Biomedical subjects

Marek Ruchała

Publications and source records attributed to Marek Ruchała.

7 recordsLinked to original sources

PubMed2005

Fractionated dosage of radioiodine for the ablation of differentiated thyroid carcinoma.

In some countries with a limited number of specialized hospital beds for radionuclide therapy, ablation therapy (RIT) of differentiated thyroid carcinoma (DTC) is performed using a fractionated dosage of radioiodine. The aim of this study was to evaluate the early clinical outcome of ablation with fractionated doses of RIT in comparison to the ablation with a single dose. A subset of 386 subjects with DTC referred for the initial RIT was selected retrospectively for the study. Of these, 113 patients (29.3%) were treated with one (131)I dose of 2.2 GBq (group 1, RIT between 2001 and 2003) and 273 patients (70.7%) with fractionated doses (1.1 GBq + 1.1 GBq administered in 24 hour intervals) (group 2, RIT between 1999 and 2001). The early outcome of the initial RIT was evaluated 6-8 months later by radioiodine uptake test (RIU), thyroglobulin concentration, whole-body diagnostic scan, and neck ultrasound. On the basis of these results, the patients were classified as: CR, complete remission; NCR, no complete remission. Frequency of CR and NCR outcomes and the parameters measured during the follow-up evaluation in both groups were compared. CR outcome was found in 69 patients (61.1%) of group 1 and in 172 patients (63.0%) of group 2 (p = n.s.). No difference in measured parameters was found in both groups at the follow-up evaluation. In uncomplicated cases of DTC, RIT using a regimen of a fractionated dosage, is equally effective as the therapy with a single dose. No influence of stunning was observed in patients treated with a fractionated dosage, but the time interval between the doses was 24 hours.

Adolescent↗

PubMed2005

Radioiodine treatment of hyperthyroidism in patients with low thyroid uptake.

BACKGROUND: The aim of the study was to analyze the effectiveness of radioactive 131I in hyperthyroid patients with confirmed lowered iodine uptake as compared to patients with an uptake of over 30%. MATERIAL AND METHODS: We retrospectively analyzed 53 consecutive patients aged from 29 to 84 (mean age 60 years) suffering from hyperthyroidism caused by Graves' disease or toxic nodular goitre. The patients were divided into 2 sub-groups: the 1st with a maximum iodine uptake of 18.7 +/- 3.2% (range, 11-23%) - 24 patients; the 2nd with a maximum iodine uptake of 27.1 +/- 2.1% (range, 24-30%) - 29 patients. The control group consisted of 50 patients treated with 131I with an iodine uptake of over 30%. Each patient was evaluated before, and 6 months after, treatment for fT3, fT4 and TSH with ECLIA; TRAb with RIA; ultrasound with a 7.5 MHz linear probe. The volume of the thyroid gland was determined using the Gutekunst method. All these factors underwent statistical analysis and were considered along with the results of clinical examinations. RESULTS: Clinical remission of hyperthyroidism was evident in 79.3% of both sub-groups, in total (83.3% and 75.3%, respectively). TSH was normalized in 62.3% of these patients (54.2% and 69.0%, respectively). The mean range of TSH levels increased from 0.081 microU/ml to 4.0 microU/ml after therapy; that is, from 0.087 microU/ml to 4.97 microU/ml in the 1st sub-group and from 0.076 microU/ml to 3.3 microU/ml in the 2nd sub-group. The volume of the thyroid gland was uniformly significantly lower, with a mean range of 40.5 ml before treatment and 21.7 ml afterwards. The results seen in both sub-groups were similar; only age and dose of radioiodine were slightly higher in the 1st, while mean uptake was higher in the 2nd. By comparison of these results to those of the control patients, we observed that the values of TSH, as well as thyroid volume and evidence of clinical remission, reflected those found in the control group. The mean dose of 131I was lower in the control group, that is 11.3 m Ci, as compared to the sub-groups as a whole, specifically, 15.7 mCi. The mean age of patients in the control group was slightly less than that of the study group (50.8 and 60, respectively). CONCLUSIONS: 1. The results of the treatment of patients with a low iodine uptake are similar to the results obtained in the group of patients with iodine uptake above 30% and therefore low iodine uptake should not be a contraindication for isotope I-131 therapy. 2. Additionally, we have demonstrated that a statistically significant decrease in thyroid volume is observed in all patients after the iodine isotope treatment which indirectly proves the effectiveness of the prescribed treatment, and that low thyroid iodine uptake is more frequently observed in elderly patients and in patients treated with iodine or anti-thyroid drugs.

Adult↗

PubMed2005

[Urinary cotinine in patients with hyperthyroidism].

The aim of our study was an analysis of cotynine, the main nicotine metabolite in the urine among hyperthyroid patients. The study group included 39 females and 4 males. The mean age was 35.59+/-14.22 yrs. (range: 18-73 yrs.; median: 32 yrs) among hyperthyroid patients suffering from: Graves-Basedow disease (GB), Graves' Ophtalmopathy (GO) and toxic nodular goiter (TNG). To evaluate the nicotine smoking intensity and ETS Environmental Tobacco Smoke, the urine analysis of cotynine level were performed. According to the statistical analysis using the Mann-Whitney test, the statistically significant difference between the level of cotynine among smokers suffering from GO and Graves-Basedow disease was revealed (p = 0.03). Similar results were obtained among the GO and TNG (p=0.02) using t-Student test with Welsch correction. To compare, there was no stastistically significant difference between the GB and TNG series (p=0.4). In the group of smoking patients with GO we found out incresed level of urine cotinine than in smoking patients with GB and TNG. We didn't found differences between GB and TNG in depends on an urine analysis of cotynine level.

Adolescent↗

PubMed2003

[Usefulness of isotope diagnosis, ultrasound neck investigation and thyroglobulin assays in quantification of patients operated on for differentiated thyroid cancer and prepared for radioiodine treatment].

UNLABELLED: The aim of the study was to assess the efficacy of surgical treatment of patients operated on differentiated thyroid carcinoma, using Tg serum assays and 131-I whole body scintigraphy. We investigated 208 patients aged from 15 to 78 yr. (mean 43.52, S.S. 16.37) including 182 females and 26 males. 183 cases of papillary cancer and 25 cases of follicular cancer were confirmed by pathologist. All the patients were investigated 6-8 weeks after thyreoidectomy. The following procedures were performed in all the patients: 1. ultrasound imaging. 2. 131 iodine uptake test, 24 hours after administration. 3. 131-I whole body scintigraphy (dose per patient 3 mCi, device Varicam). 4. TSH and Tg serum assay using FIA method. Moreover, all the tissue fragments obtained during surgery underwent histopathological assessment. RESULTS: The mean volume of the post-surgery thyroid tissue remains was 2.91 cc varying from 0 to 40. Volume was counted with Gutekunt's formula. Oncologically suspected lymph nodes were found in 8 cases. The mean TSH serum level was 79.31 (SD 59.59). The mean Tg serum level was 51.73 (SD 179). The mean value of an iodine uptake test was 6.96% (SD 6.69). Whole body scintigraphy discovered solitary thyroid site iodine uptake areas in 199 patients (95.7%). Additional uptake areas were observed in 4.3% 2 (0.9%) cases in cervical lymph nodes, 4 (1.9%) cases in lungs, 3 (1.5%) in bones. The correlation between investigations both laboratory and isotopic, and clinical state was observed in 207 cases (99.5%). The presence of high Tg serum level despite of absence of extracervical iodine uptake areas was observed in one case. We presume that the situation can be caused by the presence of multiple lung metastases not having possibility of iodine uptake. Ultrasound imaging, 131-I scintigraphy and Tg serum assays are essential methods in diagnosing and treatment process in the patients with differentiated thyroid carcinoma.

Adolescent↗

PubMed2003

Nuclear imaging techniques in the assessment of myocardial perfusion and function after CABG: does it correlate with CK-MB elevation?

BACKGROUND: An increase of the creatine kinase MB (CK-MB) isoenzyme after cardiac surgery suggests perioperative myocardial infarction. The interpretation is more difficult when increased enzymes are not accompanied by electrocardiographic markers of infarction. The aim of this study was to correlate the results of myocardial perfusion imaging (MPI) and radionuclide ventriculography (RNV) with CK-MB isoenzyme level in patients without ECG abnormalities after CABG. MATERIAL AND METHODS: 36 patients (age: 52.5 +/- 8.5 years, 33M/3F) treated with CABG were prospectively studied. CK-MB level was assessed at 0, 4, 8, 12, 24, 36, 48 and 72 hours after surgery. MPI (SPECT using Tc-99m-MIBI) and RNV were performed 2 weeks before and 3-4 months after surgery. All patients had an uneventful hospitalisation. The subjects were divided into two groups: group 1 with CK-MB increase > 50 IU/ml (n = 9) and group 2 with CK-MB levels </= 50 IU/ml (n = 27). There was no difference between the groups regarding the number of diseased arteries, haemodynamic parameters, aortic clamping time or the number of grafts. RESULTS: Perfusion improvement at stress and at rest was significantly lower in group 1 than in group 2. The ejection fraction did not change significantly in both groups (DeltaEF = 0.6 +/- 13.5 in group 1 v. 0.7 +/- 9.7 in group 2, p = NS), however, in 5 patients from group 1 (56%) and in 6 patients from group 2 (22%) the EF decreased significantly at follow-up RNV (p = 0.05). In 6 patients (5 in group 1 and 1 in group 2) a new defect of perfusion was found at follow-up MPI. The sensitivity and specificity of increased CK-MB level in predicting perfusion deterioration were 83% and 87%, respectively. CONCLUSIONS: We conclude that patients with an increased level of CK-MB isoenzyme (> 50 IU/ml) after coronary artery surgery have a higher rate of perfusion and function deterioration. The increase of CK-MB level early after coronary bypass surgery in patients without ECG markers of perioperative infarction indicates a probable ischaemic insult during surgery.

Adult↗

PubMed2002

[Is hyperthyroidism often present in patients with thyroid differentiated carcinoma?].

The coexistence of thyroid cancer and hyperthyroidism is confirmed by many authors. It appears that the frequency of both disease can be greater as a result of lack of proper and penetrating biopsy diagnosis and of qualification to surgery treatment patients with hyperfunctional goiter and Graves disease, especially coexisting with nodes. The aim of our study was estimation of occurrence of hyperthyroidism in the patients with thyroid differentiated cancer. We examined group of 217 patients with diagnosed thyroid differentiated cancer, 20 patients (9.1%) of them were earlier hyperthyroidism diagnosed. 17 of them were hyperfunctional nodular goiter diagnosed and three as Graves disease, confirmed by presence of anti-TSH receptor antibodies (TRAK). Before thyroidectomy ultrasonography showed nodular goiter in 17 patients and hypoechogenic goiter with nodules in 3 patients. After thyroidectomy at the hyperthyroid patients in 16 papillary thyroid cancer and in 4 follicular thyroid cancers were diagnosed. The frequency of coexistence of cancer and hyperthyroidism in our material amounted for 9.1%. The results of our observation do not diverge from facts given in world literature and is point out the need for precise analysis of patients with hyperthyroidism and of proper qualification to surgery treatments changes suspected to be malignant process.

Adolescent↗

PubMedDate not supplied

[Iodine prophylaxis in children population on the Wielkopolska Region area from year 1992 to 2005].

INTRODUCTION: The aim of the study was to evaluate of efficiency of iodine prophylaxis based on obligatory model of salt iodization. MATERIAL AND METHODS: The study included 1444 children from the rural and urban area, with the proportional sex and age (8-12 years) distribution--432 children in 1992 (before salt iodization), 558 children in 2000 and 454 children in 2005 (during salt iodization from 1996). RESULTS: The prevalence of goiter detected in children population in 1992 was 40% (recount by current criteria), in 2005 was reduced to 6% (p < 0.01). Parallel, median of urinary iodine concentration increased from 44 microg/l in 1992 to 107 microg/l (p < 0.01) in 2005. The increase of incidence of autoimmunological thyroid diseases is observed, especially chronic thyroiditis. CONCLUSIONS: The study proves high efficiency of iodine prophylaxis in Wielkopolska Region, but it is still the area with mild iodine deficiency.

Child↗