Displaying publications 21 - 40 of 70 in total

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  1. Asha'ari ZA, Razali MS, Ahmad RA
    Malays J Med Sci, 2010 Apr;17(2):56-60.
    PMID: 22135539
    Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
    Matched MeSH terms: Thyroid Gland
  2. Hisham AN, Aina EN
    Aust N Z J Surg, 2000 Apr;70(4):251-3.
    PMID: 10779054
    BACKGROUND: The Zuckerkandl's tubercle (ZT) of the thyroid gland is a well-described anatomical landmark, but few studies have clearly defined its association with pressure symptoms.

    METHODS: Sixty-six consecutive patients who had primary thyroid surgery were prospectively included in the present study between late January and early August 1998.

    RESULTS: A total of 96 capsular dissections were performed at thyroid surgery. Grades two and three ZT were recognized in 77 (80.2%) dissections. In general 49 (63.6%) of them were associated with significant pressure symptoms. In 43 (87.8%) of the dissections with pressure symptoms, grade 3 ZT was observed (mean weight of goitre: 154.8 g). Interestingly in this group, 16 (37.2%) patients with pressure symptoms had a goitre that was < 100 g and in one patient it was only 21 g.

    CONCLUSIONS: The pressure symptom of the thyroid gland does not always appear to be due to the large size of the goitre. In a relatively small-size goitre the ZT may cause significant pressure symptoms. Observations in the present study supported a strong association of enlarged ZT with pressure symptoms. We believe this is unlikely to be simply a coincidence but rather a consequence of the enlarged tubercle. Nonetheless a prospective randomized study is called for to allow meaningful and objective evidence to be drawn.

    Matched MeSH terms: Parathyroid Glands/anatomy & histology; Thyroid Gland/anatomy & histology*; Thyroid Gland/pathology
  3. Tan TT, Morat P, Ng ML, Khalid BA
    Clin Endocrinol (Oxf), 1989 Jun;30(6):645-9.
    PMID: 2591064
    Thirty-eight normal volunteers and 10 patients with untreated thyrotoxicosis were each given 0.5 ml of Lugol's solution daily for 10 days. On days 0, 5, 10, 15 and 20, serum levels of T4, free T4, T3 and TSH (by sensitive immunoradiometric assay) were measured. In normal subjects, the serum concentrations of free T4 declined significantly at day 10 while TSH levels were significantly increased at days 5, 10 and 15. Serum levels of T4 and T3 did not change significantly. All the observed changes took place within the limits of normal ranges for the hormones mentioned. In contrast, in the thyrotoxic subjects, both T4 and T3 were significantly decreased at days 5 and 10, while serum TSH remained below detection limit (0.14 mU/l) throughout the study. Short exposure to excessive iodide in normal subjects affects T4 and T3 release and this effect could be partially overcome by compensatory increase in TSH. In thyrotoxicosis, lack of compensatory increase in TSH results in rapid decreases in T4 and T3 levels. The integrity of the hypothalamo-pituitary-thyroidal axis may be effectively assessed by measuring TSH response to iodide suppression, using a highly sensitive immunoradiometric assay.
    Matched MeSH terms: Thyroid Gland/drug effects*; Thyroid Gland/physiopathology
  4. Wa Kammal WS, Yahaya A, Shah SA, Abdullah Suhaimi SN, Mahasin M, Mustangin M, et al.
    Malays J Pathol, 2019 Dec;41(3):293-301.
    PMID: 31901914
    INTRODUCTION: Thyroid carcinoma is classically diagnosed based on certain histological criteria. In some cases, definitive diagnoses may be challenging when morphological features are equivocal. This study evaluated the usefulness of Cytokeratin 19 (CK 19) as an immunohistochemical marker to differentiate the different histological types of malignant thyroid neoplasms, particularly papillary thyroid carcinoma (PTC) from benign thyroid lesions.

    MATERIALS AND METHODS: We collected 54 malignant and 65 benign thyroid lesions diagnosed by histology in Universiti Kebangsaan Malaysia Medical Centre between January 2010 and December 2015. All cases were immunohistochemically stained with CK 19 and evaluated by 3 independent observers. The immunostaining patterns were scored based on the intensity and proportion of staining and finally graded as negative, weak positive, moderate positive or strong positive. In addition, the immunostaining scores of the malignant cases were correlated with their TNM pathological tumour stages.

    RESULTS: Cytokeratin 19 staining expression was higher in malignant than benign thyroid lesions (p < 0.001) which was most prominent among classical PTC. The four PTC cases that showed negative or weak staining were all follicular variant of PTC. Benign conditions were mostly negative or showed weak positivity. There was no correlation between CK 19 expression and TNM primary tumour stage (pT).

    CONCLUSION: Cytokeratin 19 is a useful marker in differentiating malignant from benign thyroid conditions particularly the classical PTC, provided its interpretation is by correlation with morphology and takes into consideration the intensity and proportion of positive staining.

    Matched MeSH terms: Thyroid Gland/metabolism; Thyroid Gland/pathology*
  5. Krishnappa P, Ramakrishnappa S, Kulkarni MH
    J Environ Pathol Toxicol Oncol, 2013;32(2):149-55.
    PMID: 24099428
    Fine-needle aspiration (FNA) cytology of the thyroid is usually performed on an outpatient basis. The results of FNA are operator dependent and may be affected by the lesion characteristics and the aspiration technique. In current practice ultrasound (US) is widely used to guide the needle for aspiration of nondominant nodules. Our study aimed to compare the free-hand FNA with US-guided FNA in the evaluation of thyroid nodules. A total of 91 cases of thyroid lesions were studied at the Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, India. All the cases underwent free-hand and US-guided FNA. The cytological samples from both procedures were analyzed for adequacy, cytological features, and possible diagnosis. The results were correlated with histopathological diagnosis whenever possible. Of 91 aspirates, 89 were satisfactory and 2 were unsatisfactory on US-guided FNA, whereas 85 were satisfactory and 6 were unsatisfactory in free-hand FNA. Of 91 cases 68 (74.7%) were nonneoplastic lesions and 21 (23.1%) were neoplastic lesions in US-guided FNA, whereas 67 cases (73.6%) were nonneoplastic and 18 cases (19.8%) were neoplastic in free-hand FNA. Histopathological study was possible in 25 patients, among whom 15 lesions were nonneoplastic and 10 were neoplastic. Sensitivity and specificity of US-guided FNA to detect neoplastic lesions were 81.81% and 92.85%, respectively, compared with free-hand FNA, for which the sensitivity and specificity were 54.54% and 92.85%, respectively. The diagnostic accuracy of guided FNA was 88% against the 76% accuracy rate of free-hand FNA. US-guided FNA provides a better representative sample and has a higher diagnostic rate in the evaluation of thyroid lesions.
    Matched MeSH terms: Thyroid Gland/pathology*; Thyroid Gland/ultrasonography*
  6. Jaafar R, Tang IP, Jong DE, Narihan MZ
    Ear Nose Throat J, 2015 Jul;94(7):E8-10.
    PMID: 26214680
    Lipoblastoma is extremely rare and mainly occurs in children younger than 3 years old. It is predominantly found in the extremities and trunk. Head and neck region occurrences are rare; only 4 such cases involving patients who presented with stridor have been previously reported. We report the fifth case of lipoblastoma of the neck with stridor in a 9-year-old girl, which had gradually worsened over the previous year. Imaging showed a retrotracheal mass extending superiorly to the thyroid level and inferiorly to below the carina of the trachea. Total resection of the tumor was performed, and the histopathologic findings were consistent with lipoblastoma. Postoperatively, the patient was well with no complications.
    Matched MeSH terms: Thyroid Gland
  7. Malek KA, Kamal WW
    Malays Fam Physician, 2018;13(1):49-51.
    PMID: 29796212 MyJurnal
    An 8-year-old boy presents with asymptomatic hypopigmented patches on his bilateral cheeks which
    have been worsening for two weeks. The patches are oval in shape and have spared other parts of the
    body. There is no preceding erythematous rash. Similar lesions appeared two years ago which took
    several months to resolve. There are no recent triggers, such as personal care products. He has no history
    of atopy, but his mother has a recent history of atopic eczema. There is no known history of thyroid
    problems in the family. He was prescribed a topical cream from a general practitioner, but the patches
    persisted, and new patches appeared. He is otherwise well and actively participating in outdoor physical
    activities with frequent sun exposure. (Copied from article).
    Matched MeSH terms: Thyroid Gland
  8. Hassan S
    MyJurnal
    Background: Reflection on the process of learning is an essential ingredient in transforming novice into expert learners. Learning to compile portfolio encourages reflective skills, which help students to work systemically in translating metacognition into self-regulatory control in order to adjust their action and monitor their learning objectives. Introducing to compile portfolio in the early years of postgraduate training is an effective tool to stimulate students’ reflective abilities. Reflective learners are better motivated than the conventional learners to take the responsibilities as researcher in future. Reflective skills achieve both learning in right direction and learning for whole life. However, use of formal methods of reflective portfolio to monitor the learning objectives is an uncommon practice in postgraduate training, primarily due to intensive time and labor required. Challenged with those constraints in Master’s of Surgery Program of Otolaryngology and Head-Neck Surgery in School of Medical Sciences at Universiti Sains Malaysia, a structured self-reflective portfolio was introduced to determine its feasibility and acceptance among supervisors and trainees. Portfolio was practiced as one of the tool for formative assessment and for making recommendations to certify independent thyroid surgery allowed to practice in future. Methodology: A self-reflective structured portfolio was introduced to monitor the learning objectives in trainees of 2007 cohort, using a model as "mentor-system for authentic and structured learning with self-reflective assessment" (MASSRA). Initially a semi-structured portfolio comprising of 12 items and guidelines to compile a portfolio was followed by a structured format in training of thyroid module in sub-specialty of Head and Neck Surgery. Mentoring was organized by putting one-mentor verses 9 students to provide general pastoral guidance to compile portfolio as two entries a year. Mentors held the counseling session with student twice a year after evaluating the portfolios to monitor their progress. Besides, candidates were also observed for their performance in thyroid surgery during a 4-years training program. Those identified with problems for their level of training were referred to "Joint Committee for Surgical Training" comprising of 3 supervisors from Head and Neck Surgery Sub-specialty and a chairman supposedly the head of the department. 7 randomly selected students were also interviewed for direct feedback to evaluate this model. Result: 28 trainees at different level of their training compiled a self-reflection structured portfolio minimum twice a year with instructional feedback from the mentor, which was used as a tract for their personal development plan (produced by each trainee) for training in thyroid surgery. Initial analysis of portfolio revealed interesting feedback from the trainees reflecting on their knowledge, surgical skills and attitude towards thyroid surgery seen in tables 2-4. Conclusion: Self-reflections about each structured items in portfolio-helped trainees to identify their problems, seek mentors guidance and work systemically to help adjust their actions by revising learning objectives. Though time and labor intensive, portfolio was rated as feasible and practical.
    Matched MeSH terms: Thyroid Gland
  9. Abdul Hamid MF, Yu-Lin AB, Maharani Hassan T
    Eurasian J Med, 2018 Jun;50(2):122-124.
    PMID: 30002580 DOI: 10.5152/eurasianjmed.2018.0006
    Suture granuloma rarely occurs after thyroid surgery using non-absorbable sutures. We report the case of a 63-year-old female with a chronic discharging sinus in the anterior neck region. She had a history of subtotal thyroidectomy at the age of 45. The sinus had been excised and was reported as granulomatous lesions suggestive of tuberculosis. She was treated with anti-tuberculous medications, but unfortunately, she developed side effects. Histopathological slides were re-evaluated, which showed evidence of foreign material under polarized light; hence, the diagnosis was revised to suture granuloma. In conclusion, although sinus tract discharges are commonly attributed to tuberculosis, physicians should consider suture granuloma if they encounter a patient who has undergone a surgical procedure in the past.
    Matched MeSH terms: Thyroid Gland
  10. Zhang Y, Chang Y, Ryu S, Cho J, Lee WY, Rhee EJ, et al.
    J Clin Endocrinol Metab, 2014 Jul;99(7):2467-76.
    PMID: 24708095 DOI: 10.1210/jc.2013-3832
    CONTEXT: Hyperthyroidism and hypothyroidism, both overt and subclinical, are associated with all-cause and cardiovascular mortality. The association between thyroid hormones and mortality in euthyroid individuals, however, is unclear.
    OBJECTIVE: To examine the prospective association between thyroid hormones levels within normal ranges and mortality endpoints.
    SETTING AND DESIGN: A prospective cohort study of 212 456 middle-aged South Korean men and women who had normal thyroid hormone levels and no history of thyroid disease at baseline from January 1, 2002 to December 31, 2009. Free T4 (FT4), free T3 (FT3), and TSH levels were measured by RIA. Vital status and cause of death ascertainment were based on linkage to the National Death Index death certificate records.
    RESULTS: After a median follow-up of 4.3 years, 730 participants died (335 deaths from cancer and 112 cardiovascular-related deaths). FT4 was inversely associated with all-cause mortality (HR = 0.77, 95% confidence interval 0.63-0.95, comparing the highest vs lowest quartile of FT4; P for linear trend = .01), and FT3 was inversely associated cancer mortality (HR = 0.62, 95% confidence interval 0.45-0.85; P for linear trend = .001). TSH was not associated with mortality endpoints.
    CONCLUSIONS: In a large cohort of euthyroid men and women, FT4 and FT3 levels within the normal range were inversely associated with the risk of all-cause mortality and cancer mortality, particularly liver cancer mortality.
    Matched MeSH terms: Thyroid Gland/secretion*
  11. Irfan M, Shahid H, Baharudin A, Friedrich G
    Med J Malaysia, 2009 Mar;64(1):89-90.
    PMID: 19852333 MyJurnal
    Vocal cord palsy secondary to recurrent laryngeal nerve injury may be attributable to trauma, infiltrating neoplasm, congenital cardiac anomaly and others. Regardless the causes, majority of unilateral adductor palsy cases are usually managed by speech rehabilitation in order to allow compensation. In selected cases, medialization procedure may be required to achieve a complete glottal closure during phonation. Multiple techniques have been developed to achieve this goal. This case report illustrates the recent advancement in vocal fold medialization procedure, which has not been widely practiced in Malaysia.
    Matched MeSH terms: Thyroid Gland/surgery*
  12. Thevarajah M, Chew YY, Lim SC, Sabir N, Sickan J
    Malays J Pathol, 2009 Jun;31(1):23-7.
    PMID: 19694310 MyJurnal
    To establish trimester specific reference intervals for thyroid hormones during pregnancy in Malaysian women.
    Matched MeSH terms: Thyroid Gland/physiology*
  13. Rajandram RK, Sha PP, Hussaini HM, Jabar NA
    PMID: 23183027 DOI: 10.1016/j.oooo.2012.08.456
    Matched MeSH terms: Thyroid Gland*
  14. Harjit KD, Hisham AN
    Asian J Surg, 2005 Jan;28(1):48-51.
    PMID: 15691799
    Large goitres are common in the developing world, particularly in Asia and Africa. Nonetheless, large fungating goitres are extremely rare and represent a unique challenge to surgeons. Surgery should always be considered, when the general condition of the patient permits, to provide a better quality of life as it offers the only hope of long-term survival. The potential gain with surgery is that it allows maximum benefit for more effective radioactive iodine ablation and radiotherapy treatment. We report two cases of large fungating thyroid cancers complicated by anaemia and foul-smelling discharge.
    Matched MeSH terms: Thyroid Gland/pathology
  15. Sow YL, Aziz NA, Ng KL
    Am J Emerg Med, 2013 Apr;31(4):760.e3-5.
    PMID: 23399341 DOI: 10.1016/j.ajem.2012.12.005
    Rupture of the thyroid gland is uncommon in cases of blunt neck trauma. We report a case of thyroid rupture after a motor vehicle accident in a patient without a preexisting goiter. He presented with a painful anterior neck swelling associated with dysphagia and hoarseness of voice. Computed tomographic scans showed lacerations of the right thyroid lobe and isthmus with features suggestive of slow active bleeding. Neck exploration was subsequently performed, and a ruptured right thyroid lobe was found with ongoing venous hemorrhage. A right hemithyroidectomy was performed, and the patient recovered without complications.
    Matched MeSH terms: Thyroid Gland/injuries*
  16. Foo LC, Zulfiqar A, Nafikudin M, Fadzil MT, Asmah AS
    Eur. J. Endocrinol., 1999 Jun;140(6):491-7.
    PMID: 10366404
    Iodine deficiency endemia is defined by the goitre prevalence and the median urinary iodine concentration in a population. Lack of local thyroid volume reference data may bring many health workers to use the European-based WHO/International Council for Control of Iodine Deficiency Disorders (ICCIDD)-recommended reference for the assessment of goitre prevalence in children in different developing countries. The present study was conducted in non-iodine-deficient areas in Malaysia to obtain local children's normative thyroid volume reference data, and to compare their usefulness with those of the WHO/ICCIDD-recommended reference for the assessment of iodine-deficiency disorders (IDD) in Malaysia.
    Matched MeSH terms: Thyroid Gland/pathology*
  17. Hisham AN, Lukman MR
    ANZ J Surg, 2002 Dec;72(12):887-9.
    PMID: 12485227 DOI: 10.1046/j.1445-2197.2002.02578.x
    BACKGROUND: Identification and preservation of the recurrent laryngeal nerve (RLN) is of major concern in surgery of the thyroid gland. The purpose of this study was to review the surgical anatomy of the nerve and to describe its relationship to other important structures.
    METHODS: A total of 325 patients were accrued in this prospective non-randomized study from January 1999 to December 2000. All patients who had total, subtotal and hemithyroidectomies were included in this study. Each side of the thyroid gland was considered as a separate unit in the analysis of the results.
    RESULTS: Two hundred and seventy-six patients had thyroidectomies as their primary operation, while 49 patients had them as a reoperative procedure. There were 276 women and 46 men (6:1 female to male ratio) with a mean age of 43.1 years (range: 10-84 years). The total number of dissections was 502. The RLN was clearly identified in 491 (97.8%) dissections: single trunk in 323 dissections (65.8%), two extralaryngeal branches in 164 dissections (33.4%), and three extralaryngeal branches in three dissections (0.6%). One non-recurrent laryngeal nerve was encountered (0.2%) in the series. The proximity of the RLN to the inferior thyroid artery (ITA) was noted in 444 (90.4%) dissections: 372 (83.8%) nerves were described to be posterior and intertwined between the branches of the ITA, and in 72 (16.2%) RLNs, they were observed to be anterior to the ITA. The close association of RLN to an enlarged tubercle of Zuckerkandl was documented in 381 dissections (73.7%). A total of 231 RLNs (60.8%) was seen in the tracheoesophageal groove, 18 (4.9%) nerves were observed to be lateral to the trachea, and in 109 (28.3%), they were posterior in location. Of concern in 23 (6.0%) dissections the RLN was on the anterior surface of the thyroid gland, which is at highest risk of injury before curving down to pass behind the tubercle of Zuckerkandl. It appears that the anterior course of the RLN was seen more often in the reoperative procedures to the thyroid gland (20%).
    CONCLUSIONS: Although various methods of localizing the RLN have been described, surgeons should be aware of the variations and have a thorough knowledge of normal anatomy in order to achieve a high standard of care. This will ensure the integrity and safety of the RLN in thyroid surgery. The anatomical variation may be minor in degree, but is of great importance as it may affect the outcome of the surgery and the patient's quality of life.
    Matched MeSH terms: Thyroid Gland/anatomy & histology
  18. Goh KH, Ng ML, Roslan BA, Tan TT, Nasri BN, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):539-43.
    PMID: 8257054
    Serum concentrations of thyroid stimulating hormone (TSH) and thyroid autoantibodies in pregnant patients with thyroid disease at various stages of pregnancy were determined by in-house ELISAs. In normal pregnancy, serum TSH levels were significantly elevated (p < 0.05) from 13 weeks of gestation. The normal reference ranges for TSH for the second (0.6-5.0 mIU/l) and third trimester (0.6-5.6 mIU/l) were significantly higher (p < 0.05; p < 0.01 respectively) compared to 0.4-4.5 mIU/l for the first trimester. In pregnant thyroid patients, serum TSH levels correlated highly (p < 0.001) to T4 (r = 0.740), FT4I (r = 0.683) and MicAb (microsomal antibodies) (r = 0.825) but weaker (p < 0.01) to T3 (r = -0.512), FT3I (r = 0.520) and TgAb (thyroglobulin antibodies) (r = 0.618). Thus, measurement of TSH with the highly sensitive ELISA (enzyme linked immunosorbent assay) would form a useful first line test for thyroid dysfunction in pregnancy while measurement of thyroid autoantibodies would aid in the diagnosis of autoimmune hypothyroidism.
    Matched MeSH terms: Thyroid Gland/immunology*
  19. Lam SK, Harvey S
    PMID: 1970531
    1. Anaesthesia caused marked decreases in the plasma concentrations of triiodothyronine (T3) and thyroxine (T4) and in the body temperature of young fowl. 2. Exogenous T4 or a thyroid hormone secretagogue (somatostatin antiserum), increased endogenous T3 and T4 concentrations and body temperature in conscious birds and prevented the body temperature decline in anaesthetized fowl. 3. These results provide further evidence for a role of T3 and T4 in temperature regulation in birds, particularly during anaesthesia.
    Matched MeSH terms: Thyroid Gland/physiology*
  20. Pang KL, Lumintang JN, Chin KY
    Nutrients, 2021 Feb 06;13(2).
    PMID: 33561976 DOI: 10.3390/nu13020529
    Olive oil, which is commonly used in the Mediterranean diet, is known for its health benefits related to the reduction of the risks of cancer, coronary heart disease, hypertension, and neurodegenerative disease. These unique properties are attributed to the phytochemicals with potent antioxidant activities in olive oil. Olive leaf also harbours similar bioactive compounds. Several studies have reported the effects of olive phenolics, olive oil, and leaf extract in the modulation of thyroid activities. A systematic review of the literature was conducted to identify relevant studies on the effects of olive derivatives on thyroid function. A comprehensive search was conducted in October 2020 using the PubMed, Scopus, and Web of Science databases. Cellular, animal, and human studies reporting the effects of olive derivatives, including olive phenolics, olive oil, and leaf extracts on thyroid function were considered. The literature search found 445 articles on this topic, but only nine articles were included based on the inclusion and exclusion criteria. All included articles were animal studies involving the administration of olive oil, olive leaf extract, or olive pomace residues orally. These olive derivatives were consistently demonstrated to have thyroid-stimulating activities in euthyroid or hypothyroid animals, but their mechanisms of action are unknown. Despite the positive results, validation of the beneficial health effects of olive derivatives in the human population is lacking. In conclusion, olive derivatives, especially olive oil and leaf extract, could stimulate thyroid function. Olive pomace residue is not suitable for pharmaceutical or health supplementation purposes. Therapeutic applications of olive oil and leaf extract, especially in individuals with hypothyroidism, require further validation through human studies.
    Matched MeSH terms: Thyroid Gland/drug effects
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