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PubMedDate not supplied

[Organotherapy treatment in the course of normofunctional goiter. Long-term results in 104 patients].

Results of therapy with thyroid hormones (LT4 and/or LT3) were evaluated in 104 patients (95 females and 9 males) with simple diffuse or nodular goiter. The mean interval of observation was 7.2 years. The reported results were analysed in relation to patient's age at the onset of the pathology, time elapsed since its appearance, place of origin and sex of the patient, results of laboratory studies, and clinical signs.

Adolescent↗
PubMed1993

[Gastroenterologic pathology and replacement organotherapy in thyroidectomized patients].

Thyroid replacement therapy in patients treated by near-total or total thyroidectomy, as well as spontaneous hypothyroidism , can be difficult in patients with alterations in absorption functions or specific gastroenteric diseases. We have studied 25 patients, 22 women and 3 men, 18-72 years old (mean 47 years), affected by spontaneous or post-surgical hypothyroidism, who presented, during the usual replacement therapy, persistently elevated or high-normal TSH levels, and therefore required repeated variations in the prescribed dose of thyroxine. In these patients we evaluated hormone pattern, the presence of autoantibodies (anti-tyroglobulin, anti-Sm, anti-DNA, anti-microsomal antigens, anti-gliadin and anti-parietal cell), and performed an esophagogastroduodenoscopy (EGD) with histological examination. In all patients, plasma TSH ranged from 2.5 to 20 microU/ml. Only 17% of patients exhibited the presence of antibodies against thyroglobulin, 17% of patients had antibodies against microsomal antigens, 6% of patients presented antibodies against nuclear antigens; 4% had against gliadin. Histological examination revealed chronic gastritis (98%) with atrophic aspects (20%) and intestinal metaplasia (28%); and chronic duodenitis (86%) with villus abnormalities (23%) and total villus atrophy (4%). We underline the case of a patient, treated by total thyroidectomy for papillary carcinoma, who presented, two months after starting L-thyroxine therapy, a recurrence of celiac disease, that had been silent after childhood. The EGD showed, at the level of the second duodenal segment, a reduction of number and thickness of mucosal folds; the histological examination showed total villus atrophy, elongated crypts and a dense infiltration of chronic inflammatory cells in the lamina propria. Our experience underlines the frequent association of gastroenteric disease and hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Postoperative organotherapy for multinodular goiter].

Post-operative therapy with L-Tiroxine can have a suppressive or substitutional aim. After a total thyroidectomy the patients need a substitutional therapy, while after subtotal thyroidectomy the aim of the therapy is to suppress the TSH secretion. In the second case we want either to avoid the recurrence, either to give the hormones that residual gland cannot produce. The drug of choice is L-Tiroxine for both suppressive o substitutional therapy: There is a difference in dosage, that must be greater in first case. While there are some doubts in the literature on the success of the suppressive therapy, we believe that there is enough evidence of his utility.

Goiter, Nodular↗
PubMed2002

[Post-thyroidectomy hypocalcemia. Personal experience].

BACKGROUND: The study evaluates the incidence of both early and protracted post-thyroidectomy hypocalcemia over a 6-year period (1995-2000) in a series of 330 consecutive thryoid operations. The aim was to identify the profile of patients with the greatest risk of permanent parathyroid functional insufficiency and a suitable treatment protocol. METHODS: Having performed a statistical ana-lysis of all the variables, we divided the entire population of 330 patients into 4 groups based on the extent of demolition, the method of organotherapeutic replacement with L-Thyroxine and the (eco-radioguided) procedure used to identify the parathyroids: 59 patients undergoing subtotal thyroidectomy; 155 patients undergoing total thyroidectomy who commenced replacement organotherapy from postoperative day 15-30; 94 patients undergoing total thyroidectomy who commenced replacement organotherapy from postoperative day 1; 22 patients undergoing total thyroidectomy who underwent routine intraoperative parathyroid assay. RESULTS: The results show that the impact of more radical surgery in determining hypocalcemia, in particular protracted hypocalcemia, represents the most striking characteristic of patients with the greatest probability of permanent parathyroid insufficiency. We emphasise that early correction of postoperative hypothyroidism can drastically reduce the incidence of both early and protracted hypocalcemia. CONCLUSIONS: In conclusion, hypoparathyroidism is an exceptional event, whereas hypocalcemia is relatively common after total thyroidectomy. The effects of the early correction of postoperative hypothyroidism are undoubtedly beneficial, as is the use of eco- and radioguided methods for the intraoperative identification of the parathyroid glands, although they are not free from limits and criticism.

Adult↗
PubMed2004

Emergence of the concept of endocrine function and endocrinology.

Endocrinology as a scientific discipline is relatively new. The term "hormone" was introduced in 1905, and "endocrinology" was introduced in 1909. However, its origins are ancient and rooted in the millennia-old practice of organotherapy, from its archaic religious beginnings, through early attempts to explain the integrated functions of the body by the philosophically sound but scientifically mysterious humors of Greek medicine, to its incorporation into the pharmacopoeias of the eighteenth century. The concept of internal secretions germinated in the anatomical discoveries of the Renaissance, which described ductless glands, and after the discovery of the circulation, came the suggestion of "internal secretions" into blood as organ "emanations which are useful to the body." The principal events that led to the emergence of endocrinology occurred in the latter half of the nineteenth century, from the experimental studies of Claude Bernard (1813-1878), the clinical observations of Thomas Addison (1793-1860), and the combined experimental and clinical studies of Brow-Sequard (1817-1894). The first decades of the twentieth century saw in sequence the isolation of crude organ extracts, their preparation as hormones in pure crystalline form, and their ultimate use in the cure of diseases that had haunted mankind thereto.

Endocrine Glands↗
PubMed1989

[Are paramedical means and methods justified in the treatment of breast carcinoma?].

In industrial countries breast cancer is the second frequent malignancy of women. The often metastasizing (65 to 70%) and long-lasting illness leads patients in more than 50% to paramedical treatments. An analysis of the unproven methods and the remedies concerning the effectiveness against breast cancer is done: mistletoe preparations, nutrition directions, organotherapy (cell therapy, cytoplasmatic and thymus therapy), enzyme-preparations and further paramedical remedies and methods. In the last part, the discussion covers the findings of the 'Gesellschaft für Biologische Krebsabwehr', which presumes that biological remedies will lead to a turn in cancer treatment. An exact analysis of the paramedical literature shows that the quoted successes of paramedical treatment are nearly parallel to the successes of 'ortho-medical' therapies, which are not mentioned at all or only on incidentally.

Anthroposophy↗
PubMed2001

A brief history of testosterone.

PURPOSE: We explore the history of testosterone in the context of medical and scientific developments. MATERIALS AND METHODS: A review of the scientific and historical literature was conducted. RESULTS: The origins and effects of testosterone have been recognized throughout the history of humankind. Hunter performed testicular transplantation experiments in 1767 while studying tissue transplantation techniques, and almost a century later Berthold linked the physiological and behavioral changes of castration to a substance secreted by the testes. Brown-Séquard gave birth to the field of organotherapy in 1889 when he announced that his auto-injection of testicular extracts resulted in rejuvenated physical and mental abilities. Steinach and Niehans expanded upon Brown-Séquard's work with rejuvenation treatments involving vasoligation, tissue grafts and cellular injections. In 1935 David et al isolated the critical ingredient in organotherapeutic treatments, testosterone. CONCLUSIONS: The effects of the powerful hormone testosterone continue to inspire research and controversy 65 years later.

Animals↗
PubMed1994

Charles-Edouard Brown-Séquard: double-hyphenated neurologist and forgotten father of endocrinology.

This year is the Centenary of the death of Brown-Séquard who, although remembered today only for his eponymous syndrome, was as well known in the Victorian medical world as Robert Maxwell was to newspaper readers in the past decade. His position in the history of endocrinology is paradoxical; a good case can be made for saying that he invented the doctrine of internal secretion. Yet, the excesses of the organotherapy movement he founded at the end of his life discredited endocrinology and probably delayed the discovery of insulin.

Diabetes Mellitus↗
PubMedDate not supplied

Current issues with beta2-adrenoceptor agonists: historical background.

The discovery that dessicated adrenal glands had beneficial effects in asthma arose in 1900 following a vogue for studying organotherapy at the end of the 19th century. The adrenal hormone adrenaline was found to have sympathomimetic properties and was isolated and synthesized in 1901. The first nonselective beta-agonist, isoproterenol, was isolated in 1940, followed by the development of selective beta2-agonists in the 1960s and the introduction of the long-acting beta2-agonists in the 1990s. The introduction of beta2-selectivity reduced adverse effects, as did developments in inhaler technology that allowed subjects to inhale much smaller doses of drug selectively to the airways. The beta2-agonists are some of the more important drugs to have been developed in the 20th century. Excessive doses can cause problems, and attempts to maximize the benefit from beta2-agonists and to reduce adverse effects has led to considerable epidemiological, clinical, and mechanistic research over the last 50 yr.

Adrenergic beta-2 Receptor Agonists↗
PubMed1999

Henry Harrower and the turbulent beginnings of endocrinology.

The emergence of new medical science in the mid-19th century was usually greeted with derision by "practical men" who saw their academic colleagues as elitist intellectuals whose work bore little or no relation to the rough-and-tumble aspects of patient care. This schism, which was nowhere greater than in the field of endocrinology, widened in 1891 when a myxedematous patient was dramatically restored to health after the administration of a thyroid extract. On the one hand, academicians-who saw this result as a triumphal example of the transference of laboratory studies to the bedside--were encouraged to pursue further studies in endocrine pathophysiology and pharmacology. On the other hand, medical practitioners began to believe that crude extracts from glands or other organs, when prescribed as orally administered mixtures, were effective for the treatment of most human ailments. The organotherapeutic forces were ably championed by Henry R. Harrower, MD, a manufacturer as well as a dispenser of organotherapeutic products. For some years, the claims of the organotherapists remained unchallenged. Finally, in 1921, Harvey Cushing, pioneer neurosurgeon and endocrinologist, launched a crushing assault on the purveyors of pluriglandular therapy. These attacks continued over ensuing years, and organotherapy fell into disrepute. Nevertheless, the assertions of "practical men" have not subsided; rather, we are now confronted by insistent claims for a bewildering array of herbal remedies, over-the-counter hormonal products, and alternative therapies.

Endocrinology↗
PubMed1992

The emergence of endocrinology.

Endocrinology was recognized as a new branch of biological science mainly as a result of events which took place between about 1890 and 1905, but ideas and discoveries dating from antiquity contributed to it also. Experiments supporting the concept of internal secretions by the testicles were described by Aristotle (4th c. B.C.) and by Hunter (18th c.) and Berthold (19th c.). In 1855 Bernard described glucose as an internal secretion of the liver and Addison reported the effects of adrenal disease in man. Adrenalectomy was fatal in animals. Goitre was known in antiquity and cretinism had been described by Paracelsus. Myxoedema was reported by Gull in 1873, and Kocher described cachexia strumipriva in 1883. In 1888 cretinism, myxoedema and cachexia strumipriva were attributed to thyroid insufficiency. In the 1890s Gley found that tetany after thyroidectomy was due to removal of the parathyroids. In 1884 Rehn proposed that toxic goitre was due to thyroid excess. In 1889 Brown-Séquard claimed that injections of testicular extract rejuvenated the elderly, and in 1893 he introduced organotherapy. In 1891 Murray treated myxoedema successfully with thyroid extract. In 1893 Oliver and Schäfer found that an adrenal extract raised the blood pressure, and soon adrenaline was extracted from the adrenal medulla. Adrenocortical deficiency was proposed as the cause of Addison's disease, and in 1896 Osler prepared an extract which relieved one patient. Diabetes mellitus, described in the first century, was usually fatal. Thirst and polyuria followed experimental pancreatectomy, and pancreatic lesions were found in some human diabetics. In the 19th century workers in France and Germany found that diabetes resulted from absence of an internal secretion by the islets of Langerhans and, in 1893, Laguesse described the function of the islets as "endocrine". In 1895 Beatson treated advanced breast cancer successfully by oöphorectomy. In 1895 Schäfer commended study of the internal secretions to physiologists. In 1902 Bayliss and Starling discovered secretin, a chemical messenger secreted by the intestinal mucosa. In 1905 Starling proposed the name "hormone" for this class of internal secretions. By then endocrinology had been launched as a new branch of science. The crucial events which led to the recognition of endocrinology as a new branch of biological science took place between about 1890 and 1905. Many ideas and discoveries dating from antiquity and apparently unrelated at first had, however, contributed to it. Most of the organs and tissues that form the endocrine system were recognized over 100 years ago.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗