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PubMedDate not supplied

Cytologic changes simulating malignancy in thyrotoxic goiters treated with carbimazole.

The cytologic patterns in toxic goiters treated with carbimazole were studied. Most cases exhibited changes, especially the unusually large nuclei, that could be mistaken for malignancy in panoptic-stained material. Study of the nucleolar morphology by means of the toluidine blue stain, however, showed a clear difference from malignant nucleolar types, with the nucleoli displaying types as in the cells of benign euthyroid colloid goiters. No increased transcription activity was seen in the nuclei. Nucleolar staining is thus recommended to avoid diagnostic errors in these and similar atypical cases. The apparent cytostatic effect of carbimazole on thyroid cells is in accord with other reports in the literature.

Acid Phosphatase↗
PubMedDate not supplied

[Immunological characteristics of patients with diffuse toxic goiter].

Altogether 24 patients with diffuse toxic goiter were examined after surgical intervention and thiamazole therapy. In addition to clinical methods the levels of T- and B-lymphocytes, immunoregulatory cells (T-helpers and T-suppressors) and immunoglobulins of different classes were determined before and after therapy. A method of spontaneous and complementary rosette formation and monoclonal antibodies (Ortho) were used for the determination of the content of T- and B-lymphocytes. Immunoglobulins were determined by a method of radial immunodiffusion in gel. It was shown that in patients with diffuse toxic goiter the level of T-lymphocytes was significantly on a decrease, the levels of B-lymphocytes and IgG were on an increase before therapy. There was sharp disturbance in the ratio of immunoregulatory cells--T-helpers and T-suppressors. After therapy the clinical picture and immunological indices in 14 patients returned to normal, in the rest of 10 patients the Ig level and ratio of immunoregulatory cells remained disturbed.

Adolescent↗
PubMed1987

[Radioimmunological and immunological follow-up of toxic goiter remission following radiotherapy and thyroidectomy].

The paper is concerned with a multimodality approach to the assessment of clinical remission in 42 patients after radical therapy of toxic goiter. T4, T3, sigma TSH, delta TSH were determined in the thyrotropin releasing hormone stimulation test (TRH-test); some immunological indices (RFCc, RFCn, RFC1, a stimulation index [SI] LBTR, a migration index [MI] in the LMIT and serum immunoglobulins) were also investigated. The abnormal TRH-test was revealed in 2/3 of the patients (the hypo-TRH-test in 10 and the hyper-TRH-test in 11). A conclusion was made of the appropriateness of the multimodality approach to the assessment of toxic goiter remission after therapy.

Adult↗
PubMedDate not supplied

[Thyroid-stimulating autoantibodies in the blood of patients with diffuse toxic goiter].

The level of thyrostimulating autoantibodies (TSA) in IgG fraction isolated from the blood serum by precipitation of (NH4)2SO4 was determined in 36 patients with diffuse toxic goiter (DTG) and in 8 healthy donors. TCA which were assessed by a rise of the level of cAMP in human thyroid sections (obtained at operation from extranodal tissue of patients with nodal euthyroid goiter) after 2 h-incubation at 37 degrees C with IgG, were determined in 32 DTG patients (89%). The patients were divided into 2 groups with respect to their clinical and thyroid status: with a high and normal or subnormal content of the blood thyroid hormones. In the 1st group the frequency of detection (96%) and the level of TSA (570.64 +/- 109.63%) were much higher than in the 2nd group of patients (70 and 186.29 +/- 23.06%, respectively). The highest levels of TSA (1085.25 +/- 551.27%) were found in 4 of 26 patients (the 1st group) who had not received specific therapy.

Adolescent↗
PubMedDate not supplied

[Characteristics of the endocrine function of the pancreas in diffuse toxic goiter in children].

The examination of 28 children with diffuse toxic goiter showed disturbance of glucose tolerance with a significant decrease in the level of C-peptide in the blood serum and its response to glucose. The concentration of immunoreactive insulin (IRI) and its increment under the influence of a glucose tolerance test in children was much above the normal. At the same time the molar C-peptide/IRI ratio in the patients' sera both on an empty stomach and during the glucose tolerance test showed a dramatic decrease indicating the reduction of insulin extraction by the liver as a cause of peripheral hyperinsulinemia. Distortion of the plasma immunoreactive glucagon reaction to a glucose tolerance test was observed in children with diffuse toxic goiter.

Adolescent↗
PubMedDate not supplied

[Effect of prodectin on the activity of the blood kallikrein-kinin system in diffuse toxic goiter].

Elevated activity of the blood kallikrein-kinin system with the predominance of kinin formation over inactivation was recorded in 65 patients with diffuse toxic goiter. The use of prodectin (pyridinolcarbamat), kinin antagonist, caused a decrease in the activities of the kallikrein-kinin system and improved the clinical course of the disease. The results obtained give evidence in favour of this preparation being included into the multiple modality treatment of diffuse toxic goiter.

Adolescent↗
PubMed1987

[Surgical treatment of diffuse toxic goiter associated with autoimmune thyroiditis].

An experience of the clinic with the surgical treatment of diffuse toxic goiter associated with autoimmune thyroiditis for the recent 16 years has been generalized based upon 258 observations. Long-term results followed in 73.6% of the patients show that an improved method of operation thought to be less radical gives good results. An immune depressive effect of the operation was noted. The investigation facilitates positive solution of the problem of the expediency of the surgical treatment of the complicated form of toxic goiter having indications for surgery.

Adolescent↗
PubMedDate not supplied

[Characteristics of immunological reactivity of patients with diffuse toxic goiter in relation to the duration of the disease].

A study was made of the time course of the indices of the cellular and humoral immunity in 202 patients with diffuse toxic goiter (grave and moderately grave forms of the disease) aged 17 to 50 with a period of disease from 6 mos to 25 yrs and in 30 healthy persons of the same age. A decrease in the content of T-lymphocytes in the blood in percentage and absolute quantities, an increase in the content of O-lymphocytes and serum IgM and IgG indicated profound disorders in the immunological status of patients with diffuse toxic goiter. It was mostly observed in the patients with a period of disease up to 10 yrs.

Adolescent↗
PubMed1985

[Remote results of the surgical treatment of patients with diffuse toxic goiter depending on the immunologic status].

The work presents results of the surgical treatment of patients with a toxic goiter depending on the initial status of the immune reactivity. It was shown that recurrent thyrotoxicosis or the development of hypothyreosis occurred in patients with the disturbed immune status more frequently. A conclusion is made that the immune disorders should be corrected in patients with diffuse toxic goiters during the preoperative period in order to improve results of the surgical treatment.

Adult↗
PubMed1985

[Experience using lithium carbonate in the complex treatment of diffuse toxic goiter].

A study was made of the antithyroid effect of lithium carbonate in 163 patients with diffuse toxic goiter. In addition to clinical monitoring a radioimmunoassay was used to determine the level of serum thyroxine, triiodothyronine and thyrotropin. The most important indicators of the activities of the cardiovascular system were analysed by RCG and polycardiography findings. Data on a rapid and stable antithyroid effect of lithium carbonate were obtained. With the concentration of lithium ion within 0.4-0.8 meq/l the basal level of thyroxine and triiodothyronine decreased by 40 and 35% respectively. Reducing the level of circulating thyronines in hemocirculation lithium did not cause a sharp rise of blood thyrostimulating activity. In combined application of lithium and mercasolil the thyrostatic effect of both drugs was summarized. Lithium did not block iodine accumulating function of the thyroid permitting, if necessary, its combination with iodine drugs. Possible mechanisms of the effect of lithium on the thyroid in hyperthyroidism and its role in multimodality therapy of the diffuse toxic goiter were discussed.

Adult↗
PubMedDate not supplied

[Disorders of microcirculation in diffuse toxic goiter and their correction in the early postoperative period].

A study was made of microcirculation in 45 patients suffering from diffuse toxic goiter at the early postoperative period with the aid of microphotography of the bulbar conjunctiva vessels, and investigation of the rate of the isotope elimination from the intradermal depot and the capillary permeability by V. P. Kaznacheev's method. The data obtained permitted to draw a conclusion that on admission to the clinic patients with toxic goiter were suffering from arteriolar spasm, had poor vascular pattern in the bulbar conjunctiva, the sledge phenomenon in small venules, an acceleration of the isotope elimination from the intradermal depot and an increase of the capillary permeability. Preoperative preparation improved the microcirculation indices, without completely normalizing them, however. Microcirculatory disturbances reached their maximum the first two days after the operation and declined by the 3rd-5th day. Recommendations on correction of the microcirculatory disturbances are given.

Adolescent↗
PubMedDate not supplied

[Electrolyte metabolism in toxic goiter].

The author presents the results of parallel studies of potassium, sodium and calcium in the blood plasma and the 24-hour urine of 146 patients suffering from toxic goiter of different severity (mild course in 43 patients, of moderate severity in 59, and severe in 44). Investigations were carried out before and after the treatment with thyrotoxic preparation and in some of the patients (24) after strumectomy. Before the treatment patients with mild and moderately severe forms of the disease showed a tendency to increase of potassium and calcium and a fall of sodium level in the blood. Patients with a severe course of thyrotoxicosis displayed an opposite tendency in the changes of plasma electrolyte composition--the majority of the patients showed hypokaliemia, hypocalciemia and hypernatriemia. A tendency to normalization of plasma ionic composition was noted after the treatment with thyrotoxic preparations during the euthyroid state. Sodium and calcium plasma level became normal after strumectomy; potassium content remained lowered. Correction of electrolyte metabolism should be carried out in the patients with a severe form of toxic goiter; potassium and calcium administration is recommended.

Adult↗
PubMedDate not supplied

[Study of the functional reserves of the parathyroid glands in diffuse toxic goiter and hypothyroidism].

The author studied functional reserves of the parathyroid glands in patients with diffuse toxic goiter with thyrotoxicosis and in euthyroidism, and also at various periods after subtotal resection of the thyroid gland, in patients with autoimmune thyroiditis, and with postoperative hypothyroidism. Functional reserves of the parathyroid glands proved to decrease in 15 to 54 patients with toxic goiter and in 6 of 16 patients with hypothyroidism. Surgical intervention on the thyroid gland usually led to functional parathyroid insufficiency which compensated later. Calciemia (below 8.5 mg%) 4 hours after the beginning of the test pointed to the parathyroid gland insufficiency the intensity of which could be more accurately determined by checking calcium level 12 and 24 hours after the beginning of the test.

Calcium↗
PubMedDate not supplied

[Fibrinogen degradation products, soluble fibrin and antithrombin III in toxic goiter patients].

A total of 31 patients with toxic goiter of various severity were investigated; the blood and urine content of the products of fibrinogen and fibrin degrading (PFD), of soluble fibrin, antithrombin III, fibrinogen and fibrinolytic activity were studied. There was a marked elevation of PFD content in the blood and their normal content in the urine, an increase in soluble fibrin level, and fibrinolysis activation. Hyporegulation revealed in patients with toxic goiter is apparently connected with increased fibrin degradation, and is secondary in character.

Adolescent↗
PubMed1983

[Hormonal activity and morphological changes in the thyroid gland in toxic goiter].

The Basedow's and basedowified goiter with proliferation of the follicular epithelium was revealed in 82-88% of patients with severe and mild thyreotoxicosis. These patients, as a rule, have high indices of the thyroid hormones in the blood. In patients with a light form of toxic goiter such histological changes were noted in half of the patients, proliferation of the thyroid epithelium was noted only in 25% of cases. Data of comparison of the hormonal and orphological changes in the thyroid gland were used for choosing the volume of resection of the gland. It allowed the incidence of postoperative recurrences of thyreotoxicosis to be reduced to 0,82% and of stable hypothyrosis to 0,75%.

Graves Disease↗
PubMed1982

[X-ray cardiometric indices of healthy persons and patients with diffuse toxic goiter in the alpine climate of the Tien Shan].

Roentgenometric analysis of morphological changes of the heart was made in 114 healthy individuals and 192 patients with diffuse toxic goiter living in the Tien Shan mountains. It is shown that the main dimensions of the heart and Moore's index pointing to pulmonary hypertension increase as the disease advances and is more marked in the people living in high altitudes. Diastolic and systolic volumes of the heart in patients with diffuse toxic goiter show a statistically significant increase (p less than 0.001). Increase of the stroke and minute volumes of the blood, caused by cardiac hyperfunction, is manifest already at the early stage of the disease and is directed at satisfying the enhanced demands for oxygen by tissues. Combination of high indices of stroke and minute volumes of the heart with normal heart rate or comparatively slight increase in the patients living in high altitudes of the Tien Shan is an advantageous adaptive-compensatory reaction of the body in response to the impact of internal and external factors of the mountain climate.

Adult↗
PubMed1984

[Surgical treatment of toxic goiter in diabetes mellitus patients].

Under analysis were 55 cases of toxic goiter associated with diabetes mellitus. All the patients were operated upon with good early results. A scheme for the choice of necessary preoperative dosage of insulin is recommended. The authors believe the combination of toxic goiter and diabetes mellitus to be an indication for surgery. Decompensation of diabetes mellitus in patients with thyrotoxicosis is associated with the increased amount of contrinsular hormones. The operations resulted in the improvement of the course of both diseases.

Adult↗
PubMed1984

[Use of extracorporeal hemosorption for the preoperative preparation of toxic goiter patients].

The method of extracorporal hemosorption was used by the authors first in the clinical practice for the preoperative preparation of patients with thyrotoxicosis. Oxygenated SKN carbons were used as sorbents. The hemosorption was used in 16 patients with thyrotoxic goiter by the method developed in the clinic. The authors make a conclusion that hemosorption is an expedient method for the preoperative preparation of patients with a toxic goiter.

Female↗