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1.
J Clin Res Pediatr Endocrinol ; 14(1): 119-125, 2022 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33448212

RESUMO

Papillary thyroid cancer (PTC) is extremely rare in children. Herein, we present a case diagnosed with PTC at 15 months of age. We conducted a literature review of the published cases with PTC under five years of age. A 1.25-year-old male patient had initially presented with a complaint of progressively enlarging cervical mass that appeared four months earlier. On physical examination, a mass located in the anterior cervical region with the largest measurements of around 3x3 cm was detected. Cervical and thyroid ultrasonography showed a 50x27 mm solid mass in the right lateral neck. Excisional biopsy revealed a follicular variant of PTC with capsular invasion. Subsequently, he underwent a complementary total thyroidectomy. He was diagnosed with intermediate-risk (T3N0M0) PTC. He developed permanent hypoparathyroidism. In the first year of the operation, he was treated with radioiodine ablation (RAI) since basal and stimulated thyroglobulin (Tg) levels tended to increase. Whole-body scintigraphy was normal in the first year of RAI ablation. On levothyroxine sodium (LT4) treatment, levels of thyroid stimulating hormone (TSH) and Tg were adequately suppressed. He is now 8.5-years-old and disease-free on LT4 replacement therapy for seven years and three months. Pediatric PTC has different biological behavior and an excellent prognosis compared to adults. The optimal treatment strategy for pediatric TC is total thyroidectomy, followed by RAI ablation. Post-operative management should include regular follow-up, TSH suppression by adequate LT4 therapy, serial Tg evaluation, and radioiodine scanning when indicated.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adulto , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Criança , Pré-Escolar , Seguimentos , Humanos , Lactente , Radioisótopos do Iodo , Masculino , Tireoglobulina , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
2.
J Surg Res ; 265: 147-152, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33940237

RESUMO

BACKGROUND: Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. MATERIALS AND METHODS: This study was performed in 16 adult male rats who underwent hemithyroidectomy in the right lobe and randomized into two experimental groups: Group I (control group) was given any substance and Group II (NCHA group) received NCHA spray into their perithyroidal area. The rats were sacrificed after three weeks of thyroidectomy for assessment. RESULTS: Gross adhesions score (x̄ = 2.500) was significantly higher in Group I than Group II (x̄=1.750; P = 0.031). Group II showed significantly less fibrosis compared to the Group I (P = 0.002). The rate of inflammation was found to be significantly higher in group I (P = 0.008). Vascular proliferation was not different between two groups (p=0.083). CONCLUSIONS: Our study showed that NCHA can reduce postoperative adhesion and might be effective in preventing fibrosis after the thyroidectomy. Although this study could not demonstrate that application of NCHA is able to reduce complication rate in revision neck surgery, it could be safely used after thyroidectomy and neck surgeries to prevent adhesions.


Assuntos
Ácido Hialurônico/administração & dosagem , Tireoidectomia/efeitos adversos , Aderências Teciduais/prevenção & controle , Viscossuplementos/administração & dosagem , Animais , Avaliação Pré-Clínica de Medicamentos , Masculino , Distribuição Aleatória , Ratos , Aderências Teciduais/etiologia
3.
J Surg Oncol ; 114(7): 796-802, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27778360

RESUMO

BACKGROUND AND OBJECTIVES: It is not clear whether sentinel lymph node biopsy (SLNB) can be applied to patients with a second breast cancer or recurrence occurring at previously treated breast. The purpose of this study was to assess the feasibility of SLNB procedure in patients with recurrent breast cancer. METHODS: Patients with non-metastatic recurrent N0 breast cancer at ipsilateral breast were included. Patients were grouped according to their initial breast, axilla, and overall surgery. Presence of drainage and its pattern as well as SLNB success rate and overall axillary involvement rates were assessed. Findings were compared. RESULTS: Out of 75 patients, mean age was 52.5 years and disease-free interval was 82 (9-312) months. Lymphatic drainage was successful in 42 (56%) patients. Drainage positivity was more frequent in patients who were previously treated with SLNB (82.6%) than in patients who underwent axillary lymph node dissection (ALND) (44.2%; P = 0,002). Aberrant lymphatic drainage was detected in 64.3% of drainage positive patients. Success rate of reoperative SLNB was 92.9%. Adjuvant treatment plan was altered in 12 (16%) patients. In 15 patients, negative SLNB prevented axillary dissection. CONCLUSIONS: Reoperative SLNB seems to be technically feasible in N0 recurrent breast cancer patients. It may further avoid unnecessary ALND and lead changes in adjuvant treatment plans. J. Surg. Oncol. 2016;114:796-802. © 2016 2016 Wiley Periodicals, Inc.


Assuntos
Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Recidiva Local de Neoplasia/patologia , Biópsia de Linfonodo Sentinela , Linfonodo Sentinela/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila , Neoplasias da Mama/fisiopatologia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/fisiopatologia , Carcinoma Ductal de Mama/terapia , Carcinoma Intraductal não Infiltrante/fisiopatologia , Carcinoma Intraductal não Infiltrante/terapia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/fisiopatologia , Recidiva Local de Neoplasia/terapia , Estudos Retrospectivos , Linfonodo Sentinela/fisiopatologia
4.
Eur J Pediatr Surg ; 26(1): 133-7, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26731317

RESUMO

PURPOSES: In this experimental study, we investigated the role of ozone therapy in hepatic fibrosis caused by biliary obstruction. MATERIALS AND METHODS: In this study, 21 male Sprague-Dawley rats were divided equally into three groups. In the control group, only laparotomy was performed and intraperitoneal cavity is washed with 1 mL of saline. In the sham group (SG), common bile duct is binded with laparotomy and no treatment is given afterward. In the experimental group (EG) after the binding of common bile duct with laparotomy, 1 mg/kg dose and 50 mg/mL concentration of ozone were applied rectally for 21 days. Hepatic tissue sample and intracardiac blood samples were collected from all animals at postoperative 21st day with relaparatomy. RESULTS: When we compared the experiment to SG, we detected a decrease in aspartate aminotransferase, alkaline phosphate (ALP), total bilirubin, and direct bilirubin levels in the EG, however, only the decrease in total bilirubin levels were statistically significant (p = 0.025). Histopathological examination of livers of rats in the EG showed lower level of hepatic fibrosis and inflammation. In the SG, incomplete cirrhosis was detected in 57.1% of the rats, whereas in the EG, no cirrhosis was detected. Immunohistochemically, periportal inflammation was 100% in the SG, whereas it was seen (3/7) 42.9% in the EG. A significant decrease in positive α-smooth muscle actin reaction was observed in ozone-treated group compared with SG. CONCLUSION: We suggest that ozone can decrease the hepatic destruction levels in experimental model of biliary obstruction.


Assuntos
Colestase/complicações , Cirrose Hepática/tratamento farmacológico , Oxidantes Fotoquímicos/uso terapêutico , Ozônio/uso terapêutico , Administração Retal , Animais , Esquema de Medicação , Cirrose Hepática/etiologia , Masculino , Ratos , Ratos Sprague-Dawley , Resultado do Tratamento
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