title: Effectiveness and Mechanism of Preoperative Lugol Solution for Reducing Thyroid Blood Flow in Patients with Euthyroid Graves' Disease.
abstract: BACKGROUND
  To reduce intraoperative and postoperative complications, using Lugol solution to preoperatively prepare patients with Graves' disease has (1) rapidly reduced the severity of thyrotoxicosis and (2) reduced the vascularity of the thyroid gland. The vascularity reduction normally accompanies reducing the severity of thyrotoxicosis. However, the effects and mechanism of Lugol solution for reducing blood flow have not been well investigated in the patients with euthyroid (normally functioning thyroid) Graves' disease.
  
  
  METHODS
  Twenty-five patients with euthyroid Graves' disease being preoperatively treated with Lugol solution for 10 days were measured, at baseline and on the operative day, for (1) superior thyroid artery blood flow; (2) systemic angiogenic factor (VEGF); and (3) systemic inflammatory factor [interleukin (IL)-16].
  
  
  RESULTS
  All three parameters were significantly (p < 0.0001) lower after 10 days of Lugol solution treatment. The average reductions were blood flow: 60% (0.294 vs. 0.117 L/min), serum VEGF: 55% (169.8 vs. 76.7 pg/mL), and serum IL-16: 50% (427.2 vs. 214.2; pg/mL).
  
  
  CONCLUSIONS
  Lugol solution significantly reduced thyroid arterial blood flow, VEGF, and IL-16, even in patients with euthyroid Graves' disease. We recommend routine preoperative Lugol solution treatment for all patients with Graves' disease.
authors.affiliation: Department of Surgery, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan. smhuang@mail.ncku.edu.tw.
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Huang
authors.affiliation: Clinical Research Center, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Liao
authors.affiliation: Clinical Research Center, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chiou-Feng
authors.initials: CF
authors.lastname: Lin
authors.affiliation: Clinical Research Center, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.
authors.forename: H Sunny
authors.initials: HS
authors.lastname: Sun
authors.affiliation: Department of Pathology, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Nan-Haw
authors.initials: NH
authors.lastname: Chow
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006044:Goiter, Nodular / Q000503:physiopathology / Q000628:therapy; D006111:Graves Disease / Q000503:physiopathology / Q000628:therapy*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007454:Iodides / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D012039:Regional Blood Flow / Q000187:drug effects* / Q000502:physiology; D013961:Thyroid Gland / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
chemical_list: D006490:Hemostatics; D007454:Iodides; C010389:Lugol's solution