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21.
甲状腺手术中避免喉返神经损伤的实用解剖研究 总被引:3,自引:0,他引:3
对20例单发良性甲状腺瘤手术进行了动态解剖学观察,主要针对侧叶切除术中喉返神经的有关解剖学关系进行测量分析,对术中处理甲状腺下动脉的方法提出与传统观念不同的意见认为术中游离并托起患侧叶,紧贴腺体切断甲状腺下动脉各分支,保留甲状腺下动脉主干的方式是避免喉返神经损伤的有益方式 相似文献
22.
目的:探讨甲状腺激素水平在急性动脉栓塞中中西医结合治疗过程中的变化规律及其临床意义。方法:利用放射免疫分析法对40例本病患者及30例健康对照组进行血清甲状腺激素测定,观察中西医结合治疗前后的变化,结果;40例病人均存在在低T3、低T4和高rT3血症,且以重症病人最明显,T3水平低于0.5nmol/L者病情危重,T4低于50nmol/L者预后不良;低T3、低T4和高rT3血症均随中西医结合有效治疗后 相似文献
23.
观察30例正常对照组14例冠心病心衰患者,20例冠心病心功能代偿期患者血清T3,T4,rT3,FT3,FT4,TSH的变化,结果:两组患者与对照组比较,均有T3下降rT3升高,尤以冠心病心衰患者表现更明显,同时伴T4及FT3下降,有显著性差异,3组之间FT4比较无差异。结果提示:测定冠心病患者血清甲状腺激素水平,有助于了解病情的严重程度及判断其预后。 相似文献
24.
目的探讨声触诊组织成像量化(VTIQ)技术联合中国超声甲状腺影像报告系统(C-TIRADS)和韩国甲状腺影像分级系统(K-TIRADS)对甲状腺结节良恶性的诊断效能。 方法回顾性选择160例甲状腺结节患者,按病理结果分为良性组和恶性组。所有患者均经常规超声检查、VTIQ检查,根据C-TIRADS、K-TIRADS分级标准进行分级。ROC曲线分析C-TIRADS、K-TIRADS单独诊断或联合VTIQ对甲状腺结节良恶性的诊断效能。 结果两种系统单独应用时,K-TIRADS灵敏度低于C-TIRADS,但K-TIRADS特异性更高。与C-TIRADS、K-TIRADS比较,K-TIRADS和C-TIRADS联合VTIQ对甲状腺结节的诊断效能均有所增加,C-TIRADS联合VTIQ后特异度和灵敏度高于K-TIRADS联合VTIQ(P<0.05)。 结论C-TIRADS或K-TIRADS联合VTIQ对甲状腺结节良恶性的诊断效能高于单独诊断,C-TIRADS联合VTIQ更有利于甲状腺良恶性判断。 相似文献
25.
Cappelli C Tironi A Mattanza C Cumetti D Agosti B Gandossi E Pirola I De Martino E Cherubini L Micheletti L Castellano M Rosei EA 《Endocrine pathology》2005,16(4):349-354
Objective: To compare the cytological findings of hypoechoic thyroid nodules with intranodular vascular pattern (pattern II) obtained
by two different needles (Neolus 25 gauge, Chemil, Wenzhou, China vs Yale Spinal 25 gauge, Becton Dickinson, Madrid, Spain)
in euthyroid patients and to evaluate their cost-effectiveness.
Methods: From January 2001 to December 2003, 480 euthyroid patients with a hypoechoic thyroid nodule pattern II were referred for
US-FNAC. The nodules were alternatively evaluated by Neolus or by Yale Spinal with the stylet (YS+) or without the stylet
(YS−), in order to evaluate if the cytological results could be due to the presence of the stylet or to the different length
of the two needles. For each nodule two passes were performed and the material was obtained by capillary action. Material
was smeared on slides, fixed, and stained by Papanicolaou techniques. Cytological specimens were evaluated in blind by the
same experienced cytopathologist.
Results: Inadequate cytological specimens because of blood contamination were present in 30 (18.7%) samples by Neolus needle and in
22 (13.8%) by YS− compared to only 5 (3.1%) by YS+. In 6 (20%) cases of the 30 repeated US-FNAC by Neolus and in 4 (18%) of
the 22 US-FNAC by YS−, material remained inadequate for diagnosis because of blood contamination. All the five repeated samples
obtained by YS+ became adequate for diagnosis and resulted benign nodules. Direct costs of US-FNAC procedure are currently
Э 72.30 including cytological examination. The cost of Neolus and Yale needles is Э 0.19 and Э 3.0, respectively. The estimated
total cost to obtain a cytological diagnosis by a Neolus needle (160 + 30 repeated US-FNAC) was Э 13809.2 vs Э 12919.5 by
Yale Spinal needle (160 + 5 repeated US-FNAC).
Conclusion: This study demonstrates that the use of Yale Spinal needles greatly reduces inadequate cytological specimens, and therefore
limits both direct and indirect costs. 相似文献
26.
Page C Laude M Legars D Foulon P Strunski V 《Surgical and radiologic anatomy : SRA》2004,26(3):182-185
This surgical anatomy study aimed to evaluate the possibility of identifying the external laryngeal nerve during thyroid surgery and the possible variations of nerves at risk. Fifty patients underwent total thyroidectomies during a period of 12 months. Using a neurostimulator, the distal motor branch of the external laryngeal nerve was searched. Electrical stimulation of a nervous branch aimed to provoke a global contraction of the cricothyroid in order to identify with certitude the external laryngeal nerve. The external laryngeal nerve was identified in 20% of cases. Its course was, with almost equal frequency, either (1) between the vessels of the superior thyroid pedicle or (2) superficial and anterior to the fascia of the cricothyroid muscle. The external laryngeal nerve is hard to find during thyroid surgery, even with a neurostimulator. It can be vulnerable during thyroid surgery but only in cases of anatomic variations. Searching for the nerve systematically during thyroid surgery does not seem to be useful. Several precautions when dissecting the superior pole of the thyroid gland seem to be necessary and sufficient to respect the external laryngeal nerve. 相似文献
27.
Leo P. Lawler Susan A. Wood Harpreet S. Pannu Elliot K. Fishman 《Journal of digital imaging》2003,16(3):251-261
The continued revolution in multidetector-row CT (MDCT) scanning increases the quality of lung imaging but at the cost of a greater burden of data for review and interpretation. This article discusses our preliminary experience with prototype software for lung nodule detection and characterization using MDCT data sets. We discuss the potential role of computer-assisted detection (CAD) as applied to the automatic detection of lung nodules. We also review the process of CAD, outline its potential results, and explore how it may fit into existing radiology practice. Finally, we discuss MDCT data-acquisition parameters and how they may affect the performance of CAD. 相似文献
28.
Schmid KW Bankfalvi A Mucke S Ofner D Riehemann K Schroder S Stucker A Totsch M Dockhorn-Dworniczak B 《Endocrine pathology》1996,7(2):121-130
Routinely processed tissues from a series of benign and malignant thyroid lesions were immunohistochemically investigated
with antibodies against p53 and mdm-2. p53 was immunolocalized in <10% of nuclei in 2/80 nodular goiters, 2/60 follicular
adenomas, 26/68 follicular carcinomas, 7/40 papillary carcinomas, 3/10 “insular” carcinomas, and 10/31 anaplastic carcinomas.
More than 10% positively stained nuclei were found in 2 widely invasive follicular, 2 insular, and 15 anaplastic carcinomas.
All p53-positive cases showed a concomitant immunohistochemical mdm-2 expression; an immunohistochemical colocalization on
serial section was demonstrated in 12 anaplastic carcinomas. Screening by polymerase chain reaction single-strand conformation
polymorphism (PCR-SSCP) analysis of these 12 cases revealed no relevant mutations in the coding regions of exons 2–11 of the
p53 gene. Additionally, 1 follicular adenoma, 6 follicular carcinomas (4 minimally and 2 widely invasive), 1 papillary, and
2 poorly differentiated insular carcinomas were mdm-2 positive without immunohistochemically detectable p53 expression. These
results provide evidence that wild-type p53 expression in thyroid carcinomas may be associated with mdm-2 induced formation
of stable complexes. However, the role of p53 mutations and p53 protein inactivation owing to other factors (e.g., mdm-2)
in the progression of thyroid carcinomas is still poorly understood. 相似文献
29.
甲状腺疾病患者血清可溶性白细胞介素2受体测定的临床意义 总被引:2,自引:0,他引:2
某些甲状腺疾病时血清可溶性白细胞介素2受体(sIL-2R)水平及其与游离甲状腺素(FT_4)、游离三碘甲腺原氨酸(FT_3)和促甲状腺素(TSH)水平的相关性比较。结果发现甲状腺机能亢进症(甲亢)未治疗组(A)及甲亢未治疗伴突眼组(D)血清sIL-2R明显升高;甲状腺机能减退症(甲减)经治疗甲状腺功能灭常组(G)sIL-2R明显高于甲减未治疗组(F);10例毒性弥漫性甲状腺肿(Graves病)患者经抗甲状腺药物治疗后sIL-2R明显降低;Graves病及甲减患者血清sIL-2R均与FT_3呈正相关。提示除自身免疫外,甲状腺素水平也是甲状腺疾病患者血清sIL-2R水平的重要调节因素。 相似文献
30.
自体甲状腺组织与干细胞移植治疗甲状腺功能减退症的研究进展 总被引:1,自引:0,他引:1
不可逆性甲减患者需要终身服用甲状腺激素,对患者的日常工作和生活造成了很大的不便。随着近年来对自体甲状腺组织与干细胞移植研究的进展,有望解决甲减病人终身服药这一问题。自体甲状腺组织移植的动物实验以及人体试验均表明:甲状腺移植物不但能够存活,而且能够发挥作用。最新的胚胎干细胞(Embryonic stemcell,ESC)研究证明,ESC可以分化为甲状腺滤泡细胞。 相似文献