Potassium Iodide Solution Research Articles

Biocompatible Soft Fluidic Strain and Force Sensors for Wearable Devices.

Fluidic soft sensors have been widely used in wearable devices for human motion capturing. However, thus far, the biocompatibility of the conductive liquid, the linearity of the sensing signal, and the hysteresis between the loading and release processes have limited the sensing quality as well as the applications of these sensors. In this paper, silicone based strain and force sensors composed of a novel biocompatible conductive liquid (potassium iodide and glycerol solution) are introduced. The strain sensors exhibit negligible hysteresis up to 5 Hz, with a gauge factor of 2.2 at 1 Hz. The force sensors feature a novel multi-functional layered structure, with micro-cylinder-filled channels to achieve high linearity, low hysteresis (5.3% hysteresis at 1 Hz), and good sensitivity (100% resistance increase at a 5 N load). The sensors' gauge factors are stable at various temperatures and humidity levels. These bio-compatible, low hysteresis, and high linearity sensors are promising for safe and reliable diagnostic devices, wearable motion capture, and compliant human-computer interfaces.

КОНСЕРВАТИВНАЯ ТЕРАПИЯ БОЛЕЗНИ ПЕЙРОНИ

Целью исследования было изучение эффективности консервативной терапии у пациентов с болезнью Пейрони.
 Материал и методы. Нами проведен ретроспективный анализ историй болезни и амбулаторных карт 196 пациентов с болезнью Пейрони. Возраст пациентов был от 23 до 76 лет. Продолжительность заболевания варьировала от 2 до 32 месяцев. Угол девиации полового члена колебался от 0° до 90°. Половая жизнь была затруднена или невозможна у 102 (52,04%) мужчин там, где угол искривления составлял от 45° до 90°. Количество бляшек отмечалось от одной до трех. Болевой синдром разной степени выраженности беспокоил всех больных во время эрекции. Консистенция бляшки у 137 (69,89%) пациентов была плотноэластической, у 55 (28,06%) – хрящеподобной, у 4 (2,04%) – костной консистенции.
 Клиническое обследование пациентов осуществлялось в соответствии рекомендациям Европейской ассоциации урологов.
 Назначалась консервативная терапия, разработанная кафедрой урологии ГОО ВПО «Донецкого национального медицинского университета имени М. Горького», на протяжении до 3-х месяцев. Консервативная терапия включала: назначение плаквенила, тамоксифена, токоферола ацетата.
 Параллельно с пероральной консервативной терапией назначались физиотерапевтические методы лечения: электрофорез с лидазой (64 ЕД) через день №20; электрофорез с 3% раствором калия йодида через день №20 и фонофорез с 1% гидрокортизоновой мазью в область фиброзной бляшки через день №20, с частотой ультразвуковых волн 2500-3000 кГц, t=10'.
 Результаты и обсуждение. Болевой синдром после лечения остался у 12 (6,1%) пациентов, что потребовало продолжения консервативной терапии более трех месяцев. Размер бляшки, который измерялся пальпаторно и при помощи ультрасонографии, после проведенной консервативной терапии уменьшился у 121 (61,7%) пациента. Полного рассасывания бляшки удалось достичь у 43 (21,9%) пациентов. Угол искривления полового члена во время эрекции уменьшился у 152 (77,6%) пациентов, остался без изменений у 31 (15,8%) и увеличился у 13 (6,6%) пациентов. Улучшение эрекции наблюдалось в 167 (85,2%) наблюдениях. У 44 (22,4%) пациентов эффекта от проводимой консервативной терапии не было, что послужило показанием к хирургическому лечению.
 Выводы. Болезнь Пейрони тяжело поддается консервативному лечению, и основной его целью можно считать остановку процесса гиалинизации и оссификации структур белочной оболочки. Комплекс консервативной терапии, разработанный кафедрой урологии ГОО ВПО «Донецкого национального медицинского университета имени М. Горького», позволяет добиться удовлетворительных результатов при воспалительной стадии заболевания. В стадии стабилизации процесса необходимо хирургическое лечение.

3D Multilayered paper- and thread/paper-based microfluidic devices for bioassays.

In this paper we describe the fabrication of novel 3D microfluidic paper-based analytical devices (3D-μPADs) and a 3D microfluidic thread/paper-based analytical device (3D-μTPAD) to detect glucose and BSA through colorimetric assays. The 3D-μPAD and 3D-μTPAD consisted of three (wax, heat pressed wax-printed paper, single-sided tape) and four (hole-punched single-sided tape, blank chromatography circles, heat-pressed wax-printed paper, hole-punched single-sided tape containing trifurcated thread) layers, respectively. The saturation curves for each assay were generated for all platforms. For the glucose assay, a solution of glucose oxidase (GOx), horseradish peroxidase, and potassium iodide was flowed through each platform and, upon contact with glucose, generated a yellow-brown color indicative of the oxidation of iodide to iodine. For the protein assay, BSA was flowed through each device and, upon contact with citrate buffer and tetrabromophenol blue, resulted in a color change from yellow to blue. The devices were dried, scanned, and analyzed yielding a correlation between either yellow intensity and glucose concentration or cyan intensity and BSA concentration. A similar glucose assay, using unknown concentrations of glucose in artificial urine, was conducted and, when compared to the saturation curve, showed good correlation between the theoretical and actual concentrations (percent differences <10%). The development of 3D-μPADs and 3D-μTPADs can further facilitate the use of these platforms for colorimetric bioassays.

A rapid and economical method for the quantification of hydrogen peroxide (H2O2) using a modified HPLC apparatus

H2O2 is one of the most commonly used oxidants for the degradation of recalcitrant organic contaminants in advanced oxidation processes (AOPs). However, most research aiming to optimize AOPs is missing the monitoring of the remaining H2O2, an important parameter to assess the efficiency of the process. In this work, a novel method for [H2O2] quantification was developed using simple modifications of an HPLC-DAD setup that is available in most analytical chemistry laboratories. The modifications include the use of acidified potassium iodide solution as mobile phase and replacing the reverse phase column with a series of capillary columns. This instrument configuration allowed also the quantification of organic contaminants using the same H2O2 containing sample. The method's LOD and LOQ were calculated to be as low as 8.29 × 10−4 mM and 2.76 × 10−3 mM, respectively with an LDR range of 0.01–150 mM. The cost per analysis ranged between 0.8 and 1.8 USD cents depending on the concentration tested. This analytical method was validated by a statistical comparison to a well-known titrimetric method that is commonly used for H2O2 quantification. It was also tested using standards prepared in natural matrices such as spring and seawater, and in media containing high concentration of several spectator species such as chlorides, bicarbonates, humic acids, fumaric acids and micro pollutants. The method showed excellent robustness by maintaining high regression coefficient and excellent sensitivity in all calibration curves regardless of the matrix content.

In vitro Studies on Pollen Viability, Pollen Germination and Pollen Tube Growth of Hornstedtia conoidea Ridl. – a Philippine Endemic Ginger Species

Zingiberaceous plants are predominantly propagated through underground rhizomes and seeds. In this study, the viability of pollen, rate of pollen germination and length of pollen tube of the Philippine endemic Hornstedtia conoidea were examined. Four petri plates containing pollen samples were prepared, of which two petri plates were used immediately after the collection, while the other two petri plates were stored for one week. The determination of pollen viability was made employing stain tests using IKI (iodine + potassium iodide) solution and safranin and measured immediately after the collection and after one week. Likewise, pollen germination test was carried out in vitro on agar medium and measured after 24 hours and one week of incubation. Data revealed that pollen viability was higher in the samples which were sown immediately with safranin with percentage pollen viability of 92.43%, while IKI test was lower with 89.36%. On the other hand, the pollen stored for one week measured 47.29% for safranin test and 33.14% for IKI test. The percentage germination of pollen after 24 hours was 72.65%, while 11.13% after one week. The pollen samples which were subjected for tube growth were examined for two weeks and gave positive results. Overall, it can be concluded that H. conoidea pollen can successfully be collected and stored for certain time. Knowledge regarding the pollen viability, pollen germination and pollen tube growth of this species will give practical benefit for plant breeding and conservation purposes, since H. conoidea is found in the wild, and as of now, the species has been recorded only in the Philippines.

Paper-based 3D printing of anthropomorphic CT phantoms: Feasibility of two construction techniques.

To develop and evaluate methods for assembling radiopaque printed paper sheets to realistic patient phantoms for CT dose and image quality testing. CT images of two patients were radiopaque printed with aqueous potassium iodide solution (0.6 g/ml) on paper. Two methods were developed for assembling the paper sheets to head and neck phantoms. (1) Printed sheets were fed to a paper-based 3D printer along with corresponding 3D printable STL files. (2) Paper stacks of 5-mm thickness were glued with toner, cut to the patient shape and assembled to a phantom. In a sample application study, both phantoms were examined with five different tube current settings. Images were reconstructed using filtered-back projection (FBP) and iterative reconstruction (AIDR 3D) with three strength levels. Dose length product (DLP), signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNRs) were analysed. Data were analysed using 2-way analysis of variance (ANOVA). Both methods achieved anthropomorphic phantoms with detailed patient anatomy. The 3D printer yielded a precise reproduction of the external patient shape, but caused visible glue artefacts. Gluing with toner avoided these artefacts and yielded more flexibility with regard to phantom size. In the sample application study, non-inferior SNR and CNR and up to 83.7% lower DLP were achieved on the phantoms with AIDR 3D compared with FBP. Two methods for assembling radiopaque printed paper sheets to phantoms of individual patients are presented. The sample application demonstrates potential for simulation of patient imaging and systematic CT dose and image quality assessment. • Two methods were developed to create realistic CT phantoms of individual patients from radiopaque printed paper sheets. • Analysis of five tube current and four reconstruction settings on two radiopaque 3D printed patient phantoms yielded non-inferior SNR and CNR and up to 83.7% lower dose with iterative reconstruction in comparison with filtered back projection. • Radiopaque 3D printed phantoms can simulate patients and allow systematic analysis of CT dose and image quality parameters.

Pore‐Scale Visualization of Methane Hydrate‐Bearing Sediments With Micro‐CT

AbstractX‐ray computed tomography (CT) has become a critical technique in the study of porous media. It has attracted growing attention for analyzing hydrate‐bearing sediment, but this has been done using surrogates (Xe/Kr) only due to difficulties in distinguishing methane hydrate from water. This study presents the successful imaging of methane hydrate coexisting with pore liquid, gas, and sediments. We used potassium iodide (KI) solutions and in‐line propagation‐based phase‐contrast CT analysis of X‐ray attenuation and diffraction to distinguish the four materials. Thus, consideration for CT‐related X‐ray physics was necessary to optimize KI concentrations, improve material separation with X‐ray propagation, and properly interpret artifacts within the images. The images clearly show methane hydrate in the pore space of sand (~250 μm) coexisting with KI solution and gas. Following this, X‐ray CT can now be used to visualize pore habits of natural methane hydrate in sediment cores.

A radiopaque 3D printed, anthropomorphic phantom for simulation of CT-guided procedures.

To develop an anthropomorphic phantom closely mimicking patient anatomy and to evaluate the phantom for the simulation of computed tomography (CT)-guided procedures. Patient CT images were printed with aqueous potassium iodide solution (1 g/mL) on paper. The printed paper sheets were stacked in alternation with 1-mm thick polyethylene foam layers, cut to the patient shape and glued together to create an anthropomorphic abdomen phantom. Ten interventional radiologists performed periradicular infiltration on the phantom and rated the phantom procedure regarding different aspects of suitability for simulating CT-guided procedures. Radiopaque printing in combination with polyethylene foam layers achieved a phantom with detailed patient anatomy that allowed needle placement. CT-guided periradicular infiltration on the phantom was rated highly realistic for simulation of anatomy, needle navigation and overall course of the procedure. Haptics were rated as intermediately realistic. Participants strongly agreed that the phantom was suitable for training and learning purposes. A radiopaque 3D printed, anthropomorphic phantom provides a realistic platform for the simulation of CT-guided procedures. Future work will focus on application for training and procedure optimisation. • Radiopaque 3D printing combined with polyethylene foam achieves patient phantoms for CT-guided procedures. • Radiopaque 3D printed, anthropomorphic phantoms allow realistic simulation of CT-guided procedures. • Realistic visual guidance is a key aspect in simulation of CT-guided procedures. • Three-dimensional printed phantoms provide a platform for training and optimisation of CT-guided procedures.

Thread/paper- and paper-based microfluidic devices for glucose assays employing artificial neural networks.

This paper describes the fabrication of and data collection from two microfluidic devices: a microfluidic thread/paper based analytical device (μTPAD) and 3D microfluidic paper-based analytical device (μPAD). Flowing solutions of glucose oxidase (GOx), horseradish peroxidase (HRP), and potassium iodide (KI), through each device, on contact with glucose, generated a calibration curve for each platform. The resultant yellow-brown color from the reaction indicates oxidation of iodide to iodine. The devices were dried, scanned, and analyzed yielding a correlation between yellow intensity and glucose concentration. A similar procedure, using an unknown concentration of glucose in artificial urine, is conducted and compared to the calibration curve to obtain the unknown value. Studies to quantify glucose in artificial urine showed good correlation between the theoretical and actual concentrations, as percent differences were ≤13.0%. An ANN was trained on the four-channel CMYK color data from 54 μTPAD and 160 μPAD analysis sites and Pearson correlation coefficients of R = 0.96491 and 0.9739, respectively, were obtained. The ANN was able to correctly classify 94.4% (51 of 54 samples) and 91.2% (146 of 160 samples) of the μTPAD and μPAD analysis sites, respectively. The development of this technology combined with ANN should further facilitate the use of these platforms for colorimetric analysis of other analytes.

Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride.

This study evaluated the effect of Glutathione (GSH) bio-molecule on the reduction of enamel and dentin discoloration after application of 38% silver diammine fluoride solution (SDF). One hundred and twenty bovine teeth specimens were used. The enamel and dentin specimens were divided into three groups: (1) SDF only (control); (2) SDF followed by application of a potassium iodide solution (KI); and (3) SDF mixed with 20% GSH. Half the specimens were exposed to light and the remainder kept in dark conditions (n = 10) Color changes were measured using a spectrophotometer at the following time intervals: before solution application (baseline) and immediately after application, then 3, 6, 24, 48, 72 h, and 7, 10 and 14 days. SEM/EDS analysis was performed on treated enamel and dentin. Statistical analysis was done using a repeated measures ANOVA test. The spectrophotometer results showed that the SDF group exhibited the greatest color changes under both light exposed and dark conditions, while SDF + GSH group was effective in decreasing the color changes in both light and dark conditions. The SDF + KI group showed an insignificant color changes over time. SEM/EDS analysis showed different patterns for the silver crystal formation in each group (SDF, SDF + GSH, and SDF + KI group). It was concluded GSH can effectively minimize color changes after application of SDF, especially on enamel and to a lesser extent on dentin.

Acute Ioderma: an Uncommon Serious Adverse Event Associated with Saturated Solution of Potassium Iodide Treatment

ABSTRACT Objective: The objective of this report is to raise awareness of a case with acute life-threatening ioderma, an uncommon adverse event of saturated solution of potassium iodide (SSKI) therapy. Although extremely rare, physicians should consider the potential for ioderma development as a dangerous but treatable side effect of SSKI therapy. Methods: We present a case report of an uncommon serious adverse event associated with SSKI therapy. Results: A 67-year-old woman with mutlinodular goiter and subclinical hyperthyroidism was prescribed SSKI in preparation for total thyroidectomy. Unfortunately, the patient disregarded the instructions and took the equivalent of three doses at once without any fluid. Six hours later, she developed a reaction characterized by angioedema and hemorrhagic papulo-vesicular rash involving the oral mucosa and her extremities, sparing the trunk. The patient was hospitalized and treated with corticosteroids with prompt resolution of her symptoms. Subsequently, she underwe...

Impact of potassium iodide on thyroidectomy for Graves' disease: Implications for safety and operative difficulty

Potassium iodide often is prescribed prior to thyroidectomy for Graves' disease, but the effect of potassium iodide on the ease and safety of thyroidectomy for Graves' is largely unknown. We conducted a prospective, cohort study of patients with Graves' disease undergoing thyroidectomy. For the first 8 months, no patients received potassium iodide; for the next 8 months, potassium iodide was added to the preoperative protocol for all patients. Outcomes included operative difficulty (based on the Thyroidectomy Difficulty Scale) and complications. We included a total of 31 patients in the no potassium iodide group and 28 in the potassium iodide group. According to the Thyroidectomy Difficulty Scale, gland vascularity decreased in the potassium iodide group (mean score 2.6 vs 3.3, P = .04), but there were no differences in friability, fibrosis, or size of the thyroid or in overall difficulty of operation (P = not significant for all). Despite similar operative difficulty, patients prescribed potassium iodide were less likely to experience transient hypoparathyroidism (7% vs 26%, P = .018) and transient hoarseness (0% vs 16%, P = .009) compared with the no potassium iodide group. Potassium iodide administration decreases gland vascularity, but does not change the overall difficulty of thyroidectomy. Preoperative use of potassium iodide solution was, however, associated with less transient hypoparathyroidism and transient hoarseness, suggesting that potassium iodide improves the safety of thyroidectomy for Graves' disease.

Intensification of sonochemical reactions in solid-liquid systems under fully suspended condition

Process intensification of sonochemical reactions due to the addition of solids is studied using very high solids concentrations (up to 0.5 (v/v)). The impacts of particle size, surface roughness, and solids concentration on sonochemical yields were studied experimentally by measuring the concentration of I3− formed in the cavitation of potassium iodide solution in an agitated baffled tank fitted with an ultrasonic generator (20kHz, 131W). Solids used were cation exchange resin (625μm), sand (303μm), and spherical glass beads (207, 551 and 1290μm). It was found that, due to the net effect of wave attenuation and increased number of nucleation sites available, cavitation level initially decreases with increasing solids concentration up to 0.1 (v/v), then increases up to 0.4 (v/v), followed by a further decrease. Cavitation activity increases with increasing particle diameter due to the reduction in the liquid tensile strength in the presence of larger particles, which decrease the cavitation threshold. The cavitation level is found to be enhanced due to an increase in the surface roughness. The results imply that particle size, concentration, and surface roughness all play important roles in the formation and subsequent collapse of cavities, which cumulatively influence sonochemical reaction yields.

Artifactual degradation of secondary amine-containing drugs during accelerated stability testing when saturated sodium nitrite solutions are used for humidity control

Accelerated stability studies of pharmaceutical products are commonly conducted at various combinations of temperature and relative humidity (RH). The RH of the sample environment can be controlled to set points using humidity-controlled stability chambers or via storage of the sample in a closed container in the presence of a saturated aqueous salt solution. Herein we report an unexpected N-nitrosation reaction that occurs upon storage of carvedilol- or propranolol-excipient blends in a stability chamber in the presence of saturated sodium nitrite (NaNO2) solution to control relative humidity (∼60% RH). In both cases, the major products were identified as the corresponding N-nitroso derivatives of the secondary amine drugs based on mass spectrometry, UV–vis and retention time. These degradation products were not observed upon storage of the samples at the same temperature and humidity but in the presence of saturated potassium iodide (KI) solution (∼60% RH) for humidity control. The levels of the N-nitrosamine derivatives varied with the pH of various NaNO2 batches. The presence of volatile NOx species in the headspace of a container containing saturated NaNO2 solution was confirmed via the Griess assay. The process for formation of the N-nitrosamine derivatives is proposed to involve volatilization of nitric oxide (NO) from aqueous nitrite solution into the headspace of the container followed by diffusion into the solid drug-excipient blend and subsequent reaction of NOx with the secondary amine.

Preoperative management in patients with Graves' disease.

Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones). Graves' disease is treated with any of three effective and relatively safe initial treatment options: antithyroid drugs (ATDs), radioactive iodine ablation (RAIU), and surgery. Total thyroidectomy is favored in several clinical situations, such as intolerance, ineffectiveness or recurrence after ATD treatment, radioiodine therapy contraindicated, documented or suspected thyroid malignancy, one or more large thyroid nodules, coexisting moderate-to-severe active Graves' orbitopathy, women planning a pregnancy within 6 months. Whenever surgery is selected as treatment, selection of an expert high-volume thyroid surgeons is fundamental and careful preoperative management is essential to optimize surgical outcomes. Pretreatment with ATDs in order to promptly achieve the euthyroid state is recommended to avoid the risk of precipitating thyroid storm during surgery. For the majority of patients, euthyroidism is achieved after few weeks of ATD treatment. Beta-blockers, such as propranolol, are often added effectively to control hyperthyroid symptoms. Saturated solution of potassium iodide (SSKI) or potassium iodine (Lugol's solution), given for a short period prior to surgery, in order to reduce both thyroid hormone release and thyroid gland vascularity, is beneficial to decrease intra-operative blood loss.

Conidiobolomycosis: An Unusual Fungal Disease-Our Experience.

Conidiobolomycosis is a rare mycotic disease caused by Conidiobolus coronatus. Very few cases have been reported in English literature. Often it is clinically misdiagnosed as soft tissue tumour. A prospective case study was done from 2006 to 2015 in a tertiary care hospital of West Bengal, India. The objectives of our study were to describe the epidemiological and clinical features and treatment of Conidiobolomycosis to prevent disfigurement. Patients clinically suspected to be suffering from Conidiobolomycosis were subjected to biopsy followed by histopathological and mycological examinations. Then they were treated with oral saturated solution of potassium iodide along with other drugs. Total six cases were histopathologically proved to be suffering from Conidiobolomycosis. Fungus was isolated and identified in one case. Complete resolution was seen in five patients. Conidiobolomycosis should be brought into mind as differential diagnosis of subcutaneous swelling in the rhinofacial region.

Thin-layer chromatographic quantification of three alkaloid compounds in Sophora alopecuroides and TLC—bioautography for screening antioxidant components

This study aims at establishing a thin-layer chromatographic (TLC) scanning method for the determination of three alkaloids in Sophora alopecuroides and preliminary screening of antioxidant active components in S. alopecuroides with TLC—bioautography technology. The alkaloids in S. alopecuroides were identified by silica gel thin-layer chromatography; the expansion agent was toluene— acetone—methanol—ammonia—water (8:3:0.2:0.5:8), and the chromogenic agent was modified bismuth potassium iodide solution, sophoridine, matrine, and sophocarpine in S. alopecuroides by TLC scanning at 500 nm. The linear ranges were 0.4152–2.4912 μg for sophordine, 0.4245–2.5470 μg for matrine, and 0.4101– 2.4606 μg for sophocarpine, with correlation coefficients of 0.9939, 0.9956, and 0.9975. Ultraviolet (UV) method was used to determine the total scavenging activity of the 2,2-diphenyl-1-picrylhdrazyl (DPPH) free radical. The best TLC identification condition was selected, and the antioxidant activity of DPPH was screened wit...

Characterization of a Sodium Persulfate Sustained Release Rod for in Situ Chemical Oxidation Groundwater Remediation

In situ chemical oxidation (ISCO) using sodium persulfate (SPS) is an increasingly implemented process for the remediation of subsurface contamination. For this study, a SPS sustained release rod (SR-rod) was prepared by mixing SPS particles and melted paraffin wax with a SPS/wax mass ratio of 6/1. Observation of the rod in potassium iodide solution revealed that, as soon as the rod was placed in the solution, the color turned yellow due to the oxidation of I– to form I2. The solution became darker at the bottom and lighter toward the top because the density of dissolved SPS causes it to sink along the surface of the rod. On the basis of the results of the column experiment which creates a steady SPS release from the rod, a matrix boundary diffusion controlled two-film theory model was derived to explain the SPS release behavior. On the basis of the model developed and the effective SPS diffusion coefficient within the rod matrix, the minimum release time for the rod can be determined. The designed sustai...

Estimated Internal and External Radiation Exposure of Caregivers of Patients With Pediatric Neuroblastoma Undergoing 131I Metaiodobenzylguanidine Therapy: A Prospective Pilot Study.

Current recommendations suggest that family members should participate in the care of children receiving in-hospital I metaiodobenzylguanidine (MIBG) therapy for neuroblastoma. The present study aimed to measure the external radiation exposure and estimate the internal radiation exposure of caregivers during the hospital stay for I MIBG therapy. Caregivers received radiation safety instructions and a potassium iodide solution for thyroid blockade before patient admission. External radiation exposure was determined using a personal pocket dosimeter. Serial 24-hour urine samples were collected from caregivers during the hospital stay. Estimated internal radiation exposure was calculated based on the urine activity. Twelve cases (mean age, 6.2 ± 3.5 years; range, 2-13 years) were enrolled. The mean administered activity was 233.3 ± 74.9 (range, 150.0-350.0) mCi. The mean external radiation dose was 5.8 ± 7.2 (range, 0.8-19.9) mSv. Caregivers of children older than 4 years had significantly less external radiation exposure than those of children younger than 4 years (1.9 ± 1.0 vs 16.4 ± 5.0 mSv; P = 0.012). The mean estimated internal radiation dose was 11.3 ± 10.2 (range, 1.0-29.8) μSv. Caregivers receive both external and internal radiation exposure while providing in-hospital care to children receiving I MIBG therapy for neuroblastoma. However, the internal radiation exposure was negligible compared with the external radiation exposure.

Rescue of Graves Thyrotoxicosis-Induced Cholestatic Liver Disease Without Antithyroid Drugs: A Case Report

Graves thyrotoxicosis rarely presents with painless jaundice resulting from hyperthyroidism-associated hepatotoxicity, without preexisting liver disease. Management in patients with this presentation is challenging, given that the thionamides, methimazole and propylthiouracil, have both been associated with drug-induced liver injury. Radioactive iodine ablation and thyroidectomy are well-established alternatives, but each have their associated risks and contraindications. We present an unusual case of severe hyperthyroidism-associated hepatotoxicity, in which adjuvant therapies, including glucocorticoids, saturated solution of potassium iodide, and cholestyramine, were used as a bridge to definitive therapy with thyroidectomy.