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[en] We prove that four-dimensional Friedmann-Robertson-Walker solutions to ghost-free superstring and heterotic string effective actions are stable when compactified on a torus. We also consider the case of more general compactifications, and argue that the requirement of stability may have a role in determining the geometry of the compactification. We also discuss the effect of removing ghosts from string actions by field redefinitions. (orig.)
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[en] There is a potential hazard of thyroid cancer after exposure to external irradiation for the treatment of adolescent acne vulgaris. We noted a 60% incidence of thyroid carcinoma among 20 patients with such a history, who were operated on for thyroid nodules during a five-year period. Eighty-three percent of the patients with carcinoma had either a follicular or a mixed papillary-follicular carcinoma; 17% had a papillary carcinoma; 33% had regional node metastases; none had evidence of distant metastases. The interval between radiation exposure and thyroidectomy ranged from nine to 41 years. This association of thyroid neoplasms and a prior history of radiation for acne vulgaris may be coincidental and therefore remains to be proved by retrospective surveys of large numbers of treated patients with appropriate controls
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X radiation
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Archives of Dermatology; v. 114(1); p. 53-55
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[en] The reported incidence of thyroid carcinoma in Hashimoto's thyroiditis varies widely. For this reason the specific subpopulation of patients with Hashimoto's thyroiditis and a solitary cold nodule was analyzed. Between 1972 and 1984 we operated on 146 consecutive patients with solitary cold nodules and Hashimoto's thyroiditis. There were 47 carcinomas, for an incidence of 32%. The mean age of the 146 patients was 43 1/2 years (median 44 years), with 126 females and 20 males. There was a history of prior head and neck radiation exposure in 54 patients, with a 33% incidence of thyroid carcinoma. The 92 patients without a history of radiation exposure had a 31.5% incidence of carcinoma. The frequency of multicentricity (bilateralism) was 33% in the group that underwent radiation and 24% in the group that did not. To date, with a mean follow-up of 4.7 years, there have been no deaths and no evidence of recurrence. In conclusion, we report a 32% incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis and a solitary cold nodule, with no apparent difference between the patients with or without a history of radiation exposure, although there was a higher incidence of bilateralism (33% versus 24%) in the carcinomas of the patients with a history of head and neck irradiation. We suggest that the operative management of these patients is total thyroidectomy for those with a history of head and neck radiation and thyroid lobectomy for patients with no history of radiation, followed by contralateral lobectomy if a carcinoma is demonstrated
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[en] The in vitro growth hormone releasing activity of plasma obtained from six acromegalic subjects was measured before and during therapy. In five subjects, plasmas were obtained before and during successful medical therapy with medroxyprogesterone acetate (MPA). The sixth subject was sampled before and after transphenoidal Sr90-induced hypopituitarism. All subjects had a decrement in fasting growth hormone levels with respective therapies (29-88%). The in vitro growth hormone released from Rhesus monkey anterior pituitaries was assessed after incubating one lateral half in control plasma (pre-therapy) and the contralateral pituitary half in plasma obtained during or after therapy. Studies with plasmas obtained from the five patients successfully treated with MPA showed a decrease in growth hormone releasing activity during therapy in all (18-57%). Plasma obtained after Sr90 pituitary ablation in the sixth subject had 35% more growth hormone releasing activity than obtained before therapy. These results suggest that active acromegalics who respond to MPA with significantly lowered growth hormone levels may actually achieve this response because of a decrease in growth hormone releasing factor measured peripherally. The opposite response in one acromegalic subject, following Sr90 pituitary ablation and hypopituitarism, suggests that growth hormone releasing factor secretion may increase when growth hormone levels are lowered by ablative therapy. (orig.)
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Die in vitro wachstumshormonausloesende Aktivitaet von Plasma, das sechs an Akromegalie leidenden Patienten entnommen wurde, wurde vor und waehrend der Therapie gemessen. Bei fuenf Patienten wurde Plasma vor und nach einer erfolgreichen Therapie mit Medroxyprogesteronacetat (MPA) entnommen, beim sechsten Patienten vor und nach der transphenoidalen, durch Sr-90 induzierten Hypophysenunterfunktion. Bei allen Patienten zeigte sich bei der jeweiligen Therapie im nuechternen Zustand eine Abnahme des Wachstumshormonspiegels (29-88%). Das in vitro Wachstumshormon aus dem Hypophysenvorderlappen von Rhesusaeffchen wurde gemessen, nachdem eine laterale Haelfte in Kontrollplasma (vor der Therapie entnommen) inkubiert worden war und die kontralaterale Hypophysenhaelfte in Plasma, das waehrend oder nach der Therapie entnommen wurde. Untersuchungen am Plasma der fuenf Patienten, die erfolgreich mit MPA behandelt worden waren, zeigten bei allen Patienten eine Abnahme der wachstumshormonausloesenden Aktivitaet waehrend der Therapie (18-57%). Das nach der Sr-90-Hypophysenablation dem sechsten Patienten entnommene Plasma hatte eine um 35% hoehere wachstumshormonausloesende Aktivitaet als vor der Therapie. Die Ergebnisse lassen vermuten, dass bei Patienten mit progressiver Akromegalie, die auf MPA mit signifikant geringeren Wachstumshormonwerten reagieren, diese Reaktion auf eine Verringerung des an der Peripherie gemessenen wachstumshormonausloesenden Faktors zurueckzufuehren sein kann. Die umgekehrte Reaktion bei einem Patienten nach Sr-90-Hypophysenablation und Hypophysenunterfunktion zeigt, dass die Sekretion des Wachstumshormon-Ausloesefaktors moeglicherweise zunimmt, wenn der Wachstumshormonspiegel durch ablative Therapie gesenkt wird. (orig.)Primary Subject
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Hormone and Metabolic Research; v. 10(4); p. 310-313
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[en] In seventy patients with nodular thyroids and a history of radiation exposure, total thyroidectomy disclosed a 54 percent incidence of carcinoma; more than half of them had cervical node metastases; four had distant metastases. Fourteen patients required radical neck dissection. The carcinoma was multicentric (both lobes) in 45 percent. In four patients the carcinoma was found in the lobe contralateral to the one containing the palpable nodule. These findings support the advocates of total thyroidectomy for patients with a nodular thyroid and a history of radiation exposure, provided this operation can be performed with a low incidence of recurrent nerve palsy and hypoparathyroidism
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37. annual meeting of the Society of University Surgeons; San Diego, CA, USA; 12 Feb 1976
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Surgery; v. 80(1); p. 70-76
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[en] We consider the effect of field redefinitions on the general form of the torsion dependent terms in the O(R3) string action. (orig.)
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[en] During a period of 20 years (1965-1985), 206 consecutive patients were operated on for radiation-associated nodular thyroids. The ages ranged between 8 and 76 years (mean 38.7). there were 136 women and 70 men. The average duration between radiation exposure and operation was 27 years. The operations performed were total thyroidectomy (192) or, in patients who had undergone a previous lobectomy in another institution, another lobectomy (14). In addition, 25 patients required a neck dissection for nodal metastases and 27 underwent simultaneous subtotal parathyroidectomy for coexistent hyperparathyroidism. The pathologic findings were: 87 (42.2%) carcinoma (73 papillary, 13 follicular, 1 undifferentiated); 92 (44.7%) follicular adenomas; and 27 (13.1%) thyroiditis. To date, with an average follow-up of 6 years (0.5-31 years), only two patients have expired from recurrent disease. A third died of unrelated cause. A comparison of the first 100 patients (12 years) with the last 106 patients (8 years) demonstrated that the incidence of carcinoma has dropped from 48 to 37%, the incidence of lymph node metastases has decreased from 35 to 26%, and the incidence of bilaterality has fallen from 75 to 54%. On the basis of this series, it was concluded that total thyroidectomy is still indicated for radiation-associated nodular thyroids. However, if the trend of decreasing incidence, bilaterality, and metastatic disease persists, this approach may have to be reevaluated in the near future
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[en] Forty-four patients with primary hyperparathyroidism were followed for 18 to 126 months after subtotal or total parathyroidectomy and parathyroid autotransplantation. Indications for autotransplantation included the devascularization of parathyroid glands during concomitant thyroid lobectomy or total thyroidectomy and the excision of the only remaining parathyroid tissue in patients with persistent hyperparathyroidism after previous unsuccessful parathyroidectomies. Before implantation, all parathyroid tissue was histologically evaluated by frozen-section light microscopy with hematoxylin and eosin stain. Fifteen patients had histologically normal implants; to date none of these patients have developed recurrent hyperparathyroidism. Twenty-nine patients had either adenomatous or hyperplastic parathyroid tissue used for implants; two of these patients developed graft-dependent recurrent hyperparathyroidism 4 and 7 years later. In both patients the grafts were preoperatively localized by thallium scanning and their resection restored eucalcemia. One hundred thirty-one patients from 11 series in the current literature had a cumulative incidence of 17.5% for presumed graft-dependent recurrence and a 9.2% incidence of graft excision followed by eucalcemia. In comparison, in the present series the incidence of graft-dependent recurrent hyperparathyroidism in patients with either adenomatous or hyperplastic implants stands at 6.9%. In contrast, in 15 patients with normal parathyroid tissue implants, the incidence was zero
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[en] The merit of the preoperative localization of parathyroid tumors with thallium-technetium subtraction imaging is a subject of current debate in the treatment of primary hyperparathyroidism. Eighty patients with hyperparathyroidism underwent preoperative subtraction scintigraphy with 201Tl Cl and /sup 99m/TcO4; scan results were correlated with the operative identification and histopathology of the resected parathyroid tissue. The true-positive, false-positive and false-negative rates of these scans were compared between patients with tumors in normal and ectopic anatomic locations and between patients undergoing an initial and reoperative neck exploration. The scan was clearly valuable in patients with one or more prior neck explorations. True-positive scans were obtained in seven (77%) of nine such patients. The scan was also valuable in patients who had ectopic tumors (six mediastinal, seven intrathyroid, and two in the carotid sheath). Twelve (80%) of these 15 ectopic tumors were correctly localized either prior to their first operation or before subsequent explorations. In contrast, only 33 (50%) of 65 patients had a true-positive scan prior to their first operation and when the tumor was not in an ectopic location. In summary, in this series, the thallium-technetium scan was correct in only 50 per cent of patients undergoing an initial operation. However, it was positive in 77 per cent of patients who had at least one prior neck exploration and in 80 per cent of patients with an ectopic parathyroid tumor. These results support the selective use of this valuable imaging and localization tool
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BETA DECAY RADIOISOTOPES, BETA-MINUS DECAY RADIOISOTOPES, BODY, COUNTING TECHNIQUES, DAYS LIVING RADIOISOTOPES, DIAGNOSTIC TECHNIQUES, DISEASES, ELECTRON CAPTURE RADIOISOTOPES, ENDOCRINE DISEASES, ENDOCRINE GLANDS, GLANDS, HEAVY NUCLEI, HOURS LIVING RADIOISOTOPES, INTERMEDIATE MASS NUCLEI, ISOMERIC TRANSITION ISOTOPES, ISOTOPES, MEDICINE, NUCLEI, ODD-EVEN NUCLEI, ORGANS, RADIOISOTOPE SCANNING, RADIOISOTOPES, SURGERY, TECHNETIUM ISOTOPES, THALLIUM ISOTOPES, YEARS LIVING RADIOISOTOPES
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[en] Over a period of 32 years from 1954 to 1986, 65 patients under the age of 21 years, 52 girls and 13 boys, were operated for nodular thyroids: the overall incidence of carcinoma was 37 per cent. It was 46 per cent in those patients presenting with a solitary nodule. Among the 24 patients with a malignancy, the carcinoma was of the papillary variety in 63 per cent, follicular in 25 per cent and medullary in 12 per cent. Two thirds of the patients had metastatic disease at the time of presentation. All patients with thyroid carcinoma were treated with total thyroidectomy. Other measures included neck dissection and radioactive iodine. When the eight patients with a history of head and neck irradiation and the three patients with medullary carcinoma were excluded, the incidence of carcinoma was 28 per cent. In summary, in spite of the decline in radiation associated cases, the incidence of carcinoma in nodular thyroid disease in the population under 21 years, remains at the relatively high figure of 28 per cent
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