557 research outputs found
The Association Between Chronic Lymphocytic Thyroiditis and the Progress of Papillary Thyroid Cancer
No full textBACKGROUND: Whether chronic lymphocytic thyroiditis (CLT) influences the risk of development and the progression of papillary thyroid cancer (PTC) remains uncertain. We investigated the effects of CLT on the clinicopathologic features and prognosis of PTC.
METHODS: Two thousand nine hundred twenty-eight consecutive patients with PTC treated between 2009 and 2017 were divided into two groups: one with chronic lymphocytic thyroiditis and one without; 1174 (40%) of the patients had coincident CLT.
RESULTS: In univariate analysis, CLT correlated positively with small tumor size, frequent extrathyroidal extension, multifocal diseases, and p53 but negatively with central lymph node (LN) metastasis and BRAF mutation. In multivariate analysis, CLT was associated with extrathyroidal extension and multifocal disease; however, it was not a prognostic factor for recurrence even though it was associated with two aggressive factors. Compared with patients with PTC alone, there were more retrieved central LNs in the PTC + CLT group, and these patients also underwent more invasive diagnostic tests such as fine needle aspiration cytology and frozen biopsy of LN.
CONCLUSIONS: The CLT patients with PTC had better behavior features and prognoses than did those with PTC alone despite frequent multifocality and extrathyroidal extension. However, precaution may be necessary to avoid performing invasive diagnostic procedures for lateral LN metastasis and to manage the patients appropriately
Reoperations for structurally persistent or recurrent disease after thyroidectomy: analysis via preoperative CT
No full textThe incidence rates of structural persistent disease (PD) and recurrent disease (RD) after thyroidectomy, and their clinicoradiological (CT) characteristics, remain poorly understood. Therefore, we characterized differentiated thyroid cancer (DTC) patients who underwent re-operations, with a focus on preoperative CT scans. We examined neck CT scans obtained prior to initial surgery and reoperation, and classified the disease into four categories according to the persistence/recurrence and neck dissection/non-dissection status. In total, 121 of 9,173 DTC patients underwent reoperations to treat PD or RD; the mean time to reoperation was 25.5 and 54.1 months, respectively. Of all reoperations, 19% (23/121) were performed to treat RD; 81% (98/121) were performed to treat PD. Compared to RD, PD was commonly detected in the non-dissected neck. Tumor multiplicity and the number of pathologically positive lymph nodes were greater in the non-dissected than dissected neck. A review of the CT data revealed more false-negative findings on the 60-s- versus 30-40-s-delay scans of PD patients with non-dissected necks. In conclusion, most of the reoperations performed on DTC patients were for management of PD. Improved preoperative CT assessments and initial surgery, based on the information of clinico-radiological characteristics, are required in the care of DTC patients
Author Correction: Transcription Factor HOXA9 is Linked to the Calcification and Invasion of Papillary Thyroid Carcinoma
No full textAn amendment to this paper has been published and can be accessed via a link at the top of the paper
Suspicious thyroid nodules 4 cm require a diagnostic lobectomy regardless of their benign fine needle aspiration results
No full textBACKGROUND/OBJECTIVE: The diagnostic accuracy of fine needle aspiration biopsy (FNAB) seems limited in large thyroid nodules with Bethesda Cat. 2 result. We aimed to determine the incidence of carcinoma with benign cytology and the reason for the high false-positive rate in thyroid nodules >/=4 cm. METHODS: The records of 103 patients with thyroid nodules >/=4 cm with preoperative cytological diagnosis of Bethesda Cat. 2 who underwent thyroidectomy were consecutively reviewed. Characteristics between patients with malignant vs. benign pathology were compared. RESULTS: Forty patients (38.8%) had malignancy. Malignancy was subclassified into follicular variant of papillary thyroid carcinoma (43%), minimally invasive follicular thyroid carcinoma (20.0%), and minimally invasive Hurthle cell thyroid carcinoma (10.9%). Patients with malignant cytology had significantly more suspicious ultrasound findings than those with benign cytology (p = 0.001). CONCLUSIONS: Preoperative FNAB showed high false-negative rates in patients with thyroid nodules >/=4 cm with benign cytology. These nodules have a high malignancy rate with suspicious ultrasound findings
Risk Factors for Indeterminate Response After Radioactive Iodine Therapy in Patients With Differentiated Thyroid Cancer
No full textPURPOSE: We investigated the risk factors of indeterminate response (IDR) in patients who underwent recombinant human thyroid-stimulating hormone (rhTSH)-aided radioactive iodine therapy (RAIT).
METHODS: A total of 128 patients with papillary thyroid cancer were included in this retrospective study. The patients were classified into excellent response and IDR groups based on follow-up diagnostic whole-body scintigraphy (WBS) and TSH-stimulated thyroglobulin (Tg). Indeterminate response was defined as the presence of a faint uptake in the thyroid bed on the diagnostic WBS or a TSH-stimulated Tg detectable, but less than 10 ng/mL. Parameters that act as significant risk factors for IDR, including age, sex, stage, surgeon, time interval between surgery and RAIT, post-treatment WBS finding, urine iodine-to-creatinine ratio, TSH-unstimulated Tg, and rhTSH-stimulated Tg, were analyzed using a Cox proportional hazards regression method.
RESULTS: After treatment, 64 patients showed IDR. Recombinant human TSH-stimulated Tg was the only independent risk factor for predicting IDR. Patients with an rhTSH-stimulated Tg greater than 2 ng/mL prior to RAIT were 3.75 times more likely (95% confidence interval, 1.61-8.72) to have an IDR than those with a lower rhTSH-stimulated Tg (</=2 ng/mL).
CONCLUSIONS: Pre-RAIT TSH-stimulated Tg levels are a risk factor for IDR after RAIT
Can the basal serum thyroglobulin level be used to predict the recombinant human TSH-stimulated thyroglobulin level in differentiated patients with thyroid cancer?
No full textThis study investigated the correlation between basal thyroglobulin (Tg) and recombinant human thyroid-stimulating hormone (rhTSH)-stimulated Tg in differentiated patients with thyroid cancer, and sought to determine whether the basal Tg level predicts the rhTSH-stimulated Tg level.We retrospectively enrolled 177 patients with papillary thyroid cancer (mean age = 44 years; 50 males, 127 females) who received rhTSH before radioiodine therapy (RIT). Serum Tg levels were measured 7 days before the 1st rhTSH injection (basal Tg) and on the days of RIT (rhTSH-stimulated Tg). Patients were divided into 3 groups according to rhTSH-stimulated Tg cut-off levels of 2, 5, and 10 ng/mL. The correlation between basal Tg and rhTSH-stimulated Tg levels was assessed, and whether basal Tg was useful in predicting the rhTSH-stimulated Tg level was determined.A significant positive correlation was observed between basal and rhTSH-stimulated Tg levels (rho= 0.48, P 0.3 or 0.5 ng/mL, then the rhTSH-stimulated Tg level can be expected to be sufficiently high to necessitate clinical examination
Çağdaş Kazak Edebiyatında Milli Romantizmin Bir Örneği Ey, Dünye Ey Romanı Üzerine Bir Değerlendirme
No full textEy, Dunya Ey named novel was written depending on the facts of some affairs in 1916. During this time Russian government forcefully began to enroll Kazakh men to the army. Opposition to the unjust policy and oppression Kazakh people began to protest and this led to brutal genocide and forceful migration. At the same time, this novel also covering Russian communist revolution in 1917 and returning back home of the migrant people and their social life until the end of Soviet Union in 1991. In this novel, the author has written a wide range of genres and very long period of time. A part of the novel is based on documents which recorded at the time of these events. Some parts of the novel were written depending on documents which was described events occurring in 1916 and migrations during these period. Sections of the novel which were describing the events of after migration and back home are entirely the author’s fiction. The inadequacy of the depictions of the people and places, as well as many incidents which took place at that time covered by the novel are among the reasons for this technical weakness. © 2021, Ahmet Yesevi University. All rights reserved
An Example of National Romanticism in Contemporary Kazakh Literature an Assessment of the Novel Ey, Dunye Ey
No full textEy, Dunya Ey named novel was written depending on the facts of some affairs in 1916. During this time Russian government forcefully began to enroll Kazakh men to the army. Opposition to the unjust policy and oppression Kazakh people began to protest and this led to brutal genocide and forceful migration. At the same time, this novel also covering Russian communist revolution in 1917 and returning back home of the migrant people and their social life until the end of Soviet Union in 1991. In this novel, the author has written a wide range of genres and very long period of time. A part of the novel is based on documents which recorded at the time of these events. Some parts of the novel were written depending on documents which was described events occurring in 1916 and migrations during these period. Sections of the novel which were describing the events of after migration and back home are entirely the author's fiction. The inadequacy of the depictions of the people and places, as well as many incidents which took place at that time covered by the novel are among the reasons for this technical weakness
Le Bouvard et Pécuchet d'Henri Ey (1955)
No full textinterprétation historique d'un pastiche de "Bouvard et Pécuchet" de Flaubert, écrit par un psychiatre francais en 1955. Pour accéder à la source: http://flaubert.univ-rouen.fr/article.php?id=25In 1955, psychiatrist Henri Ey (1900-1977) edited a Treaty of Psychiatry (Traité de Psychiatrie) as part of the Medical-Chirurgical Encyclopedia (Encyclopédie Médico-Chirurgicale, EMC, Editions Techniques), gathering more than a hundred collaborators. A large portion of these were from the French psychoanalytic community and psychiatrists affiliated with public psychiatric hospitals, however excluding the main characters of academic neuropsychiatry. At a banquet organized to celebrate the publication of the contributed volume, Henri Ey reads to his guests a parody of Bouvard and Pécuchet by Flaubert. I suggest to grasp this relatively little-known manuscript under the lens of irony. Written in a derisive manner by a psychiastrist mocking the practices and doctrines of his field (from mesmerism to Freudianism), this document may also be appraised as a roman à clef about the balance of powers and struggles for monopoly within a medical profession where dissent is being fueled by distinct professional titles, intellectual itineraries or scientific networks. I will first show that Henri Ey probably relied on the "deux bonshommes" to neutralize any form of criticism against his ambition to be an encyclopedist. Henri Ey's attitude may here be compared with that of Raymond Queneau (1903-1976), at the time director of the Encyclopédie de la Pléiade: he, too, was haunted by the characters of the mad professor and the amateur scientist, and he wrote two prefaces for reissues of Bouvard and Pécuchet. However, Henri Ey's Bouvard and Pécuchet is less evocative of Queneau's stylistic composition than the pugnacity of corporatist manuscripts defending psychiatry. In a second step, I will analyze the status of the burlesque pastiche of an already burlesque work: this text hides an authentic satire featured as a comedy. The author targets a number of real individuals, sometimes named in the text and represented in a grotesque manner. Here, parody appears to be serving persiflage.En 1955 le psychiatre Henri Ey (1900-1977) publie sous sa direction un Traité de Psychiatrie dans la collection de l'Encyclopédie Médico-Chirurgicale (EMC, Editions Techniques), rassemblant autour de lui plus d'une centaine de collaborateurs. Parmi eux, une grande partie des psychanalystes français, avec qui les psychiatres du cadre des hôpitaux psychiatriques publics se répartissent les matières à exposer, tandis que les principaux représentants de la neuropsychiatrie universitaire sont exclus. Lors d'un banquet offert pour fêter la parution de l'ouvrage collectif, Henri Ey fait la lecture à ses hôtes d'une parodie (ou pastiche, voire satire ?) de Bouvard et Pécuchet de Flaubert. Je propose d'appréhender ce document méconnu des historiens par le biais de l'ironie : écrit sur le ton de la dérision par un psychiatre évoquant les pratiques et les doctrines qui prêtent le flan à la moquerie dans sa discipline (du mesmérisme au freudisme), le texte peut aussi se lire comme un roman à clef des rapports de force et des défenses de monopole, dans une profession médicale où les dissensions sont nourries par des titres professionnels, par des itinéraires intellectuels et par des réseaux savants différents. Dans un premier temps, je montrerai qu'à travers l'emprunt des " deux bonshommes ", Henri Ey avait certainement pour but de désamorcer toute critique vis-à-vis de son ambition d'encyclopédiste. On peut comparer à cette occasion la posture d'Henri Ey à celle de l'écrivain Raymond Queneau (1903-1976), directeur de l'Encyclopédie de la Pléiade à la même époque : lui aussi fut hanté par les figures du savant fou et du scientifique amateur et il rédigea deux préfaces pour des rééditions de Bouvard et Pécuchet. Cependant, le Bouvard et Pécuchet d'Henri Ey évoque moins l'exercice de style de Queneau que la pugnacité des textes corporatistes de défense de la psychiatrie. Dans un second temps, il s'agira donc d'analyser le statut de l'imitation burlesque d'une œuvre déjà burlesque : ce texte cache une véritable satire sous le travestissement du comique. L'auteur vise une série de personnes bien réelles, parfois nommées dans le texte et présentées de manière grotesque. La parodie apparaît ici comme mise au service du persiflage
미세 갑상선암의 치료
No full textThyroid microcarcinoma(TMC) is defined by the World Health Organization as carcinoma 1.0cm or less in its greatest dimension. TMC is being found in an increasing proportion of treated thyroid carcinomas due to the more frequent use and the technical improvement of ultrasonography and fine needle aspiration biopsy. Clinicians should be aware of the differences between TMC and clinical thyroid cancer (more than 1cm in diameter) when making a surgical decision. The aims of this study are to characterize the clinical and biological behaviors of TMC, to demonstrate the prognosis according to the risk factors and treatment modality, and to suggest a proper surgical management of TMC
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