A Clinical Analysis of Thyroid Tumor

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.

A Clinical Analysis of Infantile Hypertrophic Pyloric Stenosis

BACKGROUND: Infantile hypertrophic pyloric stenosis is the common disease of neonate and infant but its etiology and pathogenesis are still obscure. Frequent vomiting lead to electrolyte imbalance in infantile hypertrophic pyloric stenosis. METHODS: This study is a clinical analysis of the 30 cases of infantile hypertrophic pyloric stenosis (IHPS), that was surgically treated at the Department of Surgery, St. Columban Hospital during period of 8 years from January, 1990 to December, 1997. RESULTS: 1) The ratio of male to female was 3.3:1 and 50% of patients was first-born baby. 2) The most prevalent age group was between 3 to 4 weeks (20%). 3) The body weight percentile at admission was lower than 3 percentile in 14cases (46.7%). 4) Nonbilous projectile vomiting was noted in all cases. 5) In 15 cases (50%) of patients, the onset of symptoms was at 1 to 2 weeks of age. 6) The duration of symptoms was highest between a week to 3 weeks (50%). 7) The most frequent physical finding was palpable abdominal mass (60%). 8) At admission, clinical jaundice was noted in 3 cases (10%). 9) Hypochloremia was noted in 15 cases (50%) and hypokalemia in 6 cases (20%). 10) All cases were treated with Fredet-Ramstedt pyloromyotomy and duodenal perforation was complicated in 1 case. 11) Electrolyte abnormalities at admission did not significantly influence on the hospital stay. CONCLUSIONS: Through the surgical treatment so called Fredet-Ramstedt pyloromyotomy after accurate and rapid correction of dehydration and electrolyte imbalance, it can be cured.