Scriba, Peter Christian

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endocrinologia experimentalis VOLUME 20 NUMBER 1 MARCH 1986 Contents PAST AND PRESENT PROBLEMS OF ENDEMIC GOITRE Papers dedicated to 70th ibirthday of Doc. Julian Podoba, M. D., Ph. D, former Director of the Institute of Experimental Endocrinology, Bratislava and Editor of this Journal Scriba P. C. (Lübeck) Introduction 5 Greer M. A. (Portland) Historical Role of Endemie Goiter in Elucidating the Importance of Iodine NutritK>n, the Function and Comtrol of Thyroid Gland, the Structure of Thyroid Hormone, and the Use of Antithyroid Drugs in Thyrotoxicosis 9 Van Middlesworth L. (Memphis) Potential Metabolie Signifioance of Blood Thioeyanate . . . 17 Gerber H., Peter H. J., Studer H. (Bern) Diffusion of Thyroglobulin in the Follicular Colloid . . . . 23 Lamberg B.-A. (Helsinki) Endemie Goitre in Finland and Ghanges during 30 Years of Iodine Prophylaxis 35 Fenzi G. F., Bartalena L., Lombardi A., Chiovato L., Macchia E., Giani C, Pinchera A. (Pisa) Thyroid Autoimmunity and Endemie Goiter 49 Koutras D. A., Karaiskos K. S., Piperingos G. D., Kitsopanides J., Boukis M. A., Makriyannis D., Souvatzoglou A., Sfontouris J., Evangelopoulou K., Moulopoulos S. D., Katsouyanni K., Tricho-poulos D. (Athens) Treatment of Endemie Goitre with Iodine and Thyroid Hormones, Alone orr in Combinatk>n 57 Bauch K., Meng W., Ulrich F. E., Grosse E., Kempe R., Schönemann F., Sterzel G., Seitz W., Möckel G., Weber A., Tiller R., Rockel A., 1 Dempe A., Seige K. (Karl-Marx-Stadt—Halle—Greifswald— —Zwikau) Thyroid Status during Pregnancy and Post Partum in Regions of Iodine Deficiency and Endemie Goiter 67 Meng W., Bauch K., Knappe G. (Greifswald—Karl-Marx-Stadt— —Berlin) Iodine Deficiency Disease in the GDR 79 Nemec J., Zamrazil V., Pohunkovä D., Rohling S., Zeman V. (Praha) Some Factors Influencing the Survival of Patients with Less Ad-vanced Stages of Differentiated Thyroid Cancer 85 New Books 22, 34, 47, 66, 77 2 ENDOCRINOLOGIA EXPERIMENT ALIS, Vol. 20, 1986 Introduction P. C. SCRIBA K l i n i k für I n n e r e M e d i z i n , M e d i z i n i s c h e H o c h s c h u l e Lübeck, Lübeck, F e d e r a l R e p u b l i c of G e r m a n y It is certainly an outstanding honour and pleasure to congranulate Dr. Julian Podoba o«n the occasion of his 70th »binthdiay. A group of frieds and thyroidologists gather in this issue in Order to celebrate Dr. Podoba, who has contributed a lot to science as founder of the reknown Institute of Experimental Endocrinology, as investigator in many fields and as a promotor of public health. The knowledge of thyroidologists has been expanded by the work of Dr. Podoba particularly in two areas, the fields of naturally occurring goitrogens and of endemic goiter. The Symposium on Naturally Occurring Goitrogens and Thyroid Function organized in 1962 by the Slovak Aca-demy of Sciences, Bratislava, and published in 1964 by Podoba and Lan-ger concentrated the contributions from all the international Community of scientists and turned out to be a landmark in the relevant literature. Dr. Podoba then introduced a series of original papers from his Institute in stressing the aspects of enzootic goiter and of epcperimental endocri-nology using goitrogenic foodstuff. One of the outstanding participants of this Symposium in 1962 and, since that time, a friend of Dr. Podoba and of several of his associates, Monte A. Greer from Portland, Oregon, contributed the first flower to this scientific birthday bouquet, elucidating the early period of the re-search om iodine deficiency, goiter and naturally occurring goitrogens. It appears to be appropriate to mention the next flower contributed by Les-ter van Middlesworth fram Memphis, Tennessee, who visited several times the Institute in Bratislava. In his paper a review is given on previous findings by himself and his associates favouring the concept that thio-cyanate, both a product of normal metabolism in the human organism and from exogenous sources such as medication or cigarettes, plays a quasi physiological role in the regulation of thyroid function. Further, some goitrogens may require thiocyanate for their füll effect. The paper finally summarizes the recent finding of an abnormal thyroglobulin produced experimentally when low iodine diet and chronic thiocyanate admini-stration are combined. 5 Persuing this issue, Dr. Podoba's friends from a group of Hugo Studer in Bern, Hans Gerber et al. report their recent work on thyroglobulin diffusion in the colloid space. The autoradiographic technique used in this field was enriched by the study of a new marker (:5H-dihydrotestosterone). Thyroglobulin diffusion is another heterogenously distributed property of thyroid tissue and slow thyroglobulin diffusion in old mice may turn out as a finding of relevance to aging. Experimental lowering of thyro-globulin diffusion veloeity was shown to slow down thyroid hormone formation. Dr. Podoba's second centre of interest in thyroidology appart from na-turally occurring goitrogens is the field of endemic goiter. Obviously, it is very appropriate to include into this birthday present some contribu-tions addressing this area. Bror-Axel Lamberg from Helsinki, a long-term scientific colleague and friend of Dr. Podoba, joins in with a discussion on changes of endemic goitre in Finland during 30 years of iodine Prophylaxis which is actually analogous to that work which Dr. Podoba did in Slovakia, including the participation of genetic factors. Then Aldo Pinchera and Gian Franco Fenzi from Pisa bring up the recent evidence for immunological factors y 70 60 31 40 ! & 30 e .20 10 Q rt... A , A flv /S ä x 10 20 30 40 50 60 70 m} {VolumenJ Fig. 1. Accuracy of determination of thyroid size by ultrasound. Thyroid lobes were measured in situ immediately before autopsy (n = 25). Multiplication of lenght X width X depth X ^ resulted in sonographical volu-6 me, ordinate. After autopsy, the true volume of the thyroid lobes was determi-nated by submersion in water, abscissa. Using an optimized factor F = 0.479 instead of ~ in the above exspression, average error of the method is 16 0 o 6 [from Brunn et al.: Dtsch. med. Wochenschr. 106, 1338, 1981]. 6 stimulating thyroidal growth as they certainly play a role in sporadic goiter and may likewise contribute to endemic goiter. This work has opened up a new field of experimental and clinical research on the non-toxic goiter problem. Demetrius A. Koutras and his associates from Athens have started a well designed, placebo controlled study on the treatment of pa-tients with non-toxic goiter in the Greek endemic area, which may help Fig. 2. Thyroid volume in school children compared in Stockholm and in the Federal Republic of Germany. Thyroid volume (male/female value) was determined by ultrasound in 13 year old school children (n = 2244) from 23 places in the Federal Republic of Germa-ny and in 224 school children from Stockholm, where the iodine supply is adequate. The results show that thyroid size gradually increases from North to South. Mean thyroid volume in Swedish children was 4.2 ml, in German chil-dren 9.3 ml. More than one third of German children have a larger thyroid volume than the largest volume measured in Swedish children. The results support the need for iodine-salt Prophylaxis for the entire German Federal Republic [from Gutekunst et al.: Dtsch. med. Wochenschr. 110, 50, 1985]. 7 to fill a gap in our knowledge of the optimal treatment and of benefit side effects ratio. The paper raises again the question of the interrelation of iodine and autoimmunity. Karel Bauch and associates report from the iodine deficient German Democratic Republic. The area of Karl-Marx-Stadt was shown to house severe goiter endemy with 60 % of the pregnant women having goiter and 53 % of stillborns born with an enlarged thyroid. Administration of 150 iodine per day to pregnant women reduced the rate of neonatal goiter to 0.8 %. Wilfried Meng et al. join in giving an epidemiological and ciinical review with emphasis on the socio-economical sequelae of endemic goiter and announcing the iodination of all packed salt in the GDR. This may be the place to remember the known successes of our collegues from Czechoslovakia with their goiter prevention program as recently reviewed by the Subcommittee on Endemic Goitre and Iodine Deficiency of the European Thyroid Association (The Lancet, 1985, I. p. 1289). One part of this program was also a long-term follow up of the incidence of thyroid Cancer and survival of treated patients with regard to the con-ditions of previous long-term action of goitrogenic factors (environmental, genetic, etc.) in this country, the results of which are partly presented by Jan Nemec and his associates from Praha. Dr. Podoba has early supported the concept of an estimation of the re-lative size of the thyroid (RT-value) as it may be seen from his monograph on "Endemickä struma na Slovensku" (Bratislava 1962). This idea faci-litated a more quantitative insight into the problems of endemic goiter. These are the days of broader application of ulitrasonography for deter-mination of goiter size. Therefore, the undersigned author takes the liberty to join the group of friends of Dr. Podoba by adding two leaves to the congratulation bo»uquet (Fig. 1, 2). Our congratulation comes together with our best wishes for good health, for happy years to come and for continued interest in the achievements of science. Happy birthday, Dr. Podoba! Peter C. Scriba Lübeck September 1985 8 

Past and present problems of endemic goitre: Intoduction

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Past and present problems of endemic goitre: Intoduction

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