Selection of treatment in the management of thyrotoxicosis in childhood and adolescence.

The management of 105 patients between the ages of three and 18 years, 83 females and 22 males, with thyrotoxicosis was reviewed retrospectively (1952-1976) with the intent of identifying criteria that would help predict response to therapy with antithyroid drugs and thereby permit earlier selection of alternative treatment. All patients were initially treated with antithyroid drugs. Twenty-six per cent (27) achieved remission with thioamides, 68% (72) underwent subtotal thyroidectomy with three patients requiring subsequent therapy with radioiodine, 6% (6) received radioiodine with one patient subsequently requiring subtotal thyroidectomy.

Aneurysms of the hepatic artery.

Aneurysms of the hepatic artery are rare and, when symptomatic, they may present a triad of upper abdominal pain, gastrointestinal bleeding, and obstructive jaundice. Asymptomatic and unsuspected aneurysms are demonstrated occasionally by abdominal arteriography or are encountered infrequently during abdominal operation for an unrelated disease. Hepatic artery aneurysms have great potential for rupture with bleeding into the peritioneal cavity, the common bile duct, or an adjacent hollow viscus.

Gastrocutaneous fistula following radiation therapy for seminoma of the testis.

A case presentation of a gastrocutaneous fistula following orthovoltage radiotherapy for prophylactic lymph node sterilization for seminoma of the testis is recorded. Many factors determine the response of an organ to radiation and with certain circumstances irreversible damage ensues. The pathologic effects of radiation on the stomach in the reported patient illustrates two stages of injury, acute and chronic.