Thyroid glands from 215 patients, aged 19 to 88 years, without known thyroid disease, were serially sectioned at 2-3 mm intervals and microscopically examined for occult disease. Glands were normal in 32.5%, while nodules were observed in 60% and adenomas in 13%. Carcinomas were found in 20 cases (9.3%): occult papillary carcinomas in 19 (8.8%) and one medullary carcinoma. No carcinomas were found in the thyroids of 15 patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients and, for patients over 40 years, with increasing age. Of the 19 papillary tumours more than one focus was found in six cases (a total of 28 foci). The diameter of 27 of these tumours was less than or equal to 5 mm (96.4%), with one exception (diameter 6.3 mm). These findings were compared with those obtained in 86 thyroid glands of children surgically resected for carcinomas between 1986 and 1991. Only 10 of these tumours (11.6%) were less than or equal to 1 cm. These tumours, however, were significantly larger than the occult papillary carcinomas and their morphological features were quite different. Our results are discussed with regard to the possible role of factors other than irradiation due to the nuclear accident at Chernobyl, and the observed sharp numerical increase of thyroid carcinomas in children of the Republic of Belarus after this event.
It has been known for many years that there is a tendency to loss of height in late middle and old age (Roberts, 1878). Powys (1901) Previous workers have considered that the main aetiological factor is an increased obliquity of the ribs due to senile kyphosis and muscular weakness, but few accurate observations have been made. The present paper records the results of an investigation of the extent, causation, and possible clinical significance of this anatomical change in the aged. MethodsObservations were made on 340 subjects (152 male and 188 female). Only adults were studied, and almost all were chronic cases inhospital, with an average length of stay of 2.5 years. This makes the results inapplicable to the general population, the changes due to ageing being probably more extreme in these subjects than in the average. All adult age groups were included, but there were a great many elderly subjects, resulting in a high average age of 68 years. In all cases accurate measurements of the height of the patient and the distance between the subcostal and suprailiac lines were made. The latter measurement is here termed the " pelvi-costal distance," and the ratio of this to the height of the patient the " pelvi-costal ratio." The convention was adopted of recording these values as negative in the individuals in whom the subcostal line was lower than the supra-iliac line, this extreme deformity being found in only four patients.As the investigation was designed to study the causation and significance of a low, zero, or negative pelvi-costal ratio, all individuals with a value of this ratio below 1%were subjected to full radiological examination of the lumbar and dorsal spine. This sample consisted of 22 males and 32 females, and, as expected, contained a disproportionate number of elderly patients, the average age being 74. A group for comparison was taken from the remaining 286 patients.This group was selected to contain exactly the same number of males and females as the previous group and to have precisely the same age distribution, the method of random numbers being employed in choosing between suitable individuals. It follows, therefore, that the two groups were exactly comparable except that the former consisted only of individuals with an abnormally low pelvi-costal ratio and the latter with an average ratio for the age group concerned. These two groups will subsequently be referred to as the " cases" and the 'icontrols."The following measurements were considered to be possible factors in the production of an abnormally low pelvi-costal ratio, and were obtained directly from the xray plates: (a) the angle between the lower ribs and the anterior border of the lower dorsal spine; (b) the degree of lumbar lordosis expressed as an angular measurement; (c) the length of the lumbar spine; (d) the proporfion of the lumbar spine occupied by the intervertebral disks; and (e) the degree of spinal osteoporosis.The last factor is very difficult to express in a quantitative manner, as has been well discussed by Lachmann a...
ENDOCYME FOETUS IN A FIJI INFANT BRITISH 733 MEDICAL JOU_AL (3.74 kg.). On Aug. 25 a partial resuture of the abdomen was required, but otherwise the patient made an excellent recovery, and was discharged on Oct. 24, 1940. Her weight was then 11 lb. 4 oz. (5.12 kg.).
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