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PubMed1980

A delayed LH/FSH rise after gonadectomy and a delayed serum TSH rise after thyroidectomy in monosodium-L-glutamate (MSG)-treated rats.

The serum LH and FSH rise after gonadectomy and the serum TSH rise after thyroidectomy were examined in rats that received monosodium-L-glutamate (MSG) as neonates. The rise in serum gonadotrophins after gonadectomy was significantly delayed in both adult and peripubertal MSG-treated rats when compared to control castrates. Serum LH and FSH levels, however, eventually achieved levels in MSG-treated rats that were not significantly different than those of controls. The serum TSH rise after thyroidectomy was significantly delayed in adult female MSG-treated rats, but not in prepubertal female MSG-treated rats. Pituitary responsiveness to both exogenous LH-RH and TRH was unaffected by neonatal MSG treatment, with one exception: pituitary responsiveness to HL-RH of orchidectomized peripubertal males was blunted significantly. The results are discussed in terms of the possible neurotoxic effects of neonatal MSG treatment, as well as the altered hypothalamic sensitivity to gonadal steroids.

Animals↗
PubMed1983

Effects of thyroidectomy and season on the external granular layer of the cerebellum in metamorphosing bullfrog tadpoles (Rana catesbeiana).

Transient formation of the cerebellar external granular layer (EGL) occurs during metamorphosis in frog tadpoles and is dependent on thyroid hormone. Late prometamorphic bullfrog tadpoles at similar stages of development were thyroidectomized and then killed after 1 month and 2 months during the fall and winter. The cerebellum was studied by qualitative and quantitative light microscopy. Thyroidectomy resulted in an inhibition of external metamorphic changes such as hind limb growth. Examination of the cerebellum after thyroidectomy showed the EGL greatly decreased in thickness after 1 month and in some cases was altogether absent after 2 months. Because the disappearance of EGL cells was a result of their inward migration into the IGL, we conclude that thyroid hormone was not necessary for granule cell migration. In addition, metamorphic change normally occurs in the late spring and summer in bullfrog tadpoles, and is inhibited during the fall and winter (metamorphic stasis). During the winter, the volume of the EGL was significantly less compared with tadpoles undergoing active metamorphosis. Although lowered temperature appears to contribute to the large decline in EGL thickness, significant seasonal differences in the EGL volume ratio were still observed in tadpoles maintained under conditions of constant temperature and light. Thyroxine administered to thyroidectomized tadpoles during the winter increased the thickness of the EGL. Therefore, the seasonal decline in the EGL thickness reflects a decrease in thyroid hormone activity, which in turn appears controlled by both internal (hypothalamic) and environmental (e.g., temperature) factors.

Animals↗
PubMed1984

The effects of thyroidectomy on androgen and prolactin receptors in the dorsal skin and caudal fin of Triturus cristatus carnifex.

The interactions between thyroid hormones and receptors for steroid hormones and prolactin in dorsal skin and caudal fin of Triturus cristatus carnifex were studied during the annual cycle. Thyroidectomy induces an increase of prolactin binding in the dorsal skin and caudal fin in the animals captured in March. In these thyrodectomized animals the androgen receptors became undetectable. Results indicate that in Triturus cristatus carnifex the thyroid induces an increase of androgen receptors and a decrease, that is removed by thyroidectomy, of prolactin receptors.

Animals↗
PubMed1996

Effect of thyroidectomy on photoreceptor cells in adult rat retina.

To evaluate the effect of thyroid hormone on the retina in the adult male rat, morphometric and autoradiographic studies were made. Four days after an intravenous pulse injection of L-[3H]-leucine into adult male rats, the eyeballs were removed and the autoradiogram made. Two weeks after thyroidectomy, the length of photoreceptor cell inner segments was significantly decreased, but that of the outer segments did not change. Daily supplement of T4 (100 microg/kg sc twice for 2 days) before L-[3H]-leucine injection did not restore the decrease in the length. The silver grains of radioactive material distributed in the outer segment were divided into 3 equal portions. Thyroidectomy significantly increased the number of grains in the basal portion near the inner layer indicating a reduction in the renewal rate of the outer segment, but the T4 supplement did not restore the reduction in the renewal rate. These findings suggest that thyroid hormone is required to maintain the rate of renewal of the photoreceptor cell outer segment but the hormone supplement did not rapidly restore the renewal rate.

Animals↗
PubMed1986

Resolution of thyroid-induced schizophreniform disorder following subtotal thyroidectomy: case report.

Psychoses due to thyrotoxicosis are typically affective in nature. We report on a schizophreniform psychosis in a woman with Graves' disease whose symptoms abated following subtotal thyroidectomy. Surgical thyroidectomy should be considered in thyrotoxic patients who are unresponsive to medical therapy or who manifest unremitting or life-threatening psychotic behavior, especially if long-term compliance required for medical therapy appears unlikely.

Adult↗
PubMed1982

Effects of neonatal thyroidectomy on the development of the vomeronasal organ in the rat.

The effects of postnatal thyroidectomy (on day 8 after birth) and 131I treatment (on day 10) on the development of the vomeronasal organ (VO) has been studied In the rat. Thyroidectomized rats showed decrements in the overall VO volume, volume of the neurosensorial epithelium, neuronal population and nuclear size of neurons. These results in VO paralleled those reported in the central nervous system after thyroidectomy.

Aging↗
PubMed1989

Prognosis and morbidity after total thyroidectomy for papillary, follicular and medullary thyroid cancer.

The prognosis and the morbidity results after total thyroidectomy are reported for 148 patients with differentiated thyroid cancer. Ninety-two patients (62%) had papillary cancer, 27 (18%) had follicular cancer and 29 (20%) had medullary cancer. In the latter group, 16 patients had no clinical signs of a tumour and underwent total thyroidectomy after elevated calcitonin levels were found in a family screening programme. The mean follow-up period was 9.7 years in the present series. The 5- and 10-year overall survival in the patient group with papillary cancer was 97% and 95% respectively, in the group with follicular cancer it was 78% and 50% respectively and in the group with medullary cancer it was 91% and 82% respectively. Significantly associated with reduced disease-free survival were: extrathyroidal growth (P less than 0.0001), distant metastases at diagnosis (P less than 0.0001), follicular histology (P less than 0.0001), age over 40 (P less than 0.001) and male sex (P less than 0.05). In patients with papillary cancer, recurrences were in most cases located in the neck, while recurrences at distant sites were encountered more frequently in patients with follicular or medullary cancer. Accidental permanent unilateral recurrent laryngeal nerve palsy were registered in 1.4% of the nerves at risk; all on the side of the tumour. Permanent hypoparathyroidism was present in 4% of the patients.

Adenocarcinoma↗
PubMed1989

Changes in the levels of growth hormones, insulin, cortisol, thyroxine and somatomedin-C/IGF-1, with increasing gestational age in the fetal pig, and the effect of thyroidectomy in utero.

1. Blood samples were taken from 30 chronically catheterized pig fetuses in utero. Levels of growth hormone, insulin, cortisol, thyroxine and somatomedin-C/IGF-1 were measured in the plasma of intact fetuses and the plasma of thyroidectomized fetuses at various gestational ages during the latter part of pregnancy. 2. Growth hormone levels were high (mean +/- SEM: 83 +/- 9 ng/ml and remained constant throughout this period. 3. Insulin levels were also constant and ranged between 4 and 14 mU/l. 4. Cortisol levels showed a general increase from 400 nmol/l at 97 days to 1200 nmol/l at term and this increase was not affected by thyroidectomy. 5. IGF-1 levels were lower than in the sows (48.0 +/- 3.0 ng/ml) and did not change throughout this period. 6. Thyroxine levels were also unchanged at about 92 +/- 4 nmol/l. 7. Thyroidectomy resulted in lower (P less than 0.001) thyroxine levels (28 +/- 3 nmol/l) but had no effect on the levels of any other hormone.

Animals↗
PubMed1978

Effect of thyroidectomy on intracellular amount and distribution of exchangeable Ca2+ in isolated rat liver cells.

The effect of thyroidectomy and replacement therapy on intracellular calcium was studied in isolated rat liver cells. The cells were first loaded with 45Ca and the efflux of isotope followed for 4 h. The cells maintained their viability during this period as judged from staining with trypan blue and rate of respiration. Two different time constants could be resolved by the peeling method. The experiments showed that thyroidectomy markedly reduced the pool of calcium with the slowest turnover while the other pool remained unchanged. Administration of triiodothyronine (T3) to the thyroidectomized animals 48 h before the experiment normalized the rate of respiration but did not restore the slow turnover pool of calcium.

Animals↗
PubMed1983

Effect of thyroidectomy on testicular enzymes of the pyruvate/malate cycle involved in lipogenesis.

The specific activities of testicular enzymes of the pyruvate/malate cycle involved in lipogenesis after thyroidectomy and thyroxine replacement were studied in prepubertal, pubertal and adult rats. Thyroidectomy induced testicular ATP citrate-lyase, malate dehydrogenase and malic enzyme activities and inhibited isocitrate dehydrogenase (NADP+) activity. Thyroxine treatment on thyroidectomized animals reverted all enzyme activities to normal. The result suggests that thyroid hormones have a differential effect on testicular enzymes of the pyruvate/malate cycle involved in lipogenesis.

ATP Citrate (pro-S)-Lyase↗
PubMed1994

Effect of fasting and thyroidectomy on cysteine proteinase activities in liver and muscle.

Prolonged starvation mimics chronic negative nitrogen balance observed in many physiopathological situations. During starvation, an initial decrease in protein utilization (phase I) is followed by a long period of protein sparing (phase II) that ends with a marked rise in nitrogen excretion (phase III). Variations in protein metabolism during starvation are determined by changes in protein synthesis and degradation rates (Cherel, Y., Attaix, D. Rosolowska-Huszcz, D., Belkhou, R., Robin, J.P., Arnal, M. and Le Maho, Y. (1991) Clin. Sci. 81, 611-619), but little information is available on expression of proteolytic systems. In this study, cathepsin B, H and L activities were compared in hindlimb muscles and liver at various phases of starvation in thyroidectomized and sham-operated rats. In muscle, cathepsin activities fell from the fed state to phase II, which suggests that cathepsins may play a role in the curtailment of muscle proteolysis during protein sparing phase. This decrease of muscle cathepsin activities was reproduced by thyroidectomy alone. In contrast, liver cathepsin B and H activities fell during starvation, but were not affected by thyroidectomy alone. Liver cathepsin L decreased only during starvation in thyroidectomized animals. These observations emphasize that different mechanisms modulate cathepsin expression in skeletal muscle and liver.

Animals↗
PubMed1994

Serum hormones in response to estradiol and (or) progesterone in ovariectomized cows after thyroidectomy.

To evaluate the effect of gonadal steroid treatment and thyroidectomy on concentrations of gonadotropins and thyroid-stimulating hormone in the bovine, nonlactating Holstein cows were either thyroidectomized and ovariectomized (THYOVEX; n = 6) or ovariectomized only (OVEX; n = 4), and subsequently treated with no gonadal steroids (control), estradiol-17 beta (E2), progesterone (P4), or P4+E2 in a 2 x 4 factorial experiment. Averaged across steroid treatments, baseline concentrations of luteinizing hormone (LH; P < .05) and follicle-stimulating hormone (FSH; P < .10) were higher in THYOVEX cows than in OVEX cows. Pulse frequencies and amplitudes of LH and FSH did not differ between THYOVEX and OVEX cows. Secretion of TSH was pulsatile and all concentrations and pulsatile characteristics of TSH were increased (P < .05) in THYOVEX compared to OVEX cows. Treatment with E2 and P4 decreased (P < .05) baseline concentrations and magnitude of LH pulses, whereas P4+E2 increased (P < .01) pulse frequency of LH and FSH. Amplitude of LH and FSH pulses were not affected by treatment with either steroid. Treatment with P4+E2 decreased (P < .05) baseline concentrations of TSH, whereas pulse frequency, and magnitude and amplitude of TSH pulses were not altered by treatment with steroids. Mean concentrations of LH and FSH were similar during 48 hr after termination of E2 and P4+E2 treatments, but concentrations of TSH were higher (P = .06) after P4+E2 than after E2. Secretion of TSH showed a diurnal variation, with the lowest concentrations in the morning and highest in the afternoon. These results indicate that thyroidectomy influenced secretion of gonadotropins in OVEX cows.

Animals↗
PubMed2005

[Endoscopic thyroidectomy. A preliminary report including 40 patients].

AIM OF THE STUDY: To demonstrate the feasibility of endoscopic thyroidectomy for unilateral lobectomy and isthmectomy. MATERIAL AND METHODS: [corrected] This prospective study included 40 patients operated on between January 1999 and March 2005 by a total endoscopic approach. Only lobectomies and isthmectomies were performed for nodules inferior to 3 cm in diameter. RESULTS: Forty patients (36 females, 4 males) underwent 35 lobectomies and five isthmectomies. Twenty-four patients were operated on without ultrasonic shears (US) the rate of conversion in this group was 33%. Sixteen patients were operated on with US: the rate of conversion was 0%. In the second group, the operative time was decreasing to the half, range 45 to 90 minutes. In both the two groups, there were no morbidity: no extensive emphysema, no hematoma, no wound abscess, no cord vocal palsy. The median hospital stay was 1,75 days. After three months of follow up, all the patients were satisfied, especially concerning the cosmetic results and the short recovery time. CONCLUSIONS: Endoscopic thyroidectomy is feasible and safe for performing lobectomies and isthmectomies. In the near future, it could be extended to bilateral goitres in selected patients.

Adult↗
PubMed2006

Cortical myoclonus due to hypocalcemia 12 years after thyroidectomy.

Although seizures have been described in hypocalcemia, myoclonus has been rarely reported. We report the first case of a patient with hypocalcemic cortical myoclonus due to hypoparathyroidism following a previous thyroidectomy. The patient was an 84-year-old woman who presented with multifocal myoclonus, which was predominant in the upper extremities, neck, jaw, and facial muscles. Electrophysiological studies revealed enlarged somatosensory evoked potentials, cortical reflexes evoked by peripheral nerve stimulation, and a cerebral potential preceding myoclonic jerks determined by jerk-locked averaging. All these findings were consistent with cortical myoclonus. The myoclonic state disappeared as serum calcium level became normal. Hypocalcemia should be considered in patients who had had a thyroidectomy, even if it was performed more than 10 years previously.

Aged↗
PubMed2004

Continuous laryngeal nerve integrity monitoring during thyroidectomy: does it reduce risk of injury?

OBJECTIVE: To determine if continuous laryngeal nerve integrity monitoring (NIM) during thyroidectomy is associated with a decreased risk of postoperative recurrent laryngeal nerve (RLN) injury. STUDY DESIGN AND SETTING: Retrospective cohort study of 165 patients who underwent thyroidectomy at a resident teaching institution between 1999 and 2002. The control group had 120 nerves at risk (NAR) whereas the NIM group consisted of 116 NAR. Primary outcome measures included postoperative RLN paralysis, paresis, and total injury rates. RESULTS: RLN paralysis occurred in 2.54% NAR in the control group and 0.86% in the NIM group [relative risk (RR) = 0.34, 95% confidence interval (CI95) = 0.04-3.27, P = 0.62]. Temporary RLN paresis occurred in 4.24% NAR in the control group and 3.45% in the NIM group (RR = 0.9, CI95 = 0.23-3.55, P = 0.89). Total RLN injury occurred in 6.78% NAR in the control group and 4.31% in the NIM group (RR = 0.66, CI95 = 0.21-2.09, P = 0.48). When compared to all other NAR, advanced T-stage malignancy was associated with a significantly increased risk of RLN paresis (T4 RR = 9.0, CI95 = 2.56-31.67, P = 0.0006; T3+T4 RR = 7.5, CI95 = 2.17-25.86, P = 0.0001) but not paralysis. NIM did not significantly reduce the risk of RLN paresis in the advanced T-stage subset (T3+T4 RR = 0.36, CI95 = 0.04-3.0, P = 0.59). CONCLUSION: There were no statistically significant differences in RLN paralysis, paresis, or total injury rates between control and NIM groups, even in subsets with advanced T-stage and increased baseline risk. Advanced T-stage is a significant predictor of RLN paresis in this cohort.

Adult↗
PubMed2004

A comparison of the results of monolayer versus smear cytopreparatory techniques for fine-needle aspiration in 100 consecutive patients undergoing thyroidectomy: a surgeon's perspective.

OBJECTIVE: To compare thyroid fine-needle aspiration (FNA) using monolayer (MT) versus conventional smear (CS) cytopreparatory techniques with final histology. STUDY DESIGN: Retrospective review of 100 consecutive thyroidectomies. Setting Tertiary care university affiliated medical center. RESULTS: 26% of MT aspirates were inadequate compared with 3% of CS aspirates (P < 0.05). The negative predictive values for MT and CS were 86% and 100%, respectively. The positive predictive values for MT and CS were 69% and 90%, respectively. CONCLUSIONS: Fewer inadequate specimens will be obtained with CS than with MT. A clinician performing FNA can obtain adequate specimens at a rate comparable to that of a hospital-based cytopathologist. SIGNIFICANCE: CS provides greater assurance to the patient and the surgeon that a thyroid nodule with a FNA interpreted as benign can be observed. A higher percentage of patients with malignant tumor will receive thyroidectomy with the use of CS technique for FNA. EBM RATING: B-3.

Biopsy, Fine-Needle↗
PubMed2005

The utility of serum PTH assessment 24 hours after total thyroidectomy.

BACKGROUND: Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 24 hours after surgery. MATERIAL AND METHODS: A total of 1006 consecutive patients (mean age, 54.8 years; female/male ratio, 4/1) underwent total thyroidectomy for benign or malignant thyroid from January 1995 to November 2003. Serum calcium, phosphorus, and PTH were measured preoperatively and at 24 hours after surgery. All patients underwent preoperative examination to assess cord motility. RESULTS: A total of 253 (25.1%) patients presented with hypocalcemia demonstrated by clinical and laboratory findings. In 101 cases the hypocalcemic syndrome manifested after 24 to 36 hours whereas in 5 of 101 cases, symptom onset was between 48 and 72 hours. Serum calcium levels lower than 7.5 mg/dL were recorded in all the 101 cases. In 239 of 253 cases serum calcium returned to normal values within 7 days following surgery. PTH at 24 hours was below normal levels in 49 of the 101 patients but was within normal limits in 52 cases. The incidence of hypocalcemia was higher in patients undergoing surgery for malignant thyroid ( P < 0.05). CONCLUSIONS: We do not consider PTH levels at 24 hours postoperatively as predictive of hypocalcemia.

Calcium↗
PubMedDate not supplied

The bilateral superficial cervical plexus block with 0.75% ropivacaine administered before or after surgery does not prevent postoperative pain after total thyroidectomy.

BACKGROUND AND OBJECTIVES: Patients undergoing thyroid surgery need postoperative pain management. Bilateral superficial cervical plexus block by administration of 0.25% bupivacaine with 1:200000 epinephrine at the end of surgery has been shown to improve postoperative analgesia. The objective of this study was to assess the analgesic efficacy in the first 36 postoperative hours after total thyroidectomy of bilateral superficial cervical plexus block with 0.75% ropivacaine administered before the incision or on completion of the surgical procedure. METHODS: We performed a prospective double-blinded, randomized controlled trial that compared 3 parallel groups: the CONT group did not receive any block, the PRE group received bilateral superficial cervical plexus block before surgery while under general anesthesia, and the POST group received bilateral superficial cervical plexus block after surgery while under general anesthesia. The study included 111 patients (37 in each group). Postoperative pain was assessed every 4 hours by use of a 0 to 10 numeric rating scale. All patients received paracetamol every 6 hours. Morphine was administered following a standardized protocol if the numeric rating scale was 4 or higher. The main outcome variables were the proportion of patients given morphine during the 36 hours period, pain intensity scores, and morphine consumption. RESULTS: No intergroup differences were observed in terms of percentage of patients who required morphine, morphine delivery, pain scores, and intraoperative opioid consumption. CONCLUSIONS: Bilateral superficial cervical plexus block with 0.75% ropivacaine administered before or after surgery does not improve postoperative analgesia after total thyroidectomy.

Acetaminophen↗