Effect of dibutyryl cyclic adenosine 3′5′-monophosphate on mitotic activity in the thyroid of hypophysectomized rats

Summary Effect of dibutyryl cyclic adenosine 35-monophosphate (dbcAMP) on mitotic activity in the thyroid of hypophysectomized rats has been examined. It has been demonstrated that dbcAMP stimulates the incidence of mitoses in the thyroid follicular cells. It is therefore suggested that cAMP may be a mediator of the proliferogenic effect of TSH on the thyroid in vivo. Cyclic AMP could also release some unidentified growth-promoting factors for the thyroid. A direct stimulating effect of dbcAMP on the proliferation of the thyroid follicular cells is assumed to be possible as well.     

Pandemic Dynamics and the Breakdown of Herd Immunity

In this note we discuss the issues involved in attempting to model pandemic dynamics. More specifically, we show how it may be possible to make projections for the ongoing H1N1 pandemic as extrapolated from knowledge of seasonal influenza. We derive first-approximation parameter estimates for the SIR model to describe seasonal influenza, and then explore the implications of the existing classical epidemiological theory for the case of a pandemic virus. In particular, we note the dramatic nonlinear increase in attack rate as a function of the percentage of susceptibles initially present in the population. This has severe consequences for the pandemic, given the general lack of immunity in the global population.     

An evaluation of the value of first thyroglobulin determination in the diagnostics of metastases immediately following differentiated thyroid carcinoma surgery

INTRODUCTION: Evaluation of the differential value of the first thyroglobulin (Tg) concentration, measured after thyroidectomy (Tx) but before thyroid remnant ablation, in patients with differentiated thyroid carcinoma (DTC) as a marker of either metastases or residual cancer (M). MATERIAL AND METHODS: Data from 517 patients with DTC after Tx, with follow-up > 1.5 year were analysed retrospectively. Patients in whom either the course of the disease was unclear or interference in the Tg test was possible (a-TgAb [+], Tg recovery < 80%) were excluded from the study. Finally, the data from 247 patients were evaluated (age: 14-79 years; 223 women, 24 men). The results of TSH, thyroid radioiodine uptake (T(up24)), thyroid remnant volume (V) and Tg in patients with diagnosed M (group M1; n = 35) were compared with the same parameters in patients with remission > 1.5 year (group M0; n = 212). The area under the ROC curve was calculated. The clinical decision limit of Tg level to be suggestive of metastases was determined by means of efficiency curve. RESULTS: Groups M0 and M1 did not differ from each other with respect to TSH concentration (median 49.7 mIU/l vs 44.3; p = 0.16) or thyroid remnant volume (1.4 vs 1.1 ml; p = 0.79). However, they did differ with respect to T(up24) (7.6 vs 3.2%; p = 0.01) and Tg (4.5 vs 96.7 ng/ml; p = 0.000000). Area under ROC for Tg was 0.78 +/- 0.05 (mean +/- s.e.m.). The decision limit of Tg for suspected M was determined at 38.1 ng/ml, Tg sensitivity was 0.57 (95%CI 0.39-0.74) and specificity 0.96 (95%CI 0.92-0.98). CONCLUSIONS: First thyroglobulin concentration, determined after thyroidectomy but before other treatment, is higher in patients with metastatic DTC than in patients without such metastases. This indicates that Tg level may be used as an early marker of either residual or metastatic DTC (even if thyroid remnants are present).     

Chronic thyroiditis--current issue in the cytological diagnostics of the thyroid gland

INTRODUCTION: Lowered and non-homogenous echogenicity in patients with chronic thyroiditis (CT) may cause problems in revealing focal lesions in ultrasound scans. Moreover, frequent anisocytosis of thyroid follicular cells and of oncocytes may falsely suggest neoplastic growth. The aim of the study was to evaluate the frequency of CT diagnosed in patients subjected to fine-needle aspiration biopsy (FNAB) of the thyroid in years 1994-2005, as well as to assess the cancer frequency in the operated patients with CT. MATERIAL AND METHODS: As much as 23 173 cytological reports and corresponding outcomes were analyzed and in patients treated surgically verified against postoperative histopathological examinations. Moreover, the analysis of cytological smears in CT with distinguishing its types (lymphocytic, epithelial-hyperplastic, colloidal, oxyphillic) was performed in 50 patients; the changes between subsequent FNABs in the picture of the smears were also assessed. RESULTS: The frequency of diagnosed CT had been increasing in the evaluated time span from 2.6% to 9.7% (p < 0.0001). There were 11 cases of papillary carcinoma found coexisting with CT. The analysis of cytological types of CT showed that the lymphocytic type prevailed over the others (lymphocytic - 43%, colloidal--21%, epithelial-hyperplastic--20%, oxyphilic--16%, p < 0.001). The evolution in time of the cytological picture was observed. CONCLUSION: The increase in the frequency of CT observed in smears obtained from the thyroid gland and the reports on the coexistence of CT with papillary carcinoma suggest the necessity of prudent diagnostics and follow-up of patients with CT.     

Application of 13-cis-retinoic acid in patients with 131I scintigraphically-negative metastases of differentiated thyroid carcinoma

INTRODUCTION: The loss of iodine uptake by differentiated thyroid carcinoma (DTC) cells is a major therapeutic problem especially in patients with nonsurgical metastatic foci or local recurrence. Using 13-cis-retinoic acid, it was attempted to retain iodine uptake as a result of redifferentiation (influence by retinoic acid receptors present in DTC cells). MATERIAL AND METHODS: Between 1999 and 2005, 13-cis-retinoic acid was used in 11 patients with disseminated PTC and high serum level of thyroglobulin (Tg) before (131)I treatment (2 patients were treated twice - 13 treatment cycles in total). Side effects in skin and mucous membranes were observed in all the patients, however, their intensity did not require termination of the therapy. RESULTS: Increase of iodine uptake was observed in 5 patients (45%). Decreased Tg concentration was observed in 9 patients. In that group, increased (131)I uptake was observed in 4 patients with distant metastases. All determinations of Tg concentrations were carried out under TSH stimulation. CONCLUSIONS: 13-cis-retinoic acid causes an increase of radioiodine uptake in around half of treated patients, however, the follow-up of these patients indicates that this increase does not result in either full remission or even stabilisation of neoplastic disease. The possibility should be considered to use cis-retinoic acid as an independent therapeutic approach in patients with radioiodine non-avid foci of thyroid carcinoma especially those showing high expression of RARb and RXRg receptors.