Radioimmuno-Assay (RIA) of Thyroid-Stimulating-Hormone (TSH) was performed before and after i.v.-injection of Thyrotropin-Releasing-Hormone (TRH) in 350 patients subsequent to previous resection of euthyroid goiter to find out the optimal treatment schedule for preventing recurrent goiter. In patients without recurrent goiter the dosis of thyroid hormone was considered to be sufficient, if the difference in TSH-levels before and after TRH (delta-TSH) was equivalent to or less than 10 microunits/ml. In patients with recurrent goiter the optimal suppressive dosis of thyroid hormone was accepted for a delta-TSH less than or equal to 2,5 microunits/ml. 126 out of 135 patients, who were set on an immediate and continuous postoperative treatment were free of goiter, 58 presented a delta-TSH less than or equal to 10 microunits/ml (average interval of treatment = 2,5 years), 68 patients had elevated delta-TSH (average interval of treatment 2,1 years) as a sign of insufficient treatment. In 9 patients recurrent goiter was detected in spite of "adequate" treatment. 41 out of 57 patients, set on delayed and partly continuous, partly discontinuous treatment had recurrent goiter (in average after 10 years). delta-TSH was not indicative. 158 patients without any treatment had borderline or slightly increased delta-TSH (in average after 10 years). 122 of these 158 patients had recurrent goiter, 36 were free of goiter. The results favor the necessity of treatment with thyroid hormones starting immediately after operation and with continuous treatment. The combined use of TSH-RIA and TRH-test reliably informs about the individual thyroid hormone dosis necessary for prevention or treatment of recurrent goiters.

Goiter↗

PubMed1975

[Studies of the metabolism and excretion of silybin in the rat].

The metabolism and excretion of silybin (as N-methyl-glucamine salt) was investigated after intravenous and oral administration to rats. In the urine, silybin was excreted mostly in the unchanged form after intravenous as well as oral application, whilst in the bile it appeared above all in the form of metabolites. By hydrolysis with arylsulfatase/beta-glucuronidase, the metabolites were identified as sulfate and glucuronide conjugates of silybin and dehyrosilybin; the latter appeared in small quantities as a dehydrated product of silybin. After intravenous injection of 20 mg silybin per kg body weight, the excreted amount of silybin after 48 h was 8%, whereas 76% was eliminated in the bile within the same period of time. After oral application of 2--20 mg silybin/kg body weight 20% after 40 mg/kg 35% and after 120 mg/kg 20% of the administered silybin was excreted in the bile during 48 h. The maximum excretion rate was achieved at application of 20 mg/kg p.o. after 1 h. At this dosage, 2--5% was eliminated within the same time in the urine. The excretion of silybin mainly took place (more than 80% of the total of excreted bilybin) in the bile, both after oral and intravenous administration.

Administration, Oral↗