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Biomedical subjects

C S Hollander

Publications and source records attributed to C S Hollander.

78 records · Page 5Linked to original sources
PubMedDate not supplied

The autonomous nodule of the thyroid: correlation of patient age, nodule size and functional status.

In light of new techniques for measuring circulating thyroid hormones and for studying the thyroid gland, we present our experience with 35 patients with solitary autonomous nodules of the thyroid to define more precisely the clinical course of patients with this disorder. The patients ranged in age from 19 to 80 years and 31 of the 35 were female. Younger patients were generally euthyroid and sought attention because of a thyroid mass; virtually all older patients were hyperthyroid. Eighteen had obvious clinical features of hyperthyroidism and 5 over age 70 had apathetic hyperthyroidism; all 5 of the elderly and 13 of the 18 under age 70 had elevated thyroxine (T4) and triiodothyronine (T3) levels. Isolated elevation of T3 and elevated basal metabolic rate were observed in 5 previously untreated clinically hyperthyroid young patients. In each of these, thyroid uptake of 131-I was not suppressible with exogenous T3 and BMR was elevated in those tested. Two elderly patients, who had previously been treated for conventional hyperthyroidism with radioactive iodine, had T3 toxicosis when hypoethyroidism recurred. There was a strong positive correlation between the age of the patient, the size of the nodule and the thyroid functional state. The mean area of the nodules projected on 131-I rectilinear scan for euthyroid patients was 5.1 cm2. The mean area of the nodules in hyperthryoid subjects was significantly higher, 13.4 cm-2 in patients with T3 toxicosis and 19.3 cm-2 in subjects with conventional hyperthyroidism. Progression from a euthyroid state to hyperthyroidism was observed four patients. One of these became thyrotoxic within days after an injection of iodinated contrast medium. Spontaneous resolution of nodules occurred in two patients.

Adenoma↗
PubMedDate not supplied

Measurements of free and total serum T3 and T4 in pregnant subjects and in neonates.

Despite recent descriptions of dramatic changes in the thyroidal economy in pregnancy, the precise mechanisms of these alterations have remained obscure. Measurements of total and free triiodothyronine (T3) and thyroxine (T4) and thyroxine binding capacity (TBG) were made in 120 serum samples from 42 first trimester, 55 second trimester, and 23 third trimester pregnant women. Sixteen paired term and cord blood samples were also analyzed. Mean total serum T4 rose progressively from 9.8 in the first trimester to 11.5 mug/100 ml in the third trimester. Mean TBG capacity also increased from 38.4, first trimester, to 56.2 mug/100 ml in the third trimester. Mean total T3 concentrations were significantly elevated in all trimesters (p less than 0.02 - 0.0011) when compared to normal nonpregnant controls. Total T3, T4 and TBG levels were all significantly higher than in normal nonpregnant women in all trimesters (p less than 0.001). TSH levels remained unchanged in all three trimesters; values were 2.2, 2.0, and 2.0 muU/ml, respectively. Free T4 levels were at the lower limits (2.4, 2.5, and 2.2 ng/100 ml) and free T3 levels were below normal (0.29, 0.27, and 0.24 ng/100 ml). In addition, fetal T3 concentrations were strikingly lower in cord blood than in the maternal circulation at term. Maternal and cord free T3 and free T4 levels were not significantly different. These data underscore the need for multiple measurements of thyroid function in pregnancy and in the newborn in the evaluation of the thyroid gland activity.

Female↗
PubMedDate not supplied

Midline correction by extraction of the remaining mandibular canine: myth or reality.

Standard of practice does not always equal standard of care. When faced with a problematic situation, the dentist will either treat from experience, or else depend on what has been suggested by others. In some cases, anecdotal information may not be applicable. Recommended clinical procedures have not always been supported by adequate research. Although midline correction has been expressed as a certainty, it does not always occur. Patience on the part of the practitioner will allow the child to be observed periodically, and at the same time allow the dentition to develop naturally. Orthodontic treatment can always be used, once the permanent canines erupt.

Adolescent↗