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PubMed2003

[Plasma fibronectin in patients during toxic goiter surgery and early postoperative period].

In 63 patients with toxic goiter the fibrinonectin content in plasma and its cryoprecipitate activity (CPA) were studied during surgical treatment conduction. There were revealed lowering of its level and CPA with subsequent lowering of this indexes in postoperative period. Application of uni-group heparinized freshly frozen plasma in therapeutic complex was proposed for hypofibronectinemia correction and for reduction of postoperative thyreotoxicosis severity.

Blood Component Transfusion↗
PubMed2003

[Soluble forms of adhesion molecules sELAM-1 and sICAM-1 in Graves disease and toxic nodular goiter].

Intercellular adhesion molecule-1 (ICAM-1) and endothelial leukocyte adhesion molecule-1 (ELAM-1) are playing a significant role in an inflammatory process. In patients with autoimmune disorders of thyroid gland an increased expression of ICAM-1 and ELAM-1 was found in thyroid and also in orbital tissue in presence of active ophthalmopathy. Reports concerning concentrations of adhesion molecules soluble forms (sELAM-1 and sICAM-1) in sera of patients suffered from different thyroid gland diseases are controversial. The aim of the project was an estimation of levels of adhesion molecules soluble forms in sera of patients with Graves' disease (GD) and toxic nodular goiter (TNG). In the presented research work sICAM-1 and sELAM-1 were determined in 149 subjects (aged 17-69 years) divided to following groups: group 1--16 hyperthyroid GD patients with active ophthalmopathy (GO) (10 females and 6 males); group 2--25 euthyroid GD patients with GO (17 females and 8 males); group 3--41 hyperthyroid GD patients without GO (22 females and 16 males); group 4--36 patients with TNG (20 females and 16 males) and control group (group 5)--31 healthy subjects (16 females and 16 males). sICAM-1 and sELAM-1 serum concentrations were determined using highly sensitive enzyme linked immunosorbent assay (ELISA). In comparison with control group (group 5) in groups 1--3 significant increase of sICAM-1 and sELAM-1 concentrations was found (p < 0.001). The highest values for both adhesion molecules were demonstrated in the group of hyperthyroid GD patients with GO (group 1) as well as in group of euthyroid GD patients with GO (group 2). In group 1 the values were higher than those in group 2. Lower concentrations were present in group of GD patients with hyperthryroidism without symptoms of GO (group 3). The lowest adhesion molecules concentrations in four examined groups were present in sera of patients with TNG (group 4). The level of sICAM-1 in this group was higher than that in control group, but the difference was not statistically significant (p < 0.01), on the contrary sELAM-1 concentration was markedly elevated in comparison with group 5 (p < 0.002). From the obtained results it may be concluded that elevated sICAM-1 and sELAM-1 concentrations in sera of GD patients are dependent on autoimmunological factors, presence of inflammatory changes in the orbital tissue as well as on hyperthyroidism. Nonautoimmune hyperthyroidism has also influence on increase of sICAM-1 and sELAM-1 levels.

Adolescent↗
PubMedDate not supplied

Horseshoe kidney with mesangioproliferative glomerulonephritis and goiter.

Horseshoe kidney is a relatively common renal anomaly with which many structural and developmental anomalies have been shown to be associated. However, there are only a few case reports regarding the association of membranous glomerulonephritis and focal sclerosing glomerulonephritis in patients with horseshoe kidneys. We report a girl who was evaluated for hematuria and proteinuria, and found to have horseshoe kidney. Renal biopsy demonstrated mesangioproliferative glomerulonephritis. She also had simple diffuse goiter.

Anti-Bacterial Agents↗
PubMed2004

[Trace elements and endemic goiter].

The effects of xenobiotics on morphological structure and function of the thyroid gland (TG) were analysed. Salts of heavy metals (zink, lead, copper, cadmium, surma etc.) were measured in TG of 152 citizens of Kama region who had died of trauma in the 1960s (n = 73), 1990s (n = 20) and 2000s (n = 52). TG is shown to accumulate xenobiotics. As the examinees had no occupational contact with heavy metal salts (HMS), their deposits in TG is explained by anthropogenic pollution of the environment. HMS in the thyroid tissue was much lower than in later decades indicating aggravation of environmental pollution in the Urals. Being protoplasmic poisons, HMS bind proteins and provoke immune reaction. All the examinees who died after 2000 had histologically proved deposits of immunocompetent cells in TG tissue--lymphoid and plasmic TG infiltration. In the 1960s these TG alterations were absent. Goiter endemia can be stopped by improvement of environmental protection in each ecopolluted region and mass iodine prophylaxis.

Adult↗
PubMed2003

Squamous metaplasia in a multinodular goiter: a case report.

Squamous epithelium in thyroid is an unusual finding. It is seen in a variety of inflammatory and neoplastic conditions. It's presence has been attributed to metaplastic change of follicular epithelium by some authors and to the persistence of ultimobranchial body by others. We encountered a case of multinodular goiter with groups of squamous cells lining a cystic cavity. We report it because of it's rarity with a brief review of literature.

Adult↗
PubMed1992

[Extensive cervical hematoma complicating multinodular goiter. Apropos of a case].

The massive hemorrhagic accidents of multinodular goiter are very rare, implicating the vital prognosis through an airway obstruction by tracheal compression. To illustrate this situation, the authors present an original case with a large cervico-thoracic hematoma without any respiratory's difficulties. The serious evolutive potential of that situation in spite the unworrying aspect of the patient, bring them to operate in delayed emergency.

Aged↗
PubMed2004

[Experience of surgical treatment of diffuse thyrotoxic goiter in children and teenagers].

Results of surgical treatment of 137 children, operated on for thyrotoxic goiter (TG) in 1989-2002 yrs were analyzed. Thyrotoxic ophthalmopathy was revealed in 86 (62.7%) patients, papillary carcinoma on background of diffuse TG--in 3 (2.1%). Subtotal resection of thyroid gland according to O. V. Nikolayev was performed in 99 (72.2%) patients, almost thyroidectomy--in 30 (21.8%), thyroidectomy--in 8 (5.8%). All the patients are alive. Bilateral affection of nervus laryngeus recurrens was not observed. Unilateral injury of nervus laryngeus recurrens was revealed in 5 (3.6%) childs. Transient hypoparathyrosis was noted in 20 (14.5%) patients. The TG recurrence had occurred in 5 (3.6%) childs, postoperative hypothyrosis--in 100 (72.9%).

Adolescent↗
PubMed2004

[Application of plasmapheresis in complex of preoperative preparation in patients with autoimmune thyroiditis and diffuse toxic goiter].

The article is devoted to actulal problem of endocrinology and surgery-treatment of severe diseases of the thyroid gland. Results of plasmapheresis application in complex preoperative preparation in 90 patients, aged from 20 to 60 yrs, in severe course of the disease, were adduced. After plasmapheresis preparation conduction the reduction of the autoimmune processes in the patients organisms, the antibodies titer lowering were noted, witnessing the stable remission achievement. Plasmapheresis application in complex of treatment of patients with autoimmune thyroiditis and diffuse toxic goiter causes significant positive influence on hormonal and immune state.

Adult↗
PubMed2003

[Diagnosis and treatment of retrosternal goiter].

Retrosternal and intrathoracal goiters are actual surgical problem. This is because of the severe clinical symptoms, complications and some difficulties at the operative treatment. For the period of 1991-2002 at the Clinic of Thoraco-Abdominal Surgery at Medical University Plovdiv are operated 1131 patients with thyroid disease. Of them 38 were operated with cervical incision, 3 with median sternotomy, 2 with thoracotomy. There were complication at 7 patients. Only one patient died from pulmonary embolism.

Adult↗
PubMed2005

[The bone mineral density and the markers of the osseous circle in children with non-toxic parenchymatous or nodular goiter long-time treated with L-thyroxine].

The aim of the study was the appreciation of the influence of a therapy with L-thyroxine on the metabolism and density of the osseous tissue (BMD) in children with an euthyroid diffuse and nodular goiter. The examinations included 50 children (5 boys and 45 girls). Mean age of the investigated group: 17 years, time of therapy 2-5 years. The daily dose of L-thyroxine was not higher than 1-2 microg/kg body mass. All the children were in clinical and hormonal euthyrosis. The control group consisted of 50 healthy children (12 boys and 38 girls), mean age 16,16 years. A correlation between the age of the children, TSH level and the markers of the osseous circle was not observed. The mean level of TSH was statistical significant lower in the examined group. In the examined group the level of PTH and ICTP in the blood serum was (PTH: 35.83+/-8.34 pg/m vs 37.21+/-7.17 pg/ml); ICTP (8.7+/-3.87 microg/l vs 15.11+/-5.7 microg/l) was lower in the control group but the difference was statistical not significant (p=0.07). The mean concentration of PICP in the investigated group was significant lower in comparison with the control group. The mean level ICTP between the examined and control group was statistical significant (p<0.05). The mean concentration of osteocalcine (OC) in the treated with L-thyroxine was statistical not significant.

Adolescent↗
PubMed2005

[Cytofluorymetric evaluation of antigen regions of human thyroid peroxidase in patients with Graves' disease and non-toxic multinodular goiter using mouse monoclonal antibodies].

The aim of this study was to estimate expression of surface antigen regions of TPO (thyroid peroxidase: #1, #18, #30, #64 epitopes) on thyroid cells in 15 patients with non-toxic multinodular goiter (NTMG) and 15 patients with Graves' disease (GD). The thyrocytes were identified by indirect method: in first stage we added mouse monoclonal autoantibodies specific for TPO regions and in second stage we conjugated this complex with rabbit anti-mouse antibodies IgG (Fab')2 with FITC. All investigations were performed by flow cytometry using apparatus Coulter EPICS XL. The percentages of thyroid cells with expression of antigen regions of TPO 1, 18, 30, 64 were measured in relationship to the responsible anti-TPO concentrations: 50, 100, 200, 400, 800, 1600 microg/ml. The analysis of the expression of epitope #64 TPO revealed insignificantly increased percentages of thyroid cells in patients with GD (73% vs 45%, ns) in comparison to NTMG at anti-TPO antibody concentration of 1600 microg/ml. In addition, we observed that reduction concentration of anti-TPO antibodies leads to the decreased percentage of thyroid cells with antigen region #64 expression. In patients with GD percentage of this cells was significantly higher (48% vs 7% p<0.019, 29% vs 56% p<0.05) in compared to the percentage of thyroid cells from patients with NTMG at concentration of 200-800 microg/ml anti-TPO antibodies. Analysis of epitopes #1 and #18 shown higher percentage of thyroid cells in GD (25% vs 20%, ns for #1 epitope) and (25% vs 13%, ns for #18 epitope) in comparison to the patients with NTMG at concentration 1600 microg/ml of anti-TPO antibodies. The percentages of thyrocytes with epitopes #1 and #18 were decreased in relation to the reduction of anti-TPO concentrations. However, in all our patients epitope #30 TPO was found only in 8% thyroid cells. We conclude that in young patients thyroid immune and nonimmune diseases predispose to elevated expression of TPO epitopes (#1, #18, #64) which suggested increase stimulation and activation of thyroid cells during inflammatory reaction within thyroid gland. Furthermore, dominance expression of #64 TPO epitope in Graves' patients which recognized B domain could be a useful marker of activity of immune process in concentration between 200-800 microg/ml of TPO antibodies.

Adolescent↗
PubMedDate not supplied

[Substernal goiter: pre-, intra- and postoperative problems].

The Authors report their experience with problems in treating substernal goiter. They then explain at length the complex haemodynamic or respiratory situations encountered and the therapeutic management of the condition. Also discussed are technical surgical problems, and the prevention and therapy of possible complications. They conclude by stating that thanks to all the technical means currently available complete patient control can be achieved before, during and after the operation, thus significantly contributing to the successful outcome of surgical treatment.

Aged↗
PubMed2006

Emergency thyroidectomy in a patient with severe upper airway obstruction caused by goiter: case for regional anesthesia.

A case of severe airway obstruction caused by a giant malignant goiter is presented. The patient had emergency thyroidectomy under regional anesthesia (bilateral superficial cervical plexus block). The procedure was well tolerated and the intraoperative course was uneventful. The anesthetic challenges are discussed and a case is made for regional anesthesia as a safe and reliable anesthetic option for thyroidectomy in this situation.

Aged↗
PubMedDate not supplied

[Determination of autoantibodies to thyrotropin receptors in patients with diffuse toxic goiter].

The blood level of antithyroid autoantibodies to TSH receptors was determined in patients with toxic goiter (TG) before and during antithyroid therapy using two biological methods (by the increment in the cAMP level in slices and primary monolayer culture of human thyroid cells) and a radioreceptor method (by inhibition of TSH binding with its receptors from the animal thyroid). Comparison of the results of these three methods has shown that all methods are almost equally valuable for diagnosis of new cases of TG. However the biological method was shown to be more sensitive and informative with regard to predicting the time of immunological remission during antithyroid therapy.

Adolescent↗
PubMedDate not supplied

[Goiter in neonates of the Rzeszów region].

In August 1987-July 1988, goiter was diagnosed in 2.3% of neonates in Rzeszów region. It was inactive in the majority of patients. Hypoactive goitre was noted in 10% of examined babies. An increase in goitre incidence in neonates is related to endemic goitre in Rzeszów region.

Goiter, Endemic↗
PubMed1991

[The clinico-morphological characteristics of thyroid cancer in a region of endemic goiter].

The study deals with the results of clinico-morphologic analysis of thyroid cancer in 351 patients who have been operated on in the Carpathian Mountain [correction of Prikarpatsky] region endemic for goiter over the period of 25 years. Certain peculiarities of thyroid cancer were established: relatively high occurrence of the disease, specific ratio of basic histologic subtypes, high frequency of early stage cases and regular concomitance of cancer with other thyroid pathologies. The importance of further studies into the epidemiology of thyroid cancer is emphasized.

Adenocarcinoma, Follicular↗