Cervical masses as manifestation of papillary thyroid carcinomas ≤10 mm in diameter, in patients with unknown thyroid disease

<p>Abstract</p> <p>Background</p> <p>Papillary thyroid microcarcinomas are tumors often found accidentally after thyroidectomy for other thyroid disorders.</p> <p>Methods</p> <p>Patients with enlarged lateral cervical masses, with unknown thyroid disease, found to have metastases from papillary thyroid carcinoma ≤10 mm in diameter, were compared to patients operated on for nodular or multinodular goiter, who were incidentally found to have papillary thyroid microcarcinomas.</p> <p>Results</p> <p>Group A included 24 patients with an enlarged lateral cervical mass whereas group B included 30 patients presenting with nodular or multinodular goiter. Patients in both groups underwent surgery. After thyroidectomy and lymph node dissection, pathology revealed multifocal papillary carcinomas of 1–10 mm, with invasion of the thyroid capsule and surrounding soft tissue in most of the cases in group A. Two patients presented with distant metastases at diagnosis which were surgically removed. During follow up, 3 patients (12.5%) presented with new cervical metastases which were surgically removed or treated with additional radioactive iodine. At last follow-up, all patients were alive. In contrast, all patients in group B had unifocal papillary thyroid carcinoma 1–10 mm in maximum diameter, with no infiltration or extension into the adjacent tissue, or cervical lymph node metastases.</p> <p>Conclusion</p> <p>Two groups of papillary thyroid microcarcinomas characterized by different clinical and biological behaviours are identified. Significant differences were found between these groups concerning the age, tumor size, number of tumor foci, lymph nodes metastases and extrathyroidal extension of the tumor. Papillary thyroid carcinomas of small (≤10 mm) size may have aggressive behaviour or be metastatic, and this subgroup should be treated and followed up as are other large, differentiated thyroid cancers.</p

Reconstructing dynamic regulatory maps

Even simple organisms have the ability to respond to internal and external stimuli. This response is carried out by a dynamic network of protein–DNA interactions that allows the specific regulation of genes needed for the response. We have developed a novel computational method that uses an input–output hidden Markov model to model these regulatory networks while taking into account their dynamic nature. Our method works by identifying bifurcation points, places in the time series where the expression of a subset of genes diverges from the rest of the genes. These points are annotated with the transcription factors regulating these transitions resulting in a unified temporal map. Applying our method to study yeast response to stress, we derive dynamic models that are able to recover many of the known aspects of these responses. Predictions made by our method have been experimentally validated leading to new roles for Ino4 and Gcn4 in controlling yeast response to stress. The temporal cascade of factors reveals common pathways and highlights differences between master and secondary factors in the utilization of network motifs and in condition-specific regulation

Computational fluid dynamics of a novel perfusion strategy using direct perfusion of a left carotid-subclavian bypass during hybrid thoracic aortic repair

To mitigate the risk of perioperative neurological complications during frozen elephant trunk procedures, we aimed to computationally evaluate the effects of direct cerebral perfusion strategy through a left carotid-subclavian bypass on hemodynamics in a patient-specific thoracic aorta model