异位甲状腺与甲状腺肿瘤

目的：探讨异位甲状腺及其肿瘤的临床病理学特点及诊治原则。方法：对３２例舌根甲状腺及６例其它中线部位的异位甲状腺之临床病理学资料进行了分析。对５９例因“侧方异位甲状腺”而行同侧或双侧甲状腺切除的后病理亦作了分析。结果：３２例舌根甲状腺无症状者１１例,有症状性者２１例,完全性异位１６例,部分尾异位１６例,１６例给予甲状腺素１例无效,８例行手术切除术后病理显示２例腺瘤性甲状腺肿、２例甲状腺腺瘤、例甲状腺     

甲状腺手术后发生甲状腺肿瘤的原因探讨

甲状腺手术后发生甲状腺肿瘤的原因探讨王怡淳，张筱骅，庄建华温州市第二人民医院（３２５０００）甲状腺手术是否会促使残余腺体发生甲状腺肿瘤，这是医生感兴趣的问题，本文就此问题结合我们的资料做一简要分析。临床资料从１９８６－１９９３年，我们三所医院共碰到甲...     

甲状腺转录因子在甲状腺良恶性病变中的表达

目的：探讨甲状腺转录因子（TTF－1）在甲状腺常见良恶性病变中的表达情况，并与甲状腺球蛋白（TG）和降钙素（CT）进行比较。方法：采用Envision二步免疫组织化学分析法分别检测TTF－1和TG在45例常见的甲状腺良性病变和65例甲状腺癌中的表达，其中10例甲状腺髓样癌加做CT检查。结果：TTF－1为核阳性，TG和CT为胞浆阳性。甲状腺滤泡细胞起源的良性病变TTF－1和TG阳性率均为100.0%(45/45)；而相应的恶性肿瘤TTF－1和TG的阳性率分别为89.1%(49/55)和85．5％（47／55）。起源于甲状腺滤泡旁C细胞的髓样癌TTF－1阳性率为70.0%(7/10)，CT和TG阳性率分别为100.0%(10/10)和0（0／10）。结论：TTF－1在甲状腺常见良恶性病变中阳性率高，因其特异地表达在细胞核，是一种很好的甲状腺滤泡细胞和滤泡旁C细胞特异性标记物。     

甲状腺细针穿刺对甲状腺相关指标的影响

[目的]探讨甲状腺细针穿刺（fine-needle aspiration,FNA）对甲状腺相关指标的影响。[方法]使用SPSS 26.0软件进行非参数检验比较甲状腺FNA前后相关指标的变化。[结果]共纳入448例患者，男性患者甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）在穿刺后第1周增长0.63 IU/mL(P=0.013)，促甲状腺素（thyroid stimulating hormone,TSH）在第5周下降27.6%(P=0.043),BRAF V600E突变组甲状腺球蛋白（thyroglobulin,Tg）在第2周升高33%(P=0.023)。具有该突变的女性Tg在第1周内升高7.1%(P=0.029)，甲状腺球蛋白抗体（thyroglobulin antibody,TgAb）在穿刺后第2周内升高、第3周内降低（P<0.05）,TgAb、TPOAb在5周后仍较穿刺前升高（P<0.05），无该突变的女性甲状腺相关指标不受FNA影响（P>0.05）。[结论]男性患者的甲状腺相关指标在行甲状腺FNA的5周后恢复至穿刺前水...     

甲状腺肿瘤干细胞研究进展

肿瘤干细胞已经成为肿瘤发病机制的研究热点，并且已经在很多肿瘤中发现并分离出了肿瘤干细胞。甲状腺肿瘤干细胞模型也已经被提出，越来越多的实验研究支持甲状腺肿瘤干细胞的存在，并认为他们可能来源于甲状腺干细胞。本文综述了目前甲状腺干细胞和甲状腺肿瘤干细胞的研究进展。     

甲状腺肿瘤干细胞研究进展

肿瘤干细胞已经成为肿瘤发病机制的研究热点,并且已经在很多肿瘤中发现并分离出了肿瘤干细胞.甲状腺肿瘤干细胞模型也已经被提出,越来越多的实验研究支持甲状腺肿瘤干细胞的存在,并认为他们可能来源于甲状腺干细胞.本文综述了目前甲状腺干细胞和甲状腺肿瘤干细胞的研究进展.     

不规则甲状腺切除治疗小儿多发性甲状腺瘤六例分析

多发性甲状腺瘤是小儿一种少见疾病，我院于１９９５年～１９９８年采用不规则甲状腺切除术治疗该病６例，取得了良好效果，总结报告如下。１　临床资料１．１　一般资料　本组共６例，男１例，女５例，年龄１０～１４岁，病程０．５～２年。多发性腺瘤位于右侧叶１例，余均为双侧。术前无并发症。术后病理诊断均给予证实。１．２　手术方法　本组病人均采用全麻。常规手术入路，紧贴甲状腺固有被膜游离甲状腺，操作在被膜内进行。处理甲状腺上极时，尽量保留正常的甲状腺组织，不结扎甲状腺上动脉。在甲状腺背侧不常规显露甲状腺下动脉，用…     

传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺癌的临床对比研究

目的比较传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺癌的临床效果。方法选取2007年1月至2012年3月期间收治的80例甲状腺癌患者,随机分为对照组和观察组,每组40例。对照组患者行传统甲状腺切除术,观察组患者行小切口甲状腺切除术。比较两组患者的手术时间、术中出血量、住院时间以及并发症发生情况。结果观察组患者的手术时间、切口长度、术中出血量、住院时间及并发症发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论小切口甲状腺切除术治疗甲状腺癌具有手术时间短、术中出血量少、切口小、住院时间短以及术后并发症少等优点,尤其是切口小,外形美观,患者满意度高,值得临床推广应用。     

甲状腺母细胞瘤1例

<正>患者男性,23岁。2022年11月因“甲状腺肿物进行性增大2个月”就诊于中国人民解放军南部战区总医院。入院体检：颈部明显增粗,气管右侧移位,甲状腺区可触及肿物大小约8 cm×6 cm,质硬,表面不光滑,无压痛,随吞咽上下活动,颈部可触及明显肿大淋巴结,融合成团。PET/CT检查提示恶性肿瘤可能,且病灶压迫气管（图1A）。入院后出现急性呼吸困难,上呼吸道梗阻,紧急行气管切开及甲状腺肿瘤切除术,术中发现双侧甲状腺弥漫性肿大质硬,鱼肉样改变,与周围组织黏连,气管受压变窄,向右侧偏移,术中切除部分甲状腺峡部肿瘤并行气管切开置管术。     

甲状腺功能亢进合并甲状腺癌的诊治

目的：探讨甲状腺功能亢进合并甲状腺癌的诊断及治疗方法。方法：回顾分析我院收治的28例甲状腺功能亢进合并甲状腺癌患者的临床资料。结果：本组病例均治愈出院，无手术并发症。随访时间05—6年，均未见甲亢复发或甲状腺癌复发、转移。结论：超声检查对于术前诊断甲状腺癌有重要意义，甲状腺功能亢进合并甲状腺乳头状癌的患者经合理的手术治疗，预后良好。     

Efficacy of conservative treatment modalities used in epistaxis

Objective

To assess the efficacy of conservative modalities in the management of epistaxis.

Study design

Prospective case studies.

Setting

Rural medical college hospital.

Patients

Indoor and outdoor patients with epistaxis.

lntervention

Conservative(non surgical) management techniques in epistaxis.

Results

Chemical cauterization was successful in 72.07% cases, anterior nasal packing in 84.5% and posterior nasal packing in 95.6% cases.

Conclusion

Out of 300 cases of epistaxis included in the study (except for one case that required internal maxillary artery ligation). all cases were treated successfully with conservative treatment alongwith treating the underlying pathology causing epistaxis.     

Results of intravenous steroid injection on reduction of postoperative edema in rhinoplasty

Objective

To determine the efficacy of intravenous dexamethasone in reducing postrhinoplasty edema.

Design

A prospective, randomized clinical trial with placebo control.

Setting

Department of Otorhinolaryngology, Al-Sabah and Zain Hospital, Kuwait.

Subject

Eighty-four patients (male = 28; female = 56) aged between 20 and 40 years, undergoing open rhinoplasty with hump removal and bilateral lateral osteotomies were enrolled in this study.

Intervention

Patients were randomized to receive two doses of 10 mg of dexamethasone intravenously or placebo, first dose during surgery and second dose 12 hours after surgery.

Main outcome measures

Patients were evaluated postoperatively at 24 hours, days 2, 5, 7 and 10 for periorbital edema.

Results

10 mg of dexamethasone given intravenously during rhinoplasty and a second dose 12 hours after surgery, reduced postoperative periorbital edema significantly.

Conclusion

This study showed a statistically significant benefit of dexamethasone over placebo in reducing periorbital edema after rhinoplasty. No complications were attributed to the administration of dexamethasone.     

Diagnostic significance of nasal eosinophilia in allergic rhinitis

Background

Nasal eosinophilia is one of the potential tests for substantiating the diagnosis of allergic rhinitis.

Objective

The aim was to establish the validity of nasal eosinophilia in allergic rhinitis, to study it's various clinical correlates and interpret it in context of skin sensitivity pattern.

Study Design

Prospective cased study.

Setting

Hospital based.

Patients

The patients were selected on the basis of history and clinical examination and were from the Himalayan region.

Intervention

Diagnostic.

Methods

The patients and the equal number of controls, were subjected to nasal smear for eosinophilia and intra-dermal skin tests to various allergeus.

Results

Overall, eighty percent of nasal smears were positive in various degrees among the cases. Around eighty-eight percent of cases showed both smear and skin test positivity, thereby signifying a high degree of harmony among them and further validating and confirming the diagnosis of allergic rhinitis.

Conclusion

Nasal eosinophilia was found to be a useful diagnostic test in allergic rhinitis, with a moderately high sensitivity and a high specificity.     

The role of neuropathology in the management of progressive glioblastoma

Question

1. What are the most important diagnostic considerations in reporting progressive glioblastoma?

Target population

These recommendations apply to adults with progressive glioblastoma

Recommendations

Level III

For patients who undergo biopsy or neurosurgical resection at the time of radiologic or clinical progression, it is recommended that the pathologist report the presence and extent of progressive neoplasm as well as the presence and extent of necrosis within the pathologic material examined. Furthermore, to ensure the proper interpretation of progressive glioblastoma, it is recommended that the pathologist take into account the patient’s previous diagnosis and treatment, as well as the current clinical and neuroimaging features that have led to a second biopsy or resection.

Question

2. What techniques and ancillary studies are most useful in separating malignant progression from treatment effect?

Target population

These recommendations apply to adults with progressive glioblastoma

Recommendations

Level III

In the setting of prior radiation and chemotherapy, it is recommended to adhere to strict histologic criteria for microvascular proliferation and necrosis in order to establish a diagnosis of a glioblastoma. Immunohistochemistry and genetic studies are selectively recommended for distinguishing neoplastic cells from atypical reactive cells in progressive glioblastoma.     

Metabolic iodine and tumours

Purpose

Purpose of the work is to highlight a possible connection between metabolic iodine and natural tumour control.

Method

Method adopted is to use information available in the literature.

Result

Result indicated a means of the purpose being attained.

Conclusion

Conclusion drawn is that a tumour control method derives from the relationship studied.

     

Societal preference values for advanced melanoma health states in the United Kingdom and Australia

Background:

No studies measure preference-based utilities in advanced melanoma that capture both intended clinical response and unintended toxicities associated with treatment.

Methods:

Using standard gamble, utilities were elicited from 140 respondents in the United Kingdom and Australia for 13 health states.

Results:

Preferences decreased with reduced treatment responsiveness and with increasing toxicity.

Conclusions:

These general population utilities can be incorporated into treatment-specific cost-effectiveness evaluations.     

Intratympanic dexamethasone application in Meniere's disease—Is it superior to conventional therapy?

Objective

To compare the efficacy of conventional medical treatment versus transtympanic dexamethasone application into middle ear as treatment modality in Meniere's disease.

Study Design

Prospective randomized study.

Setting

Tertiary referral centre.

Method

Forty patients of Meniere's disease were treated, 20 by conventional method and 20 by transtympanic dexamethasone applications.

Intervention

Theraputic.

Results

Vertigo control of 85% achieved in study group when compared to 80% in control group, 15% of patients had hearing improvement in study group while 10% had hearing improvement in control group. Aural fullness and tinnitus control were identical in both groups.

Conclusions

Both modalities of therapy were found to have almost equal efficacy, with Intra tympanic steroid (ITS) therapy having an edge over conventional therapy in cases with severe attacks and shorter duration of symptoms.     

Cancers et environnement : explorer les comportements de recherche et les sources d’information des personnes atteintes et non atteintes d’un cancer

Aim

To explore information-seeking behaviors on links between cancers and environment.

Method

Focus groups and individual semi-structured interviews realized, respectively, with individuals without and with personal cancer experience.

Results

The majority of respondents reported informationscanning behaviors. Only half cancer patients searched for information regarding the links between cancers and environment.

Conclusion

Little information is sought on links between cancers and environment.

     

EBV-associated gastric carcinoma in high- and low-incidence areas for nasopharyngeal carcinoma

Background:

Approximately 10% of gastric carcinomas are associated with Epstein–Barr virus (EBV). The Inuit in Greenland have a high incidence of EBV-associated nasopharyngeal carcinoma.

Methods:

We conducted a population-based case–control study comparing gastric carcinomas in Greenland and in Denmark.

Results:

The prevalence rate of EBV-associated gastric carcinomas was 8.5% in both populations.

Conclusion:

The findings of this study argue against a general susceptibility to EBV-associated carcinomas among the Inuit.     

Anterior external bony ear canal bulge

Objective

To study the prevalence of anterior external bony ear canal bulge.

Methods

Hundred patients each of the sexes among three races in Malaysia were studied with an otoscope and microscope.

Results

Anterior external ear canal wall bulge is seen in 34% of the Malays, 32% of the Chinese and 29.5% of the Indians

Conclusion

In about one third of the population in Malaysia an anterior canal wall bulge is seen.