Familial non-medullary thyroid carcinoma (FNMTC): analysis of fPTC/PRN, NMTC1, MNG1 and TCO susceptibility loci and identification of somatic BRAF and RAS mutations. (73/220)

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Expression of Galectin-3 and Galectin-7 in thyroid malignancy as potential diagnostic indicators. (74/220)

INTRODUCTION: It has been suggested that Galectin-3 (Gal-3) and Galectin-7 (Gal-7) are potential tumour markers for differentiating thyroid carcinoma from its benign counter part. Galectins are beta-galactoside-binding proteins with Gal-3 being a redundant pre-mRNA splicing factor. They are supposed to be p53-related regulators in cell growth and apoptosis, being either anti-apoptotic or pro-apoptotic. Although the value of Gal-3 has been studied extensively, there is little knowledge regarding the expression of Gal-7 in thyroid malignancy. METHODS: We initiated an immunohistochemical (IHC) study on the expression of Gal-3 and Gal-7 on various thyroid lesions. Formalin-fixed paraffin embedded thyroid tissues were stained for IHC expression of Gal-3 and Gal-7 using monoclonal anti-human Gal-3 antibody and anti-human Gal-7 antibody (R&D Systems Inc, MN, USA). Gal-3 and Gal-7 expressions were measured semiquantitatively on their distribution and staining intensity. RESULTS: A total of 95 cases were collected, including 32 benign and 63 malignant thyroid lesions. These contained 37 cases of papillary thyroid carcinoma, nine cases of papillary thyroid carcinoma follicular variant, 16 cases of follicular carcinoma, one case of anaplastic carcinoma, 14 cases of follicular adenomas and 18 cases of nodular goitre. Gal-3 expression was significantly strong in cancer cases compared to non-cancer cases (p-value is 0.000), while no significant difference was noted with Gal-7 expression (p-value is 0.870). CONCLUSION: Our findings suggested that the IHC localisation of Gal-3 is a useful marker in conjunction with routine haematoylin and eosin staining in differentiating benign from malignant thyroid lesions, while there is no significant adjunct diagnostic value in Gal-7 for thyroid malignancy.  (+info)

Total thyroidectomy is safer with identification of recurrent laryngeal nerve. (75/220)

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Distant and lymph node metastases of thyroid nodules with no pathological evidence of malignancy: a limitation of pathological examination. (76/220)

Among thyroid nodules arising from follicular cells, benign nodular goiter is thought not to metastasize to regional or distant organs. However, we encountered five cases that were pathologically diagnosed as benign nodular goiter but showed metastasis. The prevalence of benign nodular goiter showing metastasis was 0.17% (5 of 2978 patients). On pathology, there were no detectable signs of carcinoma or follicular adenoma lesions. Two patients showed lymph node metastasis that was pathologically confirmed as metastasis of nodular goiter. One was preoperatively and another was postoperatively detected by ultrasonography. These patients also showed distant metastases that could be ablated by radioiodine. One patient preoperatively showed lung metastasis and the remaining two showed lung and bone metastases and bone metastasis postoperatively. Pathological diagnosis of thyroid nodules has limitations, and cases diagnosed as benign nodular goiter should still undergo careful follow-up.  (+info)

Thyroid diseases after treatment of Hodgkin's disease. (77/220)

BACKGROUND AND METHODS: Thyroid disease, especially hypothyroidism, is common in patients with Hodgkin's disease who have been treated with irradiation. We reviewed the records of 1787 patients (740 women and 1047 men) with Hodgkin's disease who were treated with radiation therapy alone (810 patients), radiation and chemotherapy (920 patients), or chemotherapy alone (57 patients) at Stanford University between 1961 and 1989. Among these patients, 1533 were alive at the last follow-up, and 254 had died of causes other than Hodgkin's disease. (Four other patients were excluded from the analysis because they had undergone thyroidectomy before treatment for Hodgkin's disease. The thyroid was irradiated in 1677 patients. Follow-up averaged 9.9 years. RESULTS: A total of 573 patients had clinical or biochemical evidence of thyroid disease. Among the 1677 patients whose thyroid was irradiated, the actuarial risk of thyroid disease 20 years after treatment was 52 percent, and it was 67 percent at 26 years. Hypothyroidism was found in 513 patients. A total of 486 patients received thyroxine therapy for elevated serum thyrotropin concentrations and either low free thyroxine (208 patients) or normal free thyroxine values (278 patients); 27 had transient elevations of the serum thyrotropin level that were not treated. Graves' hyperthyroidism developed in 30 patients (2 of whom had not undergone thyroid irradiation), and ophthalmopathy developed in 17 of these patients. Ophthalmopathy developed in four other patients with Graves' disease during a period of hypothyroidism (n = 3) or euthyroidism (n = 1). The risk of Graves' disease was 7.2 to 20.4 times that for normal subjects. Silent thyroiditis with thyrotoxicosis developed in six patients. Forty-four patients were found to have single or multiple thyroid nodules, 26 of whom underwent thyroidectomy. Six of the 44 had papillary or follicular cancers. Among the patients who did not undergo operation, 12 had small functioning nodules, 4 had cysts, and 2 had multinodular goiters. The actuarial risk of thyroid cancer was 1.7 percent. The risk of thyroid cancer was 15.6 times the expected risk. CONCLUSIONS: High risks of thyroid disease persist more than 25 years after patients have received radiation therapy for Hodgkin's disease, reinforcing the need for continued clinical and biochemical evaluation. Prolonged follow-up confirms an elevated risk of thyroid cancer and Graves' disease as well as hypothyroidism in these patients.  (+info)

A rapid bail-out technique for reinsertion of a displaced tracheostomy tube in difficult situations. (78/220)

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Negative pressure pulmonary edema in the coronary care unit. (79/220)

A 63-year-old woman with no known cardiac history presented with pulmonary edema accompanied by electrocardiographic evidence of ischemia. Echocardiography demonstrated normal cardiac dimensions, normal wall motion and mild diastolic dysfunction. Despite repeat attempts at extubation following aggressive diuresis, the patient required ongoing ventilatory support. Although cardiac catheterization revealed normal coronary arteries, computed tomography revealed a 4 cm 9 cm multinodular goiter extending into the mediastinum and compressing the trachea. A diagnosis of negative pressure pulmonary edema should be considered in the differential diagnosis of any patient presenting with acute heart failure.  (+info)

Immigration and the incidence of Graves' thyrotoxicosis, thyrotoxic multinodular goiter and solitary toxic adenoma. (80/220)

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