Objective:
To report a case of iodine-induced (Jod–Basedow) hyperthyroidism leading to thyrotoxic periodic paralysis (TPP).
Case Summary:
A 64-year-old white male, one day status-post-cardiac ...catheterization, presented to the local emergency department with profound weakness of his extremities and an inability to stand on his own. Pertinent laboratory test results included a potassium level of 3.0 mEq/L Treatments of oral and intravenous potassium supplementation resulted in his complete recovery. Two days later he was diagnosed with hyperthyroidism and subsequently treated with nadolol 40 mg daily and methimazole 20 mg daily. At time of writing, the patient remained euthyroid, receiving no antithyroid medications. There had been no further reports of paralysis in the 6 years since his original presentation. The Naranjo probability scale indicated a probable relationship between the patient's episode of TPP and his exposure to the iodinated contrast dye.
Discussion:
TPP is an uncommon manifestation in white patients with hyperthyroidism. Iodine-induced TPP is even more rare, with only 2 such cases reported as of November 2, 2005. In this case, Jod–Basedow hyperthyroidism was induced by the iodine-containing dye that the patient received during cardiac catheterization. Soon after the dye was administered, he developed TPP.
Conclusions:
Clinicians should be aware not only of potential causes of drug-induced thyroid disease, but also of the potential for drug-induced hyperthyroidism leading to TPP. The diagnosis of TPP should be considered in patients presenting with acute onset of extremity weakness or paralysis and hypokalemia. Quick diagnosis and prompt treatment of TPP can prevent life-threatening complications of this treatable and curable disorder.
The bacterium
Roseovarius crassostreae causes seasonal mortalities among commercially produced eastern oysters (
Crassostrea virginica) grown in the Northeastern United States. Phylogenetically, the ...species belongs to a major lineage of marine bacteria (the
Roseobacter clade), within which
Roseovarius crassostreae is the only known pathogen to be isolated in laboratory culture. The objective of the current study was to determine the location and nature of
R. crassostreae interactions with oysters affected by juvenile oyster disease (JOD). Scanning electron microscopy of diseased individuals revealed abundant colonization of the inner shell surfaces by bacteria which were morphologically similar to
R. crassostreae. The same types of cells were also observed on and within layers of host-derived conchiolin on the inner valves. Most bacterial cells were alive as determined by the use of a fluorescent viability stain. Further, most were clearly attached at the cell poles, which is consistent with the ability of
R. crassostreae to express polar fimbriae. When material from the pallial fluid, soft tissue and inner valve surfaces was cultured, the highest numbers of
R. crassostreae were recovered from the inner valves. These samples also contained the greatest abundance of
R. crassostreae as a percentage of total colonies. Cloning and sequencing of 16S rRNA genes provided culture-independent evidence of the numerical dominance of
R. crassostreae among the bacterial consortia associated with the inner shell surfaces of JOD-affected animals. The ability of
R. crassostreae to colonize shell and conchiolin is consistent with the described JOD-pathology and may aid the bacteria in avoiding hemocyte-mediated killing.
Since the beginning of the nuclear era, starting during the 1940s, large amount of radioactivity has been released into the environment. This thesis deals with the temporal and spatial distribution ...of the anthropogenic radioisotope 129I (T1/2= 15.7 Myr) in northern Europe. A routine sample preparation procedure for extraction of iodine from milligram amounts of solid materials has been developed and aimed for measuring the 129I concentration by the ultra-sensitive accelerator mass spectrometry method. The technique was further used for the analysis of 129I in sediments collected from two lakes in Sweden and one lake in Finland as well as sediments from two sites in the Baltic Sea. In addition, 129I concentrations in aerosol samples from northern and southern Sweden covering the period 1983 to 2000 have been measured. The results reveal a gradual increase in the anthropogenic 129I fluxes since the 1950s that are linked to emissions from the nuclear fuel reprocessing facilities in Sellafield (UK) and La Hague (France). A sharp increase coinciding with the Chernobyl accident is identified from the Swedish lakes located in areas characterised by relatively high Chernobyl fallout. Numerical modeling of the 129I deposition predicts that >50% of the flux to the lake sediments is related to the liquid emissions from the reprocessing facilities. The modeling also reasonably simulates the contribution of the Chernobyl event to the total 129I flux. The novel time series from northern Europe on 129I in aerosols show about one order of magnitude higher concentration in northern compared to southern Sweden. Estimate of 129I dry fallout based on the aerosol data suggests <25% contribution to the total fallout. The distribution of 129I in the sediment archives demonstrates the potential of the isotope as a new time marker for chronological and environmental investigations.
A new device for liquid–liquid extraction was developed, tested, and modeled, based on two immiscible thin films, flowing one on the top of the other while exchanging mass. The films are formed by ...impinging streams: collision of two immiscible jets flowing one toward the other on the same axis. Thus, the flow of the films is in a direction perpendicular to the initial flow of the jets. Two liquid systems (diluent–solute–solvent) were tested: water–iodine–kerosene and aqueous solution of HCl–pure water. In the latter case, HCl is transferred from its initial solution comprising one film to the other film of pure water flowing on the top of it. The experiment determined geometrical parameters of the thin film, mass‐transfer coefficients of the solute between the films, as well as power input. For a relatively identical power input, the measured mass‐transfer coefficients were higher by a factor of 10–200 compared to conventional devices. In addition, the mean residence time in the new device is shorter than in conventional devices due to minimal dispersion of the phases during the extraction stage, making the settling stage relatively simple and short.
We have developed a PCR-assay for the diagnosis of juvenile oyster disease (JOD) based on the detection of Roseovarius crassostreae directly from affected oysters. Species-specific primers are used ...to amplify the 16S-23S rDNA internal transcribed spacer (ITS) of R. crassostreae, and confirmation of product identity is accomplished by restriction enzyme analysis. No false positives were obtained with either closely related bacterial species or from other DNAs present in oyster samples. The assay has the potential to detect as few as 10 cells of R. crassostreae per oyster when samples are taken from the inner valve surfaces of the animal. Inclusion of material from soft body surfaces is not necessary, and may reduce sensitivity approximately 10-fold. In a JOD-affected population, a positive PCR result was obtained from all oysters from which these bacteria were subsequently cultured. The assay also detected the presence of R. crassostreae in 2 oysters from which no R. crassostreae isolates were recovered. No R. crassostreae was detected by either PCR or bacteriology in oysters from a population that was not exhibiting JOD-signs. This assay is expected to advance regional disease management efforts and provide valuable insights into the disease process and epizootiology of JOD.
Research Summary
In 1999, three communities were selected to participate in a research demonstration designed to test the feasibility and impact of a coordinated response to intimate partner violence ...that involved the courts and justice agencies in a central role. The primary goals of the Judicial Oversight Demonstration (JOD) were to increase victim safety, hold offenders accountable, and reduce repeat offending using coordinated community services and integrated justice system policies in intimate partner violence court cases. The partnerships differed from earlier coordinated community responses to domestic violence by placing special focus on the role of the court, specifically the judge, to facilitate offender accountability in collaboration with both nonprofit service providers and other criminal justice agencies. This article presents the results of an impact evaluation of this demonstration in all sites. The demonstration received mostly positive responses from justice system agencies, service providers, offenders, and victims. Improvements were made in offender monitoring, consistent sanctioning, and increased supervision. However, these changes did not translate into gains in victim perceptions of their safety or into reductions in repeat violence in all sites.
Policy Implications
The demonstration had minimal impact on changing offender attitudes and behavior. The mixed results of the evaluation indicate that the most effective justice system responses to intimate partner violence must include a focus on protecting victims, close monitoring of offenders, and rapid responses with penalties when violations of court‐ordered conditions are detected. Indications were found that JOD strategies were effective for some subgroups, including younger offenders with fewer ties to the victim and offenders with extensive arrest histories. The observed reductions in intimate partner violence in selected subgroups in the JOD sites may suggest a fruitful way to begin designing new intervention strategies, including prevention programs for men and women.
Početno liječenje većine bolesnika s diferenciranim karcinomom štitnjače uključuje kirurško odstranjenje štitnjače. Poslijeoperacijsko liječenje radioaktivnim jodom (I-131) indicirano je u većine ...visokorizičnih bolesnika, dok je primjena I-131 u bolesnika niskog i srednjeg rizika predmet rasprave. U prethodnih nekoliko desetljeća tireoglobulin (Tg) je prihvaćen kao primarni biokemijski tumorski biljeg visoke osjetljivosti i specifičnosti u bolesnika s diferenciranim karcinomom štitnjače. Mjerenje Tg može se izvoditi tijekom uzimanja hormonske terapije L-tiroksinom ili uz stimulaciju tireotropinom (TSH). Stimulacija putem TSH može se postići prekidom hormonske terapije L-tiroksinom ili uz primjenu rekombinantnog humanog TSH (rhTSH). Dugi niz godina se granična vrijednost TSH ≥30 mIU/L smatrala zadovoljavajućom za stimulaciju Tg, međutim, novije spoznaje osporavaju tu granicu i zahtijevaju nova istraživanja i preporuke. Nedavno je uvedena podjela bolesnika u 4 rizične skupine ovisno o odgovoru na liječenje jodom-131 nakon totalne tireoidekotmije, a mjerenje Tg jedna je od glavnih odrednica podjele. U posljednje vrijeme se značenje pridaje omjeru Tg-TSH u predviđanju ishoda ablacije jodom-131, kao i prognostičko značenje vremena udvostručenja Tg. Poslijeoperacijska serumska vrijednost Tg je važan prognostički čimbenik i odrednica daljnjeg liječenja, a određivanje Tg je osnovna metoda dugoročnog praćenja bolesnika s diferenciranim karcinomom štitnjače.
In the iodine–sulfur thermochemical hydrogen production process, a separation characteristic of 2-liquid phase (H
2SO
4 phase and HI
x
phase) in the separator at 0°C was measured. Two-phase ...separation began to occur at about 0.32 of I
2 molar fraction and over. The separation characteristic became better with the increase in iodine concentration in the solution. The effect of flow rate variations of HI solution and I
2 solution from the HI
x
distillation column on the process was evaluated. The flow rate increase in HI solution from the distillation column did not have a large effect on the flow rate of HI solution fed to the distillation column from the separator. The decreasing flow rate of I
2 solution from the distillation column decreased the flow rate of I
2 solution fed to the distillation column from the separator. The variation of I
2 molar fraction in the H
2SO
4 phase in the separator was sensitive to the variation in flow rate of both solutions from the distillation column. The tolerance level of the variation was investigated by considering I
2 solubility, 2-liquid phase disappearance and SO
2 reaction amount.
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