Mg Of Iodine Research Articles

Iodine Fortification of Vegetables Improves Human Iodine Nutrition: In Vivo Evidence for a New Model of Iodine Prophylaxis

Iodine deficiency is the result of insufficient intake of dietary iodine and as a consequence causes multiple adverse effects. About 2 billion individuals in the world are affected by iodine deficiency. It has been found that the most effective way to control iodine deficiency is through the universal salt iodization. However, salt iodization alone may not be sufficient to assure adequate iodine nutrition. In most industrialized countries, excess consumption of salt has become recognized as a health risk. Therefore, biofortification of vegetables with iodine offers an excellent opportunity to increase iodine intake. The aim of this study was to test the efficiency of a new model of iodine prophylaxis in a group of 50 healthy volunteers through the intake of vegetables (potatoes, cherry tomatoes, carrots, and green salad) fortified with iodine. Each serving of vegetables consisted of 100 g of potatoes, carrots, tomatoes, or salad containing 45 mg of iodine (30% of the Recommended Daily Allowance), and the volunteers consumed a single serving of vegetables, as preferred, each day for 2 weeks. Urinary iodine (UI) excretion was measured before and after intake of vegetables. The UI concentration measured in volunteers before the intake of vegetables was 98.3 mg/L (basal value), increasing to 117.5 mg/L during the intake of vegetables. Seven days after the discontinuation of vegetable intake, UI was 85 mg/L. UI concentration increment was 19.6% compared with the basal value; therefore, the difference was statistically significant (P = .035). Biofortification of vegetables with iodine provides a mild but significative increase in UI concentration and, together with the habitual use of iodized salt, may contribute to improve the iodine nutritional status of the population without risks of iodine excess.

Spectral Optimization of Chest CT Angiography with Reduced Iodine Load: Experience in 80 Patients Evaluated with Dual-Source, Dual-Energy CT

To determine the energy levels that provide optimal imaging of thoracic circulation at dual-energy computed tomographic (CT) angiography with reduced iodine load in comparison with a standard technique. The institutional review board approved the study with waiver of patient consent. Eighty patients underwent a dual-source, dual-energy CT examination after administration of low-concentration contrast material (170 mg of iodine per milliliter), and eight series of images were reconstructed, including the original polychromatic images at 80 and 140 kV and six series of virtual monochromatic spectral images at 50, 60, 70, 80, 90, and 100 keV. For each vascular compartment, the energy level that provided optimal evaluation on virtual monochromatic spectral images was determined, and these series were compared with the polychromatic dual-energy images and with standard chest CT images that were used as controls. Comparisons between groups were performed by using the paired Student t test for continuous variables and the McNemar test for categorical variables. Comparisons between dual-energy and standard CT images were performed by using the unpaired Student t test for continuous variables and the χ(2) test for categorical variables. For the aorta, pulmonary arteries, and veins, the reconstruction at 60 keV provided adequate attenuation without marked beam-hardening artifacts in 90% of patients, with the highest contrast-to-noise and signal-to-noise ratios, the lowest level of subjective noise, and no significant differences with images at 80 kV (mean energy, 54 keV). For the superior vena cava and brachiocephalic veins, the reconstructions at 100 keV enabled artifact-free analysis of the perivascular anatomic zone without a significant difference with images at 140 kV (mean energy, 92 keV). Compared with standard CT images acquired after administration of a 35% iodinated contrast agent, there was a statistically significant reduction in the frequency of artifacts around systemic veins at 100 keV (P < .001) and similar overall image quality for central vessels at 60 keV (P > .05). An optimal analysis of thoracic circulation can be achieved on virtual monochromatic spectral images at 60 keV and 100 keV and on the original polychromatic images at 80 kV and 140 kV. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120195/-/DC1.

Effect of High Iodine Intake on Selected Parameters of Immunity in Sheep

Abstract The study aimed at defining the immunity risks connected with high iodine supplementation in ewes and their lambs. The feed ration for control group (C) of ewes (n=6) contained 3.1 mg of iodine per kilogram of dietary dry matter and for experimental group (E) of ewes (n=6) 5.1 mg of iodine per kilogram of dietary dry matter. The animals were fed the diets for 8 months. Parallelly with different iodine supplementation, some immunological parameters (percentage of γ-globulins, concentration of immunoglobulin G, and white blood cell count) were examined in ewes and their lambs. The difference in the average concentration of immunoglobulin G between the ewes of group C and E was not significant during the experiment. A significant decrease (P&lt;0.01) in the concentration of immunoglobulin G from 19.6 mg/mL before the experiment to 9.8 mg/mL on day 60 of the experiment was demonstrated in the ewes of group E. The average percentage of γ-globulins in the whole period after parturition was lower in the ewes of group E than in group C. The concentration of immunoglobulin G and the percentage of γ-globulins in lambs from dams in group E was continually lower (P&lt;0.01) for the entire period of 1-30 d and demonstrated immunological risks of the excessive intake of iodine. The obtained results document a dangerous influence of high iodine intake on immunity in the prenatal period in ewes and mainly in the postnatal period in their lambs.

Contrast-enhanced CT with a High-Affinity Cationic Contrast Agent for Imaging ex Vivo Bovine, Intact ex Vivo Rabbit, and in Vivo Rabbit Cartilage

To quantify the affinity of a cationic computed tomography (CT) contrast agent (CA(4+)) and that of an anionic contrast agent (ioxaglate) to glycosaminoglycans (GAGs) in ex vivo cartilage tissue explants and to characterize the in vivo diffusion kinetics of CA(4+) and ioxaglate in a rabbit model. All in vivo procedures were approved by the institutional animal care and use committee. The affinities of ioxaglate and CA(4+) to GAGs in cartilage (six bovine osteochondral plugs) were quantified by means of a modified binding assay using micro-CT after plug equilibration in serial dilutions of each agent. The contrast agents were administered intraarticularly to the knee joints of five New Zealand white rabbits to determine the in vivo diffusion kinetics and cartilage tissue imaging capabilities. Kinetics of diffusion into the femoral groove cartilage and relative contrast agent uptake into bovine plugs were characterized by means of nonlinear mixed-effects models. Diffusion time constants (τ) were compared by using a Student t test. The uptake of CA(4+) in cartilage was consistently over 100% of the reservoir concentration, whereas it was only 59% for ioxaglate. In vivo, the contrast material-enhanced cartilage reached a steady CT attenuation for both CA(4+) and ioxaglate, with τ values of 13.8 and 6.5 minutes, respectively (P = .04). The cartilage was easily distinguishable from the surrounding tissues for CA(4+) (12 mg of iodine per milliliter); comparatively, the anionic contrast agent provided less favorable imaging results, even when a higher concentration was used (80 mg of iodine per milliliter). The affinity of the cationic contrast agent CA(4+) to GAGs enables high-quality imaging and segmentation of ex vivo bovine and rabbit cartilage, as well as in vivo rabbit cartilage. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112246/-/DC1.

Iodinated Contrast Media Differentially Affect Afferent and Efferent Arteriolar Tone and Reactivity in Mice: A Possible Explanation for Reduced Glomerular Filtration Rate

To determine the effect of the iodinated contrast medium iodixanol on arteriolar tone in afferent and efferent arterioles of the glomerulus and the functional interactions with the major modulators of arteriolar tone, angiotensin II and nitric oxide, in mice. Animal handling conformed to the ethics guidelines of the Office for Health and Social Matters of Berlin. Arterioles were isolated from 136 C57BL/6 mice, perfused with either vehicle solution or iodixanol (23 mg of iodine per milliliter) for 20 minutes, followed by angiotensin II administration. Fluorescence of 3-amino-4-(N-methylamino)-2',7'-difluorofluorescein (DAF-FM) and dihydroethidium (DHE) were used for quantification of nitric oxide bioavailability and superoxide concentration, respectively. Statistical analysis of time- and dose-dependent data was performed by using the nonparametric test for repeated measurements. With iodixanol, afferent arteriole diameters were significantly reduced from 9.2 µm to 8.3 µm; in control group, the diameters were increased from 8.7 µm to 9.3 µm (P = .008). Nitric oxide synthase inhibition augmented iodixanol-induced constriction, with diameters reduced from 9.9 µm to 5.8 µm (P < .0001). DAF-FM fluorescence increased less during iodixanol treatment and nitric oxide synthase inhibition (3.6% and 3.7% vs 10.7% in control group, P = .009 and P = .049, respectively), indicating impaired nitric oxide bioavailability. With iodixanol, DHE fluorescence ratio was increased by 12% (P < .0001). Angiotensin II responses were enhanced by iodixanol and by nitric oxide synthase inhibition after perfusion with iodixanol (3.3 µm and 4.3 µm vs 7.5 µm [control group] with 1 × 10(-6)/mol/L angiotensin II, P = .03 for both). In contrast, in efferent arterioles, neither their basal diameters nor the responses to angiotensin II were significantly affected by iodixanol. A more pronounced effect of iodixanol on afferent than on efferent arterioles may contribute to the reduction of glomerular filtration rate in contrast medium-induced acute kidney injury. Decreased nitric oxide bioavailability and increased concentration of superoxide explain the increased tone and reactivity in afferent arterioles perfused with iodixanol.

Effect of iodine-enriched yeast supplementation of diet on performance of laying hens, egg traits, and egg iodine content

The aim of the study was to evaluate the effect of iodine yeast (I-yeast) supplementation on the performance, egg traits, and iodine content of eggs of laying hens. The experiment was conducted as a completely randomized design. A total of 60 laying hens (Hy-Line Brown), 25 wk of age, was divided into 3 groups (4 replicates), and a feeding experiment was conducted for 12 wk. The concentrations and forms of iodine added to the basal diet were as follows: control group, 1 mg of iodine/kg of feed, Ca(IO(3))(2)•H(2)O; experimental groups E1 and E2, 1 and 2 mg of iodine per kilogram of feed, I-yeast, respectively. The iodine yeast did not significantly affect BW gain. Lower level of hen day egg production for groups E1 and E2 was not confirmed statistically; however, it was probably the consequence of low replication. Feed intake was the lowest in the E1 group and feed conversion rate was the highest in the E2 group. Furthermore, the egg and albumen weight was the highest in the group supplemented with 2 mg/kg of iodine from I-yeast (P < 0.05). The concentration of iodine in the egg yolk from groups E1 and E2 was respectively about 80 and 90% higher, compared with the control group. Eggshells from the group fed with 2 mg/kg of I-yeast contained almost 3 times more iodine than eggshells from the control group. The results suggest that iodine yeast supplementation in the diet of laying hens is an effective method for increasing iodine concentration in eggs and thus could contribute to elimination of iodine deficiency disorders in humans consuming iodine-enriched eggs.

Improvement of Image Quality at Low–Radiation Dose and Low–Contrast Material Dose Abdominal CT in Patients With Cirrhosis

To intraindividually compare a low-tube voltage, low-contrast material dose computed tomography (CT) reconstructed with iterative reconstruction (IR) algorithm at standard tube voltage reconstructed with filtered back projection (FBP) and standard-contrast material dose during liver dynamic CT. Twenty-five patients with liver cirrhosis underwent 64-section multidetector CT. One hundred twenty kilovolt (peak) (kV[p]) with standard contrast material dose of 600 mg of iodine per kilogram (protocol A) and 80 kV(p) with low-contrast material dose of 450 mg of iodine per kilogram (protocol B) CT image sets were reconstructed by using FBP algorithm and that of using IR algorithm with a 60%/40% blend of IR-FBP reconstruction at 80-kV(p) image set (protocol C). Scans obtained during 3 hepatic phases were subjected to quantitative and qualitative analysis. The mean radiation dose and the contrast medium dose were significantly lower under protocols B and C than under protocol A. In all hepatic phases, all signal-to-noise and contrast-to-noise ratios were greater under protocol C than under other protocols at all anatomic sites. Qualitative analysis showed that image noise and diagnostic acceptability were significantly higher under protocol C. In all hepatic phases, a low-tube voltage, low-contrast material dose CT with IR algorithm yielded better contrast enhancement and image quality than a standard tube voltage, standard contrast material dose CT with FBP in thin adult patients.

Computed Tomographic Venography for Varicose Veins of the Lower Extremities

To prospectively investigate the feasibility of an 80-kilovolt (peak) (kVp) protocol in computed tomographic venography for varicose veins of the lower extremities by comparison with conventional 120-kVp protocol. Attenuation values and signal-to-noise ratio of iodine contrast medium (CM) were determined in a water phantom for 2 tube voltages (80 kVp and 120 kVp). Among 100 patients, 50 patients were scanned with 120 kVp and 150 effective milliampere second (mAs(eff)), and the other 50 patients were scanned with 80 kVp and 390 mAs(eff) after the administration of 1.7-mL/kg CM (370 mg of iodine per milliliter). The 2 groups were compared for venous attenuation, contrast-to-noise ratio, and subjective degree of venous enhancement, image noise, and overall diagnostic image quality. In the phantom, the attenuation value and signal-to-noise ratio value for iodine CM at 80 kVp were 63.8% and 33.0% higher, respectively, than those obtained at 120 kVp. The mean attenuation of the measured veins of the lower extremities was 148.3 Hounsfield units (HU) for the 80-kVp protocol and 94.8 HU for the 120-kVp protocol. Contrast-to-noise ratio was also significantly higher with the 80-kVp protocol. The overall diagnostic image quality of the 3-dimensional volume-rendered images was good with both protocols. The subjective score for venous enhancement was higher at the 80-kVp protocol. The mean volume computed tomography dose index of the 80-kVp (5.6 mGy) protocol was 23.3% lower than that of the 120-kVp (7.3 mGy) protocol. The use of the 80-kVp protocol improved overall venous attenuation, especially in perforating vein, and provided similarly high diagnostic image quality with a lower radiation dose when compared to the conventional 120-kVp protocol.

Perfusion CT in Colorectal Cancer: Comparison of Perfusion Parameters with Tumor Grade and Microvessel Density

ObjectiveThe purpose of this study was to prospectively compare pre-operative computed tomography (CT) perfusion parameters with tumor grade from colorectal adenocarcinoma (CRC) and to correlate pre-operative CT perfusion parameters with microvessel density (MVD) to evaluate angiogenesis in CRC.Materials and MethodsPre-operative perfusion CTs were performed with a 64-channel multidetector row CT in 27 patients (17 women and 10 men; age range 32-82 years) who were diagnosed with CRC involving the sigmoid and rectum between August 2006 and November 2007. All patients underwent surgery without pre-operative chemotherapy or radiation therapy. Dynamic perfusion CTs were performed for 65 seconds after intravenous injection of contrast medium (100 mL, 300 mg of iodine per mL, 5 mL/sec). Before surgery, blood flow (BF), blood volume, mean transit time (MTT), and permeability-surface area product were measured in the tumor. After surgery, one gastrointestinal pathologist evaluated tumor grade and performed immunohistochemical staining using CD 34 to determine MVD in each tumor. The Kruskal-Wallis test was used to compare CT perfusion parameters with tumor grade, and Pearson's correlation analysis was used to correlate CT perfusion parameters with MVD.ResultsIn 27 patients with CRC, tumor grading was as follows: well differentiated (n = 8); moderately differentiated (n = 15); and poorly differentiated (n = 4). BF was higher in moderately differentiated CRC than well differentiated and poorly differentiated CRCs (p = 0.14). MTT was shorter in moderately differentiated than well differentiated and poorly differentiated CRCs (p = 0.039). The MVD was greater in poorly differentiated than well differentiated and moderately differentiated CRCs (p = 0.034). There was no significant correlation between other perfusion parameters and tumor grade. There was no significant correlation between CT perfusion parameters and MVD.ConclusionBF and MTT measurement by perfusion CT is effective in predicting moderately differentiated CRCs. However, perfusion CT is limited in distinguishing well differentiated and poorly differentiated CRCs. Pre-operative perfusion CT does not reflect the MVD of CRCs.

High Iodine Content of Korean Seaweed Soup: A Health Risk for Lactating Women and Their Infants?

Iodine requirements increase during pregnancy and lactation due to increased maternal thyroid hormone production and iodine excretion, fetal iodine requirements, and loss of iodine in breast milk. Seaweed preparations are a source of dietary iodine. Korean and many Korean-American women traditionally consume brown seaweed soup (Undaria pinnatifida) daily during the early postpartum period (Supplementary Data; Supplementary Data are available online at www .liebertonline.com/thy) (1). This tradition is maintained among Korean and Korean-American women such that their breast milk iodine correlates strongly with frequency and quantity of seaweed soup consumption (2,3). As the iodine content of this soup has not been reported, we randomly selected 10 brands of dried brown seaweed from Korea and China available in the United States. Seaweed soup from each brand was prepared utilizing the following ingredients: 1 oz of dried seaweed, 6 cups water, 1⁄4 pound beef, 11⁄2 tablespoons soy sauce, 2 teaspoons sesame oil, 1 teaspoon garlic, and *1⁄2 teaspoon noniodized sea salt (Supplementary Data). Iodine content of the dried seaweeds and the soups were measured spectrophotometrically after digestion with hydrochloric acid and dilution with iodine free deionized water, as described by Benotti et al. (see Supplementary Data). The mean iodine content of the dried seaweed was 359 254 mg/g (mean SD), or 10173 7200mg/oz. The mean iodine content of seaweed broth was 1.9 0.7 mg/mL, with 1 bowl (250 mL) of broth containing an average of 487 178 mg of iodine. The mean iodine content of blended seaweed soup contents (broth, cooked seaweed) was 1705 930 mg/250 mL. Potential sources of variability in soup iodine (see Supplementary Data) include the iodine contents of dry seaweed and other ingredients (e.g., iodized salt, iodine-containing soy sauce, and anchovy soup base), cooking methodologies, and the quantity of seaweed in recipes (4). The iodine content of seaweed varies with harvest location and season, salinity and temperature of water, depth and portion of seaweed harvested, and storage conditions (4). The World Health Organization (WHO) guidelines recommend 250 mg/day of iodine intake during pregnancy and lactation, whereas the Institute of Medicine (IOM) recommends 220mg/day of iodine intake during pregnancy and 290 mg/day during lactation (Supplementary Data). The IOM recommends a tolerable upper limit of iodine intake of 1100mg/day, whereas the WHO suggests an upper limit of 500mg/day for pregnant and lactating women and 180mg/ day for infants. More than 90% of postpartum lactating Korean women consume seaweed soup at least three times daily in the first postpartum week, and up to 75% of these women have seaweed soup at least once daily up to 4 weeks postpartum (3). Our findings indicate that this constitutes an average iodine intake of at least 1400 mg/day in the first postpartum week based solely on 250 mL seaweed soup broth three times daily, and at least 5000mg/day if the entire contents of each serving are consumed (broth and seaweed). High levels of breast milk iodine values in Korean postpartum women have been reported (2,3). Depending on quantity and frequency of intake, postpartum women who consume Korean seaweed soup may have daily iodine intakes and breast milk iodine concentrations that far exceed the WHO and IOM upper limits. Iodine-induced hypothyroidism, iodine-induced thyrotoxicosis, and iodine-induced goiter are potential adverse effects of excess iodine consumption. However, the effects of high iodine intake are dependent on several factors, including iodine status (i.e., degree and duration of iodine deficiency or sufficiency) before excess iodine exposure, as well as any preexisting thyroid autoimmunity, thyroid dysfunction, and/or thyroid nodularity. Chung et al. reported subclinical hypothyroidism in preterm Korean infants exposed to high iodine content in breast milk (2). Additionally, cases of iodine-induced neonatal hypothyroidism due to maternal seaweed consumption were reported in Australia. Increased incidence and/or exacerbation of postpartum thyroiditis are also potential risks of high iodine intake. However, these effects were not observed in the only Korean study to date evaluating this relationship. Further studies should be carried out to evaluate the potential adverse effects of sustained high dietary iodine in postpartum women of Korean descent and their infants. In addition, there should be a raised cultural awareness among endocrinologists and other medical providers regarding this common source of high dietary iodine. A careful dietary history should be part of the evaluation and follow-up of postpartum Korean women and their infants, especially in the setting of signs and/or symptoms of thyroid dysfunction, thyroid autoimmunity, nodular thyroid anatomy, or pre-existing thyroid dysfunction. In addition, Korean women

Proximal Aneurysmal Neck: Dynamic ECG-gated CT Angiography—Conformational Pulsatile Changes with Possible Consequences for Endograft Sizing

To assess the magnitude of variations in size of the proximal neck of the abdominal aortic aneurysm (AAA) in patients selected to undergo endovascular abdominal aortic aneurysm repair (EVAR) and the potential effect on choice of endograft diameter by using 64-section dynamic electrocardiographically (ECG)-gated computed tomographic (CT) angiography. A prospective single-center study was performed in 40 patients with AAA who underwent both static and dynamic ECG-gated CT angiography. The ethical conduct of the study was approved by the departmental review board, and all patients provided written informed consent. Dynamic ECG-gated data sets were acquired with a low-dose acquisition protocol (100 kV) by using a 0.625-mm-section collimation (40 mL iomeprol [400 mg of iodine per milliliter] versus 80 mL). Pulsatility measurements were taken at suprarenal, juxtarenal, and infrarenal levels within the aneurysmal neck. Manual CT angiographic measurements were performed on modified axial images. On static axial images, one vascular surgeon and one interventional radiologist selected the diameter of the main body of the potential infrarenal stent-graft to implant. The diameter of the main body of the stent-graft selected was compared with the dynamic measurements obtained to calculate the potential relative oversizing performed. A total of 40 patients were enrolled. Significant aortic pulsatility was demonstrated within the aneurysmal neck (mean variation, 9.01% ± 4.81 [standard deviation]; absolute change, 1.83 mm ± 1.01; P < .05). When compared with dynamic measurements, the diameter of the endograft selected on the basis of static images would be potentially changed in 12 of 40 (30%) patients. Comparing the minimum or maximum diameter of the aneurysmal neck with the diameter of the endograft selected on the basis of static images, the relative oversizing performed was considered inadequate in seven of 40 (18%) patients. Dynamic ECG-gated CT may provide information in regard to pulsatile motion that could change the diameter of the endograft selected on the basis of static imaging measurements.

Virtual Monochromatic Spectral Imaging with Fast Kilovoltage Switching: Improved Image Quality as Compared with That Obtained with Conventional 120-kVp CT

To compare image quality obtained in phantoms with virtual monochromatic spectral (VMS) imaging with that obtained with conventional 120-kVp computed tomography (CT) for a given radiation dose. Three syringes were filled with a diluted contrast medium (each syringe contained a contrast medium with a different iodine concentration [5, 10, or 15 mg of iodine per milliliter]), and a fourth syringe was filled with water. These syringes were placed in a torso phantom meant to simulate the standard human physique. The phantom was examined with a CT system and use of the fast kilovoltage switching (80 and 140 kVp) and conventional (120 kVp) modes. Image noise and contrast-to-noise (CNR) ratio were analyzed on VMS images and 120-kVp CT images. Image noise on VMS images in the range of 67-72 keV was significantly lower than that on the 120-kVp CT images (P < .014). Image noise was lowest at 69 keV and was 12% lower when compared with that on 120-kVp CT images. CNR on the VMS images was highest at 68 keV. CNR on the VMS images obtained at 68 keV in the syringes filled with diluted contrast material (5, 10, and 15 mg of iodine per milliliter) was 28%, 31%, and 30% higher, respectively, compared with that on the 120-kVp CT images (P < .001). VMS imaging at approximately 70 keV yielded lower image noise and higher CNR than did 120-kVp CT for a given radiation dose. VMS imaging has the potential to replace 120-kVp CT as the standard CT imaging modality, since optimal VMS imaging may be expected to yield improved image quality in a patient with standard body habitus.

Development of Low-Dose Photon-counting Contrast-enhanced Tomosynthesis with Spectral Imaging

To demonstrate the feasibility of low-dose photon-counting tomosynthesis in combination with a contrast agent (contrast material-enhanced tomographic mammography) for the differentiation of breast cancer. All studies were approved by the institutional review board, and all patients provided written informed consent. A phantom model with wells of iodinated contrast material (3 mg of iodine per milliliter) 1, 2, 5, 10, and 15 mm in diameter was assessed. Nine patients with malignant lesions and one with a high-risk lesion (atypical papilloma) were included (all women; mean age, 60.7 years). A multislit photon-counting tomosynthesis system was utilized (spectral imaging) to produce both low- and high-energy tomographic data (below and above the k edge of iodine, respectively) in a single scan, which allowed for dual-energy visualization of iodine. Images were obtained prior to contrast material administration and 120 and 480 seconds after contrast material administration. Four readers independently assessed the images along with conventional mammograms, ultrasonographic images, and magnetic resonance images. Glandular dose was estimated. Contrast agent was visible in the phantom model with simulated spherical tumor diameters as small as 5 mm. The average glandular dose was measured as 0.42 mGy per complete spectral imaging tomosynthesis scan of one breast. Because there were three time points (prior to contrast medium administration and 120 and 480 seconds after contrast medium administration), this resulted in a total dose of 1.26 mGy for the whole procedure in the breast with the abnormality. Seven of 10 cases were categorized as Breast Imaging Reporting and Data System score of 4 or higher by all four readers when reviewing spectral images in combination with mammograms. One lesion near the chest wall was not captured on the spectral image because of a positioning problem. The use of contrast-enhanced tomographic mammography has been demonstrated successfully in patients with promising diagnostic benefit. Further studies are necessary to fully assess diagnostic sensitivity and specificity.

Comparison of the Effect of Low- and Iso-Osmolar Contrast Agents on Heart Rate during Chest CT Angiography: Results of a Prospective Randomized Multicenter Study

To prospectively compare the effect of intravenous injection of low-osmolar iopamidol with that of intravenous injection of iso-osmolar iodixanol on heart rate (HR) during nongated chest computed tomographic (CT) angiography. This multicenter study was approved by local institutional review boards, and patients provided written informed consent. Patient enrollment and examination at centers in the United States complied with HIPAA regulations. One hundred and thirty patients (54 male; mean age, 52 years) clinically suspected of having pulmonary embolism were referred for pulmonary CT angiography and were randomly assigned to receive 80 mL of either iopamidol (370 mg of iodine per milliliter, n = 63) or iodixanol (320 mg of iodine per milliliter, n = 67) at a rate of 4 mL/sec. HR (measured in beats per minute) was monitored from 5 minutes before the start of injection to the end of imaging, and precontrast HR and maximum postcontrast HR were recorded. Student t and χ(2) tests were used for continuous and categorical variables, respectively. Precontrast HR in patients who received iopamidol (mean, 81 beats per minute ± 18 [standard deviation]) was similar to that in patients who received iodixanol (mean, 77 beats per minute ± 17) (P = .16). Mean postcontrast HR was 87 beats per minute ± 17 and 82 beats per minute ± 18 (P = .16) in the iopamidol and iodixanol groups, respectively. Mean increase from precontrast HR to postcontrast HR was 5 beats per minute ± 9 and 5 beats per minute ± 7 (P = .72) in the iopamidol and iodixanol groups, respectively. Thirty-five (56%) of the 63 patients who received iopamidol and 33 (49%) of the 67 patients who received iodixanol had an HR increase of fewer than 5 beats per minute, 15 (24%) and 18 (27%) patients, respectively, had an increase of 5-9 beats per minute, and four (6%) and three (4%) patients, respectively, had an increase of more than 20 beats per minute. These proportions were not significantly different between the groups (P = .51, χ(2) test). High-rate intravenous administration of 80 mL of iopamidol and iodixanol during pulmonary CT angiography slightly increased HR; there was no difference in HR between the contrast agent groups.

Multiple Thyroid Cysts May Be a Cause of Hypothyroidism in Patients with Relatively High Iodine Intake

Multiple cysts of the thyroid gland have not been recognized as one of the causes of hypothyroidism. Here we present six patients from a region with relatively high iodine intake in whom multiple cysts of the thyroid were associated with hypothyroidism or the development of hypothyroidism. All patients were women and ranged in age from 49 to 71. Their thyroids were mildly enlarged, tests for thyroid autoantibodies were negative, and multiple cysts were detected in the thyroid by ultrasonography. By dietary questionnaire their iodine intake was estimated to range from 2 to 10 mg of iodine daily. Otherwise, there was no evidence for disorders or factors associated with hypothyroidism. All four patients who agreed to dietary iodine restriction became euthyroid at approximately 1 month after a low-iodine diet (less than 0.5 mg iodine per day) was started. Although these patients were from a region with high-iodine intake and had a relatively high intake compared with most regions of the world, this amount of iodine intake is not associated with hypothyroidism in otherwise healthy persons. Therefore, we propose that multiple thyroid cysts, which we have termed polycystic goiter, is probably a cause of hypothyroidism in patients with a relatively high iodine intake.

Iodine Nutrition Status of Pregnant Women in an Iodine-Sufficient Area

Iodine is necessary for the synthesis of thyroid hormones, which play a decisive role in the development of the brain during fetal and early postnatal life. To evaluate whether prophylaxis with 20 to 30 mg of iodine per kilogram of salt is enough to ensure optimal iodine nutrition during pregnancy in an iodine-sufficient area. A cross-sectional study of pregnant women was conducted in 2007. The urinary iodine concentration (UIC) was measured in 300 randomly selected women in Tuzla, Bosnia, and Herzegovina, in all three trimesters of pregnancy. The median UIC of the pregnant women was 142 microg/L, ranging from 27 to 1,080 microg/L. The median UIC of the pregnant women in each trimester of pregnancy who were not restricting their salt intake was consistent with adequate iodine nutrition, as defined by the World Health Organization Technical Consultation, whereas the median UIC of women who were restricting their salt intake was insufficient. Pregnant women in the urban area of Tuzla had adequate iodine status except for those with restricted salt intake, which presents an increased risk to the mother as well to as the unborn child. Women in the rural area of Tuzla were found to be iodine-deficient, regardless of whether they had restricted their salt intake or not. However, for those pregnant women who have been advised to restrict their salt intake and who thus face the risk of iodine deficiency, the use of salt with higher concentrations of iodine could be advised.

Central Venous Catheter Integrity during Mechanical Power Injection of Iodinated Contrast Medium

To evaluate a widely used nontunneled triple-lumen central venous catheter in order to determine whether the largest of the three lumina (16 gauge) can tolerate high flow rates, such as those required for computed tomographic angiography. Forty-two catheters were tested in vitro, including 10 new and 32 used catheters (median indwelling time, 5 days). Injection pressures were continuously monitored at the site of the 16-gauge central venous catheter hub. Catheters were injected with 300 and 370 mg of iodine per milliliter of iopamidol by using a mechanical injector at increasing flow rates until the catheter failed. The infusion rate, hub pressure, and location were documented for each failure event. The catheter pressures generated during hand injection by five operators were also analyzed. Mean flow rates and pressures at failure were compared by means of two-tailed Student t test, with differences considered significant at P < .05. Injections of iopamidol with 370 mg of iodine per milliliter generate more pressure than injections of iopamidol with 300 mg of iodine per milliliter at the same injection rate. All catheters failed in the tubing external to the patient. The lowest flow rate at which catheter failure occurred was 9 mL/sec. The lowest hub pressure at failure was 262 pounds per square inch gauge (psig) for new and 213 psig for used catheters. Hand injection of iopamidol with 300 mg of iodine per milliliter generated peak hub pressures ranging from 35 to 72 psig, corresponding to flow rates ranging from 2.5 to 5.0 mL/sec. Indwelling use has an effect on catheter material property, but even for used catheters there is a substantial safety margin for power injection with the particular triple-lumen central venous catheter tested in this study, as the manufacturer's recommendation for maximum pressure is 15 psig.

X-ray fluorescence analysis (XFA) of thyroidal iodine content (TIC) with an improved measuring system.

X-ray fluorescence analysis is based on the principal that the electron structure of stable iodine in the thyroid is excited by Americium-241 gamma rays to emit a characteristic fluorescence radiation which is proportional to the amount of iodine present in the gland. A stationary measuring system consisting of a 11.1 GBq Am-241 source and a high-purity Germanium detector with spectrum analyser has been improved by a PC guided method for sonographic definition of the measuring volume. The lower limit of detectibility of the system corresponds to 0.01 mg of Iodine per ml of thyroid volume; the in vivo precision given as coefficient of variation amounts to 15%. The thyroid is exposed with a radiation dose of 6 microSv per measurement. First studies with this improved system carried out in 50 female volunteers between 20 and 40 years of age with normal thyroid volumes resulted in a mean iodine concentration of the thyroid of 0.665 +/- 0.304 mg/ml. The mean iodine excretion in urine was normal with 10.8 +/- 10.4 microg/dl.

Iodixanol, Constriction of Medullary Descending Vasa Recta, and Risk for Contrast Medium–induced Nephropathy

To determine whether a type of contrast medium (CM), iodixanol, modifies outer medullary descending vasa recta (DVR) vasoreactivity and nitric oxide (NO) production in isolated microperfused DVR. Animal handling conformed to the Animal Care Committee Guidelines of all participating institutions. Single specimens of DVR were isolated from rats and perfused with a buffered solution containing iodixanol. A concentration of 23 mg of iodine per milliliter was chosen to mimic that expected to be used in usual examinations in humans. Luminal diameter was determined by using video microscopy, and NO was measured by using fluorescent techniques. Iodixanol led to 52% reduction of DVR luminal diameter, a narrowing that might interfere with passage of erythrocytes in vivo. Vasoconstriction induced by angiotensin II was enhanced by iodixanol. Moreover, iodixanol decreased NO bioavailability by more than 82%. Use of 4-hydroxy-2,2,6,6-tetramethylpiperidine 1-oxyl (a superoxide dismutase mimetic) prevented both vasoconstriction with iodixanol alone and increased constriction with angiotensin II caused by CM. Iodixanol in doses typically used for coronary interventions constricts DVR, intensifies angiotensin II-induced constriction, and reduces bioavailability of NO. CM-induced nephropathy may be related to these events and scavenging of reactive oxygen species might exert a therapeutic benefit by preventing the adverse effects that a CM has on medullary perfusion.

Dampak Suplementasi Pil Besi Selenium Terhadap Status Hormon Tiroid Dan Kadar Hemoglobin Pada Wanita Usia Subur Di Daerah Gondok Endemik

The Effect of Combination of Iron and Selenium Supplementation on the Status of Thyroid Hormone and Haemoglobin Levels of Child Bearing Age Women In Endemic Goitre Area. Background: Iodine Deficiency Disorder (IDD) and Iron Deficiency Anemia (IDA) still considered as a public health problem in Indonesia. It is possible that some people in endemic goiter area not only suffering from IDD but also IDA, particulary among Childbearing Age Women (CBAW). Based on the national household survey (SKRT, 2001), it was reported that the prevalence of IDA among CBAW in Central Java, 22.4%, while in Cianjur District was 36.6%. Iron deficiency not only caused the decreament of hemoglobin value, but also decreased the Tyroxin (T4) and triiodotironin (T3) hormon syntesis. The trace element which has important role for iodine metabolism is selenium (Se). So far IDA and IDD control programme in Indonesia have been conducted separately, by means not integrated in strategy and not using combination of iron and selenium supplementation. Objectives: The main objectives of this study are to find out the possibilities of integrated solution of IDD and IDA. To determine the effect of combination iron and selenium supplementation to iodine status and Hb level of CBAW in the endemic goiter area. Methods: Study design was randomized control trial. The study was conducted in Cangkringan Subdistrict of Sleman District of D.I. Yogyakarta. A total of 96 CBAW were randomly assigned into 3 groups. Each group received different treatment, but before starting, all subjects were received pirantel for deworming. Group A (n=31) received 400 mg of iodine (2 capsules) + ferrosulfate (60 mg elemental iron + 0.25 mg of folic acid) + 420 ug of selenium (yeast selenium); group B (n=31) received 400 mg of iodine + ferrosulfate and group C (n = 34) received 400 mg of iodine only (control group). Two capsules of iodine were given once in the beginning of study to all subjects, while ferrosulfate and selenium were given twice a week for 16 weeks. Data of hormon thyroxin (serum T4) and Hb was collected before and after intervention. Data of socialeconomi and selenium were collected at the first of study. Results: It was revealed that before treatment there were no significant difference of the average of Hb levels and the median value of serum T4 amongs 3 groups of study (p> 0.05). After 16 weeks intervention there were thyroid hormone status improvement (serum T4) to all groups as follows: group A (100%), group B (80%) and group C (66.7%) respectively. Conclusions: After 16 weeks intervention of iron and selenium preparate to CBAW who had received iodine supplementation, was able to improve status of thyroid hormone (serum T4) higher than to those who received iodine only (33.3%). The increment of Hb levels of CBAW who received iron and selenium supplementation (group A) was lower than those who received iron only (group B). Keywords: Childbearing Age Women, IDD, IDA, anemia and selenium.