Even though thyroid carcinoma has, in general, a good prognosis and low mortality rate, its incidence, especially the incidence of early forms of the disease has been growing.Retrospective analysis of the file of surgeries of documented thyroid carcinoma within the years of 2006-2015.Thyroid carcinoma was recorded in 145 of 1820 patients operated for thyreopathy (8%); microcarcinoma (<10mm) was recorded in 64 cases (44.1%). The carcinoma was mostly detected accidentally during total thyroidectomy, which was in 70 cases (48.3%). The carcinoma was expected in 35 cases (24.1%) on the basis of prior puncture and total thyroidectomy was carried out straight away. Perioperative histology after hemithyroidectomy was requested in 31 cases (21.4%), and it was found positive only in 13 cases; thyroidectomy was finished in the second period in the other cases. Due to advanced carcinoma, tumour exploration/debulking was performed in 3 cases (2.1%) - for anaplastic carcinoma in all these cases. A permanent unilateral lesion - n. laryngeus recurrens - occurred in 3 cases (2.1%); a permanent bilateral lesion was recorded twice (1.4%).The most frequently manifested carcinoma was the papillary carcinoma in 114 patients (78.6%; 83 women/31 men; age of 1284 years; mean age of 50.6), the second most frequent carcinoma was the follicular carcinoma in 16 patients (11.0%; 15/1; 1969; 55.3), followed by the medullary carcinoma in 10 patients (6.9%; 6/4; 2576; 58.1). Anaplastic carcinoma was detected only in 4 cases (2.8%; 2/2; 6487; 75.5), and lymphoma of the thyroid gland occurred twice as well as Hürtle cell carcinoma.Thyroid carcinoma is mostly found accidentally during surgery in the early phase of the disease. This proves the high quality of endocrinology care and the correctness of the tendency to indicate early surgical treatment of thyroidal pathology.Key words: thyroid carcinoma - thyroidectomy complications.
Die Diskussion um eine monetäre Integration in Ost-/Südostasien erscheint zunächst nur als ein Gedankenexperiment. Sowohl ausgehend von den politischen Präferenzen als auch von der kürzlich erst gestarteten Integrationsform der Freihandelzone ist diese, nach dem Stufenmodell603, hohe Integrationsstufe in absehbarer Zeit eher unwahrscheinlich. Dennoch wurde speziell im Zuge der Asienkrise auch die politische Vision einer verstärkten monetären Kooperation und Integration diskutiert. Dieses Kapitel wird daher die bisherige Diskussion dieser Arbeit mit einem Überblick über Ansatzpunkte eines monetären Regionalismus komplettieren.
In Teil II dieser Arbeit wurden verschiedene Erklärungsansätze für die Bewertung regionaler Integrationsabkommen herausgearbeitet. Ausgehend von der Erkenntnis, dass Freihandel wie auch Protektionismus Vorteile besitzen (Taylor 2002, 16), kann folgende zentrale These formuliert werden: Die regionale Integration kann, entgegen der herrschenden Einschätzung einer zweitbesten Lösung, unter den unvollkommenen Umständen der Realität erste Wahl sein.
Diese Arbeit beschäftigt sich mit der ökonomischen Integration in Südostasien. Zehn der elf Länder dieser Region bilden zusammen die Association of South East Asian Nations,ASEAN'.1 Diese Entwicklungs-/Schwellenländerregion gehört zu den weltweit stärksten Wirtschaftswachstumszentren der letzten drei Jahrzehnte.2
Aim: The aim of this study was to evaluate the utility of selected tumor markers for the detection of lung cancer recurrence during follow-up. Patients and Methods: The study group consisted of 109 patients and 109 healthy controls. The following biomarkers were selected: Carcinoembryonic antigen; cytokeratin fragment 19; neuron-specific enolase; tissue polypeptide-specific antigen; cytokeratin fragments 8, 18 and 19; insulin-like growth factor 1; pro-gastrin-releasing peptide; and 25-hydroxyvitamin D. The biomarkers were assessed individually or using a multivariate analysis. Results: Carcinoembryonic antigen [area under the receiver operating characteristics curve (AUC)=0.6857, p<0.0001] and cytokeratin fragment 19 (AUC=0.6882, p<0.0001) proved best in detecting relapse. The multivariate model indicated insulin-like growth factor 1 (p=0.0006, AUC=0.6225) as the third most useful biomarker. The multivariate model using these three markers achieved the best AUC value of 0.7730 (p=0.0050). Conclusion: We demonstrated that carcinoembryonic antigen and cytokeratin fragment 19 play a key role in the detection of lung cancer recurrence. A multivariate approach can increase the effectiveness of detection.
Steatohepatitis is a type of histopathological liver injury that can be caused by chemotherapy [chemotherapy-associated steatohepatitis (CASH)] and can progress to liver fibrosis or cirrhosis. CASH impairs liver functions, including liver regeneration. Impaired liver regeneration reduces the number of patients who can undergo liver resection and reduces opportunities for curative therapies. Transforming growth factor-beta (TGFβ) is a potent mitotic inhibitor that participates during the last phase of liver regeneration. TGFβ has been studied as a potential solution to the development of liver fibrosis or hepatocellular carcinoma.The first aim of our study was to establish a large animal model of toxic liver injury and test the ability of a monoclonal antibody against TGFβ (MAB-TGFβ) to increase liver-regeneration capacity. The second aim was to evaluate the degree to which early preoperative administration of MAB-TGFβ influenced hepatic parenchyma regeneration following healthy liver resection in a swine experimental model.Toxic liver injury was induced by alcohol consumption and regular intraperitoneal administration of carbon tetrachloride (CCl4) to piglets for 10 weeks. After 10 weeks, the piglets underwent liver resection of the left lateral and left medial liver lobes. Twenty-four hours after liver resection, MAB-TGFβ was administered to the experimental group (10 piglets) and a physiological solution to the control group (10 piglets) through an implemented port-a-cath. In the second part of the study, either MAB-TGFβ or a saline solution control were administered at 12 and 4 days prior to resection of the right lobes of healthy liver (six experimental and 10 control group subjects). Observation and follow-up was performed throughout the entire experiment. Ultrasound and biochemical tests (for albumin, cholinesterase, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, bilirubin, urea, creatinine and ammonia levels) were performed on postoperative days 1, 3, 7, 10 and 14. A histopathological examination was performed after sacrificing the animals on the 14th postoperative day.No significant differences were observed between groups when using ultrasound volumetry to assess the regenerative volume of the liver in both experiments. The only significant differences found when comparing biochemical parameters between groups were higher serum levels of both creatinine and γ-glutamyl transferase in the experimental group with preoperative administration of MAB-TGFβ. There were no differences in the histological analyses of hepatic lobule cross-sectional area nor in the proliferative index between animals receiving MAB-TGFβ and those treated with physiological saline solution before resection. Hepatocytic cross-sectional areas were larger in animals treated with physiological solution versus those treated with MAB-TGFβ on the operative day; however, these values were comparable between groups by 14 days following resection.We established a large animal model of toxic liver injury that is comparable with CASH. The toxic injury that was induced without pause between administrations was probably more extensive than occurs in CASH, and there was no effect of MAB-TGFβ administration on liver regeneration. MAB-TGFβ administration did not lead to any observable side-effects, indicating that it could be a promising solution for use as an oncologic-targeted treatment.
Beim Begriff der Region sind zwei Fälle zu unterscheiden. Eine homogene Region oder Strukturregion liegt vor, wenn räumliche Beobachtungseinheiten, z.B. Länder, ein oder mehrere sachliche Merkmale gemein haben. Demgegenüber sind bei einer funktionalen Region oder Nodalregion die Beobachtungseinheiten durch ein oder mehrere Bewegungsphänomene, z.B. Informations- oder Investitionsströme, zu einem funktional organisierten Ganzen verbunden, das in einem prozessualen Kontext eine Einheit bildet.3 Diese Arbeit argumentiert, dass die südostasiatische Region nicht im Lichte des üblichen ersten, sondern des zweiten Aspekts betrachtet werden muss.
Die südostasiatischen Länder gehören, mit Ausnahme des NIC Singapurs, zu den Entwicklungsländern. Da mit der AFTA,nur’ eine Freihandelszone gründet wurde und die ASEAN keine tiefere Integrationsstufe anvisiert, behandelt dieses Kapitel zunächst die beiden The-menbereiche Freihandelszonen’ und,Integration unter Entwicklungsländern’. Dabei wird nachgezeichnet, warum — entgegen dem theoretischen Ideal des unilateralen Freihandels — die regionale Integration unter Entwicklungsgesichtspunkten Sinn machen kann.127