[Indirect exploration for localization of parathyroid tumors].
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Biomedical subjects
Publications and source records attributed to D Stoenescu.
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Digito-palmar dermatoglyphics in 93 subjects with thyroid cancer (34 males, 59 females) of which 87.1% had folliculo-papillar adenocarcinoma were studied qualitatively and quantitatively. The findings were compared to the dermatoglyphics of 100 males and 100 females from the clinically healthy autochthonous population. The thyroid cancer subjects had a lower total digital ridge count (TDRC) and a reduced number of papillar ridges between the a-d triradii, than the control subjects. The A line showed a more marked transversality in cancer males and a more marked obliquity in cancer females. Qualitative examination showed more patterns in the second interdigital area and a higher incidence of typical and atypical form of sulcus transversus in the cancer group as against the controls. Qualitative and quantitative variations in dermatoglyphics were found with respect to the relation between the anatomo-pathologic form and the A, B, or O blood group. However, this variation is not conclusive enough to support the hypothesis of an association between dermatoglyphics and the blood groups in the A, B, O system on the one hand, and dermatoglyphics and the anatomo-pathologic form of thyroid cancer, on the other.
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The authors express their opinion with respect to anatomo-clinical forms of endemic goiter. First they suggest preoperative thyroid re-equilibration to avoid postoperative complications such as hypothyroidism or recurrence. Then operative indications for endocrine goiter, especially in an endemic area are discussed. Opinions are also expressed with respect to diffuse parenchymatous (endemic) goiter, nodular and polynodular goiter together with the various forms that may have a nodular or polynodular aspect both anatomically and as localization. Extemporaneous examination is viewed by the authors as compulsory in all such goiters, whereas preoperative thyroid puncture is counterindicated. Surgical care of mixed endemic goiter (diffuse hyperplasia with nodules imbedded in the hyperplasia) is also reviewed. It is recommended that each operation be preceded by an adequate preoperative treatment, for which therapeutic schemes are indicated as well as postoperative care directions taking into account the anatomo-clinical form. The surgical approach recommended is subtotal thyroidectomy. The paper also provides some statistical figures concerning surgery in the Institute of Endocrinology in Bucharest.
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A radioimmunoassay (RIA) double antibody system for human thyroglobulin (Tgl) was developed with a sensitivity of 2.5 ng/ml T3 and T4 did not interfere in the antibody Tgl binding. The blood was collected pre-, intra- and 24 hrs post-thyroidectomy from 50 females and 4 males diagnosed as polynodular goiter, hyperthyroidism, chronic thyroiditis and thyroid cancer. The ratios of the intra- and post-operatory values versus pre-operatory values were calculated. The basal values in the patients having thyroid troubles varied within very large limits (two orders of magnitude) and these values could not be clearly correlated to the thyroid pathology, However, in untreated hyperthyroid patients the basal values exceeded 100 ng/ml, while in medullary carcinoma they were near the sensitivity limit of the technique. The intra-operatory values varied within the percentual area (thyroid carcinoma), multiplicative area (polynodular goiter and some cases of hyperthyroidism) and the order of magnitude area (hyperthyroid patients and some of the polynodular goiters). The value of the RIA measurement of the Tgl in the serum as an adjuvant in the post-treatment follow up of thyroid patients is discussed.