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November, 1956 THYROID PROBLEMS IN CHILDREN—VAN WYK 501 BLOOD IODIDE THYROIDAL IODIDE BLOOD HORMONE H H 0 H NH, Iodine deficiency Iodine excess Anions Thiocyanate Perchlorate Nitrate Diet Iodides Cabbage iTurnipsjSprouts ? Soybean milk Drugs Thiouracil drugs Cobalt Sulfonamides Congenital (Enzyme deficiency) Goiterous cretinism ?Adolescent goiter Fig. 2. Simplified scheme of thyroid hormone synthesis. Production of hormone can be blocked at several sites either by a congenital defect in the enzyme mechanism or by environmental factors. of endogenous thyroid function. Eventually iatrogenic hypothyroidism may ensue when therapy is discontinued. Thyroid Synthesis After the trapping of iodine from the blood under the influence of the pituitary gland, a series of chemical reactions finally leads to the release of L-thyroxine, the major thyroid hormone (fig. 2). This orderly process can be disrupted at any point not only by naturally acquired disease, but also by substances which are taken into the body. Whenever the thyroid manufactures insufficient hormone to meet the physiologic needs of the body, it is stimulated by the pituitary gland to enlarge. Either an increased demand or a deficient production of thyroid hormone can create this disturbance. Since the thyroid has a considerable reserve capacity, increased demand alone apparently rarely causes hypertrophy. Some impairment in function is probably also necessary. Usually the resulting hypertrophy compensates for the demand and the patient remains in euthyroid status. Occasionally there is a more severe block in the production of hormone, and hypothyroidism ensues. Thus, in most instances, thyroid enlargement represents a compensatory phenomenon. Histologically the gland may present a varied picture depending on the duration of the metabolic derangement. There is increasing opinion, for example, that the struma lymphoma-tosa of Hashimoto is the manifestation of a metabolic derangement rather than of some unidentified infection. Talbot has found this histologic picture in about one third of his patients with simple adolescent goiter(3). Goiterogenic Agents Iodine Not many years ago goiters were common in certain parts of this country as a result of iodine deficiency. Although the introduction of iodized salt has all but obliterated this condition in the United States, studies in endemic goiter regions in South America indicate that the uptake of radioiodine is greater than in non-endemic areas whether or not a goiter is present(4). In other words, whereas you and I need to concentrate only 50 per cent of our ingested iodine, if we lived in an iodine-poor area we would have adapted ourselves by concentrating 90 per cent or more of ingested iodine. Because of these adaptive mechanisms, deficiency of iodine sufficient to cause cretinism does not occur unless several generations have lived in areas almost totally deprived of iodine. The amount of iodine necessary to prevent a compensatory goiter due to iodine deficiency is very small. Therefore, iodine deficiency is probably a minor cause of goiter in this state today. If goiters of this nature do occur, even 1 minim of Lugol's solution daily would exceed the dose required to alleviate the deficiency, although a long-standing colloid due to the iodine deficiency would not disappear even on large dosages. What is becoming a more frequent prob-
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-Present] |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1956 |
Identifier | NCHH-17-017 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 17 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-017.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-017 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | keep |
Description
Fixed Title * | Page 501 (image) |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1956 |
Identifier | NCHH-17-017-0553 |
Form General | Periodicals |
Page Type | all; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | ncarolinamed171956medi_0553.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 17 |
Issue Number | 11 |
Page Number | 501 |
Health Discipline | Medicine |
Full Text | November, 1956 THYROID PROBLEMS IN CHILDREN—VAN WYK 501 BLOOD IODIDE THYROIDAL IODIDE BLOOD HORMONE H H 0 H NH, Iodine deficiency Iodine excess Anions Thiocyanate Perchlorate Nitrate Diet Iodides Cabbage iTurnipsjSprouts ? Soybean milk Drugs Thiouracil drugs Cobalt Sulfonamides Congenital (Enzyme deficiency) Goiterous cretinism ?Adolescent goiter Fig. 2. Simplified scheme of thyroid hormone synthesis. Production of hormone can be blocked at several sites either by a congenital defect in the enzyme mechanism or by environmental factors. of endogenous thyroid function. Eventually iatrogenic hypothyroidism may ensue when therapy is discontinued. Thyroid Synthesis After the trapping of iodine from the blood under the influence of the pituitary gland, a series of chemical reactions finally leads to the release of L-thyroxine, the major thyroid hormone (fig. 2). This orderly process can be disrupted at any point not only by naturally acquired disease, but also by substances which are taken into the body. Whenever the thyroid manufactures insufficient hormone to meet the physiologic needs of the body, it is stimulated by the pituitary gland to enlarge. Either an increased demand or a deficient production of thyroid hormone can create this disturbance. Since the thyroid has a considerable reserve capacity, increased demand alone apparently rarely causes hypertrophy. Some impairment in function is probably also necessary. Usually the resulting hypertrophy compensates for the demand and the patient remains in euthyroid status. Occasionally there is a more severe block in the production of hormone, and hypothyroidism ensues. Thus, in most instances, thyroid enlargement represents a compensatory phenomenon. Histologically the gland may present a varied picture depending on the duration of the metabolic derangement. There is increasing opinion, for example, that the struma lymphoma-tosa of Hashimoto is the manifestation of a metabolic derangement rather than of some unidentified infection. Talbot has found this histologic picture in about one third of his patients with simple adolescent goiter(3). Goiterogenic Agents Iodine Not many years ago goiters were common in certain parts of this country as a result of iodine deficiency. Although the introduction of iodized salt has all but obliterated this condition in the United States, studies in endemic goiter regions in South America indicate that the uptake of radioiodine is greater than in non-endemic areas whether or not a goiter is present(4). In other words, whereas you and I need to concentrate only 50 per cent of our ingested iodine, if we lived in an iodine-poor area we would have adapted ourselves by concentrating 90 per cent or more of ingested iodine. Because of these adaptive mechanisms, deficiency of iodine sufficient to cause cretinism does not occur unless several generations have lived in areas almost totally deprived of iodine. The amount of iodine necessary to prevent a compensatory goiter due to iodine deficiency is very small. Therefore, iodine deficiency is probably a minor cause of goiter in this state today. If goiters of this nature do occur, even 1 minim of Lugol's solution daily would exceed the dose required to alleviate the deficiency, although a long-standing colloid due to the iodine deficiency would not disappear even on large dosages. What is becoming a more frequent prob- |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-017.pdf |
Document Sort | all; nchh-17 |
Article Title | Thyroid Problems In Children |
Article Author | Judson J. Van Wyk |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-017 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | keep |
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