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Jaromír Astl

Publications and source records attributed to Jaromír Astl.

10 recordsLinked to original sources
PubMed2005

Expression of nitric oxide synthases in parathyroid gland adenoma and parathyroid gland hyperplasia.

OBJECTIVE: The aim of the presented study was to perform the immunohistochemical detection of endothelial (eNOS) and inducible (iNOS) isoform of nitric oxide synthase in the adenomatous and hyperplastic parathyroid gland in relation to the apoptotic process. DESIGN AND SETTING: Tissue samples from 12 patients with parathyroid gland adenoma (PGA) and 10 patients with secondary parathyroid gland hyperplasia (PGH) were collected during surgery at the Department of Otorhinolaryngology and Head and Neck Surgery of The First Faculty of Medicine in Prague. METHODS: Three-step immunoperoxidase reaction on acetone-fixed cryostat sections was performed using both polyclonal and monoclonal antibodies against eNOS and iNOS. The detection of apoptotic cells was done using antibody against cleaved caspase-3 as an apoptotic marker. RESULTS: The immunoreactivity to eNOS antibody was observed in the endothelial lining of vessels in PGA, PGH and in the rim of normal parathyroid gland adjacent to PGA sample. Variable expression of eNOS was confirmed in arteries, arterioles, capillaries and veins in the glandular parenchyma as well as in the surrounding connective tissue. There was no iNOS immunoreactive cell detected in any examined sample. No apoptotic cells were detected. MAIN RESULT: Our findings confirm that eNOS is regularly expressed in the vasculature of PGA and PGH. CONCLUSION: eNOS observed in the vasculature of the enlarged parathyroid glands can serve as a factor that contributes to the viability of hypertrophic pathologic tissue. The lack of stimulating signals may be a reason for negative iNOS detection and negligible apoptotic rate.

Adenoma↗
PubMed2004

Thyroid surgery in children and adolescents.

Authors present 114 children and adolescents of the total 3865 patients that underwent surgery on the Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague, Department of Otorhinolaryngology of IPVZ, Prague because of a thyroid disease in years 1991-2000. The male/female ratio in the group was 1:6.5, 16 (13.9%) males and 99 (86.1%) females. For non-malignant disease, the male/female ratio was 1:6.5 and for malignant disease, it was 1:5.4. Thyroid surgery was indicated for non-malignant disease in 82 (71.9%) cases--11 males and 71 females. Most frequently it was indicated because of Graves-Basedow and Hashimoto toxicosis--in 39 children (34.2%), in 5 children (4.4%) for toxic adenoma. Because of the polynodular goiter surgery was indicated in 13 cases (11.4%), in 22 cases (19.3%) for mononodular goiter. Three girls (2.6%) were recommended for surgery because of Hashimoto thyreoiditis and for mechanic syndrome in diffuse goiter one girl (0.9%). Malignant tumor was found in 32 children (28.1%)--5 males and 27 females. Most frequent histological type was papillary cancer--in 25 cases (21.9%). Follicular cancer was diagnosed in four cases (3.5%) and medullar cancer in three cases (2.6%). TNM classification in children and adults is summarized in Table 1. Surgery was carried out in two children with distant metastases (lung localization). In both children the pre-disease stage lasted more than 12 months. The first manifestation of the disease was a finding of enlarged and palpable nodes on the neck. The authors summarize indications for surgery of thyroid diseases in children and adolescents. A treatment of the thyroid gland is a teamwork. Indication for surgery is carried out by a pediatric endocrinologist in cooperation with a surgeon specialized in thyroid surgery. The possible identification of the recurrent laryngeal nerve by a surgery microscope is an unquestionable advance. Children and adults should be centralized into health-care centers capable not only of surgery, but also of endocrinology care. In children with a malignant disease there is a need for cooperation with a pediatric oncologist and a following oncological treatment on a nuclear medicine department. The authors summarize the information about today's thyroid surgery care possibilities for children and adolescents. They point out the differences in indications and the decision about extent of surgery in children and adolescents.

Adenocarcinoma↗
PubMed2004

Serum levels of growth factors HGF (Hepatocyte Growth Factor), TGFbeta1 (transforming growth factor beta1) and IGF-I (Insulin Like Growth Factor I) in parathyroid tumors.

INTRODUCTION: HGF (Hepatocyte Growth Factor), TGFbeta1 (Transforming Growth Factor beta1) and IGF-I (Insulin Like Growth Factor I) are cytokines that are involved in the parathyroid tumors formation and growth. We tried to determine, if there are changes and relationships in the production of these cytokines by tumor cells of parathyroid tumors. MATERIAL AND METHODS: We determined concentrations of HGF, TGFbeta1 and IGF-I in serum from peripheral blood of 16 patients with parathyroid adenoma and of 8 patients with parathyroid secondary hyperplasia before and after parathyroidectomy. Results were compared with serum levels in healthy people. RESULTS: Both preoperative and postoperative HGF serum levels in patients with parathyroid adenoma and secondary hyperplasia are significantly higher than in healthy people. Preoperative and postoperative serum levels of TGFbeta1 in parathyroid adenoma and postoperative TGFb1 serum levels in parathyroid secondary hyperplasia are higher, compared with those in the healthy population and in parathyroid secondary hyperplasia preoperatively. There are no significant differences of IGF-I serum levels among the all investigated groups of patients. CONCLUSIONS: Changes in the growth factors production by parathyroid tumor cells are reflected by their concentrations in peripheral blood. The elevation of HGF serum levels in patients with parathyroid adenoma and hyperplasia can be explained by very high HGF production by tumor cells. Nevertheless, there is no decrease of HGF serum levels after the parathyroidectomy. That may be the result of the extratumoral production of this cytokine. Also TGFbeta1 and IGF-I serum levels indicate high possibility of the extratumoral production of these cytokines. Higher postoperative IGF-I serum levels (but not significantly) in parathyroid secondary hyperplasia are in accordance with its bone production.

Adenoma↗
PubMed2003

Thyroid abscess at an adolescent age.

We report a case of thyroid abscess in a 17-year-old girl. She was presented with swelling and pain in the region of the left thyroid lobe. The diagnosis was confirmed by ultrasonography and fine needle aspiration. After incision, evacuation of the pus and antibiotic treatment manifestations of disease disappeared. Barium swallow did not prove any hypopharyngeal fistula. The girl is now without any problems for 3 years. The patient had infectious mononucleosis 2 months prior development of the thyroid abscess. We contemplate that it may had changed the immunological state that facilitated this rare inflammation.

Abscess↗
PubMed2003

Serum levels of angiogenic growth factors in patients with thyroid gland tumors and parathyroid adenoma.

OBJECTIVE: Angiogenic growth factors bFGF and VEGF ensure vascularisation of the growing tumor tissue. We decided to investigate their peripheral serum concentrations in patients with thyroid gland adenoma and papillary carcinoma and with parathyroid adenoma. We wanted to find the possible serum marker of these tumor diseases. METHODS: 28 patients with thyroid gland tumor (14x adenoma, 14x papillary carcinoma) and 12 patients with parathyroid gland adenoma. Growth factors serum levels were measured by ELISA method. RESULTS: We found significantly higher serum levels of bFGF in both groups of patients with thyroid adenoma (4.93 +/- 3.42 ng/ml) and papillary carcinoma (5.69 +/- 5.58 ng/ml) compared to the healthy population (1.47 +/- 1.77 ng/ml). There were no significant differences of VEGF serum levels between all examined groups of patients (adenoma 213 +/- 197, papillary carcinoma 210 +/- 179, healthy 227 +/- 231 pg/ml). We found significantly higher serum levels of bFGF in patients with parathyroid gland adenoma (7.59 +/- 9.12 ng/ml) compared to those in healthy people (1.47 +/- 1.77 ng/ml). CONCLUSIONS: Higher bFGF serum concentrations in patients with thyroid and parathyroid tumors are in accordance with their immunohistochemical tissue levels described in the literature. Not so in VEGF. bFGF may be a serum marker of thyroid and parathyroid neoplasms.

Adenoma↗
PubMed2000

Hemangiosarcoma of the Thyroid Gland. A case report.

OBJECTIVES: The authors described a case of rare histological type of primary thyroid tumor-angiosarcoma. Angiosarcoma generally represents a rare connective tissue tumor in the head and neck region. Its biological behavior is locally aggressive and destructive with a high recurrence rate. METHODS: A case of a rare histological type of primary thyroid tumor -angiosarcoma-has been described including fine needle aspiration biopsy, histology, and autopsy. RESULTS: Irrespective of the complex approach the angiosarcoma of the patient referred to was diagnosed in a radically inoperative stage of the disease. Radiation was therefore applied after the tumor mass was diminished with the partial thyroidectomy and a correct histopathological diagnosis was rendered. Nevertheless, the locally destructive course was followed with a rather rapid spread of the tumor (lymph nodes, bones, lungs, and brain). Autopsy proved with certainty that the thyroid was the primary tumor location. A suspected kidney origin due to an uncertain sonography shadow of this region was excluded with a complete absence of any neoplastic spread of the angiosarcoma in the abdominal cavity at all.

Journal Article↗
PubMedDate not supplied

Coincidence of thyroid tumor and thyroglossal duct remnants. Review of the literature and presentation of three cases.

AIMS AND BACKGROUND: The coincidence of benign or malignant thyroid tumors with thyroglossal duct remnant (TDR) cysts is rare. Although the precise etiology is still unclear, thyroid origin and spread from a primary site have been suggested and this obviously has important implications for the therapeutic approach. Three cases of thyroglossal duct carcinoma are presented and its management is discussed on the basis of the current rationale for treatment of thyroid cancer. The indication for surgery depends on positive findings in the thyroid gland (nodules, FNAB). The aim of this study was to review our experience in the management of papillary thyroid diseases associated with TDR. MATERIALS AND METHODS: The records of three patients with thyroid tumors associated with TDR treated at the Department of ENT and Head and Neck Surgery of the First Medical Faculty UK of Prague between January 1991 and January 2001 were analyzed. We searched for risk factors of thyroid carcinoma: history of ionizing radiation, history of thyroid diseases, age, tumor size, tumor spread and histopathological factors. RESULTS: We used a triple approach consisting of clinical and ultrasound examination and fine-needle aspiration biopsy for preoperative assessment. Our diagnostic and therapeutic procedures included TDR excision (Sistrunk or Schlange procedure) and total thyroidectomy. Although the therapeutic approach could be a matter of discussion, most patients agreed with our suggestion of relatively radical but non-mutilating treatment. Postoperative radiation or radioiodine ablation is considered in cases of TDR carcinoma or thyroid carcinoma associated with TDR. Oncological follow-up included clinical and ultrasound examination three times during the first year, twice in the second year, and once yearly thereafter. Tumor marker evaluation and/or scintigraphy were performed 6, 12 and/or 24 months following surgery.

Adult↗