Determination Of Protein-bound Iodine Research Articles

Bacteriologic and Systemic Effects of Intraoperative Segmental Bowel Preparation With Povidone Iodine

A technique for intraoperative segmental preparation of the large bowel, using 10% povidone iodine, was evaluated in 25 patients undergoing elective colon resection. Qualitative and quantitative bacteriology was obtained from the normal bowel content and from segments of colon treated with povidone iodine or normal saline. Forty-five of 50 segments treated with povidone iodine demonstrated no growth, whereas the segments injected with normal saline maintained bacterial counts of 3.5 x 10(8) colony forming units per milliliter. There were no septic complications in this group of patients and the levels of triiodothyroninc and thyroxin remained unchanged despite a substantial absorption of iodine, as demonstrated by protein-bound iodine determinations. Intraoperative segmental preparation of the colon with 10% povidone iodine is a simple technique that may be useful in the enhancement of other methods of bowel preparation by further reducing the endogenous bacterial inoculum at the time of transection of the colon.

Endocrine exophthalmos during lithium therapy of manic-depressive disease.

WE have observed the development of measurable exophthalmos, either bilateral or unilateral, in some psychiatric patients on maintenance lithium therapy. This exophthalmos was clinically indistinguishable from endocrine exophthalmos. Our original aim was to identify, by serial evaluation of thyroid function, susceptible persons in whom hypothyroidism or a goiter (or both) might develop during the course of lithium therapy, as has been reported by other groups.1 2 3 Material and Methods Patients with manic-depressive illness were referred to a psychiatric group for the institution of prophylactic lithium carbonate therapy. Pre-lithium thyroid evaluation consisted of a history, physical examination and determination of protein-bound iodine . . .

Thyroid Function Tests in a Group of Euthyroid Dogs

Summary A number of diagnostic tests of thyroid function were performed on a group of euthyroid dogs. The tests consisted of the thyroid uptake of radioiodine, protein bound 131 iodine (PB131I) estimations, the T3 (resin-sponge)-uptake test, protein bound iodine (PBI) determination and measurement of the serum cholesterol level. In addition to clinical and post-mortem examinations the normality of the dogs was checked by biochemical and haematological estimations. The most valuable tests of thyroid function appeared to be the thyroid uptake test, the T3 (resin-sponge)-uptake test and the PBI determination. The convenience in use of the T3 (resin-sponge)-uptake test was confirmed.

Prolonged elevation of serum protein-bound iodine following myelography with Myodil.

Serum protein-bound iodine determinations in 22 subjects at intervals varying between two and 16 years from myelography showed marked elevations even after 12 years. Evidence is presented to suggest that this is the result of iodine residues from the myelography rather than from other causes. The subsequent confusion in diagnosis which can occur is described. Possible dangers to health which may result, namely thyrotoxicosis in adults with nodular goitre and congenital myxoedema in the infants of affected mothers are discussed and suitable precautions advised.

Thyroxine derivatives in amniotic fluid: Fetal outcome in three patients with thyroid problems

Amniotic fluid protein-bound iodine determinations have been measured in 20euthyroid women in the sixteenth to fortieth week of gestation. The values ranged from 0.7 to 2.2 μg per 100 ml. with a mean of 1.3 μg per 100 ml. T 4 by column values in 11 of the women ranged from 0.7 to 2.0 μg per 100 ml. with a mean of 1.2 μg per 100 ml. Two patients with abnormal thyroid function and one woman who had previously given birth to a child with cretinism were studied. The amniotic fluid protein-bound iodine level in each instance indicated the subsequent thyroid status of the infant. Amniocentesis is a potentially useful procedure in antenatal evaluation of thyroid function.

Lingual thyroid: Report of a case

Lingual thyroid, an abnormal condition in which thyroid tissue is found in the substance of the tongue, presumably is the result of the failure of a thyroid anlage to migrate to its predetermined position. This anomaly should be included in the differential diagnosis of masses in the posterior third of the tongue. Such masses should not be removed surgically, however, until a medical and surgical consultation, a protein-bound iodine determination, and an iodine-131 scan have ruled out the possibility that this may be the only thyroid tissue the patient has.

Tests for hypothyroidism in school children.

Venous blood samples were obtained from 1,759 children, 6 to 14 years of age, in 12 schools in Los Angeles with a total enrollment of 2,502. Serum protein-bound iodine (PBI) and cholesterol were measured and 131I T3 resin uptake and T4 iodine were determined by column tests. For 139 children, column values for T4 iodine were compared with manual PBI results in the same sera; the means were, respectively, 4.7 and 5.6 μ g. per 100 ml. Semiautomated Robot Chemist PBI values (range 4.0 to 8.1) were compared with manual PBI values (range 3.2 to 13.2). The percentages of 131I T3 resin uptake had a negative correlation with the PBI values, coefficient –0.31096. No diagnostic value of this test was evident. In serum PBI determinations done by the manual technic for 570 Caucasian school children, 4.5% of the values were below 4 μ g. per 100 ml. These children were studied for evidence of need for thyroxine medication; 2.6% are being treated. Examples of high serum PBI levels maintained for three years on thyroxine medication are shown. It is suggested that biochemical values affected by hypothyroxinemia should be used to establish the diagnosis of hypothyroidism, of thyroid hormone in the serum.

Distortion of PBI Determination During Coronary Care

To the Editor. —The protein-bound iodine (PBI) determination has become the standard clinical means of thyroid evaluation. The factors known to affect its results have been summarized elsewhere. 1,2 The following report of a heretofore unrecognized cause of significant PBI distortion is the result of an investigation conducted because a disproportionate number of patients admitted to the St. Luke's Hospital intensive-care unit (ICU) were found to have elevated serum PBI levels. Over a six-month period, 50% of the PBI values of patients in the ICU were elevated above normal values, in contrast to 7.3% in the other hospital division studied. The Figure reports a study of a patient admitted to the ICU who had daily PBI determinations. This graph reveals a biphasic curve; the first peak occurred soon after the patient's admission to the ICU; the second peak corresponds to the patient's readmission to the ICU after his condition deteriorated

Removal of Inorganic Iodide in the Automated Serum Protein-Bound Iodine Determination

Abstract Values for serum protein-bound iodine (PBI) concentration obtained by the AutoAnalyzer method are too high because of the failure of the batch (Technicon) process to completely remove inorganic iodide. The Technicon method removes about 98% of the inorganic iodide; this incomplete adsorption of inorganic iodide would give falsely elevated PBI values in serums with high iodide concentrations. A rapid, economical method for removing serum inorganic iodide to the extent of 99.8% by a single pass of serum through a small column packed with an anion-exchange resin is described. Using Dowex-1 x 8, 20-50 mesh, 2 ml. of serum is filtered in 30 sec. directly into an AutoAnalyzer sample cup. Filtration through the column eliminates all possibility of clogging the sample probe with either resin beads or serum clots. The column method requires a little less serum than the batch process.

Determination of serum thyroxine using a resin sponge technique.

A method is described for the determination of serum thyroxine using ion-exchange resin sponges. The principle is based on the use of protein-binding sites and part of the technique is similar to the Triomet resin uptake test. An isotope extraction recovery procedure is incorporated in the method. Studies of factors influencing the analysis are reported and the results of tests of accuracy, precision, and specificity are presented. Serum thyroxine iodine values are compared with protein-bound iodine estimations. The values found in health and disease are similar to the results of previous workers. The specificity of the analysis represents a considerable advantage over protein-bound iodine determinations since no interference is caused by iodides, iodine-containing contrast media, mercurial diuretics, mono-iodotyrosine, di-iodotyrosine, di-iodothyronine, and also tri-iodothyronine in physiological amounts. Therapy with diphenylhydantoin and tri-iodothyronine will tend to depress protein-bound iodine levels and thyroxine values are similarly influenced.

An evaluation of an automated system for determination of protein-bound iodine

An evaluation of an automated system for determination of protein-bound iodine

PROTEIN-BOUND IODINE DETERMINATION WITH STABLE END POINT.

PROTEIN-BOUND IODINE DETERMINATION WITH STABLE END POINT.

THE CARDIAC EFFECT OF EPINEPHRINE DURING ANAESTHESIA IN HYPERTHYROID DOGS

PATIENTS WITH HYPERTHYROIDISM may develop symptoms and signs of severe toxicity during, or in association with, anaesthesia and surgery. These symptoms may vary from mild tremors and severe tachycardia to full-blown thyroid storm. 1 Mo'st frequently, the disease causes an abnormal cardiac rate or rhythm. 2 ' 3 ' 4 Murray and his associates demonstrated that an epinephrine challenge is well tolerated by a euthyroid patient, but it causes marked discomfort to the hyperthyroid individual. 5 High spinal anaesthesia has been used by some to deafferent the adrenals, while others have usednhypothermia and neuroplegks in preparing their patients for thyroidectomy, in order to reduce the amount of catecholamines in the circulation. 6i7>8 This study was undertaken to determine whether or not the hyperthyroid state alters the response to a standard epinephrin,e challenge during anaesthesia in dogs. METHOD Thirty mongrel dogs were studied. They were divided into three groups of ten clogs each. Group I dogs, weighing from 14 to 28 kg. (mean 22 kg.), were fed ground dog meal containing Protamone® (iodinated casein with 1 per cent free iodide and 7 per cent protein-bound iodine). Protamone 0.1 per cent by weight was mixed with the dog meal for the first period of nine days, 0.3 per cent Protamone for the next six days, and 0.6 per cent Protamone for the next seven to ten days. Protein-bound iodine determinations were done by Hycel technique before the dogs were placed on the Protamone-enriched diet, once during the feeding interval, and again on the day of the test. 9 Anaesthesia was induced with a sleep dose of thiopental and 20 mg. of succinylcholine chloride to facilitate endotracheal intubation. An infusion of isotonic saline was started at this time to maintain hydration and provide a route for the injection of the epinephrine challenge. Breathing was augmented with a Takaoka respirator for the maintenance of adequate pulmonary ventilation. 10 The volume of ventilation was set so that the animal would receive a minute volume of 400 ml./kg. body weight. Immediately following endotracheal intubation, ajmelectrocardiogram (lead 2) was recorded on each dog while the animal was being ventilated with 100 per cent oxygen. Following the control tracing, 1 per cent methoxyflurane with oxygen was delivered to the dog from a temperature-compensated vaporizer (Pentec®). At five-minute intervals, an electrocardiogram tracing was taken until twenty-five minutes of methoxyflurane anaesthesia had elapsed. Then, an intravenous

Ultramicrodetermination of Iodine by a Rapid Automatic Reaction-Rate Method.

An automatic spectrophotometric reaction rate method for the ultramicrodetermination of iodide is based on the Sandell-Kolthoff reaction, in which a trace of iodine or iodide acts as catalyst for the reduction of Ce(IV) in the presence of As(1H). The time required for the reaction to consume a small fixed amount of ceric ions, and therefore for the absorbance to decrease by a preselected amount (about 0.06 unit), is measured automatically and related directly to the iodide concentration. Ultramicro amounts of iodide in the range of 0.015 to 0.45 mu g were determined with relative errors of about 1 to 2% and measurement times of only about 10 to l00 seconds. The method should be adaptable for the determination of protein-bound iodine (PBI). (auth)

A GENETICAL AND CYTOLOGICAL STUDY OF REPEATED SPONTANEOUS ABORTION.

SUMMARY1. Thirty‐four patients with three or more spontaneous abortions were studied. Among 193 recorded pregnancies, 150 had ended in spontaneous abortion, two in stillbirth, three in neonatal death, and only twenty‐nine in surviving infants.2. Analysis of variance and sib‐sib correlation showed that a given patient tended to miscarry at about the same time in different pregnancies. Spontaneous abortion was most common between the tenth and the twelfth week; there was a lesser peak between 20 and 26 weeks. There were twenty‐five patients in the early group, six in the later group, and three not easily classified.3. The sex ratio for the live births was 0–94.4. The sibships of the patients and their husbands were not smaller and did not have significantly higher abortion rates than the general population.5. None of the patients' matings were consanguineous. One husband's parents were first cousins.6. The blood group types Ms and MNs were slightly commoner than expected among the patients. Otherwise, blood group frequencies did not show any significant peculiarities. No excess of serologically incompatible matings was found.7. Chromosome analyses in leucocytes from peripheral blood were made for twenty‐two of the patients and eight husbands. The only abnormality detected was a large F‐chromosome in one husband.The authors are indebted to Prof. L. S. Penrose, F.R.S., for encouragement and advice; to Prof. W. C. W. Nixon, F.R.C.O.G., for permission to study the patients in the Obstetric Department, University College Hospital; to Miss Barbara J. Warland, for enlisting the patients' co‐operation; to Dr E. S. Shalom, University College Hospital Medical School, for performing the protein‐bound iodine determinations, to Dr E. B. Robson for serum analysis of patient 3 and to Miss Linda Gorman, for technical assistance.One of us (P. T. R.) was a Donner Foundation–National Research Council Fellow in Academic Medicine during this investigation and gratefully acknowledges their support.

The effect of venous occlusion on determination of protein-bound iodine

The effect of venous occlusion on determination of protein-bound iodine

A semi-automatic determination of protein-bound iodine.

A semi-automatic determination of protein-bound iodine.

The cardiac effect of epinephrine during anaesthesia in hyperthyroid dogs

PATIENTS WITH HYPERTHYROIDISM may develop symptoms and signs of severe toxicity during, or in association with, anaesthesia and surgery. These symptoms may vary from mild tremors and severe tachycardia to full-blown thyroid storm. 1 Mo'st frequently, the disease causes an abnormal cardiac rate or rhythm. 2 ' 3 ' 4 Murray and his associates demonstrated that an epinephrine challenge is well tolerated by a euthyroid patient, but it causes marked discomfort to the hyperthyroid individual. 5 High spinal anaesthesia has been used by some to deafferent the adrenals, while others have usednhypothermia and neuroplegks in preparing their patients for thyroidectomy, in order to reduce the amount of catecholamines in the circulation. 6i7>8 This study was undertaken to determine whether or not the hyperthyroid state alters the response to a standard epinephrin,e challenge during anaesthesia in dogs. METHOD Thirty mongrel dogs were studied. They were divided into three groups of ten clogs each. Group I dogs, weighing from 14 to 28 kg. (mean 22 kg.), were fed ground dog meal containing Protamone® (iodinated casein with 1 per cent free iodide and 7 per cent protein-bound iodine). Protamone 0.1 per cent by weight was mixed with the dog meal for the first period of nine days, 0.3 per cent Protamone for the next six days, and 0.6 per cent Protamone for the next seven to ten days. Protein-bound iodine determinations were done by Hycel technique before the dogs were placed on the Protamone-enriched diet, once during the feeding interval, and again on the day of the test. 9 Anaesthesia was induced with a sleep dose of thiopental and 20 mg. of succinylcholine chloride to facilitate endotracheal intubation. An infusion of isotonic saline was started at this time to maintain hydration and provide a route for the injection of the epinephrine challenge. Breathing was augmented with a Takaoka respirator for the maintenance of adequate pulmonary ventilation. 10 The volume of ventilation was set so that the animal would receive a minute volume of 400 ml./kg. body weight. Immediately following endotracheal intubation, ajmelectrocardiogram (lead 2) was recorded on each dog while the animal was being ventilated with 100 per cent oxygen. Following the control tracing, 1 per cent methoxyflurane with oxygen was delivered to the dog from a temperature-compensated vaporizer (Pentec®). At five-minute intervals, an electrocardiogram tracing was taken until twenty-five minutes of methoxyflurane anaesthesia had elapsed. Then, an intravenous

X-Ray Spectroscopy in the Clinical Laboratory

Abstract A procedure is described for the determination of protein-bound iodine of human serum with the X-ray spectrometer. The protein-bound iodine is extracted from serum at acid pH with alcohol-ether (3:1) solution. Evaporation of this extract results in the loss of the inorganic iodine. The residue is extracted with ammoniacal methanol, evaporated on filter paper, and exposed to the X-ray field. The Lα radiation is evaluated using the flow proportional counter. An instrument is described for evaporating the ammoniacal methanol in a confined area on the paper. The residue from the alcohol-ether extract may also be digested, with the liberated iodine distilled onto a small circle of filter paper (in a simple apparatus described) and the filter paper exposed to the X-ray field. The procedure requires 2 ml. of serum. Levels obtained by this method are somewhat lower than those obtained by an ashing procedure followed by the ceric-arsenite reaction. The X-ray method is more precise than the conventional procedures. In preliminary studies, the mean normal value found by this method was 4.7 µg./100 ml. of serum, with a range of ± 0.6 (2 σ).

X-RAY SPECTROSCOPY IN BIOLOGY AND MEDICINE. V. TOTAL SERUM IODINE.

A rapid, simpie technic for the estimation of total serum iodine by means oi the x-ray spectrograph is described. Iodine L alpha radiation is quantitated, using 50- mu l specimens of serum dried in a thin film on an albumin planchet. The procedure is designed for routine use as a cross-contaminator screen for the determination of protein-bound iodine, It allows detection of every serum capable of yielding cross-contamination. Model experiments demonstrated the potentially useful application of this test procedure in the assessment of fat absorption after ingestion of triglycerides labeled with nonradioactive iodine, with the advantages that radioactive substances are not administered to the patient, and radioactive decay rates are not factors in timing analyses and calculating results. Similar adaptation of certain other test procedures, now restricted to the use of radioactive tracer techniques, seems to be possible with this principle. For lipid tolerance assessment the test procedure uses iodinated poppyseed oil (Lipiodol) in place of I/sup 131/ labeled triolein. Total serum iodine was measured for 24 hours following ingestion of 40% Lipiodol with a high fat breakfast. The type of tolerance curve obtained indicates that a practical working procedure can be devised. Measurements of iodine in urine or feces,more » or both, could also be obtained with equal ease. If the test lipid also contains free fatty acids labeled with bromine, simultaneous differential evaluation of pancreatic function and intestinal absorption is possible by x-ray spectrographic measurement of both total iodine and bromine in the same 50- mu l specimen. (BBB)« less