[Low T3 and low T3-T4 syndrome].
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Diagnosis, Differential↗
Biomedical subjects
A Flattet
Publications and source records attributed to A Flattet.
[Euthyroid sick syndrome].
The "euthyroid sick syndrome", representing the changes of thyroid hormone metabolism in disease, embraces the following hormonal changes: 1) A decrease in serum T3 levels which is often accompanied by an increase in rT3 levels. Serum T4 levels remain normal. These changes are extremely frequent in many varied diseases. 2) In very severe disease, serum T4 levels may also decrease. The free T4 index is often decreased and the free T4 may either be normal or decreased. These changes reflect alterations of thyroid hormone metabolism and can be distinguished from primary hypothyroidism by a normal serum TSH level. 3) Occasionally there are transient increases of total and free T4. This disturbance of serum thyroid hormone levels is mostly due to drug interference with thyroid hormone metabolism (amiodarone etc.). Differentiation from hyperthyroidism is difficult. It is important to diagnose the "euthyroid sick syndrome" since this will avoid erroneous diagnosis and treatment or hypo- and hyperthyroidism.
Diagnosis, Differential↗
Tomographic imaging of the human thyroid using 124I.
After receiving between 100 and 300 mu Ci of the positron-emitting radioisotope 124I (half-life, 4.2 days), 64 patients with a variety of thyroid disorders were imaged with a high resolution positron camera. A 3-dimensional image of the distribution of radioiodine uptake within the thyroid was obtained from a single 10- to 15-min scan. This image may be viewed as a sequence of 2-mm thick transverse, sagittal, or frontal sections or as a 3-dimensional shaded surface. The functional volume of the thyroid may be estimated by counting the volume elements (voxels) inside the thyroid surface. The precision of the estimate varied from 6-15%, depending on the size and clinical status of the thyroid. The volume estimation procedure was validated with phantoms and with the thyroids of patients who subsequently underwent partial thyroidectomy. This 3-dimensional imaging technique may be useful for diagnosis and management of thyroid diseases.
Adenoma↗
[Morphology of the adrenal cortex in Cushing's syndrome].
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Adenoma↗
[Morphology of the adrenal cortex in Cushing's syndrome].
Histological slides of the adrenals of 54 patients who underwent uni- or bilateral adrenalectomy for Cushing's syndrome at the Zürich University Hospital Department of urology between 1960 and 1977 were reexamined. In 29 patients (53.7%) Cushing's disease was due to diffuse bilateral adrenocortical hyperplasia, in 4 (7.4%) to micronodular cortical hyperplasia and in 3 (5.6%) to macronodular cortical hyperplasia and in 3 (5.6%) to macronodular hyperplasia. Two patients (3.7%) presented with primary bilateral nodular cortical dysplasia (so-called microadenomatosis). In 12 cases of Cushing's syndrome (22.2%) the basic lesion was a cortical adenoma and in 4 cases (7.4%) a cortical carcinoma. The histologic diagnoses corresponded well with biochemical findings, clinical diagnoses and further development of the disease. Histopathologic diagnosis of diffuse and micronodular hyperplasia presents no difficulties. Differential diagnosis of macronodular hyperplasia, cortical dysplasia, adenoma, and carcinoma may, however, be somewhat more problematic.
Adenoma↗