Examining anatomical features of exceptionally small animals presents significant challenges for researchers. Micro-Computed Tomographic (µ-CT) scanning coupled with target tissue staining has enabled many previously unseen structures of small insects to be mapped and measured in detail. Here we investigated the effectiveness of three staining regimes: Lugol's iodine solution (LS), LS plus 1% phosphotungstic acid (PTA), and LS plus 2% PTA, in enhancing the resolvability of µ-CT scans of the gut organs of the termite Nasutitermes exitiosus, which has protist-independent digestion. We compared pixel intensity and probabilistic tissue contrast (PTC) across the three staining regimes to determine their ability to enhance image contrasts and improve the resolvability of the internal structures. We measured and compared volume and surface area of the termite foregut, midgut, hindgut, salivary glands and cephalic ganglion (brain). Our results showed LS plus PTA significantly improved image resolution for these termite organs, with LS combined with 2% PTA being the most effective staining regime for enhancing pixel intensity and PTC of most of the organs studied. LS plus 1% PTA resulted in an improved image quality but was generally less effective than LS plus 2% PTA. The LS alone regime gave the lowest resolvability, especially for less radio-dense structures like the salivary glands and midgut. Our results suggest that staining with LS plus 2% PTA generally offers significant image enhancement of µ-CT derived images of microscopic insect organs. This approach can be applied more broadly to significantly improve visualizations of the internal anatomy in other small arthropods and soft-bodied invertebrates, facilitating future research in comparative morphology, developmental biology, and functional anatomy.

In patients with Graves' disease, the 2016 American Thyroid Association guidelines and 2018 European Thyroid Association guidelines recommend the administration of Lugol's solution prior to surgery. The objective of this study was to evaluate whether preoperative administration of this solution in patients undergoing thyroidectomy for Graves' disease really improves surgical outcomes. Patients who underwent total thyroidectomy for Graves' disease, performed by high-volume surgeons, in six European centers, between 2019 and 2023, were retrospectively evaluated. Based on preoperative administration of Lugol's solution, two groups were identified: LS Group, including patients who received this solution, and NoLS Group, including those who did not receive it. Surgical outcomes were assessed after performing propensity score matching (1:1). According to the inclusion criteria, 1380 patients were enrolled: 622 in LS Group and 758 in NoLS Group. After propensity score matching, the study population consisted of 494 patients: 247 in LS Group and 247 in NoLS Group. Regarding complications, neck hematomas managed conservatively were significantly greater in NoLS Group (P = 0.016); while unilateral recurrent laryngeal nerve injury, overall postoperative hypoparathyroidism, and temporary hypoparathyroidism were significantly greater in LS Group (P = 0.026, P < 0.001, P < 0.001; respectively). The duration of surgery and postoperative hospital stay were significantly longer in LS Group (P < 0.001, P < 0.001; respectively). Based on our findings and those of other authors, we believe that the recommendations of existing guidelines should be revised.

Thyroid storm is a rare but life-threatening complication of hyperthyroidism that requires urgent management. While propylthiouracil (PTU) is a key treatment, it carries multiple risks, including potentially fatal risk of agranulocytosis. We report a 40-year-old female with Graves' disease who presented with thyroid storm and compressive goiter. High-dose PTU (1 g loading dose followed by 200 mg every 4 hours) was initiated; however, severe neutropenia (ANC: 0.22×10ˆ3/µL) developed within 48 hours, necessitating immediate drug discontinuation. Bridging therapy with hydrocortisone, cholestyramine, Lugol's solution, was implemented once available, and low-dose carbimazole was cautiously reintroduced under close monitoring without recurrence of neutropenia. Once a euthyroid state was achieved, definitive management with a total thyroidectomy was performed without complications. This case highlights three key learning points: (1) agranulocytosis can occur very early during high-dose PTU therapy; (2) careful bridging strategies are essential to prevent rebound thyroid storm after antithyroid drug withdrawal; and (3) timely transition to definitive surgical management can be lifesaving when antithyroid drug intolerance occurs.

Improving chemical and pharmaceutical safety while reducing animal use and development costs is a shared objective of industry, regulators, and the public. We describe a digital imaging pipeline designed to replace the method established by Wilson and Staples using external, visceral, and skeletal imaging of rat fetuses. Gestation day 21 fetuses from timed-mated Crl:CD[SD] rats were euthanized, fixed in formalin, stained with iodine-based contrast agents, embedded in agarose, and scanned using a ZEISS Xradia Versa micro-CT system. Three-dimensional images of the cranium and brain were reconstructed and segmented using Slicer and Dragonfly 3D World software. Key anatomical structures were reviewed by a trained fetal morphologist to confirm accuracy relative to conventionally prepared specimens. Immersion in 5% Lugol's solution for 72-96 h produced uniform soft-tissue contrast. The resulting 3D µCT datasets enabled high-quality external and visceral assessments that compared favorably with traditional approaches. Skeletal evaluations of unstained specimens were of diagnostic quality whereas segmented skeletal features from stained specimens were not. Overall, CT imaging combined with an explainable AI framework shows promise for streamlining developmental toxicology through quantitative, reproducible assessment while reducing labor and subjectivity. Regulatory acceptance, GLP compliance, and a favorable industry value proposition will be essential for adoption.

Premedication with Lugol's solution (LS) has traditionally been used to reduce the vascularization and friability of the thyroid gland before total thyroidectomy in patients with Graves' disease (GD) and toxic multinodular goiter (TMNG) with thyrotoxicosis and/or with undetectable serum TSH. However, the effectiveness and applicability of this treatment remain subjects of debate. This study aims to evaluate the surgical and postoperative outcomes in patients premedicated with LS compared to those who were not premedicated. Data from 100 patients who underwent total thyroidectomy for GD and TMNG at our center from 2014 to 2024 were analyzed. Patients were divided into two groups: Lugol+, premedicated with LS (n = 57), and Lugol-, not premedicated (n = 43). Variables analyzed included thyroid diameter, thyroid weight, operative time, postoperative hemorrhage, hypocalcemia, recurrent laryngeal nerve palsy, length of hospital stay, rate of reintervention for hemorrhage, intraoperative thyroid consistency. No statistically significant differences were found between the groups regarding postoperative hemorrhage (1.7% in Group Lugol+ vs. 2.3% in Group Lugol-), operative time (median: 95 vs. 85 min), immediate postoperative complications such as transient hypoparathyroidism (15.8% vs. 9.3%) and transient recurrent laryngeal nerve (RLN) palsy (3.5% vs. 2.3%), nor the other variables analyzed. Our data suggest that routine preoperative preparation with LS may not be mandatory. This study supports the thesis that patients with GD and TMNG who cannot be premedicated due to inability to obtain LS, insufficient time for preoperative preparation, or lesser compliance by patient, may still be eligible for surgery.