Evaluation of incidental thyroid cancer in patients with thyroidectomy / Evaluación incidental del cáncer de tiroides en pacientes con tiroidectomía

OBJECTIVE: The present study aimed to emphasize the necessity and significance of thyroidectomy by determining the prevalence of incidental thyroid cancer in the cases that underwent surgical intervention for the treatment of benign thyroid disease. SUBJECTS AND METHOD: Thyroidectomy was performed in 443 cases including those with benign multinodular goitre (BMNG) or toxic adenoma or toxic multinodular goitre. Diagnosis was made based on routine physical examination, laboratory analyses, imaging methods and postoperative histopathological findings of the cases. RESULTS: The mean age of the cases was 45.5 (19-68) years and 72.5% (n = 321) were female. The most common clinical diagnosis prior to the surgery was BMNG (n = 428, 96.6%). While BMNG was determined to be the most common histopathological diagnosis after thyroidectomy at a rate of 81.7% (n = 362), the rate of thyroid cancer was found to be 14% (n = 81). The prevalence ofpapillary cancer was 84% (n = 56), whereas it was 4% (n = 4), 1% (n = 1) and 0.0% (n = 0) for medullary, follicular and anaplastic cancers, respectively. Papillary cancer was also the most common type of thyroid cancer between genders. As compared to gender, there was no statistically significant difference in terms of distribution of age among general, benign and malignant types of thyroid cancer (p > 0.05). CONCLUSION: It is appropriate to prefer thyroidectomy for the treatment of benign thyroid diseases due to the high prevalence ofincidental thyroid cancer after thyroidectomy in such cases.

OBJETIVO: El presente estudio tiene por objeto destacar la necesidad e importancia de la tiroidectomía mediante la determinación de la prevalencia del cáncer de tiroides incidental en los casos sometidos a intervención quirúrgica para el tratamiento de enfermedades tiroideas benignas. SUJETOS Y MÉTODO: Se practicó la tiroidectomía en 443 casos incluyendo aquellos con bocio multinodular benigno (BMNG) o adenoma tóxico o bocio multinodular tóxico. El diagnóstico se realizó a partir de un examen físico de rutina, análisis de laboratorio, métodos de imaginología, y resultados histopatológicos postoperatorios de los casos. RESULTADOS: La edad promedio de los casos fue 45.5 años (19-68) y 73% (n = 321) eran mujeres. El diagnóstico clínico más común antes de la cirugía fue BMNG (n = 428, 96,6%). Si bien se determinó que BMNG era el diagnóstico histopatológico más frecuente después de la tiroidectomía con una tasa de 81.7% (n = 362), se halló que la tasa de cáncer de tiroides era 14% (n = 81). La prevalencia de cáncer papilar fue de 84% (n = 56), mientras que para el cáncer medular, folicular y anaplásico, fue de 4% (n = 4), 1% (n = 1) y 0.0% (n = 0) respectivamente. El cáncer papilar también fue el tipo más común de cáncer de tiroides entre los géneros. En comparación con el género, no hubo ninguna diferencia estadísticamente significativa en cuanto a la distribución por edad entre los tipos generales, benignos y malignos de cáncer de tiroides (p > 0.05). CONCLUSIÓN: Es apropiado preferir la tiroidectomía para el tratamiento de las enfermedades tiroideas benignas debido a la alta prevalencia de cáncer tiroideo incidental después de la tiroidectomía en tales casos.

The effect of diosmin on pancreatic injury induced by hepatic ischemia reperfusion in rats.

PURPOSE: This experimental study aimed at comparing the cyanoacrylate abdomen closure to the effectiveness of triclosan coated polidioxanone abdomen closure. METHODS: The abdomen layers were closed with 3/0 polidioxanone suture in the first group. In the second group, the layers were closed with triclosan coated polidioxanone suture in a single layer. The abdomen layers of rats in the third group were attached with cyanoacrylates without sutures. The rats were sacrificed on the 14th day and the adhesive level was recorded. The incision resistance strength was measured. The tissue was examined blindly in the terms of inflammatory cell infiltration, capillary proliferation, fibrosis and micro-abscess by the pathologist. RESULTS: No significant difference was determined between the 1st and 2nd groups in the terms of inflammatory cell infiltration, capillary proliferation, collagen deposition, fibroblast activity, adhesive and tissue distension strength. The fibrosis and adhesive rate of the 3rd group was significantly higher than the 1st and 2nd groups statistically. The tissue distension strength was lower than in the other groups and the differences between the groups were found to be significant (p < 0.05). No significant difference was determined between the groups in the term of micro-abscess. CONCLUSIONS: Antibacterial suture is not superior to the conventional suture. It is concluded that cyanoacrylate is not an appropriate molecule for abdomen closure (Tab. 1, Fig. 3, Ref. 17).

Evaluation of incidental thyroid cancer in patients with thyroidectomy.

OBJECTIVES: Variations such as communications between median nerve and musculocutaneous nerve or in their abnormal branching pattern constitute a major concern in clinical and surgical field. Knowledge of these variations not only provides the clinician with a proper interpretation of the case, but also minimizes the complication in surgical approaches in this region. METHOD: We examined 50 isolated upper limbs to investigate the possible incidences of various types of communications between these two neighbouring peripheral nerves. RESULT: Twenty-eight per cent of limbs were found to have communication between these two nerves. When categorized according to Venieratos and Anagnostopoulou's classification method, 11 out of 14 cases (79%) showed type I communications, two out of 14 (14%) showed type II and the remaining one (7%) showed type III communication pattern. CONCLUSION: Prior knowledge of communications between these two neighbouring nerves, both in terms of their incidences and pattern of communications, may be of considerable significance to neurologists and orthopaedicians in dealing with nerve entrapment syndromes in the upper limb of patients.

Gallstone ileus with a giant stone and associated multiple stones.

Gallstone ileus is an uncommon cause of small bowel obstruction. Gallstone ileus accounts for only about 1-3 % of cases of mechanical obstructions of the small bowel. It usually occurs in the elderly with a female predominance and may result in high mortality rates. The diagnosis is difficult and early diagnosis reduces the mortality. Terminal ileum is the most common site of gallstone impaction. We report a case of gallstone ileus in an 81-year-old female patient who was admitted to our clinic for abdominal pain, vomiting and constipation. The ultrasonography of abdomen revealed a decrease in bowel motion, and dilated bowel segments. Intraoperatively, a giant gallstone and associated multiple stones were found in the ileum 80 cm from the ileocecal valve and extracted from a longitudinal enterotomy (Fig. 4, Ref. 24).

Diosmin ameliorates intestinal injury induced by hepatic ischemia reperfusion in rats.

BACKGROUND: Hepatic ischemia-reperfusion causes histologic injury to the intestinal mucosa. We investigated the effects of diosmin, a phelobotrophic drug with antioxidant and antiinflammatory effects, on intestinal injury in the experimental liver ischemia-reperfusion model. MATERIALS AND METHODS: Fourty rats were divided into four groups: sham group (Group 1), control group (Group 2), perop diosmin group (50 mg/kg) treatment group (Group 3) and preop 10-day diosmin (50 mg/kg) treatment group (Group 4). Ischemia-reperfusion model was carried out by clamping the hepatic pedicle for 60 min and then reperfusing the liver for 90 min. At the end of procedures, blood and ileum tissue samples were obtained for biochemical and histopathological assessments. RESULTS: According to the results of liver function tests (AST, ALT and LDH) there was a significant difference between the control and other groups (p < 0.001 for all). According to the plasma and ileum oxidative stress parameters (MDA, GSH-Px and XO), there was a significant difference between the control and other groups (p < 0.05 for all). Histopathologically; the specimens in Group 2 showed specific morphological abnormalities (the epithelial lining of the apical surface of villi was degenerated and desquamated to the lumen). Group 3 and 4 showed ileal histomorphology similar to the sham group. Pathological scores were significantly different between Group 2 and other groups. CONCLUSIONS: Diosmin can be administered for protection from destructive effects of hepatic ischemia-reperfusion injury on intestine in both emergent and elective hepatic surgical operations in which the possible ischemic periods are expected (Tab. 4, Fig. 1, Ref. 39).

Lead identification and optimization of diaminopyrimidines as histamine H4 receptor ligands.

BACKGROUND: The human histamine H(4) receptor (hH(4)R) is a promising new target in the therapy of inflammatory or immune system diseases. METHODS: For the development of new hH(4)R ligands, a broad virtual screening was performed and two hits were identified. Their annelated heterocyclic core was optimized with regard to affinity and potency. RESULTS: Pharmacological characterization of the resulting diaminopyrimidines revealed different agonist and antagonist properties within the same scaffold.

Self-organizing maps in drug discovery: compound library design, scaffold-hopping, repurposing.

High-throughput screening campaigns are fuelled not only by corporate or "maximally diverse" compound collections, but increasingly accompanied by target- or bioactivity-focused selections of screening compounds. Computer-assisted library design methods aid in the compilation of focused molecule libraries. A prerequisite for application of any such computational approach is the definition of a reference set and a molecular similarity metric, based on which compound clustering and iterative virtual screening are performed. In this context the self-organizing map (SOM, Kohonen network) and variations thereof have found widespread application. SOMs cover such diverse fields of drug discovery as screening library design, scaffold-hopping, and repurposing. Here we present the concept of the SOM technique along with recent case studies. Advantages, limitations and potential future applications are critically discussed.

The molecular mechanism of the inhibition by licofelone of the biosynthesis of 5-lipoxygenase products.

BACKGROUND AND PURPOSE: Licofelone is a dual inhibitor of the cyclooxygenase and 5-lipoxygenase (5-LO) pathway, and has been developed for the treatment of inflammatory diseases. Here, we investigated the molecular mechanisms underlying the inhibition by licofelone of the formation of 5-LO products. EXPERIMENTAL APPROACH: The efficacy of licofelone to inhibit the formation of 5-LO products was analysed in human isolated polymorphonuclear leukocytes (PMNL) or transfected HeLa cells, as well as in cell-free assays using respective cell homogenates or purified recombinant 5-LO. Moreover, the effects of licofelone on the subcellular redistribution of 5-LO were studied. KEY RESULTS: Licofelone potently blocked synthesis of 5-LO products in Ca(2+)-ionophore-activated PMNL (IC(50)=1.7 microM) but was a weak inhibitor of 5-LO activity in cell-free assays (IC(50)>>10 microM). The structures of licofelone and MK-886, an inhibitor of the 5-LO-activating protein (FLAP), were superimposable. The potencies of both licofelone and MK-886 in ionophore-activated PMNL were impaired upon increasing the concentration of arachidonic acid, or under conditions where 5-LO product formation was evoked by genotoxic, oxidative or hyperosmotic stress. Furthermore, licofelone prevented nuclear redistribution of 5-LO in ionophore-activated PMNL, as had been observed for FLAP inhibitors. Finally, licofelone as well as MK-886 caused only moderate inhibition of the synthesis of 5-LO products in HeLa cells, unless FLAP was co-transfected. CONCLUSIONS AND IMPLICATIONS: Our data suggest that the potent inhibition of the biosynthesis of 5-LO products by licofelone requires an intact cellular environment and appears to be due to interference with FLAP.