摘要:

The well differentiated thyroid carcinomas are uncommon but are increasing in frequency. This increase may be related to the recognition that even low doses of irradiation to the thyroid may be carcinogenic with a latency period of 10, 20 or more years to clinical tumor expression. Although unproven for human cancers, elevated TSH levels will enhance irradiation-associated tumor development in animal models. Currently, a large portion of the population is at an increased risk of developing thyroid cancer because of head and neck irradiation received from 1920 to 1950 for various benign conditions or more recently for the treatment of lymphoma or carcinoma. Whether these individuals should receive thyroid hormone suppression of TSH is not known but careful yearly evaluation is essential followed by open surgical biopsy should a nodule develop. Treatment of the well differentiated thyroid carcinoma is controversial due to a lack of adequate long-term, controlled trials. Based on current data, it is the author's opinion that surgery should in most cases be followed with radioactive iodine ablation of all remaining tissue which can concentrate iodine followed by lifelong thyroid hormone replacement sufficient to correct hypothyroidism and suppress thyroid stimulating hormone. All patients require close follow-up with examination and, possibly, imaging for 20 or more years.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Medical records of 1 34 patients withStaphylococcus aureusbacteremia at the Cincinnati General Hospital during 1975–1977 were reviewed. Bacteremia was community-acquired in 48 patients and hospital-acquired in 73 patients. In addition, 13 patients were on chronic hemodialysis. In 22 patients, bacteremia was associated with an infected intravenous catheter; all except one of these patients acquired the infection in the hospital. Thus 21 of 73 (29%) episodes of hospital-acquiredS aureusbacteremia were associated with an infected intravenous catheter. Four of the 22 patients with intravenous catheter-associated bacteremia had endocarditis (18%). The overall incidence of endocarditis in this study was 16% (21 of 134 patients). This contrasted with the much higher incidence of endocarditis (64%) in Staphylococcal bacteremia reported from this same hospital in patients during 1940–1954.9Possible reasons for this difference are discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

During a 1974 foodborne outbreak of viral hepatitis type A among Navy recruits, we evaluated clinical and laboratory features prospectively in 130affected persons. The ratio of anicteric to icteric persons identified during the outbreak was 1:3.5 but illness was relatively mild in this population of young adults. Infrequently reported in association with type A hepatitis, rash and arthralgias (but not arthritis) were reported by 14 and 10% of affected persons, respectively. Fourteen weeks after onset of acute illness, 8.5% of patients had persistently elevated aminotransferase activities and underwent percutaneous liver biopsy. Morphologic features included piecemeal necrosis, but clinical, biochemical, and histological evidence of disease resolved within five months to one year after the outbreak. Fecal shedding of hepatitis A virus began during the preicteric stage, did not persist beyond the second day of jaundice (even in patients with protracted illness), and was not detected in anicteric patients. Feces and serum obtained during the late incubation period, but not urine, were infectious in chimpanzees. Antibody to hepatitis A virus developed during convalescence, and serum anticomplementary activity was noted during acute illness. Failure of T-lymphocytes to bind sheep erythrocytes and form rosettes was observed, was found to be modulated in several cases by an intrinsic lymphocyte defect and in others by the presence in serum of an extrinsic immunoregulatory serum lipoprotein, “rosette inhibitory factor,” which persisted in patients with slow resolution.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The purpose of this study was to determine whether cigarette smoking acutely increased circulating platelet aggregates as detected by lowering of the platelet aggregate ratio. Eighteen (11 male and 7 female) volunteers ranging from 16 to 47 years of age rested during a 20-minute control period and smoked two unfiltered tobacco cigarettes during another 20-minute period. Platelet aggregate ratios (mean ± SD) before and after the control period were 0.86 ± 0.13 and 0.82 ± 0.12 respectively (p > 0.05) and before and after smoking were 0.84 ± 0.14 and 0.66 ± 0.18 respectively (p < 0.01). The mean plasma nonesterified fatty acid concentration was not significantly different before and after smoking suggesting that the decrease in platelet aggregate ratio was not mediated through elevation of the plasma nonesterified fatty acid concentration. Our results are consistent with the theory that platelet aggregates contribute to the increased incidence of myocardial infarction and sudden death from coronary artery disease observed among cigarette smokers.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

o,p′-DDD, administered by mouth in doses of 1 to 7 grams daily for 5 to 42 days, was found to lower serum uric acid concentration in each of eight normouricemic patients (one with Cushing's disease and seven with metastatic cancer). The decrease ranged from 21 to 53% (average 39%) and the maximum effect was apparent in five to ten days. Urinary uric acid excretion showed no change, indicating that uric acid production was unaffected and that the hypouricemic effect resulted from an increase in the renal clearance of uric acid. The present findings introduce a new type of chemical compound to the group of known hypouricemic agents.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Many patients with metastatic carcinoma have an increase in urinary excretion of 17-hydroxycorticosteroids (17-OHCS), plasma concentrations of 17-OHCS, plasma total Cortisol, plasma nonprotein-bound Cortisol, or Cortisol production rate. A small portion of circulating Cortisol is excreted in the urine as unaltered or free Cortisol. This urinary free Cortisol, which is believed to reflect the average unbound plasma Cortisol circulating during the day, is an excellent measure of adrenal cortical function. In this study, we compared the urinary free Cortisol of 35 patients with metastatic cancer (10 small cell carcinomas of the lung, 8 other types of carcinoma of the lung, 8 breast carcinomas, and 9 miscellaneous carcinomas) with a group of 15 healthy age-matched volunteers. There were no significant changes in urinary free Cortisol excretion in the patients with cancer.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Three patients presenting in a one-year period with coexisting carcinoma and presumed immune thrombocytopenia are the subject of this report. Review of the literature disclosed a paucity of previous reports of this association. Possible pathogenic mechanisms resulting in this association are discussed. All three patients responded to corticosteroids in usual doses used in treatment of chronic idiopathic thrombocytopenic purpura. The association of carcinoma with immune thrombocytopenia may be more common than has been previously appreciated.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Ataxia-telangiectasia (AT) is a multi-system disease involving the cerebellum, cutaneous blood vessels and the immune system including both cellular and humoral components. It also involves hematological, endocrine and peripheral nervous systems. This disease is often associated with abnormal liver function tests, such as, raised alkaline phosphatase and various nonspecific histological changes in the liver. High incidence of various malignancies involving lymphoreticular, gastrointestinal and mesenchymal organs have been reported in ataxia-telangiectasia. Elevated levels of alpha fetoprotein have been noted commonly in this disorder. In spite of the hepatic histological and biochemical changes associated with elevated alpha fetoprotein, to our knowledge, development of hepatocellular carcinoma has not been reported in patients with ataxia-telangiectasia. A case of a young white female with AT who developed hepatocellular carcinoma along with significantly elevated levels of alpha fetoprotein is presented.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A 23-year-old girl with a ventriculo-atrial shunt presented with hematuria, proteinuria and severe oedema. Diphtheroid organisms were cultured from blood, cerebrospinal fluid and the shunt valve. Immunoglobulin, complement components and diphtheroid antigenic material were demonstrated in the glomeruli by immunofluorescence microscopy. Treatment of her shunt infection by shunt replacement and antibiotic therapy resulted in slow resolution of her nephritis. The slow resolution of her nephritis suggests that prompt resolution of immune complex disease due to prolonged bacterial injection cannot always be anticipated, even after successful eradication of infection.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Factors determining prognosis in tetanus have been based mainly on clinical grounds and mortality is high especially in the developing countries. The biochemical changes occurring in tetanus before any form of therapy or sedation, were examined to determine screening parameters for earlier institution of intensive care in high risk patients. The results obtained from a prospective study of 73 patients are presented. The blood sugar and serum transaminases correlated well with the severity of the disease. The serum glutamic oxalate transaminase and blood urea were significantly higher in fatal cases. These findings as well as the clinical criteria utilized in determining the severity of the disease in this study are useful in predicting the outcome of the disease. It is suggested that these simple investigations could serve as screening parameters for instituting early intensive care in tetanus.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID