ABSTRACT
Transsphenoidal microdissection has been proposed as a preferred means of treating Cushing's disease. This procedure allows the surgeon to remove a pituitary microadenoma and at the same time to preserve normal tissue. Two cases described here were treated by this method. An interesting and important observation was that neither patient appeared to be cured for 2 to 6 weeks after surgery, as assessed by dexamethasone suppression. Later, normal suppressibility occurred and the course of each patient was compatible with cure. Patients treated by this method should not be automatically retreated because of adrenocorticotropic hormone (ACTH) non-suppressibility in the early postoperative period.
Subject(s)
Adenoma, Chromophobe/surgery , Cushing Syndrome/surgery , Pituitary Neoplasms/surgery , Adenoma, Chromophobe/complications , Adrenocorticotropic Hormone/metabolism , Adult , Cushing Syndrome/diagnosis , Cushing Syndrome/etiology , Dexamethasone , Female , Humans , Hypophysectomy/methods , Male , Pituitary Neoplasms/complications , Time FactorsABSTRACT
Patients treated with 10 mCi of I-131 for toxic diffuse goiter in the period January 1974--June 1976 were evaluated for development of hypothyroidism. Fifty percent were hypothyroid within 3 mo and 69% within 1 yr of treatment. Our data suggest that there is a higher incidence of hypothyroidism after standard doses of I-131 in the 1970s as contrasted with treatment groups in the 1950s and 1960s. The pathophysiology of this increased incidence is not known with certainty; however, infrequent use of thionamide medication, together with recent increases in dietary iodine, may render the gland more radiosensitive.
