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At least 973 records · Page 54Linked to original sources
PubMed1990

Changes in thyrotropin receptor antibody after subtotal thyroidectomy in Graves' disease: comparison with the degree of lymphocytic infiltration in the thyroid.

To evaluate changes in TSH receptor antibody after surgery in Graves' disease and its relationship with the degree of lymphocytic infiltration, serial serum levels of TSH receptor antibody were measured before and after the subtotal thyroidectomy in 50 patients with Graves' disease. In 22 (44%) out of 50 patients, thyrotropin binding inhibitor immunoglobulin (TBII) levels gradually decreased and disappeared completely within 12 months after surgery (TBII disappearing group). Twenty-eight (56%) patients showed persistent TBII activity and their levels were not changed until 12 months after surgery (TBII persistent group). The changes of thyroid stimulating antibody (TSab) levels were very similar to those of TBII in both groups. The thyroidal lymphocytic infiltration was more prominent in the TBII disappearing group. The degree of the decrease of TBII levels after surgery correlated with the grade of thyroidal lymphocytic infiltration. There was no significant difference of TSH receptor antibody (both TBII and TSab) levels between the thyroid and peripheral venous blood. These data suggest that the persistence or disappearance of TSH receptor antibody after surgery may reflect the difference between patients in whom the thyroid is the major site of TSH receptor antibody and those in whom additional sites of TSH receptor antibody synthesis exist.

Adolescent↗
PubMed1993

Induction of estrus after thyroidectomy in nonlactating Holstein cows.

Hypothyroidism reportedly decreased sexual behavior in several species. To confirm the role of hypothyroidism in the expression of estrus in cattle, our objective was to determine whether estrus could be induced in ovariectomized cows without intact thyroid glands using estradiol benzoate and progesterone. Eight nonlactating, nonpregnant Holstein cows were thyroidectomized and ovariectomized, and another four cows were ovariectomized only. All cows were given either estradiol benzoate in a crossover design with two replicates during 4 consecutive wk. Cows were observed continuously for estrus from 9 to 45 h after treatment with gonadal steroids. Intensity of estrus was assessed by quantitative measurement of the frequencies of mounting activity and standing behavior. The percentage of cows showing estrus was influenced by thyroidectomy-ovariectomy (78.1%) compared with ovariectomy (31.1%) but was unaffected by hormonal treatment. In contrast, other measures of estrous behavior (duration of standing estrus and frequencies of mounting and standing activities) were unaffected by thyroid status or by hormonal treatments. We concluded that ovariectomized cows without intact thyroid glands exhibit estrus and that the exhibited behavior is similar in intensity and duration to that in ovariectomized cows treated with gonadal steroids. Hypothyroidism may not cause failure to express estrus.

Animals↗
PubMed1994

Evaluation of thyroid function after bilateral subtotal thyroidectomy for Graves' disease--a long term follow up of 100 patients.

One hundred patients who underwent bilateral subtotal thyroidectomy for Graves' disease between January 1980 and September 1984 have been evaluated. The observation period ranged from 5 to 9 years, the average being 6.2 years. Postoperative thyroid function was evaluated with T3, T4 and TSH and compared with their clinical manifestations. Eighty-two patients became euthyroid, 14 patients had recurrence and 4 patients developed hypothyroidism. The thyroid hormone level of euthyroid patients were in an unstable state up to 5 years after the operation. Sixteen variables which might influence the postoperative recurrence and hypothyroidism were analyzed but no statistically significant factors were determined, although recurrences were found frequently in patients over 30 years, the patients with lower infiltration of lymphocytes and absent of fibrosis of thyroid tissue. The results obtained in the present study suggest that mean 6.0 gm of remnant thyroid is suitable for maintaining euthyroidism postoperatively in a majority of patients. In addition, patients should be followed closely for many years and should undergo hormonal determination periodically because recurrence and hypothyroidism can occur at 5 years or more after the operation.

Adolescent↗
PubMedDate not supplied

Risk of malignancy in follicular neoplasms without nuclear atypia: statistical analysis of 397 thyroidectomies.

OBJECTIVE: To determine how to triage patients with a follicular neoplasm (FN), without nuclear atypia reported by fine-needle aspiration, on the basis of risk factors. METHODS: The age, sex, tumor size, and cell type of 397 patients who underwent thyroidectomy for follicular carcinoma (FC) or follicular adenoma between 1991 and 2001 were analyzed statistically. The likelihood ratio and probability of FC for various combinations of tumor size, sex, and cell type were estimated with use of Bayes' theorem. RESULTS: FC was significantly associated with tumor size >2.1 cm (P = 0.048), male sex (P = 0.0007), and Hürthle cell type (P<0.0001). The mean size of minimally invasive FC was significantly smaller (2.9 cm versus 4.8 cm; P = 0.004) and the mean patient age was significantly younger (47.6 years versus 61.0 years; P = 0.003) than for widely invasive FC. The lowest probability (0.31%) for FC was in female patients with a small (< or = 2.1 cm) micro-follicular FN reported by a cytopathology practice with 10% accuracy of true FN at surgical intervention, whereas the highest probability (29.5%) for FC was in male patients with a large (>2.1 cm) Hürthle cell neoplasm reported by a cytopathology practice with 70% accuracy of true FN at surgical intervention. CONCLUSION: Although an estimate of probability for FC based on age, sex, thyroid nodule size, and cell type is provided in this study for patients diagnosed with FN without nuclear atypia on fine-needle aspiration, the variability of the accuracy in cytopathology practice makes it difficult to change the current treatment paradigm, which requires carefully planned prospective studies with long-term follow-up.

Adenocarcinoma, Follicular↗
PubMed1976

[Long-term critical evaluation of hypothyroidism after subtotal thyroidectomy for thyrotoxicosis].

A retrospective study was made of 66 cases in which subtotal thyroidectomy had been carried for hyperthyroid syndromes, mainly of Basedow type, with a view to establishing a more careful selection of thyrotoxicosis candidates for surgery or other management. The reasons for the different findings and post-operation evaluation of performance are analysed in the light of the time of follow-up, mostly within 5 to 15 yr of surgery. Clinical examination in the light of statistical diagnostic indices was supplemented by evaluation of RIA-T3, TSH and T4, and anti-thyroglobulin antibodies. Four different metabolic states were identified: 1) clinical euthyroidism with normal hormone profile (56.1%); 2) latent hypothyroidism, as shown by high TSH, low T4 and normal RIA-T3 (12.1%); 3) frank hypothyroidism, seen in one case only; 4) high TSH, observed as an isolated finding (30.3%). This last group is fully discussed from the prognostic standpoint. It is not considered as an expression of initial hypothyroidism within the present series and its follow-up range, but as indicative of hypersecretion of an abnormal TSH, or as evidence of an increased hypothalamus-hypophysis axis threshold for the retroactive action of circulating T4 and T3. Attention is drawn to differences between surgical and radio-iodiotherapeutic hypothyroidism. The former, in particular, is less frequent, earlier to appear, and less predictable, whereas the latter displays a gradually increasing pattern.

Adolescent↗
PubMedDate not supplied

Effects of thyroidectomy and replacement therapy on the adrenal and testis of the bird myna, Acridotheres tristis.

Thyroidectomy in Myna, Acridotheres tristis, increased the levels of cholesterol, ascorbic acid and decreased the activity of the adrenal. The size and activity of the testis also decreased following thyroid removal. The weight of the two glands and activity of testis was not affected by 0.25 mg of 1-thyroxine. The chemical and histological changes of the adrenal were however reversed. It is suggested that thyroid deficiency leads to reduced output of the trophic hormones from the adenohypophysis of the bird resulting in decreased size and activity of the gonad and of the adrenal.

Adrenal Glands↗
PubMedDate not supplied

[Total thyroidectomy with identification of parathyroid glands. Functional implications].

UNLABELLED: Several factors have been involved in the pathogenesis of postoperative hypocalcemia after total thyroidectomy (TT). The real cause is yet unclear, but postoperative (p.o), hypoparathyroidism seem s to be the most important factor. MATERIAL AND METHOD: 337 patients underwent TT; a systematic and accurate identification and preservation of parathyroid glands was always performed. In all patients calcemia was evaluated before and after surgery (1St, 2nd, 4th, 15th, and 30th day), moreover in 90 patients was also evaluated phosphorus, magnesium, alkaline phosphatase, total proteins, PTH, calcitonin serum levels and urinary levels of calcium and phosphorus. RESULTS: No permanent hypocalcemia was observed and transient hypocalcemia was present in 13.6% of patients. Among 90 patients, 84 showed normal calcium serum levels like the others parameters; the other 6 showed a post-operative hypocalcemia associated with clinical symptoms, an increase of phosphoremia and a decrease of PTH and phosphaturia in early p.o days; in these patients calcemia and PTH levels reached normal values within 30 days after surgery. CONCLUSION: The surgical manipulation of parathyroid glands should be the cause of lowering of PTH serum concentration and transient hypocalcemia.

Adolescent↗
PubMed1999

Leiomyosarcoma of the thyroid gland with rapid growth and tracheal obstruction: A partial thyroidectomy and tracheostomy using an ultrasonically activated scalpel can be safely performed with less bleeding.

Primary leiomyosarcoma of the thyroid gland is rare, and to the best of our knowledge only nine well-documented cases have been previously reported in the world literature. We herein report a 90-year-old female patient with primary leiomyosarcoma of the thyroid gland who showed a rapid tumor growth and tracheal obstruction. The patient was successfully treated by a partial resection of the thyroid gland using an ultrasonically activated scalpel and emergency tracheostomy. Immunohistochemically, the tumor cells showed positive reactivity to smooth muscle actin and negative reactivity to thyroglobin. Palliative surgery successfully allowed the patient to recover from the symptoms of dyspnea related to this rare disease. The use of an ultrasonically activated scalpel and tracheostomy thus allowed us to safely perform a thyroidectomy with substantially less bleeding than normal.

Aged↗
PubMed2000

Effect of thyroidectomy on fast and slow muscle fibres of rat gastrocnemius muscle.

A combined histochemical, biochemical and electrophoretic study with respect to the enzymes succnic dehydrogenase(SDH), myofibrillar adenosine triphosphatase (m-ATPase), lactate dehydrogenase (LDH) isozymes and myosin light chains was carried out to investigate the response of rat gastrocnemius muscle (medial head). Twelve weeks after thyroidectomy, the results indicated a shift from fast to slow type pattern of LDH isozymes, fibre type transformation from Type II to Type I and a decrease in SDH and m-ATPase activity. The results suggest, possible thyroidal involvement in determining the phenotypic properties of skeletal muscle.

Adenosine Triphosphatases↗
PubMed2000

[Complications of thyroid surgery. Report of 683 thyroidectomies].

Most important complications of thyroid gland surgery are recurrent paralysis (which usually results from section, stretching or devascularization of this neural branch) and parathyroid lesions resulting from unnoticed removal of more than two of these glands or through necrosis because deficient blood supply. We present a study about the complications of thyroid surgery based on the thyroid surgery done in our ENT Service during 1979-1998 term. An amount of 683 cases make the series. The 86% were female and 14% male, with a mean age of 40-50. Surgical techniques realized were: hemithyroidectomy (15.3%) and isthmectomy (2.9%). About 7.4% of patients were reoperated. Stated complications were: local (serohematoma 4.1%, infection 1.2%, postoperative hemorrhage 1.2%) and recurrent paralysis (unilateral transitory 2.6% and unilateral definitive 1.6%; there wasn't any case of bilateral palsy) and superior laryngeal nerve paralysis (1.4% as well as hypoparathyroidism (transitory 22.7% and definitive 5.3%). These complications were most frequent in reoperated cases and in total and subtotal thyroidectomies. In most of these series the incidence of recurrent palsy range between 1.5% and increases more than 9.5% in surgical check and the hypoparathyroidism incidence ranges over 25%.

Adolescent↗
PubMed2000

[1000 thyroidectomies--personal experience and results].

The authors made one thousand thyroidectomies in the course of five years. In the submitted paper they discuss indications, for surgery, the extent of the operations, the results of the histological findings. They describe the surgical procedure, required preoperative examinations and postoperative monitoring. They analyze different postoperative complications incl. their frequency in the discussed group. They emphasize a physiological surgical technique, verifications of the recurrent nerve, care of the parathyroid bodies and collaboration with endocrinologists.

Female↗
PubMed1975

An improved technic for thyroidectomy in guinea pigs.

A technic for thyroidectomy in the guinea pig was presented. After anesthetizing the guinea pig with methoxyflurane, the thyroid was removed by electric cautery. The step-by-step procedure was described. Possible complications such as recurrent laryngeal nerve damage and the stimulation of aberrant thyroid tissue were discussed.

Anesthesia, Inhalation↗
PubMed2001

[When is total thyroidectomy indicated? What applies in thyroid carcinoma: radical surgery according to findings].

Today, surgical treatment of thyroid carcinoma is oriented to the underlying histology and the extent of the tumourous process. Total thyroidectomy with postoperative radioiodine treatment represents only one of the spectrum of possibilities that ranges from limited to extended radical interventional procedures. Such an individualized operative strategy should be applied not only for the primary intervention, but also for locoregional tumour recurrence and confirmed distant metastases, with the aim of keeping operative morbidity to a minimum.

Humans↗
PubMed2001

Evaluation of serum calcium levels in predicting hypoparathyroidism after total/near-total thyroidectomy or parathyroidectomy.

Hospital stays for thyroid and parathyroid surgery have decreased significantly with selected patients staying under 8 hours. Strategies to recognize hypocalcemia postoperatively vary. We examined timed postoperative calcium levels to determine how long one needs to monitor patients for hypoparathyroidism. We analyzed 120 consecutive patients having total/near-total thyroidectomy and/or parathyroidectomy between April 1998 and October 1999. Total and ionized serum calcium levels were obtained at 8, 16, and 22 hours postoperatively. Strict criteria for significant hypoparathyroidism were defined as a symptomatic patient, a total calcium value of less than 7.2 mg/dL, or an ionized calcium value of less than 1.0 mmol/L. Eighteen patients (15%) met criteria for hypocalcemia. The 8-hour ionized calcium level identified 40 per cent of those that needed supplementation. With the inclusion of the 16-hour ionized calcium value 94.5 per cent of patients who met criteria were identified. Of the 74 patients who had not previously received calcium at 22 hours after surgery only one patient with hypocalcemia was identified. Serial calcium values postoperatively add to the costs associated with an overnight hospital stay. In addition to clinical examination an ionized calcium level 16 hours postoperatively is sufficient to identify significant hypoparathyroidism in the majority of patients.

Adult↗
PubMed2001

Thyroidectomy or radioiodine? The value of ultrasonography and cytology in the assessment of nodular lesions in Graves' hyperthyroidism.

Although diffuse toxic goiter is a classical feature of Graves' disease (GD) nodular goiters are occasionally found in some patients. The aim of the present study was to investigate the ultrasonographic and corresponding cytological manifestations in GD patients with nodular lesions to decide on a therapeutic strategy. Twenty-seven consecutive GD patients with nodular goiter were included in this study (21 women and six men, mean age 41.2 years, range 22-77 years). All underwent thyroid ultrasonography and fine-needle aspiration cytology. Of the 27 patients eight underwent surgical intervention because papillary thyroid carcinoma or follicular neoplasm was diagnosed by cytology; five of these were shown to have papillary thyroid carcinomas. Ultrasonography revealed the malignant nodules to be hypoechogenic, heterogeneous, and with ill-defined margins in four of these five thyroid cancers, whereas the remaining sonogram showed a cystic change and cauliflower-like tumor formation with microcalcification. The volume and maximal diameter of cancerous nodules were significantly larger than those of benign nodules. In conclusion our results reveal that ultrasonography and fine-needle aspiration cytology are reliable and quick methods for diagnosing nodular goiters in GD patients. If thyroid neoplasms are found ablative therapy with thyroidectomy is indicated instead of radioactive iodine.

Adult↗
PubMed1975

The involvement of corticosteroids in the supersensitivity produced in the rat anococcygeus muscle by morphine withdrawal, thyroidectomy or a single dose of reserpine.

The effects of chronically administered corticosterone on the responses of the rat isolated anococcygeus muscle to agonists (acetylcholine, norepinephrine) were compared with those of morphine withdrawal in intact or metyrapone-pretreated rats and with those of a single dose of reserpine in intact or adrenalectomized rats. The possibility that the similar supersensitivity, which occurs in thyroidectomized rats, might be associated with elevated corticosterone levels was investigated by measuring fluorimetrically the plasma levels of corticosterone in thyroidectomized rats. Corticosterone, morphine withdrawal or a single dose of reserpine produced similar supersensitivities, characterized by increased maximum responses to both agonists (acetylcholine, norepinephrine) and an increased pD2 value for acetylcholine. This effect of morphine withdrawal together with the weight loss characteristic of this condition was absent in metyrapone-pretreated rats. A single dose of reserpine had no effect in adrenalectomized rats. Plasma corticosterone levels were elevated in thyroidectomized rats. These results suggest that the common factor underlying the identical supersensitivities produced by corticosterone, morphine withdrawal, a single dose of reserpine or thyroidectomy is the ability of each treatment to raise plasma corticosterone levels.

Acetylcholine↗
PubMed2001

[Value of total thyroidectomy in amiodarone-induced hyperthyroidism].

The potential severity of amiodarone-induced hyperthyroidism, particularly in severe cardiopathy cases, necessitates a regular clinic and biologic thyroid control. The break in amiodarone and a medical treatment (synthetic antithyroid drugs, steroids, perchlorate of potassium) can be ineffective. The authors report the case of a patient with an right ventricle arythmogenic dysplasia, without thyroid history, who came back 3 years after the introducing of amiodarone with major hyperthyroidism. After failure of medical treatment, a total thyroidectomy permitted to quickly stop hyperthyroidism and to early reintroduce amiodarone. Surgery seems to be the radical treatment when hyperthyroidism doesn't respond to the medical treatment and when the cardiopathy requires amiodarone.

Adult↗