A 34-year-old female with papillary carcinoma of the thyroid originating in a thyroglossal cyst is described. The patient's chief complaint was a submental mass. The mass was 6 x 4 cm, elastic, soft, and smooth-surfaced. CT examination showed high-density areas in part of the interior of the mass. Resection of the mass was attempted with a diagnosis of thyroglossal cyst. Since papillary carcinoma of the thyroid was noted in the cyst by intraoperative frozen section pathological examination, primary carcinoma of the thyroid was suspected, and the thyroid and surrounding areas were examined. Since no abnormalities were noted in the thyroid, the thyroid was preserved. According to the following reasons, the tumor was considered to be primary papillary carcinoma of the thyroid arising in the thyroglossal cyst: (1) Scar formation was noted in the center of the tumor; (2) tumor cells partly infiltrated into the surrounding tissues, and (3) no tumor was noted in the thyroid. A definitive diagnosis of carcinoma arising in the thyroglossal cyst has required confirmation of the absence of carcinoma in the thyroid by total thyroidectomy. In the present case, however, total thyroidectomy was avoided, because no gross pathological changes were observed in the thyroid during the operation. This decision may be controversial both diagnostically and therapeutically, but we consider from our observation of the course that total thyroidectomy is not always necessary.

Adult↗

PubMedDate not supplied

Binocular counterrolling during sustained body tilt in normal humans and in a patient with unilateral vestibular nerve section.

Two normal persons and a patient with unilateral vestibular nerve section were held motionless for ten minutes in the upright position, at 60 degrees tilt right ear down, and at 60 degrees tilt left ear down. In addition, one normal subject was held for ten minutes at each of 30, 60, and 90 degrees tilt left ear down. Photographs were taken of both eyes every ten seconds. Measurements of ocular counterrolling during these trials revealed torsional eye movements in all positions, including the upright, even though the head and body were stationary. Variations in torsion in the upright position ranged up to 2.75 degrees. At the tilt positions, variations ranged up to 4 degrees. Disconjugate movements were seen in all subjects in all positions. There were no significant differences in measurements of ocular counterrolling during static tilt between the normal subjects and the patient with the vestibular nerve section, in contrast to measures obtained during slow velocity dynamic testing.

Adult↗

PubMedDate not supplied

Type of distribution of the test data of the optokinetic nystagmus.

In statistical analysis, the type of distribution of the population under study dictates the choice of analytical methods. Exploratory data analysis was undertaken to evaluate the type of distribution for several variables in optokinetic nystagmus: the total numbers of nystagmus (NYS), the algebraic sums of the slow-phase amplitude (AMP) and of the slow-phase velocity (VEL), and the means of the fast-phase velocity (FM). The samples were collected from 814 healthy subjects as reference data. The 5-number summaries were first calculated for each variable, and the mid-summaries for the six letter values were examined for fine structure to reveal the presence of some outliers. The upper and lower limits of the 5-number summaries were then defined to reject the outliers. After outlier rejection the distribution was examined by histogram and probability plots, and by evaluation with the chi-square test, the Kolomogorov-Smirnov test and also with skewness and kurtosis. All the variables proved to fit the normal distribution by at least three methods, except by skewness and kurtosis. Of all methods, the probability plot seems to be the best in the present evaluation.

Chi-Square Distribution↗