Follicular thyroid carcinoma in Denmark 1943-1968.
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Biomedical subjects
Publications and source records attributed to F Lindahl.
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The material presented dates from a nationwide Cancer Registry, and covers all cases of papillary thyroid carcinoma (T.C.) diagnosed in Denmark from 1943 to 1968, including those based on postmortem examinations. Direct comparison with clinical data from hospitals elsewhere will therefore tend to show less favorable results. In general, Danish cases show a higher average age than those from American hospitals. For the younger age groups this may to some extent be explained by the fact that therapeutic x-irradiation of the thymus during childhood has never been practiced in Denmark. However, the later occurrence in life of Danish cases and the less favorable prognosis might suggest a failure to realize the malignant character of the lesion in the earlier part of its course, and a variable experience on the part of the surgeons and the variety of institutions from which the material was collected. The age-adjusted incidence rate, the mortality, and complications are discussed. It is concluded that the prognosis may be improved considerably by more extensive operations on the thyroid gland, avoiding complications such as paralysis of the recurrent laryngeal nerve and tetany. The surgical efforts should be supplemented with suppression of the TSH production. In the present retrospective study it was not possible to report 20- and 30-year survival rates. This is a task for the future, as is the planning of prospective studies which, in the case of a disease as rare as papillary T.C., should be established on an international basis.
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On the basis of nation-wide Danish data on 1691 cases of thyroid carcinoma during the years 1943-1968, the author reports on 416 cases of papillary thyroid carcinoma reported to the Danish Cancer Registry. Diagnosis was made prior to surgery in about 40% of the cases, in accordance with previous experience. Papillary thyroid carcinoma tends to be less frequent in Denmark than elsewhere, contrary to the assumption of an increased occurrence in areas where goitre is not endemic. For thyroid carcinoma age-adjusted male incidence rates are lowest in Denmark and Great Britain, while female rates for Denmark are second lowest, being lower only in Great Britain. On the other hand, age-adjusted mortality rates are higher in Denmark than in any other country. These findings are discussed. In the past decade the annual number of reported cases has been constant, indicating that the incidence is stationary, although interest in a knowledge of C.T. is on the increase.
A comparison of the present non-selected, nation-wide material with series from hospitals abroad indicates that the prognosis may be improved by more extensive operations on the thyroid gland, avoiding complications such as paralysis of the recurrent laryngeal nerve and tetany. The surgical efforts should also be supplemented with postoperative suppression of the TSH production. In seeking to explain the differences from American data, it should not be overlooked that papillary thyroid carcinoma may be inclined to take a more serious course in Denmark than in a number of other countries. Moreover, a nation-wide material must by necessity show less favorable results than data from specialized units. In the present retrospective study it was not possible to report 20- and 30-year survival rates. This is a task for the future, like the planning of prospective studies which, in the case of a disease as rare as papillary thyroid carcinoma, should be established on an international basis.
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1. Ampicillin concentrations were determined in serum and bile after intravenous injection into patients with T-tube bile drainage of 1 gram ampicillin before and during probenecid medication. The concentrations were followed up to fifteen hours after injection.2. Probenecid increased the half-life of ampicillin in serum from 74 minutes to 137 minutes.3. Ampicillin concentrations in bile were higher following probenecid medication and a concentration over 5 mug/ml was obtained for 3 h longer than before probenecid.4. The ampicillin concentrations in bile were approximately the same as those in serum both before and during probenecid medication suggesting passive transport of ampicillin from blood to bile.5. A combined treatment of ampicillin and probenecid might be of clinical value in the therapy of cholangitis and typhoid carriers.
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