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PubMedDate not supplied

[Clinical study of residual function and recurrences in patients after partial thyroidectomy for non-toxic nodular goiter].

The different surgical chances for the treatment of non toxic nodular goiter led the Authors to study the residual function after partial thyroidectomy. A variable rate of recurrences and hormone deficiency was shown in patients who underwent sub-total thyroidectomy, lobectomy and enucleation. It depended on the amount of residual gland and the different methods they used. Recurrences occurred more in patients studied by ultrasonography. After sub-total thyroidectomy the Authors noted a more reduced number of recurrences than after lobectomy and enucleation. There was a meaningless connection between high plasmatic levels of TSH and recurrences. Subclinical hypothyroidism was higher in patients who underwent subtotal thyroidectomy than in patients treated with lobectomy and enucleation. These clinical data show that recurrences could depend on growth factors (EGF, IGF) in thyroid tissues and not only on TSH action. Therefore the surgical attitude of the authors in the treatment of nodular goiter consists in total thyroidectomy.

Aged↗
PubMed1993

[HLA class I and II antigens and diffuse toxic goiter].

The incidence rate of HLA class I and II antigens has been studied in 168 and 82 patients with diffuse toxic goiter, respectively. Positive association is found for HLA antigens A2, A3, A28, B8, B15, B17, Cw4, DR5; negative one with antigens A24, Bw4, Bw6, Cw1, Cw2, Cw3, Cw5, DR9. Prevalence of antigens B15, B17, Cw4, DR5 is associated with thyrotoxicosis severity, A2 with recurrent toxic goiter. Antigen B8 plays the role of an immunogenetic marker of endocrine ophthalmopathy.

Adult↗
PubMedDate not supplied

[Interactions between serum antibodies of patients with autoimmune thyropathies and isolated cells of diffuse toxic euthyroid nodular goiter].

Blood sera of 46 patients with diffuse toxic goiter (DTG) and of 48 ones with Hashimoto's thyroiditis (HT) were tested for antibodies--complement-mediated cytotoxicity carriers (ACMMC). ACMCC targets were isolated DTG cells and cells of euthyroid nodular goiter (ENG) perinodular tissue. Antimicrosomal antibodies were assayed in the sera by indirect immunofluorescence and antibodies to all thyrocyte surface antigens isolated from both tissue samples were determined by solid-phase enzyme immunoassay. When DTG cells were targets, DTG patients' sera detected ACMCC in 36% of cases and HT patients' sera in 73% of cases (p < 0.001). In ENG cells the sera of patients of both groups detected ACMCC equally frequently (in more than 70% of cases). Of the 27 DTG patients' sera tested with both tissues approximately a half detected ACMCC in only ENG tissue. There was no difference in HT patients' sera effects on ACMCC detection in both tissue samples. This has brought the authors to a conclusion about DTG cells deficiency for ACMCC mediating antigens. Moreover, DTG cells bound much less antibodies from sera of patients with autoimmune thyropathies, than ENG cells (p < 0.001), this confirming a deficiency of surface antigen on DTG cells. No correlation between the presence in the sera of antimicrosomal cells and of ACMCC was detected. A conclusion has been made about heterogeneity of antimicrosomal antibody population and about the presence of ACMCC in blood sera of patients with autoimmune thyropathies, these antibodies not belonging to antimicrosomal ones. ACMCC also may be heterogeneous and differ in DTG and HT patients.

Adolescent↗
PubMedDate not supplied

[Organotherapy treatment in the course of normofunctional goiter. Long-term results in 104 patients].

Results of therapy with thyroid hormones (LT4 and/or LT3) were evaluated in 104 patients (95 females and 9 males) with simple diffuse or nodular goiter. The mean interval of observation was 7.2 years. The reported results were analysed in relation to patient's age at the onset of the pathology, time elapsed since its appearance, place of origin and sex of the patient, results of laboratory studies, and clinical signs.

Adolescent↗
PubMed2003

[Optimal recurrence prevention of iodine deficiency related goiter after thyroid gland operation. A prospective clinical study].

In summary the data of our study show: (1) Sonographically determined thyroid volume of patients with euthyroidism after surgery is found to be significantly lower with a combination therapy (iodide 150 microgram +Levothyroxine 75 microgram) compared to patients with iodide monotherapy (200 microgram). (2) Thyroid volume of patients with hypothyroidism after surgery is found to be significantly lower during a combination therapy (150 microgram iodide + 75 microgram L-thyroxine) compared to patients with a Levothyroxine monotherapy. (3) Patients with hypothyroidism and Levothyroxine monotherapy, however present with a significant increase of thyroid volume after surgery. (4) Urinary iodide excretion in the treatment groups with iodide or combination therapy increases significantly during therapy, however, patients with Levothyroxine monotherapy do not show changes. (5) Thyroid function is well stabilized in all treatment groups with adequate controls and adjustment of Levothyoxine dosage. There data clearly demonstrate that the combination therapy with Levothyoxine and iodide significantly improves prophylaxis of goiter recurrence.

Adult↗
PubMed1975

Nontoxic goiter-diffuse or nodular.

Nontoxic goiters are very common. A single hyperfunctioning nodule is never malignant. Treatment is required only if the patient is hyperthyroid. Most single hypofunctioning thyroid nodules are cool and most are benign; however, it is important to rule out malignancy. The presence of microcalcification is consistent with psammoma bodies and the presence of papillary cancer of the thyroid. An elevated plasma calcitonin level with a further increase in calcitonin after calcium infusion is usually characteristic of medullary cancer of the thyroid. Needle biopsy of the thyroid is recommended when an experienced surgeon and pathologist are available. The treatment of benign thyroid lesions may include a trial of fully suppressive doses of thyroxine.

Biopsy, Needle↗
PubMed2006

Goiter prevalence and urinary iodine concentration in Slovenian adolescents.

CONTEXT: Slovenian school-age children are, as are more than half of European school-age children, still considered to be iodine deficient. In 1999, supplementation of salt was increased from 10 to 25 mg of KI/kg of salt. OBJECTIVE: The objective of our study was to determine the success of this intervention. DESIGN AND PATIENTS: Twelve hundred sixty-four girls (mean age +/- SD: 15.7 +/- 0.6 years) and 1200 boys (15.8 +/- 0.8 years) representing 10% of all 15-year-old Slovenian adolescents were studied. Thyroid size was estimated by clinical examination in all subjects and by ultrasound when enlarged thyroid was suspected. Thyroid volume was also determined by ultrasound in 108 random iodine-sufficient adolescents. In addition, urinary iodine concentration was determined in all subjects. RESULTS: Enlarged thyroid was determined by clinical examination and ultrasound in 0.9% of all subjects. In randomly selected iodine-sufficient subjects, enlarged thyroid was determined in 4.6%. Median urinary iodine concentration for the population was 140 microg/L. In all regions it was greater than or equal to 100 microg/L. Values less than 50 microg/L were determined in 2.5% of all subjects. CONCLUSIONS: Slovenian adolescents are iodine sufficient and the prevalence of goiter is low, indicating that increased KI supplementation of salt in 1999 was successful.

Adolescent↗
PubMed1995

Hyperthyroidism after radiographic contrast in a patient with separate cervical and intrathoracic multinodular goiters.

The authors report a case of multinodular goiter in both cervical thyroid and aberrant intrathoracic thyroid tissue which was associated with thyrotoxicosis after the use of radiographic contrast material. The role of correlative imaging in assessment of cervical and anterior mediastinal masses and the phenomenon of iodine-induced thyrotoxicosis are also discussed.

Aged↗
PubMed1989

[Malignization of goiter].

From analysis of literature data and the results of their personal studies embracing 3,139 operations for diseases of the thyroid gland the authors conclude that certain forms of goiter (nodular and recurrent in particular) play regularly the role of background processes in the development of cancer of the gland. This provides the ground for setting apart such patients into a risk group. Marked dysplasia is the main form of precancerous changes.

Adenoma↗
PubMed1986

[Choice of anesthesia in operations for goiter].

Different kinds of anesthesia used in 2644 patients were analysed with special reference to the fact that patients with diseases of goiter had pronounced endocrine shifts. It was shown that there were no reasons to oppose different methods of anesthesia to one another. Each of them has its indications and contraindications corresponding to specific features of the disease.

Anesthesia↗
PubMedDate not supplied

Fine-needle aspiration biopsy of the thyroid correlated with clinical scintigraphic, echographic and pathologic data in nodular and diffuse goiter.

In order to make thyroid aspiration biopsy, a routine diagnostic and therapeutic procedure in the "C. I. Parhon" Institute of Endocrinology, the authors carried out a study on 100 patients with nodular or diffuse goiter. The results were corroborated by clinical, scintigraphic and echographic data. The cytologic diagnosis was compared with the histopathologic one in 50 operated cases and confirmed by the post-therapeutic clinical course in the remaining 50. The study of the cases classified as benign (83%), suspect (6%) and malignant lesions (11%) was made for each individual diagnosis, taking into account the specific clinical, scintigraphic, echographic, and cytologic aspects. The cytology of cold nodules showed that only 30% of the patients required surgery, the rest of them having benign lesions that benefited from puncture and drug therapy. The cytohistologic concordance in malignant tumors was 93.3% (73.3% for certain, 20% with suspicion). The proportion of false negative diagnoses was 6.6% (one case). None of the findings was falsely positive. The advantages of this procedure are discussed.

Biopsy, Needle↗
PubMed1981

[Diagnosis of thyroid cancer in endemic goiter areas (based on Arkhangelsk Province data)].

A detailed examination of 281 patients who had undergone primary surgery for nodular formations in the thyroid was carried out. In most cases, up-to-date methods of preoperative diagnosis (thyroid scanning, diagnostic puncture followed by cytological examination and X-ray examination of soft tissues of the neck to detect calcinates in the gland) were employed. Thyroid cancer was detected in 18.1% of these cases, while background tumor process was not established in 2.1% of patients only. Cancer incidence rates were similar in the cases of single nodes (17.3%) and multiple nodes (19.3%) in the thyroid. Considering the high risk of cancer in the pathologically-altered thyroid tissue, extrafascial surgery for nodular formations rather than intrafascial (for ablastic reasons) should be indicated in patients living in areas where goiter is endemic.

Disease Reservoirs↗
PubMed1980

[Morphological characteristics of nodular goiters in Latvia].

Examinations of nodular forms of euthyroid and thyrotoxic strumas established direct relationshps between the level of hydrolytic and oxidative-reductive enzymes under study and the ultrastructural organization of the tissue. A marked decrease of the functional activity in nodes of euthyroid goiter was found whereas high functional activity was observed in nodes of thyrotoxic strumas.

Adolescent↗
PubMed1993

[Thyroid nodule disease in a previously endemic goiter area].

We conducted a 6-year study of 110 patients with thyroid nodular disease in a previously goitrogenic area. The aim of the present work was to establish its incidence, to determine if multinodular goiter and autonomous thyroid nodule have the same analytical and clinical behaviour and to verify if the iodation campaign had resulted in the development of thyrotoxicosis induced by iodine. The results demonstrated an incidence of 0.4 per 1,000 population and per year. The two modalities of thyroid nodular disease did not present any clinical and analytical differences. 58.2% of the patients had hyperthyroidism, 53.1% of which were T-4 thyrotoxicosis, 12.5% T-3 thyrotoxicosis and 34.4%, subclinical hyperthyroidism. 8.2% of the patients under study had hyperthyroidism induced by iodine (Jod Basedow), with iodide excretion values higher that 3 standard deviations with respect to the population average (> 220 micrograms/g creatinine).

Adult↗
PubMed1990

Hypothyroidism and goiter in a patient during treatment with interleukin-2.

The development of transient hypothyroidism and goiter in a patient with a metastasized malignant melanoma during treatment with recombinant interleukin-2 (rIL-2) and dacarbazine is reported. Signs of autoimmune thyroiditis became apparent 2 weeks after the start of treatment and disappeared after treatment stopped. It is likely that rIL-2 was responsible by interfering with preexisting autoimmune thyroid disease. The possible mechanisms are discussed here. Patients with positive antithyroid microsomal antibody titers are prime candidates for rIL-2-induced thyroiditis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Use of fine-needle aspiration cytology and frozen section in the management of nodular goiters.

BACKGROUND: This study evaluates the role of frozen section (FS) in surgical decisions for nodular thyroid disease when a preoperative fine-needle aspiration cytology (FNAC) is available. MATERIAL AND METHOD: The charts of 113 patients who underwent thyroidectomy for nodular goiter were reviewed. Each patient underwent FNAC, FS, or both. Results were compared with the final pathologic examination to evaluate their effectiveness in predicting malignancy. RESULTS: The sensitivity and specificity of FNAC alone (49 patients) were 73% and 93.5%, respectively, and of FS (111 patients) 68% and 99%, respectively. The result of fine-needle aspiration cytology was: benign (n = 8), malignant (n = 13), indeterminate (n = 25), and nondiagnostic (n = 3). All cases diagnosed as benign on FNAC were benign on final pathology, but of the six FS performed in these cases, four were benign and two were suspect. Of the 13 FNAC that were interpreted as malignant, 11 and 10 proved to be malignant on final pathology and FS, respectively. The 25 indeterminate cases on FNAC were on final pathology benign (n = 21) and malignant (n = 4) and on frozen section were benign (n = 12), malignant (n = 2), and suspect (n = 11). CONCLUSION: When results of FNAC are interpreted as benign or malignant, FS is of little value, because it does not change the extension of thyroidectomy. FS proved useful in determining the extent of thyroidectomy only when results of the FNAC were suspect or atypical.

Adult↗