Extended long-term drug monotherapy of Graves' disease.

The results are presented of a 3-17 years' prolongation of the usual one-year "long-term" drug treatment applied to patients with Graves' disease. Most of the 87 patients with an average age of 34.3 years were on the maintenance dose of 10 mg methimazole daily. This mono-drug therapy was well tolerated and accepted by the patients, the toxic state disappeared, glandular consistency and the size remained almost unchanged. Thirty-six patients of this group (41.4%) were in a "permanent" remission lasting over three years. The remaining 51 patients continued their maintenance dose which kept a balanced euthyroid state. The authors support the convenience of a considerable extension of the traditional long-term methimazole treatment of Graves' disease. This extended scheme of the drug suppression of euthyroid functions is reversible in contrast to radical surgical or radioiodine treatments which increase the cumulative rate of irreversible hypothyroidism over decades.

Unusual bone marrow visualization with 99mTc-damaged erythrocytes.

A visualization of the bone marrow beside that of the spleen was obtained with 99mTc-labeled N-ethylmaleimide (NEM) damaged erythrocytes in a patient with systemic lupus erythematosus. This phenomenon could be produced both with autologous and homologous red cells. The patient's NEM-damaged erythrocytes given to a healthy patient did not produce a visualization of the marrow. Such an observation was not present in a series of healthy persons and patients with different disorders to whom labeled and damaged erythrocytes were administered, and has not been reported in the literature so far.

Early diagnosis and detection of clinically non-suspected thyroid neoplasia by the cytologic method: a critical review of 1536 aspiration biopsies.

Aspiration biopsies were performed on 1536 patients with goiter who showed scintigraphically "cold" nodules. Twelve among them had clinical and cytological positive diagnosis. The remaining 1524 patients had aspiration biopsies without suspicion of the malignant nature of their goiters. Among them, 45 patients had a positive or suspect cytological diagnosis. Fourteen had not been yet operated on. Thirty-one were operated on and 28 malignancies were confirmed histologically. In three patients, cytological diagnosis was false positive. The remaining patients were cytologically negative. Thirty-seven were operated on and four false negative cases were found. The application of aspiration biopsy on every patient with a cold thyroid nodule resulted in the detection and very early diagnosis of clinically unsuspected thyroid neoplasms, the great majority of which were confined to the gland itself without metastasic spread. This fact makes the prognosis better. In addition, it is probable that the early detection of differentiated thyroid neoplasms and their surgical ablation interrupt their natural course towards anaplastic carcinoma, with its grim prognosis.