Sidney C. Werner

MODIFICATION OF THE CLASSIFICATION OF THE EYE CHANGES OF GRAVES' DISEASE

The original (1969) classification of the Eye Changes of Graves Disease has been retained except for Classes 1 and 3. Class 1 has been limited so that proptosis of 23 mm or greater is placed in Class 3, even if the patient is asymptomatic. Grading of Classes 1 and 2 has been left to the individual physician or clinic, but we urge that the suggested criteria for grading Classes 3 through 6 be used. Progression of disease is not necessarily sequential through each of the classes, and ethnic factors and myopia may influence the extent of proptosis in normal subjects.

Euthyroid patients with early eye signs of Graves' disease: Their responses to l-triiodothyronine and thyrotropin

Abstract 1.1. Ten euthyroid patients with the early eye signs of Graves disease have been described. 2.2. These patients behave functionally in response to triiodothyronine and thyrotropin like patients with overt Graves disease. It is concluded that these patients do, in fact, have Graves disease. 3.3. It is demonstrated that the normal pituitary-thyroid relation is disrupted in these patients and that euthyroidism can be maintained despite this disruption. The implications of these observations in respect to the pathogenesis of Graves disease are mentioned. 4.4. Triiodothyronine and the twenty-fourhour uptake method provide a new and highly reliable test of thyroid function.

Jaundice during methyl testosterone therapy

Abstract 1.1. A syndrome of jaundice with distinctive features is described in association with methyl testosterone therapy. Seven cases are reported. 2.2. The laboratory findings are characterized by a negative cephalin-flocculation reaction, only moderately elevated serum alkaline phosphatase and a markedly increased serum bilirubin. 3.3. Liver biopsy suggests stasis of bile in the bile canaliculi and mild derangement of the contiguous cells. 4.4. The role of methyl testosterone as the etiologic agent is discussed.

Clinical Experience in Diagnosis and Treatment of Thyroid Disorders with Radioactive Iodine (Eight-Day Half-Life)

IT IS WELL KNOWN that the thyroid gland takes up iodine (1). When radioactive isotopes of this element became available, tracer studies were carried out to discover what portion of an administered amount lodged in the gland, and what became of the remainder (2, 3). In this first work, the radioactive iodine was mixed with a relatively large amount of the stable iodine isotope .(carrier) , which competed with the radioactive form for utilization. It was not possible to administer much radioactive material without at the same time using quantities of stable isotope larger than the individuals normal daily requirement of this element. In this case, thyroid behavior might have been complicated by an iodine effect. Furthermore, with the small amounts of radioactivity used, quantitative measurements in vivo were not entirely satisfactory. Later, carrier-free radioactive iodine became available, and its use circumvented these earlier difficulties. With this material, considerable radioactivity is carried by ver...

Influence of Age, Sex, and Season upon Radioiodine Uptake by the Human Thyroid.

Summary 1. The percentage of a tracer dose of radioactive iodine deposited in the thyroid gland at the end of 24 hours was determined by measurement of radio-activity directly over the gland in 1,050 tests in 1952 apparently euthyroid individuals. 2. It is concluded that, within the New York area, there is statistically no effect of season, on the average uptake of radioiodine by the thyroid gland of the euthyroid individual. 3. The 24-hour uptake of radioiodine decreases progressively but slightly with each decade of age. The extent of fall is statistically, but not clinically, significant. 4. Women in all age groups show a slightly higher average uptake than men. The difference is not clinically significant.

Clinical and metabolic study of 17-hydroxycorticosterone (Kendall Compound F); comparison with cortisone.

Summary The clinical and metabolic effects of parenterally-administered Cpd. F were investigated and compared with those of cortisone. Preliminary observations suggest similar responses but with Cpd. F appearing to be somewhat less active.

Radioactive iodine, I-131, in the treatment of hyperthyroidism.

Abstract 1.1. The results of I 131 therapy for toxic goiter are presented. One hundred three patients were treated with dosage between 3 to 6.5 mc. 2.2. The method used and the calculation of radiation are outlined. 3.3. The results are analyzed in terms of number of treatments, total dosage per treatment, dosage per estimated Gm. of thyroid tissue and radiation received by the gland. About 92 per cent of all the patients were relieved of hyperthyroidism; about 97 per cent in those treated more recently. 4.4. The use of radioiodine therapy in primary previously unoperated goiter should be restricted in general to the older age groups. 5.5. I 131 is the method of choice in treating recurrent toxic goiter, when hyperthyroidism has reappeared after surgery. 6.6. The important complications affecting I 131 therapy are discussed.