Yoshihiko Nishikawa

Aplasia of one thyroid lobe

Abstract The clinical presentation of congenital absence of one thyroid lobe is rare. We are reporting seven cases of this anomaly which were observed at the Ito Hospital from 1959 through 1971. All cases occurred in women, and five cases were aplasia of the left lobe whereas two were aplasia of the right lobe. Among the thyroid disorders which were associated with hemiagenesis, five were hyperthyroidism, one was papillary adenocarcinoma, and one was adenomatous goiter.

Bleomycin treatment for cancer of the thyroid

Abstract BLM was evaluated in clinical application to twenty-one cases of cancer of the thyroid. BLM is not as effective against thyroid cancer as it is against squamous cell carcinoma but it is considerably more effective than other anticancer drugs in cancer of the thyroid.

Anterior pituitary, thyroid, parathyroid and adrenal responses to subtotal thyroidectomy in patients with Graves’ disease

Changes in the serum levels of anterior pituitary, thyroid, parathyroid, and adrenal hormones following subtotal thyroidectomy in 31 patients with Graves’ disease were investigated. In 14 patients, rapid ACTH tests were performed on the preoperative and the first, third, and seventh postoperative days. Remarkable differences were not seen with regard to the changes in anterior pituitary hormones or cortisol, compared to those seen during general surgery. As to the thyroid hormones, the serum level of triioodothyronine (T3) decreased markedly after surgery and fell to half that of the preoperative value on the first postoperative day. Thereafter, a low value of T3 was maintained during the early postoperative period. Unlike T3, the serum level of thyroxine (T4) decreased gradually until the 7th post-operative day. The levels of both epinephrine and norepinephrine increased transiently during surgery, but the serum level of norepinephrine increased again on the third postoperative day. In the postoperative period, almost half the number of patients showed an inadequate cortisol response to rapid ACTH tests. It is suggested that the unique responses, such as the rise in serum norepinephrine or an inadequate response of cortisol to ACTH, or hypocalcemia, after subtotal thyroidectomy in patients with Graves’ disease is largely due to the rapid decrease of T3 in the hypothyroid state, as was noted during the postoperative period.

The Incidence of Hyperthyroidism in Patients with Adenomatous Goiter

It has been reported that the occurrence of hyperthyroidism from large adenomatous goiter is high in America. Furthermore, many studies in recent years have demonstrated that the Thyrotropin (TSH) response to Thyrotropin Releasing Hormone (TRH) in clinical euthyroid patients with adenomatous goiter resulted in failure. However, there has been no data on the incidence of hyperthyroidism in patients with adenomatous goiter in Japan. The present paper reports the incidence of hyperthyroidism in a large number of patients with adenomatous goiter in Japan. Three hundred and fourteen patients (29 males and 285 females, aged 12-74) with adenomatous goiter are included in this study. The diagnosis of adenomatous goiter depends on the microscopic criteria described by Meissner and Warren, regardless of the nodularity of goiter. The resected goiter weight of these patients ranged from 2.8 to 280.5 gm. Serum concentrations of T3 T4 and TSH were measured in these patients. Furthermore, a TRH test was performed on 51 (3 males and 48 females, aged 13-64) out of 314 patients, who were supposed to be euthyroid from T3 T4 and clinical findings. 500 big TRH were injected intravenously. Blood samples for TSH determination were taken before and 15, 30 and 60 min. after injection. Serum T3 T4 and TSH were measured by using commercial kits (T3 RIA kit, T4 RIA kit and TSH RIA kit, Dainabot Japan). One hundred and sixty-four subjects (54 males and 110 females, aged 10-74), who had no clinical suspicion of thyroid disease and were apparently healthy, served as normal controls. Serum T3 , T4 and TSH values in the control subjects were 117.1 ± 18.4 ng/dl