Endoscopic dacryocystorhinostomy following radioactive iodine thyroid ablation

This article evaluates the efficacy of endoscopic dacryocystorhinostomy (eDCR) for nasolacrimal duct obstruction (NLDO) in patients exposed to radioactive iodine (RAI) for treatment of thyroid carcinoma. Retrospective chart review of 7 eDCR procedures was performed on 6 patients, aged 18 or older, with prior RAI treatment, who underwent eDCR between January 1, 2008 and December 31, 2013 for treatment of epiphora due to NLDO. Average time to tube removal was 159 days, and average follow-up was 341 days. One patient noted complete epiphora relief at the time of their final visit. Partial symptom relief was noted by 3 patients, and recurrent epiphora was noted by 2 patients. In complex patients with RAI-associated NLDO, eDCR may be a reasonable option for relief of epiphora. Appropriate counseling, including the risks of incomplete symptom relief and need for additional surgery, should be discussed pre-operatively with these patients.     

Wound healing effect of flavonoid rich fraction and luteolin isolated from Martynia annua Linn. on streptozotocin induced diabetic rats

ObjectiveTo evaluate wound healing potential of flavonoid fractions of Martynia annua (M. annua) Linn. leaves in diabetic rats on the basis of folkloric information and preliminary study.MethodsThe flavonoid compound luteolin and apigenin were isolated from dried leaves of plant by column chromatography. The two concentrations (0.2% and 0.5% w/w) of luteolin and flavonoid fraction were selected for topically applied as ointment on diabetic wound. The Povidone Iodine Ointment USP was used as a reference. On 18th days, protein content, hydroxyproline and antioxidants (SOD, CAT and GSH) level in granuloma tissues were determined.ResultsThe results showed that, percent wound contraction were observed significantly (P<0.01) greater in MAF fraction and 0.5% w/w of luteolin treatment groups. Presence of matured collagen fibres and fibroblasts with better angiogenesis were observed in histopathological studies.ConclusionsIn conclusion, our findings suggest that flavonoid fraction (MAF) and luteolin (0.5% w/w) may have potential benefit in enhancing wound healing in diabetic condition, possibly due to free-radical scavenging activity of plant.     

A review of tositumomab and I131 tositumomab radioimmunotherapy for the treatment of follicular lymphoma

The CD20 antigen has become a major therapeutic target in the management of follicular and other Bcell non-Hodgkin’s lymphomas. The murine monoclonal antibody, tositumomab, on binding CD20, is able to induce antibody-dependent cellular cytotoxicity, complement-dependent cytotoxicity and apoptosis. In addition, when radioiodinated, the antibody exploits the tumour’s sensitivity to ionising radiation by direct targeting of the malignant cell. Tositumomab and Iodine (I¹³¹) tositumomab (Bexxar^®, GlaxoSmithKline, Philadelphia, PA, USA) is administered in two steps. The dosimetric step determines individual patient pharmacokinetics, allowing a patient- specific dose to be calculated. This is followed by the therapeutic step, with administration of the therapeutic dose between 7 and 14 days after the dosimetric dose. Over a decade’s worth of experience in clinical trials has determined the efficacy and safety of the regimen in a variety of clinical ci-rcumstances; establishment of exactly where the regimen fits amongst the algorithm for the management of follicular lymphoma continues.     

Antioxidant effects of vitamin D on lacrimal glands against high dose radioiodine-associated damage in an animal model

Purpose: To evaluate antioxidant effects of active vitamin D (calcitriol) against high-dose radioiodine (RAI) therapy-associated damage of lacrimal gland.

Materials and methods: Wistar albino rats were used and divided into three groups randomly (n?=?12/group). The first group was appointed as the negative control group and received no RAI or medication. The second group was appointed as the positive control group that only received 3?mCi/kg (111 MBq/kg) RAI via gastric gavage and the last group was the treatment group that received 3?mCi/kg RAI via same method and calcitriol (200?ng/kg/day) via intraperitoneal administration. Seven days after RAI administration, bilateral intraorbital (IG), extraorbital (EG) and Harderian (HG) glands were removed for the evaluations of histopathologic, tissue cytokine, total oxidant status (TOS) and total antioxidant status (TAS).

Results: RAI led to significant increase in tissue TOS, TNF-α, IL-6 levels and significant decrease in IL-10 and TAS levels (p?p?p?p?=?0.049), periductal fibrosis in EG and HG (p?=?0.049 and 0.038, respectively), abnormal cell outlines in EG and HG (p?=?0.020 and 0.011, respectively) and variation in cell size in the IG and the HG (p?=?0.003 and 0.049 respectively).

Conclusions: RAI caused significant oxidative stress and inflammation in lacrimal glands. Vitamin D demonstrated potent anti-inflammatory, antioxidant and radio-protective effects on lacrimal glands in histopathologic, tissue cytokine and oxidant/antioxidant level evaluations.     

低碘浓度对比剂结合Z-dom及iDose4技术在颈部CT血管造影中的应用

目的：探讨低碘浓度对比剂结合Z轴自动管电流调制（Z-dom）及第四代高级迭代重建（iDose4）技术在颈部CT血管造影（CTA）中的应用价值,以降低对比剂及电离辐射伤害。方法：收集2018 年10月至2019年9月温州医科大学附属第二医院行颈部CTA检查患者100例,随机分成2组：常规组50例,行常规扫描,即120 kV、250 mAs、碘海醇（350 mgI/mL）及滤波反投影法（FBP）重建;低剂量组50例,120 kV、Z-dom自动管电流、碘克沙醇（270 mgI/mL）及iDose4迭代重建。比较2组碘注射量及辐射剂量,在颈总动脉和颈内动脉起始层面进行客观评价,并对图像进行主观评价。结果：碘注射量低剂量组[（16.61±2.87）g]比常规组[（22.82±3.81）g]低（P ＜0.01）;管电流低剂量组[（149.22±70.49）mAs]比常规组（250 mAs）低（P ＜0.01）;低剂量组容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）及有效剂量（ED）均较常规组低（均P ＜0.01）。2组图像客观评价：低剂量组两层面血管CT值和背景噪声均低于常规组,颈总动脉起始层面信噪比（SNR）、对比噪声比（CNR）均高于常规组（均P ＜0.001）;主观评价：2名医师主观评分Kappa值为0.765,一致性良好,常规组评分为（3.44±0.48）分,低剂量组为（3.60±0.47）分,2组差异无统计学意义（t>1.676,P =0.097）,2组图像均可满足诊断需要。结论：低碘浓度对比剂结合Z-dom及iDose4 技术在颈部CTA检查中,其图像质量优于常规组,能够满足诊断需要,同时可降低患者碘注射量及电离辐射剂量。