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Biomedical subjects

K Kasagi

Publications and source records attributed to K Kasagi.

At least 19 recordsLinked to original sources
PubMed1992

Recruitment of T lymphocytes and induction of tumor necrosis factor in thyroid cancer by a local immunotherapy.

To elucidate the mechanism of action for intratumoral injection of immunopotentiators, infiltrating mononuclear cells and tumor necrosis factor (TNF) were assayed by immunostaining tissue samples of differentiated thyroid cancer resected with or without presurgical local application of OK-432, a streptococcal preparation. Frozen sections of resected specimens were stained with monoclonal antibodies using either a conventional or a modified immunoperoxidase method. The tumors injected with OK-432 showed increased T lymphocyte infiltration and HLA-DR expression on cancer cells as compared to the non-injected controls. Among these T cells, the CD4+ subset was more numerous than the CD8+ population. In four out of the seven cases constituting the injected group, numerous TNF-positive cells were seen in clusters or lines as well as scattered, while none of the seven cases in the control group was associated with a considerable amount of these cells. In their morphology and distribution pattern, these TNF-positive cells appeared to be of macrophage lineage. Thus local injection of OK-432 in thyroid cancer was shown to recruit T lymphocytes of predominantly the CD4+ subset and to induce in situ production of TNF, a known potent tumoricidal cytokine. The present data warrant further studies in this direction besides wider clinical intratumoral application of the reagent.

Adult↗
PubMed1992

Transient thyrotoxicosis in a patient with a functioning nodule; a possible occurrence of silent thyroiditis.

A 48-year-old woman with diffuse goiter presented with typical symptoms and signs of thyrotoxicosis. Thyroid scanning with I-123 revealed a localized accumulation of the radionuclide in the left lobe which corresponded to a small nodule later detected by ultrasonography, with suppression of the remaining tissues. Owing to the overall reduced radioactivity in the thyroid, she was suspected of having silent thyroiditis causing thyrotoxicosis. Meanwhile, the thyrotoxicosis subsided concurrently with an increase in radioactivity in the extranodular area that had initially been suppressed. The histology of thyroid tissues obtained at the time of operation revealed follicular adenoma or hyperplasia in the area of the localized I-123 uptake and findings similar to those in Hashimoto's thyroiditis in the remaining tissues, supporting our clinical diagnosis of silent thyroiditis together with a functioning nodule.

Female↗
PubMed1992

Undifferentiated carcinoma of the thyroid gland: sonographic findings.

We report high resolution sonographic (7.5 MHz) findings in four cases of undifferentiated carcinoma of the thyroid gland. Sonographic findings in these four cases included poorly marginated, hypoechoic masses associated with calcifications, and invasion of adjacent cervical structures. A knowledge of the sonographic features of undifferentiated carcinoma of the thyroid gland is of clinical importance, since the tumour has a grave prognosis, quite different from the relatively favourable prognosis of well differentiated thyroid carcinoma.

Adult↗
PubMed1992

Dual-site thyroid ectopy in a mother and son.

We found familial thyroid ectopy in a mother and son, each of whom had an anterior neck mass corresponding to a perihyoid ectopic thyroid. In addition, technetium scintigraphy revealed another focus of aberrant uptake at their tongue roots. Neither patient showed hypothyroid symptoms or abnormal biochemical data other than a mildly elevated TSH level in the son. No other member of the family had a thyroid disorder. To our knowledge this is the first documented instance of familial thyroid ectopy in multiple sites. The observed similarity in distribution of ectopic tissue suggests a hereditary pathogenic factor.

Adult↗
PubMed1992

Ga-67 citrate accumulation in adenomatous goiter.

An elderly woman with a diffusely enlarged goiter and multiple miliary nodular lesions on chest x-ray showed Ga-67 accumulation in the right thyroid lobe. Histologic findings obtained after total thyroidectomy and open lung biopsy revealed papillary carcinoma in the left lobe with pulmonary metastases and adenomatous nodules in the right lobe. This is the first report of Ga-67 accumulation in adenomatous goiter.

Adenoma↗
PubMed1991

[Results of radioiodine therapy in 47 patients with distant metastases of differentiated thyroid carcinoma].

In the last ten years, 47 patients with distant metastases of differentiated thyroid carcinoma have been treated with 131I following total thyroidectomy. Post-therapy whole body 131I scans revealed detectable uptake in the metastatic lesions in 23 (62%) of 37 patients with lung metastases, 10 (67%) of 15 patients with bone metastases five (71%) of seven patients with mediastinal metastases, and neither of two patients with brain metastases. The concentration of 131I in the metastases was significantly correlated with serum T3 and T4 concentrations, and inversely correlated with serum TSH concentrations. Most of the patients with a strong positive scan were euthyroid, suggesting that thyroid hormones produced by the tumor compensated for hypothyroidism following total thyroidectomy. There was no significant relationship between serum thyroglobulin concentration during T4 replacement therapy and 131I uptake or the efficacy of therapy. Twenty patients with lung (54%), five with bone (33%), two with mediastinal (29%), and none with brain metastases showed tumor regression after treatment. Significantly increased 131I uptake in lung metastases, better therapeutic results and better prognosis were demonstrated in young patients. In conclusion, age, 131I whole body scanning and serum thyroid hormone concentrations are considered to be useful in predicting the efficacy of 131I treatment for distant metastases, especially in the lung.

Adenocarcinoma↗
PubMed1991

Heterogeneity of thyrotropin binding inhibitor immunoglobulins in serum from untreated patients with hyperthyroid Graves' disease.

We have previously established an assay for the simultaneous assessment of thyrotropin (TSH) binding inhibitor immunoglobulin (TBII) and thyroid stimulating autoantibody activities in cultured rat thyroid cells (FRTL-5 cell), and found a discrepancy in some patients with untreated Graves' disease between the activities of TBII measured in FRTL-5 cells (TBII-rc) and in solubilized thyroid membranes (TBII-pm). In three selected patients with untreated Graves' disease, the different dose-response relationship between TBII-rc and TBII-pm clearly indicated the heterogeneous populations of TBII-pm in patients' sera, with different binding affinities for TSH receptor in intact cells.

Animals↗
PubMed1991

Cystic papillary carcinoma of the thyroid gland: a new sonographic sign.

Cystic thyroid lesions are generally considered to be benign and managed by repeated aspiration and/or biopsy. We report characteristic sonographic signs in eight cases of cystic papillary carcinomas of the thyroid gland. In all eight cases, ultrasonography (US) revealed mostly cystic lesions with solid excrescences protruding into the cyst. These nodules contained multiple punctate echogenic foci suggesting calcification. In three of these cases the initial fine needle aspiration biopsy was negative. The 'calcified nodule in cyst' sign was found to be very specific for cystic thyroid carcinoma in a review of the ultrasound findings in 115 patients with nodular thyroid lesions. Careful evaluation and/or surgery should be recommended in patients who have such characteristic sonographic findings even if the fine needle aspiration result is negative.

Adult↗
PubMed1991

Induction of c-fos and c-myc mRNA expression by immunoglobulin G from patients with Graves' disease in thyrotrophin-dependent rat thyroid cell line (FRTL5).

The present study was conducted to evaluate effects of autoantibodies in patients with Graves' disease on induction of c-fos and c-myc mRNA expression in rat thyroid cell line (FRTL5). IgG fractions were isolated from 11 patients with Graves' disease, and six healthy subjects, with protein A-Sepharose. FRTL5 cells which had been grown to subconfluency and deprived of TSH for a week were exposed to the IgG for an hour. Expression of c-fos and c-myc mRNAs was examined by the Northern blot method using nick-translated v-fos and c-myc probes. C-fos and c-myc transcripts were induced by IgGs from two patients with Graves' disease, which displayed much higher activities in assays for TSH binding inhibitor immunoglobulins, thyroid stimulating antibodies and thyroid growth-stimulating immunoglobulins, assessed by measuring inhibition of 125I-TSH binding to the TSH-receptor, cAMP production and 3H-thymidine incorporation in FRTL5 cells, respectively, compared with those in the remaining patients. The induction of c-fos and c-myc mRNAs by IgG from a patient with Graves' disease was suppressed by preincubation with IgGs from two patients with primary myxoedema who were known to have a blocking type TSH-receptor antibody. These data suggest that the binding of the antibodies to the TSH-receptor followed by cAMP production is related to the induction of c-fos and c-myc mRNAs and, thus, to the growth of FRTL5 cells. To our knowledge, this is the first report demonstrating that autoantibodies induce proto-oncogene mRNA expression.

Adolescent↗
PubMed1991

Lymphoproliferative disorders of the thyroid gland: radiological appearances.

Images of lymphoproliferative disorders of the thyroid by ultrasonography (US), computed tomography (CT), 99Tcm and 67Ga scintigraphy were analysed in eight patients (two men and six women, aged 42-83 years). Seven patients were diagnosed as having primary lymphoma and one plasmacytoma. Ultrasound revealed a solid mass with homogeneous and very low echogenicity clearly distinguishable from residual thyroid tissue in five patients, diffuse hypoechoic goitre in one and multiple irregular hypoechoic nodules in both lobes in the patient with plasmacytoma (Case 8). Computed tomography demonstrated a focal low-density area in six cases of lymphoma and decreased density throughout the gland in the other two patients. 99Tcm scintigraphy showed hemilobar enlargement with decreased and uneven trapping, cold area or complete lobar defect in six patients with lymphoma and no trapping in the case of plasmacytoma. 67Ga scintigraphy demonstrated high accumulation in lymphoma and faint accumulation in the case of plasmacytoma. Radiological manifestations with a focal lesion were considered typical and diagnostic of primary thyroid lymphoma, while in one case with diffuse infiltration through the whole gland, the differential diagnosis from Hashimoto's thyroiditis could not be made. In the final case, cells infiltrated diffusely to form islands with patchy distribution among well preserved follicles, correlating with the multiple hypoechoic areas observed by US.

Adult↗
PubMed1991

[Prediction of remission in Graves' disease after thionamide therapy by technetium-99m early uptake].

In the clinical management of Graves' thyrotoxicosis, one of the most important subject is when to stop antithyroid drugs after achieving an euthyroid state. T3 suppression test and other methods have been used to forecast the outcome after drug cessation, but the results were not always satisfactory. We have attempted to predict remission of Graves' disease by single measurement of early technetium uptake without administration of triiodothyronine. Drugs were discontinued in the seventy-five patients with Graves' disease on maintenance doses of either methimazole or propylthiouracil who showed normalized uptake (4.0% or less). Of 64 patients evaluable after twelve months, 55 (86%) remained euthyroid, 8 relapsed, and 1 became hypothyroid. With its accuracy in prediction of short-term remission comparable or superior to T3 suppression test, this rapid and simple method seemed suitable for routine use in clinical practice.

Adult↗
PubMed1991

Follow-up study of postoperative patients with thyroid cancer by thallium-201 scintigraphy and serum thyroglobulin measurement.

The utility of 201TI scintigraphy and thyroglobulin measurement in the follow-up observation of postoperative patients with thyroid cancer was evaluated. Thallium-201 scintigraphy was performed in 149 postoperative patients with thyroid cancer. Serum thyroglobulin concentration was concomitantly evaluated in 86 patients. Among 55 patients with positive 201TI scans, 51 patients (92.7%) had recurrent diseases, while 80 of 94 patients (85.1%) with negative scans were free of disease. Twenty-five of 28 patients (89.3%) with elevated thyroglobulin levels were recurrent and 43 of 58 patients (74.1%) with normal thyroglobulin level had no recurrence nor metastasis. All 19 patients with positive 201TI scans and elevated thyroglobulin level had recurrent lesions. Seven of 10 patients with negative 201TI scans and elevated thyroglobulin level showed the presence of metastasis. By concomitant measurement of serum thyroglobulin, more than half of the recurrent patients with negative 201TI scintigraphy were detected. Both 201TI scintigraphy and serum thyroglobulin measurement should be undertaken in the follow-up evaluation of postoperative patients with thyroid cancer.

Adenocarcinoma, Papillary↗
PubMed1990

[Therapy of malignant pheochromocytoma using I-131 metaiodobenzylguanidine--report of a case].

A 67 year-old-female had multiple metastases to her lung, liver and paraaortic lymph nodes from a post-operative malignant pheochromocytoma. She was treated with 3.7 GBq (100 mCi) of I-131 metaiodobenzylguanidine (MIBG). Metastatic nodules in lung and liver almost disappeared and the secretion of catecholamines decreased than baseline rates. However, major but temporary untoward response, such as hypertension and hyperglycemia, was seen after the I-131 MIBG administration.

3-Iodobenzylguanidine↗
PubMed1990

Sonography of subacute thyroiditis: changes in the findings during the course of the disease.

Fifteen patients with subacute thyroiditis were studied with thyroid sonography. There were local hypoechoic areas in all patients during the active phase of the disease. Among 6 patients who underwent follow-up studies during the course of treatment, 3 had recurrence or aggravation of clinical symptoms such as painful swelling of the thyroid region, which was associated with, and sometimes preceded by, spread or reappearance of the sonographic abnormality. All 6 patients showed complete disappearance of the hypoechoic area when they were in remission. The thyroid sonography is useful not only for the initial diagnosis but also for the follow-up of these patients during the course of the disease.

Adult↗