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The aim of the study was to define disturbances of thyroid function in adult population of the city of Cracow followed up for ten years. The analysis included the results obtained from 891 individuals, 571 females and 320 males aged 18-78 years examined prior to and after implementation of the obligatory model of iodine prophylaxis (years 1989-1990 and 1998-1999). After the exclusion of patients diagnosed earlier as having hyperthyroidism or hypothyroidism, the mean TSH level in the years 1998-1999 was significantly higher as compared to data obtained between 1989 and 1990 (1.44 microj/ml vs. 1.30 microj/ml) in the examined population. Our 10 years observation revealed an insignificant increase in frequency of hyperthyroidism only among females (1.6% vs. 0.9%) which did not indicate a clear, endemic in character increase at the population level. In the present investigations, hypothyroidism was demonstrated to occur more frequently as compared to the 1989-90 study (2.1% vs. 1.4% among females and 0.3% vs. 0% in males). Both differences were not statistically significant. As seen from the present results, over the investigated 10-year period, in the Cracow population, there occurred a clear, statistically significant (p0.001) increase of the percentage of individuals with an elevated TPO antibody titter (3.8% vs. 11.8%). In our investigation no correlation was observed between anti-TPO antibodies and ioduria levels.The results reveal no statistically significant increase in incidence of hyperthyroidism and hypothyroidism after implementation of the obligatory model of iodine prophylaxis. The future studies are needed to clarify the mechanisms involved in increase of anti-TPO autoantibodies and verify its possible temporary nature.

The aim of the study carried out in 1989-90 and 1998-99 was to define the iodine deficiency state and goiter prevalence in adult population of Cracow. The analysis included data obtained from 230 individuals (143 females and 87 males). The mean age was 36 +/- 15 years. The thyroid size and morphology was determined by ultrasound method using Aloka unit equipped with 7.5 MHz linear transducer. The concentration of iodine in casual morning urine sample was measured using Sandell-Kolthoff's method. The 10- year observation revealed an insignificant decrease in prevalence of goiter from 26.2% to 21.8%. We observed statistically significant (p = 0.001) decrease in the parenchymal goiter prevalence from 22.7% to 11.7 in the same period of time. The significant increase in incidence of nodular goiter was found (6.5% vs 20.8%, p0.001). In all groups investigated through 1989-99, there was an increase in medians of ioduria over the 10-year period. The level of urinary iodine excretion was not essential element for risk of nodular goitre. Thus, the results indicate the beneficial effect of iodine prophylaxis which reflects in decrease of prevalence of parenchymal goiter. No clear effect of iodine prophylaxis was noticed regarding rise in nodular goiter incidence.

The environmental iodine deficiency has been a serious problem in the Polish health care system for many years. In many European countries the prevention of iodine deficiency-related health deficits in population scale is based on edible salt supplementation with KI. In the decade of the 80-ties the iodine supplementation program in Poland was stopped, which has caused a subsequent increase in prevalence of goiter and iodine deficiency-related hypothyreosis. These diseases were observed in many regions of Poland, including the areas beyond regions of formerly known iodine deficiency endemias. In order to control the whole Polish population, iodine consumption deficit in1991 the "Polish Program of Iodine Deficiency Control and Prevention of Iodine Deficiency-related Disorders" has been established in the year 1991. In 1992--1996 a common iodine supplementation of salt used for general consumption was 20 mg KI/kg of NaCl, and in 1997 the mandatory supplementation of salt was 30 (+10) per kg of salt which has been introduced for the whole country. This paper reports the results of iodine excretion assays in school children 6-12 years old, in the years 1993--94, 1996--97 and 1999--2002 respectively. The obtained collections of iodine urine concentrations have shown distributions with a remarkable rightward skewness. Normalization of distributions required logarythmic transformation. The quartile values obtained for data collections from years 1992--94, 1996--97 and 1999--2002 have shown that in 5-7 years of iodine deficiency prevention program yielded increase in iodine excretion in morning urine samples by about 37.8 microg, while the iodine excretion median values increased from 63.5 mg/L in years 1992--1994 to 94.0 mg/L in years 1999--2001, respectively. The lower limits of iodine excretion ranges calculated as the mean value minus 2SD of transformed data for the years 1992--1994 amounted to: 7.74 mg/L and for the years 1999--2001 amounted to 14.1 microg/l, respectively. Assessing percent of children obtaining low iodine suplementation then recommended (below 50 mg/L in urine sample) amounted to 35.8% in years 1992--1994 and 15.4% in years 1999--2001 respectively.

The thyroid fine-needle aspiration (FNA) is the decisive examination in the preoperative diagnostics of thyroid nodules. Different cytohistologic studies have revealed that the accuracy of FNA for thyroid nodules varied from 69% to 94%. The aim of our study was to compare the results of FNA with regard to final histopathological diagnosis among patients with follicular tumor, Hurthle cell tumor or papillary carcinoma in FNA. We retrospectively analyzed medical documentation of 51 patients (mean age 57.9 years, 49 women and 2 men) from the Endocrinology Department from 1997 to 2002 years. Based on FNA 29 patients were diagnosed as having follicular tumor, 10 as having Hurthle cell tumor and 12 as having papillary carcinoma. Carcinoma was detected histopathologically in 38% of patients with follicular tumor. Follicular carcinoma was detected histopathologically in 10% of patients with Hurthle cell tumor. Cytological diagnosis was confirmed histopathologically in 66.8% of all patients with papillary carcinoma in FNA. In accordance with our results the confirmation of malignant neoplasm can be expected in more than 80% of cases with papillary carcinoma in cytological examination. In case of follicular or Hurthle cell tumors the frequency of malignant neoplasm was less than 40% and 10% respectively.

New imaging modalities and hormonal diagnostic improvement have markedly increased the number of newly recognized pituitary tumours. Introduction of immunohistochemical assays in histopathological diagnostics of pitutary adenomas resulted in better understanding of pathology and clinics of these neoplasms. The aim of the study was to correlate the hormonal status and hematoxylin-eosin staining results with immunohistochemical staining of pituitary tumours. The study included 40 patients aged 43.8 +/- 18.3 years, diagnosed with a pituitary tumour in the Department of Endocrinology Collegium Medicum UJ, who subsequently underwent trans-sphenoidal surgery in the Department of Neurosurgery Collegium Medicum UJ. The serum pituitary hormone levels were assessed by means of radioimmuno-assays. The surgically obtained tumour tissue was evaluated both by hematoxylin-eosin and immunohistochemical staining. Using traditional staining 33 patients were diagnosed with chromophobic adenoma, 1 with basophilic adenoma, and remaining 6 with eosinophilic tumour. Immunohistochemical assays were ACTH-positive in 16, TSH-positive in 7, GH-positive in 14 and PRL-positive in 17 cases. In 15 subjects immunohistochemical staining was positive for at least two pituitary hormones. In 34 of 54 patients with positive immunohistochemical staining results, no increase in corresponding pituitary hormone serum levels was observed. In 5 of 9 patients with negative immunohistochemical staining, no increase in serum hormone level was noted, remaining 4 were characterized by hyperprolactinaemia. Tumour cells were ACTH-positive in 5 of 6 patients with elevated serum ACTH levels and GH- or TSH-positive in all cases of increased levels of these hormones. Only 6 of 15 subjects with hyperprolactinaemia revealed positive PRL immunohistochemical staining.Positive immunohistochemical staining often do not correlate with elevated basal serum pituitary hormone levels, which may be related to either impaired synthesis or excretion of the hormones by tumour cells. Increased serum levels of ACTH, TSH or GH are usually connected with positive immunohistochemical staining results. Hyperprolacinaemia in cases of PRL-negative assays arises from PRL secretion defects caused by the tumour presence itself.