Localization and Amount of Thyroid Remnant in Totally Thyroidectomized

Objective:To determine the frequency, localization and amount of thyroid remnant in extracapsular thyroidectomized patients.Methods:We postoperatively evaluated the thyroid bed of 38 totally thyroidectomized patients using thyroid scintigraphy, a thyroid uptake study and bilateral neck ultrasonography (US) to determine the extent of residual thyroid tissues.Results:In scintigraphic assessment, thyroid remnant was not seen in the thyroid bed in 13 cases, minimal thyroid remnant was detected in 15 cases, and visible uptake was seen in 10 cases. Ultrasonographic findings revealed the presence of remnant in 12 cases. However, US did not detect all remnant tissues diagnosed by TS.Conclusion:This study demonstrates that minimal thyroid remnant is left in the majority of cases, even after extracapsular total thyroidectomy, especially in the upper and middle zones

Survival Impact of Primary Tumor Resection in De Novo Metastatic Breast Cancer Patients (GEICAM/El Alamo Registry)

The debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists. We explored this approach's outcomes in patients included in a retrospective registry, named El Álamo, of breast cancer patients diagnosed in Spain (1990-2001). In this analysis we only included de novo MBC patients, 1415 of whom met the study's criteria. Descriptive, Kaplan-Meier and Cox regression analyses were carried out. Median age was 63.1 years, 49.2% of patients had single-organ metastasis (skin/soft tissue [16.3%], bone [33.8%], or viscera [48.3%]). PT surgery (S) was performed in 44.5% of the cases. S-group patients were younger, had smaller tumors, higher prevalence of bone and oligometastatic disease, and lower prevalence of visceral involvement. With a median follow-up of 23.3 months, overall survival (OS) was 39.6 versus 22.4 months (HR = 0.59, p < 0.0001) in the S- and non-S groups, respectively. The S-group OS benefit remained statistically and clinically significant regardless of metastatic location, histological type, histological grade, hormone receptor status and tumor size. PT surgery (versus no surgery) was associated with an OS benefit suggesting that loco-regional PT control may be considered in selected MBC patients. Data from randomized controlled trials are of utmost importance to confirm these results

A Case with Non-Small Cell Cancer in the Left Lung Diagnosed Following Observation of Bilateral Diffuse Lung Uptake of Tc-99m-MDP on Bone Scintigraphy

Extraskeletal accumulation of Technetium-99m methylene diphosphonate (Tc-99m-MDP) can be seen in bone scintigraphy both in benign and malignant lesions. In malignant lesions, this phenomenon is usually associated with microscopic calcifications due to the abnormal calcium metabolism, and occurs most frequently in the lungs. In this case report, we present a patient with a non-small lung cancer diagnosed following observation of incidental bilateral lung MDP accumulation in bone scintigraphy. Therefore, the tracer distribution in the soft tissues needs to be carefully examined on bone scans and any unexpected visible soft tissue activity should be stated on the scintigraphy report

Reduction of Amphotericin B-Induced Renal Tubular Apoptosis by N-Acetylcysteine▿

The reduction of amphotericin B (AmB)-induced renal tubular apoptosis and nephrotoxicity by N-acetylcysteine (NAC) in a murine model was evaluated. Four groups of rats were treated with AmB for 5 days, and each group concomitantly received two doses of 30, 60, or 120 mg of NAC/kg of body weight/day or sterile water for 5 days. Groups that received concomitant NAC at any dose had significantly decreased levels of apoptosis compared to that in animals receiving AmB only (48.8% versus 27.4, 23.6, or 23.5%, respectively; P < 0.001)

Investigation of the effect of hyperbaric oxygen on experimental cyclosporine nephrotoxicity

Hyperbaric oxygen interacts with drugs which patients use concurrently with hyperbaric oxygen treatment, which may cause in potentiation or inhibition of both therapeutic and toxic effects. We examined the effect of hyperbaric oxygen therapy on experimental cyclosporine A nephrotoxicity. The study comprised four groups of rats: a control group, a cyclosporine A group (25 mg/kg/day intraperitoneally for four days), a hyperbaric oxygen group (60 min. every day for four days at 2.5 atmospheric pressure), and a cyclosporine A+hyperbaric oxygen group (CsA 25 mg/kg/day intraperitoneally for four days+hyperbaric oxygen for 60 min. every day for four days at 2.5 atmospheric pressure). Hyperbaric oxygen did not alter biochemical parameters. Cyclosporine A increased serum urea and serum creatinine levels and decreased creatinine clearance. In the cyclosporine A+hyperbaric oxygen group serum urea level increased more than in the cyclosporine A group. Cyclosporine A increased tubular epithelial cell apoptosis and necrosis score values. The numbers of apoptotic cells in proximal tubule epithelial cells in the cyclosporine A+hyperbaric oxygen group were significantly higher than those of the cyclosporine A group. We recommend that renal functions of the patients receiving cyclosporine A should be monitored during hyperbaric oxygen therapy