but not adequate.
Repetition of the detailed studies in both types of phtients hive
been desired, but unfortunately the enormous investment of time ana effo
to fallow
a single treatment dose in one patient has been so great that it has onlp been
possible to study selected patients. Thus, it has only been a chance ocfurrence that
an additional therapeutic dose of radioiodine was necessary in a patient|who had beer.
completely studied on the first aga ion.
Partly by chance and partly by
design a
few patients were given a dose of +311 which was not sufficient to re
the patient
to a euthyroid state. A second therapeutic dose exactly equal to the fist was
subsequently given in a few instances and all of the observations repeatd@d. The
comparative studies of the two treatment doses have not revealed information that «as
particularly informative, except that the second dose was often not takem up as well
as was the first.
¥e-
ert
ohh
~ eX
940)0})
H4-5
in the Circulation Following
«
it)
Li)
*-+T Therapy
ie
odina
a
“Te
*
Ls
=i
ae)
ie
=
’
on
It has been pointed out that in serial chromatograms of serum follc ing a
treatment dose of
there was an increased amount of radioactivity at he appiicat--
point.
Paper electrophoresis was used to explore the nature of the iodinated compournx=>
which remained at the application point.
These observations although
carfied at
periodically for a number of years, did not reveal striking results excep
much of the radioactivity was in the alpha globulin fraction and probably]
the thyroxine-binding globulin. Ultimately when the patient reached the
state, considerable 131; was in the albumin fraction.
to show thay
represemted
frypo
oid
The Role of Triiodothyronine in Hyperthyroidism
Since we and others had identified triiodothyronine in the circulation
and its rapid and potent metabolic action had been proven, the possibility
represented the principle form of thyroid hormone in thyrotoxic patients
by many persons. Among other theories it was thought that thyroxine migh}
ursor of triiodo
ine. AS
iously described, the
@ mumber
Chromatograms on ity.treated
Was
of mn
that it
|
entertains
be ea
ser:
pationts probably reflected basic'chysiolody of me
disease immediately after the tly was
passed reflected the radiation effect.
given and later after hours and days
had
Triiodothyronine was found in the
ehromareran
of serum of many of the more thyrotoxic patients.
The chromatograms done [pn
the ery
early samples of blood often showed that triiodothyronine, if present, appeared sooner
and in larger quantities than thyroxine (especially in the most toxic patipnts). This
observation tended to discredit the possibility that thyroxine was the prebursor >t
triiodothyronine.
There was in our series an occasional patient treated with 1317 for nypertinroid=-
caused by a toxic adenoma.
Some patients in a euthyroid state have been theated wth
1317 and studied in the sam: detailed way. In both situations <riicdothyrpnine ws
oceasicnally detected, showing that triiodothyronine was not peculiar to Gheves'
disease.
fi