PubMed Health⌕ Search

Biomedical subjects

T S Reeve

Publications and source records attributed to T S Reeve.

At least 55 records · Page 3Linked to original sources
PubMed1988

Neuromuscular symptoms in elderly patients with hyperparathyroidism: improvement with parathyroid surgery.

In a consecutive series of 100 neck explorations for primary hyperparathyroidism, 42 patients were 60 years of age or older; in this group of elderly patients the surgical cure rate was 100%. These patients were reviewed retrospectively by means of a structure interview. Twenty-one patients had had preoperative neuromuscular symptoms that ranged from coma to subjective muscular weakness. These patients had significantly-higher preoperative serum calcium and parathyroid hormone levels than did 21 patients without neuromuscular symptoms (P = 0.003 and P = 0.046, respectively). Most of the neuromuscular symptoms improved in the postoperative period. In particular, 15 of 17 patients with muscle weakness reported a significant improvement, while 14 of 15 patients who suffered from fatigue and lethargy reported an improvement. An improvement also occurred in the level of day-to-day function in eight patients. While surgery for primary hyperparathyroidism generally is undertaken for a specific indication, such as severe hypercalcaemia or renal stones, it appears from this study that neuromuscular symptoms also may improve, particularly in elderly patients.

Adolescent↗
PubMed1988

Catalysis of lipid peroxidation by glucose and glycosylated collagen.

Peroxidation of membranes of linoleic/arachadonic acid vesicles at 40 degrees C was catalysed by glucose or glycosylated collagen. Kinetics of hydroperoxide production were similar in both cases. There was a kinetic lag, the duration of which was inversely proportional to the amount of glucose or glycosylated collagen used to initiate the peroxidation. This was followed by a rapid increase in the rate of oxidation. The final rate was independent of the amount of catalyst added. Vesicle lysis accompanied the increases in peroxidation. Addition of desferrioxamine, an iron chelator, only partially inhibited the oxidative process.

Animals↗
PubMed1988

Influence of the menstrual cycle on the concentrations of estrogen and progesterone receptors in primary breast cancer biopsies.

There is controversy in the literature regarding the effects of endogenous hormones on estrogen receptors (ER) and progesterone receptors (PR) in young women with breast cancer. We studied 117 young women with primary breast cancer and assessed their breast biopsies for ER and PR. The women had a record of their last menstrual period prior to breast biopsy. The menstrual cycle was divided into four phases--early proliferative (days 1-7), late proliferative (days 8-15), early secretory (days 16-22), and late secretory (days 23-30). There were lower levels of both ER and PR in biopsies excised during the early secretory phase than in other phases of the cycle; early proliferative phase receptor positive medians of ER = 77 fmol/mg protein and PR = 467 fmol/mg protein fell to ER = 28 fmol/mg and PR = 128 fmol/mg protein in the early secretory phase.

Adult↗
PubMed1988

An enzyme immunoassay compared with a ligand-binding assay for measuring progesterone receptors in cytosols from breast cancers.

To assay progesterone receptor (PR), we compared Abbott's enzyme immunoassay (PR-EIA) with a ligand-binding assay involving dextran-coated charcoal (PR-DCC), using cytosols prepared from 109 breast-cancer biopsies. Results by the two PR methods agreed well. Least-squares analysis produced a line of best fit having a slope of 0.88, an intercept on the PR-EIA axis of 16 fmol per milligram of protein, and a correlation coefficient (r2) of 0.87. To evaluate whether accurate PR-EIA measurements could be obtained on stored cytosols, we compared PR-EIA values for fresh cytosols with values for cytosols stored for various lengths of time up to 13 weeks. Agreement was excellent, especially when the samples showing very high binding (greater than 600 fmol per milligram of protein) were excluded. The lines of best fit after least-squares analyses of the remaining values had slopes between 1.0 and 1.1, intercepts less than 3 fmol/mg, and r2 all greater than 0.91.

Adult↗
PubMed1987

Total thyroidectomy. The preferred option for multinodular goiter.

Total thyroidectomy is an operation that has generally been reserved for the management of differentiated thyroid carcinoma. Over the last decade total thyroidectomy has become used increasingly and is now the preferred option in the authors' unit for the management of multinodular goiter affecting the entire gland. Over the period from 1975 to 1985, 853 thyroidectomies have been performed for multinodular goiter; of these, 115 have been total thyroidectomies. During that time, the incidence of total thyroidectomy for multinodular goiter has increased in percentage terms from 9% in 1975 to 50% in 1985. There have been two cases of permanent hypoparathyroidism and one case of permanent recurrent laryngeal nerve injury, and these occurred in patients who had less than total thyroidectomy. Total thyroidectomy is an appropriate operation for the management of diffuse multinodular goiter where the entire gland is involved because it precludes patients from requiring further surgery for recurrent disease, with its high associated risks. It must be emphasized, however, that protection of the recurrent laryngeal nerve and parathyroid glands must still be paramount in dealing with benign thyroid disease.

Goiter, Nodular↗
PubMed1987

Surgery for adrenal tumours: is operation for the small incidental tumour appropriate?

The last 15 years have seen a change in the indications for adrenalectomy. On the one hand there has been a decline in the number of operations for metastatic breast cancer due principally to the introduction of effective medical therapy. Moreover, the introduction of trans-sphenoidal techniques has reduced the number of adrenalectomies for Cushing's Disease. In contrast the introduction of CT scanning has seen an increase in the diagnosis of incidental adrenal masses, most of which turn out to be benign non-functioning adrenal cortical adenomas. During the period 1970-86, 124 adrenalectomies were performed at Royal North Shore Hospital. From 1970 to 1976 the primary indication for adrenalectomy was metastatic breast carcinoma (84%). Over the past three years one of the primary indications has been the discovery of an asymptomatic, non-functional adrenal mass on CT scan (26%) and, of these tumours, 95% have been less than 5 cm in size. Yet no incidentally discovered adrenal mass was an adrenocortical carcinoma and no adrenocortical carcinoma was smaller than 7 cm in diameter. We recommend that an asymptomatic adrenal mass less than 6 cm in size, with no evidence of function, should be managed conservatively.

Adenoma↗
PubMed1987

All is not quiet.

Explore the source record for details and available documents.

Australia↗
PubMed1987

Hydatid disease at Royal North Shore Hospital: results of surgical treatment.

A study of the results of surgery for hydatid disease was undertaken at Royal North Shore Hospital for the period 1966-83. There were 51 patients who underwent surgery for this disease and follow-up was obtained in all but eight cases. Comparison of cumulative survivals for this group with that of a matched Australian population showed that patients undergoing surgical treatment of their hydatid can anticipate a normal life expectancy. There was no evidence that patients with extrahepatic disease fared any worse than those with disease confined to the liver. Documented recurrence of hydatid disease occurred in eight cases following surgery and only one patient actually died from hydatid disease. This was a case in which spillage occurred at the initial procedure. This paper is presented as a reminder that hydatid disease still occurs with sufficient frequency to pose therapeutic problems for surgeons. Whilst total eradication of the parasite will only occur with enforcement of public health measures, surgery would still appear to be effective therapy for established hydatid disease so long as care is taken to avoid cyst rupture.

Adolescent↗
PubMed1987

Comparison of an estrogen receptor related protein, the ERD5 antigen, with estrogen and progesterone receptors in breast cancer patients.

Eighty five breast cancer cytosols were assessed for ERD5-antigen (an estrogen receptor associated protein) using the Amersham immunoradiometric assay. Estrogen and progesterone receptors were measured using charcoal treatment to separate receptor-bound tritiated ligand from the excess free, or weakly-bound ligand. Patients whose cytosols were receptor-rich (ER+ PR+) were more likely to be ERD5-antigen positive and had higher quantitative levels of this protein, than patients whose cytosols contained no estrogen receptor protein. However, twenty nine percent of ER-negative cytosols showed significant ERD5 antigen levels. In this preliminary study ERD5 antigen levels showed no potential value in discriminating between breast cancer cytosols from ER positive and ER negative patients.

Breast Neoplasms↗
PubMed1987

Thyroid surgery in the elderly.

Thyroid disease is common in the elderly but appropriate surgical procedures are frequently avoided in the belief that the patient's age precludes a successful outcome. This avoidance may result in surgery having to be performed at a later stage as an emergency when conditions are not necessarily ideal for treatment of airway obstruction by goitrous tissue. Between 1970 and 1985, 575 patients aged over sixty years underwent thyroidectomy in The University of Sydney Department of Surgery at Royal North Shore Hospital. The most commonly performed procedure was total thyroid lobectomy (185); there were however a significant number of total thyroidectomies (86), 41% for benign and 59% for malignant thyroid pathology. The complication rate was considered to be acceptably low in this group. Complications of thyroid surgery itself occurred in 1.2%, recurrent laryngeal nerve palsy 1%, and hypoparathyroidism 0.2%. Other complications (4.8%) were those to be expected in an elderly patient population with multiple pathology and comprised myocardial infarction, cardiac arrhythmias and respiratory problems. There were 2 deaths in this group (0.4%), one occurred when the endotracheal tube perforated the trachea of a patient whose thyroid malignancy proved to be invading the trachea. The accumulated data in this study showed that age, regardless of pathological classification, was the major single prognostic factor for survival in thyroid malignancy. Aged patients can undergo thyroid surgery with no significantly added risk provided specific associated problems are addressed before operation.

Aged↗
PubMed1986

The impact of fine-needle aspiration biopsy on surgery for single thyroid nodules.

Biopsy by fine-needle aspiration has emerged as the most effective single technique for the investigation of single thyroid nodules. A comparison was made of patients who underwent surgery for single nodules in 1979 (before the introduction of fine-needle aspiration biopsy to this Department) and in 1984, after this technique had become fully established. Biopsy by fine-needle aspiration proved to be reliable in the selection of patients for surgery. The incidence of malignancy in each category was: malignant, 83%; atypical, 26%; inadequate, 7%; and benign, none. This contrasted with nuclear scanning and ultrasound techniques that were in use over that period, where the malignancy rate of nodules that showed no uptake of radioisotope was 11% and that of an ultrasound scan that demonstrated a "solid" or "cystic/solid" was 16%. Similarly, nodules that showed an uptake of radioisotope or an ultrasound scan that demonstrated a "cystic" image did not exclude malignancy reliably. As a result of fine-needle aspiration biopsy, there was a 60% reduction in the number of thyroidectomies for single nodules during its use with a higher yield, but no change in the absolute number, of patients with malignancy of the thyroid gland.

Adult↗
PubMed1986

Total thyroidectomy in the management of differentiated thyroid cancer: a review of 258 cases.

Controversy continues to surround the management of differentiated thyroid cancer. For the past 20 years, a standardized protocol of total thyroidectomy followed by radioiodine ablation has been followed at Royal North Shore Hospital. During the period 1966-83, 327 cases of thyroid malignancy were treated surgically and, of these, 258 were differentiated thyroid cancer. Following total thyroidectomy, the incidence of recurrent nerve palsy was 2.8% and that of permanent hypoparathyroidism 3.2%. The overall 10 year cumulative survival for these patients was 87%. Whilst there were apparent differences in survival depending on the pathological type of tumour (papillary, follicular, mixed), further analysis shows that most of the differences in prognosis can be explained on the basis of age and sex alone. Young patients (less than 60 years) have an excellent 10 year survival (96%) whilst that for the elderly is only 61%. Males have a worse prognosis at 10 years than females. Total thyroidectomy is a safe procedure for the treatment of differentiated thyroid cancer. It allows the subsequent evaluation and treatment of unrecognized metastatic disease and offers the young patient a potentially normal lifespan.

Adenocarcinoma↗