The study was prospective , randomized , and single-blind , and it included 40 consecutive patients with moderate-to-severe GO randomized into : 1 ) a Tx-radioactive iodine ( RAI ) group ( 20 subjects who underwent total-Tx and ( 131 ) I ablation after recombinant human TSH stimulation ) ; and 2 ) a Tx group ( 20 subjects who underwent total-Tx alone ) .