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Biomedical subjects

F Matsuzuka

Publications and source records attributed to F Matsuzuka.

At least 127 records · Page 7Linked to original sources
PubMed1981

Gonadotropin response to luteinizing hormone releasing hormone in hyperthyroid patients with menstrual disturbances.

This study was designed to investigate the gonadotropin response to luteinizing hormone releasing hormone (LHRH) in patients with hyperthyroidism, as related to the presence or absence of menstrual disorders. Forty-one Japanese women with hyperthyroidism were separated into groups on the basis of the presence of a regular menstrual cycle, hypomenorrhea, or amenorrhea and further subdivided into the phase of the menstrual cycle at the time of testing. The findings in these groups were compared with those in normal subjects with respect to thyroid function, basal serum LH and FSH levels and serum LH and FSH responses to LHRH, and basal estradiol levels. Serum LH responses to LHRH were increased over normal subjects in those with hyperthyroidism regardless of the phase of the menstrual cycle and regardless of the presence or absence of menstrual disturbances. However, these augmented LH responses to LHRH were less marked in those with menstrual disorders than in those with regular menstruation. Both basal serum FSH and peak serum FSH response to LHRH were also increased in the follicular phase but not in the luteal phase of the cycle in hyperthyroid patients, regardless of menstrual function. These results suggest that high levels of circulating thyroid hormones augment the gonadotropin response to LHRH, and that increased LH and FSH secretion probably maintains the normal cyclic pituitary gonadal axis function in patients with hyperthyroidism.

Adult↗
PubMed1980

Postpartum recurrence of hyperthyroidism and changes of thyroid-stimulating immunoglobulins in Graves' disease.

The changes of circulating thyroid-stimulating antibody (TSAb) in three patients with Graves' disease with relapsed hyperthyroidism after delivery were examined. All three patients were in clinical remission before and during pregnancy, but hyperthyroidism, with high radioactive iodine uptake, recurred 3--5 months post partum. TSAb activity, measured serially, was not detected at the time of the postpartum relapse, although it was detectable during pregnancy and in the euthyroid state after therapy. In two cases, the titer of antithyroid microsomal antibody increased concomitantly with an increase in the free T4 index. These data suggest that TSAb may not be a pathological thyroid stimulator in patients with recurrent hyperthyroidism after delivery in Graves' disease.

Adult↗
PubMed1980

Clinical and pathological significance of sibling Graves' disease.

The clinical picture and serum antithyroid antibodies in 16 pairs of siblings with Graves' disease were compared with an age and sex matched group of 32 patients with Graves' disease who did not have a family history of any thyroid disease (control patients). There was a significant difference in frequency and mean titres of antibodies to thyroglobulin between sibling patients. (positive 76.0%) and control patients (positive 40.0 %), but not in microsomal antibodies (sibling; positive 92.0%, control; 92.0%). There were no significant differences in the mean values of 24 h 131I-thyroidal uptake, serum T3U, serum T4 and T3 concentrations before treatment between the two groups. Lymphoid follicles and degeneration of the epithelia were more often found in the thyroid glands of sibling patients than in those of the control patients, when 32 (16 sibling, 16 control) thyroid glands from the same groups in the clinical study, including antibody series, were examined pathologically after subtotal thyroidectomy for Graves' disease. Moreover, there was a strong tendency to increased lymphocyte and plasma cell infiltration in the thyroid glands of sibling patients with Grave's disease. The findings might indicate that Graves' disease is closely related to Hashimoto's thyroiditis, especially in sibling patients with Graves' disease.

Adult↗
PubMed1980

Thionamide therapy in Graves' disease: relation of relapse rate to duration of therapy.

The present study was undertaken to investigate whether there is a rational basis for the usual long periods of thionamide therapy in patients with hyperthyroid Graves' disease. Eighty untreated patients were given the minimum dose of thionamide drug needed to maintain serum thyroxine, triiodothyronine, and thyrotropin (TSH) concentrations within their normal ranges. Thyrotropin-releasing hormone (TRH) tests were done at 6 monthly intervals for 2 years. Among patients who had positive responses of TSH to TRH, approximately 10 patients every 6 months were asked to stop thionamide therapy and were followed up for at least 1 year after discontinuation of drugs. In the groups treated for 6, 12, 18, and 24 months, relapses occurred in nine of 13, five of nine, three of 12, and two of 11 patients, respectively. Values for thyroid function tests before and at the end of treatment were not different among these four groups of patients. The overall remission rates were not ascertained. However, a minimum of 1 year's treatment is recommended, at least in Japan.

Adolescent↗
PubMed1979

Internal fistula as a route of infection in acute suppurative thyroiditis.

Seven cases of acute suppurative thyroiditis are described. Six patients had a recurrent painful swelling of the left anterior neck and one was seen at her first episode of the disease. A barium meal revealed a fistula originating from the apex of the left pyriform sinus in all cases. The fistula, a remnant of the fourth pharyngeal pouch, thus seems to be a common route of infection in acute suppurative thyroiditis, allowing bacterial infection to begin in the perithyroidal space and spread to the thyroid gland. Complete extirpation of the fistula is required for a permanent cure.

Acute Disease↗
PubMed1979

Plasma dopamine-beta-hydroxylase activity and thyroid suppressibility in Graves' disease.

Plasma dopamine-beta-hydroxylase (DBH) activity, serum T4, T3, T3U, and the 24-hr thyroid uptake before triiodothyronine suppression testing were studied in 34 patients with treated Graves' disease. Although all of them were in the euthyroid state, there was a statistically significant difference in presuppression plasma DBH activity between those patients who showed suppression of their RAI uptake with triidothyronine and those who did not. This suggests a relationship between plasma DBH activity and thyroid suppressibility.

Dopamine beta-Hydroxylase↗
PubMed1978

[Changes in serum thyrotropin, thyroxine and triiodothyronine after complete thyroidectomy (author's transl)].

Changes in serum TSH, T4 and T3 concentrations after complete thyroidectomy were observed for 4 weeks in 9 euthyroid patients with thyroid carcinoma. Completeness of the thyroidectomy was confirmed by a 131 I scintigram performed one or two months after the operation. Serum TSH levels rose progressively during the 4 weeks of observation, and a significant increase was noticed as early as 3 days after the thyroidectomy. Serum T4 and T3 concentrations decreased significantly 3 days and 18 hrs, respectively, after the thyroidectomy. A sharp decrease in serum T3 concentrations within 18 hrs without a significant change in serum T4 levels and possibly without a significant change in the amount of T3 derived from T4 suggests that the amount of T3 secreted from the thyroid is large enough to affect serum T3 concentrations. The rate of decrease of serum T4 (t 1/2: 16 days) or serum T3 (t 1/2: 23 days) after the 3rd day of the thyroidectomy was much slower than the rate of disappearance of labeled T4 or T3 reported previously. The slow decrease rate of serum T3 is probably due to the conversion of T4 to T3 in peripheral tissues, and that of serum T4 may be due to either the decrease in T4 disposal rate in hypothyroidism or due to the release of T4 from peripheral tissues to serum.

Adult↗
PubMed1978

Responses to TRH and T3 suppression tests in euthyroid subjects with a family history of Graves' disease.

The relationship of Graves' disease and heredity was studied in 97 clinically and biochemically euthyroid relatives (resin T3 uptake and serum T3, T4, and TSH within normal ranges) who had more than two thyrotoxic relatives within the second degree relationship. TRH tests were preformed in all 97 cases. In 56 of the 97, T3 suppression tests were performed shortly after the TRH test. Results revealed that 29 of the 97 (29.9%) showed an abnormal response to TRH. fourteen of these (14.4%) revealed no response or a hyporesponse, and 15 (15.5%) revealed a hyperresponse to TRH. Four of 56 (7.1%) were T3 nonsuppressible. Seven individuals who showed no response or a hyporesponse to TRH consisted of 2 nonsuppressible and 5 suppressible subjects. In 14 non- or hyporesponsive cases, serum T3 (1.51 +/- 0.05 ng/ml; mean +/- SE) and T4 (9.91 +/- 0.31 micrograms/dl) were significantly higher compared with those of normal responders (1.30 +/- 0.04 ng/ml, 8.57 +/- 0.21 micrograms/dl; P less than 0.001) or hyperresponders (1.16 +/- 0.06 ng/ml, 7.77 +/- 0.63 micrograms/dl; P less than 0.01). There was no correlation between TRH responsiveness and T3 suppressibility. A relatively high occurrence of thyroglobulin and microsomal antibodies was observed, further suggesting a hereditary predisposition. The findings indicate that even in euthyroid relatives with a family history of Graves' disease who have no clinical or biochemical abnormalities of thyroid dysfunction, many have abnormalities in TRH responsiveness, T3 suppressibility, and thyroidal antibodies.

Adolescent↗
PubMedDate not supplied

Treatment of 37 patients with anaplastic carcinoma of the thyroid.

BACKGROUND: Most patients with anaplastic carcinoma of the thyroid die within several months of diagnosis, and aggressive treatment is uncommon. We evaluated the effect of active multimodal treatment (surgery, radiotherapy, and chemotherapy) on this disease, including one patient treated with autologous bone marrow transplantation and high-dose chemotherapy. METHODS: The outcome was assessed in 37 patients with anaplastic thyroid carcinoma treated between 1971 and 1993. Patients without distant metastasis when initially seen underwent surgery followed by radiotherapy. From 1984, conventional radiotherapy was replaced by hyperfractionated radiotherapy. RESULTS: All but three patients died within 1 year of diagnosis. Patients with primary lesions less than 5 cm in diameter who had complete resection and radiotherapy survived significantly longer than the other patients, and hyperfractionated radiotherapy was effective for local control. CONCLUSION: Active multimodal therapy is indicated for early-stage anaplastic carcinoma of the thyroid.

Adult↗
PubMedDate not supplied

Fate of untreated benign thyroid nodules: results of long-term follow-up.

The fate of benign thyroid nodules has been unknown because there has been no study in this regard. We re-examined 134 patients with thyroid nodules who had had benign aspiration biopsy cytology 9 to 11 years ago. The thyroid gland was palpated by the same two thyroidologists throughout the study. Ultrasonography, fine-needle aspiration biopsy (FNAB), and ultrasound-guided FNAB were employed to examine the nature of nodules of 9 to 11 years' duration. Patients (n = 61) who had nodules difficult to palpate (small nodules), multiple nodules, or cystic nodules with papillomatous proliferation underwent ultrasound-guided FNAB; patients (n = 55) having a distinctly palpable single nodule underwent usual FNAB. None of the patients received any medical or surgical treatment. There were 86 single nodules, 14 multiple nodules, and 34 cystic nodules on the first examination. These benign nodules were reexamined for changes in size and cytology 9 to 11 years later. The most striking finding was a decrease in size or disappearance of the nodule in 42% to 79% of benign nodules. About 92% of nodules remained benign without changing cytologic classification. Only one case (0.9%) previously regarded as benign turned out to be malignant; this nodule grew in size compared with the previous examination. Among single and multiple nodules, 21% to 23% of the nodules increased in size; however, most patients with enlarged nodules (86%) showed the same class 2 cytology as before. Our present study indicates that biopsy-proved benign thyroid nodules remain benign over a prolonged period. Thus no medical or surgical treatment is required so long as the nodules do not grow.

Adult↗
PubMedDate not supplied

Piriform sinus fistula: an underlying abnormality common in patients with acute suppurative thyroiditis.

We have previously reported that an internal fistula (piriform sinus fistula) was the apparent route of infection in 15 patients with acute suppurative thyroiditis (AST). Here, we describe 43 patients with AST, most of whom had a demonstrable fistula. The characteristic clinical features included: onset in infancy or childhood in 74% of cases, a left-sided predominance of involvement (40:3), and frequent recurrence. Twenty-nine patients had had several previous episodes of AST. The fistula was demonstrable in 38 of 42 patients examined by barium meal. Twenty-seven patients underwent fistulectomy. Six of 16 patients who declined fistulectomy had recurrences and 2 of them underwent surgery thereafter. None of 29 patients who had fistulectomy developed recurrences, except for 2 patients in whom the fistula could not be removed completely. The fistula ended medial or lateral to the thyroid lobe, attached to or entered the lobe in 6, 3, 6, and 12 cases, respectively. The thyroid specimens showed several features of inflammatory change. Thus, we concluded that the piriform sinus fistula is the most common underlying abnormality in patients with AST. Recurrence of inflammation can be prevented by complete fistulectomy.

Acute Disease↗
PubMedDate not supplied

Outcome of long standing solitary thyroid nodules.

We investigated the outcome of long standing palpable solitary thyroid nodules by surveying 441 patients and examining 140 patients who had untreated thyroid nodules for 15 +/- 4.5 years. In our clinical survey, the most common outcome was disappearance of the thyroid nodule (38.3%). Also a significant number of patients (36.3%) underwent surgery in other hospitals. Five (1.1%) patients died of thyroid cancer. When thyroid nodules were re-examined, most nodules indeed decreased in size or disappeared; however, 13% of nodules increased in size. Ultrasound of the nodules showed that most solitary nodules were multiple and partially cystic and solid. There was an increased incidence of calcification in long standing nodules. Thyroid cancer was found by fine needle aspiration biopsy in 26.3% of enlarging nodules and 6.4% of nodules without changing size. The risk of cancer decreased when the size of the nodule decreased. A total of 15 patients with suspicion of malignancy underwent surgery. Surgical procedures were lobectomy, near total thyroidectomy, or resection of nodules with or without modified neck dissection. Seven patients had papillary carcinoma and 2 patients with benign cytology had microscopically evident papillary carcinoma. In our study, the majority of palpable solitary thyroid nodules tended to decrease in size; these nodules do not require treatment. Enlarging solid nodules are a definite risk for thyroid cancer. If the size of the nodule remains the same, judicious approach with fine needle aspiration biopsy is needed.

Adult↗