Retrospective evaluation of the incidental finding of 403 papillary thyroid microcarcinomas in 2466 patients undergoing thyroid surgery for presumed benign thyroid disease

This research was aimed to describe the effectiveness of discovery learning model to increase student’s fluency thinking skills on chemical equilibrium subject matter.  The method of the research was quasi-experimental with  Non Equivalent Control Group Design.  The population of this research was all students in XI science class of MA Negeri 1 Metro whose sit in odd semester of academic year 2013-2014.  The sample were taken by purposive sampling technique then obtained XI IPA2 dan XI IPA3 class as sample of the research.  The effectiveness of discovery learning model was showed by the significant difference of n-Gain between control and experiment class.The result of research showed that the average n-Gain score for experiment class was  0,32 and the average n-Gain score for control class was 0,21.  Proving the hypothesis showed that discovery learning model is effective to increase student’s fluency thinking skills on chemical equilibrium subject matter. Tujuan penelitian ini adalah untuk mendiskripsikan efektivitas model discovery learning dalam meningkatkan keterampilan berpikir lancar siswa pada materi kesetimbangan kimia.  Metode dalam penelitian ini adalah kuasi eksperimen.  Populasi dalam peneliian ini adalah semua siswa kelas XI IPA MA Negeri 1 Metro semester ganjil Tahun Pelajaran 2013-2014.  Sampel diambil dengan tehnik purposive sampling sehingga diperoleh kelas XI IPA2 dan XI IPA3 sebagai sampel penelitian.  Efektivitas model discovery learning ditunjukan berdasarkan perbedaan nilai n-Gain yang signifikan antara kelas eksperimen dan kelas kontrol. Hasil penelitian menunjukan rata-rata nilai n-Gain untuk kelas eksperimen adalah 0,32 dan rata-rata nilai n-Gain  untuk kelas kontrol adalah 0,21.  Pengujian hipotesis menunjukan bahwa model discovery learning efektif dalam meningkatkan keterampilan berpikir lancar siswa pada materi kesetimbangan kimia. Kata kunci : kesetimbangan kimia, keterampilan berpikir lancar, model discovery learnin

Age as a Prognostic Factor in Anaplastic Thyroid Cancer

Background. Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P=0.000, OR = 0.43, 95% CI = 0.29–0.63), only patients age (P=0.023, OR = 0.68, 95% CI = 0.49–0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years

Survival and prognostic factors for survival, cancer specific survival and disease free interval in 239 patients with Hurthle cell carcinoma: a single center experience

Abstract Background Hurthle cell carcinoma makes up 3 to 5% of all thyroid cancers and is considered to be a true rarity. The aim of our study was to analyze clinical characteristics and survival rates of patients with Hurthle cell carcinoma. Methods Clinical data regarding basic demographic characteristics, tumor grade, type of surgical treatment and vital status were collected. Methods of descriptive statistics and Kaplan-Meier survival curves were used for statistical analysis. Cox proportional hazards regression was used to identify independent predictors. Results During the period from 1995 to 2014, 239 patients with Hurthle cell carcinoma were treated at our Institution. The average age of the patients was 54.3, with female to male ratio of 3.6:1 and average tumor size was 41.8 mm. The overall recurrence rate was 12.1%, with average time for relapse of 90.74 months and average time without any signs of the disease of 222.4 months. Overall 5-year, 10-year and 20-year survival rates were 89.4%, 77.2%, 61.9% respectively. The 5-year, 10-year and 20-year cancer specific survival rates were 94.6%, 92.5%, 87.4%, respectively. When disease free interval was observed, 5-year, 10-year and 20-year rates were 91.1%, 86.2%, 68.5%, respectively. The affection of both thyroid lobes and the need for reoperation due to local relapse were unfavorable independent prognostic factors, while total thyroidectomy as primary procedure was favorable predictive factor for cancer specific survival. Conclusion Hurthle cell carcinoma is a rare tumor with an encouraging prognosis and after adequate surgical treatment recurrences are rare

Pitfalls in diagnosing a small cystic insulinoma: a case report

<p>Abstract</p> <p>Insulinoma is a rare pancreatic endocrine tumour and is typically sporadic and solitary. Over 90% of all insulinomas are benign. Cystic insulinomas are also rare. It is not difficult to determine the site of such neoplasm, as cystic insulinomas are usually 4–10 cm in diameter. We present the case of a patient with a histologically confirmed cystic insulinoma diagnosed after approximately 10 years of hypoglycaemia symptoms. This case is unique because of the small size (2.2 cm) of the tumour. Endoscopic ultrasound (EUS) was useful for localizing this tumour.</p