BACKGROUND: Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines. PURPOSE: To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice. METHODS: Online survey on the use of TH for growing SG among thyroid experts from 28 European countries. RESULTS: The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak. CONCLUSIONS: Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.

• Klíčová slova
• Goiter, Levothyroxine, Survey, TSH-suppressive therapy, Thyroid hormone,
• MeSH
• dospělí MeSH
• endokrinologie MeSH
• endokrinologové * statistika a číselné údaje   MeSH
• hormony štítné žlázy * terapeutické užití   MeSH
• lékařská praxe - způsoby provádění * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• struma * farmakoterapie   MeSH
• uzlová struma MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• hormony štítné žlázy * MeSH

AIMS: Patients with the Pendred syndrome suffer very often from a hearing loss. They may be good candidates for a cochlear implantation, but unfortunately, due to the fluctuating character of the hearing loss, they may escape such indication. In the study, we compared speech production and speech acquisition in 2 groups of implanted patients: those with the Pendred syndrome, and standard non-syndromic patients. METHODS: Ten patients with Pendred syndrome were analyzed for speech perception and production. The control group consisted of 41 non-syndromic implanted patients. All implantees were scored according to speech perception, speech production, and the sum of both. The data were statistically analyzed. RESULTS: No statistical difference was found in language acquisition and production in implantees with Pendred syndrome when compared to non-syndromic patients with cochlear implants. Nor there was any difference in speech production and acquisition between the 2 compared groups regarding surgical age, time elapsed after surgery, or age during the testing. CONCLUSION: In this study evaluating language and speech production and acquisition, patients with Pendred syndrome who underwent cochlear implants show comparable results to their implanted peers with deafness of a different etiology.

• MeSH
• dítě MeSH
• kochleární implantáty normy   MeSH
• lidé MeSH
• mladiství MeSH
• nedoslýchavost etiologie   chirurgie   MeSH
• percepce řeči fyziologie   MeSH
• percepční nedoslýchavost komplikace   psychologie   chirurgie   MeSH
• předškolní dítě MeSH
• uzlová struma komplikace   psychologie   chirurgie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: The rising incidence of thyroid cancer observed in the last few decades requires an improvement in diagnostic tools and management techniques for patients with thyroid nodules. AIMS: The aim of this study was to assess serum concentrations of IGF-1 and IGF-1R in patients diagnosed with thyroid cancers. METHODS: 36 patients diagnosed with papillary thyroid cancer (PTC), 11 subjects with follicular thyroid cancer (FTC), 9 patients with anaplastic thyroid cancer (ATC) and 19 subjects with multinodular nontoxic goiter (MNG) were enrolled to the study. The control group (CG) consisted of 20 healthy volunteers. Blood samples were collected one day before surgery. Serum IGF-1 and IGF-1R concentrations were measured using specific ELISA methods. RESULTS: Significantly higher concentrations of IGF-1 were found in patients with PTC as compared with controls but not that obtained from subjects diagnosed with MNG. The concentration of IGF-1R was significantly elevated in subjects with PTC and ATC as compared with healthy volunteers. Similarly, patients diagnosed with PTC or ATC presented significantly higher serum concentration of IGF-1R in comparison to the MNG group. CONCLUSIONS: Our results show that the IGF-1 - IGF-1R axis plays a significant role in the development of PTC and ATC and imply that serum concentrations of both cytokines may be considered as additional markers for the differentiation of malignancies during the preoperative diagnosis of patients with thyroid gland tumors. These results indicate that IGF-1R serum concentrations allow us to differentiate between MNG and PTC or ATC. Moreover IGF-1R serum values appear to be better predictor of PTC and ATC than IGF-1 concentrations.

• Klíčová slova
• IGF-1, IGF-1R, thyroid cancer,
• MeSH
• dospělí MeSH
• folikulární adenokarcinom krev   patologie   MeSH
• insulinu podobný růstový faktor I metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nádory štítné žlázy krev   patologie   MeSH
• papilární karcinom štítné žlázy krev   patologie   MeSH
• receptor IGF typ 1 krev   MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• uzlová struma krev   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• IGF1 protein, human MeSH Prohlížeč
• IGF1R protein, human MeSH Prohlížeč
• insulinu podobný růstový faktor I MeSH
• receptor IGF typ 1 MeSH

We report 3 cases of primary renal cell tumor simulating atrophic kidney with distinct gross, morphologic, immunohistochemical, and molecular genetic features. The tumors were retrieved out of more than 17 000 renal tumors from the Plzen Tumor Registry. Tissues for light microscopy had been fixed, embedded, and stained with hematoxylin and eosin using routine procedures. The tumors were further analyzed using immunohistochemistry, array comparative genomic hybridization, and human androgen receptor. Analyses of VHL gene and loss of heterozygosity (LOH) 3p were also performed. The patients were 2 women and 1 man, with ages ranging from 29 to 35 years (mean, 31.3 years). Grossly, the neoplasms were encapsulated and round with largest diameter of 3.5 cm (mean, 3.2 cm). Follow-up available for all patients ranged from 2 to 14 years (mean, 8 years). No aggressive behavior was noted. Histologically, akin to atrophic (postpyelonephritic) kidney parenchyma, the tumors were composed of follicles of varying sizes that were filled by eosinophilic secretion. Rare areas contained collapsed follicles. Each follicle was endowed with a small capillary. The stroma was loose, inconspicuous, and focally fibrotic. Two types of calcifications were noted: typical psammoma bodies and amorphous dark-blue stained calcified deposits. Immunohistochemically, tumors were strongly positive for cytokeratins (OSCAR), CD10, and vimentin, with weak immunopositivity for CAM5.2 and AE1-AE3. WT1 and cathepsin K were weakly to moderately focally to diffusely positive. Tumors were negative for cytokeratin 20, carbonic anhydrase IX, parvalbumin, HMB45, TTF1, TFE3, chromogranin A, thyroglobulin, PAX8, and ALK. Only 1 case was suitable for molecular genetic analyses. No mutations were found in the VHL gene; no methylation of VHL promoter was noted. No numerical aberrations were found by array comparative genomic hybridization analysis. LOH for chromosome 3p was not detected. Analysis of clonality (human androgen receptor) revealed the monoclonal nature of the tumor. We describe an unknown tumor of the kidney that (1) resembles renal atrophic kidney or nodular goiter of thyroidal gland; (2) contains a leiomyomatous capsule and 2 types of calcifications; (3) lacks mitoses, atypias, necroses, and hemorrhages and nearly lack Ki-67 positivity; and (4) so far showed benign biological behavior.

• Klíčová slova
• Atrophic renal parenchyma-like tumor, Comparative genomic hybridization, HUMARA, Kidney, Thyroid-like renal tumor,
• MeSH
• androgenní receptory genetika   metabolismus   MeSH
• atrofie patologie   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• kalcinóza * MeSH
• keratiny metabolismus   MeSH
• ledviny patologie   MeSH
• leiomyomatóza diagnóza   genetika   patologie   MeSH
• lidé MeSH
• metylace DNA MeSH
• mutace MeSH
• nádorové biomarkery metabolismus   MeSH
• nádorový supresorový protein VHL genetika   metabolismus   MeSH
• nádory ledvin diagnóza   genetika   patologie   MeSH
• srovnávací genomová hybridizace MeSH
• štítná žláza patologie   MeSH
• uzlová struma patologie   MeSH
• vimentin metabolismus   MeSH
• ztráta heterozygozity MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• androgenní receptory MeSH
• AR protein, human MeSH Prohlížeč
• keratiny MeSH
• nádorové biomarkery MeSH
• nádorový supresorový protein VHL MeSH
• VHL protein, human MeSH Prohlížeč
• vimentin MeSH

BACKGROUND: Fine-needle biopsy of the thyroid gland is the most common interventional procedure used to diagnose thyroid diseases. Serious complications are rare in this procedure. They comprise an infection with abscess formation and hemorrhage. To date, only a few case reports have described an ultrasound diagnosis of active bleeding into the thyroid gland. We established such a diagnosis using computed tomography (CT). PATIENT FINDINGS: A 74-year-old woman presented to the emergency department of our hospital with complications after fine-needle biopsy of the thyroid gland. Ultrasound revealed a large hematoma surrounding the gland. A subsequent CT scan confirmed the presence of hematoma and, moreover, showed active bleeding. This finding prompted rapid surgical intervention. CONCLUSION: CT has the capability to show active bleeding into the thyroid gland.

• MeSH
• biopsie tenkou jehlou pod endosonografickou kontrolou škodlivé účinky   MeSH
• bolest krku etiologie   MeSH
• hematom diagnostické zobrazování   etiologie   chirurgie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   etiologie   chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační krvácení diagnostické zobrazování   etiologie   chirurgie   MeSH
• senioři MeSH
• štítná žláza diagnostické zobrazování   zranění   patologie   chirurgie   MeSH
• urgentní služby nemocnice MeSH
• uzlová struma diagnóza   patologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

We present a case of emergency surgery of an 86-year-old patient with an extensive cevicomediastinal toxic nodular goiter. Acutely onset mechanical syndrome during hospitalization of the patient in another department for a different diagnosis (vertebrogenic algic syndrome of Th-L spine) warranted acute intubation and mechanical ventilation. After the transfer of the patient to our department, we performed total thyroidectomy. All published cases of acute compression syndrome with respiratory insufficiency involve anaplastic carcinoma transformation, fast growing lymphoma, injuries with an intraglandular haemorrhage or infected cysts. In this case the reason was the benign disease of the thyroid gland.

• MeSH
• lidé MeSH
• náhlé příhody MeSH
• obstrukce dýchacích cest etiologie   MeSH
• respirační insuficience etiologie   MeSH
• senioři nad 80 let MeSH
• stenóza průdušnice etiologie   MeSH
• tyreoidektomie * MeSH
• uzlová struma komplikace   patologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

We report a young woman with genetically confirmed Pendred syndrome and discuss the current therapeutic strategies of dyshormonogenetic goitre. A small diffuse thyroid enlargement developed during infancy and although substitution therapy with L-thyroxine was adequate, it progressed and underwent multinodular transformation. Cervical ultrasound at the age of 22 years demonstrated three solid nodules and fine-needle aspiration biopsy showed a finding typical of follicular adenoma. It is known that dyshormonogenetic goitres have a tendency to grow despite appropriate treatment with L-thyroxine. Management of a patient with Pendred syndrome requires careful follow-up and regular imaging of the thyroid. Although the therapeutic approach to dyshormonogenetic goitres is still controversial, in our patient we chose total thyroidectomy as the most advantageous method to prevent the development of malignancies that may arise more frequently from dyshormonogenetic goitres than from goitres of other aetiologies.

• MeSH
• dospělí MeSH
• lidé MeSH
• membránové transportní proteiny genetika   MeSH
• mutace genetika   MeSH
• percepční nedoslýchavost genetika   MeSH
• syndrom MeSH
• thyreotropin krev   MeSH
• thyroxin terapeutické užití   MeSH
• transportéry síranu MeSH
• tyreoidektomie MeSH
• uzlová struma farmakoterapie   genetika   chirurgie   MeSH
• vnitřní ucho abnormality   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• membránové transportní proteiny MeSH
• SLC26A4 protein, human MeSH Prohlížeč
• thyreotropin MeSH
• thyroxin MeSH
• transportéry síranu MeSH

453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done. Struma nodosa was concommitantly present in 48 % of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6 % of treated patients had postoperative decrease of blood calcium to normal level. 5.4 % of cases were reoperations for primary hyperparathyroidism. In 12 % of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3 % intrathyroid, in 7 % mediastinal and in 2 % of all 453 cases in other localization. In 4 % of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient. Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2 % of patients. Recurrent hypercalcemia was present in 0.2 % of cases. In three cases (0.7 %), unilateral injury of recurrent laryngeal nerve was observed.

• MeSH
• adenom chirurgie   MeSH
• diferenciální diagnóza MeSH
• dítě MeSH
• dospělí MeSH
• hyperkalcemie etiologie   MeSH
• hyperparatyreóza krev   diagnóza   chirurgie   MeSH
• hyperplazie MeSH
• krk diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladiství MeSH
• nádory příštítného tělíska chirurgie   MeSH
• parathormon krev   MeSH
• paratyreoidea abnormality   patologie   MeSH
• peroperační komplikace MeSH
• pooperační komplikace MeSH
• poranění nervus laryngeus recurrens MeSH
• radiografie MeSH
• recidiva MeSH
• reoperace MeSH
• rizikové faktory MeSH
• senioři MeSH
• ultrasonografie MeSH
• uzlová struma diagnóza   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• parathormon MeSH

In our group of 176 performed operations with diagnosis of primary hyperparathyreosis during the period of 1994-1999 present thyreopathy has been established peroperatively as well as postoperatively in altogether 47% of patients. Due to high percentage of coincidence of these diagnoses the condition of establishing indication for surgical therapy appears to be necessary not only on parathyroidal glands, but also determining the extent of resection on the thyroidal gland. In terms of preoperative screening, besides usual investigation of sonography and scintigraphy, we can recommend MRI test, which is highly positive for patients with thyreopathy, particularly in the area of nodular thyroid mass. The advantage of MRI investigation enables more precise localization of ectopic parathyroidal adenoma.

• MeSH
• adenom komplikace   diagnóza   chirurgie   MeSH
• hyperparatyreóza komplikace   diagnóza   etiologie   chirurgie   MeSH
• hyperplazie MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory příštítného tělíska komplikace   diagnóza   chirurgie   MeSH
• paratyreoidea diagnostické zobrazování   patologie   MeSH
• radioisotopová scintigrafie MeSH
• reoperace MeSH
• štítná žláza diagnostické zobrazování   patologie   MeSH
• ultrasonografie MeSH
• uzlová struma komplikace   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Woman 75-year-old treated 30 years for syndrome of acromegaly refused pituitary surgery and irradiation. Five years and nine months before death she had a colon carcinoma successfully removed. Multinodular hyperfunctional goitre was treated with carbimazole. For six last years of life corticosteroids were given as a replacement therapy. Her cause of death was the heart failure due to acromegalic heart disease. In autopsy a large intrasellar and extrasellar pituitary adenoma without rests of nonneoplastic tissue was found. Nevertheless the target peripheral endocrine glands except ovaries, were not atrophic. A multinodular goitre and diffuse adrenocortical hyperplasia were revealed. Histology, and immunohistochemistry demonstrated that mot neoplastic cells were producing GH and ACTH, dispersly Prl, scattered cells were positive for beta-subunit of FSH, LH, TSH. Electron microscopy proved most of the cells to be densely granulated. We classify the adenoma according to the newly proposed WHO pituitary tumours classification (1) as plurihormonal, hyperfunctional, extrasellar, typical adenoma from densely granulated cells. We conclude that in plurihormonal adenomas with dominant (in the case referred acromegalic) symptomatology the additional hormonal production should be monitored as a possible source of important complications.

• MeSH
• adenom komplikace   metabolismus   MeSH
• akromegalie komplikace   MeSH
• ektopické hormony metabolismus   MeSH
• lidé MeSH
• nádory hypofýzy komplikace   metabolismus   MeSH
• senioři MeSH
• uzlová struma komplikace   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• ektopické hormony MeSH