Protein content and thyroid hormone release in vitro by differentiated thyroid cancer cells in the presence of estradiol, dehydroepiandrosterone, polypeptidic hormones and pesticides.

The reactivity of thyroid cancer cells treated with estradiol (E) and dehydroepiandrosterone (DHA) in the presence of other hormones (TSH, STH, insulin), myopeptide and some pesticides (aminotriazole--ATA, atrazine--ATZ, prometryne--P and ATC) proved to be active in the culture medium. Protein synthesis in sclerosing folliculo-papillary cancer cells under the treatment applied is more markedly inhibited by DHA than by E in the culture medium is compared to the control lots. Tg1 and T3 release into the culture medium under the action of T4 and TSH decreases progressively going from the control to the treated lots, in the presence of E and DHA. STH inhibits Tg1 and T3 secretion in thyroid follicular carcinoma, whether or not E or DHA are present in the culture medium.

Dermatoglyphics in thyroid cancer.

Digito-palmar dermatoglyphics in 93 subjects with thyroid cancer (34 males, 59 females) of which 87.1% had folliculo-papillar adenocarcinoma were studied qualitatively and quantitatively. The findings were compared to the dermatoglyphics of 100 males and 100 females from the clinically healthy autochthonous population. The thyroid cancer subjects had a lower total digital ridge count (TDRC) and a reduced number of papillar ridges between the a-d triradii, than the control subjects. The A line showed a more marked transversality in cancer males and a more marked obliquity in cancer females. Qualitative examination showed more patterns in the second interdigital area and a higher incidence of typical and atypical form of sulcus transversus in the cancer group as against the controls. Qualitative and quantitative variations in dermatoglyphics were found with respect to the relation between the anatomo-pathologic form and the A, B, or O blood group. However, this variation is not conclusive enough to support the hypothesis of an association between dermatoglyphics and the blood groups in the A, B, O system on the one hand, and dermatoglyphics and the anatomo-pathologic form of thyroid cancer, on the other.

Reactivity of cold thyroid nodule under hormonal influences: study on cell cultures.

The authors have studied the reactivity of cold thyroid nodule cells (CN) by comparison with the reactivity of normal thyroid cells (Ty), hot nodules cells (N), Graves' disease cells (G) and cells from the area proximal to cold nodules (TyC), under the influence of increased amounts of T3, TSH, STH, insulin, estradiol and KI present in the culture medium. The experiment lasted for 9-10 days. The study was carried out on monolayer cultures of cells obtained by tripsinization and on organocultures. Proteic synthesis, cytochemical and cytoenzymatic activities in the culture under the influence of the above substances were examined comparatively. After interruption of the treatment, the monolayer cultures were stained with Giemsa and examined by light microscopy. Proteic synthesis and release of Tg, T3 and T4 into the culture medium, were also examined. The organocultures were used in evaluating 125I uptake from the medium under the influence of the treatment. The results showed variation in relation to the tissue and hormone dose applied. It was especially found that TSH and estradiol cause enlargement of CN cell nuclei and an increased number of mitoses and polyploidia which might be premises for possible malignization.

Considerations on some anatomo-clinical phenomena of thyroid cancer. Treatment and prognosis. Personal experience with 1515 operated cases.

The authors present a retrospective study on 1515 histologically confirmed cases of thyroid cancer encountered along a period of 30 years of activity. These cases were found among 15,200 patients operated on for thyroid disorders. Of these 1515 cases, 1310 were differentiated carcinomas of the follicular, papillary or trabecular type, 156 nondifferentiated carcinomas and 49 medullary carcinomas. The treatment for all these forms of cancer was a complex one, depending on the clinical stage and the anatomo-pathologic form. The authors advocate total or quasi-total thyroidectomy in all the forms of differentiated cancer, followed by administration of radioactive iodine and hormones. Under these conditions, the prognosis is extremely favourable. For nondifferentiated and medullary cancer the authors propose a wide resection followed by application of X-ray or cobalt and hormonal substitution therapy. The prognosis of these cases is poor.

Surgical indications in endemic goiter. Pre- and postoperative care.

The authors express their opinion with respect to anatomo-clinical forms of endemic goiter. First they suggest preoperative thyroid re-equilibration to avoid postoperative complications such as hypothyroidism or recurrence. Then operative indications for endocrine goiter, especially in an endemic area are discussed. Opinions are also expressed with respect to diffuse parenchymatous (endemic) goiter, nodular and polynodular goiter together with the various forms that may have a nodular or polynodular aspect both anatomically and as localization. Extemporaneous examination is viewed by the authors as compulsory in all such goiters, whereas preoperative thyroid puncture is counterindicated. Surgical care of mixed endemic goiter (diffuse hyperplasia with nodules imbedded in the hyperplasia) is also reviewed. It is recommended that each operation be preceded by an adequate preoperative treatment, for which therapeutic schemes are indicated as well as postoperative care directions taking into account the anatomo-clinical form. The surgical approach recommended is subtotal thyroidectomy. The paper also provides some statistical figures concerning surgery in the Institute of Endocrinology in Bucharest.

The thyroglobulin variations during the thyroid surgery for polynodular goiter, hyperthyroidism and cancer.

A radioimmunoassay (RIA) double antibody system for human thyroglobulin (Tgl) was developed with a sensitivity of 2.5 ng/ml T3 and T4 did not interfere in the antibody Tgl binding. The blood was collected pre-, intra- and 24 hrs post-thyroidectomy from 50 females and 4 males diagnosed as polynodular goiter, hyperthyroidism, chronic thyroiditis and thyroid cancer. The ratios of the intra- and post-operatory values versus pre-operatory values were calculated. The basal values in the patients having thyroid troubles varied within very large limits (two orders of magnitude) and these values could not be clearly correlated to the thyroid pathology, However, in untreated hyperthyroid patients the basal values exceeded 100 ng/ml, while in medullary carcinoma they were near the sensitivity limit of the technique. The intra-operatory values varied within the percentual area (thyroid carcinoma), multiplicative area (polynodular goiter and some cases of hyperthyroidism) and the order of magnitude area (hyperthyroid patients and some of the polynodular goiters). The value of the RIA measurement of the Tgl in the serum as an adjuvant in the post-treatment follow up of thyroid patients is discussed.

Cardiovascular pathology in acromegaly and some effects of the 90 yttrium implant in the hypophysis.

Examination of the cardiovascular apparatus (cv) of 25 acromegalic patients revealed an increased incidence of cardiovascular pathology as against normal individuals. Acromegalic patients with arterial hypertension (AH) show a twice higher incidence of ischemic cardiopathy, cardiomegaly with obvious or latent cardiac failure, arrhythmias, which frequently lead to death. The uncertain pathogeny of cardiomyopathy implied: hypoxia due to heart hypertrophy (over 500 g and increased cross-section of the fibre to over 26/mu), adrenergic deficiency resulting from increased protein synthesis and decrease in thyrosine, a precursor of myocardic cathecolamines. The increased incidence of coronary pathology is favoured in acromegalic patients by diabetes, hyperlipoproteinemia, low endogenous heparin, increased ureic acid and platelet adhesivity. Hypophysectomy by hypophysolysis (20 cases) brings relief and cures cardiovascular pathology, reduces AH, corrects the coronary risk factors, cures hypophyseal diabetes. The existence of AH and cardiovascular pathology is an indication for surgical treatment in evolutive acromegaly.

The release of LH and FSH during the thyroid surgery for hyperthyroidism.

Serial blood samples, collected from 21 females and 9 males through the thyroid surgery procedures were assayed for LH and FSH by a radioimmunoassay (RIA) technique. During thyroid surgery the serum LH increased significantly in the male patients from the preoperative levels 20.66 +/- 11.67 to 45.49 +/- 18.50 mIU/ml (p less than 0.01), being unchanged or slightly lower in the female group. The serum LH progressively fell towards the end of the surgery, remaining over the preoperative levels i4 hrs after surgery; occasionally very high levels were observed. The release of LH seemed to be more precocious during the surgery in both sexes in patients belonging to the age group under 40 years by comparison to the older group. The serum FSH showed nonsignificant changes during and after surgery in both female and male patients excepting two menopaused female hyperthyroid patients and a woman of 60 years under laborious surgery for a cervicothoracic polynodular goiter. The data are suggesting the dissociated secretion of LH and FSH in both sexes excepting some cases of menopaused women.