The significance of I-131 treatment of metastatic thyroid-carcinoma.

The benefit of I-131 therapy of metastatic differentiated thyroid carcinoma is controversial. To evaluate usefulness of I-131 therapy for metastatic differentiated carcinoma, 83 patients were chosen from 276 patients with differentiated thyroid carcinoma who were operated at Nagasaki University Hospital since 1960 according to the following criteria; (i) thyroids totally removed, (ii) existence of metastases at total thyroidectomy, (iii) the cause of death related to thyroid carcinoma if the patient died. The usefulness of I-131 therapy was evaluated by analysis of survival during 10 years following total thyroidectomy. In patients without remote metastases, the survivors and nonsurvivors were 37 and 2 in those without I-131 therapy (Group I), and 11 and 1 in those with I-131 therapy (Group II), respectively. There was no significant difference between the two groups. In patients with remote metastases, the survivors and non survivors were 9 and 1 in I-131 treated patients who had I-131 accumulation in the metastases with tracer doses (Group III-1), 1 and 11 in I-131 treated patients without I-131 accumulation in metastases with tracer doses (Group III-2), and 4 and 6 in non I-131 treated patients whose metastases were not examined for I-131 accumulation (Group IV), respectively. The prognosis was best in Group III-1 and followed by Group IV and Group III-2 in this order in patients with remote metastases. There was no significant difference in age and sex among the groups and in pathological findings of carcinoma. These results suggest that I-131 therapy may be useful for patients with remote metastases which accumulate I-131 with tracer doses but not for those patients who do not accumulate I-131 and that I-131 accumulation in metastases with tracer doses may be of prognostic significance.

The effects of obstetric conditions on neonatal behaviour in Japanese infants.

The effects of obstetric conditions on neonatal neurological status and neonatal behaviour were studied using a sample of 159 Japanese infants who were neurologically and obstetrically low-risk. Observations were made using Prechtl's neonatal neurological examination and Brazelton's neonatal behavioural assessment on the 5th day after birth. The main obstetric conditions which relate to neurological status and behaviour are anaesthesia, induction of labour, previous spontaneous abortion, previous induced abortion and maternal alcohol consumption. The main areas of neurological status and behaviour which are affected by obstetric conditions are lability of states, alertness, orientation, habituation, activity, hand to mouth activity, defensive movements, head control and resistance to cuddle. The results of the present study suggest that even a small difference of low-risk obstetric conditions is related to differences in neonatal neurological status and neonatal behaviour. On the one hand inter-item relations were found and on the other hand the results supported Prechtl's finding [16] that an analysis of the relation between obstetric conditions and neonatal status as a whole is preferable to an item by item comparison.

A study on neonatal behaviour comparing between two groups from different cultural backgrounds.

Fifty-one British newborn infants and 51 Japanese newborn infants were compared using Prechtl's neonatal neurological examination and Brazelton's neonatal behavioural assessment scale on the 5th day after birth. Statistically significant differences were found between the two groups. British infants were more responsive to the stimuli displayed and showed better self-quieting activity and motor performance than Japanese infants and there were differences in the course of state change and of habituation; however, some responses may have been affected by daily posture. These results are partly supported by the findings of other studies. As conditions which have previously been reported to affect neonatal status were matched between the two groups, with cultural background being the only exception, it can be said that the differences arose from the cultural background.

The analysis of sucking behaviour in newborn infants.

A special video camera devised by the author and a fiberscope were used to film the neonatal sucking response of 50 low-risk full-term newborn infants on the 5th day after birth. Analysis of the sucking behaviour showed that the sucking movements consist mainly of a peristaltic tongue movement and two kinds of negative pressure; that the peristaltic tongue movements are synchronized with the jaw movements; that infants actively adapt to a varying environment; and that the sucking movements change to minimize the energy required.

Evaluation of the timing to reduce the initial dose of antithyroid drugs in patients with Graves' disease.

The present study was undertaken to evaluate whether the normalization of the serum TSH level in a supersensitive assay during the initial treatment with antithyroid drugs (ATD) is a useful indicator for the reduction of the initial dose of ATD in 50 patients with hyperthyroidism due to Graves' disease. The initial dose of ATD was continued until the achievement of the euthyroid state, and was then reduced either before the serum TSH level was in the normal range in 9 of 29 patients treated with methimazole (MMI) (group MMI-1) and 8 of 21 treated with propylthiouracil (PTU) (PTU-1), or after the serum TSH level was in/above the normal range in 20 of 29 treated with MMI (MMI-2) and 13 of 21 treated with PTU (PTU-2). Although there were no significant differences in age, sex, thyroid function, prevalence of autoantibodies, goiter size, duration of the disease or the initial and modified doses of ATD, the mean durations of the administration of the initial dose of ATD in MMI-2 and PTU-2 were significantly longer than those in MMI-1 and PTU-1, respectively. As a result, 4 (44%) in group MMI-1, 20 (100%) in MMI-2, 2 (25%) in PTU-1 and 7 (54%) in PTU-2 developed low free T4 levels, and 1 (11%) in MMI-1, 15 (75%) in MMI-2 and 3 (23%) in PTU-2 developed low free T3 levels. Serum TSH levels increased over the normal range in 3 (33%) in MMI-1, 18 (90%) in MMI-2 and 5 (39%) in PTU-2.(ABSTRACT TRUNCATED AT 250 WORDS)