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Biomedical subjects

D S Cooper

Publications and source records attributed to D S Cooper.

At least 19 recordsLinked to original sources
PubMed1992

Autoimmune thyroid disease, left-handedness, and developmental dyslexia.

Autoimmune thyroid disease (ATD) (Graves' disease and Hashimoto's thyroiditis) has been one of a number of autoimmune diseases possibly associated with left-handedness, mixed dominance, and learning disability. In the present study, 74 men with ATD were compared to 24 control men with non-ATD. An increased frequency of mixed dominance and traits suggestive of dyslexia were observed in the patients with ATD. These data are consistent with a link between the development of ATD and cerebral dominance.

Adult↗
PubMed1992

Stable internal fixation of fractures of the partially mineralized thyroid cartilage.

Thyroid cartilage fractures due to external blunt trauma have typically been thought to occur in patients over the age of 40. Lack of mineralization of the cartilage has been considered to be the protective mechanism. Our experience with laryngeal injuries has demonstrated that younger persons are indeed at risk for thyroid cartilage fractures, and that these injuries may be easily overlooked. Although these fractures do not lead to laryngeal stenosis if untreated, they may cause noticeable phonatory changes. Fixation of these fractures is difficult because of the usual soft character of the unmineralized cartilage, prompting us to adopt a wire-tube fixation technique. This technique has been uniformly successful in restoring the anatomic contour of the thyroid cartilage, and our results appear to justify open reduction of these moderately displaced or angulated thyroid cartilage fractures.

Adolescent↗
PubMed1991

Autoantibody tests in autoimmune thyroid disease: a case-control study.

Both positive antinuclear antibody (ANA) and anti-DNA antibodies have been reported in patients with autoimmune thyroid disease. We sought to determine the frequency of ANA and other autoantibodies in autoimmune thyroid disease versus control subjects. We measured ANA by 2 methods (mouse liver, HEp-2), anti-dsDNA, anti-Ro, anti-La, anti-Sm, anti-RNP, and anticardiolipin in 26 patients with Hashimoto's thyroiditis, 26 patients with Graves' disease, and 26 control patients. Positive ANA by either method were more common in patients with Graves' disease than in controls (p = 0.002 and 0.05). Although common (46.2%), ANA by HEp-2 method was not found significantly more often in patients with Hashimoto's thyroiditis than in controls. Evidence for systemic autoimmune diseases was not found: patients with autoimmune thyroid did not have autoantibodies other than ANA and did not differ from controls in rheumatologic symptoms. Positive ANA using the widely accepted HEp-2 method were commonly found in both Graves' disease and Hashimoto's thyroiditis. No evidence of subclinical systemic autoimmune disease was found, either by specific autoantibody tests or by increased frequency of rheumatologic symptoms or signs.

Adult↗
PubMed1990

Follicular and Hürthle cell carcinoma of the thyroid.

Follicular and Hürthle cell thyroid cancers account for about one fifth of thyroid cancers in the United States. Diagnosis can be difficult, despite the use of fine needle biopsy, and surgery is often necessary to make a definitive diagnosis. Total thyroidectomy is the treatment of choice, and in the case of follicular cancer, radioiodine ablation is usually performed. Distant metastatic disease can also be treated with radioiodine. For Hürthle cell tumors, radioiodine therapy is unlikely to be beneficial.

Adenocarcinoma↗
PubMed1990

Fatigue resistance of canine vocal fold muscle.

The objective of the experiment was to provide data from dogs, the best nonprimate model for the contractile properties of laryngeal muscles, on the fatigue characteristics of vocal fold muscle. Isometric muscle force was recorded from a transducer attached to the section of the thyroid cartilage on which the muscle inserted. Twitch contractions were recorded during supramaximal indirect electrical stimulation by DC pulses for at least 30 minutes. At 5 pulses per second (p/s), potentiation was observed in all records, peaking at an average of 7.5 minutes after stimulation onset. At 10 p/s, the peak of the potentiated average trace was earlier. One third of these records did not show potentiation. Where moderate or large potentiation was observed, the peak twitch tension declined and reached an asymptote above the initial tension, while when potentiation was small or absent, the final force was smaller than initially. Canine vocal fold muscle was observed to be fatigue-resistant, but in phonation other factors may produce fatigue.

Animals↗
PubMed1989

Contractile properties of canine thyroarytenoid muscle reinnervated from the ansa cervicalis.

In an attempt to obtain data on the contractile properties of vocal fold muscle reinnervated from the ansa cervicalis, we severed the recurrent nerve and connected its distal stump to the ansa cervicalis by an end-to-end anastomosis in a series of dogs. Each dog was allowed to heal for 5 months. Then the section of the thyroid cartilage on which the vocal fold muscle inserted was detached, connected to an isometric force transducer, and activated by indirect stimulation successively on both the operated and unoperated sides. A series of twitch contractions was recorded from each side. In two dogs no contractile response was obtained. In the three others, the twitch contraction time was increased significantly, by 23% to 60%. In two of three dogs, the operated muscle was significantly weaker than the unoperated muscle. The reinnervated thyroarytenoid muscle changed its speed in the direction of the donor sternothyroid muscle.

Anastomosis, Surgical↗
PubMed1988

Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women.

A follow-up study of 1,762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1,058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6).

Adult↗
PubMed1988

Single photon emission computed tomography of the thyroid.

Single photon emission computed tomography (SPECT) entails imaging at multiple positions along an arc and computed-assisted reconstruction of transaxial, coronal, and sagittal images. To determine if SPECT imaging of the thyroid augments information provided by planar imaging, both SPECT and pinhole planar scans were performed in 52 patients with thyroid disease. After 123I (n = 45), Tc99m (n = 5), or thallium-201 (n = 2) administration, images were acquired at 30 intervals along a 180 degree arc. Nodules that were hypofunctioning on planar scans (n = 4) were equally well shown on SPECT images. SPECT analysis of 123I uptake by 5 palpable nodules with completely normal 123I planar scans demonstrated the nodular tracer uptake was increased (n = 1), equivalent (n = 3), or decreased (n = 1) in comparison with that of extranodular tissue. In 6 of 12 multinodular goiters, transaxial SPECT images showed tracheal compression, which was confirmed by neck x-ray, flow volume loops, or surgery. A neck phantom study was performed to assess the accuracy of SPECT-determined functional thyroid volume. SPECT-estimated volumes (30-173 mL; n = 11) correlated well with true volumes (r = 0.996; P less than 0.001). Our observations suggest that SPECT is a useful adjunct to planar imaging in 1) estimating functional volume for 131I dosimetry; 2) evaluating the size, extension, and tracheal compression of multinodular goiter; and 3) determining the functional properties of palpable nodules with normal 123I planar pinhole images.

Goiter↗
PubMed1988

Psammoma bodies in fine needle aspiration biopsies of benign thyroid nodules.

The presence of psammoma bodies in a pathologic specimen or fine needle aspiration is highly suggestive of papillary carcinoma of the thyroid. We report three patients with pathologically benign hyperplastic thyroid nodules, all of whom had thyroid surgery because of the finding of psammoma bodies on fine needle aspiration biopsy. These data indicate that psammoma bodies are not pathognomonic of papillary cancer, and that their presence, in the absence of other cytologic criteria for malignancy, should not necessarily lead to immediate surgical exploration. If surgery is carried out, the approach should be limited and conservative, given the reduced likelihood of malignancy.

Biopsy, Needle↗
PubMed1987

Antithyroid drugs: to breast-feed or not to breast-feed.

Historically, women taking antithyroid drugs generally have not been permitted to breast-feed. However, recent studies suggest that infants exposed to the small amounts of antithyroid drugs in breast milk experience no change in thyroid function. Propylthiouracil is the drug of choice in this situation, since it does not cross membranes readily, and milk concentrations are therefore quite low. However, methimazole in low dosages might be used if the infant's thyroid status was monitored at frequent intervals.

Antithyroid Agents↗
PubMed1987

Rat thyroid peroxidase (TPO) biosynthesis in vitro: studies using antiserum to porcine TPO.

Using partially purified trypsin-solubilized porcine thyroid peroxidase (TPO), an antiserum was developed which inhibited enzyme activity in vitro, and which cross-reacted with partially purified rat TPO. Using rat thyroid minces, this antiserum was utilized to detect radiolabeled TPO in vitro. Newly synthesized rat TPO was observed in the presence of TSH (10 mU/ml), an effect which was completely blocked by co-incubation with cycloheximide. TPO biosynthesis was detected within 6 h of incubation, consistent within a rapid effect of TSH on thyroidal protein biosynthesis.

Animals↗
PubMed1987

Pharmacology of propylthiouracil in thyrotoxicosis and chronic renal failure.

The simultaneous occurrence of thyrotoxicosis and renal failure has rarely been reported in the literature, and data concerning appropriate antithyroid drug management in this circumstance are limited. We studied propylthiouracil pharmacokinetics in one such patient basally and while the patient was receiving hemodialysis. On a day when the patient was not receiving hemodialysis, propylthiouracil serum levels were high, but serum propylthiouracil half-life was not prolonged. During hemodialysis, serum propylthiouracil levels were normal, and the time to peak serum levels was delayed; the disappearance of the drug from the serum was normal after hemodialysis was completed. The amount of propylthiouracil that appeared in the dialysate was approximately 5% of the administered dose. These data suggest that propylthiouracil can be administered in standard dosages to patients with thyrotoxicosis and renal failure.

Adult↗
PubMed1986

Which anti-thyroid drug?

Anti-thyroid drugs are widely used to treat diffuse toxic goiter (Graves' disease). Of the two drugs currently available in the United States, propylthiouracil is prescribed far more often than is methimazole (Tapazole). However, compared with propylthiouracil, methimazole can be given as a single daily dose, is cheaper, and, at low doses, is associated with less major toxicity; for these reasons, methimazole should be used for the routine management of Graves' disease when anti-thyroid drugs are selected as primary therapy. On the other hand, because of certain pharmacologic factors, propylthiouracil should be used in selected situations, particularly in patients with "thyroid storm" and in pregnant or lactating women.

Drug Administration Schedule↗
PubMed1986

Pharmacology of propylthiouracil (PTU) in pregnant hyperthyroid women: correlation of maternal PTU concentrations with cord serum thyroid function tests.

Previous studies have characterized the pharmacology of propylthiouracil (PTU) in normal and hyperthyroid subjects, but there is little information available regarding PTU pharmacokinetics in pregnant hyperthyroid women. We investigated the serum PTU response to an oral dose of PTU in six hyperthyroid pregnant women both ante- and postpartum. The serum PTU profile during the third trimester of pregnancy was qualitatively similar to that in nonpregnant subjects, but serum PTU concentrations were consistently lower in the late third trimester compared with postpartum values. Cord serum PTU concentrations were consistently higher than simultaneously obtained maternal serum PTU concentrations, suggesting slower PTU clearance in the fetus. There was a significant inverse correlation (r = -0.92; P = 0.026) between the maternal serum PTU area under the curve in the third trimester and the cord serum free T4 index.

Adult↗