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Gallstone disease is one of the most common causes of hospitalization for gastrointestinal diseases in the world. Recent studies have examined the presence of bacteria in the formation of stones. Our main goal was to determine the overall composition of gallstone microflora. Gallstones were obtained from 24 patients during laparoscopic cholecystectomy from which DNA were extracted. Composition of bacterial flora was evaluated on 16 s rDNA sequencing technique. In the vast majority of samples, bacteria were present, and four groups could be differentiated regarding the flora. Overall composition shows that 87% of the stones were cholesterol/mixed type of gallstone. Additionally, potentially harmful microorganisms (Streptococcus, Clostridium and Kocuria) that could cause post-surgery complications were identified in several patients. The obtained results indicate that this technique may be useful in analyzing the type of stones and in pinpointing the presence of pathogenic bacteria. Supplementary Information The online version contains supplementary material available at 10.1007/s00203-021-02580-4.

lt;bgt;Introduction:lt;/bgt; Surgical site infections (SSI) involve 2-11% of all surgical procedures.lt;brgt;lt;bgt;Paper assumption:lt;/bgt; The use of 6% gel with chlorhexidine as an element of preoperative skin preparation of the operated area reduces the number of surgical site infections.lt;brgt;lt;bgt;Aim:lt;/bgt; The aim of the study was to assess the impact of body mass index (BMI), neutrophil to lymphocyte ratio (NLR), total protein, glucose, length of hospitalization before surgery, duration of surgery, length of drainage maintenance, transfusion of red blood concentrate on the number of SSI.lt;brgt;lt;bgt;Materials and methods:lt;/bgt; 248 patients were subjected to prospective analysis. Patients were operated at the Department of General and Oncological Surgery of the Provincial Specialist Hospital in Zgierz. Patients were divided into three groups depending on the microbiological degree of cleanliness of the postoperative wound: Group I - clean wounds, Group II - cleancontaminated wounds, Group III - contaminated wounds, which also included emergency surgerical procedures. In each group two subgroups were distinguished depending on the method of preoperative preparation of the surgical field: A - gel without CHG, B - 6% gel with CHG.lt;brgt;lt;bgt;Results:lt;/bgt; Surgical site infections were found in 22 patients (8.9%). The respective frequencies for groups I, II, III are: 3.0% vs 12.9% vs 12.7%. An increase in NLR by one unit resulted in a higher incidence of surgical site infections by 11%. A transfusion of RBC to the patient resulted in a 3.5-fold increase in the frequency of surgical site infections. Extending the drain maintenance time by one day increases the SSI frequency by 41%. Lowering the total protein concentration by at least 1 g/dl below normal increases the risk of surgical site infections almost three times.lt;brgt;lt;bgt;Conclusions:lt;/bgt; The use of a 6% gel preparation with chlorhexidine as an element of preoperative preparation of the surgical field reduces the risk of surgical site infections, especially in clean-contaminated and contaminated wounds.

The history of endocrine surgery in Poland begun later compared to the rest of the world. The first confirmed endocrine surgeries in Poland were performed in the XIXth ceuntry. The surgical center in Krakow had a lot of merit in that field, especially surgeons such as: Mikulicz, Rydygier and their successors. Blooming development began after the II World War – in the 70’s and 80’s of XX century. Achievements of professors such as Tadeusz Tołłoczko, Witold Rudowski, Kazimierz Rybiński and others and their successors led to a situation where the state of Polish endocrine surgery is at a world-class level.

Introduction: Operations due to benign and malignant thyroid neoplasms constitute a significant percentage of operations in general and oncological surgery wards. Therefore, unsurprisingly, better and better methods are being sought to avoid the occurrence of two major complications after those operations, i.e. laryngeal nerve palsy and hypoparathyroidism and new minimally invasive accesses. M aterial and methods: Authors searched MEDLINE database using the following search terms: modern technologies AND/ OR thyroid surgery AND/OR intermittent neuromonitoring AND/OR continuous neuromonitoring AND/OR parathyroid preservation AND/OR transoral endoscopic thyroidectomy AND/OR TOETVA. Results: The paper discusses the following new techniques of thyroid surgery with particular focus on limitations: neuromonitoring, narrowband imaging, fluorescence angiography and transoral endoscopic thyroidectomy by vestibular approach. Conclusions: Some of the new techniques are highly clinically useful. Their use can become a routine element of standard thyroidectomy.

Poland has about 25000–30000 thyroid glands operations per year. These kind of operations are in fourth place as to the frequency of scheduled operations. Most patients have total thyroidectomy. In addition to the classic method of accessing the collar cut at the neck, there are also alternative access, e.g. through the vestibule of the mouth or armpit. Surgery carries the risk of serious and even life-threatening consequences. One of the most serious complications of this surgery is failure of one or both laryngeal recurrents nerves. Laryngeal recurrents nerves are responsible for the proper functioning of vocal folds. Depending on the failure degree, results in disruption of phonation, difficulties in taking solid and liquid food, limitation of physical performance, impaired breathing to respiratory failure. The aim of this study is to assess the prevalence of early injury of the laryngeal nerves by evaluating the operation of vocal folds in direct laryngoscopy and ultrasonography. The study was carried out from 15/05/2018 to 17/01/2019 at the Department of General and Oncological Surgery. The patients were qualified for random examination from among the total number of patients qualified for goiter surgery in the Clinic. Direct laryngoscopy was performed in the Endoscopic Laboratory of the General and Oncological Surgery Clinic of the Medical University of Lodz. The ultrasound of the vocal folds was performed in the Department of Diagnostic Imaging. In the study period, 42 patients were qualified to participate in the study. In the study group, bilateral, early paresis of vocal folds was diagnosed in two patients (4.76%) and unilateral early paresis of vocal fold in seven patients (16.67%). Both operations, complicated by bilateral paresis of vocal folds, were performed without the use of intraoperative neuromonitoring (IONM - intraoperative neuromonitoring). One-sided paresis of vocal folds occurred in 3 patients (7.14%) operated without neuromonitoring, and 4 patients (9.52%) with intraoperative neuromonitoring. The study found that a severe complication in the form of early bilateral paresis of vocal folds occurred in operations without the use of neuromonitoring. A similar occurrence of one-sided damage to the vocal fold indicates a lack of connection with the additional support used in the form of intraoperative neuromonitoring.

IntroductionHypocalcaemia remains the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.Material and methodsOne hundred fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not to receive (group A) calcium carbonate (3 g/d) and alfacalcidol (1 µg/d) on the day before surgery and calcium carbonate (1 g/d) and alfacalcidol (1 µg/d) taken once in the morning on the day of operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 hour postoperatively and 6 weeks after surgery.ResultsSymptomatic hypocalcaemia was observed in 41/153(26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (pConclusionsOral supplementation of calcium and alfacalcidol may help in the prevention of postthyroidectomy hypocalcaemia. Vitamin D deficiency was widespread among operated patients.

Patient: Female, 52-year-old Final Diagnosis: Foreign body in the abdominal cavity Symptoms: Abdominal pain • hip pain Medication:— Clinical Procedure: Laparotomy Specialty: Surgery Objective: Unusual clinical course Background: Intra-abdominal impalement injuries caused by a penetrating foreign body are rare and often fatal. The mechanism of injury is usually associated with vascular and organ damage, and the course is dynamic, with high morbidity and mortality. Post-traumatic presence of glass pieces in the peritoneal cavity after an old impalement injury is rare. Case Report: A 52-year-old woman sustained a 4-cm laceration in her lumbar region after falling on a glass table that shattered. After a physical examination and wound exploration in the emergency room, no foreign body was found. The laceration was sutured without X-ray imaging. She was admitted to the Surgical Department 9 months later for diagnosis of lower abdominal pain. In a CT scan of the abdominal cavity, a 19-cm fragment of glass was found intraperitoneally, inter-looped in the pelvic cavity. A laparotomy was performed, during which the foreign body was found and removed. No abdominal organs were injured. Further outpatient treatment was normal. Conclusions: Potentially minor abdominal impalement injuries can cause serious organ damage. Every patient, even if asymptomatic, and even after trivial injury with a small skin wound, must be suspected of having a hidden foreign body. Accurate visual, manual, and instrumental wound exploration is always necessary. Imaging exams are an important diagnostic method when the presence of a post-traumatic foreign body is suspected.

Significant advances have been made in thyroid can-cer research in recent years, therefore relevant clinical guidelines need to be updated. The current Polish guidelines "Diagnostics and Treatment of Thyroid Carcinoma" have been formulated at the "Thyroid Cancer and Other Malignancies of Endocrine Glands" conference held in Wisla in November 2015 [1].

Introduction. Diabetes is one of the most common civilization diseases, which has a significant impact on particular individuals but also on society as a whole. Improper metabolism of sugars can lead to a number of complications affecting the whole body. From a surgical point of view treatment of diabetes complications, apart from optimizing the treatment of hyperglycaemia, is limited to the treatment of diabetic foot syndrome. The syndrome develops on a basis of microneuropathy, leading to development of necrotic lesions which are the perfect breeding ground for a number of bacteria. Adequate antibiotic therapy is one of the most important elements of all interdisciplinary therapy in treatment of diabetic foot syndrome. Material and methods. In the present study, results of obtained swab cultures were evaluated to assess optimal antibiotic treatment, evaluating only the first bred isolate from the patient. Results. In all 61 patients inflammatory infiltration of skin and soft tissues was observed, most of which accompa­nied by foot/leg wounds that healed after minor surgical interventions. A single pathogen was isolated in nearly half of the patients. In one patient, eight pathogens were isolated. The most commonly identified pathogens were Staphylococcus aureus , Enterococcus faecalis , Co­agulase-negative staphylococcus (other than S. Cohni , S. Epidermidis , S. Werneri , S. Haemoliticus ). Conclusions. Soft tissue infections in the diabetic foot syndrome are most frequently caused by several types of bacteria, most commonly Staphylococcus aureus . Based on the provided results, it appears that the op­timal start of antibiotic therapy would be the use of amoxicillin with clavulanic acid. (Clin Diabetol 2017; 6, 6: 189–194)

Damage to the thyroid due to blunt neck injury is rare. About half of the described cases occurred in the thyroid with pathological changes. They are usually associated with large hematomas of the neck that cause respiratory failure. We present a case of a patient whose thyroid injury caused rupture of the left thyroid lobe with a hematoma of the mediastinum and right pleural cavity.

Introduction It is essential to look for methods to define the need for central lymphadenectomy for papillary thyroid cancer patients. The aim is to determine the efficacy of one-step nucleic acid amplification (OSNA) and sentinel lymph node (SLN) biopsy in the intraoperative detection of nodal involvement. Material and methods This prospective, experimental study enrolled 49 patients with clinically negative lymph nodes. Intraoperatively, 1% Patent Blue dye was injected intratumorally. Lymph nodes that stained blue were defined as SLNs. They were directly cut into blocks at 2-mm intervals. Nonadjacent blocks were subjected to either the OSNA assay or histological examination. Results Sixty-five SLNs were found in 43 (87.8%) patients. There were 20 (30.8%) histopathologically positive SLNs. According to the OSNA, 22 (33.8%) SLNs were positive. The OSNA results were different from histopathology in 8 (12.3%) SLNs. The OSNA gave a positive result in 5 (7.7%) SLNs, while they were not involved according to the histopathology. However, OSNA upstaged N status from N0 to N1 only in 2 (3.1%) patients. Inverse results (histopathology +, OSNA-) were obtained in 3 (4.6%) SLNs. Positive and negative predictive values (PPV and NPV) for OSNA were 0.77 and 0.93, respectively. The concordance rate between examinations was 85.5%. Conclusions In some patients with clinically negative lymph nodes, OSNA and SLN biopsy may prevent unnecessary central lymphadenectomy. On the other hand, the sentinel lymph node biopsy may reveal the presence of potentially involved sentinel lymph nodes outside the central compartment. These SLNs can also be assessed by means of OSNA.

Purpose: To verify the value of dynamic magnetic resonance imaging (MRI) sequences, fast field echo (FFE), and balanced gradient echo (true fast imaging with steady-state free precession - TRUFI) in the evaluation of vocal fold mobility in healthy volunteers, against ultrasound examination (US) as the reference test. Material and methods: Vocal fold mobility in 35 healthy volunteers (age 20-59 years, 20 women and 15 men) with no history of laryngeal disorders and neck surgeries was determined by means of US and MRI during normal breathing and phonation of the "hiiii" sound. US images were used to determine the glottic angles. During MRI two dynamic sequences, fast field echo and balanced gradient echo, were applied to determine the minimum and maximum values of the glottic angles, along with the rima glottidis area, separately for the right and left compartments. Due to differences in larynx anatomy, the abovementioned parameters were analysed separately for women and men. Results: No significant differences were observed between the glottic angle values obtained during US and dynamic MRI (FFE and TRUFI sequences). Regardless of the dynamic MRI sequence used, a positive correlation was found between the maximum values of glottic angle and the rima glottidis area. This correlation was strong and statistically significant among men, but not in women. Conclusions: Dynamic MRI of vocal folds using FFE and TRUFI sequence is an accurate method for the objective evaluation of rima glottidis width.

Hypertrophic and hypoxic visceral adipose tissue (VAT) secretes proinflammatory cytokines promoting insulin resistance (IR), prediabetes and type 2 diabetes (T2DM) microRNAs (miRNAs) are markers of metabolic disorders regulating genes critical for e.g., inflammation, glucose metabolism, and antioxidant defense, with raising diagnostic value. The aim of the current study was to evaluate whether hyperglycemia is able to affect the expression of selected miRNAs in VAT of prediabetic (IFG) and diabetic (T2DM) patients vs. normoglycemic (NG) subjects using qPCR. Statistical analyses suggested that miRNAs expression could be sex-dependent. Thus, we determined 15 miRNAs as differentially expressed (DE) among NG, T2DM, IFG females (miR-10a-5p, let-7d-5p, miR-532-5p, miR-127-3p, miR-125b-5p, let-7a-5p, let-7e-5p, miR-199a-3p, miR-365a-3p, miR-99a-5p, miR-100-5p, miR-342-3p, miR-146b-5p, miR-204-5p, miR-409-3p). Majority of significantly changed miRNAs was similarly upregulated in VAT of female T2DM and IFG patients in comparison to NG subjects, positively correlated with FPG and HbA1c, yet, uncorrelated with WHR/BMI. Enrichment analyses indicated involvement of 11 top DE miRNAs in oxidative stress, inflammation and insulin signaling. Those miRNAs expression changes could be possibly associated with low-grade chronic inflammation and oxidative stress in VAT of hyperglycemic subjects.

Abdominal wall actinomycosis is a very rare infection caused by anaerobic Gram-positive bacteria Actinomyces. We present a case of a 72-year-old female with chronic pain located in the right hypochondriac region and anterior abdominal wall mass which had developed six months before. An ultrasonography (USG) and computed tomography (CT) scan of the abdomen were performed and showed an inflammatory change with a strong internal linear reflection in the right upper abdomen. The tumor was located inside the rectus abdominis muscle and connected with internal organs and subcutaneous tissue. The patient qualified for surgery. En block tumor excision was made with partial resection of the transverse colon. Postoperative study revealed fishbone-associated inflammatory actinomycosis tumor. The patient was successfully managed postoperatively with penicillin and discharged on the 11th day after the surgery.

Introduction: The diagnostic category of follicular lesion of undetermined significance (FLUS) was intended to allow selection of cases with low risk of malignancy from all smears with indeterminate, suspicious cytology (ISC), which can potentially take advantage from repeat fine-needle aspiration (rFNA). Aim of the study was a comparison of the risk of malignancy related to FLUS nodules and other nodules with ISC: suspected follicular neoplasm (SFN) and suspected malignancy (SM), as well as analysis of the usefulness of assessing ultrasonographic malignancy risk features (UMRF) in nodules with ISC. Material and methods: We analysed UMRF, rFNA, and results of histopathological examination (H) in 441 FLUS, 135 SFN, and 72 SM nodules. Results: The frequency of exposing cancer in H in FLUS nodules was 5.9%, and when cytological follow up was also included it was 2.9%. rFNAs made the diagnosis more precise in 72.7% of FLUS, and in 5.2% it was diagnosis/suspicion of cancer. The incidence of cancer in SFN nodules was 8.2%, in SM nodules with suspicion of papillary cancer — 61.1%, and in nodules with suspicion of other or unspecified malignancy — 53.8% (p < 0.0001 FLUS vs. both groups). The presence of calcifications is the only independent UMRF for nodules with ISC (OR 4.7). Features of importance are also microcalcifications (OR 3.8), especially in the SM group, and taller-than-wide-shape (OR 2.2). FLUS and SFN nodules are characterised by particularly low value of assessing suspicious margins; analysis of hypoechogenicity is of low value in SFN nodules, like suspected vascularisation in SFN and SM nodules. Conclusions: The risk of cancer in FLUS and SFN nodules is lower than in SM nodules. rFNAs of FLUS nodules make the diagnosis more precise in more than 70% of cases and are effective in revealing cancers. UMRFs present variable diagnostic value depending on the subcategory of ISC. (Endokrynol Pol 2016; 67 (1): 23–34)

Revised Guidelines of Polish National Societies Prepared on the initiative of the Polish Group for Endocrine Tumours approved in their final version between November 16th and 28th, 2015 by the Scientific Committee of the V Conference "Thyroid Cancer and other malignancies of endocrine glands" organised between November 14th and 17th, 2015 in Wisla, Poland; called by the following Societies: Polish Endocrine Society, Polish Society of Oncology, Polish Thyroid Association, Polish Society of Pathologists, Society of Polish Surgeons, Polish Society of Surgical Oncology, Polish Society of Clinical Oncology, Polish Society of Radiation Oncology, Polish Society of Nuclear Medicine, Polish Society of Paediatric Endocrinology, Polish Society of Paediatric Surgeons, Polish Society of Ultrasonography Gliwice-Wisla, 2015 DECLARATION: These recommendations are created by the group of delegates of the National Societies, which declare their willingness to participate in the preparation of the revised version of the Polish Guidelines. The members of the Working Group have been chosen from the specialists involved in medical care of patients with thyroid carcinoma. Directly before the preparation of the Polish national recommendations the American Thyroid Association (ATA) published its own guidelines together with a wide comment fulfilling evidence-based medicine (EBM) criteria. ATA Guidelines are consistent with National Comprehensive Cancer Network (NCCN) Recommendation. According to the members of the Working Group, it is necessary to adapt them to both the specific Polish epidemiological situation as well as to the rules referring to the Polish health system. Therefore, the Polish recommendations constitute a consensus of the experts' group, based on ATA information. The experts analysed previous Polish Guidelines, published in 2010, and other available data, and after discussion summed up the results in the form of these guidelines. It should be added that Part II, which constitutes a pathological part, has been available at the website of the Polish Society of Pathologists for acceptance of the members of the Society, and no essential comments have been proposed. The Members of the Group decided that a subgroup elected from among them would update the Guidelines, according to EBM rules, every year. The Revised Guidelines should help physicians to make reasonable choices in their daily practice; however, the final decision concerning an individual patient should be made by the caring physician responsible for treatment, or optimally by a therapeutic tumour board together with the patient, and should take into consideration the patient's health condition. It should be emphasised that the recommendations may not constitute a strict standard of clinical management imposed on medical staff. The data from clinical trials concerning numerous clinical situations are scarce. In such moments the opinion of the management may differ from the recommendations after considering possible benefits and disadvantages for the patient.

Introduction Adrenal insufficiency is a typical complication after surgical treatment of adrenal tumors, especially after the removal of both adrenal glands. Human beings are not able to survive without adrenal glands and without proper hormonal substitution. Autotransplantation of a fragment of the adrenal gland may prevent this complication. This can be done by transplanting the entire adrenal glands or its fragment, such as the adrenal cortex cells. In the case of adrenal tumors, the entire adrenal gland can not be transplanted. However, it is possible to transplant cells from the tumor-free part. Succesful adrenal autografts may result in a new treatment of adrenal insufficiency. Materials and Methods: Autograft transplantation was performed on 3 groups of Sprague Dawley rats. In the first group, physiological corticosterone concentrations were determined. These animals were not operated. In the second group, both adrenal glands were removed. Corticosterone concentrations were determined after bilateral adrenalectomy. The third group was divided into two parts. In the first subgroup, bilateral adrenalectomy was performed simultaneosly with adrenal transplant into the omentum. In the second subgroup, right adrenalectomy was performed simultaneosly with and adrenal transplant into the omentum followed a month later by left adrenalectomy. During the experiment, corticosterone concentrations were measured at 4 time points. Results. The statistical difference between corticosterone concentrations in rats after two timed adrenalectomies and rats after bilateral adrenalectomy was statistically different, but these results were far from physiological concentrations.

Sentence recommending the content of work: Due to the health and economic consequences of postoperative hypocalcemia, it is necessary to disseminate knowledge about non-invasive methods of limiting it that can be used in everyday clinical practice such as routine perioperative calcium and vitamin D supplementation. Abstract Introduction: Postoperative hypocalcemia is a narrow but significant problem for patients undergoing thyroid and parathyroid surgery. It is the most common complication after thyroidectomy. It is associated with transient or permanent hypoparathyroidism. It could potentially be life-threatening for patients and increases the costs of hospitalization. The aim of the study was to evaluate the results of studies that routinely administrated calcium and/ or vitamin D during the postoperative period. Materials and Methods: In this article, a literature review – 15 studies that used routine perioperative calcium (7 studies), vitamin D (2 studies) and calcium with vitamin D (11 studies) supplementation was performed. Supplementation effectiveness in prevention of postoperative hypocalcemia was compared to no prophylaxis in 10 studies. Five studies compared the effect of combined administration (calcium and vitamin D) to calcium alone. The number of works dealing with this problem is not particularly large. Results: Supplementation significantly decreased the rate of laboratory and symptomatic hypocalcemia. It was also effective in reducing the severity of symptoms. The combination calcium with vitamin D was the most effective strategy. No hypercalcemia or parathyroid hormone inhibition was observed in the supplemented groups. Routine supplementation was less expensive than performing laboratory tests in the course of treatment of hypocalcemia. Conclusions: The results of analyzed studies showed the clinical and economic advantage of routine perioperative prophylactic supplementation of vitamin D and/ or calcium as compared to no prophylaxis. However, the majority of studies showed a significant range of variability in patients’ characteristics. Numerous studies did not evaluated the preoperative 25-hydroxycholecalciferol level - a risk factor for postoperative hypocalcemia. Discussion: The use of routine prophylactic supplementation of calcium and vitamin D in the perioperative period can be useful in everyday clinical practice. Further research is needed to draw clear guidelines regarding prophylactic calcium and vitamin D therapy for patients after thyroidectomy.

During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel. grant No. 1767/B/P01/2010/39 from the National Science Centre, Poland

Introduction: The significance of lymph node metastases and the optimal extent of lymphadenectomy remain matters of controversy in papillary thyroid cancer. This study was designed to assess the feasibility and reliability of OSNA and real-time PCR for CK19 and TG mRNA in papillary thyroid cancer lymph nodes evaluation compared to standard histopathology. Material and methods: Each of 92 randomised lymph nodes from 32 papillary thyroid cancer patients were divided into representative parts and assessed using the three studied methods. Results: Eighteen (19.6%) lymph nodes from ten (31.3%) patients were positive according to histopathology. When the cut-off value distinguishing metastatic from non-metastatic lymph nodes in the OSNA assay was set at 250 copies per microlitre, the results were positive in 16 (17.4%) lymph nodes from 11 (34.4%) patients. Twenty three (25%) lymph nodes were tested positive in real-time PCR for TG mRNA. Real-time PCR for CK19 mRNA was positive in 18 (19.6%) lymph nodes from 13 (40.6%) patients. No statistically significant differences were noted between the diagnostic accuracy of either molecular method compared to the histopathological examination (p = 0.81). Overall, 20 positive molecular biology results were noted in patients with negative histopathology results. Conversely, in 18 lymph nodes, despite a metastasis finding in histopathology, at least one molecular test yielded a negative result. Conclusions: It was revealed that OSNA is a reliable technique for the evaluation of lymph node metastases in papillary thyroid cancer. This method was shown to have equivalent accuracy to histopathology and real-time PCR. (Endokrynol Pol 2014; 65 (6): 422–430)

INTRODUCTION: Locoregional relapse in medullary thyroid cancer (MTC) may be caused by nodal micrometastases. Medullary thyroid cancer lymph nodes have not yet been evaluated by one-step nucleic acid amplification (OSNA). Therefore, the aim of this study was to detect MTC cells by OSNA in cervical lymph nodes and compare the obtained outcomes with conventional histopathology. MATERIAL AND METHODS: Twenty-one randomized, unenlarged lymph nodes from 5 patients with MTC were examined by histopathology and OSNA. Lymph nodes were divided into four representative blocks by a sterile, single use, special cutting device in the same way as in the clinical protocol study performed by Tsujimoto et al. Two blocks were used for histopathology and immunohistochemistry, 2 for OSNA. RESULTS: Positive results of histopathology and OSNA were revealed in 4 patients. The outcomes of OSNA and histopathology were corresponding in 3 patients. Positive histopathology results of 2 lymph nodes from 2 patients were confirmed by OSNA. In 1 patient there were only negative results of both examinations. One-step nucleic acid amplification failed to detect metastasis in 1 lymph node in 2 patients although it did not change the TNM status in these patients. There were no false positive results in the OSNA test. CONCLUSIONS: One-step nucleic acid amplification may be an alternative method to histopathology in detecting nodal involvement in MTC. Further studies should evaluate the sensitivity and specificity of OSNA and the impact on staging in MTC.

Background Cells adapt to hypoxia by transcriptional induction of genes that participate in regulation of angiogenesis, glucose metabolism and cell proliferation. The primary factors mediating cell response to low oxygen tension are hypoxia inducible factors (HIFs), oxygen-dependent transcription activators. The stability and activity of the α subunits of HIFs are controlled by hydroxylation reactions that require ascorbate as a cofactor. Therefore, deficiency of intracellular vitamin C could contribute to HIFs overactivation. In this study, we investigated whether vitamin C content of human thyroid lesions is associated with HIF-1α and HIF-2α protein levels. Methods Expression of HIF-1α and HIF-2α as well as vitamin C content was analyzed in thyroid lesions and cultured thyroid carcinoma cell lines (FTC-133 and 8305c) treated with hypoxia-mimetic agent (cobalt chloride) and ascorbic acid. The expression of HIFs and hypoxia–induced glucose transporters were determined by Western blots while quantitative real-time PCR (qRT-PCR) was performed to detect HIFs mRNA levels. Ascorbate and dehydroascorbate levels were measured by HPLC method. Results We found an inverse correlation between vitamin C level and HIF-1α but not HIF-2α expression in thyroid lesions. These results agree with our in vitro study showing that vitamin C induced a dose - dependent decrease of HIF-1α but not HIF-2α protein level in thyroid cancer cells FTC-133 and 8305C. The decreased HIF-1α expression was correlated with reduced expression of hypoxia-related glucose transporter 1 (GLUT1) in thyroid cancer cells. Conclusion The results demonstrate that HIF-1α activation is associated with vitamin C content in thyroid lesions. Our study suggests that high tumor tissue ascorbate level could limit the expression of HIF-1α and its targets in thyroid lesions.

This study aims to present results regarding the presence and identification of bacterial strains found in bile and gallstones located in the gallbladder and bile ducts in patients operated on due to cholelithiasis. Materials and Methods. Bacterial culture was evaluated in 92 patients. There were 54 women (59%) and 38 men (41%) who underwent surgery on account of cholelithiasis and /or gallstones in bile ducts between 2013 and 2014. Bile and gallstone samples were cultured intraoperatively for bacteria; bacterial strains were identified, and their sensitivity to antibiotics was determined. Molecular methods (NGS and Sanger method) were used to separate bacterial strains in one of the gallbladder stones and the results were compared with bacterial strains grown from the bile. Results. Bile cultures were positive in 46 patients that is, 50% of the study group. The following bacteria strains were grown: Enterococcus spp. (44%), Escherichia coli (37%) and Klebsiella spp. (35%). Candidiasis accompanied by bacterial infection was detected in 7 patients (15%). Molecular testing of gallstones revealed DNA of Enterococcus spp., Escherichia spp., Streptococcus spp. and Clostridium spp. In the bile culture of the same patient Enterococcus spp. (avium and faecalis) was detected. Conclusion 1. More than one pathogen was grown on samples obtained from 31 patients (70%) with bile infection. 2. The most common pathogens include Enterococcus spp., Escherichia coli and Klebsiella spp. 3. Bacterial infections are often accompanied by a fungal infection (Candida albicans) 4. Bacterial strains grown from a gallstone sample partially corresponded with strains identified in the bile of the same patient.

Aim of the study: To determine the fea sibility of sentinel lymph node biopsy (SLNB) for the evaluation of the cervical lymph node status in patients with thy roid tumors. Material and methods: Twenty-three patients with suspected thyroid cancer were enrolled in the study. 0.5–1.0 ml of 1% Patent Blue dye was injected intra tumorally. After SLNB, thyroidectomy and proper lymphadenectomy were per formed. Results: Sentinel lymph node was detect ed in 20 (86.9%) patients. Thirty-one SLNs were found – 21 (67.7%) were locat ed in the central neck compartment, 4 (12.9%) in the lateral neck compart ment, 6 (19.4%) in the upper medi astinum. The number of SLNs ranged from 1 to 3 (mean 1.6). Sentinel lymph node was positive in 5 (25%) patients, negative in 15 (75%) in the final histo pathology. Sentinel lymph nodes were located only in the central neck compartment in 13 pa tients, and in both the central and lat eral neck compartments in 2 patients. In one patient, SLNs were located only in the central neck compartment and upper mediastinum. Three patients had SLNs only in the upper mediastinum, while one had them only in the lateral neck compartment. In one patient a node regarded as SLN was negative, while there were metastases in removed non-sentinel lymph nodes (NSLNs). In two patients, histopathology of SLNs showed that they were actually parathy roid glands. Conclusions: Our results confirm that thy roid cancer SLNB is rather easy to carry out. Its performance along with intra operative examination can help to avoid unnecessary lymphadenectomy. How ever, it should be kept in mind that parathyroid glands can be stained and removed by mistake during SLNB.

Thyroid surgery is the most commonly performed procedure in the field of endocrine surgery. Studies are still ongoing on the development of a single algorithm for diagnosis and care of patients at risk of postoperative hypoparathyroidism. The aim of the study was to determine the biochemical marker that would allow the most accurate diagnosis of patient groups at risk of developing hypoparathyroidism and to identify risk factors for this disorder.The prospective study included 142 consecutive patients undergoing total thyroidectomy for benign goiter from January 1st 2014 to December 31st 2015. Serum intact parathyroid hormone (iPTH), total calcium (Ca), phosphate (P), and magnesium (Mg) levels have been measured preoperatively and at 1, 6, 24, and 48 h postoperatively.Clinical symptoms of hypoparathyroidism developed in 25 (17.6%) of 142 patients. The best diagnostic accuracy for hypoparathyroidism based on ROC curves was obtained for iPTH at 6h (AUC 0.942; 95% CI: 0.866-1.000, p0.001) and its percentage change from baseline ΔiPTH at 6h (AUC 0.930; 95% CI: 0.858-1.000, p0.001). In an multivariate analysis, the preoperative Ca level higher by 0.1 mmol/l, and iPTH level higher by 0.1 pmol/l were associated with a lower risk of hypoparathyroidism, by 68% (p=0.012) and 61% (p=0.007), respectively. A 1% decline in iPTH from baseline increased the risk of hypoparathyroidism by 15% (p0.001).The most reliable markers indicating a high risk of postoperative hypoparathyroidism are the decline in ΔiPTH at 6h by65% or iPTH level at 6h1.57 pmol /l. A postoperative decline in iPTH levels is an independent risk factor for the development of hypoparathyroidism. Preoperative higher concentrations of Ca and iPTH are protective factors for the development of this disorder.

Introduction: The aim was to assess the usefulness of strain elastography (SEG) in the diagnostics of two groups of thyroid nodules (TNs): follicular lesions (FL) with low malignancy risk ( Material and methods : 168 TNs were analysed and eventually surgically treated: 100 UC (50 benign and 50 malignant — 90.0% PTCs) and 68 FL (60 benign, 8 malignant — 50.0% PTCs). Elasticity score (ES) and strain ratio (SR) were evaluated, and their effectiveness was compared with the evaluation of the number of ultrasound malignancy risk features (NoUMRFs). Results: In the UC group the evaluation of mean values of SR and ES in both sections (meanSR, meanES) was more efficient than NoUMRFs analysis (AUC: 0.903 and 0.869 vs. 0.754, p 0.7, and only the set of features: tSR ≥ 1.7 and NoUMRFs ≥ 1 increased the malignancy risk in nodules (OR: 12.0; SEN: 75.0%, SPC: 75.0%). Conclusions: SEG is more reliable than conventional US in the diagnostics of TNs. The efficacy of SEG decreases with lowering percentage of PTCs among cancers. But in FL nodules SEG may support the selection of nodules for surgical treatment.

This study was designed to assess the degree of risk of bacterial transmission from physician to patient through hands, equipment and enclosing surfaces (shoe soles).The study was conducted in the Clinical Department of General and Oncological Surgery UM in Łódź. In days 16.10.2013, 17.10.2013, 18.10.2013 there were done swabs from hands, stethoscopes and soles of shoes from the same group of physicians before and after doctor's rounds. The presence of alert-pathogens in swabs was regarded as positive result.Isolates included mostly aerobic saprophytic bacilli and Staphylococcus species coagulase-negative. There were detected a singly cases of Acinetobacter Baumani and Escherichia coli. Alert-pathogens were found in 4 (16%) swabs taken from hand before doctor's rounds and in 7 (28%) swabs taken after rounds. Stetoscopes were contaminated by alert-pathogens in 3 (12%) cases before doctor's rounds and in 3 (12%) cases taken after doctor's rounds. Soles of shoes were contaminated by alert-pathogens in 14 (56%) cases taken before and 16 (65%) cases taken after doctor's rounds.1. Physicians are important factor of bacterial transmission in hospital. 2. Hands, stetoscopes and particularly soles of shoes of medical staff is the source of infection.

was to assess the usefulness of prognostic scales: ASA (American Society of Anesthesiologist), MPI (Meinheim Peritonitis Index), MOFS (the Multiple Organ Failure Score) and SPI (the Simple Prognostic Index) in the prognosis of the course of disease in patients operated on for peritonitis.The study was conducted in the Clinical Department of General and Oncological Surgery of the Medical University in Łódź between January 2009 to December 2010. During this period 263 patients were operated on for peritonitis. Before surgery all patients were classifed into particular groups according to the above mentioned prognostic scales according to their criteria.There were 29 (11%) deaths. ASA ≥4 (p30 (p1. ASA, MPI, MOFS and SPI scales are of high signifcance in predicting the outcome in patients operated on for peritonitis. 2. The ASA scale in spite and due to its simplicity is adequate enough to be used in everyday practice in patients operated on for peritonitis. 3. The MPI scale is most suitable in the scientifc aims and in comparing the outcomes of patients operated on for peritonitis.

UNLABELLED Nosocomial infections caused by strains Acinetobacter baumannii strands are a growing clinical problem. The occurrence of multidrug-resistant strands is observed and that limits the ways of therapy considerably. The aim of the study was to determine the rate of infection and susceptibility spectrum of the species Acinetobacter baumannii isolated from patients treated at Maria Sklodowska-Curie Memorial Hospital in Zgierz with particular emphasis on surgical wards. MATERIALS AND METHODS The material consisted of Acinetobacter baumannii isolates were obtained from samples of materials from patients treated at Maria Sklodowska-Curie Memorial Hospital in Zgierz from January to December 2011. Isolated bacterial strains were cultured at microbiological substrates. Isolates were identified to species using the VITEK 2 GN card (bioMerieux) and Vitek 2 automated system (bioMerieux). Susceptibility towards antibiotics of particular strains was determined by the means of AST NO 93 card. In the case of resistance towards carbapenem, the MIC was marked by E-test with Mueller Hinton substrate. The occurrence of MBL was verified by the means of disc system with Mueller Hinton substrate. RESULTS We have shown that total number of Acinetobacter baumannii infections at hospital was 140 (10,31% of total results of cultures). Percentage of Acinetobacter baumannii infections at wards: Intensive Care Unit 48%, Surgical Departments 20%, Internal Diseases Department 16%, Neurology 13%, other wards - 3%. The susceptibility percentage of Acinetobacter Baumannii against antibiotics: colistin 90%, imipenem 64%, meropenem 43%, ampicillin-sulbactam 28%, amikacin 27%, gentamicin 24%, cefepime 9%, ceftazidime 7%, ciprofloxacin 7% CONCLUSIONS Acinetobacter baumannii infections are a significant proportion of nosocomial infections. Most relate to surgical wards and ICUs. Acinetobacter baumannii is resistant against most antibiotics. The highest percentage of sensitivity demonstrated for colistin and carbapenems.

Papillary thyroid cancer (PTC) metastases in the lymph nodes (LNs) were detected by real-time polymerase chain reaction (PCR) for TG and cytokeratin 19 (CK19), and the obtained results were compared with histopathology. 107 LNs from 34 PTC patients were divided into four blocks by a special cutting device - 2 for histopathology, while the other 2 were tested by quantitative real-time PCR. Metastases were detected in 20 nodes from 10 (29.4%) patients. TG and CK19 expression levels differed vastly between nodes with and without metastatic cells. ddCt of TG in the genetic material extracted from N0 nodes was 9.97 ±4.20, while in nodes with metastases ddCt was 0.91±4.20 (p < 0.0001). Cytokeratin 19 showed similar results with expression level (ddCt) in N0 nodes of 10.96 ±2.58 vs. 7.73 ±3.63 in nodes with metastases (p < 0.0001). Evaluation of the utility of both parameters showed efficient differentiation of node involvement in the case of TG, with area under the ROC curve (AUC) equal to 0.91 (95% CI: 0.85-0.96). Cytokeratin 19 also allowed for a degree of differentiation but its diagnostic efficacy was lower (AUC 0.76, 95% CI: 0.64-0.88). The combined TG and CK19 quantitative real-time PCR could be used to select a previously missed group of patients with nodal involvement undetectable by standard histopathology.

Cytokeratin 19 (CK19) is one of the most frequently studied immunohistochemical markers in thyroid pathology. The results of several studies suggest that CK19 may be useful in the diagnosis of papillary carcinoma, where it has been shown to have strong diffuse cytoplasmic reactivity. However, the published results vary, and the utility of CK19 in the diagnosis of thyroid lesions is controversial. The aim of this study was to evaluate, by Western blot analysis and the enzyme-linked immunosorbent assay (ELISA), the expression of CK19 in the cytosolic fraction obtained from 125 specimens of various thyroid lesions: nodular goiters, follicular adenomas, papillary carcinomas, follicular carcinomas and anaplastic carcinomas. The analysis of CK19 expression using the ELISA showed that the majority of papillary carcinoma cases had a much higher level of CK19 than did nodular goiters and adenomas (P

Background At present, researchers' attention has been concentrating on NDRG2 (N-Myc downstream-regulated gene 2) as a new gene candidate in the development and progression of papillary thyroid carcinoma (PTC). NDRG2, together with NDRG1, NDRG3 and NDRG4 are members of the NDRG family, a new class of genes, inhibited by N-Myc oncogene. Aim The aim of our study was to evaluate NDRG2 mRNA expression in the primary PTC and its metastases to regional lymph nodes. Materials and methods Postoperative tissue and macroscopically changed lymph nodes of sixteen (16) patients with PTC constituted the studied material. In this group, metastases of the cancer to regional lymph nodes were confirmed histopathologically in 8 cases. Quantitative evaluation of NDRG2 mRNA expression was performed by the real-time polymerase chain reaction (real-time PCR) method. Results The mean values of NDRG2 mRNA expression in the primary tumour tissues were statistically significantly lower vs. the levels of NDRG2 mRNA expression in macroscopically unchanged thyroid tissue (p < 0.0001). A comparison of the mean NDRG2 mRNA expression of primary tumours and that of their metastases to regional lymph nodes did not demonstrate any statistical differences (p > 0.05). A positive correlation was observed between NDRG2 mRNA expression in primary tumour cells and in the cancer metastases to lymph nodes (Rs = 0.7857; p < 0.05). Factors, such as age, sex, tumour stage in TNM system, were of no significance for NDRG2 mRNA expression level (p > 0.1). Conclusion The results of our study demonstrated decreased NDRG2 mRNA expression levels in PTC, when compared to macroscopically unchanged thyroid tissue, which may point to the potential role of NDRG2 in the development and progression of cancer in question.

Single N-acetylglucosamine residues attached by O-linkage to serine or threonine (O-GlcNAc) are an abundant, dynamic and inducible post-translational modification of cytoplasmic and nuclear proteins. This study analyzes the activity of the enzyme involved in the removal of these sugar residues, i.e. beta-N-acetylglucosaminidase (O-GlcNAcase) as well as the level of O-GlcNAc in benign and malignant thyroid lesions. Our results demonstrate increased activity of the enzyme in thyroid cancers in comparison to non-neoplastic lesions and adenomas. O-GlcNAc-modified proteins in thyroid cells have a predominantly nuclear distribution and are more abundant in non-neoplastic lesions than in tumors. Understanding the aberrant O-GlcNAc metabolism in thyroid cancer cells may be helpful for developing new diagnostic or treatment methods.

Aims and backgroundThe increased expression of galectin-1 on the mRNA and protein level observed in malignant thyroid tumors in comparison with benign lesions suggests that this protein may be associated with malignant transformation of thyroid epithelium. Extracellular and membrane glycoproteins are the main known ligands for this galactose-binding lectin. However, immunofluorescence studies have shown that galectin-1 is found predominantly in the intracellular compartment. The aim of this study was to examine intracellular carbohydrate ligands of galectin-1 in the thyroid, with particular attention to potential differences in their expression levels between benign and malignant lesions.MethodsIdentification of cytosolic and nuclear glycoproteins binding galectin-1 was performed by affinoblotting after separation of proteins in 8% polyacrylamide slab gels and electrotransfer onto Immobilon-P membranes. For semiquantitative analysis of glycoproteins binding galectin-1, an enzyme-linked lectino-solid-phase assay (ELLSA) was used.ResultsThe predominant cytosolic glycoproteins binding galectin-1 had molecular masses of 50, 55, 59, 64, 85–87, 100, and 133 kDa and nuclear glycoprotein had a molecular mass of 75 kDa. There were no evident differences in glycoprotein patterns between benign and malignant thyroid lesions. The results obtained by ELLSA did not show any significant differences in lectin binding by cytosolic and nuclear proteins of thyroid lesions either.ConclusionsOn the basis of these results it is tempting to suggest that interactions between galectin-1 and intracellular glycoconjugates are not critical for malignant transformation in the thyroid gland.

Papillary thyroid microcarcinoma is a particular form of cancer of the thyroid gland. This term, according to the WHO classification, is applied to papillary tumors no larger than 1.0 cm in diameter, which are incidentally detected during the postoperative histopathological examination. In clinical practice, the term pertains to all papillary tumors of the size smaller than or equal to 1 cm. The aim of the study was to determine the prevalence of papillary thyroid microcarcinoma and its selected histopathological characteristics among patients with malignant cancer of the thyroid gland identified in our own material in the years 2000-2007. Material and methods. The study included 523 patients treated for thyroid carcinoma: 401 (76.7%) women and 122 (23.3%) men aged 12-83 years (mean 49.8 years). Surgeries were carried out according to the Polish Group for Endocrine Carcinomas recommendations, in compliance with the European consensus. Results. Papillary thyroid carcinoma was identified in the postoperative histopathological examination in 391 (74.8%) patients; 285 (72.9%) women and 106 (27.1%) men. Their age ranged from 14 to 75 years (mean 49.3 years). Among 391 cases, tumor progression classified according to the WHO criteria (3) was as follows: T1 in 260 (66.5%), T2 in 59 (15.1%), T3 in 53 (13.5%) and T4 in 19 (4.8%) patients. In 150 cases (38.4% of papillary tumors), the tumor fulfilled the morphological criteria for microcarcinoma (4) and was detected in 118 (78.7%) women and 32 (21.3%) men. Carcinoma was identified in the neutral goiter in 138 cases, and in 12 patients in hyperactive, including 9 in nodular and 3 in Graves’ goiters. The disease was suspected or diagnosed preoperatively or at surgery in 112 patients. Postoperative diagnosis was performed in 38 (25.3%) individuals with micrcarcinoma. Twenty-four (38%) of 63 patients with multifocal tumors were subjected to adjunctive surgery as their cancer diagnosis was made only postoperatively in the histopathological examination. The subcapsular location of microcarcinoma was found in 78 (49.4%) cases including capsular infiltration and extracapsular invasion in 14 patients. The exact histopathological examination showed multifocality in 63 (42%) cases and involvement of the local lymph nodes in 29 (19.3%) patients. In 21 cases, the central compartment lymph nodes were involved. The presence of metastases in the central and lateral lymph node compartment was observed in 5 cases; in 3 patients skip metastases were detected in the lateral compartment on the tumor side omitting the central compartment. No patient with microcarcinoma diagnosed between the years 2000 and 2007 revealed distant metastases. Conclusions. Due to contemporary diagnostics, papillary thyroid microcarcinomas – tumors up to 1 cm – are most commonly identified cancers of the thyroid gland. High accuracy of US-guided fineneedle aspiration biopsy of high resolution permits to diagnose the majority of these tumors prior to surgery.

We sought to assess whether extensive surgical treatment, postsurgical radioiodine therapy, or both decrease the risk of locoregional recurrence (LR) after curative primary treatment in children and adolescents diagnosed with differentiated thyroid cancer (DTC) at ageor=18 y.To determine the incidence of and identify predictive factors for thyroid bed recurrence (TBR) or lymph node recurrence (NR), we performed a chart review and retrospective multivariate Cox regression analysis on 235 patients with DTC diagnosed at ageor=18 y and managed with curative intent at our tertiary referral center from 1973 to 2002; 40 of these patients had distant metastases at diagnosis. We also determined overall and recurrence-free survival and generated curves for these variables using Kaplan-Meier and Cox univariate analysis.During a median follow-up of 82 mo (range, 5-402 mo), no DTC-related deaths occurred, 203 (86%) children remained recurrence-free, and 32 (14%) children had LR, including TBR in 9 (28% of LR), NR in 20 (63% of LR), and both in 3 (9% of LR). Among patients treated with radical intent and showing no distant metastases, the most recent thyroglobulin level was1 ng/mL in all but 4% of cases. The median time from the first surgery to LR was 37 mo (range, 9-280 mo). In multivariate analysis, significant risk factors for TBR were less than total thyroidectomy and lack of postsurgical radioiodine treatment (respective risk increases of 9.5 [P = 0.04] and 11 times [P = 0.03]). For NR, classic papillary histology, incomplete primary lymph node management (i.e., lack of modified lymphadenectomy of affected lymph nodes or lack of confirmation of disease-free nodes by intraoperative staging), and absence of adjuvant radioiodine therapy were independent significant predictive factors that increased the recurrence risk by 1.9 (P = 0.02), 3.3 (P = 0.02), and 3.2 (P = 0.02) times, respectively. Age or sex did not correlate with LR risk.In DTC patientsor=18 y of age, extensive initial therapy-consisting of total thyroidectomy combined with modified lymphadenectomy performed in case of lymph node metastases and followed by radioiodine therapy--is associated with a substantial decrease of DTC LR risk.

Enhanced sialylation represents one of the most frequently occurring alterations of the sugar chain structure in various cancers. However, up to now, sialylation of intracellular proteins of thyroid carcinomas has never been investigated. The aim of this study was comparative analysis of cytoplasmic and nuclear sialoglycoproteins isolated from thyroid benign and malignant tumors as well as non-neoplastic lesions. The sialylation level and types of sialic acid linkages were analysed by lectin blotting and enzyme linked lectino-solid-phase assay (ELLSA) using Sambucus nigra (SNA) and Maakia amurensis (MAA) agglutinins. The presence of alpha2,6 and alpha2,3 linked sialic acid residues was detected in all types of thyroid lesion specimens but there were some differences in the banding and intensity patterns. Analysis of SNA and MAA binding by ELLSA method showed that in the majority of cancer samples the level of sialic acid residues was lower than in non-neoplastic lesions and adenomas. Our present results suggest that decrease in sialylation rather than increase is a characteristic feature of malignant transformation in the thyroid.

The range of lymphadenectomy in differentiated thyroid cancer remains still a matter of controversy because of the lack of reliable diagnostic methods for nodal metastases, other than histopathology. To compare the results of detection of lymph node metastases of papillary thyroid cancer by conventional histopathology and immunohistochemistry with the results of reverse transcription–polymerase chain reaction for thyroglobulin mRNA. Each of 166 cervical lymph nodes obtained from 21 patients was divided into two halves: one was used for conventional histopathology and immunohistochemistry, the other part was investigated by molecular examination. We obtained different results from examination of the lymph nodes in six (28.6%) patients. In four patients (19.1%) reverse transcription–polymerase chain reaction (RT-PCR) was more sensitive in detection of positive lymph nodes; in two patients (9.5%) it revealed fewer metastasised lymph nodes than did histopathology. The rest of the patients did not have any differences: 12 (57.1%) of them had negative lymph nodes and three (14.3%) had positive lymph nodes in all examinations. (1) Thyroglobulin (Tg) RT-PCR is an appropriate method of detection for thyroid cancer cells. (2) In combination with histopathology, it might help to qualify patients’ nodal status better.

Differences in glycosylation of nuclear and cytosolic proteins isolated from benign and malignant human thyroid neoplasms were analyzed by lectin blotting and enzyme linked lectino-solid-phase assay using Erythrina cristagalli and Ricinus communis agglutinins. The results reported in this study have not shown any significant differences in lectin binding by nuclear proteins of benign and malignant tumors, however, quantitative and qualitative differences were observed in the patterns of cytosolic glycoproteins. In the majority of carcinomas samples lectin binding to cytosolic proteins was definitely weaker in comparison with adenomas and non-neoplastic specimens, which suggested alterations in glycosylation of cytosolic proteins in malignant tumors.

From the contents: The urokinase receptor (uPAR, CD87) as a target for tumor therapy Molecular regulation of urokinase receptor (u-PAR) gene expression as one potential concept for molecular staging and therapy Stromal cell involvement in cancer Inhibition of the tumor-associated urokinase-type plasminogen activation system: effects of high level synthesis of soluble urokinase receptor in ovarian and breast cancer cells in vitro and in vivo Molecular mechanisms of carcinogenesis in gastric cancer Clinical implications of molecular diagnosis in HNPCC Minimal residual disease in gastric cancer Minimal residual disease in breast cancer and gynecological malignancies Clinical implications of the EGF-receptor/ligand system for tumor progression and survival in gastrointestinal carcinomas: evidence for new therapeutic options Minimal residual disease in the bone marrow and peripheral blood of patients with metastatic breast cancer Estrogen receptor (ER) expression profile of disseminated epithelial tumor cells in the bone marrow of breast cancer patients Detection of circulating tumor cells in blood using an optimized density gradient centrifugation Antitumoral and antimetastatic effects of continuous particle mediated cytokine gene therapy Genetic subtyping of renal cell carcinoma by comparative genomic hybridization Telomere length and hTERT expression in patients with colorectal carcinoma Evaluation of the level of bFGF, VEGF, sICAM-1, sVCAM-1 in the serum of patients with thyroid cancer.

This paper reports macro- and microscopic changes in hyperfunctioning thyroid nodules (HTN), initially diagnosed as solitary, in patients treated with percutaneous ethanol injection (PEI). In 78 patients, benign solitary HTN were diagnosed by clinical and hormonal examination. High resolution ultrasonography confirmed the solitary nodule. The results of fine needle aspiration biopsy (FNAB), performed twice, ruled out malignancy of the nodule. The patients were referred for PEI treatment. At 1-year follow-up, newly formed thyroid nodules, whose volumes increased, were detected in five patients (6.4%) with HTN, initially diagnosed as solitary. Therefore, these patients were operated on. Subtotal thyroidectomy was performed. At the intraoperative macroscopic evaluation, a hard fibrous solid mass was found in place of three nodules (n1, n2, n3) following PEI treatment. The middle area of the cut surface of PEI-treated nodules (n4 and n5) in the other two patients was firm and haemorrhagic, surrounded by a fibrous mass. Histolopathologic examination of n1, n2 and n3 revealed fibrosis and hyalinosis. Examination of n4 and n5 showed haemorrhagic necrosis in the middle of the nodules surrounded by fibrous tissue.

The aim of this study was to investigate post cryotherapy thyroid function status of normal rat thyroid tissue and to determine the topography of temperature of cryotreated tissues and of tissues adjacent to them. Nitrous oxide cryotherapy was performed in 40 male Wistar rats. They were divided into four groups of 10. In group I, the right thyroid lobe was subjected to cryotherapy and the left lobe was not frozen. In group II, both thyroid lobes were cryotreated. In group III, the right lobe was frozen and the left lobe was excised. In group IV, the thyroid was subjected to neither cryotherapy nor surgery. During cryotherapy, the temperature in various places of the thyroid and in the surrounding tissues was measured. Serum thyrotropin concentrations were determined before an experiment and 4 weeks after in all rats. The results of temperature measurements proved that it is possible to limit cryotherapy to certain areas of thyroid tissue and to spare the neighboring tissues, because they are not subjected to temperatures that are damaging. The effectiveness of cryotherapy was confirmed by functional effect. Cryotherapy changed function of thyroid tissue. There was a statistically significant difference between mean baseline and follow-up concentrations in rats of groups II and III. In both groups hypothyroidism occurred post cryotherapy.