Weight change in patients with differentiated thyroid carcinoma after total thyroidectomy versus lobectomy.

Purpose: Thyroid hormone is an important hormone in maintaining metabolism and homeostasis in the body. There exists a common perception among patients that thyroid surgery will cause weight gain. Prevention of any undesired weight gain could be important for the maintenance of well-being in most patients. Our study compares changes in body mass index (BMI) and weight after total thyroidectomy or lobectomy in thyroid cancer patients. Methods: A total of 967 patients with differentiated thyroid carcinoma were enrolled in the study, from March 2011 to July 2016 at Chung-Ang University Hospital. Exclusion criteria were less than lobectomy, modified radical neck dissection, recurred operation, and combined operation for other causes. Primary endpoints were change in body weight and BMI at 2 years after surgery. A subgroup analysis was performed for patients with significant weight change. Results: There were no differences between both groups in BMI after 2 years of thyroid operation. Thyroid stimulating hormone (TSH) levels were not significantly different. Fifteen percent of patients showed significant change in body weight after 2 years of operation. The subgroup analysis of these patients showed no significant differences in gender, age, or extent of operation between those who had gained weight compared to those who had lost weight. There were also no differences in postoperative TSH levels, levothyroxine supplementation, or radioactive iodine treatment. Conclusion: There was a minimal postoperative increase in mean BMI over the years in patients undergoing thyroidectomy for differentiated thyroid cancer. However, weight change did not differ in those undergoing thyroid lobectomy or total thyroidectomy.

Appropriate timing for thyroidectomy scar treatment using a 1,550-nm fractional erbium-glass laser.

BACKGROUND: Surgical scarring is a common cosmetic problem that occurs in various surgical fields, including dermatology. Many trials have been conducted to determine how to prevent this distressing scar formation. A 1,550-nm fractional erbium-glass laser has been used to improve the appearance of surgical scars, but an appropriate treatment time has not been established. OBJECTIVES: To determine the appropriate time to apply 1,550-nm fractional erbium-glass laser treatment for thyroidectomy scars. MATERIALS AND METHODS: Korean patients with linear surgical suture lines after thyroidectomy (N = 65) were treated using a 1,550-nm fractional erbium-glass laser. Patients were divided into three groups according to postoperative treatment time. Laser treatment was started in 40, 15, and 10 patients 3 weeks, 3 months, and 6 months postoperatively, respectively. Each patient was treated three times at 1-month intervals using the same parameters (14 mJ, 100 spots/cm(2) , 2 passes). RESULTS: Mean Vancouver Scar Scale scores were significantly lower after laser treatment (p < .01), with the greatest difference in the group that began treatment 3 weeks postoperatively. Global assessment also indicated better cosmetic outcomes in the 3-week postoperative treatment group. CONCLUSION: Early postoperative 1,550-nm fractional erbium-glass laser treatment of thyroidectomy scars is more effective than later treatment.

Methanol extract of Elaeagnus glabra, a Korean medicinal plant, inhibits HT1080 tumor cell invasion.

Elaeagnus glabra (Thunb.), an evergreen shrub with alternate leaves, has been used as a medicinal plant in Korea. Since many plant-derived molecules have inhibitory effects on tumor cell invasion, primarily via suppression of the activity of matrix metalloproteinases (MMPs), we investigated the effect of the methanol extract of E. glabra on tumor cell invasion. The invasiveness of HT1080 human fibrosarcoma cells were reduced in a dose-dependent manner following 24 h treatment of up to 200 microg/ml of the E. glabra extract, at which concentration no cytotoxicity occurred. Furthermore, gelatinolytic activities, and the protein and mRNA levels of MMP-2 and MMP-9 were also suppressed with increasing concentrations of the extract. Given that MMP-2 and MMP-9 are instrumental in tumor cell invasion, it is very likely that the reduction in tumor cell invasion by E. glabra extract is a consequence, at least in part, of suppressed expression of both MMP-2 and MMP-9. Isolation of a molecule(s) responsible for the extract inhibition of tumor cell invasion would pave the way for the development of a new generation of metastasis inhibitors.

Coexistence of primary squamous cell carcinoma of thyroid with classic papillary thyroid carcinoma.

Primary squamous cell carcinoma of the thyroid gland is very rare and its histogenesis is poorly defined so far. Although there have been some cases of squamous cell carcinoma with variant types of papillary thyroid carcinoma (PTC), the present case is the first primary squamous cell carcinoma with classic PTC to be reported. A 43-year-old woman presented with a 20 year history of neck mass. Neck ultrasound indicated a 6x4x3 cm large mass. The patient underwent total thyroidectomy. Histopathology indicated a well-differentiated squamous cell carcinoma and squamous metaplasia in conjunction with classic PTC. On immunohistochemistry cytokeratin 7 was positive in papillary carcinoma and squamous metaplasia, thyroglobulin was positive only in papillary carcinoma, and p63 was positive in squamous metaplasia and squamous cell carcinoma. Postoperatively, the patient received 59.4 Gy adjuvant radiotherapy, hormonal therapy and radioactive iodine therapy. At 8 months after surgery the patient remained disease free.

Aspiration pneumonia due to polyethylene glycol-electrolyte solution (Golytely) treated by bronchoalveolar lavage.

Polyethylene glycol (PEG)-electrolyte solution (Golytely), is most commonly used for bowel preparation before colonoscopy, as well as for barium enema and colon surgery. In this case, a 70-year-old man developed ARDS following the administration of Golytely by mouth before a scheduled colonoscopy. Aspiration of PEG-electrolyte solution was suspected, and the patient was successfully treated by BAL. Therefore, early bronchoscopy and BAL should be considered as initial treatment for PEG aspiration, because removal of PEG is most important for managing the disease.