Normal Iodine Research Articles

PHYSICOCHEMICAL DIFFERENCES BETWEEN COOKING AND PASTEURIZED BUTTER SOLD IN ALEXANDRIA CITY

Fifty random samples of cooking and pasteurized cow butter (25 samples each) were collected from different markets in Alexandria, city. Samples were examined for organoleptic and physicochemical characters. Sensory evaluation revealed that 10 (40%) ; 9 (36%) and 6 (24%) of cooking butter samples were graded as good, fair and poor, respectively, while 3 (12%) samples of pasteurized butter were excellent ; 16 (64%) good ; 4 (16%) fair and 2 (8%) of poor quality. Cooking butter samples showed average fat %, acid degree value (ADV), iodine value, solid not fat (SNF) and moisture content as 76.27 + 5.17; 2.51 + 1.8 ; 36.29 + 16.7 ; 2.88 + 1.65 and 17.55 + 2.34, respectively. While corresponding results for pasteurized butter were 81.66 + 5.96 ; 0.96 + 0.54 ; 43.07 + 11.9 ; 2.25 +1.12 and 15.07+ 2.09, respectively. Nine (36%) samples of cooking butter and 4 (16%) samples of pasteurized butter had a fat content lower than the legal limit set by the Egyptian Standards not less than 78% (EOSQC 154-5/2005). According to the results of Acid degree value (ADV) 2 (8%) of cooking butter samples graded as normal { 1.5}. Regarding pasteurized butter samples 11 (44%) were normal ; 8 (32%) borderline ; only one (4%) were slightly lipolyzed and 5 (20%) were extremely lipolyzed, while the legal limit set by the Egyptian Standards not exceed than 0.4% (EOSQC 154-5/2005). Measurement of iodine value (IV) declared that 20 (80%) and 21 (84%) of cooking and pasteurized butter samples, respectively were within the normal iodine value range (26-43). While 3 (12%) and 4 (16%) of cooking and pasteurized butter samples, respectively had higher values than the maximum limit and they may be adulterated by vegetable oils. Two (8%) of cooking butter samples showed results lower than the minimum limit of iodine value. According to the results of Solid Not Fat (SNF), 12 (48%) and 16 (64%) of cooking and pasteurized butter samples, respectively were within the normal. While, 11 (44%) and 5 (20%) of cooking and pasteurized butter samples, respectively had high (SNF) content more than 3%. Measurement of moisture content declared that 22 (88%) and 23 (92%) of cooking and pasteurized butter samples, respectively were in the normal limit, while 3 (12%) and 2 (8%) of cooking and pasteurized butter samples, respectively had moisture content higher than 18%. All the examined butter samples were proved to be free from adulteration by starch.

Longitudinal trends in thyroid function in relation to iodine intake: ongoing changes of thyroid function despite adequate current iodine status

Several cross-sectional studies on populations with iodine deficiency showed that TSH-levels are negatively associated with age, while in populations with high iodine intake TSH is positively associated with age. The question is whether such an age-thyroid function relation is an ongoing process apparent also in longitudinal studies and whether it reflects an actual iodine deficiency or an iodine insufficiency in the past. In an area with a borderline iodine status in the past, we studied 980 participants of the Nijmegen Biomedical Study. We measured serum TSH, free thyroxine (FT₄), total triiodothyronine (T₃), peroxidase antibodies, and the urine iodine and creatinine concentration 4 years after our initial survey of thyroid function, in which we reported a negative association between TSH and age. within 4 years, TSH decreased by 5.4% (95% ci 2.58.3%) and FT₄ increased by 3.7% (95% ci 2.94.6%). median urinary iodine concentration was 130 μg/l. estimated 24-h iodine excretion was not associated with TSH, T₃, change of TSH, or FT₄ over time or with the presence of antibodies against thyroid peroxidase. Only FT₄ appeared to be somewhat higher at lower urine iodine levels: a 1.01% (95% CI 0.17-1.84%) higher FT₄ for each lower iodine quintile. In this longitudinal study, we found an ongoing decrease in TSH and increase in FT₄ in a previously iodine insufficient population, despite the adequate iodine status at present. This suggests that low iodine intake at young age leads to thyroid autonomy (and a tendency to hyperthyroidism) that persists despite normal iodine intake later in life.

The Unique Utility of EUS in Diagnosis of Substernal Retroesophageal Thyroid Masses

Purpose: A 58-year-old female presented with stabbing chest pain, fatigue, and dysphagia of approximately 3 months. Cardiac work-up was negative. CT demonstrated a 3.5 x 2.1 cm mass in the left retroesophageal space of the superior mediastinum. Barium swallow revealed evidence of extrinsic compression on the upper esophagus at the level of the thoracic inlet. PET scan revealed hypermetabolic activity in the setting of an exophytic posterior thyroid nodule, with normal iodine thyroid uptake scan. EUS was performed with transesophageal FNA biopsy. A single oval mass lesion was found in the superior mediastinum with the echoendoscope positioned at 20 cm from the incisors. The mass was hypoechoic and lobulated measuring 35 x 30 mm. FNA was preceded by color Doppler imaging to confirm a lack of significant vascular structures within the path of aspiration. Cytology revealed Hurthle Cell type hyperplastic thyroid tissue. The patient underwent a substernal total thyroidectomy to relieve her compressive symptoms from the large multi-nodular goiter and to definitively evaluate for malignancy given the abnormal cytology on EUS w/FNA. Final surgical pathology revealed multifocal stage III (T3N0M0) papillary thyroid carcinoma. The patient has been doing well since undergoing thyroidectomy. Literature regarding thyroid cancer with extension of tissue in the retroesophogeal region is quite rare. This very atypical anatomy presents a challenge in diagnosis via conventional approaches such as extracutaneous ultrasound-guided biopsy (1). EUS allows for visualization and biopsy of substernal thyroid masses in retroesophageal and lateral distributions that would otherwise not be accessible by traditional methods. Use of EUS guided FNA in superior mediastinal presenting thyroid masses was first reported only within this past decade (2), making it quite the novel tool in evaluation of such masses. This case serves as an added example to solidify the role of EUS in exploration of thyroid lesions that would otherwise pose a diagnostic dilemma, potentially eliminating the need for a higher risk surgical intervention (3).

Effect of maternal excessive iodine intake on neurodevelopment and cognitive function in rat offspring

BackgroundIodine deficiency and iodine excess are both associated with adverse health consequences. Iodine deficiency during pregnancy leads to insufficient maternal thyroid hormone, subsequently causing irreversible adverse effects on the neurological and cognitive functions of the offspring. The results of our previous epidemiological study suggested that mild iodine excess might increase the prevalence of subclinical hypothyroidism. In the present study, female Wistar rats maintained on low-iodine grain were randomly assigned to three groups based on iodated water concentration: low iodine (LI, 1.2 μg/d), normal iodine (NI, 5–6 μg/d), and 3-fold high iodine (3HI, 15–16 μg/d). The present study investigated whether higher-than-normal iodine intake (3HI) by rats from before pregnancy until breastfeeding affects the postnatal (PN) neurodevelopment (PN7 and PN45) of their offspring during particularly sensitive periods in brain development.ResultsAfter 12 weeks of treatment (before pregnancy), iodine concentrations in urine and thyroid tissue and circulating thyroxine of adult females correlated with iodine intake. Brain-derived neurotrophic factor (BDNF) expression in the hippocampi of pups on PN7 and PN45 was decreased in 3HI group compared to the NI controls (P < 0.05, all) On PN7 and PN45, the BDNF levels of the 3HI pups were 83.5% and 88.8%, respectively, that of the NI pups. In addition, the 3HI group had a higher neuroendocrine-specific protein A (NSP-A) level than the NI controls on PN7 (P < 0.05). NSP-A levels of the 3HI pups were 117.0% that of the NI pups. No significant difference was observed in the expressions of c-Fos or c-Jun in the hippocampal CA1 region of the 3HI group compared to the controls (P > 0.05). Results from the Morris water maze test revealed that pups of the 3HI group had mild learning and spatial memory deficits.ConclusionsThe neurodevelopmental and cognitive deficits of the 3HI pups were mild and temporary, likely related to the changes in hippocampal protein expressions of BDNF and NSP-A.

Intrauterine diagnosis and treatment of fetal goitrous hypothyroidism

We present two cases of fetal hypothyroidism with goiter which were successfully diagnosed and treated in utero. In both cases, ultrasonographic examination demonstrated a bilobed solid anterior neck mass with increased vascularity compatible with enlarged thyroid gland. Fetal blood sampling revealed hypothyroidism. Intra-amniotic injection of L-thyroxin caused a reduction in thyroid gland size and enabled vaginal delivery without complication. In the first case, maternal thyroid hormone levels and autoantibodies were normal and the neonate had hypothyroidism suggesting the diagnosis of dyshormonogenesis. In the second case, the fetus had transient hypothyroidism, which resolved spontaneously after delivery. Maternal thyroid function tests and autoantibodies were normal and both the mother and neonate had normal urinary iodine, excluding the diagnosis of iodine deficiency or excess. Thus, we believe that transplacental transfer of undetermined factors might be a cause of transient congenital hypothyroidism. Also, we reviewed the literature and described controversial issues regarding the management of fetal goiter.

Iodotyrosine Deiodinase Defect Identified via Genome-Wide Approach

Diagnosis of congenital hypothyroidism is hampered by the heterogeneity of inborn errors of thyroid metabolism and the possible delay in hypothyroidism development leading to missed cases by neonatal screen. In the current study, we used a whole-genome approach to identify the mutation responsible for severe hypothyroidism and a huge goiter in the eldest child born to healthy first cousins. We identified a homozygous mutation of the iodotyrosine deiodinase gene (IYD). We delineated the phenotype of this defect in detail, including urinary monoiodotyrosine (MIT) and diiodotyrosine (DIT) excretion. Moreover, a 4.5-yr-old sister was found homozygous for the mutation. Her clinical and biological data were normal, except for elevated MIT and DIT excretion. The urinary loss of MIT and DIT iodine observed in most affected individuals was quite limited compared to the total iodine loss, except for the hypothyroid homozygote. Hypothyroidism could therefore be partially induced by a relative iodine deficiency caused by urinary iodine loss through MIT and DIT excretion, even in cases of normal iodine intake. The wide inter- and intrafamilial variability of the disease severity remains unclear. Besides refining the phenotype of the IYD defect, our observation shows that a global, genome-wide approach to the heterogeneous inborn thyroid defects was efficient in rapidly identifying the mutation in the proband and the disease recurrence in the still euthyroid sister. Although facilitated by consanguinity in this family, novel sequencing techniques will soon make whole-genome approaches readily amenable to more common cases.

Monitoring of haloperidol and its metabolites in plasma by SPE-RP-TLC spectrometry

We describe a simple and inexpensive SPE-RP-TLC method for the monitoring and analysis of haloperidol and its metabolites in plasma. Analysis was carried out on RP-TLC plates containing C18 silica gel using methanol having 0.001% diethylamine as a mobile phase. The chromatograms were developed up to 10 cm for 65 min at 28 ± 10°C. Detection of haloperidol and its metabolites was done by placing the dried plates in normal glass iodine chamber. The quantitative analysis of haloperidol and its metabolites were carried out by using UV-visible spectroscopy at 230 nm. RF values of haloperidol, metabolite I, metabolite II, and metabolite III in plasma samples were 0.22, 0.06, 0.16, and 0.87, respectively, and their percentage recoveries were 85.0, 88.0, 87.0, and 77.0, respectively. The detection limit of RP-TLC method for haloperidol was 1.0 mg mL−1 and for all the three metabolites I, II, III was 0.8 mg mL−1. The results show that the developed method may be used for higher recovery of drugs under consideration...

Clinical–pathological changes in differentiated thyroid cancer (DTC) over time (1997–2010): data from the University Hospital “Maggiore della Carità” in Novara

Differentiated thyroid cancer (DTC) is an important clinical entity in our population (Novara, Piedmont, Italy) which is characterized by important environmental influences, as iodine deficiency (ID) and subsequent supplementation, thyroiditis and occupational exposure. To evaluate the features of DTC in our population 20 years after the iodine-prophylaxis pondering the effects of the introduction of the new guidelines for diagnosis and management of DTC after 2005. 322 patients [244 females, age: mean (±SD) 53.8 ± 15.8 years] treated for DTC in a tertiary care center between 1997 and 2010 were retrospectively evaluated. Medical history, demographics, and pathological features were considered. Patients were subdivided into two groups: A (n = 139, diagnosis 1997–2005) and B (n = 183, diagnosis 2006–2010). The population of group A showed a mild ID, while normal iodine status was recorded in group B. A significant increase in histological tumor-associated thyroiditis was found from group A to B (p = 0.021). Recurrent or persistent diseases were found to be correlated with lymph nodes metastases and/or a distant disease at diagnosis, stimulated thyroglobulin levels at the first follow-up and an additional radioiodine therapy. Twenty percent of our patients were females employed in textile industries. The tumor-related inflammation and the occupational exposure should be considered as important factors in the pathogenesis of DTC. Further studies are required in order to confirm our findings.

Prolonged high iodine intake is associated with inhibition of type 2 deiodinase activity in pituitary and elevation of serum thyrotropin levels

Our previous epidemiological study indicated that excessive intake of iodine could potentially lead to hypothyroidism. In the present study, we aimed to investigate the time and dose effect of iodine intake on serum thyrotropin (thyroid-stimulating hormone, TSH) levels and to explore the non-autoimmune regulation of serum TSH by pituitary type 2 deiodinase (D2). A total of 360 Wistar rats were randomly divided into five groups depending on administered iodine dosages (folds of physiological dose): normal iodine (NI), 3-fold iodine (3HI), 6-fold iodine (6HI), 10-fold iodine (10HI) and 50-fold iodine (50HI). At 4, 8, 12 and 24 weeks after administration of sodium iodide, blood was collected for serum TSH measurement by chemiluminescent immunoassay. Pituitaries were also excised for measurement of TSHβ subunit expression, D2 expression and activity, monocarboxylate transporter 8 (MCT8) and thyroid hormone receptor β2 isoform (TRβ2) levels. The results showed that iodine intake of 10HI and 50HI significantly increased pituitary and serum TSH levels from 8 to 24 weeks (P<0·05 v. NI). Excess iodine had no effect on D2 mRNA or protein expression; however, 10HI and 50HI administration significantly inhibited pituitary D2 activities from 8 to 24 weeks (P<0·05 v. NI). Iodine had no effect on MCT8 or TRβ2 protein levels. We conclude that prolonged high iodine intake inhibits pituitary D2 activity and induces elevation of serum TSH levels. These findings may provide a potential mechanism of iodine excess-induced overt and subclinical hypothyroidism.

Evidence for a more Pronounced Effect of Genetic Predisposition than Environmental Factors on Goitrogenesis by a Case Control Study in an Area with Low Normal Iodine Supply

Family and twin studies suggest a genetic predisposition for euthyroid goiters. However, iodine deficiency and smoking are important exogenous factors for goiter development. We investigated goiter predisposition by a matched case control study in a region with recently documented low normal iodine supply. A sum of 376 patients were included in the study. We matched 188 patients with euthyroid/subclinically hyperthyroid goiter (TSH 4.20-0.05 mU/l) with 188 euthyroid controls without thyroid enlargement for age and gender. Thyroid ultrasound was performed in all patients, whereby 50.5% of patients with goiters showed a positive family history for goiter. In contrast, only 25% of control patients had a positive family history (p<0.001; OR=3.1). Patients with goiters had a significantly higher proportion of parents (p<0.001; OR=3.6) or siblings (p=0.004; OR=2.5) with goiters. Children of parents with goiters showed a 2.7-fold increased risk for goiter development (goiter prevalence 73.3%). Patients with a positive goiter family history had a 4.1-fold increased goiter risk (p<0.001). The contribution of smoking, obesity, and pregnancies to goiter development was less important than the genetic predisposition (OR=1.7; p=0.06; OR=1.67; p=0.13; OR=0.8; p=0.56). In a region with low normal iodine supply, the significantly higher rate of positive family histories in patients with goiters as compared to the matched controls as well as the increased goiter prevalence in children of parents with goiters indicate the importance of genetic factors in goiter development.

The Impact of Dietary Iodine Intake on Lipid Metabolism in Mice

The present study has been designed to investigate the impact of dietary iodine intake on lipid metabolism in mice, including iodine deficiency and iodine excess. Different amounts of iodine mixed in the drinking water were continuously administered to mice. The body weights and the levels of urinary iodine were measured 8months after the treatment. Thyroid hormones in the serum were detected by chemiluminescence immunoassay. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C) were determined enzymatically by automatic analyzer. Results showed that the urine iodine concentrations paralleled the amounts of iodine intakes. No statistical differences of body weights among different groups were found. The levels of thyroid hormones were dramatically decreased in iodine deficiency while no significant differences were found between iodine excess groups and normal iodine group. In iodine deficiency groups, the levels of TG, TC, and LDL were increased at varying degrees. In iodine excess groups, the levels of TG in the male mice and the levels of TC in the female mice were much lower than normal iodine group. In conclusion, dietary iodine intake may affect the metabolism of serum lipids. Hypothyroid function induced by iodine deficiency may be responsible for the changes of lipids. Higher iodine intake might benefit lipid metabolism.

A patient with Pendred syndrome whose goiter progressed with normal serum thyrotropin and iodine organification

Biallelic mutations of SLC26A4 (encoding pendrin) cause Pendred syndrome (PS), an autosomal recessive genetic disorder with deafness and goiter. The mechanism underlying the development of the goiter is unknown. Here, we report clinical and molecular findings of a patient with PS. This 27-year-old woman was born to nonconsanguineous healthy parents. She was seen at our hospital due to hearing loss at age 3 years, and subsequently developed goiter at age 10 years. From age 15 years, her thyroid gland showed progressive enlargement accompanied by elevation of serum thyroglobulin reaching 10-fold the normal amount. Thyroidal iodine uptake was also increased during goiter progression ((123)I uptake at 24 hr: 20.2% at age 17 years; 69.4% at age 24 years; reference, 8-40), while serum thyrotropin (TSH) levels and iodine organification (examined by the perchrolate or thiocyanate discharge test) remained normal. We sequenced SLC26A4 using standard PCR-based technique, and found one novel (p.T537P) and one recurrent (p.H723R) mutations in a compound heterozygous state. Expression experiments using COS-7 cells showed that the two mutants were entrapped in the endoplasmic reticulum and were poorly localized at the plasma membrane. In summary, a molecularly confirmed PS patient showed goiter progression accompanied by elevated serum thyroglobulin and increased thyroidal iodine uptake, but normal serum TSH levels and normal iodine organification. This implies that some pendrin mutations may involve direct stimulation of thyroid cell proliferation with no TSH hyperstimulation and no iodine organification defect.

Nodular thyroid disease in the erderly

The occurrence of thyroid nodules increases with age [1]. In geographical areas with a normal iodine intake, approximately 10% of the population develops a palpable thyroid nodule. This proportion increases in areas with insufficient iodine intake. Non-palpable thyroid nodules are usually diagnosed by a neck echography carried out for various reasons and are 5-10 folds more common than palpable nodules. When evaluating a thyroid nodule, we must be aware that two conditions require particular attention: a) the possibility of a “hot” (hyperfunctioning) nodule, which can induce thyrotoxicosis; b) the possibility of a malignant nodule. Both these pathological conditions increase with age [2,3]. In particular, elderly patients often show a multinodular goiter, where both hyperfunctioning nodules and hypofunctioning nodules suspicious for malignancy may coexist. When FT3 is high and/or TSH is suppressed a hyperfunctioning nodule should be suspected. In order to confirm this diagnosis the patient should carry out a thyroid scintigram. In the case that both FT3 and TSH are in the normal range, the nodule should be regarded as non-functioning. In this case a thyroid scintigram is not useful whereas a fine needle aspiration (FNAB) is the diagnostic procedure of choice [4]. Both hyperfunctioning and malignant thyroid nodules are more common in elderly patients. Notably, hyperthyroidism is a more serious condition in the elderly than in the young because of an increased risk of cardiac dysfunction. Moreover, thyroid cancer behaves more aggressively in elderly patients. In these patients thyroid cancer is usually less differentiated and lacks the ability to concentrate iodine. Therefore, thyroid cancer metastases cannot be treated with radioiodine. In the case of a hyperfunctioning nodule the therapy of choice is a thyroid lobectomy. In contrast, in the case of a multinodular goiter or of a malignant nodule, a total thyrodectomy is required.

Effects of Long-Term Exposure to Iodine Excess on the Apoptosis of Thyrocytes in Wistar Rats

To explore the effects of long-term exposure to more than adequate and excessive iodine on the apoptosis of thyrocytes in Wistar rats. Wistar rats, divided into four groups: Group 0 (control, treated with 4 μg/day of iodine), Group 1 (1.5x control dose, i. e. 6 μg/day of iodine), Group 2 (3x control dose, i. e. 12 μg/day of iodine), and Group 3 (6x control dose, i. e. 24 μg/day of iodine) had oral iodine intake for 1, 2, 4, and 8 months before being sacrificed for study. After the initial treatment course of 8 months, some rats in each group continued to have an iodine intake at 4 μg/day for extra 3 months. Urinary iodine concentration was measured by arsenic/cerium catalyzing spectrophotography. In addition, the early apoptosis was assessed by flow cytometry with Annexin V-FITC staining, while the late apoptosis was evaluated by TUNEL microscopy. Furthermore, the rate of cell death and cell cycle kinetics were determined by flow cytometry with propidium iodide (PI) staining. Moreover, the level of intracellular reactive oxygen species (ROS) quantified by the fluorescence intensity was measured via flow cytometry with a DCFH-DA probe. Immunohistochemistry technique was also used for the detection of the expression of Bcl-2 and Bax. The apoptotic rate and ROS production in thyrocytes were significantly elevated in Groups 2 and 3 after 4 and 8 months of treatment compared to the control group ( P<0.05). Groups 2 and 3 were also found to have greatly higher percentage of cells in S phase after 4 and 8 months of exposure (5%-6% vs. 3%, P<0.05), with a significant reduction in cells in G0G1-phase (64%-67% vs. 80%, P<0.05). These differences disappeared after normal iodine intake for extra 3 months. The expressions of Bcl-2 and Bax among different groups remained unchanged. Positive correlations were observed between the apoptotic rate, ROS level and urinary iodine concentration after 4 and 8 months of excessive iodine exposure (r is in the range of 0.736˜0.855, all of Ps<0.01). The experimental data indicated that more apoptosis of thyrocytes after exposure to excessive iodine was attributed to the increased free radical production, other than regulated Bcl-2 and Bax expression. The effects of iodine excess are reversible.

Determinants of iodine deficiency in school children in different regions of Ethiopia.

To determine the magnitude of goitre in school children and measure indicators of iodine deficiency including the most commonly consumed staple foods. A cross-sectional study. Ten villages from four administrative regions of Ethiopia. A total of 2485 randomly selected elementary school children were examined for clinical signs of goitre. Indicators of iodine deficiency disorders (IDD) assessed were urinary iodine excretion (UIE) rate, iodine concentration in water, the commonly consumed individual foods of plant origin and milk, and bacterial contamination of drinking water. The gross prevalence (mean of male and female values) among school children was 53.3%. The prevalence was higher in females (56.1%) than in males (50.8%). The highest prevalence (82 and 91%, respectively) were observed in the villages of Lotte and Kodowono and the lowest (31%) in the village of Abossara. Of the urinary measurements, 70% of the samples showed moderate and 30% mild iodine deficiency. Levels of iodine in water and individual food samples were low in general. Breast milk iodine content was similarly low and related to the maternal daily iodine intake which may affect the nutritional status of the nursing infant. The study also provides further evidence that coliforms and E. coli isolated from drinking water contribute to the high incidence of endemic goitre other than iodine deficiency. It is difficult to obtain a sufficient iodine intake in the survey villages as the individual foods are very low in the element. However, IDD can be prevented by ensuring normal iodine nutrition through instituting ways that avail iodinated salt to the survey population.

Pulmonary imaging using dual-energy CT, a role of the assessment of iodine and air distribution

Aim The aim of the study is to present the feasibility of using dual-energy CT and the evaluation of iodine and air distribution in differentiation of pathological conditions. Material and method We used the data of 50 CT examinations performed due to suspected pulmonary embolism with any pathological finding except consolidation of the parenchyma. The patients underwent CT angiography of the pulmonary arteries on a dual-source CT (DSCT), with the two tubes independently operated at 140 and 80 kV. By exploiting the dual-energy information, iodine distribution maps were obtained in addition to the conventional CT images which served as a marker of pulmonary perfusion. Minimum intensity projections (MinIP) were used as a marker of air content. Results By comparing the iodine distribution maps and MinIP images, it was possible to differentiate between the following templates of lung parenchyma: A – normal iodine and air distribution; B – iodine content deficit with minimal or with no redistribution of air; C – reduced iodine content and increased content of air; D – deficit of iodine content and increased content of air; E – increased iodine content and normal content of air; F – increased iodine content and reduced content of air; G – reduced perfusion and reduced content of air. The type A (five cases) was typical for the pulmonary embolism with preserved normal conditions of perfusion and ventilation. Type B (18 cases) occurred in pulmonary embolism; type C was found in case of inflammation of small respiratory airways (five cases); emphysema was typical for type D (nine cases); increased perfusion was observed in the parenchyma preserved from emphysema or preserved from embolism in cases of emphysema or pulmonary embolism; type F occurred in pulmonary interstitial edema (four cases) both with pulmonary infection; finally type G was found in interstitial lung diseases (five cases). Conclusion Imaging of the pulmonary circulation by means of dual-energy CT opens the potential to study pathological changes of circulatory and pulmonary perfusion impairments, our presented work signs the important relations between iodine and air distribution which have to be thought in the interpretation of dual-energy perfusion imaging of the lungs.

The status of iodine nutrition in newborn infants, schoolchildren, adolescents and adults in former East Germany.

In the former East Germany (GDR) like in the former West Germany (FRG) iodine deficiency and endemic goiter have been described since more than 2 decades. After a program of salt iodization which was started in East Germany in 1985 the urinary iodine excretion of the population increased significantly. The thyroid gland of the newborn is much more sensible to changes of the iodine supply than the thyroid of older children. A total of 1732 subjects was enrolled in the study. After the implementation of the mandatory salt iodization the goiter prevalence in newborns decreased markedly to less than 1%. After the reunification of Germany in 1990 the mandatory prophylaxis was stopped and the urinary iodine excretion in newborns, school-children, adolescents and adults diminished markedly. So in newborns the renal iodine excretion decreased to 2.82 micrograms I/dl in 1992. Since 1994 a reasonable improvement of the iodine supply is observed in the region of Leipzig. In school-children, adolescents and adults the mean value of the urinary iodine excretion is now above 10.0 micrograms I/dl. This value may be considered as an indicator for a normal iodine supply. In a small cohort (n = 28) of newborns infants we found a renal iodine excretion of 18.74 micrograms/dl in 1997. That value also means a significant increase since 1992 and a normal iodine supply in the fetal period. The present results from the region of Leipzig/Saxonia are not representative for the whole of East Germany. To provide an optimal iodine nutrition the use of iodized salt for food manufacturing must be significantly increased.

Small thyroid volumes and normal iodine excretion in Berlin schoolchildren indicate full normalization of iodine supply.

Iodine deficiency is the major cause of an increase in thyroid gland volume in infants and children. In this field study we monitored the iodine supply and its effect on the thyroid gland volume in prepubertal and pubertal children in the eastern and western parts of the city of Berlin, so far considered as an area with borderline iodine deficiency. The thyroid gland volume was determined by ultrasound in 1080 (f = 552, m = 528) children aged 3-15 years, and was correlated to age, body-surface area and iodine excretion, which was measured in a first-morning spot urine. The mean iodine concentration was 115.8 micrograms iodine/g creatinine (12.2 micrograms iodine/dl urine), with no significant differences between eastern parts with 114.5 micrograms iodine/g creatinine (12.3 micrograms iodine/dl urine) vs 116.7 micrograms iodine/g creatinine (12.0 micrograms iodine/dl urine) in the western parts of the city. This good iodine supply of the children was surprising compared to former studies in children and adults. Moreover this normalization of the iodine excretion was reflected by smaller thyroid gland volumes in the children. The volume was found to increase with age and was 2.4 +/- 1.1 ml in prepubertal (Prader and Largo: f < or = 10.9 ys, m < or = 11.5 ys) children, compared to 4.3 +/- 1.7 ml in pubertal children. The goiter prevalence, calculated on this data was below 5%. Among all children there were only 11 (aged 8-13 ys) with abnormal findings of the thyroid gland on ultrasound: 6 with small nodules, 1 girl with a thyroid-cyst, 2 girls had an inhomogenous echo structure and 2 girls presented with a hemithyroidea. This study shows that the iodine supply of the children in Berlin has improved, resulting in smaller sized thyroid glands, compared to those which have been previously published for Germany (Müller-Leisse 1988; Klingmüller, 1991; Menken, 1992), but they correspond well to volumes described in countries with sufficient iodine supply.

Effect of Testosterone on Thyroid Weight and Function in Iodine Deficient Castrated Rats

The prevalence of goiter, especially in iodine deficient regions, is higher in women than in men. This investigation was conducted to determine the effect of testosterone on thyroid weight and function in both normal iodine deficient and castrated rats. Male Wistar rats were divided into 6 groups of 7 animals each: castrated hormone treated (C+T); castrated nonhormone treated (C+NT); normal (N), iodine deficient diet, castrated hormone treated (ID+C+T); castrated iodine deficient diet, nonhormone treated (ID+C+NT); and normal iodine deficient diet (ID+N). Three weeks after castration, C+T and ID+C+T groups received daily intraperitoneal injections of 1 mg/kg testosterone enanthate, for 9 weeks. At the end, we measured thyroid weight and serum testosterone, T(4), free T(4), T3, and TSH, and urinary iodine concentrations. Serum testosterone level significantly decreased in the C+NT and ID+C+NT groups (p<0.001). In ID groups, serum TSH, T(3) and thyroid weight levels increased significantly and serum T4 and free T (4) levels decreased significantly as compared to iodine sufficient groups (p<0.001). ID+C+NT group, had higher serum TSH and thyroid weight and lower serum-free T4 than the ID+C+T and ID+N groups (p<0.01). The C+NT group had higher serum TSH and lower serum-free T(4) than the C+T and N groups (p<0.01). These results suggest that testosterone decreases thyroid enlargement and prevents the fall in free T(4) levels in ID castrated rats, which may explain the lower incidence of goiter in men than women in iodine deficient regions.

Exploratory study on the association between high iodine intake and lipid

To explore the association between excessive iodine intake and lipid disorder in human bodies. Based on the NTTST sample survey on water iodine in Suining of Jiangsu province, this study involved 81 residents whose drinking water containing excessive iodine and 101 residents who drank water with normal iodine content. Blood samples were tested and compared on lipids (TG, TC, HDL-C, LDL-C, apoA1, apoB) between the two groups, after adjusting the influences of age and gender. The study also compared the abnormal rate of each lipid indicator between the two groups. Corresponding RR values and 95% confidence interval were calculated. Correlation between iodine content in drinking water and blood lipid was also studied. apoA1 in the group with excessive iodine intake was significantly lower than that in the normal iodine group, while there were no significant differences between the two groups in other lipid indicators. The abnormal rate of HDL-C of excess iodine group (16.88%) was significantly higher than the rate of normal iodine group (7.22%) while there were no significant differences between the two groups in other lipid indicators. Both apoA1 and HDL-C in the excess iodine group had a negative correlation with water iodine, while the other indicators of two groups had no correlation with water iodine. Drinking water with excess iodine might increase the risk of lipid disorder.