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Biomedical subjects

J C Sisson

Publications and source records attributed to J C Sisson.

At least 145 records · Page 8Linked to original sources
PubMed1977

Dilemmas in the early diagnosis and treatment of multiple endocrine adenomatosis, type II.

Fifteen patients with the diagnosis of multiple endocrine adenomatosis, type II, syndrome (MEA II) were reported from a single center to discuss the dilemmas of early detection and treatment of the adrenal medullary, thyroid, and parathyroid gland diseases. Ten patients came from three families. Three of the patients died, none in hypertensive crisis. Bilateral adrenal medullary disease was present in six patients. Five patients with proved pheochromocytoma had hypertension. All had diagnostic urinary catecholamine values. Nine normotensive patients without proved pheochromocytoma but in a high-risk category for adrenal medullary disease, have multiple suspicious urinary cathecholamines suggestive of adrenal medullary hyperplasia. Bilateral adrenalectomy is recommended for proved adrenal medullary disease in the MEA II syndrome. Medullary carcinoma of the thyroid gland was found in 13 patients and is believed to be present in two others. Five of the proved cases were occult, being discovered by elevation of pentagastrin-stimulated serum calcitonin levels, justifying total thyroidectomy. Parathyroid hyperplasia was found in three patients with preoperative hypercalcemia and in four others with preoperative normocalcemia. Conservative treatment of parathyroid gland hyperplasia in the MEA II syndrome is substantiated. Metachronous phenotypic expression of the syndrome components was significant.

Adolescent↗
PubMed1976

Clinical decision analysis. The hazard of using additional data.

Acquisition of laboratory data bearing on a clinical problem may make patient care worse rather than better. The hazards of obtaining new information, that go beyond the monetary costs and risks to physical well-being, are frequently not appreciated by physicians. In the complex and many-faceted practice of medicine, intuition, even when expressed by experienced clinicians, may lead to faulty judgments. Decision analysis gives a systematic exposition of clinical management, and lessens, if not eliminates, the influence of biased and unreliable intuition. With practice, most physicians could employ decision analysis to help solve moderately complicated problems at the bedside or in the office. Use of this tactic will make gaps in knowledge explicit, and may thereby stimulate investigations to ensure better clinical judgments in the future.

Clinical Laboratory Techniques↗
PubMed1976

Ectopic thyroid tissue in the neck. Benign or malignant?

This is a report of ectopic thyroid tissue in the neck, associated with a nodular colloid goiter, which recurred at least three times, beginning at age 24 years, in a woman in 12 years. The ectopic tissue appeared histologically benign and was identical to that found in the thyroid gland. Scintiscans of the neck and thyroid suppression tests showed that the tissue was initially unsuppressible and presumably autonomous in its function. Our conclusion is that the most reasonable explanation for this phenomenon is the intraoperative transmission of thyroid cells, probably benign and autonomous in function, to other sites in the neck.

Adult↗
PubMed1976

99mTc-pyrophosphate scan and radiographic correlation in thyroid acropachy: case report.

A case of thyroid acropachy secondary to Graves' disease is described. Radiographic abnormalities were found to correlate with those in a 99mTc-pyrophosphate bone scan. Abnormal tracer concentrations were observed in the diaphyses of the metacarpals and phalanges of both hands and also in regions of pretibial myxedema. The differential diagnosis of the scan abnormalities is discussed.

Adult↗
PubMed1976

Simplified radioimmunoassay for triiodothyronine: evaluation of a new commercial kit.

A new triiodothyronine (T3) radioimmunoassay kit offers simplicity of method, short incubation time, specificity, and reproducibility. 125I-labeled T3 and unknown serum (or standard) are added to alkaline buffered (pH 12.4) Sephadex G-25 columns; the T3 is freed of proteins with an alkaline buffer wash, antiserum is added, and the columns are incubated at room temperature for 2 h. "Free" hormone (i.e., unbound to antiserum) remains on the column after a second wash. The radioactivity on the column is counted and related to the total activity added. The T3 standards produced a straight line on log-logit plot; reactivity of analytical-grade thyroxine was 0.6% on weight basis; and the analytical recovery of T3 added to a T3-free serum was complete. Euthroid, hyperthyroid, and hypothyroid ranges were 0.74-2.64, 2.91-7.52, and 0-1.21 mug/liter, respectively. These values correlated well with both the clinical status of patients and with values obtained by an established radioimmunoassay method. The procedure is simply done; results may be obtained in less than 4 h.

Cross Reactions↗
PubMed1975

Orbital radiation for the ocular changes of Gravess' disease.

We reviewed the records of 37 patients who received orbital radiation for ocular changes of Graves' disease. Signs of orbital congestion improved in many patients. Proptosis extraocular muscle involvement, and corneal involvement were not appreciably altered. The best response was found in patients with optic nerve involvement. Radiation therapy is recommended as an initial therapeutic attack for the optic neuropathy of Graves' disease.

Eye Diseases↗
PubMed1975

Intralesional triamcinolone therapy for pretibial myxedema.

In a prospective study, nine patients with pretibial myxedema were treated with intralesional injections of triamcinolone acetonide. Complete resolution of the myxedematous plaques was obtained in seven of the nine patients. The other two patients failed to complete their treatment programs but did show partial resolution. For most patients the monthly injection of 8 ml or less of a solution containing 5 mg/ml of triamcinolone proved to be the most effective dosage schedule. No serious side effects were encountered. New nodules of myxedema developed in some patients after the initial completion of therapy; these nodules responded to reinjection using the same dosage schedule.

Adult↗