TSH receptor antibodies (TRAb) are believed to cause hyperthyroidism of Graves' disease. Thyroid-stimulating antibody (TSAb) and TSH-binding inhibitor immunoglobulin (TBII) have been measured as TRAb to diagnose Graves' disease and to follow Graves' patients. We intended to evaluate the clinical value of TRAb (TSAb and TBII) assay in establishing the diagnosis of Graves' disease and in predicting its clinical course. TSAb and TBII were studied in 686 normal subjects and in 277 Graves' patients before antithyroid drug therapy. We followed serial changes of TSAb and TBII in 30 Graves' patients before, during and after antithyroid drug therapy over 3.5-9 yr. We measured TSAb as a stimulator assay and TBII as a receptor assay. Both TSAb and TBII were distributed normally in 686 normal subjects. ROC curves demonstrated that both TSAb and TBII had high sensitivity and specificity for the diagnosis of Graves' disease, and were equally sensitive and specific; 150% was chosen as cut-off value for TSAb and 10% for TBII. Of the 277 untreated Graves' patients, 254 (92%) had positive TSAb and positive TBII. All of the 277 untreated Graves' patients had positive TRAb (TSAb and/or TBII). We followed the serial changes of TSAb and TBII in 30 Graves' patients over 3.5-9 yr. During antithyroid drug therapy, TSAb and TBII activities decreased and disappeared in 27 patients (Group A), but continued to be high in the other 3 (Group B). The former 27 Group A patients achieved remission, but the latter 3 Group B patients continued to have hyperthyroidism. Of the 27 Group A patients, 16 (59%) had parallel decreases of TSAb and TBII activities; in 6, the changes were predominantly observed in either TSAb or TBII, and in 4, complex changes in TSAb and TBII activities were observed. Disappearance of TSAb and appearance of TSBAb was seen in one. The other 3 Group B patients continued to have high TSAb and TBII activities and to have hyperthyroidism. In conclusion, TSAb and TBII are of clinical value in establishing the diagnosis of Graves' disease and in predicting its clinical course. We clearly demonstrated its diagnostic usefulness. Both TSAb and TBII have high sensitivity and specificity. All of the 277 untreated Graves' patients had TRAb (TSAb and/or TBII). Serial changes of TSAb and TBII during therapy differ from one patient to another, and can be classified into several groups. Changes in TSAb and TBII activities reflect the clinical courses of Graves' patients. The simultaneous measurement of both TSAb and TBII is clinically useful, since TSAb and TBII reflect two different aspects of TRAb. TSAb and TBII are different.

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Serum sodium distribution patterns differed between normal subjects and patients with essential hypertension in this Japanese population. The deterioration of renal function and increased sodium intake did not explain this abnormal sodium metabolism. A higher serum sodium concentration is related to an elevated blood pressure, and, in some patients, an inappropriate elevation of plasma aldosterone levels. Of the Japanese hypertensive patients, 10-14% exhibited serum sodium concentrations of 147 mmol/l or more and inappropriate elevations of aldosterone level (suppressed PRA and normal aldosterone level). The defect in these patients presumably lies in the inappropriately high secretion of aldosterone.

Abbreviations: AITD, autoimmune thyroid disease; PCR, polymerase chain reaction; TG, thyroglobulin; TPO, thyroid peroxidase.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Association of CTLA-4 Gene A/G Polymorphism in Japanese Type 1 Diabetic Patients With Younger Age of Onset and Autoimmune Thyroid Disease O R I G I N A L A R T I C L EOBJECTIVE -We studied the association between type 1 diabetes with autoimmune thyroid disease (AITD) and A/G allele polymorphism in exon 1 of the CTLA-4 gene in a Japanese population.RESEARCH DESIGN AND METHODS -We studied 74 Japanese type 1 diabetic patients with or without AITD and 107 normal subjects to identify the association between CTLA-4 polymorphism and type 1 diabetes using polymerase chain reaction-restriction fragment length polymorphism analysis.RESULTS -The frequency of the CTLA-4 G allele differed significantly between the type 1 diabetic patients (61%) and the normal control subjects (48%) (P = 0.016). The difference in the CTLA-4 G allele became greater between patients with a younger age of onset of type 1 diabetes (age at onset Ͻ30 years) and the normal control subjects (64% and 48%, respectively). However, the frequency of the CTLA-4 G allele did not differ between type 1 diabetic patients with younger and older age of onset (64% vs. 57%). The G allele frequencies in the patients with younger-onset type 1 diabetes and AITD increased more than in the control patients (P = 0.025). These differences reflected a significant increase in the frequency of G/G genotype-that is, 54% in those with younger-onset type 1 diabetes and AITD, 39% in those without AITD, and 28% in control subjects.CONCLUSIONS -An association was detected between the CTLA-4 gene polymorphism and younger-onset type 1 diabetes with AITD. The G variant was suggested to be genetically linked to AITD-associated type 1 diabetes of younger onset in this Japanese population. The defect in these patients presumably lies in a T-cell-mediated autoimmune mechanism. E p i d e m i o l o g y / H e a l t h S e r v i c e s / P s y c h o s o c i a l R e s e a r c h 976DIABETES CARE, VOLUME 23, NUMBER 7, JULY 2000 CTLA-4 gene A/G polymorphism in type 1 diabetes and AITDtide level of Ͻ20 µg/day (20). Blood was sampled at intervals of 6-12 months for the measurement of the thyroid autoantibodies (anti-thyroid peroxidase [TPO] and anti-thyroglobulin [TG] antibodies), GAD65 antibody, and IA-2 antibody. Antibodies were determined by radioimmunoassay (20,21). Cutoff levels of GAD65 antibody, IA-2 antibody, and thyroid autoantibody were 1.2, 0.5, and 0.4 U/ml, respectively. Thyroid autoantibodies were measured Ͼ3 times in all patients with diabetes during the follow-up period. When the thyroid autoantibodies were detected Ͼ2 times in same patient, autoantibodies were considered to be positive. The diagnosis of AITD was based on the finding of palpable goiter or the presence of chronic thyroiditis with ultrasonography examination in the...

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Turmeric {Curcuma longa L ) plant species produces different sizes of daughter rhizomes (R) and mother rhizomes (MR), which are the only propagules (seed) for its cultivation. Here, we evaluated the effects of seed rhizome size on growth and yield of turmeric. Daughter rhizomes of 5-50 g (R-5 g~R-50 g) and mother rhizomes of 48-52 g (MR) were tested. The heavier the R up to 40 g, die better the plant growth, and die plants from die R-30 g, R-40 g, R-50 g and MR grew similarly well. The seed rhizomes with a greater diameter developed vigorous seedlings. The plants grown from R-30 g, R-40 g and R-50 g had a similar plant height, tiller number and leaf number, which were significantly higher than diose from lighter R. The plants from R-30 g, R-40 g and R-50 g had a significantly larger shoot biomass and higher yield than those from smaller R in both the greenhouse and field experiments. R-50 g was easily broken at the time of planting, and had secondary and tertiary daughter rhizomes, which developed thinner plants and resulted in a lower yield. The shoot biomass and yield were highest in the plants grown directly from MR, and lower in the plants grown from daughter rhizomes attached to MR.This study indicates that the turmeric seed rhizome should be 30-40 g with a larger diameter, and seed mother rhizome should be free from daughter rhizomes.