Survey of Exposure Dose during Percutaneous Coronary Intervention for Chronic Total Occlusion.

During percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), longer fluoroscopic time as compared with PCI for non-CTO lesions may cause skin injury by increased radiation. We have performed a multi-center observational study comparing the exposed dose during the PCI of CTO (CTO group) and during the PCI of non-CTO lesions (non-CTO group). Exposure doses were assessed in 313 patients with CTO and 3,310 patients with non-CTO lesions. Total fluoroscopy time (59.0 ±35.5 vs 26.8 ±18.8 min, p<0.0001) and the total air kerma (2.76±2.11 vs 1.27±0.94 Gy, p<0.0001) were significantly greater in the CTO group than in the non-CTO group. The maximum air kerma of the CTO group was 13.62 Gy. Informed consent about the risk of transient depilation and the transient erythema is required for the case with radiation dose over 3 Gy. The frequency of the patient who received radiation >3 Gy was significantly higher in the CTO group as compared with the non-CTO group (34.1% vs 4.9%). Therefore, informed consent before an operation and postoperative follow-up are indispensable for the performed PCI of CTO. Moreover, comprehensive understanding of the exposure dose during operation and to record the final exposure dose may be extremely important for the radiological technologists.

Thyroglobulin mRNA expression in peripheral blood lymphocytes of healthy subjects and patients with thyroid disease.

BACKGROUND: Thyroglobulin (Tg) mRNA is expressed focally in thyroid tissue. In recent years, the Tg gene has been detected in other tissues, including lymphocytes, although the significance of its presence has not been elucidated yet. We measured Tg mRNA expression in the lymphocytes of healthy subjects and those with thyroid disease. METHODS: Analysis of the quantification of Tg mRNA from 20 healthy subjects and 47 subjects with thyroid disease was carried out by real-time PCR. Furthermore, in cultured lymphocytes we compared changes in Tg mRNA expression following stimulation with TSH. RESULTS: Tg mRNA was detected in the lymphocytes of all subjects. Tg mRNA in the lymphocyte sequence matched that derived from thyroid tissue, and mRNA levels were higher in subjects with thyroid disease than in healthy subjects. Following lymphocyte stimulation, Tg mRNA levels were observed to be increased 2.7-fold in Graves' disease and 1.6-fold in chronic thyroiditis compared to healthy subjects. CONCLUSIONS: Tg mRNA in the lymphocytes was quantified by real-time PCR. The levels of Tg mRNA in the TSH-stimulated lymphocytes were noticeably increased in subjects with thyroid disease. These results suggest an interesting relationship between production of Tg antigen in peripheral blood and autoimmunity in thyroid disease.

The clinical utility of Lens culinaris agglutinin-reactive thyroglobulin ratio in serum for distinguishing benign from malignant conditions of the thyroid.

BACKGROUND: Traditionally, the follow-up of differentiated thyroid carcinoma consists of periodic withdrawal from L-T4-suppressive therapy to allow performance of a highly sensitive serum Tg measurement to detect recurrences. We investigated Lens culinaris agglutinin-reactive thyroglobulin ratios in serum to evaluate in usefulness for detection of thyroid carcinoma. METHODS: The study was conducted on 93 serum sample from 23 healthy volunteers, 32 patients with benign thyroid tumor, 28 patients with thyroid carcinoma without metastasis, and 10 patients with thyroid carcinoma with lymph node metastasis. RESULTS: The Lens culinaris Agglutinin reactive thyroglobulin ratio in patients with thyroid carcinoma was significantly lower than in patients with benign thyroid tumor with serum thyroglobulin concentration >200 ng/ml. Among cases of thyroid carcinoma with lymph node metastasis, Lens culinaris Agglutinin reactive thyroglobulin ratios were significantly lower than in patient with thyroid carcinoma without metastasis and those with benign tumor regardless of serum thyroglobulin concentration. CONCLUSION: Measurement of Lens culinaris Agglutinin reactive thyroglobulin ratio in serum may be useful for distinguishing between thyroid carcinoma and benign thyroid tumor.

Discrimination of thyroglobulin from thyroid carcinoma tissue and that from benign thyroid tissues with use of competitive assay between lectin and anti-thyroglobulin antibody.

Thyroglobulin is produced only by thyroid follicular cells, and has a molecular weight of 660,000 and carbohydrate content of approximately 10%. The composition of carbohydrate chains on thyroglobulin from thyroid carcinoma has been reported to differ from that in normal thyroid tissue. In this study, heterogeneities of carbohydrate chains on thyroglobulin obtained from thyroid tissues were investigated by competitive reaction between lectin and anti-thyroglobulin monoclonal antibody. Concanavalin A, Lens culinaris agglutinin, Ricinus communis agglutinin-120 and Datura stramonium agglutinin were compared. The ratio of Lens culinaris agglutinin-reactive thyroglobulin to thyroglobulin was significantly lower in thyroid carcinoma than in normal thyroid tissue, Graves' disease and benign thyroid tumor. However, no differences between malignant and benign tissues were observed with the other lectins tested. Differences in carbohydrate chain on thyroglobulin were observed between malignant and benign thyroid tissues.