ABSTRACT
Purpose@#Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. @*Methods@#This survey was prepared to collect participants’ demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. @*Results@#There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar’s length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). @*Conclusion@#Patients’ expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.
ABSTRACT
Objectives: To show whether the prognosis of oncocytic variant of papillary carcinoma [PCOV] differs from the oncocytic variant of follicular carcinoma [FCOV], and to evaluate the importance of histological features influencing tumor recurrence and prognosis
Design: Retrospective study
Setting: Department of Pathology, Faculty of Medicine, Ege University, Izmir, Turkey
Subjects: Thirty cases diagnosed as oncocytic carcinomas of thyroid during the period of January 2000 to December 2011 were included in the study
Intervention: Demographical data, follow-up time, development of recurrence and/or distant metastasis, and macroscopical features of the tumors were evaluated. Hematoxylin-eosin stained slides of the cases were reviewed retrospectively
Main outcome measures: To show the prognostic difference of PCOV from FCOV and to evaluate the importance of histological features influencing tumor recurrence and prognosis
Results: Twenty cases were PCOV and 10 were FCOV.Two of the FCOV and one PCOV case recurred locally. None of the cases of PCOV developed distant metastasis and all of these cases are alive. Only one FCOV case with extrathyroidal extension developed distant metastasis and two cases with extrathyroidal extension recurred locally. Four FCOV cases developed metastasis and three of these died from the disease. Vascular invasion was observed in most of the FCOV, but only in one of the PCOV cases. Significant association was found between the histological type of the tumor and survival, and also the vascular invasion
Conclusion: The diagnosis of oncocytic carcinomas, whether variants of papillary or follicular carcinomas, is essential, as the presence of vascular invasion and disease-free survival differs between the two variants
ABSTRACT
PURPOSE: Lipid peroxidation and consequent reactive oxygen species in the setting of oxidative stress have crucial roles in liver regeneration, which may adversely affect the regeneration itself and lead to liver failure. The aim of the current study is to investigate whether omega-3 fatty acid supplementation inhibits oxidative stress in an experimental model of liver regeneration. METHODS: Forty rats were allocated to four groups. Rats in group A received a sham operation. Rats in group B were subjected to right portal vein ligation (RPVL) and saline infusion. Rats in groups C and D were subjected to RPVL and total parenteral nutrition (TPN) with an all-in-one admixture containing a soybean oil based lipid emulsion. Rats in group D were additionally supplemented with omega-3 fatty acid infusion. Oxidative stresses in the blood and liver were measured by glutathione, superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and nitric oxide. RESULTS: Omega-3 supplementation to the TPN solution significantly corrected alterations in the blood and tissue concentrations of oxidants and anti-oxidants during regeneration (P < 0.05). CONCLUSION: Omega-3 fatty acid supplementation to the TPN solution revealed promising results in removal of oxidative stress that emerges during liver regeneration.
ABSTRACT
PURPOSE: To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. METHODS: Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10–100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. RESULTS: Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10–100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10–100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease. CONCLUSION: Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.