scholarly journals Hormonal analysis in the diagnosis of thyroid diseases: A lecture

1995 ◽  
Vol 41 (3) ◽  
pp. 31-35
Author(s):  
N. P. Goncharov
Keyword(s):  
Thyroid Gland ◽  
Solid Phase ◽  
Thyroid Stimulating Hormone ◽  
Transport Proteins ◽  
Diagnostic Methods ◽  
Hormonal Status ◽  
Free T4 ◽  
Long Time ◽  
Hormonal Analysis

The creation of methods of radioimmunological analysis (RIA) to determine hormones had a decisive influence on the development of modern endocrinology and especially thyroidology. Since 1973, RIA methods have become routine diagnostic methods for the determination of thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH). However, for a long time they made it possible to determine only the fractions of hormones associated with transport proteins, and RIA methods for determining TSH did not allow to determine its low (< 0.1 Mme/l) concentrations. Later, variants of RIA were developed based on the immunometric principle, using solid-phase carriers and monoclonal antibodies. This made it possible to determine, along with the general T4 and T3, also their free forms. Namely free T4 and T3 (FT4 and FT3) provide the entire spectrum of biological activity. Their definition is the most informative in assessing the functional state of the hypothalamus-pituitary-thyroid gland. The IRMA principle allowed to increase the sensitivity of the method for determining TSH to 0.16 mIU/L. This level of sensitivity satisfied clinicians in assessing the euthyroid state and hypothyroidism, but it did not allow to differentiate the normal level of TSH from subnormal in patients with thyrotoxicosis. In the last decade, fundamentally new non-isotopic technologies of hormonal immunoassay have been created. The sensitivity of this method in determining TSH was brought to 0.03 mIU/L. Currently, the determination of FT4 and TSH using the hypersensitive method is a strategic diagnostic approach to assessing the hormonal status of the thyroid gland.

Infants Diagnosed with Athyreosis on Scintigraphy May Have a Gland Present on Ultrasound and Have Transient Congenital Hypothyroidism

2021 ◽  
pp. 1-8
Author(s):  
Niamh McGrath ◽  
Colin Patrick Hawkes ◽  
Stephanie Ryan ◽  
Philip Mayne ◽  
Nuala Murphy
Keyword(s):  
Thyroid Gland ◽  
Congenital Hypothyroidism ◽  
Thyroid Tissue ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Ultrasound ◽  
Free T4 ◽  
Median Serum ◽  
Thyroid Glands ◽  
Rule Out

Scintigraphy using technetium-99m (<sup>99m</sup>Tc) is the gold standard for imaging the thyroid gland in infants with congenital hypothyroidism (CHT) and is the most reliable method of diagnosing an ectopic thyroid gland. One of the limitations of scintigraphy is the possibility that no uptake is detected despite the presence of thyroid tissue, leading to the spurious diagnosis of athyreosis. Thyroid ultrasound is a useful adjunct to detect thyroid tissue in the absence of <sup>99m</sup>Tc uptake. <b><i>Aims:</i></b> We aimed to describe the incidence of sonographically detectable in situ thyroid glands in infants scintigraphically diagnosed with athyreosis using <sup>99m</sup>Tc and to describe the clinical characteristics and natural history in these infants. <b><i>Methods:</i></b> The newborn screening records of all infants diagnosed with CHT between 2007 and 2016 were reviewed. Those diagnosed with CHT and athyreosis confirmed on scintigraphy were invited to attend a thyroid ultrasound. <b><i>Results:</i></b> Of the 488 infants diagnosed with CHT during the study period, 18/73 (24.6%) infants with absent uptake on scintigraphy had thyroid tissue visualised on ultrasound (3 hypoplastic thyroid glands and 15 eutopic glands). The median serum thyroid-stimulating hormone (TSH) concentration at diagnosis was significantly lower than that in infants with confirmed athyreosis (no gland on ultrasound and no uptake on scintigraphy) (74 vs. 270 mU/L), and median free T4 concentration at diagnosis was higher (11.9 vs. 3.9 pmol/L). Six of 10 (60%) infants with no uptake on scintigraphy but a eutopic gland on ultrasound had transient CHT. <b><i>Conclusion:</i></b> Absent uptake on scintigraphy in infants with CHT does not rule out a eutopic gland, especially in infants with less elevated TSH concentrations. Clinically, adding thyroid ultrasound to the diagnostic evaluation of infants who have athyreosis on scintigraphy may avoid committing some infants with presumed athyreosis to lifelong levothyroxine treatment.

Reactive Diffusion at the Cylindrical Dissolving of Copper in the Solder Melt

2011 ◽  
Vol 312-315 ◽  
pp. 387-392 ◽  
Author(s):  
Jaromír Drápala ◽  
Alena Struhařová ◽  
Daniel Petlák ◽  
Vlastimil Vodárek ◽  
Petr Kubíček
Keyword(s):  
Time Course ◽  
Solid Phase ◽  
Accurate Determination ◽  
Theoretical Description ◽  
Reactive Diffusion ◽  
Interface Boundary ◽  
Boundary Movement ◽  
Long Time ◽  
Melt Cooling

Problems of reactive diffusion at the solid phase and melt contact were studied theoretically and experimentally. The main intention was to calculate the time course of the solid phase dissolving in the case of cylindrical dissolving. These calculations were carried out on the assumption for the rate constant of dissolving K = const. In our work we give heed especially to the dominating process, which is the solid metal A dissolved in the melt B. During the dissolving the melt B saturates with the metal A and the process is influenced by convections which are characteristic for the given experimental configuration. A theoretical description of the kinetics of the solid phase dissolving in the melt will be presented for the case of cylindrical dissolving. The aim is to derive a relation for the interface boundary movement c(t) in dependence on time and a time course of growth of the element A concentration in the melt B. There are problems with accurate determination of the interface boundary movement after certain heating times of specimens, when it is observed experimentally, since intermetallic phases create in the original A metal at both the diffusion and cooling and some phases segregate at the solidifying melt cooling. The main intention was an experimental study of the copper dissolving in the tin melt. Experiments aimed to the determination of the Cu wires (diameters from 0.5 to 3.5 mm) dissolution in the solder melt were carried out at various selected temperatures and times. Rapid growth of phases in the metal A and determination of the thickness of layers with these phases pose considerable time demands to X-ray micro-analyses (WDX, EDX) of specimens after their long-time heating.

scholarly journals Graves Disease in Infancy

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A929-A930
Author(s):  
Kara A Beliard ◽  
Srinidhi Shyamkumarb ◽  
Mabel Yau ◽  
Cassie Mintz ◽  
Robert Rapaport
Keyword(s):  
Thyroid Gland ◽  
English Literature ◽  
Receptor Gene ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free T4 ◽  
Ocular Changes ◽  
Clinical Signs And Symptoms

Abstract Background: Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The usual age of presentation is between 20-30 years, and it is more common in females. Transient hyperthyroidism does occur in infants born to mothers with GD, however, the novo GD in infants is extremely rare. We are aware of only four cases of GD in children under the age of 2 years old previously reported in the literature, with the youngest being of 18 months. Although rare, the complications can be devastating, so identifying and treating GD in infants is vital. We describe an infant who presented at 12 months of life with poor weight gain. Patient Findings: A 12-month old female patient presented with weight loss, tachycardia, diaphoresis and hypertension. She had a palpable thyroid gland without ocular changes. She was found to have an undetectable Thyroid Stimulating Hormone (TSH) with an elevated free T4 of 2.1 ng/dL (normal 0.80 - 1.50 ng/dL). She was stabilized in the intensive care unit with beta-blocker and methimazole. The diagnosis of GD was subsequently confirmed with an extremely elevated elevated Thyroid Stimulating Immunoglobulins (TSI) titer of 263 Iu/L (normal 0.00-0.55 IU/L), her TSH receptor gene was normal. At 34 months of age, her TSI titer is still elevated at 34 IU/L and she still requires methimazole to maintain a euthyroid state. She is growing and developing appropriately. Conclusion: To our knowledge, this report describes the youngest child to be diagnosed with GD in the English literature. Only four patients between the ages of 18 - 24 months have been described. Autoimmune diseases are rare in infants, the reason for which GD developed at such a young age remains unclear. Clinical signs and symptoms of hyperthyroidism in infants can be subtle and easily missed: increased growth velocity, failure to gain weight, autonomic changes, and irritability. Most patients have an enlarged thyroid gland, and some have ocular changes. The major long-term complications of undiagnosed hyperthyroidism include craniosynostosis and permanent neurocognitive damage. A high index of suspicion is needed for the recognition and prompt treatment of GD in infants, leading to better clinical outcome.

scholarly journals Thyroid-stimulating hormone, leptin and insulin resistance in patients with obesity after bariatric surgery

2020 ◽  
Vol 17 (2) ◽  
pp. 187-192
Author(s):  
Anna R. Volkova ◽  
Michael B. Fishman ◽  
Galina V. Semikova
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Body Weight ◽  
Thyroid Gland ◽  
Resistance Index ◽  
Thyroid Stimulating Hormone ◽  
Obese Patients ◽  
Free T4 ◽  
Spontaneous Reduction ◽  
Stimulating Hormone

BACKGROUND: The function of the thyroid gland effects on obesity and comorbidities. It has been proven for bariatric surgery to be the most effective in obesity treatment. AIM: to evaluate the dynamics of body weight, thyroid status, leptin and insulin resistance in obese patients after bariatric surgery. MATERIALS AND METHODS: 74 obese patients were observed after bariatric surgery (sleeve gastrectomy 42, gastric bypass - 32); initial body mass index (BMI), thyroid stimulating hormone, free T4, fasting plasma leptin, insulin and glucose were estimated; the insulin resistance index HOMA-IR was calculated. The dynamics of body weight was estimated by BMI and the excess BMI loss (% EBMIL). After 3 years of follow-up, 48 patients were examined. RESULTS: Subclinical hypothyroidism (SH) was detected in 36.5% of patients with high degrees of obesity. A correlation was found between BMI and TSH level (R=0.5; p=0.01). HOMA-IR was increased in most patients with obesity of the II and III degree (4.81.9 ng / ml). In the SH group, the leptin level was significantly higher than in the group with a normal TSH level of 43.07.3 ng / ml and 33.24.6 ng / ml (p=0.004). Among patients with initial SH, spontaneous reduction of TSH levels occurred in 45% patients 3 years after surgery. CONCLUSIONS: Postoperatively, the BMI decrease was associated with the decrease of TSH, leptin and HOMA-IR. The data obtained may reflect the effect of adipose tissue on the functional state of the thyroid gland in patients with high degrees of obesity after bariatric surgery. This seems to be extremely important for maintaining body weight.

Reactive Diffusion at the Contact of a Solid Phase with the Solder Melt

2012 ◽  
Vol 322 ◽  
pp. 41-72 ◽  
Author(s):  
Jaromír Drápala ◽  
Petr Kubíček ◽  
Petr Harcuba ◽  
Vlastimil Vodárek ◽  
Pavel Jopek ◽  
...  
Keyword(s):  
Rate Constant ◽  
Solid Phase ◽  
Phase Interface ◽  
Reactive Diffusion ◽  
Fundamental Parameter ◽  
Long Time ◽  
Subsurface Layers ◽  
Model Equations ◽  
Rates Of Growth

Problems of reactive diffusion at the solid phase and melt contact are studied theoretically. The rate constant is a fundamental parameter characterizing the dissolving rate at a certain configuration of experiment. Relationships between the solid phase dissolving rate, i.e. the solid phase interface boundary movement in the melt, and rates of growth of intermetallic phases in the metal (Cu) are observed. This procedure enables the creation of surface and subsurface layers of regulated thickness in metallic materials by means of reactive diffusion. The main intention was an experimental study of copper dissolving in melts of various solder alloys and the related reactive diffusion. We used Sn, SnCu, SnAgCu, SnZn and SnIn alloys as a solder material. The problems that need to be solved preferentially are emphasized. It concerns especially the determination of the rate constant of dissolving and verifying whether the proposed model equations can be used for this constant determination in cases of cylindrical and planar dissolving. Rapid growth of phases in the metal (Cu) and determination of the thickness of layers with these phases pose considerable time demands to X-ray microanalyses (WDX, EDX, BSE, SEM) of specimens after their long-time heating.

scholarly journals ANALYSIS OF EFFECTIVENESS OF USING IgY FROM CHICKEN IN SANDWICH METHOD OF HBsAg TESTING

2016 ◽  
pp. 44-51
Author(s):  
A. A. Pechelyulko ◽  
Yu. N. Tarakanova ◽  
A. D. Dmitriev ◽  
Yu. S. Massino ◽  
O. L. Segal ◽  
...  
Keyword(s):  
Enzyme Immunoassay ◽  
Solid Phase ◽  
Polyclonal Antibodies ◽  
Diagnostic Methods ◽  
Analytical Sensitivity ◽  
Model Experiments ◽  
Sandwich Method ◽  
Binding Curve ◽  
Bivalent Interaction

Aim. Study antigen-binding ability of polyclonal antibodies (PCA) of chicken compared with monoclonal antibodies (MCA) of mice in the model of interaction with HBsAg. Materials and methods. Mice MCA 18C8 and MKA F3/F4 (IgG) were used, effective in enzyme immunoassay sandwich method of HBsAg determination (with a minimal detection dose of 0.017 ng/ml), and affinity purified anti-HBsAg PCA of chicken (IgY), obtained from 2 immunized birds (PCA No. 1 and PCA No. 2). The ability of antibodies to bind HBsAg was evaluated by analytical sensitivity (slope of binding curve) of solid-phase enzyme immunoassay system using mice MCA and chicken PCA. Results. PCA No. 2 has provided a statistically significant 40% increase of analytical sensitivity, compared with «standard» immobilized MCA 18C8, in model experiments of binding of peroxidase-labeled HBsAg. However, transition from model experiments to use of PKA No. 1 and PICA No. 2 in sandwich method of determination of HBsAg instead of immobilized MCA 18C8 or detecting MCA F3/F4 in all the cases, on the contrary, resulted in a decrease of analytical sensitivity. Conclusion. A lower flexibility of chicken PCA was assumed to be able to impede bivalent interaction in sandwich method, resulting in formation of less stable immune complexes. Without challenging value of IgY for the creation of immunochemical diagnostic methods, these facts and assumptions indicate a necessity of a deeper elucidation of the best areas of their application.

scholarly journals IMMUNOLOGICAL AND MORPHOLOGICAL PREDICTORS OF CLINICAL HETEROGENEITY OF PATIENTS WITH GRAVES' DISEASE (BASED ON RESEARCH OF THE THYROID GLAND OPERATIONAL MATERIAL)

2015 ◽  
Vol 14 (1) ◽  
pp. 81-91
Author(s):  
T. V. Saprina ◽  
T. S. Prokhorenko ◽  
N. V. Ryazantseva ◽  
I. N. Vorozhtsova ◽  
S. Yu. Martynova ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Culture Medium ◽  
Thyroid Tissue ◽  
Follicular Epithelium ◽  
Enzyme Linked Immunosorbent Assay ◽  
Mononuclear Leukocytes ◽  
Control Group ◽  
Free T4 ◽  
Immunological Changes

Very little research is devoted to the study of communication systemic immunological changes and local immunological changes in the tissue of the thyroid in autoimmune thyrophaties. The goal of the research was to establish immunologic and morphologic predictors of clinical course and functional outcomes of Graves’s disease (GD).Material and methods. We examined 45 patients with GD (14 men and 31 women) aged 18–55 years (47.0 (35.0–53.0)) years, matching the following criteria: a verified diagnosis GD, accommodation in Tomsk oblast and the Tomsk not less than 10 years, the patient's consent for the study. The control group included 30 people, with an average age of (45.3 ± 5.6) years and was comparable by age and sex with GD patients. The study included: definition of the standard for GD hormonal and serological profile (free T4, free T3, and TSH, antibodies to TPO, antibodies to the TSH receptor), the cultivation of mononuclear leukocytes in complete culture medium within 24 hours with subsequent determination of interleukins concentrations (IL-2, IL-4, TNF-alpha) in culture medium using enzyme-linked immunosorbent assay, determination of the number of blood cells carrying membrane-bound receptors to IL-2, IL-4, TNF-R1 by flow laser cytometry on cytometer BD FACS Canto tmΙΙ (USA) using labeled monoclonal antibody, the standard postoperative histological examination of thyroid gland tissue samples and immunohistochemical detection in samples of thyroid tissue receptors to IL-2, IL-4, TNF-alpha.Results. On the basis of the received results it is possible to allocate 2 clinical-immunologic and morphologic cluster of autoimmune hyperthyroidism syndrome in patients with clinical diagnosis of GD. The first includes the formation of 1 and 2 histological options GD (minimally expressed monocytes infiltration, lack of oncocytic transformation of thyroid epithelium), with some clinical characteristics (persistent and pronounced hyperthyroidism, the large size of goiter, higher titer of receptor TSH-antibody and smaller TPO-antibody, diffuse nature of the lesion), and the second – is represented by 3d histological option with oncocytic restructuring of follicular epithelium, expressed the monocyte/macrophage infiltration with the TNF-RI expression and clinical patterns, including: the older age group of patients, the smaller size of goiter, the emergence of “pseudo nodes” ultrasound, reflecting the presence of lymphoid follicles-infiltrates, more lenient for hyperthyroidism. Probably, that the 2nd cluster is a combination of “classical GD” with autoimmune thyroiditis, however, a set of clinical and laboratory-instrumental signs led to the fact that these patients were in the group of GD patients.Conclusion. This approach (combining study of indicators of systemic and local tissue-specific autoimmune inflammation) is a promising from the point of view of separate parts coverage in the autoimmune thyroids diseases pathogenesis, approximating researchers to develop immune based therapeutic technologies.

scholarly journals Immunologic aspects of autoimmune thyroiditis

1994 ◽  
Vol 40 (1) ◽  
pp. 56-58 ◽  
Author(s):  
A P Kalinin ◽  
Ye Ye Potemkina ◽  
N V Pesheva ◽  
D S Rafibekov
Keyword(s):  
Thyroid Gland ◽  
Autoimmune Thyroiditis ◽  
Adult Population ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Diseases ◽  
Diagnostic Methods ◽  
Regulatory Function ◽  
T Suppressors ◽  
Autoimmune Thyroid Diseases ◽  
Thyroid Cells

Autoimmune thyroiditis (AIT) is one of the most important and relevant problems of modern endocrinology due to the lack of study of the etiology, lack of clarity of pathogenetic mechanisms, and the absence of objective and reliable diagnostic methods, including immunological ones. The last decade is characterized by the appearance of fundamental works devoted to the immunology of autoimmune thyroid diseases. The data need generalization, a critical analysis, since the conclusions of the authors often differ in inconsistency. AIT takes first place among thyroid diseases. According to V.I. Litvinov, AIT is observed in 20-40% of the adult population, according to foreign authors, in 7.2% of the children. In 90% of cases, hypothyroidism in adults is caused by autoimmune processes, of which 70% is associated with AIT. The prevalence of the disease is primarily associated with a catastrophic environmental degradation. There are separate studies suggesting that factors associated with urbanization can contribute to the emergence of AIT. M. Podleski et al., N.I. Romanyuk, I.D. Levit revealed a greater incidence of AIT in the urban population compared with the rural one. The effect of iodine on the incidence of AIT is widely studied: a deficiency of a trace element helps to reduce it, and an excess increases it. In the occurrence of AIT, the role of radiation is significant. So, in territories affected by radiation as a result of accidents, AIT is registered 2 times more often (19.2% versus 8.8% in uncharged territory). N.V. Romashkan et al. they associate an increase in the incidence of AIT with increasing general allergization of the population, a significant recent prevalence of viral infections that enhance autoimmunization. The function of the thyroid gland, the peripheral phenotype of T cells and their function are affected by smoking. Nicotine can damage thyroid cells and release thyroglobulin into the blood, and also directly affect the function of T-suppressors. To date, there are three hypotheses for the pathogenesis of AIT: antigenic damage to the thyroid gland, a defect in specific T-suppressors, and a violation of the regulatory function of thyroid-stimulating hormone. None of the hypotheses is conclusively confirmed. It is possible that all three mechanisms are involved in the emergence and formation of an autoimmune specific process, clinically manifesting themselves in various stages and forms of the disease.

Amiodarone-induced type 2 thyrotoxicosis

2021 ◽  
Vol 14 (1) ◽  
pp. e238145
Author(s):  
Darryl Portelli ◽  
Simon Mifsud ◽  
Alexia Abela ◽  
Stephen Fava
Keyword(s):  
Atrial Fibrillation ◽  
Weight Loss ◽  
Thyroid Gland ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Exertional Dyspnoea ◽  
Free T4 ◽  
Tsh Receptor Antibody ◽  
History Of

The authors present a case of a 55-year-old gentleman with a medical history of atrial fibrillation on amiodarone who presented with weight loss, palpitations and exertional dyspnoea. Thyroid function tests revealed thyrotoxicosis with a free thyroxine (T4) of 117 pmol/L and a thyroid-stimulating hormone (TSH) of <0.008 mIU/L. Interleukin-6 level was low. The negative TSH-receptor antibody status, the presence of a small thyroid gland with heterogeneous echotexture and decreased internal vascularity on ultrasound together with the relatively quick drop in free T4 and free tri-iodothyronine (T3) levels once prednisolone therapy was added to carbimazole suggested that this was typical of amiodarone-induced thyrotoxicosis (AIT) type 2. Subsequently, carbimazole was discontinued and treatment with prednisolone was continued. This case highlights that AIT management may be challenging and it is of paramount importance to establish the type of AIT present as this will guide management and is key to improving prognosis.

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