": In Memory of Donald Graves and Arthur Applebee

    ERIC Educational Resources Information Center

    Petrosky, Anthony; Mihalakis, Vivian

    2016-01-01

    This essay explores Donald Graves' groundbreaking research of the 1980s. We show how Graves' approach to the teaching of writing built on his sensitive appreciation of the ways children actually engage in the composing process when they are given the opportunity to produce writing that is meaningful to them. However, the issue for us is not simply…

  19. 48 CFR 352.242-72 - Native American Graves Protection and Repatriation Act.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Native American Graves Protection and Repatriation Act. 352.242-72 Section 352.242-72 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of...

  20. T-cell prolymphocytic leukaemia (T-PLL): a rare disease with a grave prognosis.

    PubMed

    Vivekanandarajah, Abhirami; Atallah, Jean Paul; Gupta, Shilpi

    2013-05-02

    T-cell prolymphocytic leukaemia (T-PLL) is an extremely uncommon haematological malignancy that has an aggressive course and a grave prognosis. We describe a patient who presented with lymphocytosis, scalp erythema, ascites and splenomegaly and was diagnosed with T-PLL. He was treated with alemtuzumab with a good response and was referred for allogeneic stem cell transplantation.

  1. 78 FR 16295 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-14

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native...

  2. 77 FR 74874 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American...

  3. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    ERIC Educational Resources Information Center

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  4. Multiple Fractures in Patient with Graves' Disease Accompanied by Isolated Hypogonadotropic Hypogonadism.

    PubMed

    Yi, Hyon-Seung; Kim, Ji Min; Ju, Sang Hyeon; Lee, Younghak; Kim, Hyun Jin; Kim, Koon Soon

    2016-02-01

    Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to deficiency of sex steroid hormone. Graves' disease is also an important cause of secondary osteoporosis. However, IHH does not preclude the development of primary hyperthyroidism caused by Graves' disease, leading to more severe osteoporosis rapidly. Here, we describe the first case of 35-year-old Asian female patient with IHH accompanied by Graves' disease and osteoporosis-induced multiple fractures. Endocrine laboratory findings revealed preserved anterior pituitary functions except for secretion of gonadotropins and showed primary hyperthyroidism with positive autoantibodies. Sella magnetic resonance imaging showed slightly small sized pituitary gland without mass lesion. Dual energy X-ray absorptiometry revealed severe osteoporosis in lumbar spine and femur neck of the patient. Plain film radiography of the pelvis and shoulder revealed a displaced and nondisplaced fracture, respectively. After surgical fixation with screws for the femoral fracture, the patient was treated with antithyroid medication, calcium, and vitamin D until now and has been recovering fairly well. We report a patient of IHH with Graves' disease and multiple fractures that is a first case in Korea. PMID:26981520

  5. Tinea corporis overlying the thyroid gland after radioiodine (131I) treatment of Graves' disease

    SciTech Connect

    Moreno, A.J.; Hartshorne, M.F.; Yedinak, M.A.; Crooks, L.A.; Fox, B.J.

    1986-04-01

    A case of tinea corporis involving the skin overlying the thyroid gland is described in a 36-year-old man who had received radioiodine treatment for Graves' disease. The dermatophytosis mimicked a delayed roentgen erythema. Radiation to the dermis may have locally altered the cell-mediated immunity and predisposed this patient to the dermatophytosis.

  6. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  7. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  8. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  9. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  10. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  11. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    PubMed Central

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  12. Anti-CD38 autoimmunity in patients with chronic autoimmune thyroiditis or Graves' disease

    PubMed Central

    Antonelli, A; Fallahi, P; Nesti, C; Pupilli, C; Marchetti, P; Takasawa, S; Okamoto, H; Ferrannini, E

    2001-01-01

    Autoantibodies directed against human CD38 (an enzyme catalysing the interconversion of NAD+ and cyclic ADP-ribose) have been demonstrated recently in patients with type 2 diabetes. We tested 220 consecutive Caucasian patients with autoimmune chronic thyroiditis, 104 patients with Graves' disease, 220 subjects from the general population (control I) and 78 healthy control subjects not affected by thyroid autoimmune disorders (control II) for the presence of anti-CD38 autoimmunity. Using Western blot analysis and optical densitometry, a specific band corresponding to human recombinant CD38 was identified in the serum of several subjects. By defining anti-CD38 positivity as a standardized optical reading >3 s.d. higher than the mean value of control I, 10·4% of patients with thyroiditis and 7·7% of Graves' patients were anti-CD38 positive (P = 0·0009 versus 1·8% of control I). Similarly, 13·1% of patients with thyroiditis and 10·5% of Graves' patients had a standardized optical reading >3 s.d. higher than the mean value of the subjects not affected by thyroid autoimmune disorders (P = 0·002 versus 1·2% of control II). Anti-CD38 autoimmunity did not differ between euthyroid, hyperthyroid or hypothyroid patients or between patients with or without thyroid hypoechogenicity. Anti-CD38 autoantibodies were associated with higher levels of circulating antithyroid-peroxidase antibodies (P = 0·03) and they were more frequent in Graves' patients with ophthalmopathy (P < 0·05). Anti-CD38 autoantibodies are a new autoimmune marker in chronic autoimmune thyroiditis and Graves' disease. The specific role of CD38 and its autoantibodies in the modulation of thyroid cell function or growth remains to be investigated. PMID:11737057

  13. Therapeutic use of mini-scleral lenses in a patient with Graves' ophthalmopathy.

    PubMed

    Harthan, Jennifer S

    2014-01-01

    Patients with Graves' ophthalmopathy can be very challenging to manage secondary to the complex nature of their disease presentation. Patients may present with a variety of ocular findings including: lid retraction, periorbital and lid swelling, chemosis, conjunctival hyperemia, proptosis, optic neuropathy, restrictive myopathy, exposure keratopathy and/or keratoconjunctivitis sicca. Mini-scleral and scleral lens designs have been important in the management of irregular and regular corneas, and in the therapy of ocular surface diseases. We present here the case of a 48-year-old Caucasian male who had been diagnosed with Graves' ophthalmopathy 13 years earlier. With significant ocular surface staining and over ten diopters of astigmatism, the patient had never been able to wear contact lenses comfortably. After being fit with the Mini-Scleral Design™ lenses, his vision improved to 20/25 OU, his ocular surface improved, and overall quality of vision increased.

  14. GO-QOL--disease-specific quality of life questionnaire in Graves' orbitopathy.

    PubMed

    Sawicka-Gutaj, Nadia; Bednarczuk, Tomasz; Daroszewski, Jacek; Waligórska-Stachura, Joanna; Miśkiewicz, Piotr; Sowiński, Jerzy; Bolanowski, Marek; Ruchała, Marek

    2015-01-01

    The main goal of therapy for Graves' orbitopathy (GO) is to restore visual function and to improve quality of life (QOL); therefore, the idea of self-assessment of eye changes by the patient has been developed. We developed a validated Polish version of the GO-QOL questionnaire (GO-QOLpl). As an original version we used the English version of GO-QOL, which consists of 15 questions summarised in two subscales. GO-QOLpl was translated and validated in accordance with standard principles for translation of patient-reported outcomes (PRO). GO-QOLpl is a linguistically validated version of the original GO-QOL questionnaire, which is recommended by the European Group of Graves' Orbitopathy (EUGOGO). We strongly support the use of GO-QOLpl for the assessment of QOL among Polish patients with GO in clinical practice.

  15. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention

    PubMed Central

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-01-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome. PMID:24403961

  16. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.

    PubMed

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-07-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

  17. Psychological problems in the family members of gravely traumatised patients admitted into an intensive care unit.

    PubMed

    Pérez-San Gregorio, M A; Blanco-Picabia, A; Murillo-Cabezas, F; Domínguez-Roldán, J M; Sánchez, B; Núñez-Roldán, A

    1992-01-01

    The aim of these studies was the analysis of the psychological repercussions on the closest members of families of 76 gravely traumatised patients admitted into the Intensive Care Unit (ICU) of the Hospital Universitario de Rehabilitación y Traumatología "Virgen del Rocio", Sevilla (Spain). An investigation based on social information and the Clinical Analysis Questionnaire was used. The sample of family members was composed of 42 women and 34 men, with an average age of 41.3 years (SD +/- 12.8). Results showed that (a) more than 50% of the family members of gravely traumatised patients admitted into an ICU showed symptoms of depression, (b) the women scored more points in hypochondria, suicidal depression, anxious depression, low-energy depression, guilt-resentment, apathy-withdrawal, paranoia, schizophrenia, psychasthenia and psychological disadjustment, and (c) in general terms, the psychological characteristics of the families were far from the norm of the control group.

  18. Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine.

    PubMed

    Ahmed, Zulfiqar; Mai, Christine L; Elder, Badrea; Rodriguez, Samuel; Yaster, Myron

    2014-04-01

    Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today's society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling.

  19. A case of Mayer-Rokitansky-Küster-Hauser syndrome presenting as Graves disease.

    PubMed

    Lim, Ye-Jee; Sohn, Tae-Seo; Kang, Seung-Hun; Chang, Kyung-Yoon; Kim, Bo-Kyung; Kim, Yeon-Ji; Ha, Won-Chul; Oh, Su-Jin; Son, Hyun-Shik

    2012-01-01

    The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by aplasia of the uterus and the upper part of the vagina in an XX individual with normal development of secondary sexual characteristics. Individuals with this syndrome may also present with renal and skeletal abnormalities. We report a case of a 16-year-old girl presenting with thyrotoxicosis and primary amenorrhea. After being diagnosed with Graves disease, this patient was placed on antithyroid medication. Although her thyroid function normalized, she did not start to menstruate. Therefore, we assessed her primary amenorrhea and diagnosed the patient with MRKH syndrome through pelvic imaging. To our knowledge, an association between Graves disease and MRKH syndrome has not yet been reported. PMID:23329766

  20. Correlation of stress with outcome of radioiodine therapy for Graves disease

    SciTech Connect

    Stewart, T.; Rochon, J.; Lenfestey, R.; Wise, P.

    1985-06-01

    Between November 1965 and December 1983, 293 patients were treated for Graves disease using /sup 131/I. All patients were asked to identify a stressful event antedating the onset of overt clinical symptoms. Eighty-one patients were able to do this (27.6%). Two hundred forty-four patients received a single treatment, 49 required two or more treatments. Patients with stress initiating the symptoms of Graves disease became hypothyroid earlier, 50% at 12 mo compared with 36 mo for the nonstress group. At 10 yr 5% of the stress group remained euthyroid compared with 17% nonstress. The authors conclude that stress in the 12 mo or less before the onset of clinical symptoms potentiates the development of hypothyroidism induced by a standard dose of radioiodine.

  1. Radiotherapy for Graves' disease. The possible role of low-dose radiotherapy.

    PubMed

    Arenas, Meritxell; Sabater, Sebastià; Jiménez, Pedro Lara; Rovirosa, Àngels; Biete, Albert; Linares, Victoria; Belles, Montse; Panés, Julià

    2016-01-01

    Immunomodulatory effects of low-dose radiotherapy (LD-RT) have been used for the treatment of several benign diseases, including arthrodegenerative and inflammatory pathologies. Graves' disease is an autoimmune disease and radiotherapy (RT) is a therapeutic option for ocular complications. The dose recommended in the clinical practice is 20 Gy (2 Gy/day). We hypothesized that lower doses (<10 Gy total dose, <1 Gy/day) could results in higher efficacy if we achieved anti-inflammatory and immunomodulatory effects of LD-RT. We review current evidence on the effects of RT in the treatment of Graves' disease and the possible use of LD-RT treatment strategy. PMID:27601953

  2. Effect of Selenium Supplementation on Recurrent Hyperthyroidism Caused by Graves' Disease: A Prospective Pilot Study.

    PubMed

    Wang, L; Wang, B; Chen, S R; Hou, X; Wang, X F; Zhao, S H; Song, J Q; Wang, Y G

    2016-09-01

    The effect of selenium supplementation on recurrent hyperthyroidism caused by Graves' disease is unclear. Our study aimed to assess the efficacy of selenium supplementation therapy on recurrent Graves' disease. Forty-one patients with recurrent Graves' disease were enrolled in this study. All patients received the routine treatment using methimazole (MMI), while patients allocated to the selenium group received additional selenium therapy for 6 months. The influence of selenium supplementation on the concentrations of thyroid stimulating hormone (TSH), anti-TSH-receptor antibodies (TRAb), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed. The remission rate was also compared between 2 groups. There was no obvious difference in the demographic data and the levels of serum FT4, FT3, TSH, and TRAb between the 2 groups at baseline. Both FT4 and FT3 decreased more at 2 months in the selenium group than the controls, while the TSH level increased more in patients receiving selenium supplementation (p<0.05). The TRAb level was significantly lower in patients receiving selenium supplementation (2.4 IU/l vs. 5.6 IU/l, p=0.04). The percentages of patients with normal TRAb level at 6 months was also significantly higher in the selenium group (19.0 vs. 0%, p=0.016). Kaplan-Meier survival curve showed patients receiving selenium supplementation had a significantly higher rate of remission than controls (Log-rank test p=0.008). In conclusion, selenium supplementation can enhance the effect of antithyroid drugs in patients with recurrent Graves' disease. Randomized trials with large number of participants are needed to validate the finding above. PMID:27392116

  3. The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

    PubMed

    Papapetrou, Peter D

    2015-01-01

    According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

  4. Socioeconomic Disparities in the Presentation and Treatment of Graves' Disease and Thyroid Eye Disease.

    PubMed

    Vargason, Caroline W; Chelnis, James G; Barahimi, Behin I; Mawn, Louise A

    2016-01-01

    Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.

  5. Both interleukin-23A polymorphism and serum interlukin-23 expression are associated with Graves' disease risk.

    PubMed

    Jia, Huiying; Tao, Feng; Liu, Changqin; Guo, Ting; Zhu, Wei; Wang, Shu; Cui, Bin; Ning, Guang

    2015-03-01

    Two independent Chinese cohorts were used to study the genetic association between the interleukin-23A (IL-23A) gene polymorphism (rs11171806) and susceptibility to Graves' disease (GD). The initial Shanghai cohort consisted of 712 unrelated patients with GD and 705 healthy control subjects, and the replication cohort from Xiamen Island included 433 patients with GD and 410 healthy control subjects. The serum concentration of IL-23 in GD patients was measured significantly higher than in health controls. Moreover in the subgroup analysis, higher concentrations of IL-23 were identified in patients of older age (⩾40 years) and female gender. We also performed an association study with the IL-23 gene polymorphism rs11171806 in both cohorts, in Shanghai cohorts, the frequencies of rs11171806 alleles were strongly different between Graves' disease patients (G 95.7% and A 4.3%) and healthy controls (G 97.7% and A 2.3%) (P=2.6×10(-3), OR=1.93 (95% CI: 1.25-2.97)), and in Xiamen cohorts, the proportion of individuals carrying the A allele of rs11171806 was the same significantly higher in Graves' disease patients than in controls [Graves' disease vs. control, 4.8% vs. 4.3%, OR=2.15 (95% CI: 1.23-3.79), P(allele)=6.3×10(-3)]. The distribution of rs11171806 genotype was also investigated in subgroups according to the age and gender. All of these findings suggested that IL-23 may play an important role in the development of GD, and the IL-23A gene is a genetic risk marker for GD in Han Chinese population.

  6. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    PubMed

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay

    2015-04-01

    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted.

  7. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    PubMed

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay

    2015-04-01

    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted. PMID:25824071

  8. Randomized double-blind trial of prednisone versus radiotherapy in Graves' ophthalmopathy

    SciTech Connect

    Prummel, M.F.; Mourits, M.; Blank, L.; Berghout, A.; Koornneef, L.; Wiersinga, W.M. )

    1993-10-16

    Corticosteriods are usually given for management of Graves' ophthalmopathy, but they have many and serious side-effects. By comparison, retrobulbar irradiation is well tolerated, although its efficacy has been evaluated only in uncontrolled studies. Therefore, the authors did a double-blind randomized trial, in which 28 patients with moderately severe Graves' ophthalmopathy were treated with a 3-month course of oral prednisone and sham irradiation, and 28 received retrobulbar irradiation (20 Gy) and placebo capsules. Therapeutic outcome, assessed twenty-four weeks after the start of treatment, was determined by the change in the highest NOSPECS class. A successful outcome was observed in 14 prednisone-treated and in 13 irradiated patients. Responders to treatment (but not nonresponders) in both groups showed improvements in total and subjective eye score and a decrease in eye-muscle volume. Response to either treatment was due largely to changes in soft-tissue involvement and eye-muscle motility. Radiotherapy and oral prednisone appear to be equally effective as initial treatment in patients with moderately severe Graves' ophthalmopathy. In view of its better tolerability, radiotherapy should be considered the treatment of first choice.

  9. Radiotherapy in the treatment of Graves ophthalmopathy—to do it or not?

    PubMed Central

    2009-01-01

    To the objective of this study is to evaluate the role and toxicity of radiotherapy in the treatment of Graves ophthalmopathy. In the years 2000–2003, 121 patients with malignant exophthalmos were treated with radiotherapy of the retrobulbar area to the total dose of 20 Gy in ten fractions with a 6 MeV photon beam. The treatment was performed by the team of the Clinic of Oncology of the Jagiellonian University Medical College in Cracow. The radiotherapy was preceded by intravenous steroid therapy: methylprednisolone acetate administered at the dose of 2 g/week for four consecutive weeks. The highest efficacy, expressed as improvement of all ocular symptoms, was observed for the combined treatment. Female and non-diabetic patients responded positively to the combined treatment. Radiotherapy combined with steroid therapy in the treatment of Graves ophthalmopathy seems to be an effective treatment for strictly defined indications. In the treatment of Graves–Basedow disease, radiotherapy is a well-tolerated treatment modality. Diabetes is a factor that worsens prognosis in Graves ophthalmopathy and female sex is a favourable factor for this condition. PMID:20835395

  10. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    NASA Astrophysics Data System (ADS)

    Jervis, John R.; Pringle, Jamie K.

    2014-09-01

    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  11. [A case of membranous nephropathy with ANCA-associated necrotizing glomerulonephritis during oral administration of PTU for Graves' disease].

    PubMed

    Fujii, Takayuki; Kawamata, Toyotaka; Ueda, Shiro; Akikusa, Bunshiro; Hasegawa, Shigeru; Tsukahara, Tsunemichi; Iesato, Kenji; Ogawa, Makoto; Saisho, Hiromitsu

    2003-01-01

    We experienced a coincidental case of two types of glomerulopathy associated with Graves' disease. A 64-year-old man, who had been treated with propylthiouracil(PTU) for Graves' disease for 15 years, was admitted to our hospital for macroscopic hematuria and rapidly progressive deterioration of renal function. Although his thyroid function had been within the normal range during treatment, the level of thyrotropin receptor antibody(TRAb) gradually increased from a year before admission. Serological tests revealed that he was positive for myeloperoxidase-antineutrophil cytoplasmic antibody(MPO-ANCA). The renal biopsy specimen showed necrotizing and crescentic glomerulonephritis(GN) superimposed on membranous nephropathy(MN). This is a rare case of MN complicated with ANCA associated crescentic GN in a Graves' disease patient. Association of these two renal alterations was not clearly defined. MN involved with Graves' disease also has been rarely reported. Some reports demonstrated deposition of thyroglobulin and other thyroid related antigens in the glomeruli. In the present case, long-term impairment of Graves' disease and elevation of TRAb might have been responsible for the formation and deposition of thyroid-associated immune complex in the glomeruli. As for crescentic GN, PTU might have induced ANCA-associated GN independently of MN. This case is instructive for considering the relation between Graves' disease and renal injury.

  12. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    SciTech Connect

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. )

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  13. Current perspectives on the role of orbital fibroblasts in the pathogenesis of Graves' ophthalmopathy.

    PubMed

    Dik, Willem A; Virakul, Sita; van Steensel, Leendert

    2016-01-01

    Graves' ophthalmopathy (GO) is an extra-thyroidal complication of Graves' disease (GD; Graves' hyperthyroidism) characterized by orbital tissue inflammation, expansion, remodeling and fibrosis. Although the initiating trigger of GO is still indistinct, excessive orbital fibroblast activity is at the heart of its pathogenesis. Orbital fibroblasts are activated by cellular interactions with immune cells and the soluble factors they secrete. Orbital fibroblasts, especially from GO patients, express the thyrotropin receptor (TSH-receptor; TSHR), and activation of the orbital fibroblast population by stimulatory autoantibodies directed against the TSHR may provide an important link between GD and GO. Furthermore, stimulatory autoantibodies directed against the insulin-like growth factor-1 receptor have been proposed to contribute to orbital fibroblast activation in GO. Activated orbital fibroblasts produce inflammatory mediators thereby contributing to the orbital inflammatory process in GO. Moreover, orbital fibroblasts exhibit robust proliferative activity and extracellular matrix (especially hyaluronan) synthesizing capacity and can differentiate into adipocytes and myofibroblasts with disease progression, thereby contributing to tissue expansion/remodeling and fibrosis in GO. Orbital fibroblasts, especially those from GO patients, exhibit a hyper-responsive phenotype when compared to fibroblasts from other anatomical regions, which may further contribute to GO pathogenesis. Fibrocytes have been identified as additional source of orbital fibroblasts in GO, where they may contribute to orbital tissue inflammation, adipogenesis and remodeling/fibrosis. This review addresses our current view on the role that orbital fibroblasts fulfill in GO pathogenesis and both established as well as less established not fully crystallized concepts that need future studies will be discussed.

  14. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    PubMed

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing

    2012-01-01

    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P < 0.05). There were neither significant difference of the O/OC ratio in 13 GO patients between pre- and post-treatment periods, nor significant difference in the 9 (9/11) patients before and after three months. Orbital (99m)Tc-TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  15. Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults

    PubMed Central

    Dominguez, Paulette N.; Jimeno, Cecilia A.; Obaldo, Jerry M.; Ogbac, Ruben V.

    2016-01-01

    Background Radioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease. Methods A hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those randomized to fixed activity received either low fixed activity at 9.9 mCi for thyroid gland size <40 g or high fixed activity at 14.9 mCi for thyroid gland size 40 to 80 g, and those grouped to calculated activity received 160 µCi/g of thyroid tissue adjusted for 24 hours radioiodine uptake. Thyroid function tests (free thyroxine [T4] and thyroid stimulating hormone [TSH]) were monitored at 10, 16, and 24 weeks after radioactive iodine therapy. The primary outcome, treatment failure was defined as persistently elevated free T4 and low TSH. Results Of the 122 patients randomized, 56 in the fixed dose group and 56 in the calculated dose group completed the follow-up. At the end of 6 months, the percentage of treatment failure was 37.50% in the calculated dose group versus 19.64% in the fixed dose group with a relative risk of 0.53 (95% confidence interval, 0.28 to 0.98) favoring the fixed dose group. Conclusion Fixed dose radioiodine has a significantly lower incidence of persistent hyperthyroidism at 6 months post-radioactive therapy. PMID:26996425

  16. Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

    SciTech Connect

    Chen, J.J.; Ladenson, P.W.

    1986-07-01

    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or /sup 131/I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among the 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. The low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism.

  17. Réactions immunoallergiques graves aux antibacillaires: à propos de 10 cas

    PubMed Central

    Alami, Sabah El Machichi; Hammi, Sanae; Bourkadi, Jamal Eddine

    2014-01-01

    L'hypersensibilité aux antituberculeux est l'un des effets secondaires imprévisibles qui apparait chez 4 à 5 % de la population exposée et s’élève à 25% chez les sujets VIH positifs. Dans notre étude parmi 39 patients ayant présenté des réactions immunoallergiques, 10 avaient des formes graves. Le délai moyen d'apparition des signes était de 23 jours. Les réactions immunoallergiques observées étaient 5 cas de toxidermie généralisée fébrile, un cas de Dress syndrome, un cas de neutropénie, un cas de pancitopénie et 2 cas de thrombopénie. Tous nos patients avaient bien évolué cliniquement et bactériologiquement après l'adoption d'un régime thérapeutique excluant le ou les médicaments incriminés. En pratique, si l'effet indésirable imputé à un antituberculeux est grave, il est impératif de l'arrêter, de traiter l'incident et d'associer une autre molécule chez certains cas. Notre étude a montré une fréquence significative des complications graves probablement sous-estimée, surtout dans les pays fortement touchés par l'infection HIV.

  18. Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease.

    PubMed

    Miyake, Teruki; Matsuura, Bunzo; Furukawa, Shinya; Todo, Yasuhiko; Yamamoto, Shin; Yoshida, Osamu; Imai, Yusuke; Watanabe, Takao; Yamamoto, Yasunori; Hirooka, Masashi; Tokumoto, Yoshio; Kumagi, Teru; Abe, Masanori; Seike, Hirotaka; Miyauchi, Shozo; Hiasa, Yoichi

    2016-01-01

    3,5,3'-triiodo-L-thyronine regulates the glucose metabolism, lipid metabolism, and hepatic steatosis. Several groups have shown the relationships between hypothyroidism and nonalcoholic fatty liver and hypothyroidism and nonalcoholic steatohepatitis (NASH). However, the effect of hyperthyroidism on NASH has not yet been investigated. We herein report effects of thyroid hormone on the pathological condition of NASH in a patient with NASH complicated by Graves' disease. In our case, the liver enzyme level improved with the increasing thyroid hormone level; however, the liver enzyme level was aggravated with the improving thyroid hormone level. Therefore, hyperthyroidism may improve the pathological condition of NASH. PMID:27477408

  19. Progressive bilateral ophthalmoparesis--a case of simultaneous autoimmunity: balancing Graves' ophthalmoparesis and ocular myasthenia.

    PubMed

    Canepa, Carlo; Venu, Maya

    2016-01-04

    A 44-year-old woman with no medical history presented with a 1-year history of horizontal diplopia, bilateral exophthalmos and progressive asymmetrical ophthalmoparesis, with no pupillary dysfunction or ptosis. Within 3 months of her initial presentation, she noticed paresis of right eye abduction, followed after 1 month with paresis of left eye abduction. Initial investigations revealed positive antiperoxidase antibodies for Graves' disease and positive AChR for myasthenia gravis. MRI of the brain showed increased intensity in bilateral inferior rectus muscles and CT of the chest showed thymic hyperplasia. Treatment with carbimazole and pyridostigmine was started, with complete resolution after 1 month.

  20. Peritonitis secondary to ruptured splenic abscess: a grave complication of typhoid fever.

    PubMed

    George, Peter; Ahmed, Ashfaq; Maroli, Roshan; Tauro, Leo Francis

    2012-12-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever. PMID:23199723

  1. Walter Miles, Pop Warner, B. C. Graves, and the psychology of football.

    PubMed

    Baugh, Frank G; Benjamin, Ludy T

    2006-01-01

    In 1926-1927, a graduate student, B. C. Graves, working with Stanford University psychologist Walter Miles and legendary football coach Pop Warner, conducted an investigation of variations in signal calling as they affected the charging times of football players. The study was one of two that involved Miles and the ingenious multiple chronograph that he had invented to time the reactions of seven players simultaneously. These studies represented a brief digression in the career of Miles, who certainly was no sport psychologist. They tell of an interesting collaboration between scientist and coaches that produced one of the richest studies in sport psychology in the first half of the twentieth century.

  2. Unusual locations of localized myxedema in Graves disease. Report of three cases

    SciTech Connect

    Noppakun, N.; Bancheun, K.; Chandraprasert, S.

    1986-01-01

    Three patients with Graves disease had very unusual locations of localized myxedema. One patient had localized myxedema on the pretibial and shoulder areas after sodium iodide I 131 therapy. The second patient had localized myxedema on his neck, shoulders, and upper part of the back as well as on the pretibial area. The third patient had localized myxedema on the pinnae, also following sodium iodide I 131 therapy. After surgical removal followed by intralesional triamcinolone acetonide injections, the first patient's lesions recurred. The lesions in the second case did not respond to topical steroid cream. The third patient had a partial response to intralesional steroid injections.

  3. Graves' Disease

    MedlinePlus

    ... our online catalog. ​ Additional Links Hashimoto's Disease Hyperthyroidism Hypothyroidism Pregnancy & Thyroid Disease Thyroid Tests Find a Specialist ... everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make ...

  4. Graves disease

    MedlinePlus

    ... in men (possible) Problems concentrating Fatigue Frequent bowel movements Hair loss Heat intolerance and increased sweating Increased appetite , despite having weight loss Irregular menstrual periods in women Muscle weakness of the hips and shoulders Moodiness, ...

  5. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    PubMed

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

  6. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    PubMed

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease. PMID:27609732

  7. Analysis of HLA-DQB and HLA-DPB alleles in Graves' disease by oligonucleotide probing of enzymatically amplified DNA.

    PubMed

    Weetman, A P; Zhang, L; Webb, S; Shine, B

    1990-07-01

    We have tested the possible association of HLA-DQB and HLA-DPB alleles with Graves' thyrotoxicosis, with or without severe ophthalmopathy, by polymerase chain amplification of genomic DNA and allele-specific oligonucleotide probing. There was no significantly abnormal distribution of DQB alleles compared to 50 control subjects except for a reduced prevalence of DQw 3.1 in the Graves' patients with severe ophthalmopathy (X2 = 6.23, P less than 0.02). HLA-DPB 2.1/8 was found in only 1 of 40 of these patients compared with 15 of the controls (X2 = 11.49, P less than 0.001). Ten of 48 patients with Graves' disease but without clinically significant eye involvement were HLA-DPB 2.1/8 positive, not significantly different from controls, but significantly different from the ophthalmopathy group (X2 = 6.70, P less than 0.01). The other DPB alleles in both groups of Graves' disease patients were the same as controls. These results suggest that HLA-DPB 2.1/8 may confer a protective effect in Graves' disease with respect to ophthalmopathy. PMID:2401099

  8. [Perioperative treatment for the urgent orbital decompression surgery in a 30-weeks pregnant woman with Graves' orbitopathy].

    PubMed

    Guerrero-Domínguez, R; López-Herrera-Rodríguez, D; Domínguez-Blanco, A; Medina-de Moya, I; Sánchez-Carrillo, F

    2014-01-01

    Thyroid ophthalmopathy is a rare extra-thyroid complication usually associated with Graves' disease. This disease can occur in the euthyroid pregnant patient. Graves' orbitopathy is characterized by eyelid retraction, proptosis, extraocular muscle dysfunction, and periorbital edema. In some cases an emergency surgical repair may be required to avoid irreversible vision loss. We present the case of a 35-year-old woman in her 30th gestational week, who suffered from Graves' ophthalmopathy, severe exophthalmia, and visual acuity decrease. Following consultations among anesthesiologists, ophthalmologists, maxillofacial surgeons, endocrinologists, obstetricians and the patient, it was decided to perform a surgical orbital wall decompression. The anesthetic and perioperative implications associated with gestational age and the considerations for this surgical procedure, and how to avoid increasing intraocular pressure are discussed. PMID:23835254

  9. Prolonged suppressed thyroid-stimulating hormone levels in hyperthyroidism in a neonate born to a mother with Graves' disease.

    PubMed

    Hojo, M; Momotani, N; Ikeda, N; Ueda, A; Uno, K; Ishikita, T; Ishiguro, A; Shimbo, T

    1998-10-01

    We report here a case of neonatal hyperthyroidism born to a mother, whose pregnancy was complicated by poorly controlled Graves' disease. The patient demonstrated exophthalmos and marked goiter at birth, indicating the existence of thyrotoxicosis in utero. The mother's Graves' disease was well controlled in the third trimester, resulting in a slightly lower level of free thyroxine (FT4) in the umbilical cord blood serum; however, thyroid-stimulating hormone (TSH) was undetectable. Thyroid-stimulating hormone remained undetectable for 2 months, while FT4 levels varied in the course. This case suggests that severe and prolonged thyrotoxicosis in utero, due to poor control of pregnancy with Graves' disease, might induce unresponsiveness of the hypothalamo-pituitary system in the newborn.

  10. Time-lapse geophysical investigations over a simulated urban clandestine grave.

    PubMed

    Pringle, Jamie K; Jervis, John; Cassella, John P; Cassidy, Nigel J

    2008-11-01

    A simulated clandestine shallow grave was created within a heterogeneous, made-ground, urban environment where a clothed, plastic resin, human skeleton, animal products, and physiological saline were placed in anatomically correct positions and re-covered to ground level. A series of repeat (time-lapse), near-surface geophysical surveys were undertaken: (1) prior to burial (to act as control), (2) 1 month, and (3) 3 months post-burial. A range of different geophysical techniques was employed including: bulk ground resistivity and conductivity, fluxgate gradiometry and high-frequency ground penetrating radar (GPR), soil magnetic susceptibility, electrical resistivity tomography (ERT), and self potential (SP). Bulk ground resistivity and SP proved optimal for initial grave location whilst ERT profiles and GPR horizontal "time-slices" showed the best spatial resolutions. Research suggests that in complex urban made-ground environments, initial resistivity surveys be collected before GPR and ERT follow-up surveys are collected over the identified geophysical anomalies. PMID:18808369

  11. Celiac Disease in a Predisposed Subject (HLA-DQ2.5) with Coexisting Graves' Disease.

    PubMed

    Hwang, In Kyoung; Kim, Seon Hye; Lee, Unjoo; Chin, Sang Ouk; Rhee, Sang Youl; Oh, Seungjoon; Woo, Jeong Taek; Kim, Sung Woon; Kim, Young Seol; Chon, Suk

    2015-03-27

    Celiac disease is an intestinal autoimmune disorder, triggered by ingestion of a gluten-containing diet in genetically susceptible individuals. The genetic predisposition is related to human leukocyte antigen (HLA) class II genes, especially HLA-DQ2-positive patients. The prevalence of celiac disease has been estimated to be ~1% in Europe and the USA, but it is rarer and/or underdiagnosed in Asia. We report a case of celiac disease in a predisposed patient, with a HLA-DQ2 heterodimer, and Graves' disease that was treated successfully with a gluten-free diet. A 47-year-old woman complained of persistent chronic diarrhea and weight loss over a 9 month period. Results of all serological tests and stool exams were negative. However, the patient was found to carry the HLA DQ2 heterodimer. Symptoms improved after a gluten-free diet was initiated. The patient has been followed and has suffered no recurrence of symptoms while on the gluten-free diet. An overall diagnosis of celiac disease was made in a genetically predisposed patient (HLA-DQ2 heterodimer) with Graves' disease.

  12. Clinical efficacy of combined rituximab treatment in a woman with severe Graves' ophthalmopathy

    PubMed Central

    Liu, Xiaomei; Guo, Hui; Liu, Juan; Shi, Bingyin

    2016-01-01

    The present study reports the case of a female Chinese patient with Graves' disease (GD) and severe Graves' ophthalmopathy (GO) in its active phase, who was treated with propylthiouracil and oral prednisolone for 2 months at a local hospital. However, a lack of improvement in symptoms meant that the patient was transferred to the First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China), whereupon the patient received high-dose intravenous methylprednisolone pulse therapy, although with limited efficacy. Subsequently, rituximab (RTX; anti-CD20 monoclonal antibody) combined with orbital irradiation treatment was initiated. The patient responded positively to the combined treatment; the clinical symptoms and enlargement of the extraocular muscles were ameliorated, and there were marked decreases in the clinical activity and NOSPECS grading scores. Furthermore, the serum levels of anti-thyrotropin receptor antibodies (TRAb) were markedly decreased at 2 months following RTX therapy. The patient was maintained in a euthyroid state by treatment with methimazole during and following RTX therapy. It was concluded that RTX treatment may attenuate severe GO by depleting lymphocytes, and may promote the recovery of GD by reducing the serum levels of TRAb. PMID:27446325

  13. The relationship between serum adipocytokines and Graves' ophthalmopathy: A hospital-based study.

    PubMed

    Kim, Bo-Yeon; Mok, Ji-Oh; Kang, Sung-Koo; Jang, Sun-Young; Jung, Chan-Hee; Kim, Chul-Hee

    2016-05-31

    Adipocytokines are thought to be associated with inflammatory disorders and autoimmune diseases. However, limited information is available on the relationship between serum adipocytokine levels, Graves' disease (GD), and Graves' ophthalmopathy (GO). The present study examined the relationship between serum adipocytokine levels and GD and GO. A total of 80 patients with GD participated in this study. The medical records of patients were reviewed retrospectively. GO activity was assessed using the clinical activity score (CAS). GO severity was assessed by the modified NOSPECS classification and included soft tissue involvement, proptosis, and extraocular muscle involvement. Serum adiponectin, leptin, resistin, and retinol-binding protein 4 (RBP-4) levels were measured using commercially available enzyme-linked immunosorbent assays. The prevalence of GO was 36.3%. Serum adiponectin, leptin, and resistin levels were significantly higher in patients with GO than in those without GO. The CAS was positively correlated with serum adiponectin and leptin levels. The total eye score was positively correlated with serum adiponectin, leptin, resistin, and RBP-4 levels. A multivariate analysis revealed that serum leptin and resistin levels were associated with the presence of GO after adjusting for clinical factors. Free thyroxine was negatively correlated with serum leptin level. These results suggest that adipocytokines, such as leptin and resistin, may play a role in inflammatory and autoimmune processes of GD and GO. Future studies with larger numbers of patients are required to establish relationships between serum adipocytokines levels and GO and ascertain the role of adipocytokines in GD and GO.

  14. Post-radioiodine De Novo Onset Graves' Ophthalmopathy: Case Reports and a Review of the Literature.

    PubMed

    Batra, Ruchika; Krishnasamy, Senthil Kumar; Buch, Harit; Sandramouli, Soupramanien

    2015-05-01

    New-onset Graves' ophthalmopathy (GO) following radioiodine treatment (RAI) and worsening of existing GO are well-described in the endocrinology literature. These phenomena are recognized by ophthalmologists, yet poorly documented in the ophthalmology literature. Two male patients, aged 43 and 62 years, respectively, with Graves' disease without GO, received RAI. Four months later, one patient developed acute GO with unilateral reduction in visual acuity, conjunctival chemosis, lagophthalmos, bilateral severely restricted ocular motility, and lid retraction. High-dose intravenous steroids, followed by oral steroids, led to a dramatic clinical improvement. The second patient received a second dose of RAI for persistent hyperthyroidism and subsequently developed acute GO-comprising restricted ocular motility, peri-orbital swelling, and conjunctival chemosis. Symptoms gradually resolved on continued carbimazole treatment. Neither patient received pre-RAI prophylactic glucocorticoids, as currently they are only recommended for patients with pre-existing GO or multiple risk factors. We discuss the limitations of using this risk-based approach in preventing new-onset GO following RAI therapy.

  15. DNA Identification of Skeletal Remains from World War II Mass Graves Uncovered in Slovenia

    PubMed Central

    Marjanović, Damir; Durmić-Pašić, Adaleta; Bakal, Narcisa; Haverić, Sanin; Kalamujić, Belma; Kovačević, Lejla; Ramić, Jasmin; Pojskić, Naris; Škaro, Vedrana; Projić, Petar; Bajrović, Kasim; Hadžiselimović, Rifat; Drobnič, Katja; Huffine, Ed; Davoren, Jon; Primorac, Dragan

    2007-01-01

    Aim To present the joint effort of three institutions in the identification of human remains from the World War II found in two mass graves in the area of Škofja Loka, Slovenia. Methods The remains of 27 individuals were found in two small and closely located mass graves. The DNA was isolated from bone and teeth samples using either standard phenol/chloroform alcohol extraction or optimized Qiagen DNA extraction procedure. Some recovered samples required the employment of additional DNA purification methods, such as N-buthanol treatment. QuantifilerTM Human DNA Quantification Kit was used for DNA quantification. PowerPlex 16 kit was used to simultaneously amplify 15 short tandem repeat (STR) loci. Matching probabilities were estimated using the DNA View program. Results Out of all processed samples, 15 remains were fully profiled at all 15 STR loci. The other 12 profiles were partial. The least successful profile included 13 loci. Also, 69 referent samples (buccal swabs) from potential living relatives were collected and profiled. Comparison of victims' profile against referent samples database resulted in 4 strong matches. In addition, 5 other profiles were matched to certain referent samples with lower probability. Conclusion Our results show that more than 6 decades after the end of the World War II, DNA analysis may significantly contribute to the identification of the remains from that period. Additional analysis of Y-STRs and mitochondrial DNA (mtDNA) markers will be performed in the second phase of the identification project. PMID:17696306

  16. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

    SciTech Connect

    Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria; Souhami, Luis; Gois Manso, Paulo; Souza Dias, Rodrigo; Comodo Segreto, Helena Regina; Araujo Segreto, Roberto

    2012-03-01

    Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.

  17. Associations of CTLA4 Gene Polymorphisms with Graves' Ophthalmopathy: A Meta-Analysis.

    PubMed

    Du, Pengfei; Ma, Xiaojie; Wang, Changjiang

    2014-01-01

    Many studies have established that T-lymphocyte antigen-4 (CTLA4) is a susceptible gene for Graves' disease (GD). Also many studies showed the association between the CTLA4 exon-1 49A/G polymorphism and the risk of developing Graves' ophthalmopathy (GO) in GD patients. But those results were inconsistent. In recent years many new studies were published which helped to shed light on the relationship of CTLA4 SNP49 with GO. So we performed the meta-analysis to explore the association between the SNP49 and GO susceptibility in GD patients. Studies up to February 29, 2012, were searched by using PubMed. The odds ratio was used to evaluate the strength of the association. Altogether 12 case-control studies involving 2,505 participants were included in the meta-analysis. Results showed that the G allele was related to the increased risk of GO compared with the A allele under allelic genetic model (OR = 1.14, 95% CI: 1.14-1.72, P = 0.001) in European subgroup. No publication bias was detected. Our results showed that the SNP49 polymorphism of CTLA4 gene was related to increased risk of GO.

  18. Human spumaretrovirus-related sequences in the DNA of leukocytes from patients with Graves disease.

    PubMed Central

    Lagaye, S; Vexiau, P; Morozov, V; Guénebaut-Claudet, V; Tobaly-Tapiero, J; Canivet, M; Cathelineau, G; Périès, J; Emanoil-Ravier, R

    1992-01-01

    Viruses, and more particularly retroviruses, have been postulated to play a role in the pathogenesis of autoimmune diseases. In a search for spumaretrovirus infection markers, we screened a group of 29 patients with Graves disease and a representative healthy population (23 subjects) as a control. Southern blot hybridization under stringent conditions, of patients' DNA extracted from peripheral blood lymphocytes, with a spumaretrovirus-specific genomic probe derived from the human spumaretrovirus (HSRV) prototype, gave a positive signal in 10 cases. Moreover, by PCR, HSRV-related sequences were detected in the DNA of 19 patients (66%). Positive DNA samples in Southern blots were also positive in PCR for all regions tested (gag, bel1, bel2, long terminal repeat). Amplified (gag and bel2) products were cloned and sequenced; they showed high homology with HSRV. On the other hand, all 23 control subjects were negative by both procedures. Sera from both populations were examined for the presence of antibodies reactive with antigens of the spumaretrovirus family. These sera were negative by several immunodetection techniques: ELISA, indirect immunofluorescence, serum neutralization, and Western blotting. These results strongly suggest the existence of an association between Graves disease and the presence of HSRV-related infection markers. Images PMID:1332028

  19. Use of antihistamines after serious allergic reaction to methimazole in pediatric Graves' disease.

    PubMed

    Toderian, Amy B; Lawson, Margaret L

    2014-05-01

    Antithyroid drugs are usually considered first-line therapy for management of pediatric Graves' disease because they avoid permanent hypothyroidism, provide a chance for remission, and are less invasive than the alternatives of thyroidectomy or radioactive iodine. Methimazole (MMI) is the only antithyroid drug recommended in pediatrics due to the risk of propylthiouracil-induced liver toxicity. Allergic reactions with MMI occur in up to 10% of patients and, when mild, can be managed with concurrent antihistamine therapy. Guidelines recommend discontinuation of MMI with serious allergic reactions. We present the case of an adolescent girl with Graves' disease and a serious allergic reaction after starting MMI whose family refused radioactive iodine and was reluctant to proceed to surgery. Antihistamine therapy was successfully used to allow continued treatment with MMI. This case demonstrates extension of management guidelines for minor cutaneous allergic reactions to MMI, through the use of antihistamines for a serious allergic reaction, allowing us to continue MMI and provide treatment consistent with the family's preferences and values.

  20. [Particular evolution of the thyroid state in Grave's disease: two cases].

    PubMed

    Cherif, Lotfi; Ben Abdallah, Néjib; Khairi, Karima; Hadj Ali, Inçaf; Turki, Sami; Ben Maïz, Hédi

    2003-09-01

    We report two cases of Grave's disease (GD) caracterized by the succession of hypothyroid and hyperthyroid states. Case 1: A 32 years old woman, has presented initially a typical GD with hyperthyroidism. Grave's ophtalmopathy and homogenous goiter. Four months later, she presented a spontaneous hypothyroidism necessiting treatment with thyroxine and a severe myasthenia gravis. More later (6 months), she experienced symptoms of hyperthyroidism after thymectomy. The level of anti-thyrotropin-receptor antibodies (TSab) was very high (141 UI/I, NV < 10). Case 2: A 29 years old woman has been treated by thyroxine (150 microg/day) for a primary hypothyroidism. Ten months later, she presented symptoms of hyperthyroidism even after stoppage of thyroxine. TSH value was decreased (TSH < 0.05 microU/ml) and FT4 level was raised (FT4 = 25.5 pmol/l). The thyroid antibodies were positive. We discuss, after review of the litterature, the physiopathological mecanisms of these changes in the thyroid state, particularly the role of the blocking and stimulating anti-thyrotropin-receptor antibodies.

  1. The gravimeter "B-grave" for the in-situ surface gravity measurements of an asteroid

    NASA Astrophysics Data System (ADS)

    van Ruymbeke, Michel; karatekin, ozgur; rasson, jean; wielant, françois; dumont, Phillipe; Ritter, Birgit; zhu, Ping

    2016-04-01

    In the context of the preliminary study phase for the CubeSats supporting ESA's Asteroid Impact Mission (AIM) to the Didymos, we investigate a miniaturized gravimeter as part of the geophysical instrument package for the Asteroid Geophysical Explorer (AGEX). AGEX intends to land a CubeSat on the secondary object in the Didymos system, Didymoon in order to characterize the asteroid surface and internal structure A 3D compact gravimeter is developed at the Royal Observatory of Belgium. Its design allows to meter a weak 50 μm/sec² gravity field corresponding to 5 ppm of Earth gravity in a harsh environment. A system with three components mounted in an orthogonal geometry allows obtaining the gravity field in amplitude and in angular position without any requirement of levelling. B-GRAVES will use a in-situ calibration and multi-parameter approach for validation of the measurements. A laboratory simulation is induced with centrifugal forces applied to the pendulum set-up in a vertical position to reject the Earth gravity field. Signal treatment and uncertainties are discussed keeping in mind questions of thermal and vibration influence. The B-GRAVES can serve as a novel and robust instrument for future lander and rover missions .

  2. Rapid resolution of fetal goiter associated with maternal Grave's disease: a case report.

    PubMed

    Friedland, D R; Rothschild, M A

    2000-08-11

    The incidence of abnormal fetal thyroid function with maternal Grave's disease is about 2-12%. The development of larger fetal goiters can complicate labor and precipitate life-threatening airway obstruction at delivery. A case is presented of a large stable goiter confirmed by sonography, which unexpectedly resolved by the time of parturition. A 3 x 6 cm fetal goiter was detected at 34 weeks gestation in a mother treated with propylthiouracil for Grave's disease. A repeat sonogram at 36 weeks showed no change in goiter size. Umbilical blood sampling showed the fetus to be markedly hyperthyroid. Planned Cesarean section took place 11 days after the final sonogram. A multi-disciplinary operative team was present including the Otolaryngology service with equipment for emergency intubation, bronchoscopy and tracheotomy. Upon delivery, the infant had no evidence of goiter and no airway compromise. Fetal goiter is a rare entity, and recent advances in the field of maternal-fetal medicine have enabled intra-uterine diagnosis and treatment of such conditions. A review of published case reports demonstrates two trends in treated fetuses: preterm progressive resolution of the goiter, or delivery with gross evidence of goiter. This reported case is unique, as a persistent goiter resolved completely in less than 2 weeks. Otolaryngologic response to and management of potential congenital airway compromise is discussed. PMID:10960698

  3. Transient Hypothyroidism after Radioiodine for Graves' Disease: Challenges in Interpreting Thyroid Function Tests.

    PubMed

    Sheehan, Michael T; Doi, Suhail A R

    2016-03-01

    Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves' disease will help in the timely management of patients. PMID:26864507

  4. Radioiodine-induced hypothyroidism in Graves' disease: factors associated with the increasing incidence

    SciTech Connect

    Cunnien, A.J.; Hy, I.D.; Gorman, C.A.; Offord, K.P.; Scanlon, P.W.

    1982-11-01

    A retrospective analysis was done of the records of 454 patients who received their first I-131 treatment for Graves' disease during six periods covering 1951 to 1978. In the earliest group, 3% of patients were hypothyroid 3 mo after I-131 use, and 40% were hypothyroid at 1 yr. In the most recent group, 36% of patients were hypothyroid at 3 mo and 91% were myxedematous at 1 yr. Although no obvious trends were noted, whether in the number of patients pretreated with thionamide drugs, in the mean 24-hr I-131 uptake, or in the calculated dose of I-131 (..mu..Ci/estimated gram of thyroid tissue) during the years of the study, the initial mean dose of I-131 administered increased from 8.1 mCi in the earliest group to 13.8 mCi in the latest group. Concurrently, estimates of gland size increased from a mean of 26 g in the first group to 43 g in the last. If, in patients with Graves' disease, the thyroid gland size did not truly increase during the years of the study, the increasing occurrence of early hypothyroidism seen after I-131 use may reflect the conscious or unconscious decision to use larger doses of I-131 calculated on the basis of inflated estimates of thyroid gland weight.

  5. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt, Morocco, 11-12,000 BP): the case of Grave XII.

    PubMed

    Belcastro, Maria Giovanna; Condemi, Silvana; Mariotti, Valentina

    2010-06-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12000 BP), excavated by Roche in the 1950s, contains 28 multiple graves. The funerary practices of the Taforalt population have been the focus of a previous work (Mariotti et al., 2009). In the absence of the excavation records of the necropolis, these funerary practices were investigated through the analysis of the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cut marks). Previous research has drawn particular attention to Grave XII (containing three male adults and two juveniles), where many intentionally modified specimens were identified. The present study focused specifically on the human remains recovered from Grave XII. Analysis of these remains has provided evidence of interventions, such as dismemberment and defleshing of the cadaver, and the use of ochre to colour the bones. Furthermore, the presence of lesions on two skulls suggests the possibility of intentional killing and cannibalism among the Taforalt population. This study further supports our previous impression of the complex and diversified funerary practices, characterising the social life of the Iberomaurusian population of Taforalt.

  6. Repatriation in the United States: The Current State of the Native American Graves Protection and Repatriation Act

    ERIC Educational Resources Information Center

    Daehnke, Jon; Lonetree, Amy

    2011-01-01

    Repatriation in the United States today is synonymous with the passage of the Native American Graves Protection and Repatriation Act (NAGPRA). Although repatriations of Native American ancestral remains and cultural objects certainly occurred--and continue to occur--outside of the purview of NAGPRA, this law remains the centerpiece of repatriation…

  7. L'Attitude Chirurgicale dans les Brulures Electriques Graves par Haut Voltage: À Propos de Deux Cas

    PubMed Central

    Moussaoui, A.; Fejjal, N.; Achbouk, A.; Tourabi, K.; Ribag, Y.; Bakkali, H.; Ababou, K.; Ihrai, H.

    2008-01-01

    Summary Devant une brûlure électrique grave, deux attitudes chirurgicales se distinguent: 1. une attitude conservatrice; 2. une attitude d'amputation. A la lumière de deux observations, les Auteurs discutent les avantages et les difficultés de la mise en oeuvre de chaque attitude. PMID:21991118

  8. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt, Morocco, 11-12,000 BP): the case of Grave XII.

    PubMed

    Belcastro, Maria Giovanna; Condemi, Silvana; Mariotti, Valentina

    2010-06-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12000 BP), excavated by Roche in the 1950s, contains 28 multiple graves. The funerary practices of the Taforalt population have been the focus of a previous work (Mariotti et al., 2009). In the absence of the excavation records of the necropolis, these funerary practices were investigated through the analysis of the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cut marks). Previous research has drawn particular attention to Grave XII (containing three male adults and two juveniles), where many intentionally modified specimens were identified. The present study focused specifically on the human remains recovered from Grave XII. Analysis of these remains has provided evidence of interventions, such as dismemberment and defleshing of the cadaver, and the use of ochre to colour the bones. Furthermore, the presence of lesions on two skulls suggests the possibility of intentional killing and cannibalism among the Taforalt population. This study further supports our previous impression of the complex and diversified funerary practices, characterising the social life of the Iberomaurusian population of Taforalt. PMID:20471665

  9. A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis

    PubMed Central

    2010-01-01

    A 56-year-old woman with Graves' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved. PMID:20731531

  10. Graves Disease Induced by Radioiodine Therapy for Toxic Nodular Goiter: A Case Report.

    PubMed

    Yürekli, Yakup; Cengiz, Arzu; Güney, Engin

    2015-10-01

    Graves' disease (GD) may be observed as an infrequent adverse effect after radioiodine therapy (RAIT) for toxic thyroid adenoma (TA) and toxic multi nodular goiter (MNG). We present a case of a 55-year-old male with a toxic nodule who was treated with RAI. After therapy, the patient's serum free triiodothyronine (fT3) and free thyroxine (fT4) levels gradually increased. Antithyroid peroxidase (TPOAb), antithyroglobulin (TgAb) and TSH-receptor antibodies (TRAb) were also positive. Thyroid scintigraphy revealed diffuse intense uptake after four months of RAIT. Radiation-induced GD should be considered in patients with aggravated hyperthyroidism 3-4 months after therapy. PMID:27529890

  11. Hazardous materials management using a Cradle-to-Grave Tracking and Information System (CGTIS)

    SciTech Connect

    Kjeldgaard, E.; Fish, J.; Campbell, D.; Freshour, N.; Hammond, B.; Bray, O.; Hollingsworth, M.

    1995-03-01

    Hazardous materials management includes interactions among materials, personnel, facilities, hazards, and processes of various groups within a DOE site`s environmental, safety & health (ES&H) and line organizations. Although each group is charged with addressing a particular aspect of these properties and interactions, the information it requires must be gathered into a coherent set of common data for accurate and consistent hazardous material management and regulatory reporting. It is these common data requirements which the Cradle-to-Grave Tracking and Information System (CGTIS) is designed to satisfy. CGTIS collects information at the point at which a process begins or a material enters a facility, and maintains that information, for hazards management and regulatory reporting, throughout the entire life-cycle by providing direct on-line links to a site`s multitude of data bases to bring information together into one common data model.

  12. Recurrent Thyrotoxicosis due to Both Graves' Disease and Hashimoto's Thyroiditis in the Same Three Patients

    PubMed Central

    Schaffer, Ashley; Puthenpura, Vidya

    2016-01-01

    Hashimoto's thyroiditis (HT) and Graves' disease (GD) are the 2 most common autoimmune disease processes affecting the thyroid gland. The relationship between the two is complex and not clearly understood. It has been theorized that HT and GD are 2 separate disease processes due to unique genetic differences demonstrated by genome studies. On the other hand, based on occurrence of both HT and GD in monozygotic twins and within the same family, they have been regarded to represent 2 ends of the same spectrum. This case report describes 3 patients who presented with thyrotoxicosis due to both GD and HT. The initial presentation was thyrotoxicosis due to GD treated with antithyroid medication followed by temporary resolution. They all subsequently experienced recurrence of thyrotoxicosis in the form of Hashitoxicosis due to HT, and then eventually all developed thyrotoxicosis due to GD, requiring radioablation therapy. PMID:27340576

  13. TL, OSL and C-14 dating results of the sediments and bricks from mummified nuns' grave.

    PubMed

    Tudela, Diego R G; Tatumi, Sonia H; Yee, Márcio; Brito, Silvio L M; Morais, José L; Morais, Daisy de; Piedade, Silvia C; Munita, Casimiro S P; Hazenfratz, Roberto

    2012-06-01

    This paper presents the results of TL and OSL dating of soil and fragments of bricks from a grave, which was occupied by two mummified nuns, found at "Luz" Monastery, located in the state of São Paulo, Brazil. The TL and OSL ages were compared to C-14 dating ones obtained from bone collagens of the mummies. The majority of the ages is related to the eighteenth century. The gamma-ray spectroscopy was used to evaluate natural radioisotope concentrations in the samples, and by using these concentrations the annual dose rates, from 3.0 to 5.3 Gy/kyr, were obtained. Neutron activation analysis was performed and the radioisotope contents results are in agreement with those obtained by gamma-ray spectroscopy. The contents of U, Th and Ce elements were higher than those found in usual sediments.

  14. Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran.

    PubMed

    Razavi, M E; Abotoraby, R B; Kakhki, R D; Ghanavati, S Z; Layegh, P; Taghavi, M; Rajabian, M T

    2008-01-01

    This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients (n = 68) presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 (SD 14.0) years, range 15 to 71 years. The most common complaints were foreign body sensation (54.0%) and puffy eyelids (48.4%). The most common apparent abnormality was lid retraction in 64.2% of patients (bilateral in 95.3% of cases). The patients had a mean modified Werner's NO SPECS classification score of 3.00 (SD 1.46). The score was significantly higher in males than females [3.58 (SD 1.44) versus 2.63 (SD 1.35)] and was positively correlated with age.

  15. Purification and crystallisation of the autoantigen thyroid peroxidase from human Graves' thyroid tissue.

    PubMed

    Gardas, A; Sohi, M K; Sutton, B J; McGregor, A M; Banga, J P

    1997-05-19

    Milligram quantities of the human membrane autoantigen thyroid peroxidase (TPO) have been purified to a high degree of homogeneity by a combination of detergent solubilisation, monoclonal antibody affinity, and ion exchange chromatography, from pooled Graves' disease thyroid glands. The purified TPO of greater than 90% purity was enzymatically active as judged by its ability to oxidise guaiacol. Crystals of TPO have been grown from solutions of the protein solubilised in sodium deoxycholate, in the presence of ammonium sulphate. The crystals exhibited birefringence under polarised light, indicative of molecular order. Crystallisation of this large, membrane autoantigen represents the first step in delineating the complete three-dimensional structure of a human autoantigen involved in destructive thyroiditis.

  16. Rhabdomyolysis Induced by Nonstrenuous Exercise in a Patient with Graves' Disease

    PubMed Central

    Summachiwakij, Sarawut

    2014-01-01

    Hyperthyroidism can result in several musculoskeletal conditions such as thyrotoxic periodic paralysis, thyrotoxic myopathy, and thyroid ophthalmopathy. Rhabdomyolysis has been rarely reported to be associated with hyperthyroidism. We describe a 33-year-old man who presented with bilateral thigh pain and dark brown urine after regular squatting. He had a past medical history of hyperthyroidism but stopped taking it 2 months prior to admission. He was found to have rhabdomyolysis, myoglobinuria, and thyrotoxicosis. Presence of thyroid-stimulating immunoglobulins (TSI) and high radioiodine uptake confirmed a diagnosis of Graves' disease. He received aggressive fluid resuscitation and sodium bicarbonate intravenously along with monitoring fluid and electrolyte. Methimazole was also resumed. The patient responded to treatment and rhabdomyolysis gradually resolved. Therefore, nonstrenuous exercise can potentially induce rhabdomyolysis in patients with hyperthyroidism. Although hyperthyroidism is not widely recognized as a cause of rhabdomyolysis, it should be considered in the differential diagnosis of rhabdomyolysis. PMID:24716006

  17. PTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.

    PubMed

    Hardy, Olga T; Smolinski, Kara N; Yan, Albert C; Grimberg, Adda

    2006-01-01

    Palpable purpura is a concerning clinical finding in pediatric patients and can have many causes, including infectious and autoimmune processes. A rare cause, drug-induced vasculitis, may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. We report a girl with Turner syndrome and Graves' disease who presented with palpable purpuric lesions. The diagnosis of propylthiouracil (PTU)-associated vasculitis was made by observation of consistent clinical features, the detection of elevated ANA and ANCA in the blood, and the observed clinical resolution of symptoms following withdrawal of PTU. Subsequent treatment of persistent hyperthyroidism with radioablation did not result in an exacerbation of the vasculitis, a complication described in prior case reports.

  18. Delayed Diagnosis of Graves' Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency.

    PubMed

    Naik, Dukhabandhu; Jebasingh, K Felix; Thomas, Nihal

    2016-04-01

    Adrenal crisis is a potential life threatening complication. The common causes of adrenal crisis are infections, surgical stress and abrupt cessation of steroid medications. Endocrine causes like Graves' disease with thyrotoxicosis is one of the less common causes of an adrenal crisis. We report a 42-year-old female who presented with recurrent episodes of adrenal crisis due to delayed diagnosis of thyrotoxicosis. She was initially treated with Carbimazole followed by Radio-iodine ablation and currently she is euthyroid. Her adrenal insufficiency was initially treated with hydrocortisone during the time of adrenal crisis followed by Prednisolone 5 mg once daily in the morning along with fludrocortisone 50 mcg once daily. This case highlights the need for high index of suspicion and less common causes like thyrotoxicosis should be ruled out in patients with adrenal crisis.

  19. Graves' Disease Mechanisms: The Role of Stimulating, Blocking, and Cleavage Region TSH Receptor Antibodies

    PubMed Central

    Morshed, S. A.; Davies, T. F.

    2016-01-01

    The immunologic processes involved in Graves' disease (GD) have one unique characteristic – the autoantibodies to the TSH receptor (TSHR) – which have both linear and conformational epitopes. Three types of TSHR antibodies (stimulating, blocking, and cleavage) with different functional capabilities have been described in GD patients, which induce different signaling effects varying from thyroid cell proliferation to thyroid cell death. The establishment of animal models of GD by TSHR antibody transfer or by immunization with TSHR antigen has confirmed its pathogenic role and, therefore, GD is the result of a breakdown in TSHR tolerance. Here we review some of the characteristics of TSHR antibodies with a special emphasis on new developments in our understanding of what were previously called “neutral” antibodies and which we now characterize as autoantibodies to the “cleavage” region of the TSHR ectodomain. PMID:26361259

  20. Fieldpath Lunar Meteorite Graves Nunataks 06157, a Magnesian Piece of the Lunar Highlands Crust

    NASA Technical Reports Server (NTRS)

    Zeigler, Ryan A.; Korotev, R. L.; Korotev, R. L.

    2012-01-01

    To date, 49 feldspathic lunar meteorites (FLMs) have been recovered, likely representing a minimum of 35 different sample locations in the lunar highlands. The compositional variability among FLMs far exceeds the variability observed among highland samples in the Apollo and Luna sample suites. Here we will discuss in detail one of the compositional end members of the FLM suite, Graves Nunataks (GRA) 06157, which was collected by the 2006-2007 ANSMET field team. At 0.79 g, GRA 06157 is the smallest lunar meteorite so far recovered. Despite its small size, its highly feldspathic and highly magnesian composition are intriguing. Although preliminary bulk compositions have been reported, thus far no petrographic descriptions are in the literature. Here we expand upon the bulk compositional data, including major-element compositions, and provide a detailed petrographic description of GRA 06157.

  1. Role of genetic and non-genetic factors in the etiology of Graves' disease.

    PubMed

    Marinò, M; Latrofa, F; Menconi, F; Chiovato, L; Vitti, P

    2015-03-01

    In spite of the advancements in understanding the pathogenic mechanisms of Graves' disease (GD), its ultimate cause remains elusive. The majority of investigators agree that GD is likely a multifactorial disease, due to a complex interplay of genetic and non-genetic factors that lead to the loss of immune tolerance to thyroid antigens and to the initiation of a sustained autoimmune reaction. Twin and family studies support a role of genetic factors, among which the HLA complex, CD40, CTLA-4, PTPN22, FCRL3, thyroglobulin, and the TSH receptor may be involved. Among non-genetic factors, iodine, infections, psychological stress, gender, smoking, thyroid damage, vitamin D, selenium, immune modulating agents, and periods of immune reconstitution may contribute the development of the diseases. Here we review in detail the respective role of genetic and non-genetic factors in the etiology of GD, taking advantage of the great bulk of data generated especially over the past 30 years.

  2. Antioxidant supplementation and serum lipids in patients with Graves' disease: effect on LDL-cholesterol.

    PubMed

    Vrca, Vesna Bačić; Mayer, Ljiljana; Skreb, Franjo; Rahelić, Dario; Marušić, Srećko

    2012-03-01

    The effect of supplementation with a fixed combination of antioxidants (beta-carotene, selenium, vitamins C and E) on serum lipids was monitored in patients with newly detected Graves' disease. Measurements were made prior to the commencement of therapy and after 30 and 60 days. Patients were randomized into two groups. Test group comprised patients who received antioxidant supplementation in addition to methimazole, while patients treated with methimazole only were in the control group. The concentration of total and HDL-cholesterol increased significantly in test and control groups (p < 0.05) but these groups did not differ significantly. Concentration of LDL-cholesterol increased significantly in the test group only (p < 0.005) and was significantly different from the control group 60 days after the commencement of therapy (p < 0.005). Significant increase in the LDL-cholesterol concentration in the test group requires further investigations.

  3. Painful acute radiation thyroiditis induced by 131I treatment of Graves' disease.

    PubMed

    Shah, Kinjal K; Tarasova, Valentina; Davidian, Michael; Anderson, Robert J

    2015-01-01

    A 44-year-old woman, chronic smoker with Graves' disease was treated with radioactive iodine ablation (RAI). One week after the treatment, she presented with severe pain in the anterior neck with radiation to the angle of the jaw associated with fatigue, tremor and odynophagia. Physical examination demonstrated an asymmetric and exquisitely tender thyroid gland. There was no laboratory evidence of thyrotoxicosis. Acute radiation thyroiditis was diagnosed. Non-steroidal anti-inflammatory drugs and hydrocodone-acetaminophen started initially were ineffective for pain control. Prednisone provided relief and was continued for 1 month with a tapering dose. Symptoms completely resolved after 1 month at which time the thyroid remained diffusely enlarged and non-tender. Three months following RAI ablation she developed hypothyroid symptoms. Levothyroxine was initiated. The patient has remained asymptomatic on continued follow-up care. PMID:25576511

  4. A predictive mathematical model for the calculation of the final mass of Graves' disease thyroids treated with 131I

    NASA Astrophysics Data System (ADS)

    Traino, Antonio C.; Di Martino, Fabio; Grosso, Mariano; Monzani, Fabio; Dardano, Angela; Caraccio, Nadia; Mariani, Giuliano; Lazzeri, Mauro

    2005-05-01

    Substantial reductions in thyroid volume (up to 70-80%) after radioiodine therapy of Graves' hyperthyroidism are common and have been reported in the literature. A relationship between thyroid volume reduction and outcome of 131I therapy of Graves' disease has been reported by some authors. This important result could be used to decide individually the optimal radioiodine activity A0 (MBq) to administer to the patient, but a predictive model relating the change in gland volume to A0 is required. Recently, a mathematical model of thyroid mass reduction during the clearance phase (30-35 days) after 131I administration to patients with Graves' disease has been published and used as the basis for prescribing the therapeutic thyroid absorbed dose. It is well known that the thyroid volume reduction goes on until 1 year after therapy. In this paper, a mathematical model to predict the final mass of Graves' diseased thyroids submitted to 131I therapy is presented. This model represents a tentative explanation of what occurs macroscopically after the end of the clearance phase of radioiodine in the gland (the so-called second-order effects). It is shown that the final thyroid mass depends on its basal mass, on the radiation dose absorbed by the gland and on a constant value α typical of thyroid tissue. α has been evaluated based on a set of measurements made in 15 reference patients affected by Graves' disease and submitted to 131I therapy. A predictive equation for the calculation of the final mass of thyroid is presented. It is based on macroscopic parameters measurable after a diagnostic 131I capsule administration (0.37-1.85 MBq), before giving the therapy. The final mass calculated using this equation is compared to the final mass of thyroid measured 1 year after therapy administration in 22 Graves' diseased patients. The final masses calculated and measured 1 year after therapy are in fairly good agreement (R = 0.81). The possibility, for the physician, to decide a

  5. Analysis of T cell subsets in Graves' disease: alterations associated with carbimazole.

    PubMed Central

    Ludgate, M E; McGregor, A M; Weetman, A P; Ratanachaiyavong, S; Lazarus, J H; Hall, R; Middleton, G W

    1984-01-01

    Conflicting data on subpopulations of peripheral blood lymphocytes in patients with autoimmune disease largely reflect variations in methods of study. An investigation was therefore conducted aimed at avoiding this difficulty. Serial samples of peripheral blood mononuclear cells from 42 patients with hyperthyroid Graves' disease were collected at monthly intervals before, during, and for 12 months after a six month course of carbimazole. Samples were stored in liquid nitrogen until completion of the study, when they were thawed and all samples from each patient analysed within the same assay using mouse monoclonal antibodies to human cell subsets and a fluorescence activated cell sorter. Proportions of cytotoxic/suppressor (OKT8) positive cells before treatment (mean 17.4 (SEM 0.8)%) were significantly lower (p less than 0.001) than those in normal controls (29.8 (1.9)%; n = 10) and returned to normal by the end of treatment. In contrast, the proportions of activated T cells (OKIa-OKM1) were significantly raised before treatment as compared with normal (14.4 (0.6)% versus 4.6 (0.8)%; p less than 0.001) and fell to normal by the end of treatment. Proportions of OKT3 and OKT4 positive T cells remained unchanged throughout treatment and in the succeeding 12 months. In patients who relapsed after treatment there was a rise in the proportion of activated T cells and a fall in OKT8 positive T cells, which returned towards normal with retreatment. The explanation for the alterations in numbers of circulating T cells remains to be determined but they may provide a means for predicting more accurately the outcome of Graves' disease after treatment with carbimazole. Images p530-a PMID:6421364

  6. Non-invasive management of fetal goiter during maternal treatment of hyperthyroidism in Grave's disease.

    PubMed

    Lembet, Arda; Eroglu, Derya; Kinik, Sibel Tulgar; Gurakan, Berkan; Kuscu, Esra

    2005-01-01

    There is an increased risk of fetal goiter in patients who have a history of Grave's disease and undergo propylthiouracil (PTU) treatment during pregnancy. In this report, we describe a case of a fetal goiter detected by antenatal ultrasound at the 26th week of gestation in a mother treated with PTU for Grave's disease. A 32 x 38 x 20 mm fetal goiter was detected, each lobe measured 30 x 18 x 18 mm and estimated volume was 10 cm3. Subsequently, fetal thyroid function was assessed by umbilical fetal blood sampling. Cord blood showed elevated serum TSH (40.2 mU/l) and normal concentrations of free T4 (9.5 pmol/l) and free T3 (2.6 pmol/l). There were no other ultrasonographic signs of fetal hypothyroidism. Based on the above findings, the mother's PTU dosage was reduced to 50 mg daily from a total of 150 mg and weekly ultrasonographic examinations were performed. Six weeks after the initial ultrasound, a complete regression of the fetal goiter was noted. At the 34th week of gestation, the patient was delivered due to intrauterine growth restriction and oligohydramnios and gave birth to a male, weighing 1,920 g. The newborn thyroid was not palpable and thyroid ultrasonography was normal. Cord blood TSH was normal (8.4 mU/l) and free T4 was within lower normal limit (9.03 pmol/l). Ten days later, newborn thyroid function was normal and the baby did well afterwards. In conclusion, after the evaluation of fetal thyroid status, selected cases with fetal goiter can be initially managed without intrauterine treatment. PMID:15980635

  7. Adjuvant Treatment of Graves' Disease with Diclofenac: Safety, Effects on Ophthalmopathy and Antibody Concentrations

    PubMed Central

    Lantz, Mikael; Calissendorff, Jan; Träisk, Frank; Tallstedt, Leif; Planck, Tereza; Törring, Ove; Hallengren, Bengt; Åsman, Peter

    2016-01-01

    Background Orbital morphological changes are often present in patients with Graves' disease (GD) already at diagnosis, and cyclooxygenase type 2 (COX-2) is overexpressed in active Graves' ophthalmopathy (GO). Objective To investigate if adjuvant treatment of GD with the COX inhibitor and peroxisome proliferator-activated receptor-γ (PPAR-γ) antagonist diclofenac decreases the development of ophthalmopathy and if laboratory parameters are affected. Methods This is a multicenter trial where 61 subjects were randomized to methimazole (block and replace with l-thyroxine) either with or without diclofenac 50 mg 1 × 2 for 12 months. The primary end point development of GO after 24 months was evaluated. Smoking habits were registered and the thyroid parameters TSH, free T4, free T3, TSH receptor antibodies (TRAb) and anti-TPO were followed. Safety parameters (kidney, liver and blood) and adverse events were regularly registered. Results GO developed in 11% (n = 3) of the patients treated with diclofenac and in 21% (n = 6) of the controls (p = 0.273). The adverse event profile was acceptable without any severe events related to diclofenac. Both TRAb and anti-TPO concentrations decreased during treatment with methimazole, but the anti-TPO concentrations were lower in patients treated with diclofenac after 15 months (p = 0.031). The TRAb concentrations were not significantly changed between groups. Smokers had higher concentrations of TRAb than nonsmokers both at diagnosis of GD (p = 0.048) and after 15 months (p = 0.042). Conclusions Treatment with diclofenac had no significant influence on development of GO. Diclofenac reduces anti-TPO concentrations and seems to be safe to use in GD patients. PMID:27099839

  8. Usefulness of Measuring Thyroid Stimulating Antibody at the Time of Antithyroid Drug Withdrawal for Predicting Relapse of Graves Disease

    PubMed Central

    Kwon, Hyemi; Jang, Eun Kyung; Kim, Mijin; Park, Suyeon; Jeon, Min Ji; Kim, Tae Yong; Ryu, Jin-Sook; Shong, Young Kee; Kim, Won Bae

    2016-01-01

    Background Hyperthyroidism relapse in Graves disease after antithyroid drug (ATD) withdrawal is common; however, measuring the thyrotropin receptor antibody (TRAb) at ATD withdrawal in order to predict outcomes is controversial. This study compared measurement of thyroid stimulatory antibody (TSAb) and thyrotropin-binding inhibitory immunoglobulin (TBII) at ATD withdrawal to predict relapse. Methods This retrospective study enrolled patients with Graves disease who were treated with ATDs and whose serum thyroid-stimulating hormone levels were normal after receiving low-dose ATDs. ATD therapy was stopped irrespective of TRAb positivity after an additional 6 months of receiving the minimum dose of ATD therapy. Patients were followed using thyroid function tests and TSAb (TSAb group; n=35) or TBII (TBII group; n=39) every 3 to 6 months for 2 years after ATD withdrawal. Results Twenty-eight patients (38%) relapsed for a median follow-up of 21 months, and there were no differences in baseline clinical characteristics between groups. In the TSAb group, relapse was more common in patients with positive TSAb at ATD withdrawal (67%) than patients with negative TSAb (17%; P=0.007). Relapse-free survival was shorter in TSAb-positive patients. In the TBII group, there were no differences in the relapse rate and relapse-free survivals according to TBII positivity. For predicting Graves disease relapse, the sensitivity and specificity of TSAb were 63% and 83%, respectively, whereas those of TBII were 28% and 65%. Conclusion TSAb at ATD withdrawal can predict the relapse of Graves hyperthyroidism, but TBII cannot. Measuring TSAb at ATD withdrawal can assist with clinical decisions making for patients with Graves disease. PMID:27118279

  9. Earliest floral grave lining from 13,700–11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel

    PubMed Central

    Nadel, Dani; Danin, Avinoam; Power, Robert C.; Rosen, Arlene M.; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R.; Barzilai, Omry; Boaretto, Elisabetta

    2013-01-01

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700–11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000–11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene. PMID:23818584

  10. Earliest floral grave lining from 13,700-11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel.

    PubMed

    Nadel, Dani; Danin, Avinoam; Power, Robert C; Rosen, Arlene M; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R; Barzilai, Omry; Boaretto, Elisabetta

    2013-07-16

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700-11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000-11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene.

  11. Determining thyroid {sup 131}I effective half-life for the treatment planning of Graves' disease

    SciTech Connect

    Willegaignon, Jose; Sapienza, Marcelo T.; Barberio Coura Filho, George; Buchpiguel, Carlos A.; Traino, Antonio C.

    2013-02-15

    Purpose: Thyroid {sup 131}I effective half-life (T{sub eff}) is an essential parameter in patient therapy when accurate radiation dose is desirable for producing an intended therapeutic outcome. Multiple {sup 131}I uptake measurements and resources from patients themselves and from nuclear medicine facilities are requisites for determining T{sub eff}, these being limiting factors when implementing the treatment planning of Graves' disease (GD) in radionuclide therapy. With the aim of optimizing this process, this study presents a practical, propitious, and accurate method of determining T{sub eff} for dosimetric purposes. Methods: A total of 50 patients with GD were included in this prospective study. Thyroidal {sup 131}I uptake was measured at 2-h, 6-h, 24-h, 48-h, 96-h, and 220-h postradioiodine administration. T{sub eff} was calculated by considering sets of two measured points (24-48-h, 24-96-h, and 24-220-h), sets of three (24-48-96-h, 24-48-220-h, and 24-96-220-h), and sets of four (24-48-96-220-h). Results: When considering all the measured points, the representative T{sub eff} for all the patients was 6.95 ({+-}0.81) days, whereas when using such sets of points as (24-220-h), (24-96-220-h), and (24-48-220-h), this was 6.85 ({+-}0.81), 6.90 ({+-}0.81), and 6.95 ({+-}0.81) days, respectively. According to the mean deviations 2.2 ({+-}2.4)%, 2.1 ({+-}2.0)%, and 0.04 ({+-}0.09)% found in T{sub eff}, calculated based on all the measured points in time, and with methods using the (24-220-h), (24-48-220-h), and (24-96-220-h) sets, respectively, no meaningful statistical difference was noted among the three methods (p > 0.500, t test). Conclusions: T{sub eff} obtained from only two thyroid {sup 131}I uptakes measured at 24-h and 220-h, besides proving to be sufficient, accurate enough, and easily applicable, attributes additional major cost-benefits for patients, and facilitates the application of the method for dosimetric purposes in the treatment planning of

  12. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt; Morocco, 11-12,000BP): new hypotheses based on a grave by grave skeletal inventory and evidence of deliberate human modification of the remains.

    PubMed

    Mariotti, Valentina; Bonfiglioli, Benedetta; Facchini, Fiiorenzo; Condemi, Silvana; Belcastro, Maria Giovanna

    2009-04-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12,000BP), excavated by Roche in the 1950s, contains 28 multiple graves. The osteological collection has been the focus of many anthropological studies and has been used as a comparative sample for other paleoanthropological investigations. The presence of particular sepulchral structures and the use of ochre testify to complex funerary practices, which have not been adequately investigated thus far. Unfortunately, neither the excavation records nor detailed descriptions of the graves are available today. The aim of this study is to investigate the funerary practices of the population based on examination of the human osteological collection (Institut de Paléontologie Humaine, Paris). The bones of adolescents and adults were inventoried to analyse the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cutmarks). The minimum number of individuals was also calculated. The results suggest that the necropolis is a group of primary and secondary burials, even within the same "grave," of about 40 adolescents and adults. The previous estimate of 86 individuals by Ferembach in 1962 appears to be an overestimation. The presence of red ochre and cutmarks on some bones suggests various rituals, which denote a certain profundity of thinking about life and death. It is possible that the Taforalt cave was a special, perhaps sacred, place where particular rituals were celebrated or where more occasional social or religious events took place. Comparison with other Iberomaurusian and Capsian sites provides evidence of cultural continuity in North Africa for a long period of time. The present study demonstrates that re-examination of human osteological collections deriving from ancient excavations, for which a lack of adequate documentation of the context of the specimens is fairly common, can also provide information about aspects like funerary practices, which are usually

  13. Estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese patients with Graves׳ disease.

    PubMed

    Suzuki, Yoshitake; Matsushita, Kazuyuki; Seimiya, Masanori; Yoshida, Toshihiko; Sawabe, Yuji; Ogawa, Makoto; Nomura, Fumio

    2015-12-01

    Glomerular filtration rate (eGFR) by serum creatinine (eGFRCr) or standardized cystatin C (eGFRCysC) were estimated in Japanese patients with Graves׳ disease (GD) of different sex. Clinical samples were collected from patients with GD with normal renal function to accurately validate eGFRCr and eGFRCysC levels and evaluate how hyperthyroidism affects renal function. Levels of eGFRCr and eGFRCysC showed clinical usefulness in successfully treated euthyroid patients with GD regardless of sex. The article includes detailed experimental methods and data used in our analysis. The data relates to the "Paradoxical effect of thyroid function on the estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese Graves' disease patients" (Suzuki et al., 2015) [1].

  14. [Variability in the clinical presentation of Pompe disease: development following enzyme replacement therapy].

    PubMed

    Ley-Martos, Myriam; Salado-Reyes, María J; Espinosa-Rosso, Raúl; Solera-García, Jesús; Jiménez-Jiménez, Luis

    2015-11-01

    Introduccion. La enfermedad de Pompe es un trastorno generalizado progresivo producido por el deficit de la enzima alfa-glucosidasa acida (AGA) de los lisosomas. Se presentan tres casos manifestados de forma muy diferente y tratados con terapia enzimatica sustitutiva (TES), con evolucion favorable. Casos clinicos. Caso 1: varon de 3 meses, con debilidad y rechazo de la alimentacion, hepatomegalia leve, ligera macroglosia e hipotonia, y aumento de las enzimas musculares. Caso 2: varon de 5 meses, con retraso del desarrollo motor, sordera neurosensorial grave, trastornos respiratorios de repeticion de evolucion torpida, hipotonia y leve elevacion de la creatincinasa. Caso 3: varon de 22 años con disnea progresiva, con antecedentes de elevacion de la creatincinasa y las transaminasas, e hipercolesterolemia. Sufrio insuficiencia respiratoria grave que preciso intubacion endotraqueal. La biopsia muscular presento depositos de glucogeno sugestivos de la enfermedad. En los tres casos, el estudio electromiografico dio un patron caracteristico, con descargas pseudomiotonicas, y se confirmo el deficit de AGA en los linfocitos. Se encontro una mutacion en un caso y dos mutaciones en los otros dos. Todos recibieron TES con evolucion favorable: desaparicion de las alteraciones cardiacas en el caso 1, mejoria en los hitos motores en los dos casos infantiles y retirada del respirador en el caso 3. Conclusion. La enfermedad de Pompe tiene una amplia variabilidad en la expresion clinica. La TES consigue una buena respuesta, especialmente en las formas infantiles. La supervivencia a largo plazo de las formas infantiles tratadas permitira conocer mas aspectos del curso de la enfermedad.

  15. Cigarette Smoke Extract-Induced Oxidative Stress and Fibrosis-Related Genes Expression in Orbital Fibroblasts from Patients with Graves' Ophthalmopathy

    PubMed Central

    Kau, Hui-Chuan; Wu, Shi-Bei; Tsai, Chieh-Chih; Liu, Catherine Jui-Ling; Wei, Yau-Huei

    2016-01-01

    Cigarette smoking is the most important risk factor for the development or deterioration of Graves' ophthalmopathy. Smoke-induced increased generation of reactive oxygen species may be involved. However, it remains to be clarified how orbital fibroblasts are affected by cigarette smoking. Our study demonstrated that Graves' orbital fibroblasts have exaggerated response to cigarette smoke extract challenge along with increased oxidative stress, fibrosis-related genes expression, especially connective tissue growth factor, and intracellular levels of transforming growth factor-β1 and interleukin-1β. The findings obtained in this study provide some clues for the impact of cigarette smoking on Graves' ophthalmopathy and offer a theoretical basis for the potential and rational use of antioxidants in treating Graves' ophthalmopathy. PMID:27340508

  16. Semblance analysis to assess GPR data from a five-year forensic study of simulated clandestine graves

    NASA Astrophysics Data System (ADS)

    Booth, Adam D.; Pringle, Jamie K.

    2016-02-01

    Ground penetrating radar (GPR) surveys have proven useful for locating clandestine graves in a number of forensic searches. There has been extensive research into the geophysical monitoring of simulated clandestine graves in different burial scenarios and ground conditions. Whilst these studies have been used to suggest optimum dominant radar frequencies, the data themselves have not been quantitatively analysed to-date. This study uses a common-offset configuration of semblance analysis, both to characterise velocity trends from GPR diffraction hyperbolae and, since the magnitude of a semblance response is proportional to signal-to-noise ratio, to quantify the strength of a forensic GPR response. 2D GPR profiles were acquired over a simulated clandestine burial, with a wrapped-pig cadaver monitored at three-month intervals between 2008 and 2013 with GPR antennas of three different centre-frequencies (110, 225 and 450 MHz). The GPR response to the cadaver was a strong diffraction hyperbola. Results show, in contrast to resistivity surveys, that semblance analysis have little sensitivity to changes attributable to decomposition, and only a subtle influence from seasonality: velocity increases (0.01-0.02 m/ns) were observed in summer, associated with a decrease (5-10%) in peak semblance magnitude, SM, and potentially in the reflectivity of the cadaver. The lowest-frequency antennas consistently gave the highest signal-to-noise ratio although the grave was nonetheless detectable by all frequencies trialled. These observations suggest that forensic GPR surveys could be undertaken with little seasonal hindrance. Whilst GPR analysis cannot currently provide a quantitative diagnostic proxy for time-since-burial, the consistency of responses suggests that graves will remain detectable beyond the five years shown here.

  17. The Accuracy of the Osteological Sexing of Cremated Human Remains: A Test Based on Grave Goods from East Lithuanian Barrows.

    PubMed

    Kurila, Laurynas

    2015-12-01

    The accuracy of the sex determination of cremated human remains is one of the vital parameters for archaeologists and skeletal anthropologists dealing with cremations. Few studies have so far aimed at testing it. In the present paper, the accuracy of the sexing techniques was assessed by paralleling biological sex (identified morphologically) to gender (presumed on the basis of the grave goods which accompanied the deceased). A collection of cremated bones from East Lithuanian barrows (c. fourth/fifth--eleventh/twelfth centuries AD) was employed. The fragmentary nature and poor state of the bones generally represents cremains from similar archaeological contexts. The database inevitably underwent several stages of filtration. Out of 364 cremations with a minimum of 445 individuals, only 157 were sexed single adult burials, of which only 81 had "gender-related" grave goods. The relationship of artefact type to gender was defined statistically, revising the results in line with the chronological and typological differences and the probable symbolism of the grave goods. Sex and gender coincided in 56 cases (69.14%), but a considerable distance between the results for both sexes was observed. Biological females displayed a fairly high match level, i.e. 35 out of the 41 (85.37%) individuals osteologically identified as females had been given "feminine" items. The burials of biological males, on the other hand, yielded a surprisingly low match rate, i.e. only 21 out of 40 (52.50%). This disparity suggests a possible misinterpretation of grave goods as gender markers, rather than (only?) erroneous sexing. It is thus argued that for females, the mean value for the accuracy of sexing is 85.5%. In most cases, such precision is entirely satisfactory for the analysis of a poorly-preserved osteological material. For males, however, the accuracy is likely to fall somewhere in the range between 52.5 and 85.5%, with the applied methodology so far failing to contribute to higher

  18. Iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a concurrent diagnosis of primary hyperaldosteronism

    PubMed Central

    Snell, L; Morris, D V

    2015-01-01

    Summary Myxoedema madness was first described as a consequence of severe hypothyroidism in 1949. Most cases were secondary to long-standing untreated primary hypothyroidism. We present the first reported case of iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a second concurrent diagnosis of primary hyperaldosteronism. A 29-year-old woman presented with severe hypothyroidism, a 1-week history of psychotic behaviour and paranoid delusions 3 months after treatment with radioactive iodine ablation for Graves' disease. Her psychiatric symptoms abated with levothyroxine replacement. She was concurrently found to be hypertensive and hypokalemic. Primary hyperaldosteronism from bilateral adrenal hyperplasia was diagnosed. This case report serves as a reminder that myxoedema madness can be a complication of acute hypothyroidism following radioactive iodine ablation of Graves' disease and that primary hyperaldosteronism may be associated with autoimmune hyperthyroidism. Learning points Psychosis (myxoedema madness) can present as a neuropsychiatric manifestation of acute hypothyroidism following radioactive iodine ablation of Graves' disease.Primary hyperaldosteronism may be caused by idiopathic bilateral adrenal hyperplasia even in the presence of an adrenal adenoma seen on imaging.Adrenal vein sampling is a useful tool for differentiating between a unilateral aldosterone-producing adenoma, which is managed surgically, and an idiopathic bilateral adrenal hyperplasia, which is managed medically.The management of autoimmune hyperthyroidism, iatrogenic hypothyroidism and primary hyperaldosteronism from bilateral idiopathic adrenal hyperplasia in patients planning pregnancy includes delaying pregnancy 6 months following radioactive iodine treatment and until patient is euthyroid for 3 months, using amiloride as opposed to spironolactone, controlling blood pressure with agents safe in pregnancy such as nifedipine and avoiding

  19. The Accuracy of the Osteological Sexing of Cremated Human Remains: A Test Based on Grave Goods from East Lithuanian Barrows.

    PubMed

    Kurila, Laurynas

    2015-12-01

    The accuracy of the sex determination of cremated human remains is one of the vital parameters for archaeologists and skeletal anthropologists dealing with cremations. Few studies have so far aimed at testing it. In the present paper, the accuracy of the sexing techniques was assessed by paralleling biological sex (identified morphologically) to gender (presumed on the basis of the grave goods which accompanied the deceased). A collection of cremated bones from East Lithuanian barrows (c. fourth/fifth--eleventh/twelfth centuries AD) was employed. The fragmentary nature and poor state of the bones generally represents cremains from similar archaeological contexts. The database inevitably underwent several stages of filtration. Out of 364 cremations with a minimum of 445 individuals, only 157 were sexed single adult burials, of which only 81 had "gender-related" grave goods. The relationship of artefact type to gender was defined statistically, revising the results in line with the chronological and typological differences and the probable symbolism of the grave goods. Sex and gender coincided in 56 cases (69.14%), but a considerable distance between the results for both sexes was observed. Biological females displayed a fairly high match level, i.e. 35 out of the 41 (85.37%) individuals osteologically identified as females had been given "feminine" items. The burials of biological males, on the other hand, yielded a surprisingly low match rate, i.e. only 21 out of 40 (52.50%). This disparity suggests a possible misinterpretation of grave goods as gender markers, rather than (only?) erroneous sexing. It is thus argued that for females, the mean value for the accuracy of sexing is 85.5%. In most cases, such precision is entirely satisfactory for the analysis of a poorly-preserved osteological material. For males, however, the accuracy is likely to fall somewhere in the range between 52.5 and 85.5%, with the applied methodology so far failing to contribute to higher

  20. Geophysical monitoring of simulated graves with resistivity, magnetic susceptibility, conductivity and GPR in Colombia, South America.

    PubMed

    Molina, Carlos Martin; Pringle, Jamie K; Saumett, Miguel; Evans, Gethin T

    2016-04-01

    In most Latin American countries there are significant numbers of both missing people and forced disappearances, ∼71,000 Colombia alone. Successful detection of buried human remains by forensic search teams can be difficult in varying terrain and climates. Three clandestine burials were simulated at two different depths commonly encountered in Latin America. In order to gain critical knowledge of optimum geophysical detection techniques, burials were monitored using: ground penetrating radar, magnetic susceptibility, bulk ground conductivity and electrical resistivity up to twenty-two months post-burial. Radar survey results showed good detection of modern 1/2 clothed pig cadavers throughout the survey period on 2D profiles, with the 250MHz antennae judged optimal. Both skeletonised and decapitated and burnt human remains were poorly imaged on 2D profiles with loss in signal continuity observed throughout the survey period. Horizontal radar time slices showed good anomalies observed over targets, but these decreased in amplitude over the post-burial time. These were judged due to detecting disturbed grave soil rather than just the buried targets. Magnetic susceptibility and electrical resistivity were successful at target detection in contrast to bulk ground conductivity surveys which were unsuccessful. Deeper burials were all harder to image than shallower ones. Forensic geophysical surveys should be undertaken at suspected burial sites. PMID:26921813

  1. [A study on observation of bone metabolism in middle-aged and senile female Graves' disease].

    PubMed

    Zhu, L Q; Liu, Y H; Zhou, Y B

    1996-08-01

    Sixty-nine cases of middle aged and senile female Graves' desease (GD) patients suffered from abnormal bone metabolism have been studied. They were divided randomly into group A and B, treated separately with antithyroid drugs (Tapazol and inderal, etc.) in group A, and added with Chinese herbal medicine for tonifying Kidney and promoting blood circulation in group B. Before treatment, patients of both groups showed obvious higher blood calcium (Ca) 24-hour urinary Ca, phosphorus (P) and serum clcitonin (CT) levels than that in normal subjects. These patients' serum Ca, moreover, had a parallel relationship with serum T3 levels (r = 0.6142, P < 0.01) and the serum Ca also a paralleled with serum CT levels (r = 0.5714, P < 0.05). After six months of treatment, the serum Ca, 24-hour urinary Ca, P and blood CT values were all reduced in various degree. The decrease of these bone metabolic parameters were more significant in group B than that in group A. PMID:9387746

  2. Synthetic gene network restoring endogenous pituitary-thyroid feedback control in experimental Graves' disease.

    PubMed

    Saxena, Pratik; Charpin-El Hamri, Ghislaine; Folcher, Marc; Zulewski, Henryk; Fussenegger, Martin

    2016-02-01

    Graves' disease is an autoimmune disorder that causes hyperthyroidism because of autoantibodies that bind to the thyroid-stimulating hormone receptor (TSHR) on the thyroid gland, triggering thyroid hormone release. The physiological control of thyroid hormone homeostasis by the feedback loops involving the hypothalamus-pituitary-thyroid axis is disrupted by these stimulating autoantibodies. To reset the endogenous thyrotrophic feedback control, we designed a synthetic mammalian gene circuit that maintains thyroid hormone homeostasis by monitoring thyroid hormone levels and coordinating the expression of a thyroid-stimulating hormone receptor antagonist (TSHAntag), which competitively inhibits the binding of thyroid-stimulating hormone or the human autoantibody to TSHR. This synthetic control device consists of a synthetic thyroid-sensing receptor (TSR), a yeast Gal4 protein/human thyroid receptor-α fusion, which reversibly triggers expression of the TSHAntag gene from TSR-dependent promoters. In hyperthyroid mice, this synthetic circuit sensed pathological thyroid hormone levels and restored the thyrotrophic feedback control of the hypothalamus-pituitary-thyroid axis to euthyroid hormone levels. Therapeutic plug and play gene circuits that restore physiological feedback control in metabolic disorders foster advanced gene- and cell-based therapies.

  3. T cell responses to synthetic TSH receptor peptides in Graves' disease.

    PubMed Central

    Tandon, N; Freeman, M A; Weetman, A P

    1992-01-01

    Twenty-eight peptides, representing the entire extracellular domain of the TSH receptor, were synthesised to investigate which parts of this autoantigen may be targets for the T cell response in Graves' disease (GD). T cells from 11 of 21 controls and 26 of 36 newly diagnosed GD patients proliferated in response to one or more peptides with a stimulation index (SI) of greater than 2.0 (chi 2 = 2.31, P greater than 0.1). The response of patients and controls to any of the individual peptides was also not statistically different. However, individual patients gave high SIs with certain peptides to which controls either gave an absent or very weak response. HLA-DR3 was not associated with any particular response to TSHR peptides. Three out of seven GD patients whose T cells were evaluated before and after treatment showed a response of this kind only early in the course of their disease. Intrathyroidal T cells from four GD patients did not give a consistent proliferative response to pools of five peptides, and depleting peripheral blood T cells of their CD8+ population did not affect the proliferative response. These results indicate that the T cell response to the TSH receptor in GD does not seem to be directed against any one particular epitope on the peptides we have tested which cover the extracellular domain. PMID:1516261

  4. Disease activity in Graves' ophthalmopathy: diagnosis with orbital MR imaging and correlation with clinical score.

    PubMed

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-10-01

    In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone.

  5. Educational interventions targeted at minors in situations of grave social vulnerability and their families

    NASA Astrophysics Data System (ADS)

    de La Caba Collado, Mariangeles; Bartau Rojas, Isabel

    2010-10-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The design, intervention and assessment process of this study was carried out in two phases over a period of a year and a half. For both phases, three different groups—of men/fathers, women/mothers and children—were established. Study variables (parenting skills and children's personal and social development) were evaluated before and after the intervention in every group, as well as during the entire process. The results, taking into account the improvements reported by all the participants (social workers, group monitors, fathers, mothers, children) show that inter-professional involvement and coordination at all phases of the intervention is vital in order to achieve small but significant improvements.

  6. Early Medieval Muslim Graves in France: First Archaeological, Anthropological and Palaeogenomic Evidence

    PubMed Central

    Pemonge, Marie-Hélène; Hubert, Christophe; Groppi, Alexis; Houix, Bertrand; Deguilloux, Marie-France; Breuil, Jean-Yves

    2016-01-01

    The rapid Arab-Islamic conquest during the early Middle Ages led to major political and cultural changes in the Mediterranean world. Although the early medieval Muslim presence in the Iberian Peninsula is now well documented, based in the evaluation of archeological and historical sources, the Muslim expansion in the area north of the Pyrenees has only been documented so far through textual sources or rare archaeological data. Our study provides the first archaeo-anthropological testimony of the Muslim establishment in South of France through the multidisciplinary analysis of three graves excavated at Nimes. First, we argue in favor of burials that followed Islamic rites and then note the presence of a community practicing Muslim traditions in Nimes. Second, the radiometric dates obtained from all three human skeletons (between the 7th and the 9th centuries AD) echo historical sources documenting an early Muslim presence in southern Gaul (i.e., the first half of 8th century AD). Finally, palaeogenomic analyses conducted on the human remains provide arguments in favor of a North African ancestry of the three individuals, at least considering the paternal lineages. Given all of these data, we propose that the skeletons from the Nimes burials belonged to Berbers integrated into the Umayyad army during the Arab expansion in North Africa. Our discovery not only discusses the first anthropological and genetic data concerning the Muslim occupation of the Visigothic territory of Septimania but also highlights the complexity of the relationship between the two communities during this period. PMID:26910855

  7. Disease Activity in Graves' Ophthalmopathy: Diagnosis with Orbital MR Imaging and Correlation with Clinical Score

    PubMed Central

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-01-01

    Summary In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone. PMID:24199816

  8. Le Point sur la Pharmacologie des Agents Anesthesiques Chez le Brule Grave

    PubMed Central

    Siah, S.; Ababou, K.; Benziane, H.; El Jaoudi; Bensghir, M.; Bakali, H.; El Wali, A.; Ihrai, I.; Drissi, N.K.

    2008-01-01

    Summary La pharmacologie des agents anesthésiques chez le brûlé est variable et imprévisible. Dans les premières 48 h, il y a une hypovolémie avec chute du débit cardiaque et des fuites plasmatiques. Après 48 h, il y a une hypervolémie avec augmentation du débit cardiaque, hypermétabolisme et la clearance des médicaments est augmentée. Parmi les facteurs de déséquilibre, on retrouve les variations des protéines plasmatiques. Deux protéines sont importantes chez le brûlé grave : l'albumine et l'alpha 1- glycoprotéine. Leur taux varie beaucoup au cours de l'évolution de la brûlure. Les agents anesthésiques dont la liaison avec ces deux protéines est prédominante verront leur pharmacocinétique modifiée. L'anesthésiste-réanimateur du service des brûlés va maîtriser ces notions pharmacologiques pour utiliser à bon escient les agents anesthésiques. PMID:21991108

  9. Synthetic gene network restoring endogenous pituitary-thyroid feedback control in experimental Graves' disease.

    PubMed

    Saxena, Pratik; Charpin-El Hamri, Ghislaine; Folcher, Marc; Zulewski, Henryk; Fussenegger, Martin

    2016-02-01

    Graves' disease is an autoimmune disorder that causes hyperthyroidism because of autoantibodies that bind to the thyroid-stimulating hormone receptor (TSHR) on the thyroid gland, triggering thyroid hormone release. The physiological control of thyroid hormone homeostasis by the feedback loops involving the hypothalamus-pituitary-thyroid axis is disrupted by these stimulating autoantibodies. To reset the endogenous thyrotrophic feedback control, we designed a synthetic mammalian gene circuit that maintains thyroid hormone homeostasis by monitoring thyroid hormone levels and coordinating the expression of a thyroid-stimulating hormone receptor antagonist (TSHAntag), which competitively inhibits the binding of thyroid-stimulating hormone or the human autoantibody to TSHR. This synthetic control device consists of a synthetic thyroid-sensing receptor (TSR), a yeast Gal4 protein/human thyroid receptor-α fusion, which reversibly triggers expression of the TSHAntag gene from TSR-dependent promoters. In hyperthyroid mice, this synthetic circuit sensed pathological thyroid hormone levels and restored the thyrotrophic feedback control of the hypothalamus-pituitary-thyroid axis to euthyroid hormone levels. Therapeutic plug and play gene circuits that restore physiological feedback control in metabolic disorders foster advanced gene- and cell-based therapies. PMID:26787873

  10. Analyses to help identify individuals from a historical mass grave in Kassel, Germany.

    PubMed

    v Grumbkow, Philipp; Zipp, Anna; Grosskopf, Birgit; Fueldner, Kai; Hummel, Susanne

    2012-01-01

    In 2008, the skeletal remains of more than 60 human individuals were found in a mass grave on the grounds of the University of Kassel, Germany. There was no evidence helping to identify them or throwing light on the cause of their death. Mainly due to 14C age determination and initial hints on age and sex distribution, historians hypothesized that they had been soldiers of Napoleon's army who died in an epidemic in the winter of 1813/14. To test this assumption, morphological and molecular analyses were carried out on a sample. The morphological analyses comprised an age and sex determination as well as a macro- and micro-morphological inspection for pathological deviations after the commingled bones had been assembled as individuals. The molecular investigations aimed to identify the geographic origin of the remains. For this, mitochondrial and Y-chromosomal haplotypings were carried out. The results point to a group of mainly young men, some of them suffering from systemic inflammation of the periosteum. Others revealed severe aberrations in bone microstructure. The greatest similarities revealed by Y-haplogroup and -haplotype distribution were to populations that live in what are now the Benelux countries. All aspects support the thesis that these were soldiers of the Napoleonic army. PMID:22338792

  11. The diagnostic criteria of Graves' disease and especially the thyrotropin receptor antibody; our own experience.

    PubMed

    Paunkovic, Nebojsa; Paunkovic, Jane

    2007-01-01

    It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity and is the major pathogenic factor in Graves' disease (GD). In spite of that, TRAb is not routinely examined in clinical practice. The aim of this article is to briefly review the subject and suggest protocols for the diagnosis, treatment and follow-up of patients with GD based on our own studies and referring especially to TRAb. Clinical symptoms and signs and thyroid hormones may have poor sensitivity or specificity, especially in cases of endocrine ophthalmopathy and subclinical hyperthyroidism. In these cases the TRAb test is 98% sensitive and specific with a diagnostic accuracy of almost 99%. By this test it is possible to differentiate between autoimmune and other forms of thyrotoxicosis such as autonomous hyperthyroidism, destructive thyroiditis, iodine induced hyperthyroidism etc. Antithyroid drugs decrease serum TRAb levels and also induce immune remission. If after treatment TRAb remains increased as in about 30%of our cases, patients will relapse. In pregnant women with GD the follow-up of serum TRAb levels is also important as predictive of immune thyroid disease in the newborn. Data presented in this article confirm that the determination of serum TRAb levels in some rare hyperthyroid disorders, such as associated autoimmune and autonomous forms and in epidemiological studies, is also justified.

  12. Autoantibody against diiodinated tyrosine-gastrin in a patient with Graves' disease

    SciTech Connect

    Noguchi, M.; Adachi, H.; Aoki, E.; Iida, Y.; Kasagi, K.; Endo, K.; Konishi, J.; Torizuka, K.

    1987-01-01

    We describe autoantibodies against iodinated gastrin in a patient with Graves' disease. Values for serum gastrin differed in this case, depending on which of two different radioimmunoassay (RIA) kits was used. RIA with the dextran-coated charcoal method for separation of free tracer gastrin gave a value less than 9.5 pmol/L, whereas the value by a RIA kit by the double-antibody method was 318 pmol/L. The patient's serum contained a binding protein for /sup 125/I-labeled gastrin, as detected by Sephadex G-200 column chromatography. The IgG fraction was responsible for the ability of serum to bind /sup 125/I-labeled gastrin. Interestingly, of the two possible forms of iodinated gastrins, monoiodinated (MIT) and diiodinated (DIT) tyrosine-/sup 125/I-labeled gastrin, only the latter bound to patient's IgG. Furthermore, DIT-gastrin, but not gastrin or MIT-gastrin, inhibited the binding of DIT-/sup 125/I-labeled gastrin. The patient's serum evidently contains autoantibodies against DIT-gastrin that interfere with RIA of gastrin.

  13. Early Medieval Muslim Graves in France: First Archaeological, Anthropological and Palaeogenomic Evidence.

    PubMed

    Gleize, Yves; Mendisco, Fanny; Pemonge, Marie-Hélène; Hubert, Christophe; Groppi, Alexis; Houix, Bertrand; Deguilloux, Marie-France; Breuil, Jean-Yves

    2016-01-01

    The rapid Arab-Islamic conquest during the early Middle Ages led to major political and cultural changes in the Mediterranean world. Although the early medieval Muslim presence in the Iberian Peninsula is now well documented, based in the evaluation of archeological and historical sources, the Muslim expansion in the area north of the Pyrenees has only been documented so far through textual sources or rare archaeological data. Our study provides the first archaeo-anthropological testimony of the Muslim establishment in South of France through the multidisciplinary analysis of three graves excavated at Nimes. First, we argue in favor of burials that followed Islamic rites and then note the presence of a community practicing Muslim traditions in Nimes. Second, the radiometric dates obtained from all three human skeletons (between the 7th and the 9th centuries AD) echo historical sources documenting an early Muslim presence in southern Gaul (i.e., the first half of 8th century AD). Finally, palaeogenomic analyses conducted on the human remains provide arguments in favor of a North African ancestry of the three individuals, at least considering the paternal lineages. Given all of these data, we propose that the skeletons from the Nimes burials belonged to Berbers integrated into the Umayyad army during the Arab expansion in North Africa. Our discovery not only discusses the first anthropological and genetic data concerning the Muslim occupation of the Visigothic territory of Septimania but also highlights the complexity of the relationship between the two communities during this period. PMID:26910855

  14. White goddess--the unspeakable name. An inquiry into Robert Graves' King Jesus.

    PubMed

    Nakano, N

    1984-03-01

    Robert Graves is a poet-mythographer, well-known in the U. K. and the U. S. A., but not in Japan despite his huge amount of poetic, mythographical, prose and critical works. Furthermore, even in the U. S. A. and the U. K., some people have been shunning him politely as a versatile iconoclast possessed of the White Goddess. In fact, it is not difficult to imagine that when King Jesus, a life story of Christ, was published, people were shocked at his extraordinary mythographical Christology derived from his enthusiasm towards the White Goddess Cult. In Christ he discovered the fragments of maternal doctrine as a new concept in opposition to the Apollonian theory of Judaism, but they seemed to be quite incomplete in the author's eyes lacking in something most essential in life, recognition of love and hatred discipline. This paper is an inquiry into how the author developed his own hermaneutics of Christ through his wide and thorough scholarship on mythology, history, the Bible and Celtic poetry.

  15. Preliminary results of sequential monitoring of simulated clandestine graves in Colombia, South America, using ground penetrating radar and botany.

    PubMed

    Molina, Carlos Martin; Pringle, Jamie K; Saumett, Miguel; Hernández, Orlando

    2015-03-01

    In most Latin American countries there are significant numbers of missing people and forced disappearances, 68,000 alone currently in Colombia. Successful detection of shallow buried human remains by forensic search teams is difficult in varying terrain and climates. This research has created three simulated clandestine burial styles at two different depths commonly encountered in Latin America to gain knowledge of optimum forensic geophysics detection techniques. Repeated monitoring of the graves post-burial was undertaken by ground penetrating radar. Radar survey 2D profile results show reasonable detection of ½ clothed pig cadavers up to 19 weeks of burial, with decreasing confidence after this time. Simulated burials using skeletonized human remains were not able to be imaged after 19 weeks of burial, with beheaded and burnt human remains not being able to be detected throughout the survey period. Horizontal radar time slices showed good early results up to 19 weeks of burial as more area was covered and bi-directional surveys were collected, but these decreased in amplitude over time. Deeper burials were all harder to image than shallower ones. Analysis of excavated soil found soil moisture content almost double compared to those reported from temperate climate studies. Vegetation variations over the simulated graves were also noted which would provide promising indicators for grave detection.

  16. The Efficacy of Radiation Therapy in the Treatment of Graves' Orbitopathy

    SciTech Connect

    Matthiesen, Chance; Thompson, J. Spencer; Thompson, David; Farris, Bradley; Wilkes, Byron; Ahmad, Salahuddin; Herman, Terence; Bogardus, Carl

    2012-01-01

    Purpose: To review our institutional outcomes of patients treated with radiation therapy (RT) for Graves' orbitopathy (GO), assess the role of orbital reirradiation, and identify prognostic factors of complete response (CR). Methods and Materials: This is a retrospective review of 211 patients who presented with a diagnosis of GO and received RT between January 2000-2010. RT dose was 20 Gy in 10 fractions. Patient median age was 51 years (range, 15-84 years), median follow-up was 11 months (range, 1-88 months). Patient symptoms included any combination of proptosis (90.9%), extraocular muscle dysfunction (78.9%), soft tissue signs (68.4%), and diplopia (58.4%). Corticosteroids were used as first-line therapy in 20.6% of patients. Among those who achieved either CR or partial response (PR), prognostic factors were evaluated. Results: Stabilization of disease without recurrence was clinically achieved overall in 202 patients (96.7%). At the completion of RT, 176 patients (84.2%) reported a symptomatic improvement of pretreatment symptoms. CR of GO symptoms was achieved using multiple treatment modalities, including RT by 93 patients (44.5%), of which 32 patients received RT only. Corticosteroids were discontinued in 97.8% of patients who received them as initial therapy. Surgical intervention following radiotherapy was required for 144 (68.9%) of all patients. Fourteen patients received orbital reirradiation for persistent or recurrent symptoms. Five of these achieved a CR, and the other nine achieved disease stabilization but retained persistent ocular symptoms. Long-term side effects of RT included dry eyes (12%). Of the prognostic factors we investigated, only gender predicted CR, which was less common in men (33.9%) than in women (49.7%) p = 0.0471. Conclusions: Orbital radiation for GO is an established treatment modality for patients. Orbital reirradiation is beneficial for patients who do not respond to initial RT or experience symptom recurrence without an

  17. Characterization of Regulatory B Cells in Graves' Disease and Hashimoto's Thyroiditis.

    PubMed

    Kristensen, Birte; Hegedüs, Laszlo; Lundy, Steven K; Brimnes, Marie K; Smith, Terry J; Nielsen, Claus H

    2015-01-01

    A hallmark of regulatory B cells is IL-10 production, hence their designation as IL-10+ B cells. Little is known about the ability of self-antigens to induce IL-10+ B cells in Graves' disease (GD), Hashimoto's thyroiditis (HT), or other autoimmune disease. Here we pulsed purified B cells from 12 HT patients, 12 GD patients, and 12 healthy donors with the thyroid self-antigen, thyroglobulin (TG) and added the B cells back to the remaining peripheral blood mononuclear cells (PBMCs). This procedure induced IL-10+ B-cell differentiation in GD. A similar tendency was observed in healthy donors, but not in cells from patients with HT. In GD, B cells primed with TG induced IL-10-producing CD4+ T cells. To assess the maximal frequency of inducible IL-10+ B cells in the three donor groups PBMCs were stimulated with PMA/ionomycin. The resulting IL-10+ B-cell frequency was similar in the three groups and correlated with free T3 levels in GD patients. IL-10+ B cells from both patient groups displayed CD25 or TIM-1 more frequently than did those from healthy donors. B-cell expression of two surface marker combinations previously associated with regulatory B-cell functions, CD24hiCD38hi and CD27+CD43+, did not differ between patients and healthy donors. In conclusion, our findings indicate that autoimmune thyroiditis is not associated with reduced frequency of IL-10+ B cells. These results do not rule out regulatory B-cell dysfunction, however. The observed phenotypic differences between IL-10+ B cells from patients and healthy donors are discussed.

  18. Thyroglobulin Autoantibodies Are Associated with Refractoriness to Antithyroid Drug Treatment for Graves' Disease.

    PubMed

    Katahira, Masahito; Ogata, Hidetada

    2016-01-01

    Objective The recurrence rate associated with antithyroid drug (ATD) treatment for Graves' disease (GD) is high compared with that for radioiodine therapy or surgery. It is important to identify patients in whom remission is unlikely, so that they are not given treatment that is destined to fail. The objective of this study was thus to evaluate factors influencing the prognosis of GD patients treated with ATDs. Patients One hundred and sixty-one patients were divided into two groups: 100 patients who could not discontinue ATDs for eight years or more (refractory group) and 61 patients who achieved remission within eight years after starting ATD treatment (nonrefractory group). The groups were compared in terms of age, thyroid function and thyroid-related autoantibodies at diagnosis, and the durations to the recovery of thyroid function and thyroid-related autoantibodies. Results The baseline levels of free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating antibodies (TSAbs) and thyroid-stimulating hormone (TSH) receptor antibodies (TRAbs) were high, and the age at diagnosis and the baseline level of thyroglobulin autoantibodies (TgAbs) were low in the refractory group compared with those in the nonrefractory group. The durations to the recovery of TSH, free T4, TRAb and TSAb levels were longer in the refractory group than in the nonrefractory group. No significant difference was observed with regard to thyroid peroxidase autoantibodies. Conclusion We compared the clinical features of these two groups in order to identify factors influencing the prognosis of GD patients treated with ATDs. A low baseline level of TgAbs is associated with the refractoriness of GD to ATD treatment. PMID:27301499

  19. Gene Map of the HLA Region, Graves' Disease and Hashimoto Thyroiditis, and Hematopoietic Stem Cell Transplantation.

    PubMed

    Sasazuki, Takehiko; Inoko, Hidetoshi; Morishima, Satoko; Morishima, Yasuo

    2016-01-01

    The human leukocyte antigen (HLA) genomic region spanning about 4 Mb is the most gene dense and the polymorphic stretches in the human genome. A total of the 269 loci were identified, including 145 protein coding genes mostly important for immunity and 50 noncoding RNAs (ncRNAs). Biological function of these ncRNAs remains unknown, becoming hot spot in the studies of HLA-associated diseases. The genomic diversity analysis in the HLA region facilitated by next-generation sequencing will pave the way to molecular understanding of linkage disequilibrium structure, population diversity, histocompatibility in transplantation, and associations with autoimmune diseases. The 4-digit DNA genotyping of HLA for six HLA loci, HLA-A through DP, in the patients with Graves' disease (GD) and Hashimoto thyroiditis (HT) identified six susceptible and three resistant HLA alleles. Their epistatic interactions in controlling the development of these diseases are shown. Four susceptible and one resistant HLA alleles are shared by GD and HT. Two HLA alleles associated with GD or HT control the titers of autoantibodies to thyroid antigens. All these observations led us to propose a new model for the development of GD and HT. Hematopoietic stem cell transplantation from unrelated donor (UR-HSCT) provides a natural experiment to elucidate the role of allogenic HLA molecules in immune response. Large cohort studies using HLA allele and clinical outcome data have elucidated that (1) HLA locus, allele, and haplotype mismatches between donor and patient, (2) specific amino acid substitution at specific positions of HLA molecules, and (3) ethnic background are all responsible for the immunological events related to UR-HSCT including acute graft-versus-host disease (GVHD), chronic GVHD, graft-versus-leukemia (GvL) effect, and graft failure.

  20. Evaluation of TSH receptor antibody by 'natural in vivo human assay' in neonates born to mothers with Graves' disease.

    PubMed

    Tamaki, H; Amino, N; Iwatani, Y; Tachi, J; Kimura, M; Mitsuda, N; Ichihara, K; Tanizawa, O; Miyai, K

    1989-05-01

    Neonatal thyrotoxicosis induced by transferred TSH receptor antibody (TRAb) is the ideal human in-vivo experimental system for the evaluation of TRAb. The clinical significance of circulating TRAb in Graves' disease was evaluated by this 'natural in-vivo human assay'. TRAb activity in vitro was measured by radioreceptor assay (thyrotrophin-binding inhibitor immunoglobulin, TBII) and sensitive cAMP accumulation assay using FRTL-5 cells (thyroid-stimulating antibody, TSAb). Further, the binding-stimulation index (B-S index) was newly introduced, which was the most useful indicator for prediction of neonatal thyrotoxicosis, calculated as the product of TBII and TSAb (Tamaki et al., 1988a). Maternal serum TRAb indices showed highly significant correlations with the serum free T4 index (FT4I) and free T3 index (FT3I) in neonates (5-10 days after birth) born to 20 mothers with Graves' disease who had positive TBII and/or TSAb (FT4I: r = 0.825 for TBII, r = 0.908 for TSAb, r = 0.944 for the B-S index, P less than 0.001; FT3I: r = 0.622 for TBII, P less than 0.01, r = 0.812 for TSAb, r = 0.791 for the B-S index, P less than 0.001; n = 20). In contrast, in 57 untreated adult patients with hyperthyroid Graves' disease, the FT4I and FT3I levels were not correlated with any of the TRAb indices. The linear regression relationship between the B-S index and FT4I found in neonates was applied to values in adult patients with Graves' disease, and the patients were divided into three groups on the basis of the 95% confidence limit: high, normal, and low responders of thyroid hormone (FT4I) secretion to the B-S index. FT4I and the ratio of FT4I to the B-S index were highest and the TRAb indices were lowest in the high responders, while FT4I and the FT4I/B-S index ratio were lowest and the TRAb indices were highest in the low responders. The FT4I/B-S index ratio was inversely correlated with the titres of antithyroid microsomal antibody in all the adult patients with untreated Graves

  1. Thyroid storm associated with Graves' disease covered by diabetic ketoacidosis: A case report

    PubMed Central

    2011-01-01

    Background Thyroid storm is a condition in which multiple organ dysfunction results from failure of the compensatory mechanisms of the body owing to excessive thyroid hormone activity induced by some factors in patients with thyrotoxicosis. While diabetic ketoacidosis (DKA) is an important trigger for thyroid storm, simultaneous development of DKA and thyroid storm is rare. Case presentation A 59-year-old woman with no history of either diabetes mellitus or thyroid disease presented to our hospital because of developing nausea, vomiting and diarrhea for 2 days. Physical examination showed mild disturbance of consciousness, fever, and tachycardia. There were no other signs of thyrotoxicosis. Laboratory studies revealed elevation of random blood glucose and glycosylated hemoglobin, strongly positive of urine acetone, and metabolic acidosis. Since DKA was diagnosed, we initiated the patient on treatment with administration of insulin and adequate fluid replacement. Although the hyperglycemia and acidosis were immediately relieved, the disturbance of consciousness and tachycardia remained persistent. Levels of FT3 and FT4 were extremely high and TSH was below the detectable limit. TRAb was positive. The thyroid storm score of Burch & Wartofsky was 75/140, and the thyroid storm diagnostic criteria of the Japan Thyroid Association were satisfied. Oral administration of thiamazole, potassium iodide and propranolol resulted in immediate relief of the tachycardia. Discussion We encountered a case of thyroid storm associated with Graves' disease covered by DKA. Thyroid storm and DKA are both potentially fatal, and the prognosis varies depending on whether or not these conditions are detected and treated sufficiently early. The thyroid storm diagnostic criteria prepared in 2008 by the Japan Thyroid Association are very simple as compared to the Burch & Wartofsky scoring system for thyroid storm. The Japanese criteria may be useful in the diagnosis of this condition since they

  2. Methylprednisolone Pulse Treatment of Graves' Ophthalmopathy Is Not Associated with Secondary Adrenocortical Insufficiency

    PubMed Central

    Jespersen, Sofie; Nygaard, Birte; Kristensen, Lars Østergaard

    2015-01-01

    Objective Graves' ophthalmopathy (GO) is an inflammatory disease in the orbital region. The first-line medical treatment is glucocorticoids. An important potential side effect of glucocorticoid treatment is suppression of the hypothalamic-pituitary-adrenal (HPA) axis with impairment of endogenous cortisol production, implicating symptoms of adrenocortical insufficiency, especially in the period after cessation of therapy with possible risks in cases of intercurrent illness. The aim of this study was to evaluate HPA axis function before and after methylprednisolone pulse treatment of GO. Study Design HPA axis function was evaluated by measurements of plasma ACTH and an ACTH stimulation test with plasma cortisol measurements at 0 and 30 min after an intravenous bolus of synthetic ACTH (Synacthen® 250 µg). This was done in 12 patients with GO before and at cessation of methylprednisolone pulse treatment (500 mg i.v. per week for 6 weeks followed by 250 mg i.v. per week for an additional 6 weeks). Results All patients included fulfilled the criteria of intact HPA axis function before and at cessation of methylprednisolone pulse treatment. Data are given as medians (with ranges). Before glucocorticoid treatment basal plasma cortisol was 290 nM (196-579) and 786 nM (612-1,050) after ACTH stimulation. At cessation of therapy the corresponding values were 309 nM (88-718) and 852 nM (524-1,011), respectively. Thus, all patients passed a 30-min stimulated plasma cortisol of 500 nM. Before treatment plasma ACTH was 4.2 pmol/l (4-16) and at cessation of therapy the corresponding value was 4.8 pmol/l (2-9; p = 0.27). Conclusion Transient suppression of the HPA axis with secondary adrenocortical insufficiency does not seem to be a common phenomenon after intravenous methylprednisolone pulse therapy for GO. Therefore, routine precautions are not necessary. However, our results do not exclude that transient secondary adrenocortical insufficiency might occur occasionally. PMID

  3. Immunoglobulins from Graves' disease patients interact with different sites on TSH receptor/LH-CG receptor chimeras than either TSH or immunoglobulins from idiopathic myxedema patients.

    PubMed

    Tahara, K; Ban, T; Minegishi, T; Kohn, L D

    1991-08-30

    To examine the identity of binding sites for thyrotropin (TSH) and thyroid stimulating antibodies (TSAbs) associated with Graves' disease, we constructed eight human TSH receptor/rat LH-CG receptor chimeras. Substitution of amino acid residues 8-165 of the TSH receptor with the corresponding LH-CG receptor segment (Mc1 + 2) results in a chimera which retains high affinity TSH binding and the cAMP response to TSH but loses both the cAMP response to Graves' IgG and Graves' IgG inhibition of TSH binding. Two of three IgGs from idiopathic myxedema patients which contain thyroid stimulation blocking antibodies (TSBAbs) still, however, react with this chimera. Chimeras which substitute residues 90-165 (Mc2) and 261-370 (Mc4) retain the ability to interact with TSH, Graves' IgG, and idiopathic myxedema IgG. The data thus suggest that residues 8-165 contain an epitope specific for TSAbs and that TSH receptor determinants important for the activities of TSAbs and TSH are not identical. Further, binding sites for TSBAbs in idiopathic myxedema may be different from receptor binding sites for both Graves' IgG TSAb as well as TSH and may be different in individual patients.

  4. Origin of primary PGM assemblage in сhromitite from a mantle tectonite at Harold's Grave (Shetland Ophiolite Complex, Scotland)

    NASA Astrophysics Data System (ADS)

    Badanina, Inna Yu.; Malitch, Kreshimir N.; Lord, Richard A.; Meisel, Thomas C.

    2013-12-01

    In this paper we present textural and mineral chemistry data for a PGM inclusion assemblage and whole-rock platinum-group element (PGE) concentrations of chromitite from Harold's Grave, which occurrs in a dunite pod in a mantle tectonite at Unst in the Shetland Ophiolite Complex (SOC), Scotland. The study utilized a number of analytical techniques, including acid digestion and isotope dilution (ID) ICP-MS, hydroseparation and electron microprobe analysis. The chromitite contains a pronounced enrichment of refractory PGE (IPGE: Os, Ir and Ru) over less refractory PGE (PPGE: Rh, Pt and Pd), typical of mantle hosted `ophiolitic' chromitites. A `primary' magmatic PGM assemblage is represented by euhedrally shaped (up to 60 μm in size) single and composite inclusions in chromite. Polyphase PGM grains are dominated by laurite and osmian iridium, with subordinate laurite + osmian iridium + iridian osmium and rare laurite + Ir-Rh alloy + Rh-rich sulphide (possibly prassoite). The compositional variability of associated laurite and Os-rich alloys at Harold's Grave fit the predicted compositions of experiment W-1200-0.37 of Andrews and Brenan (Can Mineral 40: 1705-1716, 2002) providing unequivocal information on conditions of their genesis, with the upper thermal stability of laurite in equilibrium with Os-rich alloys estimated at 1200-1250 °C and f(S2) of 10-0.39-10-0.07.

  5. The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves' Disease.

    PubMed

    English, Collette; Casey, Ruth; Bell, Marcia; Bergin, Diane; Murphy, Joseph

    2016-01-01

    The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. Volume, vascularity, echogenicity and echotexture of the glands were noted. The presence of nodules and lymph nodes was also documented. The mean volumes of the right lobe were 2.4 mL ± 2.9 SD (0.6-14) and the left lobe were 1.8 mL ± 1.9 SD (0.4-9.1), with a mean total volume of 4.2 mL ± 4.7 SD (1.3-19.1). Of those who had a pre-treatment ultrasound (23%), the percentage reduction in volume was 87% (p < 0.05); 93% of the glands were hypovascular, with the remaining 7% showing normal vascularity. The glands were hyperechoic and of coarse echotexture. Overall, the sonographic features of the post-RIT gland included a significantly reduced mean total volume of 4.2 mL, hypovascularity, coarse echotexture and hyperechogenicity.

  6. Methimazole, but not betamethasone, prevents 131I treatment-induced rises in thyrotropin receptor autoantibodies in hyperthyroid Graves' disease

    SciTech Connect

    Gamstedt, A.; Wadman, B.; Karlsson, A.

    1986-04-01

    The effects of methimazole or betamethasone therapy on the TSH receptor antibody response to radioiodine therapy were compared in a prospective randomized study of 60 patients with hyperthyroidism due to Graves' disease. The patients were followed for 1 yr after treatment with 131I. Twenty-three patients received 131I alone, 17 were treated with methimazole for 2 months before and 3 months after 131I therapy, and 20 patients were treated with betamethasone for 3 weeks before and 4 weeks after 131I therapy. 131I induced a transient rise in the mean serum level of TSH receptor autoantibodies, measured as TSH binding inhibitory immunoglobulin (TBII), but in patients receiving methimazole treatment, no such rise occurred. In the betamethasone-treated patients, TBII increased similarly to that in patients treated with 131I alone. In addition, in patients given betamethasone, there was an early decrease in total serum immunoglobulin G, which persisted throughout the follow-up period. In the other 2 groups, no changes in total immunoglobulin G were found. The results demonstrate that in hyperthyroid Graves' disease, TBII production is influenced by therapy. Methimazole abolished the 131I-induced increase in TBII, whereas betamethasone did not have such an inhibitory effect.

  7. Noble gases and halogens in Graves Nunataks 06129: The complex thermal history of a felsic asteroid crust

    NASA Astrophysics Data System (ADS)

    Claydon, Jennifer L.; Crowther, Sarah A.; Fernandes, Vera A.; Gilmour, Jamie D.

    2015-06-01

    The meteorite Graves Nunataks 06128/06129 is a rare example of felsic asteroidal crust. Knowledge of its history can help shed light on the evolution processes of planetesimals. The noble gases can be used to constrain both the chronology of meteorites and the processes that result in movements of volatile elements on asteroidal bodies. We have examined the I-Xe and Ar-Ar systems of the plagioclase-rich achondrite, Graves Nunataks 06129 by high-resolution laser step-heating of irradiated samples. Iodine and 129Xe∗ are both present but are released at different temperatures and do not show a correlation, therefore the I-Xe system in GRA 06129 has no chronological significance. We propose that radiogenic 129Xe∗ was lost from primary phases and parentless 129Xe∗ was later introduced into the rock by interaction with a fluid sourced from a reservoir that evolved with a high I/Xe ratio. This could have been the same halogen-rich fluid that induced the conversion of merrillite and pyroxene into chlorapatite. Inherited 40Ar (i.e. not generated by in situ decay of 40K) is also present in one of three fragments studied here and may have been introduced at the same time as parentless 129Xe∗.

  8. The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves' Disease.

    PubMed

    English, Collette; Casey, Ruth; Bell, Marcia; Bergin, Diane; Murphy, Joseph

    2016-01-01

    The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. Volume, vascularity, echogenicity and echotexture of the glands were noted. The presence of nodules and lymph nodes was also documented. The mean volumes of the right lobe were 2.4 mL ± 2.9 SD (0.6-14) and the left lobe were 1.8 mL ± 1.9 SD (0.4-9.1), with a mean total volume of 4.2 mL ± 4.7 SD (1.3-19.1). Of those who had a pre-treatment ultrasound (23%), the percentage reduction in volume was 87% (p < 0.05); 93% of the glands were hypovascular, with the remaining 7% showing normal vascularity. The glands were hyperechoic and of coarse echotexture. Overall, the sonographic features of the post-RIT gland included a significantly reduced mean total volume of 4.2 mL, hypovascularity, coarse echotexture and hyperechogenicity. PMID:26603660

  9. Immunization of mice with a newly identified thyroid-stimulating hormone receptor splice variant induces Graves'-like disease.

    PubMed

    Endo, Toyoshi; Kobayashi, Teturo

    2013-06-01

    We have cloned a thyroid-stimulating hormone receptor (TSHR) cDNA from mouse thyroid glands. The sequence of this cDNA indicated that it encoded a 739 amino acid TSHR splice variant that lacked exon 5 (TSHR739). In thyroid gland samples from adult mice, the amount of TSHR739 mRNA was about 10% of the amount of full-length TSHR (TSHR764) mRNA. A eCFP-tagged TSHR739 integrated into plasma membrane, but lacked TSH binding activity and it did not produce cAMP in response to TSH. However, thyroid-stimulating antibodies from patients with Graves' disease stimulated cAMP production in HEK293 cells that expressed TSHR739. Quantitative PCR revealed that TSHR739 transcript levels were low in the fetal mouse thyroid samples, but TSHR739 transcript levels increased after birth and as the mice grew. We used plasmid injection combined with electroporation into skeletal muscles to immunize BALB/c mice with TSHR739, TSHR764,, or control plasmid; TSHR739 caused goiters, high (125)I uptake activity, thyrotoxicosis, and production of thyroid-stimulating antibodies, but TSHR764, or control did not. These results indicated that immunization with an autologous TSHR antigen, TSHR739, induced Graves'-like disease in mice, and that TSHR739 is a candidate autoantigen in autoimmune thyroid disease. PMID:23538203

  10. Isotopic composition and identification of the origins of individuals buried in a Neolithic collective grave at Bronocice (southern Poland).

    PubMed

    Szostek, K; Haduch, E; Stepańczak, B; Kruk, J; Szczepanek, A; Pawlyta, J; Głąb, H; Milisauskas, S

    2014-04-01

    The oxygen present in a human organism comes from numerous sources, but the major factor that causes variation in the isotopic composition of this element in a tissue is available drinking water. The isotopic ratio of oxygen in an organism's tissue, including that found in bones and teeth, reflects the isotopic oxygen composition typical for the area where a given individual developed and lived. Of particular interest with regard to this issue were a series of skeletons from the multiple grave discovered at the Funnel Beaker-Baden settlement at Bronocice (southern Poland). The question therefore arose whether the specimens buried in this grave were part of the local community. The oxygen isotope level was established using apatite isolated from bones or teeth. A femur and root dentine samples taken from permanent teeth were subjected to oxygen isotope analysis. The oxygen isotope level of the site was established on the basis of local water precipitation and measurements taken from the oxygen isotope concentration in apatite samples isolated from the bones of animals co-occurring with the studied human group. It has been found that the oxygen isotope levels in the bones and dentine of almost all the analysed specimens from the excavated site at Bronocice were within the established range for the area's environment, providing evidence for their local origin. Thus, it can be assumed that the analysed group inhabiting the macrosettlement at Bronocice during the Funnel Beaker phase of the Baden culture was most probably of local origin.

  11. Increased microRNA-155 and decreased microRNA-146a may promote ocular inflammation and proliferation in Graves' ophthalmopathy.

    PubMed

    Li, Kaijun; Du, Yi; Jiang, Ben-Li; He, Jian-Feng

    2014-04-18

    Graves' ophthalmopathy is an inflammatory autoimmune disease of the orbit, characterized by inflammation and proliferation of the orbital tissue caused by CD4+T cells and orbital fibroblasts. Despite recent substantial findings regarding its cellular and molecular foundations, the pathogenesis of Graves' ophthalmopathy remains unclear. Accumulating data suggest that microRNAs play important roles in the pathophysiology of autoimmunity and proliferation. Specifically, microRNA-155 (miR-155) can promote autoimmune inflammation by enhancing inflammatory T cell development. In contrast to miR-155, microRNA-146a (miR-146a) can inhibit the immune response by suppressing T cell activation. Furthermore, miR-155 and miR-146a are involved in cell proliferation, differentiation, and many other life processes. Thus, miR-155 and miR-146a, with opposite impacts on inflammatory responses carried out by T lymphocytes, appear to have multiple targets in the pathogenesis of Graves' ophthalmopathy. Our previous work showed that the expression of miR-146a was significantly decreased in peripheral blood mononuclear cells from Graves' ophthalmopathy patients compared with normal subjects. Accordingly, we proposed that the expression of miR-155 increased and the expression of miR-146a decreased in the target cells (CD4+T cells and orbital fibroblasts), thus promoting ocular inflammation and proliferation in Graves' ophthalmopathy. The proposed hypothesis warrants further investigation of the function of the differentially expressed microRNAs, which may shed new light on the pathogenesis of Graves' ophthalmopathy and lead to new strategies for its management.

  12. The significant increase in incidence of Graves' disease in eastern Serbia during the civil war in the former Yugoslavia (1992 to 1995).

    PubMed

    Paunkovic, N; Paunkovic, J; Pavlovic, O; Paunovic, Z

    1998-01-01

    The incidence of Graves' disease for the last 25 years in eastern Serbia (Yugoslavia), Timok Region is reported. Registration of all Graves' disease patients was conducted in the Endocrinology-Thyroid Unit of Nuclear Medicine Service, Medical Center Zajecar. Timok Region has a population of 315,000 people in seven counties. From 1971 to 1980 an average of 16 new patients per year were registered; from 1981 to 1990 an average of 33 patients per year were registered; in 1995 the number reached 100, and in 1996 there were 148 newly registered patients. Some of the possible factors influencing this significant annual increase of autoimmune hyperthyroidism are discussed.

  13. Effects of Prostaglandin F2α on Adipocyte Biology Relevant to Graves' Orbitopathy

    PubMed Central

    Draman, Mohd Shazli; Grennan-Jones, Fiona; Zhang, Lei; Taylor, Peter N; Tun, Tommy Kyaw; McDermott, John; Moriarty, Paul; Morris, Daniel; Lane, Carol; Sreenan, Seamus; Dayan, Colin

    2013-01-01

    Background: In Graves' orbitopathy (GO), increased proliferation, excess adipogenesis, and hyaluronan overproduction produce GO exophthalmos. Enophthalmos occurs in some glaucoma patients treated with Bimatoprost (prostaglandin F2α, PGF2α) eye drops. We hypothesized that enophthalmos is secondary to reductions in orbital tissue proliferation, adipogenesis, and/or increased lipolysis. We aimed to determine which of these is affected by PGF2α by using the 3T3-L1 murine preadipocyte cell line and primary human orbital fibroblasts (OFs) from GO patients (n=5) and non-GO (n=5). Methods: 3T3-L1 cells and orbital OFs were cultured alone or with PGF2α (all experiments used 10−8 to 10−6 M) and counted on days 1/2/3 or 5, respectively; cell cycle analysis (flow cytometry) was applied. Adipogenesis (in the presence/absence of PGF2α) was evaluated (day 7 or 15 for 3T3-L1 and primary cells, respectively) morphologically by Oil Red O staining and quantitative polymerase chain reaction measurement of adipogenesis markers (glycerol-3-phosphate dehydrogenase and lipoprotein lipase, respectively). For lipolysis, in vitro–differentiated 3T3-L1 or mature orbital adipocytes were incubated with norepinephrine and PGF2α and free glycerol was assayed. Appropriate statistical tests were applied. Results: The population doubling time of 3T3-L1 was 27.3±1.4 hours—significantly increased by dimethyl sulfoxide 0.02% to 44.6±4.8 hours (p=0.007) and further significantly increased (p=0.049 compared with dimethyl sulfoxide) by 10−8 M PGF2α to 93.6±19.0 hours, indicating reduced proliferation, which was caused by prolongation of G2/M. GO OFs proliferated significantly more rapidly than non-GO (population doubling time 5.36±0.34 or 6.63±0.35 days, respectively, p=0.035), but the proliferation of both was significantly reduced (dose dependent from 10−8 M) by PGF2α, again with prolongation of G2/M. Adipogenesis in 3T3-L1 cells was minimally affected by PGF2α when assessed

  14. Could the eucrite Graves Nunataks 98098 be Vesta's equivalent to Lunar KREEP?

    NASA Astrophysics Data System (ADS)

    Sarafian, A. R.; Marschall, H.; Nielsen, S.

    2013-12-01

    Basaltic eucrites, members of the HED achondrite clan, are thought to derive from the asteroid 4-Vesta [1]. Most eucrites show little compositional and petrographic variability, thus anomalous eucrite could provide key insights into differentiation processes that operated on Vesta. The eucrite Graves Nunataks (GRA) 98098 is an unbrecciated eucrite with cross cutting white tabular veins consisting of mainly equigranular tridymite and euhedral plagioclase with some pyroxene [2]. In addition, GRA has the second highest modal (volume) abundance of apatite in a eucrite studied thus far. The apatite is associated with the veins [2]. The GRA bulk rock composition is enriched in incompatible elements with concentrations ca. 3-5 times higher than in most basaltic eucrites [3]. Additionally, GRA has 10-20 times more Cl than any other analyzed eucritic apatite [2]. Here we measured the trace-element concentrations of plagioclase and pyroxene by laser ablation ICP-MS and the D/H ratio of the apatites by SIMS. In the domains of GRA cut by veins, the trace elements in plagioclase and pyroxene show an up to 15x enrichment in incompatible elements compared to other basaltic eucrites [4]. Here we report the first D/H measurement of any magmatic material from Vesta. The D/H of apatite in GRA is relatively light compared to vSMOW. Based on the high abundance of incompatible elements in GRA and the high Cl content found in apatites, Sarafian et al. [2] suggested that GRA could be akin to Lunar KREEP (lunar rocks enriched in K, REEs and P). With the additional evidence of enriched incompatible elements in plagioclase and pyroxene and the similarity in D/H compared to KREEP, it is likely that GRA was infiltrated by a late-stage melt enriched in incompatible elements, similar to Lunar KREEP. Further study is needed to determine if this late-stage melt formed in a similar manner as KREEP. 1. Consolmango, G.J. and M.J. Drake, Composition and evolution of the eucrite parent body: Evidence

  15. Mössbauer study of the warrior figures of pottery in the grave site of the first Chinese emperor (221 B.C.)

    NASA Astrophysics Data System (ADS)

    Zhongtian, Sun; Xianjia, Pan; Guangyong, Qin; Guoqiao, Jin; Zhongyi, Yuan

    1988-12-01

    Mossbauer spectroscopy measurements at both room and liquid nitrogen temperature of potsherd samples of terracotta figures of warriors and horses excavated from within the pit at the grave site of the First Emperor (221 B.C.), lead us to conclude that the No. 4 potsherd sample was fired at a temperature of 980±50°C in a reducing atmosphere.

  16. Anti-Ku antibody-positive scleroderma-dermatomyositis overlap syndrome developing Graves' disease and immune thrombocytopenic purpura.

    PubMed

    Kamei, Nozomu; Yamane, Kiminori; Yamashita, Yasuyo; Nakanishi, Shuhei; Watanabe, Hiroshi; Fujikawa, Rumi; Hiyama, Keiko; Ishioka, Shinichi; Mendoza, Ciro; Kohno, Nobuoki

    2002-12-01

    Graves' disease (GD) has been reported to be frequently complicated with other autoimmune diseases. However, it is rarely complicated with scleroderma-polymyositis overlap syndrome. Recently, we encountered a 35-year-old woman who developed GD and immune thrombocytopenic purpura during follow-up observation of scleroderma-dermatomyositis overlap syndrome. Platelet counts recovered after high-dose gamma-globulin therapy and bolus methylprednisolone therapy. The present case is the first report of a combination of scleroderma, dermatomyositis, GD, and immune thrombocytopenic purpura. The patient was anti-Ku antibody-positive and had relatively low natural killer T cell counts, both of which might contribute to the complication of multiple autoimmune diseases.

  17. Unusual presentation of Warthin variant of Papillary thyroid carcinoma with lymph nodal metastases in a patient of Graves' disease.

    PubMed

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga; Arun, B R

    2015-01-01

    Warthin-like Papillary thyroid carcinoma (WPTC) is a rare variant of papillary carcinoma of thyroid, PTC which derives its name by closely resembling Warthin's tumor of salivary gland. Hallmark histological feature of this variant is papillary folding lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. It is thought to be one of those differentiated thyroid cancers with favorable prognosis. We report a case of Graves' disease with a cold nodule harboring WPTC with initial presentation of lymph nodal metastases. It is important to identify this peculiar variant of PTC as 5 to 10% of them undergo dedifferentiation and 30% have the lymph nodal metastases and extra thyroidal extension.

  18. A genomic point mutation in the extracellular domain of the thyrotropin receptor in patients with Graves` ophthalmopathy

    SciTech Connect

    Bahn, R.S.; Dutton, C.M.; Heufelder, A.E.; Sarkar, G. |

    1994-02-01

    Orbital and pretibial fibroblasts are targets of autoimmune attack in Graves` ophthalmopathy (GO) and pretibial dermopathy (PTD). The fibroblast autoantigen involved in these peripheral manifestations of Graves` disease and the reason for the association of GO and PTD with hyperthyroidism are unknown. RNA encoding the full-length extracellular domain of the TSH receptor has been demonstrated in orbital and dermal fibroblasts from patients with GO and normal subjects, suggesting a possible antigenic link between fibroblasts and thyrocytes. RNA was isolated from cultured orbital, pretibial, and abdominal fibroblasts obtained from patients with severe GO (n = 22) and normal subjects (n = 5). RNA was reverse transcribed, and the resulting cDNA was amplified by the polymerase chain reaction, using primers spanning overlapping regions of the entire extracellular domain of the TSH receptor. Nucleotide sequence analysis showed an A for C substitution in the first position of codon 52 in 2 of the patients, both of whom had GO, PTD, and acropachy. Genomic DNA isolated from the 2 affected patients, and not from an additional 12 normal subjects, revealed the codon 52 mutation by direct sequencing and AciI restriction enzyme digestions. In conclusion, the authors have demonstrated the presence of a genomic point mutation, leading to a threonine for proline amino acid shift in the predicted peptide, in the extracellular domain of the TSH receptor in two patients with severe GO, PTD, acropachy, and high thyroid-stimulating immunoglobulin levels. RNA encoding this mutant product was demonstrated in the fibroblasts of these patients. They suggest that the TSH receptor may be an important fibroblast autoantigen in GO and PTD, and that this mutant form of the receptor may have unique immunogenic properties. 28 refs., 3 figs., 2 tabs.

  19. PPARg2 Ala¹² variant protects against Graves' orbitopathy and modulates the course of the disease.

    PubMed

    Pawlak-Adamska, Edyta; Daroszewski, Jacek; Bolanowski, Marek; Oficjalska, Jolanta; Janusz, Przemyslaw; Szalinski, Marek; Frydecka, Irena

    2013-07-01

    Orbital fibroblast differentiation to adipocytes is a peroxisome proliferator-activated receptor g (PPARg)-dependent process essential for pathogenic tissue remodeling in Graves' orbitopathy (GO). PPARg2 Pro¹²Ala polymorphism modulates expression and/or function of the molecule encoded by this gene and is a promising locus of GO. Here, we analyzed associations of PPARg2 Pro¹²Ala with clinical manifestation of GO in 742 Polish Caucasians including 276 Graves' disease (GD) patients. In our study, the Ala¹² allele and Ala¹² variant (Ala¹²Ala and/or Pro¹²Ala genotype) decreased the risk of GO (p = 0.000012 and p = 0.00013). Moreover, Ala¹²Ala genotype was observed only in patients without GO (p = 0.002). GD patients with Ala¹² variant had less active and less severe eye symptoms. Female carriers of the Ala¹² allele rarely developed GO, but the marker was not related to symptoms of GO. The opposite finding was recorded in males, in whom the studied polymorphism was related to activity, but not to the development, of GO. In Ala¹² variant carriers without familial history of thyroid disease, risk of GO was lower than in persons with a familial background. The Ala¹² allele seemed to protect smokers from GO, but in nonsmokers, such a relation was not obvious. A multivariate analysis indicated the Pro¹²Ala marker as an independent risk factor of eye symptoms (p = 0.0001) and lack of Ala increases the risk of GO 3.24-fold. In conclusion, the gain-of-function Ala¹² variant protects against GO and modulates the course of the disease.

  20. Evaluation of quality of life in patients with Graves´ ophthalmopathy, before and after orbital decompression.

    PubMed

    Iacobæus, Lykke; Sahlin, Sven

    2016-06-01

    Graves' ophthalmopathy (GO) is a potentially sight threatening orbital disease that can have a large negative impact on the quality of life of the patient. Studies on long-term effects of GO on the quality of life are few. The aim of this study is to evaluate the health-related quality of life in patients with GO, before and after orbital decompression surgery. This is a prospective, longitudinal, interventional study in which patients who had orbital decompression were given the Graves´ ophthalmopathy quality of life questionnaire (GO-QOL) before and after surgery. The GO-QOL is a disease specific instrument to measure health-related quality of life. The answers are transformed into scores from 0-100 on 2 subscales. Higher score indicates better health. An additional patient satisfaction questionnaire was also given post-surgery. A significant, long-term, improvement in quality of life after orbital decompression was noted (p < 0.001, paired t-test). 50 patients were included and follow-up time was 5.3 ± 1.2 years (mean ± SD). The QOL-scores increased 28 ± 35 and 26 ± 31 points, respectively, on the two subscales, "visual functioning" and "appearance" (mean ± SD). The patient satisfaction questionnaire showed that 88% of the patients would recommend orbital decompression to a fellow patient. Persistent disturbing oscillopsia was seen in 2% and persistent disturbing infraorbital nerve hypoesthesia in 8% of the patients. Orbital decompression surgery has a positive effect on quality of life for patients with severe GO. The GO-QOL questionnaire showed significant improvement in QOL-scores even many years after surgery.

  1. Accuracy and optimal timing of activity measurements in estimating the absorbed dose of radioiodine in the treatment of Graves' disease

    NASA Astrophysics Data System (ADS)

    Merrill, S.; Horowitz, J.; Traino, A. C.; Chipkin, S. R.; Hollot, C. V.; Chait, Y.

    2011-02-01

    Calculation of the therapeutic activity of radioiodine 131I for individualized dosimetry in the treatment of Graves' disease requires an accurate estimate of the thyroid absorbed radiation dose based on a tracer activity administration of 131I. Common approaches (Marinelli-Quimby formula, MIRD algorithm) use, respectively, the effective half-life of radioiodine in the thyroid and the time-integrated activity. Many physicians perform one, two, or at most three tracer dose activity measurements at various times and calculate the required therapeutic activity by ad hoc methods. In this paper, we study the accuracy of estimates of four 'target variables': time-integrated activity coefficient, time of maximum activity, maximum activity, and effective half-life in the gland. Clinical data from 41 patients who underwent 131I therapy for Graves' disease at the University Hospital in Pisa, Italy, are used for analysis. The radioiodine kinetics are described using a nonlinear mixed-effects model. The distributions of the target variables in the patient population are characterized. Using minimum root mean squared error as the criterion, optimal 1-, 2-, and 3-point sampling schedules are determined for estimation of the target variables, and probabilistic bounds are given for the errors under the optimal times. An algorithm is developed for computing the optimal 1-, 2-, and 3-point sampling schedules for the target variables. This algorithm is implemented in a freely available software tool. Taking into consideration 131I effective half-life in the thyroid and measurement noise, the optimal 1-point time for time-integrated activity coefficient is a measurement 1 week following the tracer dose. Additional measurements give only a slight improvement in accuracy.

  2. The incidence of ophthalmopathy after radioiodine therapy for Graves` disease: Prognostic factors and the role of methimazole

    SciTech Connect

    Kung, A.W.C.; Cheng, A.

    1994-08-01

    Radioactive iodine-131 (RAI) has been reported to be associated with a high incidence of development or exacerbation of Graves` ophthalmopathy (GO). This is thought to be associated with a surge of autoantibodies after RAI therapy. The role of methimazole (MMI), which possesses immunomodulatory action, in the prevention of GO was explored by studying 114 patients with Graves` disease. They were assigned randomly to receive either RAI alone or adjunctive antithyroid drugs, which consisted of MMI and L-T{sub 4} as a block-replacement therapy for 12 months and were followed for 2 yr. Thirty-five patients (30.7%) had GO at presentation. Twenty-one (18%) patients developed new GO, and six had worsening of preexisting GO. The development of hypothyroidism (P < 0.01) and an elevation of TSH (P < 0.05) were associated with increased risk of development or exacerbation of GO. The chance of development or exacerbation of GO is higher in those with no ophthalmopathy than in those with preexisting GO at presentation (P = 0.002). The incidence of development or exacerbation of GO was similar in the two treatment groups (RAI, 22.8%; adjunctive antithyroid drugs, 23.7%; P = NS). MMI was able to suppress the surge of TSH receptor antibody (TRAB) after RAI, but a surge in TRAB was not of prognostic significance for the development of GO after RAI. Patients who developed or had exacerbation of GO actually had lower TRAB at presentation (P = 0.02). The authors conclude that hypothyroidism with elevated TSH is an important adverse factor for the development or exacerbation of GO, and MMI was unable to prevent the development or exacerbation of GO after RAI. 35 refs., 4 tabs.

  3. Pretreatment with betamethasone of patients with Graves' disease given radioiodine therapy: thyroid autoantibody responses and outcome of therapy

    SciTech Connect

    Gamstedt, A.; Karlsson, A. )

    1991-07-01

    The effects of betamethasone on thyroid autoantibody responses and outcome of radioiodine therapy were determined over a period of 1 yr in a prospective randomized study of 40 patients with Graves' disease. Twenty patients were given placebo tablets, and 20 patients were treated with betamethasone from 3 weeks before until 4 weeks after {sup 131}I therapy. At the time of inclusion in the study, the mean serum concentrations of TSH receptor antibodies, thyroid peroxidase antibodies, and thyroglobulin antibodies (TgAb) were increased in both groups. Three weeks of treatment with betamethasone reduced the thyroid peroxidase antibody and TgAb titers as well as the serum concentrations of thyroid hormones. A decrease in the TSH receptor antibody level was not statistically significant. After radioiodine therapy, transient increases in thyroid autoantibody levels were observed. The titers of the different antibodies generally changed in parallel. In some patients a detectable level of a given antibody was found only after the radioiodine treatment, and in two cases, TgAb did not appear at all, although the two other antibodies increased temporarily. Betamethasone delayed, but did not abolish, the {sup 131}I-induced antibody peaks. Betamethasone also caused a reduction in the total serum immunoglobulin G, a reduction which persisted throughout the study period. When the study ended, 17 patients given placebo and 9 patients given betamethasone were receiving replacement therapy due to the development of hypothyroidism. These patients at this point in time had lower antibody levels than those not requiring T4. The results of this study demonstrate that betamethasone reduces and modifies the thyroid autoantibody responses as well as the outcome of radioiodine therapy in patients with Graves' disease.

  4. Implications of FoxP3-positive and -negative CD4(+) CD25(+) T cells in Graves' ophthalmopathy.

    PubMed

    Matsuzawa, Kazuhiko; Izawa, Shoichiro; Okura, Tsuyoshi; Fujii, Shinya; Matsumoto, Kazuhisa; Shoji, Kyoko; Nakamura, Risa; Sumi, Keisuke; Fujioka, Yohei; Yoshida, Akio; Shigemasa, Chiaki; Kato, Masahiko; Yamamoto, Kazuhiro; Taniguchi, Shin-Ichi

    2016-08-31

    Graves' ophthalmopathy (GO) is a common manifestation of Graves' disease (GD); however, its pathogenesis is not well understood. Recently, the dysregulation of regulatory T cells (Tregs) has been thought to be closely associated with the pathogenesis and clinical symptoms of autoimmune disease. We therefore evaluated whether T cell subsets, including Tregs, are associated with GO pathogenesis and clinical symptoms. In this observational study we evaluated 35 GD patients with overt ophthalmopathy (GOs) and 28 patients without ophthalmopathy (non-GOs). Fifteen healthy euthyroid patients served as healthy controls (HCs). Peripheral blood mononuclear cells from GOs, non-GOs and HCs were analyzed for CD4, CD25, and FoxP3 expression using flow cytometry. We also evaluated their correlation with disease activity according to the clinical activity score (CAS) and magnetic resonance imaging (MRI) findings. Disease severity was evaluated using the NOSPECS score, and clinical progression of GO was followed for 24 weeks. The main outcome measures were the frequencies of FoxP3-positive and -negative CD4(+) CD25(+) T cells at study outset, namely Tregs and effector T cells (Teffs), respectively. GOs had higher frequencies of Teffs (30.8±8.4%) than non-GOs (19.4±7.1%) and HCs (22.7±7.9%). Notably, patients with improved GOs had lower frequencies of Tregs (5.8±1.1%) than patients with stable or deteriorated GOs (7.3±1.2%), although ophthalmic and radiological parameters were not significantly different at the start of the study. In conclusion, an expanded Teff population may be associated with GO pathogenesis. Additionally, decreased Tregs in peripheral blood may predict a good clinical outcome. PMID:27349268

  5. Immunoglobulin Heavy Chain Variable Region and Major Histocompatibility Region Genes Are Linked to Induced Graves' Disease in Females From Two Very Large Families of Recombinant Inbred Mice

    PubMed Central

    Aliesky, Holly; Banuelos, Bianca; Magana, Jessica; Williams, Robert W.; Rapoport, Basil

    2014-01-01

    Graves' hyperthyroidism is caused by antibodies to the TSH receptor (TSHR) that mimic thyroid stimulation by TSH. Stimulating TSHR antibodies and hyperthyroidism can be induced by immunizing mice with adenovirus expressing the human TSHR A-subunit. Prior analysis of induced Graves' disease in small families of recombinant inbred (RI) female mice demonstrated strong genetic control but did not resolve trait loci for TSHR antibodies or elevated serum T4. We investigated the genetic basis for induced Graves' disease in female mice of two large RI families and combined data with earlier findings to provide phenotypes for 178 genotypes. TSHR antibodies measured by inhibition of TSH binding to its receptor were highly significantly linked in the BXD set to the major histocompatibility region (chromosome 17), consistent with observations in 3 other RI families. In the LXS family, we detected linkage between T4 levels after TSHR-adenovirus immunization and the Ig heavy chain variable region (Igvh, chromosome 12). This observation is a key finding because components of the antigen binding region of Igs determine antibody specificity and have been previously linked to induced thyroid-stimulating antibodies. Data from the LXS family provide the first evidence in mice of a direct link between induced hyperthyroidism and Igvh genes. A role for major histocompatibility genes has now been established for genetic susceptibility to Graves' disease in both humans and mice. Future studies using arrays incorporating variation in the complex human Ig gene locus will be necessary to determine whether Igvh genes are also linked to Graves' disease in humans. PMID:25051451

  6. Incidence and Clinical Presentation of Moderate to Severe Graves' Orbitopathy in a Danish Population before and after Iodine Fortification of Salt

    PubMed Central

    Berman, Dalia C.; Bülow Pedersen, Inge; Andersen, Stig; Carlé, Allan

    2012-01-01

    Context: Population-based data on the incidence and clinical presentation of moderate to severe Graves' orbitopathy (GO) are scarce, and virtually nothing is known on the effect of an iodization program on the incidence and presentation of GO. Objective: The objective of the study was to characterize incident moderate to severe GO in North Jutland County, Denmark, during the period 1992–2009, before and after the Danish salt iodization program. Design and Patients: The design of the study was a prospective register of patients with incident moderate to severe GO in a population during 8.9 million persons × years of observation. Setting: The study was conducted at a thyroid-eye clinic of university hospital. Main Outcome Measures: Clinical presentation and incidence before and after the year 2000 initiation of the mandatory Danish iodization of salt were measured. The incidence of GO was related to the incidence of Graves' hyperthyroidism (GH) in the same population. Results: The incidence rate of moderate to severe GO was 16.1/million per year (women: 26.7; men: 5.4), with no change associated with iodization of salt. The moderate to severe GO incidence was 4.9% of the incidence of GH. The incidence rate ratio between women and men with GO (4.9) was not different from the ratio in GH. Compared with GH, only a few patients (<2%) suffered from moderate and severe GO below the age of 40 yr, whereas GO was relatively common in age groups 40–60 yr (∼8%). Conclusions: Approximately 5% of the patients with Graves' disease develop moderate to severe GO, with a similar risk in women and men with Graves' disease. The risk of GO is much higher in patients aged 40–60 yr than in young patients with Graves' disease. Salt iodization was not associated with a change in the incidence of GO. PMID:22518849

  7. [Studies on the renal handling of urea nitrogen, creatinine, water and electrolytes in hyperthyroid patients with Graves' disease].

    PubMed

    Shirota, T

    1991-05-20

    To delineate the pathophysiological basis for increased blood urea nitrogen (BUN), decreased serum creatinine (SCr) and increased BUN/SCr ratio in patients with hyperthyroidism due to Graves' disease, systematic evaluation on renal handling of solutes and water was carried out before and during treatment of the disease. First, BUN, SCr, serum sodium (Na), serum potassium (K), serum chloride (Cl), creatine kinase (CK), serum triiodothyronine (T3) and serum thyroxine (T4) were consecutively measured in 16 patients (aged 18-62 yrs, 4 males and 12 females) with Graves' disease before and during antithyroid drug therapy, and 16 healthy subjects (aged 22-64 yrs, 4 males and 12 females) served as controls. BUN (14.8 +/- 2.9 mg/100ml) was significantly higher (p less than 0.01), and SCr (0.62 +/- 0.16 mg/100ml) and CK (41.7 +/- 23.6 U/l) were significantly lower (p less than 0.01) in untreated patients compared to respective values in the control group (BUN, 13.2 +/- 2.9 mg/100ml; SCr, 0.87 +/- 0.16 mg/100ml; CK, 99.3 +/- 49.5 U/l). Consequently, BUN/SCr ratio was significantly elevated (p less than 0.01) in the patients. As T4 and T3 returned to normal, BUN, SCr, BUN/SCr ratio and CK of the patients also normalized. Serum electrolytes were not significantly different in the patients compared to the controls. Second, renal clearance of para-aminohippurate (CPAH), inulin (CIn), creatinine (CCr), free water (CH2O) and chloride (CCl) was evaluated in 7 untreated patients (aged 17-44 yrs, 4 males and 3 females) and in 7 controls (aged 24-39 yrs, 5 males and 2 females). In patients with untreated Graves' disease, CPAH, CCr and Curea were significantly greater than in the controls (847 +/- 367 vs 442 +/- 124 ml/min, p less than 0.05, 132.7 +/- 14.7 vs 76.6 +/- 14.4 ml/min, p less than 0.01, and 86.9 +/- 16.0 ml/min vs 52.1 +/- 12.6 ml/min, p less than 0.05, respectively). CIn was slightly but insignificantly increased in the patients (95.3 +/- 20.8 ml/min) compared to the

  8. Hashimoto's Thyroiditis and Graves' Disease in One Patient: The Extremes of Thyroid Dysfunction Associated with Interferon Treatment.

    PubMed

    Bishay, R H; Chen, R C Y

    2016-01-01

    Autoimmune thyroid disease associated with interferon therapy can manifest as destructive thyroiditis, Graves' Hyperthyroidism, and autoimmune (often subclinical) hypothyroidism, the latter persisting in many patients. There are scare reports of a single patient developing extremes of autoimmune thyroid disease activated by the immunomodulatory effects of interferon. A 60-year-old man received 48 weeks of pegylated interferon and ribavirin therapy for chronic HCV. Six months into treatment, he reported fatigue, weight gain, and slowed cognition. Serum thyroid stimulating hormone (TSH) was 58.8 mIU/L [0.27-4.2], fT4 11.1 pmol/L [12-25], and fT3 4.2 pmol/L [2.5-6.0] with elevated anti-TPO (983 IU/mL [<35]) and anti-TG (733 U/mL [<80]) antibodies. He commenced thyroxine with initial clinical and biochemical resolution but developed symptoms of hyperthyroidism with weight loss and tremor 14 months later. Serum TSH was <0.02 mIU/L, fT4 54.3 pmol/L, and fT3 20.2 pmol/L, with an elevated TSH receptor (TRAb, 4.0 U/L [<1.0]), anti-TPO (1,163 IU/mL) and anti-TG (114 U/mL) antibodies. Technetium scan confirmed Graves' Disease with bilateral diffuse increased tracer uptake (5.9% [0.5-3.5%]). The patient commenced carbimazole therapy for 6 months. Treatment was ceased following spontaneous clinical and biochemical remission (TSH 3.84 mIU/L, fT4 17pmol/L, fT3 4.5 pmol/L, and TRAb <1 U/L). This raises the need to monitor thyroid function closely in patients both during and following completion of interferon treatment. PMID:27042364

  9. Pre-Hispanic Mortuary Practices in Quebrada de Humahuaca (North-Western Argentina): Genetic Relatedness among Individuals Buried in the Same Grave.

    PubMed

    Russo, M Gabriela; Mendisco, Fanny; Avena, Sergio A; Dejean, Cristina B; Seldes, Verónica

    2016-07-01

    Almost all pre-Hispanic societies from Quebrada de Humahuaca (north-western Argentina) buried their defuncts in domestic areas, demonstrating the importance of death and its daily presence among the living. Presumably, the collective graves contained related individuals, a hypothesis that can be tested through the study of ancient DNA. This study analyzes autosomal and uniparental genetic markers in individuals from two archaeological sites in Quebrada de Humahuaca occupied during the Late Formative (1450-1050 BP) and Regional Developments I (1050-700 BP) periods. Mitochondrial and Y-chromosome haplotypes were compared in order to establish possible maternal and paternal relatedness. Genotypes for 15 autosomal STRs were used to calculate pairwise relatedness coefficients and pedigree probabilities. High kinship levels among individuals buried in the same graves were found in both sites. Although only two particular cases were analyzed, these results represent an important contribution to the study of mortuary practices in the region by means of ancient DNA.

  10. Chylous Ascites: A Rare Adverse Effect of Methimazole Treatment for Grave's Disease—A Case Report and Review of the Literature

    PubMed Central

    Khoury, Tawfik; Schneider, Ronen

    2015-01-01

    A 40-year-old woman was admitted due to an urticarial rash that was attributed to recent onset of methimazole treatment for a diagnosis of Grave's disease. The patient had no prior significant medical history and used no medications, including over-the-counter or herbal medications. Her sister had Grave's disease. On admission, the patient received corticosteroids with improvement in her rash. On the second day of the hospitalization, the patient complained of abdominal discomfort. Abdominal ultrasound revealed a large amount of new onset ascites. Peritoneal tap yielded a milky fluid with high triglyceride level (12.2 mmol/L or 1080 mg/dL), consistent with chylous ascites. After discontinuation of the methimazole, the ascites disappeared. The patient later underwent therapeutic thyroidectomy, after which all features of thyrotoxicosis had improved. PMID:26366308

  11. Pre-Hispanic Mortuary Practices in Quebrada de Humahuaca (North-Western Argentina): Genetic Relatedness among Individuals Buried in the Same Grave.

    PubMed

    Russo, M Gabriela; Mendisco, Fanny; Avena, Sergio A; Dejean, Cristina B; Seldes, Verónica

    2016-07-01

    Almost all pre-Hispanic societies from Quebrada de Humahuaca (north-western Argentina) buried their defuncts in domestic areas, demonstrating the importance of death and its daily presence among the living. Presumably, the collective graves contained related individuals, a hypothesis that can be tested through the study of ancient DNA. This study analyzes autosomal and uniparental genetic markers in individuals from two archaeological sites in Quebrada de Humahuaca occupied during the Late Formative (1450-1050 BP) and Regional Developments I (1050-700 BP) periods. Mitochondrial and Y-chromosome haplotypes were compared in order to establish possible maternal and paternal relatedness. Genotypes for 15 autosomal STRs were used to calculate pairwise relatedness coefficients and pedigree probabilities. High kinship levels among individuals buried in the same graves were found in both sites. Although only two particular cases were analyzed, these results represent an important contribution to the study of mortuary practices in the region by means of ancient DNA. PMID:27346733

  12. Bridge Technology with TSH Receptor Chimera for Sensitive Direct Detection of TSH Receptor Antibodies Causing Graves' Disease: Analytical and Clinical Evaluation.

    PubMed

    Frank, C U; Braeth, S; Dietrich, J W; Wanjura, D; Loos, U

    2015-11-01

    Graves' disease is caused by stimulating autoantibodies against the thyrotropin receptor inducing uncontrolled overproduction of thyroid hormones. A Bridge Assay is presented for direct detection of these thyroid-stimulating immunoglobulins using thyrotropin receptor chimeras. A capture receptor, formed by replacing aa residues 261-370 of the human thyrotropin receptor with residues 261-329 from rat lutropin/choriogonadotropin receptor and fixed to microtiter plates, binds one arm of the autoantibody. The second arm bridges to the signal receptor constructed from thyrotropin receptor (aa 21-261) and secretory alkaline phosphatase (aa 1-519) inducing chemiluminescence. The working range of the assay is from 0.3 IU/l to 50 IU/l with a cutoff of 0.54 IU/l and functional sensitivity of 0.3 IU/l. Sensitivity and specificity are 99.8 and 99.1%, respectively, with a diagnostic accuracy of 0.998. The low grey zone is from 0.3-0.54 IU/l. The stimulatory character of the assayed antibodies is shown through a good correlation (r=0.7079, p<10(-7)) to serum T4 levels of untreated patients. In Graves' disease, titers are increased in associated eye disease. In 3 hypothyroid patients with sera positive in the thyrotropin receptor competition assay and in the blocking bioassay, antibodies are not detected by the Bridge Assay, while the monoclonal blocking antibody K1-70 was detected. In Hashimoto disease thyrotropin receptor autoantibodies are detected in some patients, but not in goiter. This Bridge Assay delivers good diagnostic accuracy for identification of Graves' disease patients. Its high sensitivity may facilitate early detection of onset, remission, or recurrence of Graves' disease enabling timely adaption of the treatment.Human genes: TSHR, Homo sapiens, acc. no. M31774.1.

  13. 18-Fluorodeoxyglucose Uptake by Positron Emission Tomography in Extraocular Muscles of Patients with and without Graves' Ophthalmology

    PubMed Central

    García-Rojas, Leonardo; Adame-Ocampo, Gloria; Alexánderson, Erick; Tovilla-Canales, José Luis

    2013-01-01

    Objective. To compare 18-fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) in extraocular muscles (EOMs) of patients with Graves' ophthalmopathy (GO) versus patients without GO. Design. Prospective, observational, comparative, and cross-sectional study. Participants. Thirty-two eyes of patients with GO and seventy eyes of patients without GO. Methods. We prospectively included patients older than 18 years of age with and without GO. FDG-PET imaging study was performed; standardized unit value (SUVmax) was quantified in EOMs. Standard deviation and significant statistical difference (P < 0.05) were calculated. Results. Thirty-two eyes of sixteen patients of the GO group were included, with a mean age of 44.31 (20–71) years. Seventy eyes of thirty-five patients of the group without GO were included, with a mean age of 49.20 (24–77) years. EOMs average uptake of the groups with and without GO were 3.38 ± 1.31 and 1.89 ± 0.51 SUVmax (P < 0.05), respectively. Conclusion. FDG uptake was significantly increased in EOMs of patients with GO. PET gives valuable information and may be a helpful tool in detecting, localizing, and quantifying GO inflammation. Further research is needed to define the role of PET in detecting, grading, and following up GO in order to optimize treatment in the inflammatory stage. PMID:23476741

  14. Human breast milk excretion of iodine-131 following diagnostic and therapeutic administration to a lactating patient with Graves' disease

    SciTech Connect

    Dydek, G.J.; Blue, P.W.

    1988-03-01

    Previous reports on the excretion of /sup 131/I into human breast milk have recommended discontinuance of breast feeding from 1 to 12 days following diagnostic tracer doses of /sup 131/I. Recent excretion models have calculated that breast feeding could safely resume 56 days following a 5 microCi (0.185 MBq) /sup 131/I maternal tracer dose. We studied a postpartum patient with Graves' disease following first an uptake dose of 8.6 microCi (0.317 MBq) and then for 38 days following a 9.6 mCi (355 MBq) therapy dose of Na/sup 131/I. We calculated from our data that although nursing could not be safely resumed for 46 days following the 8.6-microCi uptake dose, nursing could resume in this patient 8 days after a 100-nCi (3.7 KBq) dose. Extrapolating this data to impure /sup 123/I (p, 2n or p, 5n) we feel that standard 100-microCi (3.7 MBq) doses of either /sup 123/I preparation is not suitable if nursing is to be resumed.

  15. Proposal of success criteria for strabismus surgery in patients with Graves' orbitopathy based on a systematic literature review.

    PubMed

    Jellema, Hinke Marijke; Braaksma-Besselink, Yvette; Limpens, Jacqueline; von Arx, Georg; Wiersinga, Wilmar M; Mourits, Maarten P

    2015-11-01

    Proposal of success criteria for strabismus surgery for patients with Graves' orbitopathy (GO) based on a systematic review of the literature. We performed a systematic search of OVID MEDLINE, OVID Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and the publisher subset of PubMed, to identify studies reporting on success criteria of strabismus surgery in GO. In addition, we handsearched several orthoptic journals and proceedings of strabismological congresses. Of the 789 articles retrieved, 42 articles described success criteria for strabismus surgery in GO. Most studies defined success in terms of a subjective diplopia-free field in primary and down gaze. Almost half of the studies used a graded scale (excellent, good, acceptable and failure) to describe the outcome of surgery. Three of the eligible studies described a tool to quantify the field of single vision in detail. Quality of life was not reported as an outcome measure in any of the published studies. In conclusion, success criteria for strabismus surgery in patients with GO are poorly defined and no consensus is available. The lack of standardization hampers comparative studies and thus the search for the best surgical treatment for diplopia in patients with GO. Therefore, we propose strict success criteria including a tool for quantification of remaining diplopia plus a disease-specific quality of life questionnaire (the GO-QoL).

  16. Proposal of success criteria for strabismus surgery in patients with Graves' orbitopathy based on a systematic literature review.

    PubMed

    Jellema, Hinke Marijke; Braaksma-Besselink, Yvette; Limpens, Jacqueline; von Arx, Georg; Wiersinga, Wilmar M; Mourits, Maarten P

    2015-11-01

    Proposal of success criteria for strabismus surgery for patients with Graves' orbitopathy (GO) based on a systematic review of the literature. We performed a systematic search of OVID MEDLINE, OVID Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and the publisher subset of PubMed, to identify studies reporting on success criteria of strabismus surgery in GO. In addition, we handsearched several orthoptic journals and proceedings of strabismological congresses. Of the 789 articles retrieved, 42 articles described success criteria for strabismus surgery in GO. Most studies defined success in terms of a subjective diplopia-free field in primary and down gaze. Almost half of the studies used a graded scale (excellent, good, acceptable and failure) to describe the outcome of surgery. Three of the eligible studies described a tool to quantify the field of single vision in detail. Quality of life was not reported as an outcome measure in any of the published studies. In conclusion, success criteria for strabismus surgery in patients with GO are poorly defined and no consensus is available. The lack of standardization hampers comparative studies and thus the search for the best surgical treatment for diplopia in patients with GO. Therefore, we propose strict success criteria including a tool for quantification of remaining diplopia plus a disease-specific quality of life questionnaire (the GO-QoL). PMID:25876459

  17. Enhancement of CD4(+) T cell response and survival via coexpressed OX40/OX40L in Graves' disease.

    PubMed

    Wang, Qin; Shi, Bi-Min; Xie, Fang; Fu, Zhao-Yang; Chen, Yong-Jing; An, Jing-Nan; Ma, Yu; Liu, Cui-Ping; Zhang, Xue-Kun; Zhang, Xue-Guang

    2016-07-15

    OX40/OX40L pathway plays a very important role in the antigen priming T cells and effector T cells. In the present study, we aimed to examine the involvement of OX40/OX40L pathway in the activation of autoreactive T cells in patients with Grave's disease (GD). We found that OX40 and OX40L were constitutively coexpressed on peripheral CD4(+) T cells from GD patients using flow cytometry analysis. The levels of OX40 and OX40L coexpression on CD4(+) T cells were shown to be correlated with TRAbs. Cell proliferation assay showed that blocking OX40/OX40L signal inhibited T cell proliferation and survival, which suggested that OX40/OX40L could enhance CD4(+) T cell proliferation and maintain their long-term survival in GD by self-enhancing loop of T cell activation independent of APCs. Confocal microscopy and coimmunoprecipitation analysis further revealed that OX40 and OX40L formed a functional complex, which may facilitate signal transduction from OX40L to OX40 and contribute to the pathogenesis of GD. PMID:27107937

  18. Prospective study of the changes in thyrotropin binding inhibitory immunoglobulins in Graves' disease treated by subtotal thyroidectomy or radioactive iodine

    SciTech Connect

    Teng, C.S.; Yeung, R.T.T.; Khoo, R.K.K.; Alagaratnam, T.T.

    1980-06-01

    The effects of subtotal thyroidectomy and radioactive iodine on thyroid-stimulating immunoglobulins, as measured by a receptor assay, more appropriately termed TSH binding inhibitory immunoglobulins (TBII), were studied in 74 patients with Graves' disease. Fourty-four patients received radioactive iodine therapy, while 30 were subjected to subtotal thyroidectomy. After radioactive iodine, more patients were TBII-positive (90.5% vs 81.8%) than before treatment, and the mean TBII index decreased dramatically, the maximum decrease being 3 months. The mean TBI index subsequently returned gradually to the pretreatment level. Subtotal thyroidectomy had a different effect on TBII activity. TBII indices were positive in 89.3% of these patients before any treatment but were positive in only 40% (12 patients) after antithyroid drugs had been given before surgery. After surgery, TBII indices remained positive in 7 patients, while the remaining 5 patients became TBII negative. Seventeen patients (56.7%) were TBII negative before operation and remained so after surgery. One patient who was TBII negative before operation became TBII positive 2 months after operation. Interestingly, postoperative relapse of hyperthyroidism occurred in 3 patients who were TIBII positive, while hypothyroidism occurred in patients who were TBII negative. Thus, the TBII activity after subtotal thyroidectomy might be an important factor in determining the outcome of surgery.

  19. Results after En Bloc Lateral Wall Decompression Surgery with Orbital Fat Resection in 111 Patients with Graves' Orbitopathy

    PubMed Central

    Fichter, Nicole; Guthoff, Rudolf F.

    2015-01-01

    Purpose. To evaluate the effect of en bloc lateral wall decompression with additional orbital fat resection in terms of exophthalmos reduction and complications. Methods. A retrospective, noncomparative case series study from 1999 to 2011 (chart review) in Graves' orbitopathy (GO) patients. The standardized surgical technique involved removal of the lateral orbital wall including the orbital rim via a lid crease approach combined with additional orbital fat resection. Exophthalmos, diplopia, retrobulbar pressure sensation, and complications were analyzed pre- and postoperatively. Results. A total of 111 patients (164 orbits) with follow-up >3 months were analysed. Mean exophthalmos reduction was 3.05mm and preoperative orbital pressure sensation resolved or improved in all patients. Visual acuity improved significantly in patients undergoing surgery for rehabilitative or vision threatening purposes. Preoperative diplopia improved in 10 patients (9.0%) but worsened in 5 patients (4.5%), necessitating surgical correction in 3 patients. There were no significant complications; however, one patient had slight hollowing of the temporalis muscle around the scar that did not necessitate revision, and another patient with a circumscribed retraction of the scar itself underwent surgical correction. Conclusions. The study confirms the efficiency of en bloc lateral wall decompression in GO in a large series of patients, highlighting the low risk of disturbance of binocular functions and of cosmetic blemish in the temporal midface region. PMID:26221142

  20. Long-term follow-up study of compensated low-dose /sup 131/I therapy for Graves' disease

    SciTech Connect

    Sridama, V.; McCormick, M.; Kaplan, E.L.; Fauchet, R.; DeGroot, L.J.

    1984-08-16

    We treated 187 patients who had Graves' disease with low-dose radioactive iodide (/sup 131/I), using a protocol that included a compensation for thyroid size. The incidence of early hypothyroidism (12 per cent) was acceptably low in the first year after /sup 131/I treatment, but we found a cumulative high incidence (up to 76 per cent) at the end of the 11th year. In contrast, the incidence of permanent hypothyroidism was relatively stable in 166 surgically treated patients, increasing from 19 to 27 per cent at the end of 11 years. Among 122 medically treated patients, only 40 per cent entered remission, and hypothyroidism developed in 2 per cent during the same period of follow-up. The long-term incidence of hypothyroidism in our patients treated with low-dose /sup 131/I therapy was much higher than that found in earlier studies using a comparable dose. Our study suggests that it will be difficult to modify therapy with /sup 131/I alone to produce both early control of thyrotoxicosis and a low incidence of hypothyroidism.

  1. AIRE genetic variants and predisposition to polygenic autoimmune disease: The case of Graves' disease and a systematic literature review.

    PubMed

    Colobran, Roger; Giménez-Barcons, Mireia; Marín-Sánchez, Ana; Porta-Pardo, Eduard; Pujol-Borrell, Ricardo

    2016-08-01

    Autoimmune Regulator (AIRE) is a transcriptional regulator that is crucial for establishing central tolerance as illustrated by the Mendelian Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) syndrome associated with AIRE-inactivating recessive or dominant mutations. Polymorphisms in AIRE have been proposed to be implicated in genetic susceptibility to non-Mendelian organ specific autoimmune diseases. Because there is evidence that in predisposition to Graves' disease (GD) central tolerance is crucial, we investigated whether AIRE polymorphisms could modulate risk of GD. A case-control association study using 29 variants and conducted in 150 GD patients and 200 controls did not detect any significant association. This result is not exceptional: a systematic review of the literature, including GWAS, on the association of AIRE variants with organ specific autoimmune diseases did not show clear associations; similarly heterozygous recessive mutations are not associated to non-Mendelian autoimmunity. Dominant negative mutations of AIRE are associated to autoimmunity but as mild forms of APECED rather than to non-Mendelian organ specific autoimmunity. The lack of association of common AIRE polymorphisms with polygenic autoimmune diseases is counterintuitive as many other genes less relevant for immunological tolerance have been found to be associated. These findings give rise to the intriguing possibility that evolution has excluded functionally modifying polymorphisms in AIRE.

  2. Glucose variability before and after treatment of a patient with Graves' disease complicated by diabetes mellitus: assessment by continuous glucose monitoring.

    PubMed

    Torimoto, Keiichi; Okada, Yosuke; Arao, Tadashi; Mori, Hiroko; Yamamoto, Sunao; Narisawa, Manabu; Kurozumi, Akira; Tanaka, Yoshiya

    2014-01-01

    A 48-year-old woman was diagnosed and treated for Graves' disease (GD) in 1999 but she discontinued treatment at her own discretion. In 2011, she was admitted to a local hospital for management of thyrotoxic crisis. Treatment with propylthiouracil, iodide potassium (KI), and prednisolone (PSL) was started, which resulted in improvement of the general condition. PSL and KI were discontinued before she was transferred to our hospital. At the local hospital, fasting plasma glucose (FPG) was 212 mg/dL and hemoglobin A1c concentration was 11.2%; intensive insulin therapy had been instituted. Upon admission to our hospital, FPG level was 122 mg/dL, but insulin secretion was compromised, suggesting aggravation of thyroid function and deterioration of glycemic control. The FPG level increased to 173 mg/dL; continuous glucose monitoring (CGM) identified dawn phenomenon at approximately 0400 h. Resumption of KI resulted in improvement of FPG and disappearance of the dawn phenomenon, as assessed by CGM. These results indicate that in patients with compromised insulin secretion, hyperthyroidism can induce elevation of not only postprandial blood glucose, but also FPG level due to the dawn phenomenon and that the dawn phenomenon can be alleviated with improvement in thyroid function. To our knowledge, no studies have assessed glucose variability by CGM before and after treatment of Graves' disease. The observations made in this case shed light on the understanding of abnormal glucose metabolism associated with Graves' disease.

  3. Digging up the recent Spanish memory: genetic identification of human remains from mass graves of the Spanish Civil War and posterior dictatorship.

    PubMed

    Baeta, Miriam; Núñez, Carolina; Cardoso, Sergio; Palencia-Madrid, Leire; Herrasti, Lourdes; Etxeberria, Francisco; de Pancorbo, Marian M

    2015-11-01

    The Spanish Civil War (1936-1939) and posterior dictatorship (until 1970s) stands as one of the major conflicts in the recent history of Spain. It led to nearly two hundred thousand men and women executed or murdered extra-judicially or after dubious legal procedures. Nowadays, most of them remain unidentified or even buried in irretraceable mass graves across Spain. Here, we present the genetic identification of human remains found in 26 mass graves located in Northern Spain. A total of 252 post-mortem remains were analyzed and compared to 186 relatives, allowing the identification of 87 victims. Overall, a significant success of DNA profiling was reached, since informative profiles (≥ 12 STRs and/or mitochondrial DNA profile) were obtained in 85.71% of the remains. This high performance in DNA profiling from challenging samples demonstrated the efficacy of DNA extraction and amplification methods used herein, given that only around 14.29% of the samples did not provide an informative genetic profile for the analysis performed, probably due to the presence of degraded and/or limited DNA in these remains. However, this study shows a partial identification success rate, which is clearly a consequence of the lack of both appropriate family members for genetic comparisons and accurate information about the victims' location. Hence, further perseverance in the exhumation of other intact graves as well as in the search of more alleged relatives is crucial in order to facilitate and increase the number of genetic identifications. PMID:26378723

  4. Digging up the recent Spanish memory: genetic identification of human remains from mass graves of the Spanish Civil War and posterior dictatorship.

    PubMed

    Baeta, Miriam; Núñez, Carolina; Cardoso, Sergio; Palencia-Madrid, Leire; Herrasti, Lourdes; Etxeberria, Francisco; de Pancorbo, Marian M

    2015-11-01

    The Spanish Civil War (1936-1939) and posterior dictatorship (until 1970s) stands as one of the major conflicts in the recent history of Spain. It led to nearly two hundred thousand men and women executed or murdered extra-judicially or after dubious legal procedures. Nowadays, most of them remain unidentified or even buried in irretraceable mass graves across Spain. Here, we present the genetic identification of human remains found in 26 mass graves located in Northern Spain. A total of 252 post-mortem remains were analyzed and compared to 186 relatives, allowing the identification of 87 victims. Overall, a significant success of DNA profiling was reached, since informative profiles (≥ 12 STRs and/or mitochondrial DNA profile) were obtained in 85.71% of the remains. This high performance in DNA profiling from challenging samples demonstrated the efficacy of DNA extraction and amplification methods used herein, given that only around 14.29% of the samples did not provide an informative genetic profile for the analysis performed, probably due to the presence of degraded and/or limited DNA in these remains. However, this study shows a partial identification success rate, which is clearly a consequence of the lack of both appropriate family members for genetic comparisons and accurate information about the victims' location. Hence, further perseverance in the exhumation of other intact graves as well as in the search of more alleged relatives is crucial in order to facilitate and increase the number of genetic identifications.

  5. Adhesion molecule expression in Graves' thyroid glands; potential relevance of granule membrane protein (GMP-140) and intercellular adhesion molecule-1 (ICAM-1) in the homing and antigen presentation processes.

    PubMed Central

    Miyazaki, A; Mirakian, R; Bottazzo, G F

    1992-01-01

    To assess the potential role of adhesion molecules in the pathogenesis of Graves' disease, we examined the expression of several of these adhesion molecules, including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule (VCAM-1) and granule membrane protein-140 (GMP-140), in sections of Graves' thyroid glands and control thyroids, using immunohistochemical techniques. Up-regulated expression of GMP-140 was frequently observed on endothelial cells (EC) of post-capilliary venules in all Graves' thyroids examined, compared with an occasional weak staining on EC control glands. Some capillary EC around thyroid follicles (perifollicular EC) were strongly positive for GMP-140 in the Graves' thyroids in contrast to a negative staining on the same structures in the control glands. In addition, there was a correlation between the reactivity and frequency of GMP-140 expression on EC and the severity of mononuclear cell (MNC) infiltration in the Graves' thyroids. The expression of ICAM-1 was up-regulated on perifollicular EC and EC of small venules in some thyroids of both Graves' and control groups. Conversely, no significant expression was observed on any type of EC for both endothelial-leucocyte adhesion molecule-1 (ELAM-1) and VCAM-1. However, dendritic-like cells, present within lymphocytic infiltrates, were positive for VCAM-1 in most of the Graves' thyroids examined, especially in those with a severe lymphocytic infiltration. Thyrocytes were constantly negative for the expression of all four adhesion molecules investigated. These data suggest that GMP-140, as well as ICAM-1, could play an important role in the initiation of MNC infiltration in Graves' disease. ELAM-1 and VCAM-1 appear not to be relevant for the migration of MNC from the blood vessels into the target gland, although VCAM-1 expression on dendritic-like cells might play an additively tissue-selective role in autoantigen presentation and subsequent elicitation of autoimmune

  6. Treatment with lithium prevents serum thyroid hormone increase after thionamide withdrawal and radioiodine therapy in patients with Graves' disease.

    PubMed

    Bogazzi, Fausto; Bartalena, Luigi; Campomori, Alberto; Brogioni, Sandra; Traino, Claudio; De Martino, Fabio; Rossi, Giuseppe; Lippi, Francesco; Pinchera, Aldo; Martino, Enio

    2002-10-01

    Serum thyroid hormone concentrations increase after radioiodine (RAI) therapy for Graves' disease. This phenomenon has been ascribed to either antithyroid drug withdrawal before RAI therapy or release of preformed thyroid hormones into the bloodstream from the RAI-damaged thyroid. Lithium blocks the release of iodine and thyroid hormones from the thyroid, thus enhancing the effectiveness of RAI therapy. Changes in serum-free thyroxine (FT4) and triiodothyronine (FT3) levels after methimazole (MMI) discontinuation and RAI therapy were evaluated in a prospective, randomized, control study of 36 patients with Graves' disease. After a 3- to 4-month course of MMI, patients were assigned to one of three groups: G1 (RAI alone); G2 (RAI plus lithium for 6 d starting on the day of RAI therapy); or G3 (RAI plus lithium for 19 d starting on the day of MMI withdrawal). G1-G2 patients had an increase in serum FT4 and FT3 levels from 13.5 +/- 6.5 to 19.8 +/- 9.2 pmol/liter and 5.0 +/- 2.0 to 8.0 +/- 4.8 pmol/liter, respectively (P < 0.0001), 2-5 d after MMI withdrawal, but G3 patients showed no changes. In the 30 d after RAI therapy, mean serum FT4 values increased in G1 patients (P = 0.02), peaking at 3-7 d (P < 0.05) but not in G2 and G3 patients. Serum FT3 levels decreased in G1, G2, and G3 (P = 0.03, P = 0.001, P = 0.02, respectively). Hyperthyroidism was cured in 8 of 12 G1 patients, 11 of 12 G2 patients, and 11 of 12 G3 patients (P = 0.31). Control of hyperthyroidism was prompter in G2 (P = 0.08) and G3 (P < 0.05) than in G1 patients. Patients in the three groups received a similar dose of RAI, but the committed radiation to the thyroid was higher in G3 (563 +/- 174 Gray) and G2 (588 +/- 347 Gray) than in G1 (429 +/- 204 Gray) (P < 0.03). In conclusion, the results of the present study demonstrate that: 1) MMI withdrawal is associated with a slight rise in serum thyroid hormone levels; 2) a further increase occurs after RAI therapy; 3) changes in serum thyroid hormone

  7. [Not Available].

    PubMed

    Angulo, Daniela; Bustos, Edson; Sánchez, Andrés; Barja, Salesa

    2016-01-01

    Introducción: la rehabilitación de la alimentación por vía oral (RVO) es compleja en pacientes que han recibido nutrición enteral (NE) prolongada. Objetivo: describir este proceso en niños con enfermedades respiratorias crónicas y sonda nasoenteral (SNE) o gastrostomía (GT).Pacientes y métodos: estudio retrospectivo con revisión de registros clínicos de niños con NE mayor a dos meses, ingresados entre 2005 y 2014 al Hospital Josefina Martínez.Resultados: Se incluyeron 116 pacientes, con mediana de edad 10 meses (Rango: 3 a 101), 56% hombres. Diagnóstico: 34,5% Daño pulmonar crónico postinfeccioso (DPC), 29,3% Insuficiencia respiratoria por enfermedad neuromuscular, 19% Displasia broncopulmonar y 17,2% enfermedad de la vía aérea. Con traqueostomía: 82,8%. Eran usuarios de GT 89,7% y de SNG 10,3%, instaladas con mediana de edad 6 meses (0 a 74), por ingesta insuficiente (6,6%) o trastorno de deglución (92,4%). Del grupo total, 36,2% (42/116) tenía indicación de RVO, los cuales habían recibido NE durante 12,2 meses (2 a 41); de estos 50% (21/42) logró alimentarse exclusivamente por vía oral (91% SNG y 35,4% GT, Chi2 p = 0,023), 14% parcialmente y 36% no lo logró. El tiempo para lograr la vía oral exclusiva fue de 9,75 meses (0,5 a 47), sin diferencia por edad, sexo, vía de acceso, duración NE ni presencia de enfermedad neurológica.Conclusión: en pacientes con enfermedades respiratorias crónicas graves y NE prolongada, la RVO es un proceso lento pero posible: 64% lo logra de modo completo o parcial. PMID:27571646

  8. [Not Available].

    PubMed

    Angulo, Daniela; Bustos, Edson; Sánchez, Andrés; Barja, Salesa

    2016-07-19

    Introducción: la rehabilitación de la alimentación por vía oral (RVO) es compleja en pacientes que han recibido nutrición enteral (NE) prolongada. Objetivo: describir este proceso en niños con enfermedades respiratorias crónicas y sonda nasoenteral (SNE) o gastrostomía (GT).Pacientes y métodos: estudio retrospectivo con revisión de registros clínicos de niños con NE mayor a dos meses, ingresados entre 2005 y 2014 al Hospital Josefina Martínez.Resultados: Se incluyeron 116 pacientes, con mediana de edad 10 meses (Rango: 3 a 101), 56% hombres. Diagnóstico: 34,5% Daño pulmonar crónico postinfeccioso (DPC), 29,3% Insuficiencia respiratoria por enfermedad neuromuscular, 19% Displasia broncopulmonar y 17,2% enfermedad de la vía aérea. Con traqueostomía: 82,8%. Eran usuarios de GT 89,7% y de SNG 10,3%, instaladas con mediana de edad 6 meses (0 a 74), por ingesta insuficiente (6,6%) o trastorno de deglución (92,4%). Del grupo total, 36,2% (42/116) tenía indicación de RVO, los cuales habían recibido NE durante 12,2 meses (2 a 41); de estos 50% (21/42) logró alimentarse exclusivamente por vía oral (91% SNG y 35,4% GT, Chi2 p = 0,023), 14% parcialmente y 36% no lo logró. El tiempo para lograr la vía oral exclusiva fue de 9,75 meses (0,5 a 47), sin diferencia por edad, sexo, vía de acceso, duración NE ni presencia de enfermedad neurológica.Conclusión: en pacientes con enfermedades respiratorias crónicas graves y NE prolongada, la RVO es un proceso lento pero posible: 64% lo logra de modo completo o parcial.

  9. The Effect of Early Thyroidectomy on the Course of Active Graves' Orbitopathy (GO): A Retrospective Case Study.

    PubMed

    Meyer Zu Horste, M; Pateronis, K; Walz, M K; Alesina, P; Mann, K; Schott, M; Esser, J; Eckstein, A K

    2016-07-01

    The aim of the work was to investigate the effect of early thyroidectomy on the course of active Graves' orbitopathy (GO) in patients with low probability of remission [high TSH receptor antibody (TRAb) serum levels, severe GO] compared to that of continued therapy with antithyroid drugs. Two cohorts were evaluated retrospectively (total n=92 patients with active GO, CAS≥4). Forty-six patients underwent early thyroidectomy (Tx-group) 6±2 months after initiation of antithyroid drug (ATD) therapy, while ATD was continued for another 6±2 months in the ATD-group (n=46). These controls were consecutively chosen from a database and matched to the Tx-group. GO was evaluated (activity, severity, TRAb) at baseline and at 6 month follow-up. At baseline, both cohorts were virtually identical as to disease severity, activity and duration, as well as prior anti-inflammatory treatment, age, gender, and smoking behavior. At 6 month follow-up, NOSPECS severity score was significantly decreased within each group, but did not differ between both groups. However, significantly more patients of the Tx-group presented with inactive GO (89.1 vs. 67.4%, * p=0.02), and mean CAS score was significantly lower in Tx-group (2.1) than in ADT-group (2.8; * p=0.02) at the end of follow-up. TRAb levels declined in both groups (Tx-group: from 18.6 to 5.2 vs. ATD-group: 12.8-3.2 IU/l, p0=0.07, p6months=0.32). Residual GO activity was lower in Tx-group, associated with a higher rate of inactivation of GO. This allows an earlier initiation of ophthalmosurgical rehabilitation in patients with severe GO, which may positively influence quality of life of the patients.

  10. The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves' Disease and the Predictive Factors Influencing its Development.

    PubMed

    Husseni, Maha Abd El-Kareem El-Sayed

    2016-01-01

    The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 ((131)I) activities in the treatment of Graves' disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis was performed on 272 patients with GD who were treated with (131)I, among whom 125 received 370 MBq and 147 received 555 MBq. The outcome was categorized as hypothyroidism, euthyroidism, and persistent hyperthyroidism. Multiple logistic regression analysis was performed to identify significant risk factors that affect the development of hypothyroidism. The incidence of hypothyroidism following the first low activity was 24.8% with a high treatment failure rate of 58.4%, compared with 48.3% and 32% following high activity. The overall cumulative incidence of hypothyroidism following repeated activities was 50.7%, out of which 73.9% occurred after the first activity and 20.3% after the second activity. The higher (131)I activity (P < 0.001) and average and mild enlargement of the thyroid gland (P = 0.004) were identified as significant independent factors that increase the rate of incidence of hypothyroidism (Odds ratios were 2.95 and 2.59). No correlation was found between the development of hypothyroidism and the factors such as age, gender, presence of exophthalmos, previous antithyroid medications, and the durations, and Technetium-99m (Tc-99m) pertechnetate thyroid uptake. In view of the high treatment failure rate after first low activity and lower post high activity hypothyroid incidence, high activity is recommended for GD patients, reserving the use of 370MBq for patients with average sized and mildly enlarged goiter; this increases patient convenience by avoiding multiple activities to achieve cure and long-term follow-up. PMID:26912976

  11. The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves' Disease and the Predictive Factors Influencing its Development.

    PubMed

    Husseni, Maha Abd El-Kareem El-Sayed

    2016-01-01

    The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 ((131)I) activities in the treatment of Graves' disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis was performed on 272 patients with GD who were treated with (131)I, among whom 125 received 370 MBq and 147 received 555 MBq. The outcome was categorized as hypothyroidism, euthyroidism, and persistent hyperthyroidism. Multiple logistic regression analysis was performed to identify significant risk factors that affect the development of hypothyroidism. The incidence of hypothyroidism following the first low activity was 24.8% with a high treatment failure rate of 58.4%, compared with 48.3% and 32% following high activity. The overall cumulative incidence of hypothyroidism following repeated activities was 50.7%, out of which 73.9% occurred after the first activity and 20.3% after the second activity. The higher (131)I activity (P < 0.001) and average and mild enlargement of the thyroid gland (P = 0.004) were identified as significant independent factors that increase the rate of incidence of hypothyroidism (Odds ratios were 2.95 and 2.59). No correlation was found between the development of hypothyroidism and the factors such as age, gender, presence of exophthalmos, previous antithyroid medications, and the durations, and Technetium-99m (Tc-99m) pertechnetate thyroid uptake. In view of the high treatment failure rate after first low activity and lower post high activity hypothyroid incidence, high activity is recommended for GD patients, reserving the use of 370MBq for patients with average sized and mildly enlarged goiter; this increases patient convenience by avoiding multiple activities to achieve cure and long-term follow-up.

  12. Transport aérien longue distance des brûlés graves: revue de la littérature et application pratique

    PubMed Central

    Leclerc, T.; Hoffmann, C.; Forsans, E.; Cirodde, A.; Boutonnet, M.; Jault, P.; Tourtier, J.-P.; Bargues, L.; Donat, N.

    2015-01-01

    Summary Les brûlés graves nécessitent une prise en charge multidisciplinaire dans des centres hautement spécialisés. La rareté de ces centres impose souvent le transport aérien médicalisé longue distance. Cependant, il y a peu de données publiées sur ces transferts. Dans cette mise au point, pour optimiser la prise en charge des brûlés dès qu’un transport aérien est décidé ou même seulement envisagé, nous proposons d’extraire de cette littérature limitée des principes simples s’appuyant aussi sur l’expérience pratique du Service de Santé des Armées françaises. Nous décrivons d’abord comment les contraintes aéronautiques peuvent affecter le transport de brûlés graves à bord d’aéronefs. Nous abordons ensuite la régulation de ces missions, en analysant les risques associés au transport aérien des brûlés graves et leurs implications sur les indications, la chronologie et les modalités du transport. Enfin, nous développons la conduite de la mission, comprenant la préparation du matériel et des consommables avant le vol, l’évaluation et la mise en condition du patient avant l’embarquement, et la poursuite de la prise en charge en vol. PMID:26668564

  13. The preliminary clinical observation and analysis of childbearingage women with a history of iodine-131 treatment for Graves' disease.

    PubMed

    Guan, Liang; Chen, Gang; Zhang, Jiali; Wang, Ling

    2016-09-01

    Whether radioactive iodine treatment of Graves' disease (GD) during pregnancy will increase pregnancy loss and affect fetal development is still a matter of concern. From May 2005 to December 2015, 2,276 childbearing-age women with GD received iodine-131 treatment in our departments and were retrospectively enrolled in our study. When some of them were found to have been pregnant, their thyroid functions were measured every 4 weeks, in addition, thyroid-stimulating hormone (TSH) was measured 6 weeks after delivery. When necessary, levothyroxine or propylthiouracil (PTU) was given in order to control their TSH levels during pregnancy. Finally, 69 pregnant women (29 ± 3.5 years old) and 1346 women who were not pregnant during the follow-up period were enrolled into this study. They were all hyperthyroid before or during pregnancy. Among 69 pregnant women, the administrated amount of iodine-131 was 254.9 ± 99.9 MBq. Fifty patients became subclinically hypothyroid after treatment and were administrated levothyroxine (55 ± 25 μg/d). Seven patients were diagnosed with subclinical hyperthyroidism during pregnancy and they received PTU (25 ± 12.5 mg/d). Twelve patients with normal thyroid function were also clinically followed. Among 69 women, 63 had a single birth, 3 had dizygotic twins, 2 had two pregnancies and 1 had a single twin birth. Sixty five babies were born full-term, while 9 were premature (4 ± 1 weeks early) with birth weight 3.2 ± 0.5 kg. Six new born babies were considered to be low birth weight infants (< 2.5 kg) while 5 were high birth weight (> 4 kg), but the weights of all the infants were within the normal range. During the period of observation to December 2015, all the infants were found to grow and develop normally. Among 1346 women who were not pregnant were in the further follow-up. Our study found no detrimental effects of the iodine-131 treatment in the pregnant women or their offspring so far. PMID:27181740

  14. Use of Color Doppler Ultrasonography to Measure Thyroid Blood Flow and Differentiate Graves' Disease from Painless Thyroiditis

    PubMed Central

    Hiraiwa, Tetsuya; Tsujimoto, Naoyuki; Tanimoto, Keiji; Terasaki, Jungo; Amino, Nobuyuki; Hanafusa, Toshiaki

    2013-01-01

    Backgrounds Color Doppler ultrasonography (CDU) has not yet been established as a method to investigate the pathogenesis of thyrotoxicosis. Objectives Our first objective was to determine whether the measurement of peak systolic blood-flow velocity in the superior thyroid artery (STV) and thyroid tissue blood flow (TBF) using CDU could differentiate Graves' disease (GD) from painless thyroiditis (PT). The second objective was to examine the factors mediating increased blood flow to the thyroid gland in GD. Methods Recruited patients had untreated GD or PT and visited the Department of Internal Medicine (I), Osaka Medical College, between April 1, 2006 and May 31, 2010. Age, gender, blood pressure, pulse rate, thyroid-stimulating hormone, free thyroxine, tri-iodothyronine, TSH receptor antibody and thyroid volume were evaluated in patients. In addition, bilateral measurements of STV, TBF and peak systolic velocity in the common carotid artery (CCV) were also performed. TBF was quantified by calculating the ratio of blood-flow pixels to total pixels in the region of interest using sagittal section images of the thyroid gland. Receiver-operating characteristic curve analysis was performed to determine the ability of STV and TBF measurements to differentiate GD from PT. Results For the average of STV measured on both sides, the area under the receiver-operating characteristic curve (AUC) was 0.956. For the average of TBF measured on both sides, the AUC was 0.920. At an average STV cut-off value of 43 cm/s, the sensitivity to discriminate GD from PT was 0.87 and the specificity was 1.00. At an average TBF cut-off value of 3.8%, the sensitivity was 0.71 and the specificity was 1.00. In the GD group, neither blood pressure nor pulse rate correlated with the average STV or TBF. Moreover, there was no correlation between STV and CCV or between TBF and CCV on either side. However, STV was correlated with TBF (right side: R = 0.47; left side: R = 0.52). Conclusions The

  15. Clandestine grave detector

    DOEpatents

    Andrews, Jr., William H.; Thompson, Cyril V.; Vass, Arpad A.; Smith, Rob R.

    2011-12-13

    An apparatus and a method for detecting a burial site of human remains are disclosed. An air stream is drawn through an air intake conduit from locations near potential burial sites of human remains. The air stream is monitored by one or more chemical sensors to determine whether the air stream includes one or more indicator compounds selected from halogenated compounds, hydrocarbons, nitrogen-containing compounds, sulfur-containing compounds, acid/ester compounds, oxygen-containing compounds, and naphthalene-containing compounds. When it is determined that an indicator compound is present in the air stream, this indicates that a burial site of human remains is below or nearby. Each sensor may be in electrical communication with an indicator that signals when the sensor has detected the presence of the indicator compound in the air stream. In one form, the indicator compound is a halogenated compound and/or a hydrocarbon, and the presence of the halogenated compound and/or the hydrocarbon in the air stream indicates that a burial site of human remains is below or nearby.

  16. Grave Songs in Stone.

    ERIC Educational Resources Information Center

    Hunter, J. Mark

    A survey of images on gravestones yields a fascinating array of symbols and visual communication. This paper describes a project in which over 300 symbols in graveyards of the southeastern United States were examined. The method of recording the images and information about them was to photograph the symbol with a 35mm single lens reflex (SLR) and…

  17. Assisting the diagnosis of Graves' hyperthyroidism with Bayesian-type and SOM-type neural networks by making use of a set of three routine tests and their correlation with free T4.

    PubMed

    Sato, W; Hoshi, K; Kawakami, J; Sato, K; Sugawara, A; Saito, Y; Yoshida, K

    2010-01-01

    In our previous paper, we proposed a novel screening method that assists the diagnosis of Graves' hyperthyroidism via two types of neural networks by making use of routine test data. This method can be applied by non-specialists during physical check-ups at a low cost and is expected to lead to rapid referrals for examination and treatment by thyroid specialists, that is, to improve patients' QOL. In this report, the amount of female sample data was increased and routine test data (14 parameters) from 120 subjects with a known diagnosis (35 patients with Graves' hyperthyroidism and 85 healthy volunteers) were adopted as training data, before 171 individuals who had also undergone the same routine tests at the Tohoku University Hospital were screened by the network for Graves' hyperthyroidism. The present re-examination of the screening method showed its high screening ability with the set of parameters used (low serum creatinine was added to the established measures of elevated alkaline phosphatase and low total cholesterol that appear in the Graves' hyperthyroidism guidelines) and robustness due to the increase of the training sample data. It was also found that there is a strong correlation between the three parameters and serum free thyroxine (FT4) in Graves' hyperthyroidism, which supports the usefulness of our screening method.

  18. The massacre mass grave of Schöneck-Kilianstädten reveals new insights into collective violence in Early Neolithic Central Europe.

    PubMed

    Meyer, Christian; Lohr, Christian; Gronenborn, Detlef; Alt, Kurt W

    2015-09-01

    Conflict and warfare are central but also disputed themes in discussions about the European Neolithic. Although a few recent population studies provide broad overviews, only a very limited number of currently known key sites provide precise insights into moments of extreme and mass violence and their impact on Neolithic societies. The massacre sites of Talheim, Germany, and Asparn/Schletz, Austria, have long been the focal points around which hypotheses concerning a final lethal crisis of the first Central European farmers of the Early Neolithic Linearbandkeramik Culture (LBK) have concentrated. With the recently examined LBK mass grave site of Schöneck-Kilianstädten, Germany, we present new conclusive and indisputable evidence for another massacre, adding new data to the discussion of LBK violence patterns. At least 26 individuals were violently killed by blunt force and arrow injuries before being deposited in a commingled mass grave. Although the absence and possible abduction of younger females has been suggested for other sites previously, a new violence-related pattern was identified here: the intentional and systematic breaking of lower limbs. The abundance of the identified perimortem fractures clearly indicates torture and/or mutilation of the victims. The new evidence presented here for unequivocal lethal violence on a large scale is put into perspective for the Early Neolithic of Central Europe and, in conjunction with previous results, indicates that massacres of entire communities were not isolated occurrences but rather were frequent features of the last phases of the LBK. PMID:26283359

  19. Long-term Geophysical Monitoring of Simulated Clandestine Graves using Electrical and Ground Penetrating Radar Methods: 4-6 Years After Burial.

    PubMed

    Pringle, Jamie K; Jervis, John R; Roberts, Daniel; Dick, Henry C; Wisniewski, Kristopher D; Cassidy, Nigel J; Cassella, John P

    2016-03-01

    This ongoing monitoring study provides forensic search teams with systematic geophysical data over simulated clandestine graves for comparison to active cases. Simulated "wrapped," "naked," and "control" burials were created. Multiple geophysical surveys were collected over 6 years, here showing data from 4 to 6 years after burial. Electrical resistivity (twin electrode and ERI), multifrequency GPR, grave and background soil water were collected. Resistivity surveys revealed that the naked burial had low-resistivity anomalies up to year four but then difficult to image, whereas the wrapped burial had consistent large high-resistivity anomalies. GPR 110- to 900-MHz frequency surveys showed that the wrapped burial could be detected throughout, but the naked burial was either not detectable or poorly resolved. 225-MHz frequency GPR data were optimal. Soil water analyses showed decreasing (years 4 to 5) to background (year 6) conductivity values. Results suggest both resistivity and GPR surveying if burial style unknown, with winter to spring surveys optimal and increasingly important as time increases.

  20. Long-term Geophysical Monitoring of Simulated Clandestine Graves using Electrical and Ground Penetrating Radar Methods: 4-6 Years After Burial.

    PubMed

    Pringle, Jamie K; Jervis, John R; Roberts, Daniel; Dick, Henry C; Wisniewski, Kristopher D; Cassidy, Nigel J; Cassella, John P

    2016-03-01

    This ongoing monitoring study provides forensic search teams with systematic geophysical data over simulated clandestine graves for comparison to active cases. Simulated "wrapped," "naked," and "control" burials were created. Multiple geophysical surveys were collected over 6 years, here showing data from 4 to 6 years after burial. Electrical resistivity (twin electrode and ERI), multifrequency GPR, grave and background soil water were collected. Resistivity surveys revealed that the naked burial had low-resistivity anomalies up to year four but then difficult to image, whereas the wrapped burial had consistent large high-resistivity anomalies. GPR 110- to 900-MHz frequency surveys showed that the wrapped burial could be detected throughout, but the naked burial was either not detectable or poorly resolved. 225-MHz frequency GPR data were optimal. Soil water analyses showed decreasing (years 4 to 5) to background (year 6) conductivity values. Results suggest both resistivity and GPR surveying if burial style unknown, with winter to spring surveys optimal and increasingly important as time increases. PMID:27404604

  1. Circulating T-cell subsets in Graves' disease: differences between patients with active disease and in remission after /sup 131/I-therapy

    SciTech Connect

    Canonica, G.W.; Bagnasco, M.; Ferrini, S.; Biassoni, P.; Giordano, G.; Corte, G.

    1983-08-01

    In the present investigation some surface markers in peripheral blood T lymphocytes of patients with active Graves' disease and subjects in remission after /sup 131/I-therapy have been studied. We confirmed low TG levels in untreated patients and normal values in treated subjects. Increased percentages of DR+, MLR4+ (activated T cells), and 5/9+ (inducer-helper) T cells were detected in patients with active disease, thus indicating the presence of activated T cells and suggesting increased levels of helper T cells. High percentages of MLR4+ and 5/9+, but normal levels of DR+ were found in /sup 131/I-treated subjects. The different distribution of DR and MLR4 positivities on 5/9+ and 5+9-T cells confirm the different meaning of these two markers of the activation state. The imbalance of T-cell subsets found in /sup 131/I-treated subjects and the normal values observed in patients with hyperthyroidism due to toxic adenoma indicate that hyperthyroidism per se is not sufficient to explain the T-cell alterations. The possible meaning of these findings is discussed with respect to previous hypotheses on the pathogenesis of Graves' disease.

  2. Sanguineous Pericardial Effusion and Cardiac Tamponade in the Setting of Graves' Disease: Report of a Case and Review of Previously Reported Cases

    PubMed Central

    2016-01-01

    Introduction. Pericardial effusion in the setting of hyperthyroidism is rare. We present a patient with Graves' disease who developed a sanguineous pericardial effusion and cardiac tamponade. Case Description. A 76-year-old man presenting with fatigue was diagnosed with Graves' disease and treated with methimazole. Two months later, he was hospitalized for uncontrolled atrial fibrillation. Electrocardiography showed diffuse low voltage and atrial fibrillation with rapid ventricular rate. Chest radiograph revealed an enlarged cardiac silhouette and left-sided pleural effusion. Thyroid stimulating hormone was undetectable, and free thyroxine was elevated. Diltiazem and heparin were started, and methimazole was increased. Transthoracic echocardiography revealed a large pericardial effusion with cardiac tamponade physiology. Pericardiocentesis obtained 1,050 mL of sanguineous fluid. The patient progressed to thyroid storm, treated with propylthiouracil, potassium iodine, hydrocortisone, and cholestyramine. Cultures and cytology of the pericardial fluid were negative. Thyroid hormone markers progressively normalized, and he improved clinically and was discharged. Discussion. We found 10 previously reported cases of pericardial effusions in the setting of hyperthyroidism. Heparin use may have contributed to the sanguineous nature of our patient's pericardial effusion, but other reported cases occurred without anticoagulation. Sanguineous and nonsanguineous pericardial effusions and cardiac tamponade may be due to hyperthyroidism. PMID:27446216

  3. Sanguineous Pericardial Effusion and Cardiac Tamponade in the Setting of Graves' Disease: Report of a Case and Review of Previously Reported Cases.

    PubMed

    Bui, Peter V; Zaveri, Sonia N; Pierce, J Rush

    2016-01-01

    Introduction. Pericardial effusion in the setting of hyperthyroidism is rare. We present a patient with Graves' disease who developed a sanguineous pericardial effusion and cardiac tamponade. Case Description. A 76-year-old man presenting with fatigue was diagnosed with Graves' disease and treated with methimazole. Two months later, he was hospitalized for uncontrolled atrial fibrillation. Electrocardiography showed diffuse low voltage and atrial fibrillation with rapid ventricular rate. Chest radiograph revealed an enlarged cardiac silhouette and left-sided pleural effusion. Thyroid stimulating hormone was undetectable, and free thyroxine was elevated. Diltiazem and heparin were started, and methimazole was increased. Transthoracic echocardiography revealed a large pericardial effusion with cardiac tamponade physiology. Pericardiocentesis obtained 1,050 mL of sanguineous fluid. The patient progressed to thyroid storm, treated with propylthiouracil, potassium iodine, hydrocortisone, and cholestyramine. Cultures and cytology of the pericardial fluid were negative. Thyroid hormone markers progressively normalized, and he improved clinically and was discharged. Discussion. We found 10 previously reported cases of pericardial effusions in the setting of hyperthyroidism. Heparin use may have contributed to the sanguineous nature of our patient's pericardial effusion, but other reported cases occurred without anticoagulation. Sanguineous and nonsanguineous pericardial effusions and cardiac tamponade may be due to hyperthyroidism. PMID:27446216

  4. The massacre mass grave of Schöneck-Kilianstädten reveals new insights into collective violence in Early Neolithic Central Europe.

    PubMed

    Meyer, Christian; Lohr, Christian; Gronenborn, Detlef; Alt, Kurt W

    2015-09-01

    Conflict and warfare are central but also disputed themes in discussions about the European Neolithic. Although a few recent population studies provide broad overviews, only a very limited number of currently known key sites provide precise insights into moments of extreme and mass violence and their impact on Neolithic societies. The massacre sites of Talheim, Germany, and Asparn/Schletz, Austria, have long been the focal points around which hypotheses concerning a final lethal crisis of the first Central European farmers of the Early Neolithic Linearbandkeramik Culture (LBK) have concentrated. With the recently examined LBK mass grave site of Schöneck-Kilianstädten, Germany, we present new conclusive and indisputable evidence for another massacre, adding new data to the discussion of LBK violence patterns. At least 26 individuals were violently killed by blunt force and arrow injuries before being deposited in a commingled mass grave. Although the absence and possible abduction of younger females has been suggested for other sites previously, a new violence-related pattern was identified here: the intentional and systematic breaking of lower limbs. The abundance of the identified perimortem fractures clearly indicates torture and/or mutilation of the victims. The new evidence presented here for unequivocal lethal violence on a large scale is put into perspective for the Early Neolithic of Central Europe and, in conjunction with previous results, indicates that massacres of entire communities were not isolated occurrences but rather were frequent features of the last phases of the LBK.

  5. The massacre mass grave of Schöneck-Kilianstädten reveals new insights into collective violence in Early Neolithic Central Europe

    PubMed Central

    Meyer, Christian; Lohr, Christian; Gronenborn, Detlef; Alt, Kurt W.

    2015-01-01

    Conflict and warfare are central but also disputed themes in discussions about the European Neolithic. Although a few recent population studies provide broad overviews, only a very limited number of currently known key sites provide precise insights into moments of extreme and mass violence and their impact on Neolithic societies. The massacre sites of Talheim, Germany, and Asparn/Schletz, Austria, have long been the focal points around which hypotheses concerning a final lethal crisis of the first Central European farmers of the Early Neolithic Linearbandkeramik Culture (LBK) have concentrated. With the recently examined LBK mass grave site of Schöneck-Kilianstädten, Germany, we present new conclusive and indisputable evidence for another massacre, adding new data to the discussion of LBK violence patterns. At least 26 individuals were violently killed by blunt force and arrow injuries before being deposited in a commingled mass grave. Although the absence and possible abduction of younger females has been suggested for other sites previously, a new violence-related pattern was identified here: the intentional and systematic breaking of lower limbs. The abundance of the identified perimortem fractures clearly indicates torture and/or mutilation of the victims. The new evidence presented here for unequivocal lethal violence on a large scale is put into perspective for the Early Neolithic of Central Europe and, in conjunction with previous results, indicates that massacres of entire communities were not isolated occurrences but rather were frequent features of the last phases of the LBK. PMID:26283359

  6. Assisting the diagnosis of Graves' hyperthyroidism with pattern recognition methods and a set of three routine tests parameters, and their correlations with free T4 levels: Extension to male patients.

    PubMed

    Aoki, Sorama; Hoshi, Kenji; Kawakami, Junko; Sato, Kenichi; Satoh, Ken; Mori, Kouki; Sugawara, Akira; Saito, Yoshihiko; Yoshida, Katsumi

    2011-03-01

    In our previous paper, we proposed a novel screening method that aids the diagnosis of female patients with Graves' hyperthyroidism via two types of neural networks and the use of routine test data. This method can be applied by non-specialists during physical checkups at a low cost and is expected to lead to rapid referrals for examination and treatment by thyroid specialists; i.e., to improve patients' QOL. In this report, we investigate whether the screening method is also applicable to males since sex differences exist in routine test data. The values of 14 routine test parameters for 78 subjects with definite diagnoses (31 patients with Graves' hyperthyroidism and 48 healthy volunteers) were adopted as training data, and 133 individuals who had also undergone the same routine tests at Tohoku University Hospital were screened for Graves' hyperthyroidism using our method. The present examination of our screening method in males showed its high screening ability with the set of parameters used (low serum creatinine, elevated alkaline phosphatase, and low total cholesterol). It was also found that there is strong multiple correlation between a set of three parameters and serum free thyroxine (FT4) in male patients with Graves' hyperthyroidism. A formula for FT4 consisting of three parameters was obtained, and this can be utilized in place of the true FT4 value. This result also supports the usefulness of our screening method.

  7. Choice of therapy in young adults with hyperthyroidism of Graves' disease. A brief, case-directed poll of fifty-four thyroidologists

    SciTech Connect

    Dunn, J.T.

    1984-06-01

    We asked 54 thyroidologists how they would treat each of four patients having moderate hyperthyroidism of Graves' disease and a thyroid gland weighing 70 g (three to four times normal). For a 19-year-old woman, 67% of thyroidologists recommended an initial course of therapy with antithyroid drugs, usually for 1 year; 24% favored radioiodine treatments; and 9%, surgery. Choices for treating a 19-year-old man were similar. For a 29-year-old man, 44% of thyroidologists preferred drug therapy; 50%, radioiodine; and 6%, surgery. For a 29-year-old woman, choices were similar to those for the 29-year-old man, except for a slight preference for drugs over radioiodine. If hyperthyroidism recurred after a first course of antithyroid drugs, the consultants favored radioiodine treatments and surgery about equally, except in the 29-year-old man, in whom radioiodine was preferred. This survey shows considerable variation among experts in treating hyperthyroidism in young adults.

  8. Unilateral symptomatic intracranial arterial stenosis and myopathy in an adolescent with Graves disease: a case report of an high-resolution magnetic resonance imaging study.

    PubMed

    Yin, Jia; Zhu, Jiajia; Huang, Dongling; Shi, Changzheng; Guan, Yuqing; Zhou, Liang; Pan, Suyue

    2015-01-01

    Vascular and muscular involvements in Graves disease (GD) are rare. Here, we report a case of a 17-year-old patient with unilateral symptomatic middle cerebral artery stenosis concurrent with GD and myopathy. He presented with a 1-day history of acute severe right-sided hemiparesis and aphasia and a 3-week history of high metabolic syndrome. The pathogenesis of the stenosis is most likely vasculitis rather than atherosclerosis, based on contrast-enhanced high-resolution magnetic resonance imaging showing concentric wall enhancement. We suggest that lipid storage myopathy is secondary to GD, and it is likely mitochondrial dysfunction or immune dysfunction induced by GD responsible for the myopathy and that magnetic resonance spectroscopy (MRS) is capable of establishing the diagnosis of myopathy. Thus, MRS can be used for follow-up evaluations of the myopathy along with the pathology biopsy.

  9. Location and assessment of an historic (150-160 years old) mass grave using geographic and ground penetrating radar investigation, NW Ireland.

    PubMed

    Ruffell, Alastair; McCabe, Alan; Donnelly, Colm; Sloan, Brian

    2009-03-01

    Reburial of human remains and concerns regarding pathogens and pollution prompted the search for, and assessment of, a 156-year-old graveyard. To locate this graveyard, historic and anecdotal information was compared to landscape interpretation from aerial photography. To assess and map the contents, surface collapses, metal detector indications, and ground-penetrating radar (GPR) were used. Some 170 anomalies compatible with burials were identified on 200 MHz GPR data, 84 of which coincided with surface collapses, suggesting both noncollapsed ground, subsequent infill, and multiple inhumations. The graveyard was possibly split into Roman Catholic plots with multiple inhumations; Protestant plots; and a kileen, or graveyard for the unbaptized (often children). The work serves as one approach to the location and mapping of recent and historic unmarked graves.

  10. Extensive scaling and nonuniformity of the Karhunen-Lo{grave e}ve decomposition for the spiral-defect chaos state

    SciTech Connect

    Zoldi, S.M.; Liu, J.; Liu, J.; Greenside, H.S.

    1998-12-01

    By analyzing large-aspect-ratio spiral-defect chaos (SDC) convection images, we show that the Karhunen-Lo{grave e}ve decomposition (KLD) scales extensively for subsystem sizes larger than 4d ({ital d} is the fluid depth), which strongly suggests that SDC is extensively chaotic. From this extensive scaling, the intensive length {xi}{sub KLD} is computed and found to have a different dependence on the Rayleigh number than the two-point correlation length {xi}{sub 2}. Local computations of {xi}{sub KLD} reveal a spatial nonuniformity of SDC images that extends over radii 18d{lt}r{lt}45d in a {Gamma}=109 aspect-ratio cell. {copyright} {ital 1998} {ital The American Physical Society}

  11. Increased TRAb and/or low anti-TPO titers at diagnosis of graves' disease are associated with an increased risk of developing ophthalmopathy after onset.

    PubMed

    Lantz, M; Planck, T; Asman, P; Hallengren, B

    2014-02-01

    Patients with low thyroid peroxidase antibodies (anti-TPO) and increased TSH-receptor antibodies (TRAb) at diagnosis of Graves' disease (GD) have been suggested to have an increased risk to develop Graves' ophthalmopathy (GO). The aim was to evaluate if GO development can be predicted.This is an observational study with registration of possible GD and GO risk factors.399 patients with GD were registered 2003-2008 in Malmö, Sweden and out of these 310 were retrospectively followed up to 6 years. The main outcome measures were anti-TPO titer, TRAb titer, smoking habits, radioiodine treatment and GO development.TRAb was assessed with a third generation assay at GD diagnosis in 231 patients. The proportion of patients with GO increased above the median 6.3 IU/L both at diagnosis of GD (p=0.001) and at follow-up (p=0.0001).The distribution of GO patients anti-TPO above or below 20 kIU/L at diagnosis of GD was similar between groups (p=0.239). However at follow-up anti-TPO<20 kIU/L was associated with an increased proportion of newly developed GO as compared to the cohort with anti-TPO>20 kIU/L (p=0.018).87% of patients who developed GO after GD diagnosis had TRAb above 6.3 IU/L and/or anti-TPO below 20 kIU/L. The proportion of GO was doubled in GD patients treated with radioiodine but could not explain the described findingsAnti-TPO<20 kIU/L and/or TRAb>6.3 IE/L at the time of GD diagnosis were associated with an increased risk to develop GO after diagnosis of GD.

  12. The late effect of subtotal thyroidectomy and radioactive iodine therapy on calcitonin secretion and bone mineral density in women treated for Graves' disease.

    PubMed

    Lowery, W D; Thomas, C G; Awbrey, B J; Rosenstein, B D; Talmage, R V

    1986-12-01

    This study was designed to evaluate the effect of subtotal thyroidectomy and/or radioactive iodine therapy on plasma immunocalcitonin (iCT) levels and bone densities in patients treated for Graves' disease. Forty-eight women whose ages ranged from 29 to 79 years (mean, 55 years) were evaluated. All were at least 10 years beyond treatment. Fourteen patients had undergone subtotal thyroidectomy, 22 had received radioactive iodine therapy, and 12 had received both. Serum calcitonin levels were measured with the patient fasting and at 30 minutes and 2 hours after the ingestion of 15 mg of calcium in orange juice. Single photon absorptiometry was used to measure bone mineral density of the middle and distal radius. The mean fasting plasma levels of iCT for patients undergoing subtotal thyroidectomy was 27 +/- 2 mumol/L; women treated with radioactive iodine, 26 +/- 2; women undergoing subtotal thyroidectomy followed by radioactive iodine, 24 +/- 2, and for normal control women, 48.5 +/- 4.7. The mean stimulated iCT level of each of the patient groups was significantly lower than that of the normal controls (p = 0.01). There were no significant differences among the groups. Although there was an increased loss of bone mineral density in postmenopausal patients, with age and race as covariates, the bone densities of the distal radius in women undergoing subtotal thyroidectomy and/or receiving radioactive iodine were not significantly lower than those of normal control subjects (p greater than 0.05). These findings are consistent with other observations that patients treated by thyroidectomy and/or radioactive iodine for Graves' disease have lower basal levels of calcitonin and decreased calcitonin response to a provocative stimulus. Whether this loss of calcitonin reserve is a significant factor in development of postmenopausal osteoporosis remains unanswered.

  13. A massacred village community? Agent-based modelling sheds new light on the demography of the Neolithic mass grave of Talheim.

    PubMed

    Duering, Andreas; Wahl, Joachim

    2014-01-01

    The virtual experiments presented below reveal the counterintuitive archaeological demography of the Neolithic mass grave of Talheim and underline the importance of distinguishing between the demographic structures of living and dead populations, as well as between attritional and catastrophic mortality patterns. We utilise a new agent-based modelling approach called Population & Cemetery Simulator based on the NetLogo programming language and the Behaviour Composer of the modelling4all project, which allows us to extrapolate from dead to living populations and vice versa. Contrary to received opinion, we argue that the population of the Neolithic mass grave holds specific demographic information only, as it represents a pure catastrophic mortality pattern, i.e. a living population at a single point in time rather than the population of a conventional cemetery. The first experiments illustrate why the published demographic data (e.g. mortality, life expectancy, mean age at death) is misleading. It is illogical to utilise mortality tables devised for conventional (attritional) cemeteries in the case of living populations. Modelled populations with the published mortality rates of the massacre site are, furthermore, unable to stand up to plausible human demographic circumstances. In the second part, we evaluate the actual demographic information content of the Talheim sample. Comparative modelling illustrates that the Talheim population appears to be similar to possible living populations based on the mortuary record of Schwetzingen, an isochronal site of the Linear Pottery Culture (LBK), and Bärenthal, a site which dates back to the early medieval period (7th to 10th centuries). It is therefore very likely that the Talheim population is a representative sample of a living population in the LBK and might even represent a massacred village community in its entirety. PMID:25774830

  14. Cutting edge: retrobulbar inflammation, adipogenesis, and acute orbital congestion in a preclinical female mouse model of Graves' orbitopathy induced by thyrotropin receptor plasmid-in vivo electroporation.

    PubMed

    Moshkelgosha, Sajad; So, Po-Wah; Deasy, Neil; Diaz-Cano, Salvador; Banga, J Paul

    2013-09-01

    Graves' orbitopathy (GO) is a complication in Graves' disease (GD) but mechanistic insights into pathogenesis remain unresolved, hampered by lack of animal model. The TSH receptor (TSHR) and perhaps IGF-1 receptor (IGF-1R) are considered relevant antigens. We show that genetic immunization of human TSHR (hTSHR) A-subunit plasmid leads to extensive remodeling of orbital tissue, recapitulating GO. Female BALB/c mice immunized with hTSHR A-subunit or control plasmids by in vivo muscle electroporation were evaluated for orbital remodeling by histopathology and magnetic resonance imaging (MRI). Antibodies to TSHR and IGF-1R were present in animals challenged with hTSHR A-subunit plasmid, with predominantly TSH blocking antibodies and were profoundly hypothyroid. Orbital pathology was characterized by interstitial inflammation of extraocular muscles with CD3+ T cells, F4/80+ macrophages, and mast cells, accompanied by glycosaminoglycan deposition with resultant separation of individual muscle fibers. Some animals showed heterogeneity in orbital pathology with 1) large infiltrate surrounding the optic nerve or 2) extensive adipogenesis with expansion of retrobulbar adipose tissue. A striking finding that underpins the new model were the in vivo MRI scans of mouse orbital region that provided clear and quantifiable evidence of orbital muscle hypertrophy with protrusion (proptosis) of the eye. Additionally, eyelid manifestations of chemosis, including dilated and congested orbital blood vessels, were visually apparent. Immunization with control plasmids failed to show any orbital pathology. Overall, these findings support TSHR as the pathogenic antigen in GO. Development of a new preclinical model will facilitate molecular investigations on GO and evaluation of new therapeutic interventions.

  15. A massacred village community? Agent-based modelling sheds new light on the demography of the Neolithic mass grave of Talheim.

    PubMed

    Duering, Andreas; Wahl, Joachim

    2014-01-01

    The virtual experiments presented below reveal the counterintuitive archaeological demography of the Neolithic mass grave of Talheim and underline the importance of distinguishing between the demographic structures of living and dead populations, as well as between attritional and catastrophic mortality patterns. We utilise a new agent-based modelling approach called Population & Cemetery Simulator based on the NetLogo programming language and the Behaviour Composer of the modelling4all project, which allows us to extrapolate from dead to living populations and vice versa. Contrary to received opinion, we argue that the population of the Neolithic mass grave holds specific demographic information only, as it represents a pure catastrophic mortality pattern, i.e. a living population at a single point in time rather than the population of a conventional cemetery. The first experiments illustrate why the published demographic data (e.g. mortality, life expectancy, mean age at death) is misleading. It is illogical to utilise mortality tables devised for conventional (attritional) cemeteries in the case of living populations. Modelled populations with the published mortality rates of the massacre site are, furthermore, unable to stand up to plausible human demographic circumstances. In the second part, we evaluate the actual demographic information content of the Talheim sample. Comparative modelling illustrates that the Talheim population appears to be similar to possible living populations based on the mortuary record of Schwetzingen, an isochronal site of the Linear Pottery Culture (LBK), and Bärenthal, a site which dates back to the early medieval period (7th to 10th centuries). It is therefore very likely that the Talheim population is a representative sample of a living population in the LBK and might even represent a massacred village community in its entirety.

  16. Late effect of subtotal thyroidectomy and radioactive iodine therapy on calcitonin secretion and bone mineral density in women treated for Graves' disease

    SciTech Connect

    Lowery, W.D.; Thomas, C.G. Jr.; Awbrey, B.J.; Rosenstein, B.D.; Talmage, R.V.

    1986-12-01

    This study was designed to evaluate the effect of subtotal thyroidectomy and/or radioactive iodine therapy on plasma immunocalcitonin (iCT) levels and bone densities in patients treated for Graves' disease. Forty-eight women whose ages ranged from 29 to 79 years (mean, 55 years) were evaluated. All were at least 10 years beyond treatment. Fourteen patients had undergone subtotal thyroidectomy, 22 had received radioactive iodine therapy, and 12 had received both. Serum calcitonin levels were measured with the patient fasting and at 30 minutes and 2 hours after the ingestion of 15 mg of calcium in orange juice. Single photon absorptiometry was used to measure bone mineral density of the middle and distal radius. The mean fasting plasma levels of iCT for patients undergoing subtotal thyroidectomy was 27 +/- 2 mumol/L; women treated with radioactive iodine, 26 +/- 2; women undergoing subtotal thyroidectomy followed by radioactive iodine, 24 +/- 2, and for normal control women, 48.5 +/- 4.7. The mean stimulated iCT level of each of the patient groups was significantly lower than that of the normal controls (p = 0.01). There were no significant differences among the groups. Although there was an increased loss of bone mineral density in postmenopausal patients, with age and race as covariates, the bone densities of the distal radius in women undergoing subtotal thyroidectomy and/or receiving radioactive iodine were not significantly lower than those of normal control subjects (p greater than 0.05). These findings are consistent with other observations that patients treated by thyroidectomy and/or radioactive iodine for Graves' disease have lower basal levels of calcitonin and decreased calcitonin response to a provocative stimulus. Whether this loss of calcitonin reserve is a significant factor in development of postmenopausal osteoporosis remains unanswered.

  17. [Clinical features of patients with influenza-like illness who went to a third level center in the winter of 2013-2014].

    PubMed

    Albarrán-Sánchez, Alejandra; Ramírez-Rentería, Claudia; Huerta-Montiel, Fernando; Martínez-Jerónimo, Angélica; Herrera-Landero, Alejandro; García-Álvarez, José Luis; Ortiz-Rodríguez, Elia; Palmas-Pineda, Lorena

    2016-01-01

    Introducción: el Centro para el Control y Prevención de Enfermedades (CDC, por sus siglas en inglés) registró, entre octubre de 2013 y abril de 2014, el pico más alto de casos relacionados con la influenza AH1N1. No todos los casos sospechosos de influenza resultan positivos, pero todos les generan costos a las instituciones. Nuestro objetivo fue describir las características de la población que acude con sospecha de influenza al Hospital de Especialidades del Centro Médico Nacional Siglo XXI durante una nueva epidemia. Métodos: estudio transversal de casos admitidos al servicio de Urgencias del hospital mencionado por sospecha de influenza de acuerdo con las guías de práctica clínica. Con base en estas se analizaron los factores asociados a la severidad de la infección. Resultados: se registraron 109 pacientes con promedio de 44 años edad; el 78 % de ellos tenía menos de 60 años; el 62 % fueron mujeres; 75 % tenía por lo menos un factor de riesgo como obesidad (26 %) o hipertensión (27 %). Solo 65 pacientes tuvieron prueba confirmatoria, 33.8 % fueron diagnóstico positivo y 21 % de ellos fallecieron. Conclusiones: la frecuencia de casos confirmados de influenza es baja. Los factores asociados a mortalidad en los casos confirmados son la presencia de hipertensión, de leucocitosis y la presentación clínica de insuficiencia respiratoria aguda grave (IRAG).

  18. Analyze of waves dynamic over an intertidal mudflat of a sandy-gravely estuarine beach - Field survey and preliminary modeling approach

    NASA Astrophysics Data System (ADS)

    Morio, Olivier; Sedrati, Mouncef; Goubert, Evelyne

    2014-05-01

    As well as marine submersion or erosive phenomena, clay-silted sediment in-filling on estuarial and bay beaches are a main issue in these human-attractive areas. Coupled sandy/gravely and clay/silty intertidal areas can be observed in these particular coastal areas, depending of rivers characteristic (discharge of particle, water flow), ocean dynamics (wave exposure, current) and sediments sources. All around the world, sandy/gravely beaches are exposed to punctual or continuous input clay sediments. Vilaine estuary, Bay of Arcachon and Bay of Seine in France, Plymouth Bay in UK and also Wadden Sea in Deutschland are few examples of muddy/sandy coupled or mixed system. The beach of Bétahon (Ambon town, Brittany - France) is located on the external Vilaine estuary and is an example of this issue. This meso-macrotidal intermediate (low tide terrace) beach presents heterogeneous sediments. The upper intertidal zone is composed by sand and gravel and characterized by a steep slope. A very gentle slope characterized the lower part of the beach and is constituted by silt and clay. Clay/sand limit is characterized by a decimetric erosion cliff of mudflat along the beach. In order to understand bed variations and sediment transport of this complex heterogeneous beach, a well understanding of wave dynamic across the beach is necessary. This study focus on wave dynamics over the beach, using field observations and MIKE 21 3D wave numerical model. This paper is a preliminary approach of an upcoming global understanding of this estuarial beach behavior. Swell from deep-sea to near-shore area is modeled over a 100 km² area and real wind, deep sea wave characteristic, river water flow and tidal level are defined as open boundary conditions for the regional model. This last one is based on multiple bathymetric surveys over the last 50 years. Local model, triangular mesh gridded to 5 meters, covering Bétahon beach , is based on topographic and photographic survey of the mudflat

  19. Recent trends in the management of Graves' hyperthyroidism in Japan: opinion survey results, especially on the combination therapy of antithyroid drug and thyroid hormone.

    PubMed

    Mori, T; Sugawa, H; Kosugi, S; Ueda, M; Hai, N; Matsuda, A

    1997-08-01

    An opinion survey concerning the management of Graves' hyperthyroidism was conducted among the council members of the Japan Thyroid Association. The selection of 3 major treatments by 90 respondents for their patients was 98.6 +/- 4.2% for antithyroid drug (ATD), 7.8 +/- 12.6% for partial thyroidectomy and 5.2 +/- 8.1% for radioiodide. They expressed a movement away from the past trend of surgery because of postoperative complications and unsatisfactory therapeutic results, and they assumed a further reduction in the future. On the other hand, the frequency of radioiodide treatment was not considered to have decreased greatly, and they expected a slight increase in the future. Of the respondents, 65% suggested that hyperthyroidism should be completely cured even if the patient would fall into hypothyroidism. The major reasons for choosing surgery or radioiodide after ATD were the adverse effects of ATD and the age and social backgrounds of the patients. Large goiter size was the 3rd reason for surgery but was a minimal indicator for radioiodide. As for ATD treatment, none of the respondents reported the routine application of any uniform fixed-time therapy protocol. Japanese Graves' patients were shown to be less responsive to ATD than Caucasian patients. This was assumed to result at least from high iodide intake, and half of them had ordered their patients to restrict iodide intake. Furthermore, 78% of them had treated with a combined therapy of ATD and thyroid hormone. Most of them apply this for selected patients mainly to lower TSH receptor antibody activity, to better control their patients and to reduce the goiter size. All but 8 (9%) did not give T4 (or T3) after the cessation of ATD, and they felt this to be unnecessary, doubtful about the effect, unsuitable or even possible to induce recurrence. The excellent findings reported by Hashizume et al. (N Engl J Med 324: 947-953, 1991) are well known among them. However, most of them did not agree with the

  20. Expression Profile of Human Fc Receptor-Like 1, 2, and 4 Molecules in Peripheral Blood Mononuclear Cells of Patients with Hashimoto's Thyroiditis and Graves' Disease.

    PubMed

    Rostamzadeh, D; Dabbaghmanesh, M H; Shabani, M; Hosseini, A; Amirghofran, Z

    2015-08-01

    Recently identified Fc receptor-like (FCRL) molecules are new members of the immunoglobulin superfamily dominantly expressed by B cells. Although FCRL expression patterns have been studied in normal and malignant cells, their biological functions and roles remain to be clearly identified in humans. Research has particularly focused on FCRL gene polymorphisms in autoimmune diseases, however, their involvement in the pathogenesis of autoimmune diseases is an interesting field for investigation. In the present study, we have investigated the gene expression profiles of FCRL1, 2, and 4 in 2 common thyroid diseases, Hashimoto's thyroiditis (HT) and Graves' disease (GD). FCRL1, 2, and 4 expressions were determined in peripheral blood samples of 55 HT patients, 40 GD patients and equal numbers of normal subjects by quantitative real-time PCR. Our results showed downregulation of FCRL1 and upregulation of FCRL2 transcripts in both HT and GD groups compared to healthy counterparts. Overexpression of FCRL4 was observed only in GD patients compared to controls. A significant correlation was observed between all FCRL gene expression levels in HT patients. Only FCRL2 and 4 had a correlation in GD patients. In addition, FCRL1, 2, and 4 gene expressions showed no correlations with the level of anti-thyroid peroxidase antibody (anti-TPO) or anti-thyroglobulin (anti-Tg) antibody from patients' sera. In conclusion, expressions of activating or inhibitory FCRL1, 2, and 4 showed significant alterations in HT and GD patients compared to healthy subjects. PMID:25738996

  1. The onset of antineutrophil cytoplasmic antibody-associated vasculitis immediately after methimazole was switched to propylthiouracil in a woman with Graves' disease who wished to become pregnant.

    PubMed

    Kimura, Moritsugu; Seki, Toshiro; Ozawa, Hideki; Ishihara, Toru; Komatsu, Masamichi; Tajiri, Sakurako; Yanagi, Hidetaka; Nishina, Makoto; Noh, Jaeduk Yoshimura; Fukagawa, Masafumi; Takagi, Atsushi

    2013-01-01

    Propylthiouracil (PTU) is recommended as a first-line antithyroid drug (ATD) during first trimester organogenesis in pregnancy because recent evidence suggests that methimazole (MMI) may be associated with congenital anomalies. However, PTU more commonly causes myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, which usually occurs during prolonged treatment, compared with MMI. We report a case of MPO-ANCA-associated vasculitis in a 35-year-old woman with Graves'disease. Although her thyroid function could be maintained euthyroid by MMI, her ATD was switched to PTU because she wished to become pregnant. The patient presented with flu-like symptoms 8 days after starting PTU and developed hemoptysis and dyspnea at 22 days. Her MPO-ANCA titer was 21 ELISA units (EUs) before PTU treatment but increased to 259 EUs at 22 days after PTU treatment. Her clinical condition improved with the discontinuation of PTU and with immunosuppressive therapy. This case indicated that MPO-ANCA vasculitis occurred within several weeks after the initiation of PTU and that this side effect could be caused by the change from MMI to PTU. Thus, our clinical observation suggests that patients treated with PTU should be carefully monitored for MPO-ANCA titers and variable manifestations of MPO-ANCA-associated vasculitis regardless of the period of administration.

  2. Predictive factors for early response to methimazole in children and adolescents with Graves disease: a single-institute study between 1993 and 2013

    PubMed Central

    Hwang, Sun Mi; Lee, Dae-Yeol

    2016-01-01

    Purpose We aimed to investigate the predictive factors for early response to methimazole (MMI) in pediatric patients with Graves disease (GD). Methods Our study included 44 pediatric patients who were diagnosed with GD between January 1, 1993, and December 31, 2013, and were available for follow-up, achieving a normalization of thyroid functions (TFs) at the Chonbuk National University Hospital Pediatric Department. We retrospectively analyzed TFs such as tri-iodothyronine (T3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), and thyroid antibody levels at diagnosis. We also examined their family history of thyroid disease, symptoms at presentation, and normalization time for TF after treatment. We divided our clinical series of patients into the following 4 age groups: <7 years old, 7–12 years old, 13–15 years old, and 16–18 years old. Results At diagnosis, the time of normalization of T3 was significantly shorter in the higher antimicrosomal antibody (AMA) group compared with the lower AMA group (2.53 months vs. 6.18 months) (P<0.05). However, the time of normalization of T3/fT4/TSH had no significant correlations with other variables such as age, sex, a family history of thyroid diseases, thyroglobulin, thyroid-stimulating immunoglobulin, or antithyroglobulin antibody (ATA). Conclusion Higher serological titers of AMA at diagnosis may have prognostic value in the response to initial MMI treatment in pediatric hyperthyroid GD patients. PMID:27462582

  3. A long-term follow-up of serum myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) in patients with Graves disease treated with propylthiouracil.

    PubMed

    Ishii, Reiko; Imaizumi, Misa; Ide, Akane; Sera, Nobuko; Ueki, Ikuko; Horie, Ichiro; Ando, Takao; Usa, Toshiro; Ejima, Eri; Ashizawa, Kiyoto; Eguchi, Katsumi

    2010-01-01

    Propylthiouracil (PTU) is known to induce myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) in patients with Graves disease (GD). Previously, we showed that serum MPO-ANCA were frequently seen in patients with GD treated with PTU. In this study, we analyzed 13 patients with positive MPO-ANCA examining a long-term clinical consequence of these patients as well as antibody titers during 5.6 +/- 3.0 years. PTU therapy was continued in 8 patients and discontinued in 5 patients. Antibody titers decreased in 7 of 8 patients who discontinued PTU therapy but remained positive in 5 patients 5 years after PTU withdrawal. The initial MPO-ANCA levels were significantly higher in those antibody titers remained positive for longer than 5 years (n=5) than in those titers turned to be negative within 5 years after PTU withdrawal (n=3) (203 +/- 256 EU and 22 +/- 2 EU, respectively, P=0.04), but there were no significant differences in age, gender, duration of PTU therapy or dosage of PTU. Among 5 patients who continued PTU therapy, 2 patients with initially low MPO-ANCA titers turned to having negative antibody. No patients had new symptoms or signs of vasculitis throughout the follow-up periods. The long-term follow-up study suggests that higher MPO-ANCA levels remain positive for years after PTU withdrawal but are rarely associated with vasculitis.

  4. Association of PTPN22 1858T/T genotype with type 1 diabetes, Graves' disease but not with rheumatoid arthritis in Russian population.

    PubMed

    Zhebrun, Daria; Kudryashova, Yulia; Babenko, Alina; Maslyansky, Alexei; Kunitskaya, Natalya; Popcova, Daria; Klushina, Alexandra; Grineva, Elena; Kostareva, Anna; Shlyakhto, Evgeny

    2011-04-01

    The protein tyrosine phosphatase nonreceptor 22 gene (PTPN22) is an important negative regulator of signal transduction through the T-cell receptors (TCR). Recently a single-nucleotide polymorphism (SNP) 1858 C/T within this gene was shown to be a risk factor for several autoimmune diseases, such as rheumatoid arthritis (RA), Graves' Disease (GD), systemic lupus erythematosus (SLE), Wegener's granulomatosis (WG) and type 1 diabetes mellitus (T1D). The aim of this study was to analyze a possible association between 1858 C/T SNP and a number of autoimmune diseases, including RA, GD and T1D in Russian population. Patients with T1D, GD, RA and healthy controls were genotyped for the 1858 C/T SNP in PTPN22 gene. We found a significant association between PTPN22 1858 C/T SNP and T1D and GD. 1858T/T genotype was observed more frequently in T1D and GD patients compared to control subjects. No such association was observed for RA. In concordance with a previous data establishing PTPN22 1858 C/T SNP association with several autoimmune diseases, our findings provide further evidence that the PTPN22 gene may play an important role in the susceptibility to some autoimmune diseases. PMID:21467606

  5. A partial melting study of an ordinary (H) chondrite composition with application to the unique achondrite Graves Nunataks 06128 and 06129

    NASA Astrophysics Data System (ADS)

    Usui, Tomohiro; Jones, John H.; Mittlefehldt, David W.

    2015-04-01

    Melting experiments of a synthesized, alkali-bearing, H-chondrite composition were conducted at ambient pressure with three distinct oxygen fugacity conditions (IW-1, IW, and IW+2). Oxygen fugacity conditions significantly influence the compositions of partial melts. Partial melts at IW-1 are distinctly enriched in SiO2 relative to those of IW and IW+2 melts. The silica-enriched, reduced (IW-1) melts are characterized by high alkali contents and have silica-oversaturated compositions. In contrast, the silica-depleted, oxidized (≥IW) melts, which are also enriched in alkali contents, have distinctly silica-undersaturated compositions. These experimental results suggest that alkali-rich, felsic, asteroidal crusts as represented by paired achondrites Graves Nunataks 06128 and 06129 should originate from a low-degree, relatively reduced partial melt from a parent body having near-chondritic compositions. Based on recent chronological constraints and numerical considerations as well as our experimental results, we propose that such felsic magmatism should have occurred in a parent body that is smaller in size and commenced accreting later than those highly differentiated asteroids having basaltic crusts and metallic cores.

  6. Fistule artério-urétérale après une pelvectomie antérieure : Complication rare et grave

    PubMed Central

    Zine el abidine, Mohamed Hosni; Hmida, Wissem; Slama, Adel; Hidoussi, Adnene; Jaidane, Mehdi; Ben Sorba, Nabil; Mosbah, Ali Fawzi

    2012-01-01

    Résumé La fistule artério-urétérale (FAU), qui survient immédiatement après une cystectomie, est une complication exceptionnelle et grave. De nos jours, seulement quelques cas sporadiques ont été signalés dans la littérature. Elle se manifeste presque exclusivement par une hématurie brutale, massive et intermittente pouvant être à l’origine d’une instabilité hémodynamique menaçant le pronostic vital du patient à court terme. Son diagnostic doit être fait sans retard. Les explorations radiologiques restent peu spécifiques et peu sensibles et se basent essentiellement sur l’artériographie. Le traitement est non codifié selon l’état général du patient et surtout de la nature de la fistule. Nous décrivons un cas de FAU faisant suite à une pelvectomie antérieure et nous discuterons à l’aide d’une revue de la littérature les aspects diagnostiques, thérapeutiques et pronostiques de cette complication. PMID:23283100

  7. Graves'-Basedow disease in pregnancy. New trends in the management and guidance to reduce the risk of birth defects caused by antithyroid drugs.

    PubMed

    Laurberg, Peter; Andersen, S L

    2015-01-01

    Thyroid hormones are essential development factors and maternal thyroid dysfunction may cause pregnancy complications and diseases in the fetus/child. In the present review we discuss new data on the incidence of Graves'-Basedow disease (GBD) in and around pregnancy, and how hyperthyroidism may affect the risk of spontaneous abortion and stillbirth. A special concern in pregnant women is the potential side effects from the use of antithyroid drugs (ATDs). One type of side effects is the allergic/toxic reactions to the drugs, which seem to be similar in and outside pregnancy, and another is that ATDs tend to over treat the fetus when the mother with GBD is made euthyroid. To avoid fetal hypothyroidism, the lowest possible ATD dose should be used to keep maternal thyroid function at the upper limit of normality with low serum TSH. Birth defects after the use of methimazole (MMI) (or its prodrug carbimazole) have been considered to be very rare, and no risk has previously been associated with the use of propylthiouracil (PTU). However, a recent Danish national study found that 1/30 of children exposed to MMI in early pregnancy had birth defects associated with this, and many defects were severe. PTU exposure was associated with defects in 1/40, and these defects were less severe. Proposals are given on how to reduce the risk of ATD associated birth defects.

  8. A novel hypothesis for the etiology of Graves' disease: TSAb may be thyroid stimulating animal IgG-like hormone and TBAb may be the precursor of TSAb.

    PubMed

    Ochi, Yukio; Kajita, Yoshihiro; Hachiya, Takashi; Hamaoki, Masaru

    2012-06-01

    There are doubtful points about the theory that autoimmunity with auto-antibody (Ab) to TSH receptor (R) causes hyperthyroidism in Graves' disease (GD). A main doubtful point is no curative effect of corticosteroid on Graves' hyperthyroidism in spite of curative effect of corticosteroid for all autoimmune diseases. Recently we demonstrated the immunological similarity of TSAb and TBAb-IgG to animal IgGs, except for human (h)IgG, by neutralization and purification of TSAb and TBAb-IgG using (1) heterophilic Ab to animal IgG in GD sera and (2) experimentally generated anti-animal IgG Abs [such as dog (d), bovine (b), porcine (p), and rabbit (rb)]. Furthermore, greater immunological similarity of Fab- and F(ab')(2)-portion of TSAb- and TBAb-IgG to bovine Fab, compared to hFab, was demonstrated using goat anti-bovine F(ab')(2) Ab. Existence of b and p TSH-like portions in the LATS-IgG molecule (probably Fab portion) was suggested by a previous report of neutralization of LATS activity by anti-b- or anti-p-TSH Ab. We suggested the existence of a mammalian animal-TSH-like structure, excepting hTSH, in the TSAb-IgG molecule (probably Fab portion), by discovery of anti-mammalian TSH Ab (such as d, b, p, guinea-pig, rat, whale, except h) in sera of GD. Lately, similar TSHR binding of H- and L-chain of human stimulating monoclonal TSHR Ab (M22)-Fab with TSH-α and-β subunit was reported. This evidence suggests that Fab portion of TSAb has a structure like mammalian TSH, but not hTSH. IgG-λ type of d, horse, b, p, goat, ovine is 95% and IgG-κ type is 5%, while human κ and λ chain is 60:40. Previous report that LATS (TSAb)-IgG composed of predominant λ type is supporting evidence that TRAb-IgG has immunological similarity with these animal IgGs compared to hIgG. We speculate that TSAb-IgG may be referred as a mermaid consisted in face (Fab) and trunk-leg (Fc). Face may be a kind of hormone with animal TSH-like structure and trunk-leg has animal IgG-like structure (in

  9. A novel hypothesis for the etiology of Graves' disease: TSAb may be thyroid stimulating animal IgG-like hormone and TBAb may be the precursor of TSAb.

    PubMed

    Ochi, Yukio; Kajita, Yoshihiro; Hachiya, Takashi; Hamaoki, Masaru

    2012-06-01

    There are doubtful points about the theory that autoimmunity with auto-antibody (Ab) to TSH receptor (R) causes hyperthyroidism in Graves' disease (GD). A main doubtful point is no curative effect of corticosteroid on Graves' hyperthyroidism in spite of curative effect of corticosteroid for all autoimmune diseases. Recently we demonstrated the immunological similarity of TSAb and TBAb-IgG to animal IgGs, except for human (h)IgG, by neutralization and purification of TSAb and TBAb-IgG using (1) heterophilic Ab to animal IgG in GD sera and (2) experimentally generated anti-animal IgG Abs [such as dog (d), bovine (b), porcine (p), and rabbit (rb)]. Furthermore, greater immunological similarity of Fab- and F(ab')(2)-portion of TSAb- and TBAb-IgG to bovine Fab, compared to hFab, was demonstrated using goat anti-bovine F(ab')(2) Ab. Existence of b and p TSH-like portions in the LATS-IgG molecule (probably Fab portion) was suggested by a previous report of neutralization of LATS activity by anti-b- or anti-p-TSH Ab. We suggested the existence of a mammalian animal-TSH-like structure, excepting hTSH, in the TSAb-IgG molecule (probably Fab portion), by discovery of anti-mammalian TSH Ab (such as d, b, p, guinea-pig, rat, whale, except h) in sera of GD. Lately, similar TSHR binding of H- and L-chain of human stimulating monoclonal TSHR Ab (M22)-Fab with TSH-α and-β subunit was reported. This evidence suggests that Fab portion of TSAb has a structure like mammalian TSH, but not hTSH. IgG-λ type of d, horse, b, p, goat, ovine is 95% and IgG-κ type is 5%, while human κ and λ chain is 60:40. Previous report that LATS (TSAb)-IgG composed of predominant λ type is supporting evidence that TRAb-IgG has immunological similarity with these animal IgGs compared to hIgG. We speculate that TSAb-IgG may be referred as a mermaid consisted in face (Fab) and trunk-leg (Fc). Face may be a kind of hormone with animal TSH-like structure and trunk-leg has animal IgG-like structure (in

  10. Inhibitory Effects of α-Lipoic Acid on Oxidative Stress-Induced Adipogenesis in Orbital Fibroblasts From Patients With Graves Ophthalmopathy.

    PubMed

    Hwang, Sena; Byun, Jung Woo; Yoon, Jin Sook; Lee, Eun Jig

    2016-01-01

    A choice of the optimal treatment for Graves ophthalmopathy (GO) is a challenge due to the complexity of the pathogenesis. Alpha-lipoic acid (ALA) is well known as a multifunctional antioxidant, helping to protect cells against oxidative stress and inflammatory damage.The aim of this study was to investigate the effects of ALA on intracellular production of reactive oxygen species (ROS), inflammation, and adipogenesis using primary cultured orbital fibroblasts from patients with GO.Intracellular ROS levels and mRNA expressions of proinflammatory cytokines and chemokines including intercellular adhesion molecule-1 (ICAM-1), interleukin (IL)-6, monocyte chemoattractant protein (MCP)-1, and regulated upon activation normal T cell expressed and presumably secreted (RANTES) were measured. After adipogenesis, the expressions of peroxisome proliferator-activated receptor (PPAR)γ, CCAAT-enhancer-binding proteins (C/EBP)α and β, and heme oxygenase-1 (HO-1) were investigated.H2O2 dose-dependently stimulated ROS production and HO-1 expression. Addition of ALA strongly attenuated ROS production and further increased HO-1 expression. However, by pretreatment of zinc protoporphyrin (ZnPP), HO-1 inhibitor, ALA inhibition of ROS generation by H2O2 was abolished. Tumor necrosis factor (TNF)α-induced mRNA expressions of ICAM-1, IL-6, MCP-1, and RANTES were inhibited by ALA treatment. In this context, TNFα-induced phosphorylation of P65 was also inhibited. In addition, ALA dose-dependently inhibited H2O2-induced intracellular accumulation of lipid droplets. The expression of adipogenic transcription factors, including PPARγ, C/EBPα, and β, was also inhibited.ALA is a potential therapeutic agent for GO because of the inhibitory effects on ROS production and gene expression of proinflammatory cytokines and chemokines, resulting in prevention of adipose-tissue expansion. PMID:26765462

  11. A pilot study evaluating 99mTc-anti-TNF-alpha scintigraphy in graves' ophtalmopathy patients with different clinical activity score.

    PubMed

    Rebelo Pinto, E dos S; Lopes, F P P L; de Souza, S A L; da Fonseca, L M B; Vaisman, M; Gutfilen, B; dos Santos Teixeira, P de F

    2013-09-01

    The present study describes the preliminary results of the use of 99mTc-anti-TNF-α scintigraphy as a new diagnostic approach to evaluate patients presenting with Graves' ophthalmopathy (GO). Patients (n=25) presenting at different inflammatory stages of GO and 10 healthy volunteers underwent 99mTc-anti-TNF-α scintigraphy. Images were obtained 15 min after the intravenous injection of 370 MBq (10 mCi) 99mTc-anti-TNF-α. Planar images were obtained in a 256×256 matrix (each lasting 5 min) and single photon emission computed tomography (SPECT) scan lasting 13 min. Regions of interest (ROI) were drawn on the orbit and cerebral hemispheres. The uptake of 99m Tc-anti-TNF-α in these regions was compared and positive scintigraphy established when the ROI was >2.5. In addition, uptake for each positive exam was scored as either slight (2.6-5.1), moderate (5.2-7.6), or high (>7.6). In this pilot study, 69 orbits were evaluated (1 patient had only 1 eye), and 27 had a positive CAS (≥3/7). Scintigraphies were positive in 38 orbits. Comparing the results of the exams with CAS, a high sensitivity and negative predictive values were determined for scintigraphy (96.3% and 96.7%, respectively). However, the specificity and the positive predictive values were 71.4% and 68.4%, respectively, with an accuracy of 81.2%. The exclusion of examinations that were slightly positive from the analysis resulted in an improvement in test accuracy (95.5%). The preliminary results suggest that 99mTc-anti-TNF-α scintigraphy is a promising procedure for the evaluation of active orbital inflammation in GO. PMID:23918686

  12. Opaque assemblages in CR2 Graves Nunataks (GRA) 06100 as indicators of shock-driven hydrothermal alteration in the CR chondrite parent body

    NASA Astrophysics Data System (ADS)

    Abreu, Neyda M.; Bullock, Emma S.

    2013-12-01

    We have studied the petrologic characteristics of sulfide-metal lodes, polymineralic Fe-Ni nodules, and opaque assemblages in the CR2 chondrite Graves Nunataks (GRA) 06100, one of the most altered CR chondrites. Unlike low petrologic type CR chondrites, alteration of metal appears to have played a central role in the formation of secondary minerals in GRA 06100. Differences in the mineralogy and chemical compositions of materials in GRA 06100 suggest that it experienced higher temperatures than other CR2 chondrites. Mineralogic features indicative of high temperature include: (1) exsolution of Ni-poor and Ni-rich metal from nebular kamacite; (2) formation of sulfides, oxides, and phosphates; (3) changes in the Co/Ni ratios; and (4) carbidization of Fe-Ni metal. The conspicuous absence of pentlandite may indicate that peak temperatures exceeded 600 °C. Opaques appear to have been affected by the action of aqueous fluids that resulted in the formation of abundant oxides, Fe-rich carbonates, including endmember ankerite, and the sulfide-silicate-phosphate scorzalite. We suggest that these materials formed via impact-driven metamorphism. Mineralogic features indicative of impact metamorphism include (1) the presence of sulfide-metal lodes; (2) the abundance of polymineralic opaque assemblages with mosaic-like textures; and (3) the presence of suessite. Initial shock metamorphism probably resulted in replacement of nebular Fe-Ni metal in chondrules and in matrix by Ni-rich, Co-rich Fe metal, Al-Ti-Cr-rich alloys, and Fe sulfides, while subsequent hydrothermal alteration produced accessory oxides, phosphates, and Fe carbonates. An extensive network of sulfide-metal veins permitted effective exchange of siderophile elements from pre-existing metal nodules with adjacent chondrules and matrix, resulting in unusually high Fe contents in these objects.

  13. Peroxisome proliferator-activated receptor {alpha} agonists modulate Th1 and Th2 chemokine secretion in normal thyrocytes and Graves' disease

    SciTech Connect

    Antonelli, Alessandro; Ferrari, Silvia Martina; Frascerra, Silvia; Corrado, Alda; Pupilli, Cinzia; Bernini, Giampaolo; Benvenga, Salvatore; Ferrannini, Ele; Fallahi, Poupak

    2011-07-01

    Until now, no data are present about the effect of peroxisome proliferator-activated receptor (PPAR){alpha} activation on the prototype Th1 [chemokine (C-X-C motif) ligand (CXCL)10] (CXCL10) and Th2 [chemokine (C-C motif) ligand 2] (CCL2) chemokines secretion in thyroid cells. The role of PPAR{alpha} and PPAR{gamma} activation on CXCL10 and CCL2 secretion was tested in Graves' disease (GD) and control primary thyrocytes stimulated with interferon (IFN){gamma} and tumor necrosis factor (TNF){alpha}. IFN{gamma} stimulated both CXCL10 and CCL2 secretion in primary GD and control thyrocytes. TNF{alpha} alone stimulated CCL2 secretion, while had no effect on CXCL10. The combination of IFN{gamma} and TNF{alpha} had a synergistic effect both on CXCL10 and CCL2 chemokines in GD thyrocytes at levels comparable to those of controls. PPAR{alpha} activators inhibited the secretion of both chemokines (stimulated with IFN{gamma} and TNF{alpha}) at a level higher (for CXCL10, about 60-72%) than PPAR{gamma} agonists (about 25-35%), which were confirmed to inhibit CXCL10, but not CCL2. Our data show that CCL2 is modulated by IFN{gamma} and TNF{alpha} in GD and normal thyrocytes. Furthermore we first show that PPAR{alpha} activators inhibit the secretion of CXCL10 and CCL2 in thyrocytes, suggesting that PPAR{alpha} may be involved in the modulation of the immune response in the thyroid.

  14. A study of the efficacy of radioiodine therapy with individualized dosimetry in Graves' disease: need to retarget the radiation committed dose to the thyroid.

    PubMed

    Schiavo, M; Bagnara, M C; Calamia, I; Bossert, I; Ceresola, E; Massaro, F; Giusti, M; Pilot, A; Pesce, G; Caputo, M; Bagnasco, M

    2011-03-01

    Although Iodine-131 (131I) therapy is fully validated for Graves' disease (GD), there is debate about radioiodine amount to be administered (prescribed activity), as well as the use of individualized dosimetry vs fixed 131I activity. The clinical outcome of 119 GD patients treated with 131I from 2003 to 2008 has been evaluated. The prescribed activity was calculated according to a dosimetric protocol taking into account several variables, including thyroid volume reduction during treatment. In addition, we performed a simulation according to other dosimetric protocols, by calculating the corresponding prescribed activities. The patients were followed up for at least 12 months after treatment. In the first period of observation (2003), a 120-200 Gray (Gy) radiation dose to the thyroid was prescribed, according to the guidelines published by the Italian Societies of Endocrinology, Nuclear Medicine and Medical Physics: hyperthyroidism cure with a single radioiodine administration was obtained in 53% of patients. This outcome raised up to 89% when a higher radiation dose to the target (200- 250 Gy) was prescribed, although the administered activities were still lower, as a rule, than the most commonly employed fixed activities (400-600 Mega-Becquerel--MBq). Our method showed a high level of individual dose optimisation, particularly when compared to simplified methods. In conclusion, the protocol adopted in this study ensures a satisfactory rate of hyperthyroidism cure, while administering quite low 131I activities, provided that an adequate committed radiation dose to the thyroid is prescribed. In this context, the dose indication given by the aforementioned guidelines should probably be revised.

  15. Accuracy of two simple methods for estimation of thyroidal {sup 131}I kinetics for dosimetry-based treatment of Graves' disease

    SciTech Connect

    Traino, A. C.; Xhafa, B.

    2009-04-15

    One of the major challenges to the more widespread use of individualized, dosimetry-based radioiodine treatment of Graves' disease is the development of a reasonably fast, simple, and cost-effective method to measure thyroidal {sup 131}I kinetics in patients. Even though the fixed activity administration method does not optimize the therapy, giving often too high or too low a dose to the gland, it provides effective treatment for almost 80% of patients without consuming excessive time and resources. In this article two simple methods for the evaluation of the kinetics of {sup 131}I in the thyroid gland are presented and discussed. The first is based on two measurements 4 and 24 h after a diagnostic {sup 131}I administration and the second on one measurement 4 h after such an administration and a linear correlation between this measurement and the maximum uptake in the thyroid. The thyroid absorbed dose calculated by each of the two methods is compared to that calculated by a more complete {sup 131}I kinetics evaluation, based on seven thyroid uptake measurements for 35 patients at various times after the therapy administration. There are differences in the thyroid absorbed doses between those derived by each of the two simpler methods and the ''reference'' value (derived by more complete uptake measurements following the therapeutic {sup 131}I administration), with 20% median and 40% 90-percentile differences for the first method (i.e., based on two thyroid uptake measurements at 4 and 24 h after {sup 131}I administration) and 25% median and 45% 90-percentile differences for the second method (i.e., based on one measurement at 4 h post-administration). Predictably, although relatively fast and convenient, neither of these simpler methods appears to be as accurate as thyroid dose estimates based on more complete kinetic data.

  16. Evaluation de la fonction hépatique au cours du paludisme grave chez les enfants de moins de cinq ans à Kinshasa en République Démocratique du Congo

    PubMed Central

    Kabamba, Arsène Tshikongo; Mukuku, Olivier; Shamashanga, Laurent Kwete; Kamunga, Daniel Badibanga; Bokanya, Alex Impele; Lukumwena, Zet Kalala; Longanga, Albert Otshudi

    2014-01-01

    Introduction Le paludisme est toujours compté parmi les problèmes de santé publique prioritaires en République Démocratique du Congo suite au nombre de malades et de décès qu'il provoque. Cette étude évalue l'atteinte de la fonction hépatique au cours du paludisme grave chez les enfants de moins de 5 ans. Méthodes Il s'agit d'une étude cas-témoins menée de janvier à juin 2013 à Kinshasa (République Démocratique du Congo) où le dosage des bilirubines totale, directe et indirecte et la mesure de l'activité enzymatique de la Glutamate Pyruvate Transaminase (GPT), de la Glutamate Oxaloacétate Transaminase (GOT) et du taux d'hémoglobine ont été faits chez 46 enfants âgés de moins de 5 ans atteints de paludisme grave (groupe I) et chez 46 autres considérés sains avec une goutte négative (groupe II). Les résultats obtenus ont été comparés dans les deux groupes et le seuil de signification a été fixé à p <0,05. Résultats Les analyses statistiques relèvent que les valeurs sont considérablement élevées en ce qui concerne les deux transaminases (GOT et GPT), la bilirubine directe, la bilirubine indirecte et la bilirubine totale chez les enfants atteints du paludisme grave. Ces analyses montrent une différence significative en défaveur de ces derniers (p < 0,001). Conclusion En effet, cette augmentation des taux plasmatiques des paramètres biologiques analysés observée chez les enfants gravement impaludés traduit ainsi une altération de la fonction hépatique au cours d'un paludisme grave chez l'enfant de moins de cinq ans. PMID:25870721

  17. A novel and major association of HLA-C in Graves' disease that eclipses the classical HLA-DRB1 effect.

    PubMed

    Simmonds, Matthew J; Howson, Joanna M M; Heward, Joanne M; Carr-Smith, Jackie; Franklyn, Jayne A; Todd, John A; Gough, Stephen C L

    2007-09-15

    Association of the major histocompatibility complex (MHC) class II-encoded HLA-DRB1-DQA1-DQB1 haplotype with Graves' disease (GD) has been known for several years. Recent evidence from other autoimmune diseases has suggested that the HLA class I encoded HLA-B/-C molecules could be conferring HLA-DRB1-DQA1-DQB1 independent effects on disease. The aim of this study was to determine the effect of HLA-B and HLA-C in GD in a white ethnic group of 806 patients with GD and 487 control subjects from the UK. Of the five loci (HLA-B, -C, -DRB1, -DQA1, -DQB1), HLA-C demonstrated the strongest association (P = 1.20 x 10(-20)) with HLA-C*07 predisposing [OR = 1.63, 95% CI (1.23-2.17)] and both HLA-C*03 [OR = 0.54, 95% CI (0.38-0.77)], HLA-C*16 [OR = 0.36, 95% CI (0.21-0.61)] protective. The other loci were then tested for HLA-C-independent associations. HLA-B was found to be associated independently of HLA-C (P = 1.54 x 10(-6)) with the other three loci, HLA-DRB1, HLA-DQB1 and HLA-DQA1, also improving the model but with less confidence (P > 10(-5)). This study has for the first time provided evidence of a primary association of HLA-C, and to a lesser extent HLA-B, with GD. Class II loci could still have effects on GD, but they appear smaller than the HLA-C association. A full investigation of the MHC region, including all class I and II loci is now required. Our results point to a primary role for class I-mediated responses in GD, a condition classically assumed to be a straightforward HLA-class II-restricted autoantibody response to the thyroid stimulating hormone receptor. PMID:17597093

  18. A novel and major association of HLA-C in Graves' disease that eclipses the classical HLA-DRB1 effect.

    PubMed

    Simmonds, Matthew J; Howson, Joanna M M; Heward, Joanne M; Carr-Smith, Jackie; Franklyn, Jayne A; Todd, John A; Gough, Stephen C L

    2007-09-15

    Association of the major histocompatibility complex (MHC) class II-encoded HLA-DRB1-DQA1-DQB1 haplotype with Graves' disease (GD) has been known for several years. Recent evidence from other autoimmune diseases has suggested that the HLA class I encoded HLA-B/-C molecules could be conferring HLA-DRB1-DQA1-DQB1 independent effects on disease. The aim of this study was to determine the effect of HLA-B and HLA-C in GD in a white ethnic group of 806 patients with GD and 487 control subjects from the UK. Of the five loci (HLA-B, -C, -DRB1, -DQA1, -DQB1), HLA-C demonstrated the strongest association (P = 1.20 x 10(-20)) with HLA-C*07 predisposing [OR = 1.63, 95% CI (1.23-2.17)] and both HLA-C*03 [OR = 0.54, 95% CI (0.38-0.77)], HLA-C*16 [OR = 0.36, 95% CI (0.21-0.61)] protective. The other loci were then tested for HLA-C-independent associations. HLA-B was found to be associated independently of HLA-C (P = 1.54 x 10(-6)) with the other three loci, HLA-DRB1, HLA-DQB1 and HLA-DQA1, also improving the model but with less confidence (P > 10(-5)). This study has for the first time provided evidence of a primary association of HLA-C, and to a lesser extent HLA-B, with GD. Class II loci could still have effects on GD, but they appear smaller than the HLA-C association. A full investigation of the MHC region, including all class I and II loci is now required. Our results point to a primary role for class I-mediated responses in GD, a condition classically assumed to be a straightforward HLA-class II-restricted autoantibody response to the thyroid stimulating hormone receptor.

  19. Batteries, from Cradle to Grave

    ERIC Educational Resources Information Center

    Smith, Michael J.; Gray, Fiona M.

    2010-01-01

    As battery producers and vendors, legislators, and the consumer population become aware of the consequences of inappropriate disposal of batteries to landfill sites instead of responsible chemical neutralization and reuse, the topic of battery recycling has begun to appear on the environmental agenda. In the United Kingdom, estimates of annual…

  20. Genetics Home Reference: Graves disease

    MedlinePlus

    ... genes are part of a family called the human leukocyte antigen (HLA) complex . The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders ( ...

  1. Chemicals from Cradle to Grave

    ERIC Educational Resources Information Center

    Science Scope, 2005

    2005-01-01

    About two years ago, an urban school district had planned for the disposal of some hazardous chemicals. It contracted with a chemical recycling company that was considered to be reputable. The school district, along with several other companies, was charged and fined by the Environmental Protection Agency for improperly releasing hazardous…

  2. Cloning and characterization of the novel thyroid and eye muscle shared protein G2s: autoantibodies against G2s are closely associated with ophthalmopathy in patients with Graves' hyperthyroidism.

    PubMed

    Gunji, K; De Bellis, A; Li, A W; Yamada, M; Kubota, S; Ackrell, B; Wengrowicz, S; Bellastella, A; Bizzarro, A; Sinisi, A; Wall, J R

    2000-04-01

    Serum autoantibodies against eye muscle antigens are closely linked with thyroid-associated ophthalmopathy (TAO), although their significance is unclear. The two antigens that are most often recognized are eye muscle membrane proteins with molecular masses of 55 and 64 kDa, as determined from immunoblotting with crude human or porcine eye muscle membranes. We cloned a fragment of the 55-kDa protein by screening an eye muscle expression library with affinity-purified anti-55 kDa protein antibody prepared from a TAO patient's serum. A complementary DNA (cDNA) encoding a novel protein, which we have called G2s, was sequenced on both strands, and its size was 411 bp. The open reading frame of G2s corresponded to a 121-amino acid peptide with a size of 1.4 kb. Using the rapid amplification of 5'-cDNA ends technique we were able to clone an additional 0.3 kb of the protein. G2s did not share significant homologies with any other entered protein in computer databases and had one putative transmembrane domain. Using the 1.4 kb cDNA as probe in Northern blotting of a panel of messenger ribonucleic acids prepared from human tissues, the parent protein was shown to correspond to a large molecule of about 5.8 kb with a calculated molecular mass of approximately 220 kDa, consistent with earlier immunoblot studies performed in the absence of reducing agents. G2s was strongly expressed in eye muscle, thyroid, and other skeletal muscle and to a lesser extent in pancreas, liver, lung, and heart muscle, but not in kidney or orbital fibroblasts. We tested sera from patients with Graves' hyperthyroidism with and without ophthalmopathy and from control patients and subjects for antibodies against a G2s fusion protein by immunoblotting and enzyme-linked immunosorbent assay. In immunoblotting, antibodies reactive with G2s were identified in 70% of patients with TAO of less than 3 yr duration, 53% with TAO of more than 3 yr duration, 36% with Graves' hyperthyroidism without evident

  3. Origin of felsic achondrites Graves Nunataks 06128 and 06129, and ultramafic brachinites and brachinite-like achondrites by partial melting of volatile-rich primitive parent bodies

    NASA Astrophysics Data System (ADS)

    Day, James M. D.; Walker, Richard J.; Ash, Richard D.; Liu, Yang; Rumble, Douglas; Irving, Anthony J.; Goodrich, Cyrena A.; Tait, Kimberly; McDonough, William F.; Taylor, Lawrence A.

    2012-03-01

    New major- and trace-element abundances, highly siderophile element (HSE: Os, Ir, Ru, Pt, Pd, Re) abundances, and oxygen and rhenium-osmium isotope data are reported for oligoclase-rich meteorites Graves Nunataks 06128 and 06129 (GRA 06128/9), six brachinites (Brachina; Elephant Morraine 99402/7; Northwest Africa (NWA) 1500; NWA 3151; NWA 4872; NWA 4882) and three olivine-rich achondrites, which are referred to here as brachinite-like achondrites (NWA 5400; NWA 6077; Zag (b)). GRA 06128/9 represent examples of felsic and highly-sodic melt products from an asteroid that may provide a differentiation complement to brachinites and/or brachinite-like achondrites. The new data, together with our petrological observations, are consistent with derivation of GRA 06128/9, brachinites and the three brachinite-like achondrites from nominally volatile-rich and oxidised 'chondritic' precursor sources within their respective parent bodies. Furthermore, the range of Δ17O values (˜0‰ to -0.3‰) among the meteorites indicates generation from isotopically heterogeneous sources that never completely melted, or isotopically homogenised. It is possible to generate major- and trace-element compositions similar to brachinites and the three studied brachinite-like achondrites as residues of moderate degrees (13-30%) of partial melting of primitive chondritic sources. This process was coupled with inefficient removal of silica-saturated, high Fe/Mg felsic melts with compositions similar to GRA 06128/9. Melting of the parent bodies of GRA 06128/9, brachinites and brachinite-like achondrites halted well before extensive differentiation, possibly due to the exhaustion of the short-lived radionuclide 26Al by felsic melt segregation. This mechanism provides a potential explanation for the cessation of run-away melting in asteroids to preserve achondrites such as GRA 06128/9, brachinites, brachinite-like achondrites, acapulcoite-lodranites, ureilites and aubrites. Moderate degrees of

  4. Lack of B7-1/BB1 and B7-2/B70 expression on thyrocytes of patients with Graves' disease. Delivery of costimulatory signals from bystander professional antigen-presenting cells.

    PubMed

    Matsuoka, N; Eguchi, K; Kawakami, A; Tsuboi, M; Nakamura, H; Kimura, H; Ishikawa, N; Ito, K; Nagataki, S

    1996-11-01

    We have previously demonstrated that thyrocytes from patients with Graves' disease induce autologous peripheral blood T cell proliferation in response to soluble antigens, and a synergistic augmentation of T cell response by adding suboptimal numbers of monocytes. In the present study, we examined the role of costimulatory molecules, expressed on the surface of thyrocytes and intrathyroidal mononuclear cells, in antigen-specific T cell proliferation. Intercellular associated molecule (ICAM)-1 and lymphocyte function associated antigen-3 were constitutively expressed on the surface of both normal and Graves' thyrocytes. However, ICAM-2, vascular cell adhesion molecule-1, B7-1, and B7-2 were not detected and induced by cytokines. B7-1, was expressed on intrathyroidal monocytes only, while B7-2 was present on intrathyroidal lymphocytes, peripheral blood monocytes, and intrathyroidal monocytes. Furthermore, the density of B7-2 was higher on intrathyroidal monocytes than on peripheral blood monocytes. The intensity of CD28 expression on intrathyroidal CD8bright+ cells was less than that on peripheral blood CD8bright+ cells. The antigen-specific T cell response induced by thyrocytes was blocked completely by anti-human leukocyte antigen-DR monoclonal antibody (mAb) and partially by anti-ICAM-1 mAb and anti-lymphocyte function associated antigen-3 mAb. Furthermore, the synergistic augmentation of T cell response, induced by the addition of suboptimal number of monocytes, was suppressed completely by combining anti-B7-1 mAb and anti-B7-2 mAb, to a level equivalent to that observed when thyrocytes were used alone as antigen-presenting cells. Our results suggest that T cell proliferation was induced by cooperation of thyrocytes and infiltrating professional antigen-presenting cells.

  5. Une intoxication peut en cacher une autre plus grave. Exemple d'une intoxication fatale à l'éthylène glycol masquée par une intoxication à un insecticide pyréthrinoïde

    PubMed Central

    Aissaoui, Younès; Kichna, Hicham; Boughalem, Mohammed; Kamili, Noureddine Drissi

    2013-01-01

    Les pyréthrinoïdes sont des insecticides largement utilisés du fait de leur efficacité et de leur relative sécurité chez l'homme. Les intoxications mortelles liées à ces agents restent exceptionnelles. Leur métabolisme hépatique rapide limite considérablement leur toxicité chez l'homme. Cette observation relate une intoxication grave à un pyréthrinoïde (la cyperméthrine) dont le solvant était l'éthylène glycol. Ce dernier est un toxique nettement plus dangereux pour l'homme. Le tableau clinique consistait en une atteinte multiviscérale avec prédominance de la défaillance cardiovasculaire et neurologique. Le faible potentiel toxique des pyréthrinoïdes suggère l'implication évidente de l'éthylène glycol dans la gravité de cette intoxication. La prise en charge thérapeutique, essentiellement symptomatique, n'a pas pris en compte la présence d'éthylène glycol dans la formulation de l'insecticide. L'évolution clinique était défavorable. Devant toute intoxication grave à un insecticide pyréthrinoïde une intoxication associée au solvant tel que l'éthylène glycol doit être recherchée et traitée. PMID:23734273

  6. Comparison of the effectiveness and tolerability of intravenous or oral glucocorticoids associated with orbital radiotherapy in the management of severe Graves' ophthalmopathy: results of a prospective, single-blind, randomized study.

    PubMed

    Marcocci, C; Bartalena, L; Tanda, M L; Manetti, L; Dell'Unto, E; Rocchi, R; Barbesino, G; Mazzi, B; Bartolomei, M P; Lepri, P; Cartei, F; Nardi, M; Pinchera, A

    2001-08-01

    Eighty-two consecutive patients with moderate-to-severe and active Graves' ophthalmopathy were randomly treated with orbital radiotherapy combined with either oral (prednisone; starting dose, 100 mg/d; withdrawal after 5 months) or iv (methylprednisolone; 15 mg/kg for four cycles and then 7.5 mg/kg for four cycles; each cycle consisted of two infusions on alternate days at 2-wk intervals) glucocorticoids. The two groups did not differ for age, gender, duration of hyperthyroidism and ophthalmopathy, prevalence of smokers, thyroid volume, and pretreatment ocular conditions. Both groups of patients received radioiodine therapy shortly before treatment for Graves' ophthalmopathy. Follow-up lasted for 12 months. A significant reduction in proptosis (from 23.2 +/- 3.0 to 21.6 +/- 1.2 mm in the iv glucocorticoid group, P < 0.0001; and from 23 +/- 1.8 to 21.7 +/- 1.8 mm in oral glucocorticoid group, P < 0.0001) and in lid width (from 13.3 +/- 2.5 to 11.8 +/- 2.2 mm, and from 13.6 +/- 2.0 to 11.5 +/- 1.9 mm, respectively; P < 0.001 in both cases) occurred, with no difference between the two groups. Diplopia significantly improved in both groups: it disappeared in 13 of 27 (48.1%) iv glucocorticoid patients (P < 0.005) and in 12 of 33 (36.4%) oral glucocorticoid patients (P < 0.03). The degree of amelioration of diplopia did not significantly differ between the two groups (P = 0.82). Optic neuropathy improved in 11 of 14 iv glucocorticoid (P < 0.01) and only in 3 of 9 oral glucocorticoid (P = 0.57) patients, with no significant difference in these outcomes. The Clinical Activity Score decreased from 4.5 +/- 1.2 to 1.7 +/- 1.0 (P < 0.0001) in the iv glucocorticoid group and from 4.2 +/- 1.1 to 2.2 +/- 1.2 (P < 0.0001) in the oral glucocorticoid group; final Clinical Activity Score was significantly lower in iv glucocorticoid than in oral glucocorticoid patients (P < 0.01). By self-assessment evaluation, 35 (85.3%) iv glucocorticoid and 30 (73.2%) oral glucocorticoid patients

  7. Épidémiologie des accidents domestiques graves de l'enfant admis en réanimation pédiatrique polyvalente à l'hôpital d'enfants de Rabat-Maroc

    PubMed Central

    Rafai, Mostafa; Mekaoui, Nour; Chouaib, Naoufal; Bakkali, Hicham; Belyamani, Lahcen; El Koraichi, Alae; El Kettani, Salma Ech-Cherif

    2015-01-01

    Introduction Les accidents domestiques de l'enfant représentent un vrai problème de santé publique dans les pays industrialisés. Au Maroc, la priorité en santé publique est toujours donnée aux pathologies infectieuses, et bien qu'elle soit très peu décrite, la pathologie accidentelle de l'enfant devient de plus en plus fréquente dans notre pays avec une mortalité importante. L'objectif est de mettre le point sur la prévalence, la gravité, les aspects étiologiques, les facteurs de risque et les circonstances de survenue de ces accidents, ainsi que les moyens de prévention active et passive. Méthodes Enquête rétrospective descriptive sur une période de douze mois portant sur tous les enfants pris en charge pour accident domestique grave au service de réanimation pédiatrique polyvalente de l'hôpital universitaire d'enfants de Rabat. Résultats Parmi 698 admissions, 108 cas d'accidents domestiques graves ont étaient colligés (soit 15,5%), L’âge moyen des enfants était de 04ans tout accident confondu, avec un sex-ratio de 1,08 en faveur des garçons. L’évolution générale était marquée par le décès de 16 enfants (soit 14,8%) parmi 164 décès toute pathologie confondue au cours de la même période d’étude (soit 9,75% des décès) avec une durée moyenne d'hospitalisation de 04jours. les brûlures constituaient le premier accident dans notre série par 37cas, et elles étaient la première cause de mortalité par huit cas; par ailleurs, la population la plus à risque de brûlure était les nourrissons (67,6%). L'inhalation intrabronchique d’épingle à foulard (accident particulier dans notre contexte islamique) à été retrouvée chez six cas. Conclusion Les accidents domestiques de l'enfant constituent rarement une préoccupation de premier plan dans la population alors qu'ils sont parfois très graves et source d'une mortalité importante. Le meilleur traitement reste la prévention active et passive. PMID:26015848

  8. Les formes graves de la grippe A(H1N1) 2009 chez la femme enceinte: expérience du centre hospitalier universitaire de Fès, Maroc et revue de la littérature

    PubMed Central

    Adnane Berdai, Mohamed; Labib, Smael; Harandou, Mustapha

    2012-01-01

    Introduction Le but de cette étude est de décrire les caractéristiques épidémiologiques, cliniques, paracliniques ainsi que l’évolution des femmes enceintes ou en post partum atteintes de formes graves de Grippe A(H1N1) 2009. Méthodes C’est une étude prospective observationnelle monocentrique, menée au sein de notre service de réanimation mère et enfant au centre hospitalier universitaire Hassan II à Fès, sur une période de 3 mois, allant de novembre 2009 à janvier 2010. Résultats L’âge moyen était de 28 ans, dans 85% des cas la grossesse se situaient au troisième trimestre, le syndrome grippal était constant, la SpO2 initiale était en moyenne de 86%. A la radiographie thoracique, un syndrome alvéolaire bilatéral était toujours présent. L’infection virale était confirmée dans tous les cas par la polymerase chain reaction. Chez 3 patientes la PaO2/FiO2 était inférieure à 300. L’Oseltamivir était l’antiviral utilisé chez toutes les parturientes. Un syndrome de détresse respiratoire aigu a été développé chez 28% des parturientes, elles ont été ventilées artificiellement avec des niveaux de pressions expiratoires positives à 14 +/- 1 cmH2O. L’évolution était favorable dans 71% des cas, cependant, 2 décès ont été déplorés. Conclusion Les résultats rejoignent les données de la littérature, à savoir, un risque accru pour la femme enceinte de développer une forme grave, une présentation clinique similaire au reste de la population, l’intérêt de la vaccination et d’un traitement antiviral précoce et le rôle de l’ECMO dans le traitement des hypoxémies réfractaires. PMID:22514770

  9. [Role of TSH receptor autoantibodies for the diagnosis of Graves' disease and for the prediction of the course of hyperthyroidism and ophthalmopathy. Recommendations of the Thyroid Section of the German Society of Endocrinology].

    PubMed

    Eckstein, Anja; Mann, Klaus; Kahaly, George J; Grussendorf, Martin; Reiners, Christoph; Feldkamp, Joachim; Quadbeck, Beate; Bockisch, Andreas; Schott, Matthias

    2009-05-15

    Graves' disease (GD) is the only autoimmune disease where autoantibodies stimulate the target organs. Among the most common clinical manifestations are hyperthyroidism and orbitopathy (GO). To ensure the diagnosis of autoimmune hyperthyroidism, activity of TSH receptor autoantibodies (TRAb) should be determined. Because of their significantly improved sensitivity and equal specificity, second-generation TRAb assays (activity given in IU/l) should be preferred over first-generation assays (activity given in U/l). During follow-up of antithyroid drug therapy it is possible to predict outcome for some patients with high chances if TRAb levels are high. On this basis, thyreoablative treatment (operation or radioiodine) can already be indicated before the 1st year of antithyroid drug treatment has passed. If TRAb antibody titers are > 10 IU/l, it is possible to predict outcome as early as 6 months after initiation of antithyroid drug therapy. Below a certain threshold, depending on the time point of measurement, no representative risk analyses are available for TRAbs. TRAb measurement is also helpful to determine the course of GO. This may guide the physician through crucial treatment decisions, especially if the patient is at risk of deterioration.

  10. Association of the HLA-DRB1*0301 and HLA-DQA1*0501 alleles with Graves' disease in a population representing the gene contribution from several ethnic backgrounds.

    PubMed

    Maciel, L M; Rodrigues, S S; Dibbern, R S; Navarro, P A; Donadi, E A

    2001-01-01

    Graves' disease (GD) is the most frequent cause of hyperthyroidism. Although the etiology is not completely elucidated, there are several lines of evidence suggesting multifactorial mechanisms. Genetic, constitutional, and environmental factors are involved in its pathogenesis. Major histocompatibility complex (MHC) class II alleles have been associated with GD in several populations of distinct ethnic backgrounds and there is increasing evidence supporting an association between GD and HLA-DR3 in Caucasian populations. The MHC class II alleles were evaluated in 75 Brazilian patients presenting with GD and in 166 control individuals from the same geographic area. HLA-DRB, DQB, and DQA alleles were identified using polymerase chain reaction (PCR)-amplified DNA hybridized with sequence-specific probes. The HLA-DRB1*0301 allele was significantly increased in patients (34/75, 45.3%) as compared with controls (37/166, 22.3%, p = 0.009), conferring a relative risk (RR) of 2.8 and an etiologic fraction (EF) of 0.287. The HLA-DQA1*0501 allele was also overrepresented in patients (48/71, 67.6%) in relation to controls (24/71, 33.8%; p = 0.004), conferring an RR of 3.74 and an EF of 0.351. The susceptibility conferred by HLA-DQA1*0501 was independent of the HLA-DRB1*0301 allele. On the other hand, the HLA-DQB1*0602 allele was significantly decreased in patients (6/75, 8.0%) in relation to controls (53/166, 31.9%, p = 0.0008), conferring an RR of 0.18 and a preventive fraction of 0.267. Although the Brazilian population comprises individuals of several ethnic backgrounds, these results corroborate the participation of the HLA-DRB1*0301 and HLA-DQA1*0501 alleles as susceptibility markers for GD, and emphasize the participation of the HLA-DQB1*0602 allele as conferring protection against the development of the disease. PMID:11272094

  11. Ampleur et impact des évènements indésirables graves liés aux soins: étude d'incidence dans un hôpital du Centre-Est tunisien

    PubMed Central

    Bouafia, Nabiha; Bougmiza, Iheb; Bahri, Fathi; Letaief, Mondher; Astagneau, Pascal; Njah, Mansour

    2013-01-01

    Introduction La prévention des événements indésirables représente une priorité de santé du fait de leur fréquence et de leur gravité potentielle. Ce travail a été mené afin d'avoir un diagnostic de la situation épidémiologique relative aux événements indésirables survenant dans notre hôpital. Méthodes Une étude prospective a été menée auprès de tous les patients qui ont été hospitalisés au CHU Farhat Hached - Sousse (Tunisie) sur une période d'un mois dans quatorze services de l'hôpital. La détection d'évènement indésirable grave (EIG) était basée sur les critères adoptés dans différentes études. Les tests T et Chi 2 ont été utilisés pour identifier les facteurs contribuant à l'apparition d'évènements indésirables. Résultats Au total, 162 EIG ont été identifiés pendant la période. 45% de ces évènements étaient des infections nosocomiales. Ces EIG ont eu comme conséquences un décès chez 9,2% des patients, la mise en jeu du pronostic vital de 26% des patients et la prolongation de la durée de séjour chez 61,7% d'entre eux. L'admission dans des circonstances particulières et l'exposition à des soins invasifs étaient identifiés comme des facteurs de risque potentiels EIG. Conclusion Le renforcement de la stratégie de gestion des risques sanitaires en ciblant préférentiellement le risque infectieux constitue une étape fondamentale dans l'amélioration de la sécurité des patients au sein de notre établissement de santé. PMID:24711868

  12. Lots of Red Meat, an Earlier Grave?

    MedlinePlus

    ... early than those who consume a lot of animal protein, the researchers said. However, not all animal proteins carry the same level of risk, said ... related death for every 10 percent increase of animal protein in their total daily calories. Swapping 3 ...

  13. A difficult diagnosis: severe Graves' ophthalmolopathy.

    PubMed

    Yip, Ivan Yeu Ming; Mushtaq, Fizza; Reuser, Tristan

    2015-03-09

    An 81-year-old woman with atrial fibrillation, on warfarin, with known hyperthyroidism, was admitted to hospital following a fall with proptosis and severely restricted movements in her left eye. Medics initially thought the presentation was related to an intracranial pathology but through subsequent tests and examination, ophthalmologists diagnosed a severe case of thyroid eye disease with intense inflammation. The patient responded well to systemic steroid treatment. This case report highlights a severe rapidly progressing case of thyroid eye disease with diagnostic difficulties arising from multiple comorbidities in an elderly patient.

  14. [An international medical expert committee's participation in uncovering the truth on the liquidation of Polish officers found in mass graves at Katyn in the spring of 1943 and the biography of a Danish participant, Helge Tramsen (1910-1979)].

    PubMed

    Rosdahl, Nils

    2008-01-01

    The article is based on a paper read as a invited speaker at a conference, entitled "Medical experts and expertise in cases of humanitarian crises "convened by the University of Geneva and the Committee of the International Red Cross in April 2007. The article starts with an overview of Polish history from the end of World War I up to the disclosure of the mass graves in the spring of 1943, but is otherwise a translation of the original English lecture with some additions from new findings.in archives. Helge tramsen was born into a bourgois family in Copenhagen. After graduation in medicine from the University of Copenhegen in 1936 he married a British woman and joined the naval medical corps and also embarked on a surgical career.. From 1940 to 1943 he was prosector at the Institute of Forensic Medicine at the University of Copenhagen. After the finding of the mass graves at Katyn, Germany requested from a number of European countries under German control forensic experts to join an international commission to investigate the findings. As the professor of forensic medicine declined perobably due to health reasons Tramsen was sent. During the German occupation of Denmark 1940 to 1945 Tramsen according to family tradition participated in the resistance movement and he consulted with members of the more conservative part of it and was recommended to go to Germany with an added purpose of being able to transport material out of Germany. He went with special plane from Copenhagen to Berlin, where he joined the international group, which later flew to Smolensk via Warszawa. He conducted a post mortem on the body of a Polish officer, selected by himself. Following that he attended in the discussion on the final report, which later in Berlin was handed over to the German minister of health, and which later formed an important part of the official German material accusing the USSR for the killing. During his stay in Berlin he claimed to have collected material, which in

  15. [An international medical expert committee's participation in uncovering the truth on the liquidation of Polish officers found in mass graves at Katyn in the spring of 1943 and the biography of a Danish participant, Helge Tramsen (1910-1979)].

    PubMed

    Rosdahl, Nils

    2008-01-01

    The article is based on a paper read as a invited speaker at a conference, entitled "Medical experts and expertise in cases of humanitarian crises "convened by the University of Geneva and the Committee of the International Red Cross in April 2007. The article starts with an overview of Polish history from the end of World War I up to the disclosure of the mass graves in the spring of 1943, but is otherwise a translation of the original English lecture with some additions from new findings.in archives. Helge tramsen was born into a bourgois family in Copenhagen. After graduation in medicine from the University of Copenhegen in 1936 he married a British woman and joined the naval medical corps and also embarked on a surgical career.. From 1940 to 1943 he was prosector at the Institute of Forensic Medicine at the University of Copenhagen. After the finding of the mass graves at Katyn, Germany requested from a number of European countries under German control forensic experts to join an international commission to investigate the findings. As the professor of forensic medicine declined perobably due to health reasons Tramsen was sent. During the German occupation of Denmark 1940 to 1945 Tramsen according to family tradition participated in the resistance movement and he consulted with members of the more conservative part of it and was recommended to go to Germany with an added purpose of being able to transport material out of Germany. He went with special plane from Copenhagen to Berlin, where he joined the international group, which later flew to Smolensk via Warszawa. He conducted a post mortem on the body of a Polish officer, selected by himself. Following that he attended in the discussion on the final report, which later in Berlin was handed over to the German minister of health, and which later formed an important part of the official German material accusing the USSR for the killing. During his stay in Berlin he claimed to have collected material, which in

  16. Décision d'amputation dans la prise en charge initiale d'une luxation ouverte grave de la cheville à propos d'un cas observé à l'Hôpital Laquintinie de Douala suite à un accident par moto-taxi

    PubMed Central

    Tsatedem, Faustin Atemkeng; Tsiagadigui, Jean Gustave; Ndando, Richard Polle; Arabo, Mohamadou Saidou; Bayiha, Alphonse; Kenfack, Bruno

    2012-01-01

    La décision d'amputation pour traumatisme grave de membre n'est pas toujours facile à prendre. Les auteurs rapportent le cas d'un traumatisme ouvert de la cheville gauche avec luxation tibiotalienne complète, référé pour amputation. Il s'agit d'une passagère d'une moto-taxi percutée par une voiture. A l'admission, le pouls tibial postérieur était présent et le score dit MESS (Mangled Extremity Severity Score) côté à 5, ce qui a permis et d'éviter l'amputation. Après débridement et réduction, une broche transplantaire a permis d'immobiliser la cheville et de faire les pansements. L'amputation a été évitée. La cicatrisation dirigée de la peau a été suivie par la kinésithérapie. La mobilité de la cheville autorise une marche avec cannes au quatrième mois post-opératoire. Les auteurs recommandent l'utilisation du MESS dans la décision d'amputation après traumatisme grave de membre. PMID:23396997

  17. [Extrinsic allergic alveolitis. Clinical experience at the Instituto National de Enfermedades Respiratorias (INER)].

    PubMed

    Chapela-Mendoza, R; Selman-Lama, M

    1999-01-01

    Extrinsic allergic alveolitis is an interstitial lung disease caused by exposure to a variety of inhaled antigens. In Mexico, the most frequent form is due to the inhalation of avian antigens, markedly pigeon proteins. Depending on type and time exposure, the disease presents different clinical forms usually characterized by progressive dyspnea, ground glass or reticulonodular images on chest x rays, a restrictive functional pattern, rest hypoxemia worsening with exercise, and increase of T lymphocytes in bronchoalveolar lavage with an inversion in the helper/suppressor ratio. In this paper, we discuss a 15-year experience with this pathological problem in Mexico, emphasizing the differences with this disorder in Caucasian populations. Generally, our patients display a chronic form of the disease, which evolves to fibrosis in about one-half of the patients. In this sense, the diagnostic, prognostic, and therapeutic focusing exhibit different elements, and thus the development of clinical and basic research is strongly required.

  18. [Study of death with secondary diagnosis of malnutrition in a third level hospital].

    PubMed

    Fernández Valdivia, Antonia; Lobo Támer, Gabriela; Martínez Cirre, Ma Carmen; Valero Aguilera, Beatriz; Peña Taveras, Manuel del Carmen; Rodríguez Rodríguez, José María; Martínez Tapias, Jesús; Pérez de la Cruz, Antonio Jesús

    2013-01-01

    Introducción: La desnutrición constituye uno de los principales problemas de Salud Pública, según datos de la OMS, es la primera causa de mortalidad, cuando la misma afecta al colectivo de los sujetos hospitalizados, toma entidad propia denominándose “desnutrición hospitalaria”. Objetivos: El objetivo general es cuantificar los diagnósticos principales de alta más frecuentes, que causan exitus, con el diagnóstico secundario de desnutrición. Métodos: Se trata de un estudio transversal y descriptivo, en el que se han incluido todas las altas hospitalarias del año 2011 y primer semestre de 2012, que han sido exitus y que tienen como diagnóstico secundario la desnutrición, siendo el total de 33. Se ha realizado un análisis estadístico descriptivo, efectuándose el test de Mann-Whitney para pruebas no paramétricas (p < 0,05). Resultados: Los diagnósticos principales más frecuentes entre las 33 altas analizadas son la sepsis (12,1%), metástasis hepáticas (9,1%), neumonía (6,1%), insuficiencia respiratoria aguda (6,1%) e insuficiencia renal aguda (6,1%). Conclusiones: Aunque el diagnóstico principal más frecuente es la sepsis, al agrupar los diagnósticos, el GRD más frecuente es de patología respiratoria, por lo que se ha de hacer codificación exhaustiva y de calidad para ajustar el peso relativo de los mismos a la realidad. Es fundamental especificar en la fuente de información clínica utilizada para la codificación, el grado de desnutrición, para obtener mayor especificidad en los datos.

  19. Total Thyroidectomy: a safe and effective treatment for Graves' disease

    PubMed Central

    Liu, Jing; Bargren, Anna; Schaefer, Sarah; Chen, Herbert; Sippel, Rebecca S.

    2011-01-01

    Background Thyroidectomy as a first line treatment for Graves’ disease is rarely utilized in the US. The purpose of this study was to analyze the safety and efficacy of thyroid surgery among patients with Graves’ disease. Methods 56 patients with Graves’ disease underwent thyroid surgery between 05/1994 and 05/2008 at a single academic institution. Pre-operative, intra-operative, and post-operative variables were analyzed. Results A total of 58 surgeries were performed: 55.1% (n=32) total thyroidectomy, 41.3% (n=24) subtotal/lobectomy, 3.4 % (n=2) completion thyroidectomy. The average gland weight was 47.3 ± 10.8 gm, with 70% weighing > 30 gm. Reasons for having thyroid surgery were persistent disease despite medical therapy (46.6%), patient preference (24.1%), multinodular goiter/cold nodules (20.3%), failed RAI (radioactive iodine) treatment (16%), and opthalmopathy (12.1%). Of those patients that failed prior RAI therapy, the only factor that was predictive of failure was disease severity, as demonstrated by a markedly elevated initial free-T4 value (11.8 ± 4.5 ng/dL, p=0.04). Transient symptomatic hypocalcemia occurred in 10.7% (n=6) of patients, and 1 patient (1.8%) had symptomatic hypocalcemia lasting > 6 months. There were no permanent recurrent laryngeal nerve injuries. There was no difference in overall complication rates between patients based on surgical procedure (subtotal vs. total thyroidectomy), preoperative RAI treatment, or gland size. Recurrences occurred in 6% of the subtotal thyroidectomy group and 0% of the total thyroidectomy group (p=0.008). Conclusion Thyroidectomy for patients with Graves’ disease can be performed with very low complication rates and when a total thyroidectomy is performed there is almost no risk of recurrence. PMID:21345453

  20. Xylem development - from the cradle to the grave.

    PubMed

    Růžička, Kamil; Ursache, Robertas; Hejátko, Jan; Helariutta, Ykä

    2015-08-01

    The development and growth of plants, as well as their successful adaptation to a variety of environments, is highly dependent on the conduction of water, nutrients and other important molecules throughout the plant body. Xylem is a specialized vascular tissue that serves as a conduit of water and minerals and provides mechanical support for upright growth. Wood, also known as secondary xylem, constitutes the major part of mature woody stems and roots. In the past two decades, a number of key factors including hormones, signal transducers and (post)transcriptional regulators have been shown to control xylem formation. We outline the main mechanisms shown to be essential for xylem development in various plant species, with an emphasis on Arabidopsis thaliana, as well as several tree species where xylem has a long history of investigation. We also summarize the processes which have been shown to be instrumental during xylem maturation. This includes mechanisms of cell wall formation and cell death which collectively complete xylem cell fate.

  1. Waste minimization: The planned-parenthood-to-grave'' philosophy

    SciTech Connect

    Cash, K.M. ); Ostergaard, A.P. Corp. )

    1992-02-11

    Until 1985, the Y-12 Plant, a DOE facility, had concentrated waste minimization efforts on select large waste streams. However, during the past seven years, Y-12 has been faced with the challenge of complying with all of these requirements as well as striving to develop and implement a comprehensive proactive program to reduce waste. Thus, the Y-12 Plant Waste Minimization Program has gradually developed toward an all encompassing program. The overall strategy and structure of the Y-12 program is centered around four basic elements: Waste Minimization Process Waste Assessments (PWAs), Opportunities, and Projects; Waste Minimization and Pollution Prevention Promotional Campaign; Waste Tracking; and Information Exchange and Technology Transfer. Activities within each of these elements are described in this report.

  2. Waste minimization: The ``planned-parenthood-to-grave`` philosophy

    SciTech Connect

    Cash, K.M.; Ostergaard, A.P.

    1992-02-11

    Until 1985, the Y-12 Plant, a DOE facility, had concentrated waste minimization efforts on select large waste streams. However, during the past seven years, Y-12 has been faced with the challenge of complying with all of these requirements as well as striving to develop and implement a comprehensive proactive program to reduce waste. Thus, the Y-12 Plant Waste Minimization Program has gradually developed toward an all encompassing program. The overall strategy and structure of the Y-12 program is centered around four basic elements: Waste Minimization Process Waste Assessments (PWAs), Opportunities, and Projects; Waste Minimization and Pollution Prevention Promotional Campaign; Waste Tracking; and Information Exchange and Technology Transfer. Activities within each of these elements are described in this report.

  3. White dwarf evolution - Cradle-to-grave constraints via pulsation

    NASA Technical Reports Server (NTRS)

    Kawaler, Steven D.

    1990-01-01

    White dwarf evolution, particularly in the early phases, is not very strongly constrained by observation. Fortunately, white dwarfs undergo nonradial pulsation in three distinct regions of the H-R diagram. These pulsations provide accurate masses, surface compositional structure and rotation velocities, and help constrain other important physical properties. We demonstrate the application of the tools of stellar seismology to white dwarf evolution using the hot white dwarf star PG 1159-035 and the cool DAV (or ZZ Ceti) stars as examples. From pulsation studies, significant challenges to the theory of white dwarf evolution emerge.

  4. Grave New World? Workplace Skills for Today's College Graduates

    ERIC Educational Resources Information Center

    Eisner, Susan

    2010-01-01

    Today's college graduates face an uncertain and demanding job market in which they are likely to encounter evolving skill needs, reduced hiring, and heightened competition from experienced laid off workers and globally available labor. These realities underscore the importance expressed by educators and practitioners of identifying attributes new…

  5. Organic Carbon Inclusions in CR2 Chondrite Graves Nunataks 95229

    NASA Astrophysics Data System (ADS)

    Peeters, Z.; Changela, H.; Stroud, R. H.; Alexander, C. M. O'D.; Nittler, L. R.

    2012-09-01

    We report coordinated XANES, TEM, and nanoSIMS analysis of two large, carbon-rich veins in CR2 chondrite GRA 95229. The variability in morphological, isotopic, and chemical properties is compared to previous results on C-rich veins in CR3 QUE 99177.

  6. Precision medicine in myasthenia graves: begin from the data precision

    PubMed Central

    Hong, Yu; Xie, Yanchen; Hao, Hong-Jun; Sun, Ren-Cheng

    2016-01-01

    Myasthenia gravis (MG) is a prototypic autoimmune disease with overt clinical and immunological heterogeneity. The data of MG is far from individually precise now, partially due to the rarity and heterogeneity of this disease. In this review, we provide the basic insights of MG data precision, including onset age, presenting symptoms, generalization, thymus status, pathogenic autoantibodies, muscle involvement, severity and response to treatment based on references and our previous studies. Subgroups and quantitative traits of MG are discussed in the sense of data precision. The role of disease registries and scientific bases of precise analysis are also discussed to ensure better collection and analysis of MG data. PMID:27127759

  7. Graves' disease presenting as unilateral anterior ischaemic optic neuropathy.

    PubMed

    Monigari, Naresh; Deshpande, Anirudda; Nalabothu, Murali; Rao, Shilpa

    2014-03-19

    We report a case of a 28-year-old man who presented with 1-day history of sudden diminution of vision in the right eye. Examination showed unilateral exophthalmos with restricted eyeball movement on upward gaze in the right eye. MRI of the orbit showed no evidence of compression of the optic nerve on the right side. Visual-evoked potential showed prolonged P100 in the right eye. Fundus examination revealed swollen optic disc and para papillary nerve fibre layer splinter haemorrhages with corresponding altitudinal field defect on perimetry suggestive of anterior ischaemic optic neuropathy.

  8. The Grave Dangers in the Discourse on Democracy.

    ERIC Educational Resources Information Center

    Scheurich, James Joseph

    1998-01-01

    Democracy rightly holds a critical significance in any context in which relatively small elites have subjugated majorities. When a democracy has been established in a societal context that encompasses minority subgroups along with a dominant majority, minority groups are in danger. Democracy is not equity, nor any guarantee of equity. (MLH)

  9. Randomised trial of low-dose amiodarone in severe congestive heart failure. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA)

    PubMed

    Doval, H C; Nul, D R; Grancelli, H O; Perrone, S V; Bortman, G R; Curiel, R

    1994-08-20

    In severe heart failure many deaths are sudden and are presumed to be due to ventricular arrhythmias. The GESICA trial evaluated the effect of low-dose amiodarone on two-year mortality in patients with severe heart failure. Our prospective multicentre trial included 516 patients on optimal standard treatment for heart failure. Patients were randomised to 300 mg/day amiodarone (260) or to standard treatment (256). Intention-to-treat analysis showed 87 deaths in the amiodarone group (33.5%) compared with 106 in the control group (41.4%) (risk reduction 28%; 95% CI 4%-45%; log rank test p = 0.024). There were reductions in both sudden death (risk reduction 27%; p = 0.16) and death due to progressive heart failure (risk reduction 23%; p = 0.16). Fewer patients in the amiodarone group died or were admitted to hospital due to worsening heart failure (119 versus 149 in the control group; risk reduction 31%; 95% CI 13-46%; p = 0.0024). The decrease in mortality and hospital admission was present in all subgroups examined and independent of the presence of non-sustained ventricular tachycardia. Side-effects were reported in 17 patients (6.1%); amiodarone was withdrawn in 12. Low-dose amiodarone proved to be an effective and reliable treatment, reducing mortality and hospital admission in patients with severe heart failure independently of the presence of complex ventricular arrhythmias.

  10. [Risk prescription associated to treatment at home of the elderly patient when admitted to the hospital].

    PubMed

    Iniesta-Navalón, C; Urbieta-Sanz, E; Gascón-Cánovas, J J; Rentero-Redondo, L; Cabello Muriel, A; García-Molina, C

    2013-01-01

    Objetivo: Determinar la prevalencia, la incidencia de error y el daño potencial asociado a determinadas prescripciones señaladas como de riesgo de error de medicación en el tratamiento domiciliario de pacientes ancianos que ingresan en el hospital, así como los factores asociados a su aparición. Material y métodos: Estudio transversal descriptivo. Se incluyeron los pacientes de edad igual o mayor a 65 años que ingresaron en el hospital desde el servicio de urgencias durante el último trimestre de 2009.Para el análisis estadístico se utilizó el programa SPSSv15.0. Resultados: Se incluyeron en el estudio 324 pacientes. Se identificaron 1176 (47%) prescripciones de riesgo en el 91% de los pacientes. La prescripción de riesgo más relevante fue la prescripción de medicamentos de alto riesgo (51.5% pacientes) que presentó una incidencia de error de 88/100 pacientes con medicamentos de alto riesgo, de los cuales en 68 pacientes fue grave. Los factores asociados a la presencia de error grave/moderado ocasionado por prescripciones de riesgo fueron tener enfermedad respiratoria crónica o diabetes y la polimedicación. Conclusiones: Se deben priorizar actuaciones dirigidas a disminuir errores por medicamentos de alto riesgo.

  11. Taking it to the grave: gender, cultural capital, and ethnicity in Turkish death announcements.

    PubMed

    Ergin, Murat

    Popularly considered a great equalizer, death and the rituals around it nevertheless accentuate social distinctions. The present study focuses on a sample (N = 2554) of death announcements in a major Turkish daily newspaper (Hürriyet) from 1970 to 2006. Out of the liminal position of Turkish death announcements between obituaries and death notices emerges a large decentralized collection of private decisions responding to death, reflecting attitudes toward gender, ethnic/religious minority status and cultural capital, and echoing the aggregate efforts of privileged groups to maintain a particular self-image. Class closures lead to openings for traditionally under-represented minorities, such as Jewish Turkish citizens and citizens of Greek or Armenian origin. Results reveal that signs of status and power in announcements are largely monopolized by men of Turkish-Muslim origins. Although the changes in the genre-characteristics of death announcements are slow, they correspond to major turning points in Turkish social history. PMID:20222236

  12. Genotypic testing in clinically defined HHT: would Osler approve or turn in his grave?

    PubMed

    Kettritz, R; Hinrichs, C; Althoff, C E; Luft, F C

    2012-06-01

    Modern diagnostic possibilities pose a number of challenges. When is a precise genetic diagnosis justifiable in today's climate of cost-cutting? We would like to pose that question to Sir William Osler. Sir William was a keen observer, a master 'translator' of science into clinical medicine. Would he have required or supported genetic testing? We treated a patient whose case reminded us of Sir William's belief that clinical exactness was the ultimate aim, regardless of cost. PMID:22693697

  13. Genotypic testing in clinically defined HHT: would Osler approve or turn in his grave?

    PubMed

    Kettritz, R; Hinrichs, C; Althoff, C E; Luft, F C

    2012-06-01

    Modern diagnostic possibilities pose a number of challenges. When is a precise genetic diagnosis justifiable in today's climate of cost-cutting? We would like to pose that question to Sir William Osler. Sir William was a keen observer, a master 'translator' of science into clinical medicine. Would he have required or supported genetic testing? We treated a patient whose case reminded us of Sir William's belief that clinical exactness was the ultimate aim, regardless of cost.

  14. Mapping Soil Carbon from Cradle to Grave: 'Omic and Isotope Based Measurements of Root C Transformations

    NASA Astrophysics Data System (ADS)

    Pett-Ridge, J.; Nuccio, E. E.; Shi, S.; Neurath, R.; Brodie, E.; Zhou, J.; Lipton, M. S.; Herman, D.; Firestone, M.

    2014-12-01

    Carbon cycling in the rhizosphere is a nexus of biophysical interactions between plant roots, microorganisms, and the soil organo-mineral matrix. Plant roots are the primary inputs of soil organic C; the presence of roots significantly alters rates of organic matter mineralization by soil microbes. Our research on how roots influence decomposition of soil organic matter in both simplified and complex microcosms uses geochemical characterization, molecular microbiology, isotope tracing, 'omics and novel imaging approaches ('ChipSIP' and 'STXM-SIMS') to trace the fate of isotopically labelled root exudates and plant tissues. Our work seeks to understand the genomic basis for how organic C transformation and decomposition in soil is altered by interactions between plant roots and the soil microbial community (bacteria, archaea, fungi, microfauna). We hypothesize that root-exudate stimulation of soil microbial populations results in the altered expression of transcripts and proteins involved in decomposition of macromolecular C compounds. Using an isotope array that allows us to follow root C into bacterial, fungal, and microfaunal communities, we have tracked movement of 13C from labeled exudates and 15N from labeled root litter into the soil microbial community, and linked this data to 16S profiles and community gene transcripts. By integrating stable isotopes as tracers of natural resource utilization (i.e. root litter), and analysis of the functional properties of the communities that respond to those resources, we can identify the molecular pathways that are stimulated in the soil microbiome in response to root litter, living roots, and their interfaces.

  15. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    SciTech Connect

    Willegaignon, J. Sapienza, M. T.; Coura-Filho, G. B.; Buchpiguel, C. A.; Watanabe, T.; Traino, A. C.

    2014-01-15

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurements were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG and A{sup ~} was determined by the integration of measured {sup 131}I activity in the thyroid gland and based on T{sub eff}, respectively. No statistically significant relationship was found between therapeutic response and patients’ age, administered {sup 131}I activity (MBq), 24-h thyroid {sup 131}I uptake (%) or T{sub eff} (p ≥ 0.064); nonetheless, a good relationship was found between the therapeutic response and m{sub th} (p ≤ 0.035). Conclusions: According to the results of this study, the most effective thyroid absorbed dose to be targeted in GD therapy should not be based on a fixed dose but rather should be individualized based on the patient'sm{sub th} and A{sup ~}. To achieve a therapeutic success (i.e., durable euthyroidism or hypothyroidism) rate of at least 95%, a thyroid absorbed dose of 200 or 330 Gy is required depending on the methodology used for estimating m{sub th} and A{sup ~}.

  16. Towards Image Documentation of Grave Coverings and Epitaphs for Exhibition Purposes

    NASA Astrophysics Data System (ADS)

    Pomaska, G.; Dementiev, N.

    2015-08-01

    Epitaphs and memorials as immovable items in sacred spaces provide with their inscriptions valuable documents of history. Today not only photography or photos are suitable as presentation material for cultural assets in museums. Computer vision and photogrammetry provide methods for recording, 3D modelling, rendering under artificial light conditions as well as further options for analysis and investigation of artistry. For exhibition purposes epitaphs have been recorded by the structure from motion method. A comparison of different kinds of SFM software distributions could be worked out. The suitability of open source software in the mesh processing chain from modelling up to displaying on computer monitors should be answered. Raspberry Pi, a computer in SoC technology works as a media server under Linux applying Python scripts. Will the little computer meet the requirements for a museum and is the handling comfortable enough for staff and visitors? This contribution reports about the case study.

  17. Functional relationships of the hypothalamic-pituitary-testicular system in Graves' disease.

    PubMed

    Földes, J; Bános, C; Fehér, T; Bodrogi, L; Szalay, F; Borvendég, J; Csillag, J; Takó, J

    1982-01-01

    An increased secretion of gonadotropic hormone was found in hyperthyroid males despite the high basal serum total testosterone and oestradiol levels. This suggests that hyperthyroidism affects the responsiveness of the hypothalamic-pituitary axis to sexual steroid hormones. While in the hyperthyroid patients the elevation of the serum testosterone level in response to chorionic gonadotropin was lower than normally, the LH and FSH responses to LRH were increased. The results indicate that male hyperthyroidism is associated with a loss of responsiveness of the Leydig-cells to adequate stimuli, to which the pituitary reacts by a compensatory increase in its LH-secretion and by an increased reactivity to LRH. It is suggested that in addition to the direct effect of the increased thyroid hormone levels, a secondary elevation of the oestradiol concentration plays a major part in the alterations in question.

  18. Epigenetic Deficiencies and Replicative Stress: Driving Cancer Cells to an Early Grave.

    PubMed

    Shoaib, Muhammad; Sørensen, Claus Storgaard

    2015-11-01

    Cancer cell-specific synthetic lethal interactions entail promising therapeutic possibilities. In this issue of Cancer Cell, Pfister et al. describe a synthetic lethal interaction where cancer cells deficient in H3K36me3 owing to SETD2 loss-of-function mutation are strongly sensitized to inhibition of WEE1, a cell cycle controlling kinase. PMID:26555168

  19. 78 FR 5205 - Native American Graves Protection and Repatriation Review Committee Findings Related to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

    ... the views of the National Park Service or Secretary of the Interior. The National Park Service and the... State Museum presented evidence proving that the Museum has a ``right of possession'' to the cultural... State Museum had not presented evidence proving that the Museum has a ``right of possession'' to...

  20. Out of the "Graves of the Polluted Debauches": The Boys of the Cherokee Male Seminary.

    ERIC Educational Resources Information Center

    Mihesuah, Devon

    1991-01-01

    Opened in 1851, the Cherokee Male Seminary was the first nonsectarian secondary school west of the Mississippi River. It fulfilled the goals of the Cherokee national council to prepare students for higher education, promote the Cherokee economy, and expose children to white values and lifestyle. (SV)

  1. 78 FR 27078 - Native American Graves Protection and Repatriation Act Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... (Department) published the initial rules to implement NAGPRA in 1995 (60 FR 62158, December 4, 1995), which... concerning: Civil penalties (68 FR 16354, April 3, 2003); Future applicability (72 FR 13189, March 21, 2007); and Disposition of culturally unidentifiable human remains (75 FR 12378, March 15, 2010). Since...

  2. 77 FR 39406 - Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    .... Coast Guard Sector Buffalo; telephone 716- 843-9343, email SectorBuffaloMarineSafety@uscg.mil . If you... of Homeland Security FR Federal Register NPRM Notice of Proposed Rulemaking A. Regulatory History and... display will be held on Port Bay near Wolcott, NY. The Captain of the Port Buffalo has determined...

  3. From the Cradle to the Grave: the stoichiometry of C, N and P in peat formation

    NASA Astrophysics Data System (ADS)

    Moore, T. R.; Wang, M.; Zivkovic, T.

    2013-12-01

    Nutrients, particularly N and P, play an important role in controlling the rates of plant production and litter and peat decomposition, and thus C accumulation in peatlands. Here we examine the changes in the stoichiometry of C, N and P in the transformation from vegetation, foliar senescence and litter to the peat profile in bogs, fens and swamps. Although there is a large variability in C:N:P ratio among peatland plants, decomposition reduces this variability, to produce a ';Redfield Ratio' of 1250:50:1 (mass) derived from the analysis of 400 peat profiles in Ontario, compared to average ratios of 180:6:1 reported in tundra microbial biomass. Peat C:N ratios decrease with depth, from 30:1 to 50:1 at the surface to 20:1 (swamp) to 30:1 (bog) at depth, while C:P ratios increase from 500 to 1000:1 at the surface to 1500:1 at depth. These results can be used to estimate long-term accumulation rates of N and P in peatlands: C accumulation rates of 20 to 40 g C/m2/yr translate into average accumulation rates of 0.8 to 1.6 g N/m2/yr and 13 to 26 mg P/m2/yr. We examine processes affecting the biogeochemistry of N and P in peat formation to account for these patterns

  4. From Cradle to Grave: Research on Atmospheric Aerosols (Vilhelm Bjerknes Medal Lecture)

    NASA Astrophysics Data System (ADS)

    Baltensperger, Urs

    2014-05-01

    Atmospheric aerosol particles are liquid or solid particles suspended in the atmosphere. Generally, the sizes of aerosol particles are in the range 0.001 - 100 μm. Atmospheric aerosols are of interest mainly because of their effects on health and climate. Concerning health, many epidemiological studies have shown a link between increased mortality/morbidity and increased PM10 or PM2.5 (particulate matter with an aerodynamic diameter smaller than 10 and 2.5 μm, respectively). Concerning climate, aerosol particles scatter and absorb light (known as the direct effect on climate), and modify cloud properties (with a variety of effects known as indirect effects). These effects are influenced by the chemical and physical properties of the aerosol particles, which makes these properties important to be measured. Atmospheric aerosol particles are produced by a large variety of sources, and are either emitted as primary particles (i.e., they are directly emitted as particles into the atmosphere) or formed by secondary processes (i.e., by transformation of emitted precursor gases). While the formation pathways of secondary inorganic aerosols such as nitrate and sulfate in general are reasonably well understood, the formation of secondary organic aerosol (SOA) is still an area of active research. A wide variety of gaseous precursors contribute to SOA, and their aerosol yields depend on a wide variety of conditions. In addition, it is still largely unknown to which extent and under which conditions oxidized organic molecules can contribute to nucleation, i.e., the formation of new particles. Elimination of aerosol particles from the atmosphere mostly occurs by wet deposition, where the ice phase plays an important role. Even though cloud glaciation augments precipitation formation and affects cloud radiative properties little is still known about mixed-phase cloud formation via heterogeneous nucleation. To elucidate some of the involved mechanisms in situ research in such mixed phase clouds has been performed in a series of Cloud Aerosol Characterization Experiments (CLACE) at the high altitude research station Jungfraujoch (3580 m asl). This presentation will give an overview on recent laboratory experiments and field campaigns. The lab studies relate to SOA formation from a variety of precursors as well as the formation of new particles from gaseous sulfuric acid in combination with other precursor gases where the latter experiments have been performed in the CLOUD experiment at CERN. The field studies relate to the latest developments of source apportionment studies for the organic aerosol, which build on positive matrix factorization of aerosol mass spectrometer data, as well as to aerosol cloud interaction studies on the Jungfraujoch.

  5. Collective secondary cremation in a pit grave: a unique funerary context in Portuguese Chalcolithic burial practices.

    PubMed

    Silva, A M; Leandro, I; Pereira, D; Costa, C; Valera, A C

    2015-02-01

    Perdigões is a large site with a set of ditched enclosures located at Reguengos de Monsaraz, Alentejo, South Portugal. Recently at the central area of this site burnt human remains were found in a pit (#16). This structure had inside human remains, animal bones (namely pig, sheep or goat, cattle, dog, deer and rabbit), shards, ivory idols and arrowheads. All have been subjected to fire and later deposited in that pit, resulting in a secondary disposal of human bones. The recovered fragmented human bones (4845.18 g) correspond to a minimal number of 9 individuals: 6 adults and 3 sub-adults. The aim of this work is to document and interpret this funerary context based on the study of the recovered human remains. For that purpose, observations of all alterations due to fire, such as colour change and type of bone distortion, as well as anthropological data were collected. The data obtained suggest that these human remains were probably intentionally cremated, carefully collected and finally deposited in this pit. The cremation was conducted on probably complete corpses, some of them still fairly fresh and fleshed, as some bones presented thumbnail fractures. The collective cremation of the pit 16 represents an unprecedented funerary context for Portuguese, and Iberian Peninsula, Chalcolithic burial practices. Moreover, it is an example of the increasing diversity of mortuary practices of Chalcolithic human populations described in present Portuguese territory, as well as, in the Iberian Peninsula.

  6. Dried blood spots in toxicology: from the cradle to the grave?

    PubMed

    Stove, Christophe P; Ingels, Ann-Sofie M E; De Kesel, Pieter M M; Lambert, Willy E

    2012-03-01

    About a century after its first described application by Ivar Bang, the potential of sampling via dried blood spots (DBS) as an alternative for classical venous blood sampling is increasingly recognized. Perhaps best known is the use of DBS in newborn screening programs, ignited by the hallmark paper by Guthrie and Susi half a century ago. However, it is only recently that both academia and industry have recognized the many advantages that DBS sampling may offer for bioanalytical purposes, as reflected by the strong increase in published reports during the last few years. Currently, major DBS applications include newborn screening for metabolic disorders, epidemiological surveys (e.g. HIV monitoring), therapeutic drug monitoring (TDM), as well as toxicology. In this review, we provide a comprehensive overview of the distinct subdisciplines of toxicology for which DBS sampling has been applied. DBS sampling for toxicological evaluation has been performed from birth until autopsy, aiming at the assessment of therapeutic drugs, drugs of abuse, environmental contaminants, toxins, as well as (trace) elements, with applications situated in fields as toxicokinetics, epidemiology and environmental and forensic toxicology. We discuss the strengths and limitations of DBS in the different subdisciplines and provide future prospects for the use of this promising sampling technique in toxicology.

  7. Book Review. School Ways: The Planning and Design of America's Schools, by Ben Graves.

    ERIC Educational Resources Information Center

    Buck, George

    1994-01-01

    The reviewed book summarizes successful school designs and recommends directions for planning of new school buildings, both large and small. Criticisms of the book include an introduction that predicts future trends; a critical tone toward teachers and certain aspects of education; limited information on certain topics such as portable buildings…

  8. Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis

    PubMed Central

    Donkol, Ragab Hani; Nada, Aml Mohamed; Boughattas, Sami

    2013-01-01

    AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves’ disease and 8 cases with Hashimoto’s thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves’ disease and Hashimoto’s thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves’ disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. PMID:23671754

  9. 75 FR 12377 - Native American Graves Protection and Repatriation Act Regulations-Disposition of Culturally...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... first rules to implement the Act on December 4, 1995 (43 CFR part 10, 60 FR 62158). --We published rules for assessing civil penalties under the Act on April 3, 2003 (43 CFR 10.12, 68 FR 16354). --We....13, 72 FR 13189). --We are publishing this rule today. --We are developing additional rules to...

  10. A Cradle-to-Grave Integrated Approach to Using UNIFORMAT II

    ERIC Educational Resources Information Center

    Schneider, Richard C.; Cain, David A.

    2009-01-01

    The ASTM E1557/UNIFORMAT II standard is a three-level, function-oriented classification which links the schematic phase Preliminary Project Descriptions (PPD), based on Construction Standard Institute (CSI) Practice FF/180, to elemental cost estimates based on R.S. Means Cost Data. With the UNIFORMAT II Standard Classification for Building…

  11. 77 FR 74875 - Native American Graves Protection and Repatriation Review Committee Findings Related to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... to the Identity and Return of Cultural Items in the Possession of the University of Pennsylvania... the identity and return of cultural items, and to facilitate the resolution of such a dispute,...

  12. 75 FR 17953 - Native American Graves Protection and Repatriation Review Committee Findings Related to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... to the Identity of Cultural Items in the Possession of the American Museum of Natural History, New... made findings of fact related to the identity of 45 cultural items in the possession of the American... NAGPRA Working Group, to request from the Review Committee findings of fact on the identity, by...

  13. 77 FR 53228 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ...)(3), for review and findings of fact related to the identity or cultural affiliation of human remains..., pursuant to 25 U.S.C. 3006 (c)(3), for review and findings of fact related to the identity or cultural...), for review and findings of fact related to the identity or cultural affiliation of human remains...

  14. Collective secondary cremation in a pit grave: a unique funerary context in Portuguese Chalcolithic burial practices.

    PubMed

    Silva, A M; Leandro, I; Pereira, D; Costa, C; Valera, A C

    2015-02-01

    Perdigões is a large site with a set of ditched enclosures located at Reguengos de Monsaraz, Alentejo, South Portugal. Recently at the central area of this site burnt human remains were found in a pit (#16). This structure had inside human remains, animal bones (namely pig, sheep or goat, cattle, dog, deer and rabbit), shards, ivory idols and arrowheads. All have been subjected to fire and later deposited in that pit, resulting in a secondary disposal of human bones. The recovered fragmented human bones (4845.18 g) correspond to a minimal number of 9 individuals: 6 adults and 3 sub-adults. The aim of this work is to document and interpret this funerary context based on the study of the recovered human remains. For that purpose, observations of all alterations due to fire, such as colour change and type of bone distortion, as well as anthropological data were collected. The data obtained suggest that these human remains were probably intentionally cremated, carefully collected and finally deposited in this pit. The cremation was conducted on probably complete corpses, some of them still fairly fresh and fleshed, as some bones presented thumbnail fractures. The collective cremation of the pit 16 represents an unprecedented funerary context for Portuguese, and Iberian Peninsula, Chalcolithic burial practices. Moreover, it is an example of the increasing diversity of mortuary practices of Chalcolithic human populations described in present Portuguese territory, as well as, in the Iberian Peninsula. PMID:25500530

  15. "My Grandfather Would Roll over in His Grave": Family Farming and Tree Plantations on Farmland

    ERIC Educational Resources Information Center

    Neumann, Pamela D.; Krahn, Harvey J.; Krogman, Naomi T.; Thomas, Barb R.

    2007-01-01

    In this paper we hypothesize that farmers with a stronger valuation of family farming will be more resistant to converting farmland to tree plantations. Our survey data analysis from 106 farmers in northern Alberta reveals that general opposition to trees on farmland is the strongest predictor of farmers' resistance to the establishment of poplar…

  16. From the cradle to the grave: how fast can we run?

    PubMed

    Sterken, Elmer

    2003-06-01

    I model average running speed on distances from 5000 m to the marathon as a function of age, distance and sex. Using data on US age-dependent road-racing records, I simulate optimal performance forages ranging from 3 to 95 years. The results of the correlation between running speed and age are in line with medical results on the relation between age and maximal oxygen uptake. The results show that official track and field age-grading overestimates human performance at older ages. PMID:12846535

  17. 75 FR 70028 - Native American Graves Protection and Repatriation Review Committee: Meeting 2253-665

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... and findings of fact related to the identity or cultural affiliation of human remains or other.... 3006 (c)(3), for review and findings of fact related to the identity or cultural affiliation of human... identity or cultural affiliation of human remains or other cultural items, or the return of such items....

  18. 78 FR 22292 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... religious leaders. The nominee need not be a traditional Indian religious leader. Nominations must include the following information: 1. Nominations by traditional religious leaders: Nominations must be... that he or she is a traditional religious leader. 2. Nominations by Indian tribes or Native...

  19. Mapping Soil Carbon from Cradle to Grave: C Transformations of Root Exudates and Plant Litter

    NASA Astrophysics Data System (ADS)

    Pett-Ridge, J.; Keiluweit, M.; Nuccio, E.; Bougoure, J.; Weber, P. K.; Brodie, E.; Mayali, X.; Shi, S.; Hwang, M.; Thelen, M.; Firestone, M.; Kleber, M.; Nico, P. S.

    2013-12-01

    Carbon cycling in the rhizosphere is a nexus of biophysical interactions between plant roots, microorganisms, and the soil organo-mineral matrix. Plant roots provide 30-40% of soil organic C inputs, accelerate the rate of organic matter mineralization by ~10X, and support an active microhabitat for microbial transformation of soil C. Our research on how roots influence decomposition of soil organic matter in both simplified and complex microcosms uses geochemical characterization, molecular microbiology, isotope tracing, metabolomics and novel imaging approaches (';ChipSIP' and ';STXM-SIMS') to trace the fate of isotopically labelled root exudates and plant tissues. Our previous work suggests root exudates drive O2 limitation, alter metal chemistry and mineralogy, and influence the availability of SOM. Our most recent experiments using synthetic rhizospheres were designed to identify the role of root exudates on ligno-cellulose decomposition in soils. Cultures of 13C/15N-labeled single plant cells (lignin-rich tracheary elements) were added to rhizosphere microcosm soils, and their decomposition followed under the influence of different root exudates using the dual imaging approach ';STXM-SIMS'. Using this combination of X-ray spectromicroscopy and NanoSIMS, we imaged the deconstruction of 13C/15N-labeled ligno-cellulose in situ, and mapped associations of plant cell-derived decomposition products with specific soil minerals. We've also looked at microbial community function in the more complex rhizospheres surrounding roots of the annual grass Avena fatua. Using an isotope array that allows us to follow root C into bacterial, fungal, and microfaunal communities, we tracked the movement of 13C from labeled exudates and 15N from labeled root litter into the soil microbial community. Our results indicate that the microbial communities involved in litter decomposition differ in rhizosphere versus bulk soils, which may have implications for carbon stabilization in soil.

  20. PKI - Crawling Out of the Grave & Into the Arms of Government

    NASA Astrophysics Data System (ADS)

    D'Angio, Phil; Vassilliadas, Panos; Kaklamanis, Phaidon

    This paper will analyze the characteristics of successful PKI projects lead by Government organizations. The paper will examine a recent E-Government project based on PKI credentials as well as suggest the approach for Government PKI programs emphasize strong collaboration with non-government use cases. It also examines the characteristics of PKI projects that were not successful in the past, and their role in creating the industry analyst perception that PKI was dead.

  1. 75 FR 62320 - Safety Zone; Fireworks for USS GRAVELY Commissioning Ceremony, Cape Fear River, Wilmington, NC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... Ceremony, Cape Fear River, Wilmington, NC AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a safety zone on the navigable waters of Cape Fear River in Wilmington... fireworks display on the western shore of the Cape Fear River at Battleship Park. The fireworks...

  2. Tales from the grave: Opposing autopsy reports from a body exhumed.

    PubMed

    Gunasekera, R S; Brown, A B; Costas, E H

    2012-07-01

    We report an autopsy case of a 42-year-old woman who, when discovered, had been dead in her apartment for approximately 1 week under circumstances involving treachery, assault and possible drug overdose. This case is unique as it involved two autopsies of the deceased by two different medical examiners who reached opposing conclusions. The first autopsy was performed about 10 days after death. The second autopsy was performed after an exhumation approximately 2 years after burial. Evidence collected at the crime scene included blood samples from which DNA was extracted and analysed, fingerprints and clothing containing dried body fluids. The conclusion of the first autopsy was accidental death due to cocaine toxicity; the conclusion of the second autopsy was death due to homicide given the totality of evidence. Suspects 1 and 2 were linked to the death of the victim by physical evidence and suspect 3 was linked by testimony. Suspect 1 received life in prison, and suspects 2 and 3 received 45 and 20 years in prison, respectively. This case indicates that cocaine toxicity is difficult to determine in putrefied tissue and that exhumations can be important in collecting forensic information. It further reveals that the combined findings of medical examiners, even though contradictory, are useful in determining the circumstances leading to death in criminal justice. Thus, this report demonstrates that such criminal circumstances require comparative forensic review and, in such cases, scientific conclusions can be difficult.

  3. Turning in Their Graves? A Tale of Two Coalitions--and What Happened in Between

    ERIC Educational Resources Information Center

    Gillard, Derek

    2013-01-01

    Amid the horrors of the Second World War, a group of Board of Education officials met to plan a new public education system which would be fair to and free for all. In the seventy years since then, successive governments have not only failed to live up to their vision but have increasingly sought to interfere with the teaching and learning process…

  4. [Guidelines for the diagnosis and management of heart failure and cardiogenic shock. Informe del Grupo de Trabajo de Insuficiencia Carddiacade la Sociedad Espanñola de Cardiología].

    PubMed

    Navarro-López, F; de Teresa, E; López-Sendón, J L; Castro-Beiras, A

    1999-01-01

    Guidelines for the Diagnosis and Management of Heart Failure and Cardiogenic Shock have been developed by the Working Group on Heart Failure of the Spanish Society of Cardiology, in collaboration with other Scientific Sections and members of the society. The aim of this report is to promote a more consistent and effective clinical practice according to the principles of evidence based medicine or the recommendations widely accepted by the scientific community. At the same time the aim is to give guidance for epidemiological surveys, heart failure registers clinical assays and clinical quality assessment, and to contribute to cost containment. These twelve guidelines have been designed for doctors in general practice as well as specialists. Criteria for diagnosis and classification of heart failure (systolic and diastolic heart failure, left or right, acute or chronic) are defined. The more appropriate use of clinical or high technology laboratory studies are recommended as well as the most efficient strategies nowadays for the management of chronic stable, unstable or refractory heart failure, or acute heart failure and cardiogenic shock.

  5. Amiodarone therapy in chronic heart failure and myocardial infarction: a review of the mortality trials with special attention to STAT-CHF and the GESICA trials. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina.

    PubMed

    Pinto, J V; Ramani, K; Neelagaru, S; Kown, M; Gheorghiade, M

    1997-01-01

    Amiodarone appears to reduce sudden death in patients with left ventricular dysfunction resulting from an acute MI or a primary dilated cardiomyopathy, particularly if complex ventricular arrhythmias are present. Amiodarone's beneficial effect on mortality in these patients could be unrelated to its antiarrhythmic effects. Multiple factors could account for the improvement in mortality such as the drug's antiischemic effects, neuromodulating effects, its effect on left ventricular function and on heart rate. Moreover, patients with LV dysfunction who have survived an episode of sudden death would potentially benefit from amiodarone therapy. Future trials are needed to determine the precise subsets(s) of patients who would benefit from the drug and the most efficacious dosing regimen for the drug. Based on available data, amiodarone is the only antiarrhythmic agent which has not been shown to increase mortality in patients with chronic heart failure.

  6. Class III antiarrhythmic agents in cardiac failure: lessons from clinical trials with a focus on the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA).

    PubMed

    Doval, H C

    1999-11-01

    The results of previous clinical trials, in a variety of clinical settings, showed that class I agents may consistently increase mortality in sharp contrast to the effects of beta blockers. Attention has therefore shifted to class III compounds for potential beneficial effects on long-term mortality among patients with underlying cardiac disease. Clinical trials with d-sotalol, the dextro isomer (devoid of beta blockade) of sotalol, showed increased mortality in patients with low ejection fraction after myocardial infarction and in those with heart failure; whereas in the case of dofetilide, the impact on mortality was neutral. Because of the complex effects of its actions as an alpha-adrenergic blocker and a class III agent, the impact on mortality of amiodarone in patients with heart failure is of particular interest. A meta-analysis of 13 clinical trials revealed significant reductions in all-cause and cardiac mortality among patients with heart failure or previous myocardial infarction. Among these were 5 controlled clinical trials that investigated the effects of amiodarone on mortality among patients with heart failure. None of these trials was large relative to the beta-blocker trials in the postinfarction patients. However, the larger 2 of the 5 amiodarone trials produced discordant effects on mortality, neutral in one and significantly positive in the other. Some of the differences may be accounted for by the differences in eligibility criteria and baseline characteristics. Future trials that may be undertaken to resolve the discrepancies may need to allow for the newer findings on the effects of concomitant beta blockers, implantable devices, and possibly, spironolactone. All these modalities of treatment have been shown in controlled clinical trials to augment survival in patients with impaired ventricular function or manifest heart failure. Additional trials, some of which are currently in progress, compare amiodarone with implantable devices and other therapeutic interventions, and should help to clarify the optimal management strategy for patients with underlying heart failure.

  7. [Peripheral nervous system and speech disorders].

    PubMed

    Ferri, Lluís

    2014-02-24

    Introduccion. Las afectaciones de la neurona motora inferior en la infancia, de etiologia congenita o adquirida, provocan dificultades en la respuesta motriz del habla en un periodo especialmente critico para el desarrollo del lenguaje. El interes por esta patologia radica en su baja incidencia, en su comorbilidad con otras afectaciones cerebrales y en su pronostico incierto. Objetivo. Hacer una revision de las alteraciones motoras del habla, de la valoracion funcional y de la intervencion logopedica en la disartria flacida. Desarrollo. Se plantea la caracterizacion clinica de las alteraciones en la produccion verbal de origen periferico, concretamente de la disartria flacida y sus manifestaciones respiratorias, fonatorias, de resonancia, de articulacion y de prosodia. Seguidamente, se esboza la valoracion funcional y se plantean las lineas de intervencion para su tratamiento. Conclusiones. Las manifestaciones clinicas de la disartria flacida son muy heterogeneas y van desde leves dificultades articulatorias a graves trastornos que limitan gravemente la capacidad para la expresion verbal. En la mayoria de los casos, la exploracion funcional proporciona hallazgos valiosos para su identificacion y tipificacion, para determinar la necesidad de valoraciones complementarias y para establecer el programa idoneo de intervencion logopedica. La participacion guiada de la familia y el abordaje interdisciplinar son factores que contribuyen decisivamente a mejorar estos procesos.

  8. [Silicosis and industrial bronchitis by exposure to silica powders and cement].

    PubMed

    Méndez-Vargas, María Martha; Báez-Revueltas, Fabiola Berenice; López-Rojas, Pablo; Tovalín-Ahumada, José Horacio; Zamudio-Lara, José Othón; Marín-Cotoñieto, Irma Araceli; Villeda, Francisco

    2013-01-01

    Objetivo: asociar la exposición a polvos inorgánicos en trabajadores de una cantera y una cementera y la generación de alteraciones pulmonares. Métodos: estudio transversal con 32 trabajadores expuestos a polvos inorgánicos en una cantera y 57 en una cementera. Se les realizaron pruebas de función respiratoria y telerradiografías de tórax. Se midieron polvos totales. Resultados: existieron diferencias demográficas significativas entre las dos líneas de producción: los empleados de la cantera fueron más jóvenes, menos altos y ligeramente más delgados. La proporción de enfermos fue significativamente diferente entre las dos áreas: en la cementera fue menor que en la cantera. Aun cuando los trabajadores de la cantera tuvieron una antigüedad menor, presentaron problemas pulmonares más graves. Conclusiones: la cantidad de sílice libre que se maneja en la cantera afecta gravemente la salud de los trabajadores, ya que con un promedio de tres años de antigüedad laboral presentaban silicosis. Por ello, deben establecerse mejores programas de higiene industrial para el control de los polvos.

  9. Campylobacter jejuni: A rare agent in a child with peritoneal dialysis-related peritonitis.

    PubMed

    Tural Kara, Tugce; Yilmaz, Songul; Ozdemir, Halil; Birsin Ozcakar, Zeynep; Derya Aysev, Ahmet; Ciftci, Ergin; Ince, Erdal

    2016-10-01

    La peritonitis es un problema grave en los niños que reciben diálisis peritoneal. La bacteria Campylobacter jejuni es una causa infrecuente de peritonitis. Un niño de 10 años de edad con insuficiencia renal terminal causada por síndrome urémico hemolítico atípico ingresó a nuestro hospital con dolor abdominal y fiebre. El líquido de la diálisis peritoneal era turbio; en el examen microscópico se observaron leucocitos abundantes. Se inició tratamiento con cefepime intraperitoneal. En el cultivo del líquido peritoneal se aisló Campylobacter jejuni, por lo que se agregó claritromicina oral al tratamiento. Al finalizar el tratamiento, el resultado del cultivo del líquido peritoneal era negativo. Hasta donde sabemos, no se había informado previamente peritonitis por C. jejuni en niños. Conclusión. Si bien la peritonitis por C. jejuni es rara en los niños, debe considerarse como factor etiológico de la peritonitis.

  10. Singing from the Grave: DNA from a 180 Year Old Type Specimen Confirms the Identity of Chrysoperla carnea (Stephens)

    PubMed Central

    Price, Ben W.; Henry, Charles S.; Hall, Andie C.; Mochizuki, Atsushi; Duelli, Peter; Brooks, Stephen J.

    2015-01-01

    Historically serving as repositories for morphologically-based taxonomic research, natural history collections are now increasingly being targeted in studies utilizing DNA data. The development of advanced molecular techniques has facilitated extraction of useable DNA from old specimens, including type material. Sequencing diagnostic molecular markers from type material enables accurate species designation, especially where modern taxonomic hypotheses confirm morphologically cryptic species complexes. One such example is Chrysoperla carnea (Stephens), which belongs to a complex of about 20 cryptic species, most of which can only be reliably distinguished by their pre-mating courtship songs or by DNA analysis. The subtle morphological variation in the group has led to disagreement over the previous designation of the lectotype for C. carnea, an issue that has been further compounded because Chrysoperla carnea is a highly valued biological control agent in arable crops. Archival DNA extraction and sequencing from the 180 year old lectotype specimen, combined with Bayesian and Likelihood based phylogenetic analyses of modern specimens from the entire complex, were used to establish unambiguously the true identity of Chrysoperla carnea. PMID:25853856

  11. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... INFORMATION: This invention concerns small molecule compounds that antagonize the activity of the thyroid... autoimmune disease that is commonly associated with hyperthyroidism. In addition, certain small...

  12. The clinical value of human leukocyte antigen HLA-DRB1 subtypes associated to Graves' disease in Romanian population.

    PubMed

    Martin, Sorina; Dutescu, Monica Irina; Sirbu, Anca; Barbu, Carmen; Albu, Alice; Florea, Suzana; Fica, Simona

    2014-01-01

    The aim of this study was to identify the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population and to seek whether specific HLA-DRB1 haplotypes are associated with differences in the clinical presentation of GD at diagnosis. Molecular typing of HLA-DRB1 alleles was performed in 77 Romanian Caucasian GD patients and 445 racially matched controls. In GD patients, age, presence of eye disease, goiter grade, autoantibody status and titer, TSH, FT4, FT3, TT3 levels were recorded at diagnosis. The allelic frequencies of HLA-DRB1*03 (41.55% vs. 17.75%, p < 0.0001, χ(2) = 20.81) and DRB1*11 (42.85% vs. 30.56%, p = 0.045, χ(2) = 3.98)were higher, whereas those of HLA-DRB1*01(3.89% vs. 16.40%, p = 0.007, χ(2) = 7.281) and DRB1*15 (10.38% vs. 21.34%, p = 0.038, χ(2) = 4.309)were lower in GD patients than in controls. FT4/TT3 ratio (p = 0.015) and anti-thyroglobulin antibodies (p = 0.024) were higher in *03/11 patients compared to *X/X, *11/Z, *03/Y patients (where X is any other allele than *03 and *11, Y is any other allele than *11, Z is any other allele than *03). In conclusion, HLA-DRB1*03 and DRB1*11 may be the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population, whereas HLA-DRB1*01 and DRB1*15 seem to be protective. At diagnosis, HLA-DRB1*03/11 GD patients had higher FT4/TT3 ratio and anti-thyroglobulin antibody levels.

  13. America, you are digging your grave with your spoon--should the FDA tell you that on food labels?

    PubMed

    Card, Melissa M

    2013-01-01

    R.J. Reynolds Tobacco Co. v. Food & Drug Admin. discussed whether the FDA's promulgation of graphic images violated tobacco companies' First Amendment rights. While the tobacco companies contested the graphic images, the tobacco companies did not contest the promulgation of nine textual statements about the adverse effects of cigarettes. This uncontested mandate opens a door for the FDA to further expand its regulatory scheme. If the FDA can mandate textual statements about the adverse effects of cigarettes, can the FDA mandate textual statements about the adverse effects of sugar to combat the obesity crisis? This Article presents three textual statements about the adverse effects of sugar, to define the line between acceptable and unacceptable forms of compelled commercial speech under Central Hudson. Establishing this line ensures that the commercial speech doctrine does not deny the FDA from its authority to provide consumers with accurate information. While three textual statements are presented, this Article advocates that one of the textual statements is likely to serve as the best solution to the obesity crisis. The chosen textual statement serves as an effective solution because it presents meaningful information to the consumers enabling consumers to make healthful decisions about their food and encourages manufacturers to modify their products. PMID:24640612

  14. The prevention of dental caries and periodontal disease from the cradle to the grave: what is the best available evidence?

    PubMed

    Davies, Robin M

    2003-05-01

    Increasing weight is being given to applying an evidence-based approach to clinical practice. There is evidence to support a range of preventive measures which the profession and patients can apply to maximize the control of caries and periodontal disease. This paper examines the strength of evidence to support the advice and procedures that may be used by dental professionals to provide an effective preventive programme of advice and procedures for patients of all ages. A hierarchy of evidence is used ranging from Cochrane Reviews at the top, observational studies in the middle, and opinion at the bottom. Whilst the evidence to support preventive advice and procedures in children and adolescents is relatively strong, few studies have been conducted in adults and the elderly.

  15. Higher Education over a Lifespan: A Gown to Grave Assessment of a Lifelong Relationship between Universities and Their Graduates

    ERIC Educational Resources Information Center

    Gallo, Maria L.

    2013-01-01

    Graduation day often includes an oration by a Vice-Chancellor or President reminding the newest cohort of alumni to "keep in touch" with their alma mater. Often, graduates dismiss this invitation instead of embracing this lifelong opportunity. As the only constant -- and constantly growing -- stakeholder group of higher education…

  16. Storm deposits as graves in Early Life: the Fezouata Lagerstätte case (Lower Ordovician, Morocco)

    NASA Astrophysics Data System (ADS)

    Vaucher, Romain; Pittet, Bernard; Hormière, Hélène; Martin, Emmanuel L. O.; Lefebvre, Bertrand

    2016-04-01

    The Fezouata Shale (Early Ordovician, Morocco) is renowned in the palaeontological community for its Konservat-Lagerstätte (Tremadocian in age) that yielded thousands of exceptionally well-preserved fossils (EPF) from the Great Ordovician Biodiversification Event. Lower Ordovician deposits in the central Anti-Atlas Mountain (Zagora area) are expressed by the Fezouata Shale and the Zini Formation. They consist in ca. 900m of siltstones and sandstones deposited in an epicontinental sea at the periphery of the Gondwanaland. Sedimentologic field analysis and sequence analysis were achieved on ten stratigraphic sections in order to constrain the palaeoenvironmental context of the Fezouata Biota and to predict the location (geographically and stratigraphically) of new Lagerstätten. Sedimentary structures (cm- to m-scale symmetrical ripples) and geometries (lobe, lobe-channel) point to storm dominance on the sedimentation but peculiar sedimentary features suggest a tide modulation. Thus, a wave-dominated tide-modulated model of deposition recording proximal offshore to shoreface environments for the Fezouata Shale and shoreface to foreshore environments for the overlying Zini Fm is proposed. Layers yielding EPF are argillaceous siltstones (with wave ripples of cm-scale wavelength) always overlain by fine-grained sandstones (distal storm deposits, few cm-thick, several m-long, with cm- to dm-scale hummocky cross-stratifications). Fast burying by storm deposits appear to be of prime importance to initiate the exceptional preservation of the soft tissues of animals in the fossil record. According to the model of deposition it correspond to environments close to the storm weather wave base. Lower Ordovician succession was deposited during a 2nd order cycle, although 3rd and 4th order cycles were also identified. Encoding these different orders of sea level fluctuations giving a value of "1" for the deepest part of sequences (for each order) and a value of "0" for the shallowest, a reconstruction of the sea level fluctuation is then proposed. This reconstruction clearly highlights the stratigraphic position of the today discovered Lagerstätte. It also suggests that a second, younger (Floian in age) stratigraphic interval has very comparable sedimentary conditions in terms of facies and sea level, and has the potential for being a new Lagerstätte in the Fezouata Shale.

  17. Peripheral blood lymphocyte apoptosis and its relationship with thyroid function tests in adolescents with hyperthyroidism due to Graves' disease

    PubMed Central

    Grywalska, Ewelina; Surdacka, Agata; Tarach, Jerzy; Klatka, Janusz; Roliński, Jacek

    2012-01-01

    Introduction Failures in apoptotic pathways can contribute to various autoimmune diseases, including autoimmune hyperthyroidism due to Graves’ disease (GD). The aim of the present research was to assess changes in the degree of peripheral blood (PB) lymphocyte apoptosis during methimazole (MMI) treatment in the group of teenage children, and to describe its relationship with thyroid function tests. Material and methods The percentage of PB apoptotic lymphocytes, assessed by the decrease in mitochondrial transmembrane potential (CMXRos staining), was measured in 30 adolescents at the time of diagnosis and after obtaining normalization of the thyroid hormone levels. Results The percentage of apoptotic lymphocytes in previously untreated patients with GD (5.16 ±2.81%) was significantly lower (p = 0.000001) than the percentage of apoptotic cells in the same group of patients after obtaining methimazole-induced euthyroidism (10.72 ±4.66%). There was a correlation between the increase of the mean percentages of apoptotic lymphocytes and the reduction of FT4 levels (R = 0.63, p < 0.0001), as well as the reduction of TT3 levels (R = 0.95, p < 0.0001). The more signs and symptoms accompanying the diagnosis of GD, the higher was the increment of the degree of lymphocyte apoptosis observed during the MMI-treatment (R = 0.74, p < 0.0000001). The methimazole dosage correlated (R = 0.85, p < 0.0001) with the percentage of apoptotic cells. Conclusions The use of methimazole in treatment of hyperthyroidism due to GD leads to an increment of apoptotic cells in PB. Higher doses of methimazole cause a higher increase of apoptotic lymphocytes. Apoptosis induction of human PB lymphocytes seems to be one of the indicators of proper hyperthyroidism treatment. PMID:23185197

  18. Cribra orbitalia and trace element content in human teeth from Neolithic and Early Bronze Age graves in southern Poland.

    PubMed

    Gleń-Haduch, E; Szostek, K; Głab, H

    1997-06-01

    Determination of element levels in bones and teeth can complement knowledge of the diagnostics and etiology of various diseases in prehistoric populations. Calcium (Ca), cadmium (Cd), copper (Cu), iron (Fe), and lead (Pb) content were analyzed in teeth from human skeletons dated to 3,000-1,400 BC from Malopolska Upland loess. Levels of iron and calcium were determined using atomic absorption spectroscopy (AAS), and lead, cadmium, and copper levels were measured using anodic stripping voltametry (ASV). Molar teeth from specimens with cribra orbitalia were selected for analyses, and teeth from specimens with no pathological changes were used as a control. No significant correlations between the content of particular elements and the tooth class, specimen age, or depth of burial pit were observed. The Fe content in specimens with cribra orbitalia is not the best measure for this disease's etiology. Thus, interelement correlations and proportions might give a better picture of the biological condition of the specimen and of the investigated groups.

  19. Beyond the material grave: Life Cycle Impact Assessment of leaching from secondary materials in road and earth constructions

    SciTech Connect

    Schwab, Oliver; Bayer, Peter; Juraske, Ronnie; Verones, Francesca; Hellweg, Stefanie

    2014-10-15

    Highlights: • We model environmental impacts of leaching from secondary construction material. • Industrial wastes in construction contain up to 45,000 t heavy metals per year (D). • In a scenario, 150 t are leached to the environment within 100 years after construction. • All heavy metals but As, Sb and Mo are adsorbed by 20 cm subsoil in this scenario. • Environmental impacts depend on material, pollutant, construction type, and geography. - Abstract: In industrialized countries, large amounts of mineral wastes are produced. They are re-used in various ways, particularly in road and earth constructions, substituting primary resources such as gravel. However, they may also contain pollutants, such as heavy metals, which may be leached to the groundwater. The toxic impacts of these emissions are so far often neglected within Life Cycle Assessments (LCA) of products or waste treatment services and thus, potentially large environmental impacts are currently missed. This study aims at closing this gap by assessing the ecotoxic impacts of heavy metal leaching from industrial mineral wastes in road and earth constructions. The flows of metals such as Sb, As, Pb, Cd, Cr, Cu, Mo, Ni, V and Zn originating from three typical constructions to the environment are quantified, their fate in the environment is assessed and potential ecotoxic effects evaluated. For our reference country, Germany, the industrial wastes that are applied as Granular Secondary Construction Material (GSCM) carry more than 45,000 t of diverse heavy metals per year. Depending on the material quality and construction type applied, up to 150 t of heavy metals may leach to the environment within the first 100 years after construction. Heavy metal retardation in subsoil can potentially reduce the fate to groundwater by up to 100%. One major challenge of integrating leaching from constructions into macro-scale LCA frameworks is the high variability in micro-scale technical and geographical factors, such as material qualities, construction types and soil types. In our work, we consider a broad range of parameter values in the modeling of leaching and fate. This allows distinguishing between the impacts of various road constructions, as well as sites with different soil properties. The findings of this study promote the quantitative consideration of environmental impacts of long-term leaching in Life Cycle Assessment, complementing site-specific risk assessment, for the design of waste management strategies, particularly in the construction sector.

  20. Hands-on Space Experiments from Cradle to Grave: The Role of the Sounding Rocket Program in Developing Human Infrastructure

    NASA Astrophysics Data System (ADS)

    Chakrabarti, S.

    2005-12-01

    Sounding rockets in university research provide a unique opportunity to train future space scientists and engineers. Besides fitting the typical schedule of a student, they allow a small group of students to be involved in all aspects of a space project from its inception through execution to a conclusion involving scientific discovery. Furthermore, universities with sounding rocket programs are cradles of innovations where the interdisciplinary nature of space experimentation is nurtured. These programs have formed the core research of many of the current Principal Investigators of NASA Space Science Missions. Additionally, they typically involve a large number of undergraduate students who gain in-depth experience into well-defined and critical components of a space mission. Researchers involved in sounding rocket experiments typically develop the science payload consisting of one or more instrument with the NASA Sounding Rocket Program Office (SRPO) providing all support necessary to make the science program a success. Unlike satellite missions, the sounding rocket experiments offer an opportunity to take more risks in terms of their science return. Some of these risks come in the form of new technology invention and development. Sounding rockets, with their flexible schedule and fewer formal procedural requirements, thus play an important role in maturing technology and developing new capabilities for satellite missions. The Student Launch Program was designed by NASA to provide a new opportunity where space science took a back seat to education and training. The program required that the proposing team provide components such as the nose cone, power and telemetry systems, which are typically provided to rocket experimenters by SRPO. The students involved in such programs thus gained invaluable experience with "mini-satellite" missions. We believe that they are essential for the long-term vitality of the space program and maintaining a technology-savvy workforce of the 21st Century. In this talk we will highlight the unique aspects of several sounding rocket experiments. We will also describe a Student Launch Program where the proposal was developed as a class project in the astronomy department at Boston University and the flight hardware were built through the Senior Design Projects class in the College of Engineering.

  1. Two Sisters with Graves' Disease and Similar Clinical Features who Tested Positive for Anti-insulin Antibodies after Thiamazole Treatment.

    PubMed

    Torimoto, Keiichi; Okada, Yosuke; Mori, Hiroko; Tanaka, Yoshiya

    2016-01-01

    The older of a pair of sisters experienced hypoglycemia after the start of thiamazole (MMI) treatment. Based on a high insulin antibody level, she was diagnosed with insulin autoimmune syndrome (IAS). HLA-DNA typing identified DRB1*04:06. Although a 75-g oral glucose tolerance test (OGTT) showed biphasic insulin secretion, the secretion pattern became monophasic after discontinuation of the MMI. The younger sister was diagnosed with IAS after the start of MMI treatment. HLA-DNA typing identified DRB1*04:06. The 75-g OGTT showed biphasic insulin secretion, but it became monophasic after discontinuation of the MMI. According to the similar insulin secretion kinetics in the two sisters with IAS, we suspect that a genetic predisposition may be associated with the features of anti-insulin antibodies. PMID:27150866

  2. Development of Graves' disease after long-standing hypothyroidism on treatment, with acute toxicity to thionamides and lithium.

    PubMed

    Gupta, Yashdeep; Singh, Sandeep; Ammini, Ariachery C

    2012-08-01

    Thyroid hyperfunction in a patient with long-standing hypothyroidism is uncommon. Here, we describe and discuss the unusual scenario of development of severe skin rash to carbimazole, with subsequent acute toxicity to lithium in clinically indicated doses, in a patient who manifested hyperthyroidism after being on treatment for hypothyroidism for 7 years.

  3. [THE FRENCH ANATOMICAL XAVIER BICHAT (1771 - 1802). FUNDATOR OF DOCTRINE OF TISSUES. BIOGRAPHICAL MEMORY BEFORE HIS GRAVE].

    PubMed

    Pérez García, José Manuel

    2014-01-01

    It is reminded to Marie Francois Xavier Bichat (1771-1802), French physician who figure in the pages of the history of the Universal Medicine. With him begins the anatomic mentality in the nineteenth century, which in 1801 introduced the concept of tissue in his book "Anatomie Generale". With unprecedented nature is disclosed his tomb in Paris' Pere Lachaise cemetery visited by the author, fact that motivated before it about his memories and historical work, which appears in the communication, as a tribute to his memory.

  4. A case of acute oesophageal necrosis (AEN) in a hypothermic patient. The grave prognosis of the black oesophagus.

    PubMed

    Salem, George A; Ahluwalia, Sumit; Guild, Ralph T

    2015-01-01

    Acute oesophageal necrosis, also known as black oesophagus, is a rare, and potentially lethal syndrome which is often diagnosed incidentally during upper endoscopy for evaluation of upper gastrointestinal bleed. It is characterised by diffuse circumferential black mucosal discolouration in the distal oesophagus secondary to necrosis that may extend proximally to involve variable length of the oesophagus. One theory of pathogenesis is that the relatively low perfusion state in the distal areas of the oesophagus makes it susceptible to mucosal injury. We present a case of acute oesophageal necrosis in a 62year-old lady with history of alcoholic cirrhosis who presented with haematemesis and severe hypothermia, and was eventually found to have acute oesophageal necrosis.

  5. [First report of complete genome sequence and phylogenetic analysis of Human Bocavirus 1 isolated in Argentina].

    PubMed

    Cardozo Tomas, Agustina; Ghietto, Lucia Maria; Insfran, Constanza; Wasinger, Nicolas; Marchesi, Ariana; Adamo, Maria Pilar

    2015-01-01

    Antecedentes. El Bocavirus humano (HBoV) es un parvovirus descripto por primera vez en 2005, asociado a cuadros leves y graves de infección respiratoria aguda (IRA), una de las principales causas de morbimortalidad en la población infantil en todo el mundo. Al presente se han identificado 4 genotipos, nombradas HBoV1 a 4, de los cuales el primero es el que se asocia a IRA con predominancia. Objetivo. Obtener el genoma completo de HBoV respiratorio aislado localmente. Métodos. Se diseñaron primers para fragmentos superpuestos del genoma completo de HBoV, empleando las herramientas informáticas ClustalW y NCBI Primer-Blast. Los fragmentos se amplificaron por PCR convencional y se secuenciaron mediante tecnología capilar BigDye Terminator. La edición de las secuencias y análisis filogenético se realizó con el programa MEGA v6. Resultados. Se obtuvo la secuencia genómica completa de HBoV1 cepa 307AR09, aislada de secreción respiratoria de paciente pediátrico con bronquiolitis. La misma fue depositada en la base de datos GenBank con número de acceso KJ634207. El análisis filogenético con secuencias genómicas completas de los 4 genotipos obtenidas en distintas regiones del mundo muestra similitud cercana al 100% con la secuencia original descubierta en Suecia (DQ000495), así como el agrupamiento de los 4 genotipos en 2 clusters de alta homología interna: HBoV1-HBoV3 y HBoV2-HBoV4. Conclusiones. Se aportan datos locales para futuros desarrollos tecnológicos destinados tanto a la investigación como al diseño de métodos diagnósticos para la práctica médica. Por otra parte, los resultados sustentan la propuesta de redistribución taxonómica de los 4 genotipos en 2 especies.

  6. [Anthracycline-induced cardiotoxicity: report of fatal cases].

    PubMed

    Vargas-Neri, Jessica Liliana; Castelán-Martínez, Osvaldo Daniel; de Jesús Estrada-Loza, María; Betanzos-Cabrera, Yadira; Rivas-Ruiz, Rodolfo

    2016-01-01

    Introducción: las antraciclinas son fármacos eficaces en el tratamiento de pacientes pediátricos con cáncer. Sin embargo, la cardiotoxicidad inducida por antraciclinas (CIA) es una reacción adversa grave que afecta la sobrevida de niños y jóvenes. Casos clínicos: el caso 1 estuvo constituido por una paciente de nueve años con linfoma de Hodgkin estadio IV con 12 ciclos de quimioterapia con epirrubicina y una dosis acumulada de 576 mg/m2. Después del último ciclo de quimioterapia, la paciente ingresó con respuesta inflamatoria sistémica, astenia y adinamia. El ecocardiograma reportó una FEVI de 22 %, FA de 11 % e insuficiencia mitral moderada. La paciente falleció dos días después con diagnóstico de cardiomiopatía dilatada secundaria a antraciclinas. El caso 2 fue el de una paciente de 15 años con linfoma no Hodgkin tipo Burkitt estadio IV, con dos ciclos de quimioterapia con epirrubicina y una dosis acumulada de 90 mg/m2. Después del último ciclo, la paciente presentó diversos focos infecciosos. El ecocardiograma reportó una FEVI de 49 %, una FA de 20 % y dilatación del ventrículo izquierdo con aplanamiento septal. La paciente falleció 13 días después del diagnóstico de cardiomiopatía dilatada por antraciclinas. Conclusión: la CIA es un problema en los pacientes pediátricos que reciben antraciclinas. El monitoreo durante y después de la quimioterapia es indispensable para detectar el inicio del daño cardiaco a fin de brindar una intervención oportuna que evite la evolución a una insuficiencia cardiaca.

  7. [Adverse effects with ambulatory intravenous immunoglobulin administration in adult patients with common variable immunodeficiency].

    PubMed

    Rodríguez-Mireles, Karen A; Galguera-Sauceda, Angélica; Gaspar-López, Arturo; López-Rocha, Eunice G; Campos-Romero, Freya; Del Rivero-Hernández, Leonel; Amaya-Mejía, Adela; Galindo-Pacheco, Lucy; O'Farril-Romanillos, Patricia; Segura-Méndez, Nora Hilda

    2014-01-01

    Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria sintomática más frecuente, afecta a 1 por cada 25,000 a 75,000 sujetos. Se distingue por la ausencia o disminución de anticuerpos. Su tratamiento consiste en el reemplazo de anticuerpos con inmunoglobulina humana y la vía de administración más frecuente es la intravenosa, a dosis de 400 a 800 mg/kg de peso/dosis cada tres a cuatro semanas. Los efectos adversos asociados con la administración de inmunoglobulina intravenosa (IgIV) ocurren incluso en 25% de todas las infusiones realizadas, las reacciones severas afectan a menos de 1% de los pacientes. Entre las reacciones adversas severas están la insuficiencia renal aguda, que sobreviene 1 a 10 días después del inicio de tratamiento con IgIV. En nuestro centro elaboramos e implementamos un esquema ambulatorio para la aplicación de IgIV que permite su administración en un promedio de 3 h, sin efectos adversos graves. Objetivos: describir los efectos adversos y evaluar la frecuencia de insuficiencia renal secundaria a la aplicación ambulatoria de IgIV en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo y prospectivo en el que participaron pacientes adultos con diagnóstico definitivo de inmunodeficiencia común variable, que recibían IgIV a dosis de sustitución cada tres semanas, a quienes se realizó exploración física, somatometría, determinación sérica de creatinina, albúmina y urea, depuración de creatinina en orina de 24 horas, cálculo de la tasa de filtración glomerular por la fórmula CKD-EPI y evaluación de la función renal inmediata, así como la asociada con la administración acumulada de IgIV a través del cálculo de la tasa de filtración glomerular. Los resultados se analizaron con estadística descriptiva para el reporte de los efectos en la función renal y la dosis acumulada de IgIV. Resultados: se determinó la frecuencia de reacciones adversas

  8. [Metabolic myopathies].

    PubMed

    Papazian, Óscar; Rivas-Chacón, Rafael

    2013-09-01

    Objetivo. Revisar las miopatias metabolicas manifestadas solamente por crisis de mialgias, calambres y rigidez musculares con dificultad para contraer los musculos afectados y el examen neurologico normal entre las crisis en niños y adolescentes. Desarrollo. Estas miopatias metabolicas se deben a deficits enzimaticos heredados en forma autosomica recesiva del metabolismo de los carbohidratos y lipidos. El resultado final es una reduccion del trifosfato de adenosina principalmente a traves de la fosforilacion oxidativa mitocondrial con disminucion de la energia disponible para la contraccion muscular. Las secundarias a trastornos del metabolismo de los carbohidratos se producen por ejercicios de alta intensidad y breves (< 10 min) y las secundarias a trastornos de los lipidos, por ejercicios de baja intensidad y prolongados (> 10 min). Los deficits enzimaticos en el primer grupo son de miofosforilasa (glucogenosis V), fosfofructocinasa muscular (glucogenosis VII), fosfoglicerato mutasa 1 (glucogenosis X) y beta enolasa (glucogenosis XIII), y en el segundo, de carnitina palmitol transferasa tipo II y de acil-CoA deshidrogenasa de cadena muy larga. Conclusiones. Las caracteristicas diferenciales de los pacientes en cada grupo y dentro de cada grupo permitiran el diagnostico clinico presuntivo inicial en la mayoria y solicitar solamente los examenes necesarios para corroborar el diagnostico. El tratamiento de las crisis consiste en hidratacion, glucosa y alcalinizacion de la orina. Las medidas preventivas son evitar el tipo de ejercicio que induce las crisis y el ayuno. No existe cura o tratamiento especifico. El pronostico es bueno con la excepcion de casos raros de insuficiencia renal aguda debido a la elevacion sanguinea de la mioglobina producto de una rabdomiolisis grave.

  9. A Personal and Collaborative Journey of Change: Lessons Learned about Leadership, Mentoring and Motivation from an Educational Community's Work with Donald Graves

    ERIC Educational Resources Information Center

    Jasinski, Barbara Plummer

    2013-01-01

    Change is often expected as the logical outcome of large scale investments in professional development, yet research studies (e.g., Tyack & Cuban, 1995; Lipson, Mosenthal & Woodside-Jiron, 2000; Schraw & Olafson, 2002) note wide variations in instructional practice despite such efforts. This qualitative inquiry was designed to…

  10. Superior Mesenteric Artery Syndrome Complicated by Diabetic Ketoacidosis and Graves' Disease in Slowly Progressive Insulin Dependent Diabetes Mellitus (SPIDDM): A Case Report and a Review of the Literature.

    PubMed

    Hirai, Hiroyuki; Fukushima, Naotaro; Hasegawa, Koji; Watanabe, Tsuyoshi; Hasegawa, Osamu; Satoh, Hiroaki

    2016-01-01

    A 48-year-old woman with a history of diabetes was admitted for nausea and vomiting with body weight loss. A blood examination revealed high plasma glucose and thyroid hormone levels and metabolic acidosis. She was therefore diagnosed with both diabetic ketoacidosis (DKA) and hyperthyroidism. Nausea and vomiting continued intermittently despite the administration of saline and insulin. The patient was further diagnosed with superior mesenteric artery syndrome (SMAS) after abdominal computed tomography revealed that a horizontal portion of the duodenum was sandwiched between the aorta and the superior mesenteric artery. Clinicians should be vigilant for SMAS in patients with both DKA and hyperthyroidism who present body weight loss. PMID:27477411

  11. Alloimmunisation fœto-maternelle Rhésus grave à propos d'un cas et revue de la littérature

    PubMed Central

    Zineb, Benkerroum; Boutaina, Lachiri; Ikram, Lazrak; Driss, Moussaoui Rahali; Mohammed, Dehayni

    2015-01-01

    L'incompatibilité fœto-maternelle Rhésus peut être à l'origine d'un syndrome hémolytique dont l'expression clinique est l′anémie fœtale éventuellement compliquée par une anasarque fœto-placentaire ou à l'extrême une mort fœtale in utéro. Nous rapportons l'observation d'un cas d'allo immunisation Rhésus à 34 SA ayant aboutit un hydrops foetalis, l'extraction fœtale par césarienne en vue d'une exsanguino-transfusion a été réalisée, mais le nouveau né est décédé au cours de l'exsanguino-transfusion. Le dépistage des femmes à risque et l'utilisation d'Immunoglobulines anti D ont permis une réduction importante de l′incidence des accidents d'incompatibilité. La mesure du pic systolique de vélocité dans l'artère cérébrale moyenne a bouleversé la surveillance et la prise en charge prénatale des anémies fœtales secondaires à une allo-immunisation Rhésus. Son utilisation dans la surveillance des cas d'allo-immunisation Rhésus permettrait ainsi de réserver les procédures invasives (cordocentèse) comme geste thérapeutique qui permet la transfusion fœtale in utéro. Grâce à une collaboration multidisciplinaire cohérente, l'extraction fœtale peut être programmée, ce qui permet une prise en charge adéquate et rigoureuse, même des nouveaux nés avec atteinte sévère. PMID:26889318

  12. Different fetal-neonatal outcomes in siblings born to a mother with Graves-Basedow disease after total thyroidectomy: a case series

    PubMed Central

    2010-01-01

    Introduction We describe three different fetal or neonatal outcomes in the offspring of a mother who had persistent circulating thyrotropin receptor antibodies despite having undergone a total thyroidectomy several years before. Case presentation The three different outcomes were an intrauterine death, a mild and transient fetal and neonatal hyperthyroidism and a severe fetal and neonatal hyperthyroidism that required specific therapy. Conclusions The three cases are interesting because of the different outcomes, the absence of a direct correlation between thyrotropin receptor antibody levels and clinical signs, and the persistence of thyrotropin receptor antibodies several years after a total thyroidectomy. PMID:20170485

  13. The grave is wide: the Hibakusha of Hiroshima and Nagasaki and the legacy of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation.

    PubMed

    O'Malley, Gerald F

    2016-07-01

    Following the atomic bomb attacks on Japan in 1945, scientists from the United States and Japan joined together to study the Hibakusha - the bomb affected people in what was advertised as a bipartisan and cooperative effort. In reality, despite the best efforts of some very dedicated and earnest scientists, the early years of the collaboration were characterized by political friction, censorship, controversy, tension, hostility, and racism. The 70-year history, scientific output and cultural impact of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation are described in the context of the development of Occupied Japan.

  14. Formes hémorragiques graves de la fièvre de la vallée du Rift: à propos de 5 cas

    PubMed Central

    Salem, Mohamed Lemine Ould; Baba, Sidi El Wafi Ould; Fall-Malick, Fatimetou Zahra; Boushab, Boushab Mohamed; Ghaber, Sidi Mohamed; Mokhtar, Abdelwedoud

    2016-01-01

    La fièvre de la vallée du Rift (FVR) est une arbovirose due à un virus à ARN appartenant à la famille de Bunyaviridae (genre phlebovirus). C'est une zoonose touchant principalement les animaux mais pouvant aussi contaminer l'homme, soit directement par la manipulation des viandes ou avortons d'animaux malades ou indirectement par la piqure de moustiques infectées (Aèdes sp, anophèles sp, Culex sp). Dans la majorité des cas, l'infection humaine à FVR est asymptomatique, mais elle peut également se manifester par un syndrome fébrile modérée d’évolution favorable. Néanmoins, certains patients peuvent développer un syndrome hémorragique et/ou des lésions neurologiques d’évolution mortelle. Nous décrivons l’évolution de cinq cas de patients atteints de la FVR, admis dans le service de médecine interne du Centre Hospitalier National de Nouakchott (Mauritanie), le mois d'Octobre 2015 et présentant tous, un syndrome hémorragique dans un contexte fébrile. L’évolution n’était favorable que pour 2 des cinq patients. Les 3 autres sont décédés, deux dans un tableau de choc hémorragique et dans un état de choc septique. PMID:27642413

  15. [Acute community-acquired pneumonia of moderate and grave severity investigated by bronchoscopy. Analysis of 193 cases hospitalized in a general hospital].

    PubMed

    Vivès, L; Biel, P; Maler, G; Labonne, F; Lecoules, N; Dufour, M; Marignol, G; Vanche, J

    1996-01-01

    Between February 1989 and June 1994 193 cases of acute community acquired pneumonia (PAC) which were of intermediate or great severity were admitted to two hospitals in the South West of France. These patients were explored using bronchofibroscopy (FB) with a protected brush (BP) and alveolar microlavage (MLBA) and quantitative cultures were performed, also there were other specimens taken in a regular fashion. The percentage of positive examinations was 60% for brushings (BP), 59% for MLBA and 21% for blood cultures and 16% for serological tests. An aetiology was determined in 137 cases (70.9%). The organisms recovered were Streptococcus pneumoniae (49.6%), gram negative bacilli (17.4%), Haemophilus influenzae (11.7%), Mycoplasma pneumoniae (4.4%), Mycobacterium tuberculosis (4.4%), Staphylococcus aureus (3.6%), Chlamydia pneumoniae (2.2%), Legionella pneumophila (0.7%), and various 5.8%. The overall mortality was 15% despite immediate antibiotics based on the likely organism in 88% of cases. The study of prognostic factors confirmed the Fine score system (determined a posteriori) which constitutes a useful and practical index determining the management of PAC. On the other hand the role of bacteriological documentation in improving the vital prognosis remains to be confirmed. If bronchofibroscopy has appeared to us as a safe and useful means of investigation, the management of these disease remains to specified. We suggest that its use is reserved for subjects with life threatening disease (a Fine score equal to or greater than 3) or for those patients who are likely to have unusual germs: failure of previous antibiotics, diabetes, malnourishment, cancer, airflow obstruction and inhalation. PMID:8711237

  16. The grave is wide: the Hibakusha of Hiroshima and Nagasaki and the legacy of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation.

    PubMed

    O'Malley, Gerald F

    2016-07-01

    Following the atomic bomb attacks on Japan in 1945, scientists from the United States and Japan joined together to study the Hibakusha - the bomb affected people in what was advertised as a bipartisan and cooperative effort. In reality, despite the best efforts of some very dedicated and earnest scientists, the early years of the collaboration were characterized by political friction, censorship, controversy, tension, hostility, and racism. The 70-year history, scientific output and cultural impact of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation are described in the context of the development of Occupied Japan. PMID:27158765

  17. From cradle to grave: tracking socioeconomic inequalities in mortality in a cohort of 11 868 men and women born in Uppsala, Sweden, 1915–1929

    PubMed Central

    Juárez, Sol P; Koupil, Ilona

    2016-01-01

    Background Ample evidence has shown that early-life social conditions are associated with mortality later in life. However, little attention has been given to the strength of these effects across specific age intervals from birth to old age. In this paper, we study the effect of the family's socioeconomic position and mother's marital status at birth on all-cause mortality at different age intervals in a Swedish cohort of 11 868 individuals followed across their lifespan. Methods Using the Uppsala Birth Cohort Multigenerational Study, we fitted Cox regression models to estimate age-varying HRs of all-cause mortality according to mother's marital status and family's socioeconomic position. Results Mother's marital status and family's socioeconomic position at birth were associated with higher mortality rates throughout life (HR 1.18 (95% CI 1.12 to 1.26) for unmarried mothers; 1.19 (95% CI 1.12 to 1.25) for low socioeconomic position). While the effect of family's socioeconomic position showed little variation across different age groups, the effect of marital status was stronger for infant mortality (HR 1.47 (95% CI 1.23 to 1.76); p=0.04 for heterogeneity). The results remained robust when early life and adult mediator variables were included. Conclusions Family's socioeconomic position and mother's marital status involve different dimensions of social stratification with independent effects on mortality throughout life. Our findings support the importance of improving early-life conditions in order to enhance healthy ageing. PMID:26733672

  18. Gold from the tomb of Scribe Beri: a comparative analytical approach to the New Kingdom gold grave goods from Riqqa (Egypt)

    NASA Astrophysics Data System (ADS)

    Troalen, Lore; Guerra, Maria Filomena

    2016-03-01

    The gold necklace and penannular earrings from tomb 296 at Riqqa, containing the coffins of a female and of a male, the latter a scribe named Beri of the reign of Tuthmosis III (eighteenth Dynasty Egypt), were analysed by PIXE, XRF, and EDS, together with eight penannular earrings from other find-spots of the same period. Analysis of jewellery items from tomb 296 at Riqqa revealed the use of high-purity gold alloys and electrum alloys, while the other earrings investigated were found to be made of electrum with high Ag content. Two earrings conserved in different museums were shown to be originally a pair. PIXE mapping revealed the extensive use of a hard soldering technique for the joints, with the solders being obtained by the addition of Cu to the base alloy. The presence of PGE inclusions indicated the use of alluvial gold, but the variability of their composition could be ascribed to the recycling of gold from different origins, in the case of some objects.

  19. [Prevalence of malnutrition in not critically ill older inpatients].

    PubMed

    Fernández López, María Teresa; Fidalgo Baamil, Olga; López Doldán, Carmen; Bardasco Alonso, María Luisa; de Sas Prada, María Trinidad; Lagoa Labrador, Fiz; García García, María Jesús; Mato Mato, José Antonio

    2015-06-01

    Introducción: los cambios fisiológicos propios del envejecimiento, junto con distintos procesos patológicos, predisponen a los ancianos a la aparición de complicaciones nutricionales, siendo el estado nutricional un factor pronóstico importante. El objetivo del estudio es conocer la prevalencia de desnutrición en los mayores de 65 años en nuestro centro, tanto al ingreso como al alta. Métodos: realizamos un estudio transversal, observacional. Para ello evaluamos 174 pacientes mayores de 65 años que ingresaron de forma consecutiva, mediante la aplicación del Nutritional Risk Screening 2002 (NRS- 2002) y el Mini Nutritional Assessment Short Form (MNA-SF) en las primeras 48 horas de ingreso. Los pacientes oncológicos también se evaluaron mediante la Valoración Global Subjetiva Generada por el Paciente (VGS-GP). Al alta se realizó de nuevo el NRS-2002. Resultados: el 29,31% de los pacientes estaban en situación de riesgo nutricional según los resultados del NRS-2002 al ingreso. Este porcentaje aumentaba hasta el 57,89% al alta. El MNA-SF objetivó alteración nutricional en el 70,35% (54,65% riesgo de desnutrición, 15,7% desnutrición). Según el NRS-2002 el 34,14% de los pacientes con cáncer presentaban riesgo nutricional; sin embargo, la VGS-GP mostraba deterioro nutricional en el 56,41% de los casos (46,15% desnutrición moderada y 10,26% desnutrición grave). Existen grupos de pacientes (los de mayor edad, los ingresados de forma urgente, los que presentan insuficiencia cardíaca) con mayor riesgo de deterioro nutricional durante el ingreso (p < 0,05). Conclusiones: el porcentaje de pacientes mayores de 65 años en riesgo nutricional en nuestro centro es muy alto, tanto al ingreso como al alta. Se hace necesario el cribado nutricional sistemático.

  20. Tétraplégie révélatrice d'une méningomyélite grave à pneumocoque: à propos d'un cas et revue de littérature

    PubMed Central

    Nebhani, Tahir; Bakkali, Hicham; Belyamani, Lahcen

    2015-01-01

    L'atteinte médullaire est une complication rare des méningites à streptocoque pneumoniae. notre observation clinique décrit le cas d'une Jeune femme immunocompétente qui s'est présentée au service d'accueil des urgences pour tétraplégie dont les investigations ont mis en évidence une méningite à pneumocoque. Le traitement était basé sur l'antibiothérapie plus une corticothérapie concomitante. L’évolution était marquée par la persistance des séquelles neurologiques. PMID:26113898

  1. Grave infarctus mésentérique par occlusion artérielle mésentérique supérieure chez un patient atteint de la maladie de Buerger

    PubMed Central

    Ratbi, Moulay Ibrahim; Abissegue, Ghislain Yves; Tarchouli, Mohamed; Tajedine, Mohammed Tariq

    2014-01-01

    La thromboangéite oblitérant ou maladie de Buerger, est une artérite inflammatoire non-artériosclérotique touchant classiquement les réseaux vasculaires périphériques des membres. Elle atteint principalement les hommes jeunes tabagiques et sans autres facteurs de risques cardiovasculaires. Les atteintes des artères digestives sont très rares et souvent fatales si elles ne sont pas évoquées et prises en charge précocement. Nous rapportons l'observation d'un jeune patient tabagique chronique qui s’était présenté aux urgences dans un tableau de péritonite aigue négligée due a un infarctus entero-mésentérique massif. L'origine était une ischémie mésentérique due à une thrombose de l'artère mésentérique supérieure. L’étude anatomopathologique avait objectivée une atteinte des artères digestive due à la maladie de Buerger. PMID:25918562

  2. Pontage fémoro-fémoral croisé avec tunnulisation périnéale sous-scrotale pour une infection grave du triangle de scarpa

    PubMed Central

    Mrad, Melek Ben; Miri, Rim; Kaouel, Karim; Derbel, Bilel; Tarzi, Mariem; Ghedira, Faker; Kalfat, Tawfik; Mizouni, Hbiba; Khayati, Adel

    2015-01-01

    Nous décrivons dans cet article une technique de revascularisation des patients ayant une infection de prothèse vasculaire sus-crurale au niveau dutriangle de scarpa, et qui minimise le risque d'infection récurrente du greffon. Cette technique consiste en un pontage fémoro-fémoral croisé avec un tunnel périnéal sous-cutané loin du scarpa infecté que le tunnel classique sus-pubiensous-cutané ne permet pas. Nous rapportons le cas d'un patient âgé de 52 ans, artéritique, multi-opérés, admis pour infection du scarpa droit sur un pontage fémoro-fémoral prothétique perméable, le patient a eu une explantation de ce pontage et une revascularisation par un pontage périnéal sous-scrotal veineux loin du site infectieux; l’évolution a été excellente et le pontage est encore perméable après deux ans de suivi. Le pontage fémoro-fémoral périnéal est une procédure exceptionnellement réalisée, mais qui peut constituer une vraie option thérapeutique de revascularisation chez les patients avec une infection du scarpa. PMID:26955419

  3. Extra-ocular muscle cells from patients with Graves' ophthalmopathy secrete α (CXCL10) and β (CCL2) chemokines under the influence of cytokines that are modulated by PPARγ.

    PubMed

    Antonelli, Alessandro; Ferrari, Silvia Martina; Corrado, Alda; Franceschini, Stefano Sellari; Gelmini, Stefania; Ferrannini, Ele; Fallahi, Poupak

    2014-11-01

    To our knowledge, no study has evaluated the involvement of T helper (Th)1- and Th2-chemokines in extra-ocular muscle (EOM) myopathy in "patients with thyroid-associated ophthalmopathy" (TAO-p). We tested the effects of interferon (IFN)γ and tumor necrosis factor (TNF)α stimulation, and of increasing concentrations of peroxisome proliferator-activated receptor (PPAR)γ agonists (pioglitazone or rosiglitazone; 0.1 μM-20 μM), on Th1-chemokine [C-X-C motif ligand (CXCL)10] and Th2-chemokine [C-C motif ligand (CCL)2] secretion in primary EOM cultures from TAO-p vs. control myoblasts. Moreover, we evaluated serum CXCL10 and CCL2 in active TAO-p with prevalent EOM involvement (EOM-p) vs. those with prevalent orbital fat expansion (OF-p). Serum CXCL10 was higher in OF-p and EOM-p vs. controls, while serum CCL2 was not significantly different in controls, or in OF-p and EOM-p. We showed the expression of PPARγ in EOM cells. In primary EOM cultures from TAO-p: a) CXCL10 was undetectable in the supernatant, IFNγ dose-dependently induced it, whereas TNFα did not; b) EOM produced basally low amounts of CCL2, TNFα dose-dependently induced it, whereas IFNγ did not; c) the combination of TNFα and IFNγ had a significant synergistic effect on CXCL10 and CCL2 secretion; and d) PPARγ agonists have an inhibitory role on the modulation of CXCL10, while they stimulate CCL2 secretion. EOM participates in the self-perpetuation of inflammation by releasing both Th1 (CXCL10) and Th2 (CCL2) chemokines under the influence of cytokines, in TAO. PPARγ agonist activation plays an inhibitory role on CXCL10, but stimulates the release of CCL2.

  4. 77 FR 68824 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Tongass National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... village, about 50 feet from the high water line of the beach. The grave was marked by a marble headstone.... About six inches of soil covered the top layer of planks. A fence surrounded the grave and the...

  5. Eyelid lift

    MedlinePlus

    ... or other circulatory disorders Thyroid problems such as hypothyroidism and Graves disease After the Procedure You can ... Read More Diabetes Eyelid drooping Facelift Graves disease Hypothyroidism Myasthenia gravis Ptosis - infants and children Update Date ...

  6. Antithyroglobulin antibody

    MedlinePlus

    Thyroglobulin antibody; Thyroiditis - thyroglobulin antibody; Hypothyroidism - thyroglobulin antibody; Thyroiditis - thyroglobulin antibody; Graves disease - thyroglobulin antibody; Underactive thyroid - thyroglobulin antibody

  7. The free neural grafting for recurrent nerve laceration Experimental study in rabbit.

    PubMed

    Engin, Omer; Yildirim, Mehmet; Kulan, Ahmet; Dalgic, Abdullah; Yagci, Ayse; Toptay, Huseyin; Akcay, Emrah

    2015-01-01

    Quando viene rilevato un danno al nervo ricorrente riteniamo che sia meglio procedere ad una correzione chirurgica che non danneggi la fisiologia respiratoria piuttosto che non fare nulla. Pertanto, dopo la sperimentazione da noi condotta, raccomandiamo questo metodo chirurgico che rispetta la normale anatomia e la fisiologia.

  8. The effectiveness of ground-penetrating radar surveys in the location of unmarked burial sites in modern cemeteries

    NASA Astrophysics Data System (ADS)

    Fiedler, Sabine; Illich, Bernhard; Berger, Jochen; Graw, Matthias

    2009-07-01

    Ground-penetration radar (GPR) is a geophysical method that is commonly used in archaeological and forensic investigations, including the determination of the exact location of graves. Whilst the method is rapid and does not involve disturbance of the graves, the interpretation of GPR profiles is nevertheless difficult and often leads to incorrect results. Incorrect identifications could hinder criminal investigations and complicate burials in cemeteries that have no information on the location of previously existing graves. In order to increase the number of unmarked graves that are identified, the GPR results need to be verified by comparing them with the soil and vegetation properties of the sites examined. We used a modern cemetery to assess the results obtained with GPR which we then compared with previously obtained tachymetric data and with an excavation of the graves where doubt existed. Certain soil conditions tended to make the application of GPR difficult on occasions, but a rough estimation of the location of the graves was always possible. The two different methods, GPR survey and tachymetry, both proved suitable for correctly determining the exact location of the majority of graves. The present study thus shows that GPR is a reliable method for determining the exact location of unmarked graves in modern cemeteries. However, the method did not allow statements to be made on the stage of decay of the bodies. Such information would assist in deciding what should be done with graves where ineffective degradation creates a problem for reusing graves following the standard resting time of 25 years.

  9. 21 CFR 866.5870 - Thyroid autoantibody immunological test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (chronic lymphocytic thyroiditis), nontoxic goiter (enlargement of thyroid gland), Grave's disease (enlargement of the thyroid gland with protrusion of the eyeballs), and cancer of the thyroid....

  10. 21 CFR 866.5870 - Thyroid autoantibody immunological test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (chronic lymphocytic thyroiditis), nontoxic goiter (enlargement of thyroid gland), Grave's disease (enlargement of the thyroid gland with protrusion of the eyeballs), and cancer of the thyroid....

  11. 21 CFR 866.5870 - Thyroid autoantibody immunological test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (chronic lymphocytic thyroiditis), nontoxic goiter (enlargement of thyroid gland), Grave's disease (enlargement of the thyroid gland with protrusion of the eyeballs), and cancer of the thyroid....

  12. [Implementation of respiratory rehabilitation in the municipalities of Valparaíso, Viña del Mar, Quilpué and Villa Alemana in 2013].

    PubMed

    Manriquez Villarroel, Pablo; Colines Rodríguez, Yasna; Poblete Vega, Felipe; Otárola Bravo, Jaime; Paredes Barrera, Cristhian; Acuña Cabrera, Ana María

    2014-10-03

    Introducción: La rehabilitación respiratoria es un pilar fundamental en el tratamiento del paciente con Enfermedad Pulmonar Obstructiva Crónica. Reduce importantemente los costos para el sistema de salud, el uso de recursos sanitarios, disminuyendo la estadía hospitalaria y las consultas a servicios de urgencia. Objetivo: Describir la condición actual de la rehabilitación respiratoria en los centros de atención primaria ubicados en la región de Valparaíso. Método: Se aplicó una encuesta cerrada a cada profesional a cargo del área respiratoria en los centros de atención primaria de salud. La muestra estuvo conformada por 32 centros de salud correspondientes a las comunas de Valparaíso, Viña del Mar, Quilpué y Villa Alemana. Resultados: 9 centros (28%) del total de la muestra realizan rehabilitación respiratoria y el mismo número tiene un programa de rehabilitación estructurado. En 15 (47%) de los centros existe un Nutricionista dentro del equipo de salud. En el 100% de los centros se evalúa a los pacientes mediante espirometría y escalas de disnea. La mayoría de los centros (89%) realiza entrenamiento de extremidades superiores e inferiores. Dentro de los factores que limitan la realización de la rehabilitación respiratoria, 20 (63%) centros refieren que el horario de atención es uno de los factores más limitantes, mientras que 23 (72%) centros refieren que no cuentan con espacio físico adecuado y 22 (69%) centros relatan no contar con los implementos mínimos necesarios. Discusión: Los datos obtenidos indican que en la mayoría de los centros encuestados no se realiza rehabilitación respiratoria como parte del tratamiento del paciente con Enfermedad Pulmonar Obstructiva Crónica, principalmente por problemas de recursos humanos, materiales e infraestructura.

  13. [Prevalence of undernutrition in hospital patients with unbalanced heart failure; subjective global assessment like prognosis sign].

    PubMed

    Guerra-Sánchez, Luis; Martinez-Rincón, Carmen; Fresno-Flores, Mar

    2015-04-01

    Introducción: Existe una gran variabilidad en los estudios sobre la prevalencia de malnutrición en pacientes con insuficiencia cardiaca crónica. La proporción de pacientes desnutridos depende del método de valoración utilizado y del momento en que se realice. Se ha descrito la relación entre desnutrición y aumento de las complicaciones, de la estancia hospitalaria, de la mortalidad y de reingreso hospitalario. Por lo que merece la pena señalar y tratar a estos pacientes. Objetivos: El objetivo fue aproximarnos a la prevalencia de la desnutrición, en los pacientes con insuficiencia cardiaca crónica ingresados por descompensación, en nuestro medio y analizar cuál de los dos métodos de valoración nutricional utilizados, era mejor predictor de mortalidad. Métodos: Estudio observacional, transversal, en el que se evaluaron mediante la Valoración Subjetiva Global y Mini Nutritional Assesment , el estado nutricional de 377 pacientes ingresados en un hospital terciario de alta complejidad con diagnósticos compatibles con descompensación de insuficiencia cardiaca crónica. Resultados: La edad media fue de 75±10. El 51,5%(n=194) fueron hombres. Según la Valoración Subjetiva Global, el 50,7% (45,6%-55,7%) estaban normonutridos, el 41,9% (37,0%-46,9%) presentaban riesgo o sospecha de desnutrición y el 7,4% (5,2%-10,5%) presentaban desnutrición franca. Conclusiones: La prevalencia de desnutrición de los pacientes hospitalizados por descompensación de Insuficiencia Cardiaca crónica en nuestro ámbito es alta. La Valoración Subjetiva Global es un buen predictor de la mortalidad.

  14. 1. EXTERIOR VIEW, LOOKING WEST, OF CAST IRON FENCE AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. EXTERIOR VIEW, LOOKING WEST, OF CAST IRON FENCE AND MARBLE MONUMENTS IN THIS GRAVE PLOT IN THE COLUMBIANA CEMETERY WHICH DATE TO 1864. IRON WORK MANUFACTURED AT SHELBY IRONWORKS FOR IRONMASTER'S FIRST WIFE AND DAUGHTER'S GRAVES. - Ware Cemetery Plot, Shelby County Road 25, Columbiana, Shelby County, AL

  15. 75 FR 15493 - Proposed Information Collection Activity: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... comments on the information needed to obtain a government headstone, grave marker or medallion. DATES.... Titles: a. Application for Standard Government Headstone or Marker for Installation in a Private or State... 40-1330 to apply for Government provided headstones or markers for unmarked graves. b. A...

  16. GPR Detection and Geophysical Characteristics of Burials in an 19th Century Cemetery

    NASA Astrophysics Data System (ADS)

    Bobyarchick, A. R.; Brooks, C.; Flowers, M.; Johnson, B.

    2009-12-01

    We conducted a GPR (Ground Penetrating Radar) survey as part of a forensic investigation of the Second Site Cemetery (Rice Cemetery, Hartt Cemetery) in Mecklenburg County, North Carolina. The oldest marked grave at Second Site is 1797, although it is likely that unmarked graves date back to 1780. The most recent marked grave is dated 1848, but forensic evidence suggest that Second Site was in active use until at least the 1880s. The Second Site cemetery contains a "members" section and a "servants" section. The servants section contains graves of slaves, former slaves, and possibly other individuals. Our objectives were to determine the locations of unmarked graves in the servants cemetery, and to define the GPR characteristics that might help distinguish between burials in simple (or no) enclosures and those involving ornamented caskets with hardware. We selected a 15 m by 15 m section of the servants cemetery (Section A) and a second 5 m by 5 m section (Section Z) to conduct GPR surveys, and excavated one grave in each section. Our GPR surveys were done with a GSSI SIR 3000 and a 400 MHz antenna in distance mode. The Section A GPR survey comprised parallel north-south profiles at 0.2 m intervals, and a set of cross lines at 0.5 m spacing. The Section Z profiles were north-south but at a spacing of 0.4 m. Soils in the cemetery are CeB2: Cecil sandy clay loam, clay, clay loam, and sandy loam derived from saprolitized metagranite. We established that a relative permittivity of 3 was suitable for this site at average depths of about 1.5 m, the nominal depth of burial. GPR profiles in both sections revealed some common geophysical characteristics. Most graves are longitudinally oriented east-west. Our north-south profiles therefore define grave lengths. Graves in non-migrated GPR sections are parabolic reflections with lower frequency responses than background. The size, shape, and spectral qualities of these reflections distinguish them from other sources (debris

  17. Geophysical Investigation Using Ground Penetrating Radar (GPR) to Detect Unmarked Burial Sites

    NASA Astrophysics Data System (ADS)

    Ameen, T. H.; Mahdi, H. H.; Hussein, R. R.; Al-Shukri, H. J.

    2015-12-01

    Comprehensive Ground Penetrating Radar surveys were conducted at the Old Carlisle Cemetery, east of Little Rock, Arkansas, to investigate the locations of historic burial sites and to identify unmarked graves. The Old Carlisle Cemetery, Arkansas, since 1872 has been in use and a potential expansion will be planed if the geophysics data help to identify unused lands. GPR survey was conducted at the cemetery using GSSI SIR-3000 with 400 MHz antenna and 900 MHz antennas. A total of 234.5 m profiles of GPR data were acquired from three locations within the old and new parts of the cemetery. At the 1stlocation, GPR data collected along 6 parallel profiles. Data reveals, after the normal comprehensive processing; two unmarked graves at about a depth of 1m and one misplaced headstone or collapsed grave were detected. Other marked graves around 1m depth with headstones were also verified by their typical reflections hyperbola on the GPR profiles. At the 2ndlocation, the data collection was performed along 4 parallel profiles to locate potential areas that were not used for burial in the past. The GPR data showed that there were no graves in the area below at least two of the profiles. Three marked graves which were verified by their headstones might have metal caskets due to their strong reflection hyperbolas around a depth of about 1.2 m. Three other graves were either collapsed or decomposed due to their very weak reflections within a subsided surface area. Animal burrows and a rusted old key were found and verified by near surface digging. At the 3rd location, the data was collected along 3 parallel profiles. The GPR was able to detect one unmarked grave and two marked graves, each with two coffins, by showing strong reflection hyperbolas at about 0.75 m depth. A grave with a headstone to the north of the two graves did not show strong reflection hyperbola although the burial date (1987) is younger than the other two. This might reflect different type of burial practice

  18. Postpartum thyroid dysfunction.

    PubMed

    Browne-Martin, K; Emerson, C H

    1997-03-01

    Four disorders of the postpartum period are associated with thyroid dysfunction. The most common is PPT. Although recovery from thyroid dysfunction often occurs in PPT, many patients eventually develop permanent hypothyroidism. Postpartum Graves' Disease is less common than PPT, but it is not unusual. Whereas antithyroid drugs are indicated for postpartum Graves' Disease, they are not useful in PPT. Although they are rare, lymphocytic hypophysitis and postpartum pituitary infarction are important entities because they cause deficiencies of many critical hormones. The autoimmune nature of PPT, postpartum Graves' disease, and lymphocytic hypophysitis highlights the unique effects of pregnancy on the immune system.

  19. [Thyroid-associated ophthalmopathy: physiopathology, endocrine status].

    PubMed

    Teissier, M-P; Lopez, S

    2004-09-01

    The pathogenesis of Graves' ophthalmopathy remains uncertain. An inflammatory reaction is well established in orbital tissues in Graves' thyrotoxicosis. This inflammation is associated with antithyroid antibody action, but is not systematic in autoimmune hyperthyroidism patients. If ocular manifestations are pathognomonic for Graves' disease they can present in association with euthyroidism or hypothyroidism. Ophthalmopathy factors could be genetically determined but environmental parameters such as smoking and stress may also be involved, supporting the hypothesis that the autoimmune process in this ocular inflammation could be modulated in each patient based on personal and environmental factors.

  20. 36 CFR 12.10 - Floral and commemorative tributes.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of fresh cut or artificial flowers in or on a metal or other non-breakable rod or container... statue, vigil light, or other commemorative object on a grave, or the securing or attaching of any...

  1. 36 CFR 12.10 - Floral and commemorative tributes.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of fresh cut or artificial flowers in or on a metal or other non-breakable rod or container... statue, vigil light, or other commemorative object on a grave, or the securing or attaching of any...

  2. [Women in Francavilla Marittima (CS) between indigenous world and the Greek city].

    PubMed

    Pace, Rossella

    2011-01-01

    Francavilla Marittima is a protohistorical site; its ancient traces dates from the Medium Bronze Age. The article examines two female graves in the Temparella Cairn, collecting 93 graves from VIII to VI cent. B.C.. Grave n. 8 preserved a rich female set (i.e. a loom weight; a ceramic pix; a portable kotyle), made of imported and 'masculine' objects, here intended for a female use. Grave n. 26 is characterised by a great number of vases, turned upside-down to cover the body of a woman. This particular burial modality recalls the religious cerimonies of Demeter in Gela; it probably alludes not to a social role (a women seller of vases? An 'object' between objects?) but to the specific role of the dead inside a female cult.

  3. 1. Historic American Buildings Survey Nathaniel R. Ewan, Photographer March ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey Nathaniel R. Ewan, Photographer March 20, 1937 EXTERIOR - CAST IRON GRAVE MARKER IN WEYMOUTH ME CHURCH BURYING GROUND - Rosanna Ireland Babington Cast Iron Gravestone, Batsto Museum (moved from ME, Weymouth), Batsto, Burlington County, NJ

  4. Archaeoastronomy in Transylvania PDF: http://astro.elte.hu/phd2000/csillik.pdf

    NASA Astrophysics Data System (ADS)

    Csillik, Iharka; Oproiu, Tiberiu; Chis, Dorin; Maxim, Zoie; Lazarovici, Gheorge

    2001-02-01

    The paper presents some astronomical considerations on the orientation of graves and other ancient vestiges on the Transylvanian territory, which - we prove - are mainly aligned with respect to the solar phenomena.

  5. 77 FR 48203 - Final Federal Agency Actions on Proposed Highway in North Carolina

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    .... 11593 Protection and Enhancement of Cultural Resources; E.O. 13007 Indian Sacred Sites; E.O. ] 13287... Act [16 U.S.C. 469-469(c)]; Native American Grave Protection and Repatriation Act (NAGPRA) . 6....

  6. 43 CFR 10.9 - Inventories.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Lands: Interior Office of the Secretary of the Interior NATIVE AMERICAN GRAVES PROTECTION AND REPATRIATION REGULATIONS Human Remains, Funerary Objects, Sacred Objects, or Objects of Cultural Patrimony in... tribes and Native Hawaiian organizations. Museums and Federal agencies are encouraged to...

  7. 43 CFR 10.9 - Inventories.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Lands: Interior Office of the Secretary of the Interior NATIVE AMERICAN GRAVES PROTECTION AND REPATRIATION REGULATIONS Human Remains, Funerary Objects, Sacred Objects, or Objects of Cultural Patrimony in... tribes and Native Hawaiian organizations. Museums and Federal agencies are encouraged to...

  8. 75 FR 62182 - Notice of Final Federal Agency Actions on Proposed Highway in North Carolina

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... Indian Sacred Sites; E.O. 13287 Preserve America; E.O. 13175 Consultation and Coordination with Indian... Preservation Act ; Native American Grave Protection and Repatriation Act (NAGPRA) [25 U.S.C. 3001-3013]....

  9. 78 FR 64592 - Notice of Final Federal Agency Actions on the Stehekin Valley Road Improvement Project From the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... Resources; E.O. 13007 Indian Sacred Sites, E.O. 13287 Preserve America; E.O. 13175 Consultation and...]; Archeological and Historic Preservation Act [16 U.S.C. 469-469(c)]; Native American Grave Protection...

  10. 43 CFR 10.9 - Inventories.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Lands: Interior Office of the Secretary of the Interior NATIVE AMERICAN GRAVES PROTECTION AND REPATRIATION REGULATIONS Human Remains, Funerary Objects, Sacred Objects, or Objects of Cultural Patrimony in... tribes and Native Hawaiian organizations. Museums and Federal agencies are encouraged to...

  11. A comparison of the morphological and physiochemical characteristics of ten carambola cultivars

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Carambola (Averrhoa carambola L.) was grown on a Krome gravely loam soil (Loamy-skeletal, carbonic, hyperthermic Lithic Udorthents) in Miami, FL. Carambola morphological characteristics were determined by measuring fruit length, diameter and weight. Carambola physiochemical characteristics were det...

  12. 1. PERSPECTIVE VIEW OF MAIN AND SIDE ELEVATION, SHOWING EGYPTIAN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. PERSPECTIVE VIEW OF MAIN AND SIDE ELEVATION, SHOWING EGYPTIAN REVIVAL TOMB SITUATED WITHIN SURROUNDING GRAVES - Mount Pleasant Cemetery, George Opdyke Tomb, 375 Broadway Street, Newark, Essex County, NJ

  13. EVALUATION OF PUBLIC DATABASES AS SOURCES OF DATA FOR LIFE CYCLE ASSESSMENTS

    EPA Science Inventory

    Methods to determine the environmental effects of production systems must encourage a comprehensive evaluation of all "upstream" and "downstream" effects and their interrelationships. This cradle-to-grave approach, called Life Cycle Assessment (LCA), has led to the development...

  14. Abacavir

    MedlinePlus

    ... is used along with other medications to treat human immunodeficiency virus (HIV) infection. Abacavir is in a ... in your body, such as pneumonia, herpes virus, tuberculosis, hepatitis, Graves' disease (condition where the body attacks ...

  15. AN HISTORICAL PERSPECTIVE ON LIFE CYCLE MANAGEMENT AND CURRENT PRACTICES WORLDWIDE

    EPA Science Inventory

    Environmental life cycle management looks at products, processes, and activities by recognizing all the "cradle to grave" stages that are involved and identifying where potential environmental and economic impacts occur. Government, industry and non-governmental organizations can...

  16. 78 FR 19305 - Notice of Intent To Repatriate Cultural Items: Yale Peabody Museum of Natural History, New Haven, CT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-29

    .... and Mrs. William H. Moseley of New Haven, CT. Catalog records indicate the two objects, a string of rolled metal tube beads and a string of shell beads, were recovered from Native American graves...

  17. [Structural and functional heart diseases in adult patients with common variable immunodeficiency].

    PubMed

    Cambray-Gutiérrez, Julio César; Fernández-Muñoz, María Jesús; Del Rivero-Hernández, Leonel Gerardo; López-Pérez, Patricia; Chávez-García, Aurora Alejandra; Segura-Méndez, Nora Hilda

    2015-01-01

    Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria con mayor cantidad de comorbilidades en la vida adulta. Se ha asociado con bronquiectasias en 17 a 76%, y éstas, con complicaciones cardiovasculares, como hipertensión arterial pulmonar e insuficiencia cardiaca. Los nuevos métodos diagnósticos de imagen permiten evaluar la conformación estructural y funcional cardiovascular de los pacientes adultos con bronquiectasias y, de esta manera, establecer diagnósticos más eficientes y oportunos. Objetivo: determinar las cardiopatías estructurales y funcionales en pacientes con inmunodeficiencia común variable mediante ecocardiografía transtorácica. Material y método: estudio transversal, descriptivo, efectuado en una cohorte de 26 pacientes adultos con diagnóstico de inmunodeficiencia común variable y tratamiento sustitutivo con inmunoglobulina intravenosa (IgIV), pertenecientes a la Clínica de Inmunodeficiencias. A todos los pacientes se les realizó ecocardiografía transtorácica con ecocardiograma doppler y tisular; los resultados fueron evaluados por un médico cardiólogo ecocardiografista. Resultados: evaluamos a 26 pacientes; de ellos, 10 fueron del género masculino, con media de edad de 35.7 ± 13.7 años. Los resultados de la ecocargiografia torácica en las cavidades cardiacas izquierdas reportaron las siguientes alteraciones funcionales: 17 de 26 pacientes tuvieron insuficiencia mitral y sólo 2 tuvieron insuficiencia aórtica; ninguno de ellos con síntomas. Respecto de las alteraciones estructurales de las cavidades derechas: 8 pacientes adultos con inmunodeficiencia común variable tuvieron crecimiento de las cavidades derechas y en 5 pacientes se encontró tabique interauricular delgado e hipermóvil; respecto de las alteraciones funcionales, 24 pacientes tuvieron insuficiencia tricuspídea, en 21 de ellos fue leve y sólo en 3 fue moderada. Además, 12 pacientes tuvieron insuficiencia de la válvula pulmonar

  18. [Current status of alternative therapies renal function at the Instituto Mexicano del Seguro Social].

    PubMed

    Méndez-Durán, Antonio; Ignorosa-Luna, Manuel Humberto; Pérez-Aguilar, Gilberto; Rivera-Rodríguez, Francisco Jesús; González-Izquierdo, José Jesús; Dávila-Torres, Javier

    2016-01-01

    Introducción: el IMSS realiza de manera sistemática la actualización de datos de los pacientes en terapias sustitutivas de la función renal (TSFR) mediante un registro electrónico denominado: Censo de administración de pacientes con Insuficiencia Renal Crónica (CIRC), cuyo objetivo es conocer la prevalencia de pacientes con insuficiencia renal crónica y el comportamiento de las TSFR en el IMSS. Métodos: estudio retrospectivo, incluye 212 hospitales de segundo nivel con programas de diálisis, pacientes pediátricos y adultos. Datos obtenidos del CIRC de enero a diciembre de 2014, cédulas numeral y nominal de diálisis peritoneal (DP) y hemodiálisis (HD). Se identifica prevalencia de pacientes y terapias por delegación, distribución por género y edad, causa de la enfermedad renal, la morbilidad y mortalidad. Resultados: 55 101 pacientes, de los cuales fueron 29 924 masculinos (54 %) y 25 177 femeninos (46 %); edad promedio 62.1 años (rng: 4 a 90); pensionados 20 387 (36.9 %). Las causas de la insuficiencia renal fueron: diabetes 29 054 (52.7 %), hipertensión arterial 18 975 (34.4%), glomerulopatías crónicas 3951 (7.2 %), riñones poliquísticos 1142 (2.1 %), congénitos 875 (1.6 %), y otras 1104 (2 %). La HD se otorgó en 41 % de los pacientes y la DP al 59 % restante; el costo anual fue de 5 608 290 622 pesos. Conclusiones: la prevalencia incrementada de diabetes mellitus e hipertensión arterial repercuten en el inicio de una TSFR, las cuales muestran un panorama financiero catastrófico para el Instituto.

  19. Prevalence of pollinosis in patients with allergic asthma, rhinitis and conjunctivitis in the South of Mexico City 2007-2013.

    PubMed

    Gaspar-López, Arturo; López-Rocha, Eunice; Rodríguez-Mireles, Karen; Segura-Méndez, Nora; Del Rivero-Hernández, Leonel

    2014-01-01

    Antecedentes: la prevalencia de la polinosis se ha duplicado en las últimas dos décadas. Diversos estudios sugieren que incluso 50% de los adultos residentes del Distrito Federal pueden tener datos de alergia respiratoria y que los pólenes de árboles, pastos y malezas constituyen una causa frecuente. Conocer la prevalencia de sus familias y cruces antigénicos permite ofrecer diagnósticos y tratamientos adecuados. Objetivo: conocer la prevalencia de sensibilización a pólenes de árboles, gramíneas y malezas en adultos con alergia respiratoria de la zona sur del Distrito Federal en el periodo de enero de 2007 a diciembre de 2013. Material y método: estudio transversal, observacional y retrospectivo efectuado con pacientes que acudieron al servicio de Alergia e Inmunología Clínica del Hospital de Especialidades Dr. Bernardo Sepúlveda del Centro Médico Nacional Siglo XXI de la Ciudad de México, de 2007 a 2013, con diagnóstico de rinitis, asma y conjuntivitis alérgica. Analizamos los resultados de las pruebas cutáneas para pólenes de árboles, gramíneas y malezas de los pacientes. Los resultados se analizaron mediante estadística descriptiva. Resultados: se incluyeron 672 pacientes, 70% hombres, la edad promedio fue de 34 ± 16 años. En relación con su ocupación 31% eran estudiantes, 48% trabajadores y 21% amas de casa. El 53% tenía rinitis alérgica, 47% asma y 40.5% tenía ambos padecimientos. Se encontró prevalencia de sensibilización a malezas de 56%, a árboles de 33% y a gramíneas de 11%. Conclusiones: la sensibilización a malezas constituye en México la primera causa de polinosis respiratoria de la zona sur del Distrito Federal, el polen del amaranto fue el más prevalente en esta zona. La sensibilización a los árboles es la segunda causa de polinosis, con predominio de las familias Betulaceae, Fagaceae y Oleacea. La sensibilización a gramíneas constituye la tercera causa de polinosis respiratoria. Las más frecuentes son la

  20. Mystery solved: the identification of the two missing Romanov children using DNA analysis.

    PubMed

    Coble, Michael D; Loreille, Odile M; Wadhams, Mark J; Edson, Suni M; Maynard, Kerry; Meyer, Carna E; Niederstätter, Harald; Berger, Cordula; Berger, Burkhard; Falsetti, Anthony B; Gill, Peter; Parson, Walther; Finelli, Louis N

    2009-01-01

    One of the greatest mysteries for most of the twentieth century was the fate of the Romanov family, the last Russian monarchy. Following the abdication of Tsar Nicholas II, he and his wife, Alexandra, and their five children were eventually exiled to the city of Yekaterinburg. The family, along with four loyal members of their staff, was held captive by members of the Ural Soviet. According to historical reports, in the early morning hours of July 17, 1918 the entire family along with four loyal members of their staff was executed by a firing squad. After a failed attempt to dispose of the remains in an abandoned mine shaft, the bodies were transported to an open field only a few kilometers from the mine shaft. Nine members of the group were buried in one mass grave while two of the children were buried in a separate grave. With the official discovery of the larger mass grave in 1991, and subsequent DNA testing to confirm the identities of the Tsar, the Tsarina, and three of their daughters--doubt persisted that these remains were in fact those of the Romanov family. In the summer of 2007, a group of amateur archeologists discovered a collection of remains from the second grave approximately 70 meters from the larger grave. We report forensic DNA testing on the remains discovered in 2007 using mitochondrial DNA (mtDNA), autosomal STR, and Y-STR testing. Combined with additional DNA testing of material from the 1991 grave, we have virtually irrefutable evidence that the two individuals recovered from the 2007 grave are the two missing children of the Romanov family: the Tsarevich Alexei and one of his sisters.