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Content available remote Isolated Desmoid Tumor of the Thyroid Gland - Case Report
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This paper presents a case of a 59-year old female patient with a desmoids tumor in a very rare location - in the thyroid gland. Due to marked local disease advancement and impossible radical surgical resection, the patient underwent chemotherapy. The treatment resulted in reduction of the tumor size while patient's condition was assessed as good, stable. Medical history and expanded diagnostic workup ruled out the possibility that this thyroid lesion was a part of familial adenomatous polyposis of the colon and Gardner's syndrome. It is highly probable that this desmoids tumor found in our patient was an isolated lesion, limited to the thyroid gland.
PL
Przedstawiono zarys symptomatologii oraz problematykę leczenia gruczołu tarczowego ze szczególnym uwzględnieniem nadczynności tarczycy. Wzorując się na znanych systemach ekspertowych uwypuklono konieczność standaryzacji procedur diagnostyczno-terapeutycznych. Zaproponowano skomputeryzowany system nadzoru skuteczności leczenia nadczynności tarczycy za pomocą izotopu J131, opierając się na analizie porównawczej rozkładu maksimów emisji w scyntygramach wyjściowych i kontrolnych. W odróżnieniu od stosowanego aktualnie uśrednionego pomiaru jodochwytność lub wzrokowej oceny scyntygrafii metoda umożliwia obserwację ewolucji nawet niewielkich ognisk patologii.
EN
The outline of symptomatology and problems connected with thyroid gland treatment, especially taking hyperthyroidism into consideration, are presented in the study. Modelling on known expert systems, the need for standardisation of diagnostic and therapeutic procedures is emphasised. A computerised system for supervision of efficacy in hyperthyroidism treatment with use of isotope J 131, based on comparative analysis of distribution of emission maximums in initial and test scintigrams was proposed. Contrary to the currently applied averaging measurement of thyroid iodine uptake or visual judgement of scintigraphy, the proposed method makes it possible to observe evolution of even not big focuses of pathology.
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Simultaneous analysis of histological and ultrasonic (US) images of human thyroid glands for thyroid cancer diagnostics is proposed in the paper. It allows to explain the characteristics of US pictures of the thyroid gland via the sizes of its follicles. To show the dependence of US image features on the state of follicles, statistical analysis of US-texture is performed. In addition, the size of follicles in histological images is calculated by analysis of a distance map for the nuclei of cells. It is shown that echogenicity of the thyroid gland in US images depends essentially on the size of its follicles. The organ regions that contain many follicles of a size smaller than the size of healthy follicles, or contain many destroyed follicles, have low echogenicity. The same effect is observed for regions with oversized follicles. This information can be used to avoid a surgical procedure, including histological analysis.
EN
Breast cancer is the most common malignant neoplasm among women. Metastases to the thyroid are relatively rare. Those lesions annunciate neoplasm dissemination in most cases. Metastatic breast cancer of thyroid lobe regrowth hasn’t been described yet. In the article the authors present a case of a 66-year old women with isolated, metachronous breast cancer metastasis in regrowth of the right thyroid lobe. Resection of the right lobe with metastatic tumor was performed with a purpose of total recovery. Despite surgery, multiple bone metastases were detected a few months after. In conclusion, regrowth of the thyroid is a potential site of recurrence and metastasis. Therefore, the thyroid bed cannot be omitted in routine examination during and after oncological treatment.
EN
Langerhans cell histiocytosis (LCH), a monoclonal disease of histiocytes, may involve several organ systems but rarely primarily involves the thyroid gland. This report presents an extremely rare case of LCH of the thyroid in a 3-year-old boy who presented with a neck mass for several weeks. LCH of the thyroid should be considered in the differential diagnosis of a child with a thyroid mass. Pulmonary examination should be done in these patients.
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Introduction. Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer. Aim. Herein described is a case of hypertensive patient, after removal of Merkel cancer of the left gluteus skin (2011), after pulmonary embolism (2013), with degenerative changes of the spine and uterine myoma, chronically treated with Warfarin, because of suspected thyroid cancer. Description of the case. A 70-year-old woman case after removing Merkel cancer of the left buttock skin (2011), after pulmonary embolism (2013), with degenerative changes of the spine and uterine fibroids treated chronically with Warfarin because of suspected thyroid cancer is described. Conclusion. Increasing evidence of Merkel cell carcinoma with immunodeficiency and neoplasia, and the management and outcome of these patients requires study
EN
Today, surgical dissection and tissue coagulation with both monopolar and bipolar coagulation as well as LigaSure high frequency current generator (HFCG) are the surgical modalities of choice in the treatment of thyroid pathology. However, the question of the high frequency current effect on the morphofunctional condition of the posthemithyroidectomic parenchyma is still disputable. The goal of the research is a thorough histological analysis of the surgically removed thyroid tissue specimen. The nodular goitre of 50 patients was subject to the histological study. The surgery was performed with the LigaSure HFCG. The 1.0x0.5 thyroid tissue specimens were excised from three areas. Hemithyroidectomy lasted for 40-50 min and thyroidectomy – 120 ± 4.2 min. In both procedures, the blood loss was within 70-150 ml, no haemorrhage being observed in both intra-and postoperative period. The zonal effect of high frequency current on the thyroid structure was determined morphologically, namely coagulation necrosis in the site of direct action, intensified secretory response of the thyroid tissue to the extremal factor in the perifocal area, and typical structure of the nodular goitre with the signs of impaired microcirculation in the remote area. Morphologic changes of the thyroid gland, with high frequency current used as a dissector, are distance-dependent.
EN
Ultrasonography is a cheap and quick non-invasive medical imaging technique, used as a diagnostic method for autoimmune thyroiditis. Another important diagnostic method for this chronic inflammation is measuring the increased level of thyroid antibodies (anti-thyroid peroxidase (TPOAb) and/or anti- thyroglobulin (TgAb)) in blood samples. This paper shows that B-mode ultrasound images contain weak information related to the presence or absence of these antibodies. Ultrasound image analysis is based on textural recognition using probabilistic spatial features. Two studies are performed. The results of the first study show that the spatial texture features we used contain weak information about the presence or absence of TPOAb and TgAb antibodies as measured by conditional entropy. In the second study, a classifier derived from Bayesian decision theory is tested on a set of 2820 sonograms of 94 subjects. The training set contains 67 subjects and the test set consists of 27 independent subjects. The results of classification to three classes (healthy, thyroiditis with positive antibody test, thyroiditis with negative antibody test) achieved sensitivity 29% and specificity 100% on the test set.
EN
The morphology and distribution of the cholinergic and adrenergic nerve fibres were described in the thyroid gland of the domestic hen. The adrenergic structures were visualised with glyoxylic acid and with immunohistochemical staining for tyrosine hydroxylase (TH), the marker for adrenergic nerve structures. Cholinergic structures were visualised using the Karnovsky and Roots method. It was found that the thyroid gland is supplied with numerous adrenergic and cholinergic nerve fibres, which occur as small or large bundles or single nerve fibres. These were located around blood vessels, under the fibrous capsule and in the vicinity of secretory vesicles.
EN
The size and shape of the thyroid gland is subject to much variation, as stated by Wood Jones. Literature is replete with a large number of variations of the gland. By utilizing various techniques like gross dissection, histology, developmental anatomy, and recently thyroid scans and scintigraphy, some common and certain rare anomalies of the thyroid with their possible developmental bases are described in the literature. An attempt has been made to study the thyroid glands in 90 male cadavers available in our department, with ages ranging from 60 to 75 years with mean height of 5’4”. The parameters that were observed included the length and width of lobes, presence or absence of pyramidal lobe, levator glandulae thyroideae, and isthmus with its relation to the tracheal rings. The average length of the right lobe was 4.32 cm, and the left lobe was 4.22 cm. The thickness of the right lobe was 1.13 cm, and the left lobe was 1.18 cm. Pyramidal lobe was present in 34 (37.77%) cases, frequently arising from the left lobe, while the levator glandulae thyroideae was present in 27 (30%) instances, mostly attached superiorly to the body of the hyoid bone. The isthmus was absent in 15 (16.66%) cases; its relation with the tracheal rings greatly varied from the cricoid cartilage to the fourth tracheal ring. Knowledge of variations of the thyroid assumes significance as this has relevance in the resection of thyroid, tumours, and tracheostomy. (Folia Morphol 2010; 69, 1: 47–50)
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