In vivo expression of monokine and inducible nitric oxide synthase in experimentally induced pulmonary granulomatous inflammation. Evidence for sequential production of interleukin-1, inducible nitric oxide synthase, and tumor necrosis factor.

The present study examined the temporal pattern and localization of interleukin-1, tumor necrosis factor-alpha, and inducible nitric oxide synthase expression in lung tissue undergoing foreign body granuloma formation. Pulmonary granulomas were induced by the intratracheal injection of dextran beads into genetically high granuloma responder, carrying Bcgs (BALB/c), and low responder, carrying Bcgr (C3H/HeJ and DBA/2), mice. There was a pattern of sequential expression of these molecules in BALB/c mice. Thus, interleukin-1 alpha and inducible nitric oxide synthase were induced mostly in the cells accumulated around the beads and also in some bronchiolar epithelial cells during the early phase (1 to 3 days), whereas tumor necrosis factor-alpha was induced in the cells around the beads at the later resolution phase (3 to 7 days). By contrast, in low responder mice, an increase in the expression of interleukin-1 alpha and inducible nitric oxide synthase was detected in lung macrophages as well as in alveolar cells and bronchiolar epithelial cells on day 1, but that of tumor necrosis factor-alpha was not detected throughout the period. These results together with our previous findings on cytokine activity in granuloma extract suggest that interleukin-1 and nitric oxide produced by recruited macrophages may take part in the early, macrophage-dependent phase of granuloma formation whereas tumor necrosis factor-alpha may be more crucial as a mediator responsible for the difference in innate resistance or susceptibility to granuloma formation.     

Effect of fetal tissue transplantation on reparative processes in experimental liver cirrhosis

Reparative regeneration after fetal tissue transplantation and after surgical stimulation was studied in rats with experimental cirrhosis of the liver. Fetal tissue restored the morphology and function of cirrhotic liver and modified functional activity of peritoneal macrophages. Translated fromByulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 130, No. 8, pp. 216–219, August, 2000     

Retrosternal (intrathoracic) goitre--diagnosis and surgical treatment

For a period of 12 years (1987-1998) 2033 patients underwent surgical treatment of the thyroids in the surgical clinics of the Higher Medical Institute in Plovdiv. Retrosternal or intrathoracic goitre was found in 29 patients (p +/- Sp = 1.43 +/- 0.26%). Of these, seven were males and 22 females all aged 32 to 76 years. Twenty two of the patients were euthyroid and seven hyperthyroid (75.9 +/- 7.9% and 24.1 +/- 7.8%, respectively). Compression of adjacent organs was detected in 19 of the patients (65.5 +/- 8.8%) (P < 0.05). X-ray, ultrasonography, scintigraphy (gamma-chamber), computed tomography, and in cases of voice disorders, direct laryngoscopy were used in making the diagnosis. All patients underwent surgical treatment. Cervical collar incision was suitable in 27 patients and in one patient longitudinal sternotomy was used and in other, who had deep posterior mediastinal goitre, Hart's method of combined thoracotomy and cervicotomy was required. The weight of the resected glands varied from 50 to 1500 g. The results obtained are discussed in terms of the incidence, type, and site of the retrosternal (intrathoracic) goitre, capabilities of the contemporary methods of diagnostics, surgical necessities, surgical approach and compared with literature data.     

Early hypothyroidism after subtotal thyroidectomy in patients with Graves' disease--the role of the preoperative conservative treatment and hormonal status

AIM: The aim of the present study was to evaluate the role of the preoperative antithyroid drug treatment and hormonal status in the development of early postoperative hypothyroidism after subtotal thyroidectomy in patients with Graves' disease. MATERIAL AND METHODS: Eighty-five patients with Graves' disease (males : females ratio 1:5.54, age range 19 to 64, 37.52 +/- 1.09 yrs) who had previously undergone surgical treatment were enrolled in the study. All patients underwent bilateral subtotal thyroidectomy with the amount of remnant tissue of 2-3 g for each lobe (total 4-6 g). Development of early (within one year after the operation) postoperative hypothyroidism was analyzed regarding the type of the antithyroid drug, preoperative dose, duration of the preoperative medical treatment, FT3, FT4, FT3/FT4 and hTSH. RESULTS: Forty six percent of all examined patients (54.12%) were euthyroid and 39 (45.88%/)--hypothyroid. Postoperative hypothyroidism was developed by 33.33% of the patients that had received preoperatively propylthiouracil compared with 50.82% of those treated with methymazol (p > 0.05). The duration of the preoperative treatment was 38.36 +/- 3.53 months for the hypothyroid patients and 30.11 +/- 2.34 months for the euthyroid patients (p < 0.05). Postoperative hypothyroidism developed in 58.70% of the patients with preoperatively suppressed thyroid-stimulating hormone (hTSH) and in 33.33% of those with normalized values of hTSH (p < 0.05). No statistically significant between-group difference was found in the preoperative dose of antithyroid agent, mean values of free triiodothyronine (FT3), free thyroxine (FT4), FT3/FT4, thyrotropic hormone (TSH). CONCLUSIONS: Longer preoperative antithyroid drug treatment and suppression of hTSH in the preoperative period correlated with higher risk of hypothyroidism after subtotal thyroidectomy. The type and the preoperative dose of the antithyroid agent, as well as the mean values of thyroid hormones before the operation have no prognostic significance for postoperative thyroid hypofunction.