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Biomedical subjects

M Blichert-Toft

Publications and source records attributed to M Blichert-Toft.

At least 163 records · Page 9Linked to original sources

Serum levels of calcium and parathyroid hormone after subtotal thyroid resection for Graves' disease.

The following serum constituents were measured in 19 patients operated on for Graves' disease: calcium, protein, parathyroid hormone (PTH), alkaline phosphatase, thyroxine, triiodothyronine, free thyroxine index, and thyroid-stimulating hormone. Blood was sampled systematically on the day before and 5 days, 1 month, 2, 3, 4 and 6 months after operation. All patients were pretreated with antithyroid drugs, and 2 months before surgery levothyroxine was added. The study showed that the thyroid function was impaired for 3 months postoperatively. Serum calcium level was lowered in the same period. Serum PTH increased with decreasing serum calcium, and vice versa. The results support the theory that the transient fall in serum calcium level is due to lowered PTH sensitivity in bone tissue caused by temporary impaired thyroid function after surgery. On the other hand, a direct action of lowered thyroid hormone on bone tissue is also a possible explanation.

Adolescent↗

Serum thyroglobulin and its autoantibody following subtotal thyroid resection of Graves' disease.

Thyroid surgery leads to marked changes of the levels of serum thyroglobulin and its autoantibodies in the subsequent 3 postoperative weeks. Furthermore in Graves' disease progression of exophthalmos has sometimes been seen following thyroidectomy. Nineteen medically pretreated patients with Graves' disease and no signs of exophthalmos were studied systematically up to 6 months postoperatively. Nine patients had thyroglobulin antibodies. Mean values rose to 3.5 times pretreatment values within 2 months (P less than 0.001) followed by a gradual fall below pretreatment level after 6 months. None of the antibody negative patients reverted to positive or vice versa. Serum thyroglobulin (n = 10) was elevated preoperatively (mean 309 micrograms/l, SD 251), their values being normalized within 1-2 months (mean 19.4 micrograms/l, SD 7.3). The preoperative serum thyroglobulin correlated to the weight of the removed thyroid tissue (r = 0.87, P less than 0.01). Three patients showed elevated thyroid stimulating hormone after 1 month. Of these, two developed myxoedema, the third remained euthyroid with persistently elevated serum thyroglobulin. None showed recurrence or developed exophthalmos within the period of observation. In spite of rising levels of thyroglobulin antibodies in all patients with antibodies none developed exophthalmos and only one patient with thyroglobulin antibodies had clinical myxoedema.

Adolescent↗

Lobular carcinoma in situ occurring in adenolipoma of the breast. Report of a case.

A case of malignant transformation in adenolipoma of the breast is presented. It is generally agreed that adenolipomas are benign lesions, but it must be kept in mind that a certain risk of malignant transformation exists due to the glandular tissue content. In order to establish the correct diagnosis high quality films and close collaboration between radiologist, breast surgeon and pathologist are important.

Adenoma↗

Phantom breast syndrome in young women after mastectomy for breast cancer. Physical, social and psychological aspects.

Phantom breast syndrome (PBS) developed in 11 out of 31 (35.5%) consecutive young women, who had undergone mastectomy for breast cancer. Six to 21 months after operation the patients were asked to take part in a follow-up investigation in which physical sequelae, social condition, and psychological reactions were assessed and related to the presence of PBS. There was no correlation between PBS and postsurgical physical sequelae, those who had received adjuvant radiotherapy, or the side on which mastectomy was performed. Socially, the group with PBS was dominated by women with an occupation outside the home. The psychological examination showed that the group with PBS had a definite predominance of women with a severely damaged body image and impaired sexual function in comparison to the group without PBS. However, the predominance did not reach a statistically significant level. Sexual identity, anxiety, affective disorder or changes in close family relationships did not reveal any distinct pattern. In our opinion, the appearance of PBS should be seen in relation to complex psychological reactions to the mastectomy.

Adult↗

Serum prolactin and oestradiol levels in women with cyclical mastalgia.

Basal serum prolactin and serum oestradiol-17-beta concentrations were measured four times during one menstrual cycle in 20 women with severe cyclical mastalgia and normal to slightly fibroadenotic breasts. A group of 10 normal women who had never experienced mastalgia served as controls. Basal serum prolactin was significantly elevated in patients compared to normals, although within the normal range. Serum oestradiol concentrations did not differ in the two groups and were also within the normal range. A significant positive correlation between oestradiol and prolactin was found in patients and normals, but with larger prolactin levels in patients. The results point towards a prolactin secretory hypersensitivity for oestradiol in patients with cyclical mastalgia. Prolactin is considered a central factor in the eliciting of cyclical mastalgia.

Adult↗

Cortisol, glucose, and hemodynamic responses to surgery after naloxone administration.

The adrenocortical, hyperglycemic, and hemodynamic responses to cholecystectomy or vagotomy were studied in 16 patients under halothane and N2O/O2 anesthesia. The patients were randomly divided into two groups: eight patients received naloxone in doses used clinically (2.5 microgram/kg i.v.) just before induction of anesthesia, while eight subjects received placebo. The results showed insignificant differences in plasma concentrations of cortisol and glucose between groups. Nor did blood pressure, heart rates, and inspired halothane concentrations differ significantly between groups. Thus, inhibition of opiate receptors and endorphins by naloxone in an otherwise clinically effective dosage does not influence the adrenocortical, hyperglycemic, or hemodynamic responses to surgical stress. We therefore conclude from our data that opiate receptors and endorphins are not involved in the initial phase of the endocrine-metabolic responses to surgery nor are they part of the neural mechanisms mediating stress-induced analgesia.

Adolescent↗

Mammography directed wire marking of nonpalpable breast lesions. A consecutive biopsy study of 100 patients.

Among 665 patients referred for breast complaints, 100 women (15%) had mammographically detected nonpalpable lesions suspected of malignancy. Using a mammography directed hook wire marking, 115 excisional biopsies were carried out. A correct biopsy containing the lesion was obtained in 113 instances. There were 2 failures, due to displacements of the wire in one case and surgical inexperience in another case. Two patients had minor wound complications. Invasive carcinoma was found in 12 and carcinoma in situ in 4 biopsies, i.e., a cancer rate of 16% of patients and 14% of biopsies. The biopsy procedure was simple, time saving, and acceptable of patients. The excisions were small and the cosmetic results excellent. During mammography for control of wire position, and during dressing and surgical manipulations the flexible hooked wire remained as originally placed in all cases but one.

Adult↗

Reliability of axillary lymph node scintiphotography in suspected carcinoma of the breast.

The ability of axillary lymph nodes to take up 99Tcm-labelled antimony sulphide colloid in suspected carcinoma of the breast was investigated in 111 consecutive patients. Eight out of 17 patients with histologically confirmed carcinoma of the breast had a low colloid uptake on the affected side, i.e. a positive scintiphoto. Eighty-two out of 94 patients with benign breast disease had an equal colloid uptake on the two sides or increased uptake on the symptomatic side, i.e. a negative scintiphoto. The reliability of the test is low and the test can neither be recommended for screening to select patients for further investigations nor as a routine examination.

Adolescent↗

30 Min ACTH stimulation test as predictor of hypothalamic-pituitary-adrenocortical function. Comparison with metyrapone test.

In 32 subjects the hypothalamic-pituitary-adrenocortical (HPA) response to metyrapone was found to correlate significantly with the adrenocortical response to exogenous ACTH. This report provides additional evidence suggesting that a 30 min exogenous ACTH stimulation test accurately predicts the integrated responsiveness of the HPA system to various stimuli.

Adolescent↗

[Mastalgia].

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Breast Diseases↗