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Mobascher A, Brinkmeyer J, Warbrick T, Musso F, Schlemper V, Wittsack HJ, Saleh A, Schnitzler A, Winterer G. Brain activation patterns underlying fast habituation to painful laser stimuli. Int J Psychophysiol 2009; 75:16-24. [PMID: 19833154 DOI: 10.1016/j.ijpsycho.2009.10.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 09/29/2009] [Accepted: 10/05/2009] [Indexed: 10/20/2022]
Abstract
A painful experience is modified by processes like habituation/antinociception or sensitization. Altered habituation may be one characteristic of chronic pain syndromes. In the present study we sought to investigate the functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) correlate of rapid habituation to pain using simultaneous single trial electrodermal activity (EDA)/fMRI measurements. A total of N=32 healthy subjects have been investigated. Subjects received painful laser stimulation of the left hand. The fMRI BOLD response was measured simultaneously with continuous EDA recordings. Single trial EDA responses to laser stimulation habituated over time with substantial subject-to-subject differences in the degree and speed of habituation. fMRI BOLD habituation was assessed by contrasting the first half of the experiment against the second half and was found in primary and secondary somatosensory cortices, the insula and the anterior cingulate cortex (ACC). We hypothesized that single trial EDA habituation would reflect BOLD habituation which was investigated separately in subjects with 'faster' (N=15) and 'slower' (N=14) EDA habituation. Significant habituation of the BOLD signal was only found in subjects with 'faster' EDA habituation that was accompanied by a signal increase in the rostral ACC and the periaqueductal grey. Furthermore, subjects with faster EDA habituation provided lower pain ratings. Therefore the EDA habituation profile to painful stimulation may constitute a pain-related (endo)phenotype and may be an informative additional endpoint measure in fMR-imaging of pain, especially when people suffering from chronic pain states in which pain processing is often altered are studied.
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102
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Ringelstein A, Oelschläger C, Husstedt IW, Hasselblatt M, Mathys C, Saleh A, Arendt G. Severe aseptic leucoencephalopathy as immune reconstitution inflammatory syndrome in Caucasian and African patients. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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103
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Mobascher A, Brinkmeyer J, Warbrick T, Musso F, Wittsack HJ, Saleh A, Schnitzler A, Winterer G. Habituation patterns of fMRI BOLD and sympathetic skin responses to painful laser stimulation. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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104
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Mobascher A, Brinkmeyer J, Warbrick T, Musso F, Wittsack H, Stoermer R, Saleh A, Schnitzler A, Winterer G. Fluctuations in electrodermal activity reveal variations in single trial brain responses to painful laser stimuli — A fMRI/EEG study. Neuroimage 2009; 44:1081-92. [DOI: 10.1016/j.neuroimage.2008.09.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 07/22/2008] [Accepted: 09/01/2008] [Indexed: 12/24/2022] Open
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105
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Cheong SC, Chandramouli GVR, Saleh A, Zain RB, Lau SH, Sivakumaren S, Pathmanathan R, Prime SS, Teo SH, Patel V, Gutkind JS. Gene expression in human oral squamous cell carcinoma is influenced by risk factor exposure. Oral Oncol 2009; 45:712-9. [PMID: 19147396 DOI: 10.1016/j.oraloncology.2008.11.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Revised: 11/04/2008] [Accepted: 11/04/2008] [Indexed: 10/21/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is a world health problem and is associated with exposure to different risk factors. In the west, smoking and alcohol consumption are considered to be the main risk factors whilst in India and southeast Asia, betel quid (BQ) chewing is predominant. In this study, we compared the gene expression patterns of oral cancers associated with BQ chewing to those caused by smoking using Affymetrix microarrays. We found that 281 genes were differentially expressed between OSCC and normal oral mucosa regardless of aetiological factors including MMP1, PLAU, MAGE-D4, GNA12, IFITM3 and NMU. Further, we identified 168 genes that were differentially expressed between the BQ and smoking groups including CXCL-9, TMPRSS2, CA12 and RNF24. The expression of these genes was validated using qPCR using independent tissue samples. The results demonstrate that whilst common genes/pathways contribute to the development of oral cancer, there are also other gene expression changes that are specific to certain risk factors. The findings suggest that different carcinogens activate or inhibit specific pathways during cancer development and progression. These unique gene expression profiles should be taken into consideration when developing biomarkers for future use in prognostic or therapeutic applications.
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106
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Negm S, Saleh A, Abd El-Hady A, Bekheat H, Abd El-Wahab R. Metabolic Resistance Mechanisms of Different Pesticides in The Two-Spotted Spider Mite, Tetranychus urticae Koch (Tetranychidae:Acari). ACARINES: JOURNAL OF THE EGYPTIAN SOCIETY OF ACAROLOGY 2009; 3:45-53. [DOI: 10.21608/ajesa.2009.4965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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107
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Saleh A, Potemkowski A, Abu-Zidan FM. Endovascular aortic stent graft repair for blunt traumatic thoracic aortic transection. Singapore Med J 2008; 49:847-848. [PMID: 18946622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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108
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Clausen C, Bauer M, Saleh A, Picker O. Finanzierungsproblematik von Investitionsgütern. Anaesthesist 2008; 57:711-6. [DOI: 10.1007/s00101-008-1403-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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109
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Saleh A, Stephen LXG. Oral manifestations of Fanconi's anaemia: a case report. SADJ : JOURNAL OF THE SOUTH AFRICAN DENTAL ASSOCIATION = TYDSKRIF VAN DIE SUID-AFRIKAANSE TANDHEELKUNDIGE VERENIGING 2008; 63:028-31. [PMID: 18543739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Fanconi's anaemia (FA) is a rare, inherited autosomal recessive genetic disease characterized by progressive bone marrow failure, congenital abnormalities, and high predisposition to malignancies. The incidence of the disease is unusually high in the Afrikaner population of South Africa with calculated heterozygote prevalence being approximately 1 in 77. This report describes the oral clinical and radiological findings in a 16 year old male with FA. METHODS Medical and dental history was noted, the oral mucosa was examined and the teeth were screened for fillings and caries. Periodontal examination consisted of: measurement of probing depths, recession, mobility of teeth, furcation involvement, plaque index and gingival index. An orthopantomograph was taken. RESULTS There was a generalized black hyper-pigmentation on the buccal mucosa, tongue and palate. The patient had generalized gingival recession and most of the periodontal pockets were deeper than 5mm. Several teeth were mobile and the orthopantomograph showed loss of alveolar bone in the furcation areas of most posterior teeth. A diagnosis of severe generalized periodontitis associated with systemic disease was made. CONCLUSIONS Patients with Fanconi's anaemia are susceptible to severe dental and periodontal diseases.
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Cohnen M, Blondin D, Assadi S, Wittsack HJ, Saleh A, Turowski B, Mödder U. Strahlenexposition des Patienten bei Schlaganfallbildgebung mit Mehrzeilen-Detektor-CT: Schädel-CT, CT-Angiographie und CT Perfusion. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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111
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Mathys C, Wittsack H, Ringelstein AS, Mödder U, Saleh A. No time to relax! Inhomogenity of white matter is normal in T2-weighted brain images at 3T. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1074062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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112
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Kurz KD, Steinhaus D, Klar V, Cohnen M, Wittsack HJ, Saleh A, Mödder U, Blondin D. Assessment of three different software systems in the evaluation of dynamic MRI of the breast. Eur J Radiol 2007; 69:300-7. [PMID: 18060715 DOI: 10.1016/j.ejrad.2007.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 09/03/2007] [Accepted: 10/03/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim was to compare the diagnostic performance and handling of dynamic contrast-enhanced MRI of the breast with two commercial software solutions ("CADstream" and "3TP") and one self-developed software system ("Mammatool"). MATERIALS AND METHODS Identical data sets of dynamic breast MRI from 21 patients were evaluated retrospectively with all three software systems. The exams were classified according to the BI-RADS classification. The number of lesions in the parametric mapping was compared to histology or follow-up of more than 2 years. In addition, 25 quality criteria were judged by 3 independent investigators with a score from 0 to 5. Statistical analysis was performed to document the quality ranking of the different software systems. RESULTS There were 9 invasive carcinomas, one pure DCIS, one papilloma, one radial scar, three histologically proven changes due to mastopathy, one adenosis and two fibroadenomas. Additionally two patients with enhancing parenchyma followed with MRI for more than 3 years and one scar after breast conserving therapy were included. All malignant lesions were classified as BI-RADS 4 or 5 using all software systems and showed significant enhancement in the parametric mapping. "CADstream" showed the best score on subjective quality criteria. "3TP" showed the lowest number of false-positive results. "Mammatool" produced the lowest number of benign tissues indicated with parametric overlay. CONCLUSION All three software programs tested were adequate for sensitive and efficient assessment of dynamic MRI of the breast. Improvements in specificity may be achievable.
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113
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Saleh A, Kamel L, Ghali A, Ismail A, El Khayat H. Serum levels of astroglial S100-beta and neuron-specific enolase in hepatic encephalopathy patients. EASTERN MEDITERRANEAN HEALTH JOURNAL 2007; 13:1114-23. [DOI: 10.26719/2007.13.5.1114] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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114
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Abdel-Kader D, Saleh A, Abu-Elsaoud A. Enhanced UVA+Binduced oxidative damage and antioxidant defence system inGlycine maxL. cultivars. ACTA ACUST UNITED AC 2007. [DOI: 10.1556/abot.49.2007.3-4.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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115
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Wang X, Saleh A, McBroom MW, Williams JR, Yin L. Test of APEX for nine forested watersheds in East Texas. JOURNAL OF ENVIRONMENTAL QUALITY 2007; 36:983-95. [PMID: 17526877 DOI: 10.2134/jeq2006.0087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Hydrologic/water quality models are increasingly used to explore management and policy alternatives for managing water quality and quantity from intensive silvicultural practices with best management practices (BMPs) in forested watersheds due to the limited number of and cost of conducting watershed monitoring. The Agricultural Policy/Environmental eXtender (APEX) model was field-tested using 6 yr of data for flow, sediment, nutrient, and herbicide losses collected from nine small (2.58 to 2.74 ha) forested watersheds located in southwest Cherokee County in East Texas. Simulated annual average stream flow for each of the nine watersheds was within +/- 7% of the corresponding observed values; simulated annual average sediment losses were within +/- 8% of measured values for eight out of nine watersheds. Nash-Sutcliffe efficiency (EF) values ranged from 0.68 to 0.94 based on annual stream flow comparison and from 0.60 to 0.99 based on annual sediment comparison. Similar to what was observed, simulated flow, sediment, organic N, and P were significantly increased on clear-cut watersheds compared with the control watersheds. APEX reasonably simulated herbicide losses, with an EF of 0.73 and R(2) of 0.74 for imazapyr, and EF of 0.65 and R(2) of 0.68 for hexazinone based on annual values. Overall, the results show that APEX was able to predict the effects of silvicultural practices with BMPs on water quantity and quality and that the model is a useful tool for simulating a variety of responses to forest conditions.
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Abstract
Wilson disease is an autosomal recessive inherited copper metabolic disorder that is characterized by diminished biliary excretion of copper and a raised serum level of free copper. This leads to a toxic copper accumulation, particularly in the liver and the brain. Therefore, clinical symptoms are dominated by hepatic and extrapyramidal symptoms. Untreated Wilson disease has an unfavorable outcome. Cerebral changes are depicted most sensitively by magnetic resonance tomography. Pathological findings mainly focus on the basal ganglia, the midbrain and the brainstem. Depending on the therapy and the severity of the neurological symptoms, signal increase as well as signal decrease may be observed in T1-weighted (T1w) and T2-weighted (T2w) images and can be reversible when using an appropriate therapy. Hyperintense areas in T2-weighted images are induced by edema, gliosis, demyelinisation or cystic degeneration. Signal increase in T1-weighted images are found in patients with hepatic insufficiency and are probably due to manganese deposits. Signal decrease in T2-weighted images is probably caused by the paramagnetic effect of the copper accumulation. Furthermore, recent studies show a correlation between the clinical severity and changes in diffusion-weighted sequences. Although cross-section imaging plays a rather subordinate role in the primary diagnostics of Wilson disease, the described cerebral changes in patients with extrapyramidal disturbances should include Wilson disease in the differential. Persistent or progressive hyperintense lesions in T2-weighted images reflect therapy failure, and clinical recovery correlates to an improvement in MR images. Therefore, repeat MR imaging can be used to monitor medical therapy.
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Kamel L, Saleh A, Morsy A, Ghali A, El Khayat H. Plasma met-enkephalin, beta-endorphin and leu-enkephalin levels in human hepatic encephalopathy. EASTERN MEDITERRANEAN HEALTH JOURNAL = LA REVUE DE SANTE DE LA MEDITERRANEE ORIENTALE = AL-MAJALLAH AL-SIHHIYAH LI-SHARQ AL-MUTAWASSIT 2007; 13:257-65. [PMID: 17684846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
To address the role of the opioid system in the pathogenesis of hepatic encephalopathy (HE) we measured plasma met-enkephalin, beta-endorphin and leu-enkephalin in patients with different grades of HE compared to control subjects and patients with cirrhosis. Plasma met-enkephalin levels were significantly higher in patients with cirrhosis and all grades of HE than controls. Plasma beta-endorphin levels were similar in the 3 groups. Plasma leu-enkephalin levels were significantly higher in HE grades II, III and IV than in controls, patients with cirrhosis and HE grade I patients. Our results support data on the involvement of met-enkephalin and leu-enkephalin in the pathogenesis of HE and provide a rationale for the use of opioid receptor antagonists in the treatment of HE.
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Turowski B, Hänggi D, Saleh A, Mödder U. Effekt der interventionellen Therapie des zerebralen Vasospasmus nach Subarachnoidalblutung. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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119
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Schellhammer F, Rapp M, Saleh A. [Melorheostosis of the HWS in an intraspinal lipoma]. ROFO-FORTSCHR RONTG 2006; 178:822-3. [PMID: 16862512 DOI: 10.1055/s-2006-926706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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120
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Cohnen M, Wittsack HJ, Assadi S, Muskalla K, Ringelstein A, Poll LW, Saleh A, Mödder U. Radiation exposure of patients in comprehensive computed tomography of the head in acute stroke. AJNR Am J Neuroradiol 2006; 27:1741-5. [PMID: 16971627 PMCID: PMC8139787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND PURPOSE To assess patient radiation exposure in comprehensive stroke imaging using multidetector row CT (MDCT) combining standard CT of the head, cerebral perfusion (CTP), and CT angiography (CTA) studies. METHODS Examination protocols for CT and CTA of cerebral and cervical vessels, as well as CTP were simulated using a Somatom Sensation Cardiac 64. Effective doses were derived from measurements with the use of lithium-fluoride thermoluminescent dosimeters (LiF-TLD) at several organ sites using an Alderson-Rando phantom. RESULTS LiF-TLD measurements resulted in effective doses of 1.7 mSv for CT, 1.9 mSv for CTA of intracranial vessels, and 2.8 mSv for CTA of cervical vessels, respectively. Depending on examination parameters, effective doses varied between 1.1 and 5.0 mSv for cerebral CTP. For CTP, local doses in the area of the primary beam ranged between 114 and 444 mGy. CONCLUSIONS Comprehensive stroke imaging may result in up to 9.5 mSv with possible local doses of 490 mGy. Although critical doses for organ damage (eg, cataract formation or hair loss) are not reached, physicians need to be aware of possible radiation induced sequelae particularly in repetitive examinations.
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Köller H, Neuen-Jacob E, Saleh A, Kieseier BC, Jander S, Hartung HP. A patient with a benign course of neuromyelitis optica (Devic's syndrome) over 12 years: MRI follow up and histological findings. J Neurol 2006; 253:819-20. [PMID: 16511648 DOI: 10.1007/s00415-006-0116-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Revised: 12/02/2005] [Accepted: 12/15/2005] [Indexed: 10/25/2022]
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122
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Cohnen M, Kircheis G, Miese F, Wittsack HJ, Saleh A, Wenserski F, Häussinger D, Mödder U. Hepatische Enzephalopathie alkoholischer und nicht-alkoholischer Genese: Korrelation der Magnetisierungs-Transfer-Ratio, des ADC und der kritischen Flicker-Frequenz. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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123
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Jung G, Poll L, Cohnen M, Saleh A, Vogler H, Wettstein M, Willers R, Mödder U, Koch JA. Dignitätsbeurteilung fokaler Leberläsionen mit der kontrastverstärkten MRT mit SHU 555 A im Vergleich zur nativen MRT und zur Mehrzeilen-Detektor-Spiral-CT. ROFO-FORTSCHR RONTG 2005; 177:1571-7. [PMID: 16302139 DOI: 10.1055/s-2005-858627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the ability of contrast-enhanced MRI with SHU 555 A to provide additional information for characterization of focal liver tumors compared with non-enhanced MRI and multislice spiral CT. MATERIALS AND METHODS In a prospective manner the images of 45 patients who underwent multislice spiral CT, unenhanced MRI alone and unenhanced and SHU 555 A-enhanced MRI including dynamic imaging at a field strength of 1.0 T were analyzed in a blinded reading. The readers had to determine on a scale from 1 to 5 whether a tumor was benign or malignant. Furthermore, the readers had to give a definitive diagnosis for each lesion. A true cut needle biopsy served as gold standard against which all imaging procedures were compared. RESULTS The sensitivity for differentiation malignant vs. benign lesion was 77 % with spiral CT, 72 % with unenhanced MRI and 94 % with SHU 555 A-enhanced MRI, respectively (p < 0.05). The specificity for spiral CT was 73 %, for unenhanced MRI 83 % and for contrast-enhanced MRI 83 %, respectively (n. s.). Compared with the histopathologic results, the correct diagnosis was made with spiral CT in 25/45 (56 %), unenhanced MRI in 16/45 (36 %) and contrast-enhanced MRI in 32/45 (71 %) of the patients (p < 0.05). For the subgroup of patients with liver cirrhosis, the correct diagnosis was established with spiral CT in 16/23 (70 %), unenhanced MRI in 9/23 (39 %) and contrast-enhanced MRI in 19/23 (83 %) of the patients (p < 0.05). CONCLUSION Contrast-enhanced MRI with SHU 555 A has the ability to improve the differential diagnosis of focal liver tumors compared with unenhanced MRI and multislice spiral CT.
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Nickel J, Neuen-Jacob E, Saleh A, Gattermann N, Hartung HP, Köller H. CIDP and isolated osteosclerotic myeloma. Neurology 2004; 63:2439. [PMID: 15623724 DOI: 10.1212/01.wnl.0000141861.67742.68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Saleh A, Cohnen M, Fürst G, Mödder U, Feldkamp J. Prediction of Relapse after Antithyroid Drug Therapy of Graves' Disease: Value of Color Doppler Sonography. Exp Clin Endocrinol Diabetes 2004; 112:510-3. [PMID: 15505758 DOI: 10.1055/s-2004-821308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Opinions differ regarding the indications for antithyroid drugs, radioiodine and surgery in patients with Graves' disease because the likelihood of long-term remission after medical treatment cannot be predicted. The aim of this study was to assess the value of quantifying thyroid blood flow in an attempt to predict outcome following withdrawal of antithyroid drug therapy. Spectral Doppler recordings were obtained from the thyroid arteries in 24 patients with Graves' disease at the time of diagnosis. Thyroid blood flow levels measured at the time of diagnosis of Graves' disease were correlated with outcome following withdrawal of medical treatment (mean duration of treatment: 14 months). Clinical follow-up for at least 18 months (range: 18 - 39 months) after antithyroid drug withdrawal was possible in 13 patients (12 women). Mean peak systolic velocity and volume flow rate values as well as thyroid volume measured at the time of diagnosis were significantly higher (139 cm/s, SD 46; 195 ml/min, SD 170; 52 ml, SD 18) in patients who relapsed after drug treatment compared with patients in remission (71 cm/s, SD 27; 67 ml/min, SD 61; 25 ml, SD 13). The correlation between thyroid blood flow measurements and thyroid volume was high (r = 0.79 - 0.96). Recurrence of disease could be predicted with a sensitivity of 71 % and a specificity of 100 % based on thyroid blood flow measurements. This preliminary data suggest that quantification of thyroid blood flow by means of Doppler sonography might be a useful tool to predict the outcome of Graves' disease following withdrawal of medical treatment and could be helpful in finding the adequate kind of therapy.
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