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Increased iodine uptake by obese strain thyroid glands transplanted to normal chick embryos.

The Obese strain (OS) of chickens spontaneously develops autoimmune thyroiditis. Since a defect or abnormality of the thyroid gland may be involved in this disease experiments were performed to compare the iodine uptake of OS with normal thyroid glands. To minimize the interaction of the OS immune system with the thyroid gland during these studies, thyroids were removed from 16-day-old embryos and transferred to the chorioallantoic membrane (CAM) of 9-day-old normal White Leghorn (NWL) embryos. NWL thyroid glands were transferred to the same CAM. Six days later the 20-hr 131I uptake of the transplants was determined. Twenty OS thyroid lobes had a mean 131I uptake of 2960 +/- 740 cpm, whereas the NWL thyroids incorporated significantly less iodine (890 +/- 160 cpm; p less than 0.025). These results, along with a previous report suggest that an abnormality of the thyroid gland might be an important factor in the development of autoimmune thyroiditis.

Animals↗

[Roentgen computer tomography and sonography in thyroid gland diagnosis].

Echography of the thyroid gland is a non-invasive and simple method without contraindications. The method is reliable, inexpensive and of high diagnostic efficiency. The structural information provided by the ultrasound technique complements the results of laboratory tests and other in-vivo techniques. Normal echogenicity can be observed in health persons as well as in diffuse goiters. An echofree area with enhanced echogenicity is a typical sonogram of a cystic structure. Circumscript enhanced echogenicity is usually due to a benign lesion. Areas of diminished echogenicity may be benign or malignant. In patients with Graves' disease or patients suffering from lymphocytic thyroiditis, diffuse diminished echogenicity is found in a high percentage. CT of thyroid masses allows an exact measurement of the volume of the organ to be made together with its retrosternal parts. CT examinations can locate the spread into the frontal and posterior mediastinum, thus providing optimal operative access to retrosternal goiters. Remnants of thyroid malignancies, lymph-node metastasis, infiltration into the sternum and occlusions of larger vessels due to tumour growth are visible in the CT-Scan. It is not possible to differentiate between malignant tumours or benign masses, if there is no infiltration into the surrounding organs. Also hyperthyroidism and thyreoiditis cannot be differentiated. In our opinion ultrasound examinations should immediately follow the patient's history and physical examination. Additional in-vivo methods should be performed according to the specified problems.

Calcinosis↗

Malignant lymphoma of the thyroid gland.

Malignant lymphoma of the thyroid gland is a rare entity; only 200 cases have been reported to date since 1960. Four patients with this disease presented at the Kingston clinic of the Ontario Cancer Treatment and Research Foundation. Those with localized malignant lymphoma, particularly the histiocytic types, responded favourably to resection of as much of the tumour as possible and subsequent local radiation with cobalt-60 telecurietherapy (3000 to 4000 rads in 3 to 4 weeks). The results of local radiation alone after a biopsy in patients with inoperable localized diseases are encouraging; it is possible, but not yet established, that some of these patients are cured. It has been suggested that the tumour is dependent on thyroid-stimulating hormone but conclusive evidence is not yet available.

Aged↗

Morphology, immunohistochemistry and morphometry of the thyroid gland in cases of sudden infant death syndrome (SIDS).

The thyroid glands of 107 SIDS victims (sudden infant death syndrome) have been studied. Controls consisted of 20 thyroid glands from infants who died of other causes (accidents, pneumonia etc.). The thyroid glands were investigated histologically, immunohistologically and morphometrically. Immunohistochemistry (S-100 protein and calcitonin) and morphometry showed no significant results. Histologically, hyperemia (severe: 34 cases = 31.8%; mild: 23 cases = 21.5%), and fibrosis (45 cases = 42.1%; mild: 26 cases = 24.3%) were found. A large number of cases showed depleted follicles (87 cases = 81.3%), little colloid (little: 37 cases = 34.6%; none: 9 cases = 8.4%) and desquamation (severe: 21 cases = 19.6%; abundant: 20 cases = 18.7%). Only fibrosis and depleted follicles were found more often in SIDS than in the controls (conditional logistic regression: rise of incidence for SIDS 2.9 times, P = 0.028, and 1.2 times, P = 0.051, respectively), a commoner occurrence of hyperemia in SIDS was of limited significance (P = 0.105). The alterations found can be taken as stress reactions to current or recurrent hypoxemia and the mild fibrosis indicates recurrent hypoxemia. All alterations indicate that the victims had previously suffered near death episodes. Even though the glands were handled with care, artefacts and autolysis must be taken into consideration. Neither the histological, immunohistological nor morphometrical studies of the thyroid gland gave an explanation as to the cause of death or showed any changes providing explicit help in diagnosing SIDS.

Calcitonin↗

[Therapy related alterations to the thyroid gland].

Therapy related alterations to the thyroid gland are associated with more or less specific morphological changes. The therapy (thyrostatic drugs, radio-iodine) may be administered for the treatment of thyroid dysfunction (hyperthyroidism), or the thyroid gland is involved during or after the treatment (irradiation, various drugs) of primarily non-thyroid related diseases. The present review summarizes the most important morphological changes related to therapy.

Amiodarone↗

Thyroid gland tumor diagnosis at US elastography.

PURPOSE: To prospectively evaluate the elastographic appearance of thyroid gland tumors and explore the potential sensitivity and specificity of ultrasonographic (US) elastography for differentiating benign and malignant tumors, with histopathologic analysis as the reference standard. MATERIALS AND METHODS: The study was institutional review board approved, and each patient gave written informed consent. Fifty-two thyroid gland lesions (22 malignant, 30 benign) in 31 consecutive patients (six men, 25 women; mean age, 49.7 years +/- 14.7 [standard deviation]) were examined with real-time elastography in the elasticity imaging mode implemented on a clinical US scanner modified for research. In addition, the radiofrequency echo data stored during US were exported from the scanner and used for off-line strain image reconstruction. All elastograms were evaluated for the lesion visibility, relative brightness, and margin regularity and definition by using a four-point scale. In addition, normal thyroid gland tissue and thyroid gland tumor strains were measured on off-line processed elastograms, and the thyroid gland-to-tumor strain ratio (ie, strain index) was calculated. The potential of elastographic criteria for the diagnosis of thyroid gland cancer was evaluated with univariate analysis and multivariate logistic regression. Qualitative variables were compared by using the chi2 test, and quantitative variables were compared by using the Mann-Whitney U test. P < .05 was considered to indicate significance. RESULTS: A strain index value greater than 4 on off-line processed elastograms was the strongest independent predictor of thyroid gland malignancy (P < .001); this criterion had 96% specificity and 82% sensitivity. Two other elastographic criteria, which were evaluated on real-time elastograms--a margin regularity score higher than 3 (88% specificity, 36% sensitivity) and a tumor area ratio higher than 1 (92% specificity, 46% sensitivity)--also were associated with malignancy (P < .05). However, the usefulness of these criteria was not considered to be high because of their low sensitivity. CONCLUSION: Elastography is a promising imaging technique that can assist in the differential diagnosis of thyroid cancer.

Adult↗

Cholinergic nerves in the thyroid gland.

The cholinergic innervation of the thyroid gland has been studied in the human. AChE positive nerve fibers are localized in the wall of the thyroid artery, arranged in two plexuses, a superficial (adventitial) and a deep one (medial). The glandular tissue is provided with cholinergic nerve fibers, localized between and around thyroid follicles. The present results suggest that the endocrine activity of the thyroid gland is also under the control of the autonomic nervous system.

Acetylcholinesterase↗

The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland.

Ninety-five patients with papillary thyroid carcinoma (PTC) who received primary surgical treatment in 1983 at Kuma Hospital and were followed until 1992 were the subjects of this study. Initial therapy was tumor resection for 5 patients, lobectomy for 23 patients, total thyroidectomy with unilateral modified neck dissection for 60 patients, and total thyroidectomy with bilateral modified neck dissection for 7 patients. Clinical stage at diagnosis was as follows. Class I included 28 patients with intrathyroidal disease, class II included 60 patients with positive cervical lymph nodes, and class II included 7 patients with tumor invasion into tissue outside of the thyroid gland. Recurrence of the tumor was evaluated according to lymphocytic infiltration in the thyroid gland. Group A consisted of 36 patients with PTC associated with lymphocytic infiltration, 26 with infiltration surrounding the tumor, 3 with infiltration inside of the tumor, and 7 with both. Group B consisted of the remaining 59 patients with PTC with no lymphocytic infiltration. There were no differences in age, sex, initial tumor size, or initial treatment between groups A and B. Antithyroglobulin antibody and/or antimicrosomal antibody were positive in 16 patients from group A and 4 patients from group B (P < 0.001). Class I included 14 patients from each group, class II included 22 patients from group A and 38 patients from group B, and class III included 7 patients, all from group B. Recurrence of the tumor was found in only 1 group A patient (2.8%), but in 11 patients of group B (18.6%). The percentage of patients free from recurrence over the 10 yr of follow-up in group A was significantly higher than that in group B (by Cox-Mantel test, P < 0.01). The time between initial treatment and recurrence was 2-10 yr. In comparing the clinical stage at the time of initial treatment, recurrence was found in 1 class II patient from group A (4.5%) and in 1 class I (7.1%), 6 class II (15.8%), and 4 class III (57.1%) patients from group B. No patients died during the 10 yr of follow-up. In conclusion, 1) lymphocytic infiltration surrounding the tumor or inside the tumor in PTC might be of use as a means for predicting a favorable prognosis; and 2) class II or class III patients with no lymphocytic infiltration had a high rate of recurrence.

Adult↗

Acetyl-cholinesterase and mono-amine-oxidase activities in the microganglia of the thyroid gland in the rat.

The nervous microganglia of the thyroid gland have been studied in forty adult male rats, their morphology being analyzed by the osmium-zinc iodide technique their acetyl-cholinesterase activity (AChE) by an histochemical specific technique and their mono-amine-oxidase activity (MAO) by a tetrazolium technique. Few but constant microganglia were observed in the thyroid glands. These microganglia are formed by some 4 to 8 nerve cells. Intense mono-amine-oxidase activity (MAO) was found in the nerve cells of these microganglia, being absent in the rest of the thyroid gland. Intense specific acetyl-cholinesterase (AChE) was observed in the nerve cells scattered along nerve branches located in the connective tissue (single nerve cells or small cellular groups). AChE activity was not observed in the microganglia of the thyroid gland.

Acetylcholinesterase↗

Thyroid gland morphology in young adults: normal subjects versus those with prior low-dose neck irradiation in childhood.

Thyroid glands obtained at autopsy from young adults were studied to establish more accurately the "normal" morphology in the groups 20 to 40 years of age. A total of 56 autopsy specimens (many obtained from trauma victims) were examined in detail by totally embedding and sectioning the thyroid glands. The morphology of these thyroid glands also was compared to that of surgically removed thyroid glands from 47 young adult patients with prior low-dose neck irradiation. The "normal" thyroid specimens frequently showed morphologic features, such as thyroid tissue outside the recognizable capsule of the gland (40 of 56 patients) and in the strap muscles of the neck (six of 56 patients), which are conditions commonly considered as evidence for invasive thyroid carcinoma. The thyroid glands from the "normal" young adult population were significantly different from those thyroid glands surgically removed from patients who had received irradiation. The irradiated thyroid glands invariably showed multiple nodules of a wide variety of histologic types, extensive lymphocytic infiltrates, and distorting fibrosis as well as a high incidence of malignancy (27 of 47 patients). A single 0.1 cm focus of papillary carcinoma was found in one specimen in the nonirradiated thyroid group. This study suggests that "occult" thyroid carcinomas in the group 20 to 40 years of age are rare and are significantly fewer in number than in the older population (P less than 0.02).

Adult↗

Position of ultimobranchial body cysts in the human fetal thyroid gland.

In a series of 21 human fetal thyroid glands examined histologically in serial sections, seven ultimobranchial body cysts were found. The position of these cysts correlated well with the distribution of calcitonin-containing cells found by previous investigators in the adult thyroid gland. Ultimobranchial body cysts found external to the thyroid lobes may offer a developmental explanation for the paucity of calcitonin found in some adult thyroid glands. The close developmental relationship between the parathyroid gland and the ultimobranchial body could explain the presence of calcitonin found in these glands in some adults.

Animals↗

[Effect of weightlessness and artificial gravitation on thyroid gland morphology].

The investigation of the thyroid gland was carried out in Wistar rats, SPF colony 4.5--13 h and 25 days after a 18.5 days flight on board the space biosatellite "Cosmos-936". In animals subjected to weightlessness, moderate symptoms of the thyroid hypofunction were observed, statistically significant decrease in number and volume of the nuclei in calcitonin-secreting cells (C-cells) was especially pronounced during 4.5--9 h after landing. Similar but less pronounced changes were observed in C-cells of the rats subjected to artificial conditions of space flight, besides weightlessness. The similarity of the changes in the animals of both groups made it possible to connect the increasing amount of C-cells and the morphological symptoms of their functional inhibition with the effect of weightlessness and hypokinesia. During the space flight, the animals were kept under the conditions of artificial gravitation on board the biosatellite and therefore morphological peculiarities specific for the earth conditions were preserved in C-cells and the thyroid gland. Thus, it was concluded that artificial gravitation prevented the development of the thyroid changes which appeared under the influence of weightlessness.

Animals↗

Decreased thyroid gland volume in alcoholic cirrhosis of the liver.

Thyroid function and thyroid gland volume were studied in 40 consecutive alcoholic patients with histologically proven cirrhosis of the liver, and compared with data obtained from 40 sex-, age-, and weight-matched normal subjects. Thyroid volume, measured ultrasonically, was significantly decreased in the patients with cirrhosis: median, 11 ml (range, 6-16 ml); compared to normal subjects: median, 20 ml (range, 10-31 ml) (P less than 0.001). Serum T3 concentrations were significantly reduced: median, 1.5 nmol/liter (range, 0.1-2.5 nmol/liter); compared to normal subjects: median, 2.2 nmol/liter (range, 1.5-2.8 nmol/liter) (P less than 0.001). The free T3 index was reduced accordingly. Serum TSH levels were significantly increased in cirrhosis: median, 2.1 microU/ml (range, 0.4-5.3 microU/ml); compared to normal subjects: median, 1.1 microU/ml (range, 0.3-3.8 microU/ml) (P less than 0.05). No significant differences were found in T3 resin uptake, free T4 index, or serum T4 levels between the two groups. No significant correlations could be demonstrated between thyroid gland volume and biochemical indices of liver function or thyroid function tests. It is suggested that alcohol might have a direct effect on the thyroid gland.

Adult↗

Serum thyroid hormone and thyroid gland weight measurements in protein-energy malnutrition.

Protein-energy malnutrition (PEM) is a problem which concerns about half the world's children. We investigated the effects of malnutrition on thyroid gland weight and thyroid hormone levels. 22 children suffering from malnutrition (14 children suffering from marasmus and 8 children suffering from kwashiorkor) and 7 healthy controls were studied. Malnutrition was confirmed clinically and according to the Wellcome classification definition of malnutrition. Serum thyroid hormone concentrations were measured by radioimmunoassay and the weights of the thyroid gland were evaluated scintigraphically. In the groups with marasmus and kwashiorkor the mean TT4, TT3 and FT3 levels were significantly lower, and TSH levels were significantly higher, compared to controls. FT4 was not influenced by PEM. The mean thyroid gland weights of the groups with marasmus and kwashiorkor were higher than that of the control group. We found no significant differences in all these parameters between groups with marasmus and kwashiorkor. In each of the three groups, the most marked positive correlation was between thyroid gland weight and ratio of thyroid gland weight to body surface area.

Body Surface Area↗