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C P Roudebush

Publications and source records attributed to C P Roudebush.

8 recordsLinked to original sources

Changes in thyroid-stimulating immunoglobulins during antithyroid therapy.

Thyroid-stimulating immunoglobulin (TSI) activity was measured by radioreceptor assay in sera from patients with Graves' disease, Hashimoto's thyroiditis, and thyroid cancer. In untreated Graves' disease (47 cases), TSI index was significantly lower [76.7 +/- 1.4 (SE)] than the average of a normal control group (30 cases; 94.4 +/- 1.9). In untreated Hashimoto's thyroiditis (25 cases), it was also significantly lower (83.0 +/- 2.4). In patients with thyroid cancer (19 cases), there was no significant difference from normal controls. After 131I treatment, the TSI index in Graves' disease decreased during 2--4 months, then increased and reached normal levels in 1 yr. During propylthiouracil treatment, the TSI index increased and reached a normal level in 5--6 months without the decreasing phase seen after 131I treatment. Free T4 index values were gradually decreased by both treatments. There was no significant relationship between TSI index and thyroid antibodies (microsomal antibodies and thyroglobulin antibodies) in untreated Graves' disease or Hashimoto's thyroiditis. It is concluded that 1) in the sera of patients with Graves' disease and Hashimoto's thyroiditis, there are immunoglobulin Gs that can displace TSH binding to thyroid membranes; 2) these immunoglobulins Gs are different from the classic antithyroid antibodies; and 3) 131T treatment of Graves' disease may enhance TSI production during the first 1--2 months after therapy.

Adult

Natural history of radiation-associated thyroid cancer.

The clinical courses of 91 patients with radiation-associated thyroid cancer were compared with courses in a control population. Radiation-associated carcinoma appears to be a disease of younger persons, and 90% of the tumors are papillary. No anaplastic or medullary tumors were observed. Ninety percent of the tumors were larger than those found in an autopsy series that surveyed for "biologically benign" thyroid tumors. There was a higher incidence of multicentric disease, locally invasive disease, and distant metastases in the population that had had x-ray exposure. Although the population with x-ray exposure had had more aggressive treatment, more recurrences were present in patients who had had radiation therapy. The death rate was similar in both groups. Parathyroid adenoma occurred more frequently in the population that had radiation exposure than in controls and appears to be a radiation-associated illness.

Adenoma

Compensated low-dose 131I therapy of Graves' disease.

To minimize the high rate of residual thyrotoxicosis encountered in low-dose 131I therapy of Graves' disease, we have treated 62 patients with a low-dose 131I protocol that includes a compensation for thyroid size. Dose varied between 40 muCi retained/g for glands of normal size to 100 muCi/g for glands of 100 g or greater. Mean dose was 51.9 muCi/g. At 1 year after therapy, 66.1% of subjects were euthyroid, 9.7% hypothyroid, and 24.2% hyperthyroid, a significant improvement (P less than 0.01) over our previous experience using 50 muCi/g independent of gland size. Several factors, other than 131I dose, which might influence the outcome of therapy, were investigated. Initial free thyroxine index observed before therapy was found to have prognostic significance. Hypothyroidism developed only in patients having an initial free thyroxine index of 22.5 or less (about 2.5 times the upper limit of normal in our laboratory).

Adult