No abstract

Radical surgery for papillary adenocarcinoma of the thyroid has been associated with a significant incidence of complications. In some instances, postoperative irradiation is given when there is some suspicion of persistent or occult disease, although thyroid suppression and ablative radioiodine therapy have proved to be very effective adjuvants to surgery. Three patients with papillary adenocarcinoma of the thyroid developed severe, delayed complications 25, 7, and 2 years, respectively, after treatment with primary radical surgery and postoperative irradiation. The degree of injury to the aerodigestive tract as a result of the surgery and irradiation therapy makes treatment difficult regardless of the modality. The possible mechanisms that cause these complications, along with proposed methods of treatment, are discussed.

No abstract

alpha-Melanotrophin was detected by radioimmunoassay in the human fetal pituitary gland from 11 weeks of gestation. The peak hormone concentration of 3.4 nmol/g pituitary tissue was reached at 17-20 weeks. From 17 to 36 weeks of gestation the total gland content rose gradually from 28 to 102 pmol. During this latter period, the pituitary gland grew some 10-fold, with the result that the alpha-melanotrophin concentration declined steadily to 1.3 nmol/g. In the final month of gestation, both the total gland content and the concentration of alpha-melanotrophin rose significantly to 254 pmol and 2.4 nmol/g respectively. The variations in pituitary gland content of alpha-melanotrophin were consistent with a role for pars intermedia peptides in the fetus. alpha-Melanotrophin-like peptides were not demonstrated in human placental tissue.

Between January 1, 1970, and December 31, 1990, 42 consecutive pediatric patients were treated at the Medical College of Wisconsin Affiliated Hospitals for early-stage Hodgkin's disease. Thirty patients were clinically staged. Twelve underwent staging laparotomy as a part of staging work-up. Thirty-one patients were treated with radiation therapy (RT) alone. Eleven were treated with combined chemotherapy and RT. For the entire group, overall survival at 5, 10, and 15 years was 98, 98, and 92%, respectively. Disease-free survival was 86, 86, and 79, respectively. There was no significant difference in overall survival or disease-free survival comparing clinically versus pathologically staged patients. There was a trend toward improved disease-free survival favoring pathologically staged patients; however, this difference did not reach statistical significance (p = 0.07). The long-term results of this series fail to show statistically significant superior disease-free or overall survival with surgical staging.