Biomedical subjects

S Lennquist

Publications and source records attributed to S Lennquist.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Surgery for hyperthyroidism: hemithyroidectomy plus contralateral resection or bilateral resection? A prospective randomized study of postoperative complications and long-term results.

Fifty consecutive patients undergoing surgical treatment for hyperthyroidism were randomized to have either bilateral subtotal resection (n = 23) or hemithyroidectomy plus contralateral resection (n = 27). No significant differences in operating time or intra-operative bleeding were found. No postoperative bleeding and no temporary or persistent recurrent laryngeal nerve paralysis occurred. Four patients who underwent bilateral resection and 2 patients who had hemithyroidectomy resection needed temporary calcium supplementation, and the serum calcium concentrations were slightly lower during the first few postoperative days in the patient undergoing hemithyroidectomy/resection. No persistent hypocalcemia occurred in either of the groups. At follow-up 3-4 years (mean 3.6 years) postoperatively, 1 patient in the bilateral resection group developed recurrent hyperthyroidism; no patients in the hemithyroidectomy/resection group developed recurrent hyperthyroidism. Twelve (44%) patients in the hemithyroidectomy/resection group and 8 (35%) patients in the bilateral resection group needed thyroxine supplementation because of a rise in thyroid stimulating hormone concentration combined with clinical signs of hypothyroidism that developed during follow-up. Hyperthyroidism can be treated by hemithyroidectomy plus contralateral resection without increasing the risk of complications. The results also suggest that when using this method, a slightly larger thyroid remnant should be left to avoid an increase in the incidence of hypothyroidism postoperatively.

Adult↗

PubMedDate not supplied

Relationships between thyroid hormone and catecholamines in experimental trauma.

The relationship between thyroid hormones (T4 and T3) and the catecholamines (adrenaline and noradrenaline) was studied as regards the possible value of administered T3 in the treatment of severely injured patients. Preparative surgery was performed on 36 pigs, 26 of which were then submitted to a standardized high-energy missile trauma to a hind leg. In 14 of the latter group, infusion of T3 was begun immediately before the trauma (n = 6), or after a delay of 8 h (n = 4) or 24 h (n = 4). A correlation was found between the disappearance rate of T3 and T4 and the catecholamine release, r = 0.79 (p less than 0.001) for adrenaline and 0.64 (p less than 0.01) for noradrenaline. T3 infusion started immediately before high-energy trauma resulted in raised serum levels of catecholamines, mainly noradrenaline, and was associated with a high mortality (4/6), and a clinical picture resembling thyrotoxic crisis. At 8 h the catecholamine-response to T3 administration was blunted and at 24 h post-trauma no influence on catecholamine levels could be determined. The high correlation between adrenaline release and disappearance rates of T3 and T4 after trauma suggests that adrenaline may in some way be connected to the fall in serum T3 and T4 concentrations following major trauma. The results further accord with the suggested role of T3 as a false neurotransmitter. Administration of T3 in the initial phase of the "low T3 state", presumably would not be of benefit for the severely injured patient.

Animals↗

PubMedDate not supplied

Effects of portal glucose infusion on thyroid hormone concentrations in serum after high energy trauma in pigs.

The effect of portal glucose infusion on serum thyroid hormone levels was studied in five anaesthetized pigs during 48 h observation in an intensive care unit following standardized high energy trauma. At 10-18 h post-trauma, and again at 28-36 h, 100 g glucose was infused into the portal circulation via a splenic vein. In six animals, otherwise treated in the same way, the glucose infusions were given via a peripheral venous catheter. During portal glucose infusion at 28-36 h post-trauma, serum T3 rose significantly above the level in the controls. After termination of the portal glucose infusion, the serum concentration again fell. At 48 h the rT3 concentration was significantly lower in the pigs given portal glucose than in the control pigs. It was concluded that portal, but not peripheral, glucose infusion can temporarily reverse the trauma-induced change in triiodothyronine metabolism. This indicates that increase of the splanchnic, and more specifically the hepatic, glucose concentration could be important for amelioration of the low T3 state.

Animals↗