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Biomedical subjects

J M Lore

Publications and source records attributed to J M Lore.

9 recordsLinked to original sources
PubMed1997

Total thyroidectomy for Graves' disease.

BACKGROUND: Therapeutic options for treatment of hyperthyroidism caused by Graves' disease remain controversial. There are three main options: thiourea drugs, radioactive iodine ablation, and thyroidectomy. Each treatment has significant advantages and potential problems. METHODS: The present study is a retrospective analysis of our experience with total thyroidectomy in Graves' disease. Sixty-two patients underwent this procedure in 11 years' time and were followed for a minimum of 2 years after surgery. All had measurement of total thyroxine, T3 uptake, and radioactive iodine (RAI) uptake and scanning. Sixty-three percent of all patients had some element of hyperthyroid eye signs. All patients were rendered euthyroid with pharmacologic therapy prior to surgery. Postoperatively, the patients were evaluated for improvement in eye signs, incidence of recurrent laryngeal nerve injury, and hypoparathyroidism. RESULTS: None of the patients in this study have developed recurrent hyperthyroidism. All patients are maintained on levothyroxine. None of our patients incurred bilateral vocal cord paralysis. One patient (1.6%) demonstrated an immobile vocal cord more than 1 year following surgery. Ten patients (16%) demonstrated impaired mobility of one vocal cord in the immediate postoperative period. Nine of these patients recovered full vocal cord mobility within 6 months after surgery. Only one patient (1.6%) still required calcium and vitamin D therapy 1 year following surgery. However, in the immediate postoperative period, 23 patients (37%) required supplemental calcium and vitamin D. In 12 patients, calcium and vitamin D was discontinued within 1 month. In an additional 6 patients, calcium and vitamin D were discontinued within 4 months; 3 patients, within 6 months; and 1 patient, within 12 months after surgery. Incidental papillary carcinoma was found in 3 patients (5%). CONCLUSIONS: Total thyroidectomy for Graves' disease is an effective and safe therapy. When performed by an experienced head and neck surgeon, it carries a low morbidity rate. It should be presented to patients as a therapeutic option within the context of a comprehensive discussion of the risks and benefits of radioactive iodine, pharmacologic therapy, and surgery.

Adolescent↗
PubMed1984

Osteoporosis relative to head and neck.

Osteoporosis generally represents changes in the skeletal mass encountered in various groups of disorders. In the head and neck region, however, the term has been used to describe radiologic findings which would be better described in relation to each specific disease entity. A brief review of these diseases is presented. This review led to the conclusion that perhaps the term osteoporosis should be replaced by another suitable and more specific term for these bony changes.

Cushing Syndrome↗
PubMed1983

Preoperative chemotherapy for hypopharyngeal carcinoma.

Twenty patients with advanced squamous cell carcinoma of the hypopharynx received two courses of chemotherapy with cisplatinum, vincristine and bleomycin before undergoing surgery. The chemotherapy was well tolerated, with minimal toxicity and no intra or postoperative complications attributable to it. The response to the chemotherapy was dramatic with all but 2 patients exhibiting a greater than 50% tumor shrinkage. Only 3 patients, all with positive surgical margins, received postoperative radiation therapy. Surgical salvage of recurrent lesions was performed on 2 patients who are now free of disease. With a median follow-up of 20 months, 1 patient has died of recurrent disease, 3 have died of other causes, all others remain free of disease.

Antineoplastic Agents↗
PubMed1977

Partial horizontal supraglottic laryngectomy. A method of reconstruction.

Despite the low occurrence of early laryngeal lesions amenable to Partial Supraglottic Laryngectomy, they form a very interesting and important group of lesions. Timing is important in their recognition, since adequate treatment can then be secured and important functions of the larynx preserved. The draw back in the treatment of these lesions by partial laryngectomy lies in the difficulty in restoring the patient to his preoperative pattern of life. Repeated aspiration pneumonitis becomes a life threatening problem in a good number of such patients. A new method of reconstruction is described here by which the aspiration problem is obviated with the aid of a pedicle flap to line the raw surface of the transected base of the tongue allowing the organ to remain in a position capable of occluding the glottis during deglutition, and at the same time guiding the food along the posterior pharyngeal wall and into the esophagus.

Humans↗