Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe.

Papillary thyroid carcinoma (PTC) frequently metastasizes to the regional lymph nodes and, thus, guidelines edited by Japan Association of Endocrine Surgeons/Japanese Society of Thyroid Surgery routinely recommend central node dissection even for patients with no clinically detectable node metastasis (N0). However, in the central compartment, metastasis to the right paraesophageal node has not been intensively investigated. We investigated the incidence and predictors of right paraesophageal node metastasis based on pre- and intraoperative findings in 922 patients with N0 PTC in the right lobe.

Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report.

Background: Thyroid hemiagenesis is a rare anomaly, more commonly seen on the left side (ratio 4:1) and in females (ratio 3:1). The first to describe this anomaly was Handfield Jones in 1852.

Case Presentation: We present a 66 year old female patient with right thyroid hemiagenesis, parathyroid adenoma on the side of hemiagenesis and parathyroid hyperplasia on the contralateral side.

Evaluation of cytologically benign solitary thyroid nodules by ultrasonography: a retrospective analysis of 1877 cases.

Objective: The purpose of this study is to evaluate the role of ultrasonography (US) in the management of thyroid nodules when the cytology is benign tumor on fine needle aspiration biopsy (FNAB).

Methods: Between 2006 and 2011, we investigated 13,972 patients who had solitary thyroid nodule with cytological findings of benign. Surgery was performed according to our criteria for surgical indication.

Prognostic indicators in 35 patients with extramammary Paget's disease.

Background: Extramammary Paget's disease (EMPD) is an uncommon skin tumor that usually occurs in the genital area. Few studies on EMPD have been conducted.

Objective: To evaluate the clinical and pathologic features, treatments, recurrence, survival rates, and prognostic factors of EMPD.

Tumor size is the strongest predictor of microscopic lymph node metastasis and lymph node recurrence of N0 papillary thyroid carcinoma.

It is well-known that papillary thyroid carcinoma (PTC) frequently metastasizes to the regional (central and lateral) lymph nodes, even though it is diagnosed as node-negative on preoperative imaging studies. In this study, we investigated predictors of microscopic node metastasis and lymph node recurrence of PTC without node metastasis detected preoperatively (N0). Of the clinicopathological features that can be evaluated pre- and intraoperatively, tumor size (> 2 cm) was the strongest predictor of microscopic central and lateral node metastasis on multivariate logistic analysis.

Radioactive iodine-refractory differentiated thyroid cancer: unmet needs and future directions.

Approximately 90% of thyroid cancers are differentiated (DTCs) and have papillary, follicular or Hürthle cell morphology. Although treatment with surgery and radioactive iodine (I-131; RAI), as appropriate, is associated with significant cure rates and survival benefits, clonal disease progression with development of refractoriness to RAI poses a major therapeutic challenge in about 15% of patients. Traditional chemotherapeutic agents are relatively ineffective and are associated with significant toxicities.

Endoscopic management of pancreatic duct injury by endoscopic stent placement: a case report and literature review.

Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase.

Improvement of lymph node recurrence rate, but not distant recurrence and carcinoma death rates, in patients with papillary thyroid carcinoma after disease-free survival for 5 years.

In this study, we investigated the difference in lymph node-recurrence free survival (LN-RFS), distant recurrence-free survival (DRFS), and cause-specific survival (CSS) between patients with papillary thyroid carcinoma (PTC) in the entire group (Group I) and those with lymph node- and distant-recurrence-free survival (DFS) for 5 years after initial surgery (Group II). The LN-RFS of patients with all risk classifications in Group II was significantly better than that of those in Group I. The LN-RFS of intermediate-risk patients in Group II did not differ from that of low-risk patients in Group I, but LN-RFS of high-risk patients in Group II was significantly poorer than intermediate- and low-risk patients in Group I.

The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery.

Background: The right recurrent laryngeal nerve (RLN) is more difficult to identify than the left RLN. The superior, lateral and inferior approaches are currently used to identify the RLN. This report presents a new technique, called the ima approach (the most inferior approach) for the quick identification of the right RLN.

TSH-suppressive doses of levothyroxine are required to achieve preoperative native serum triiodothyronine levels in patients who have undergone total thyroidectomy.

Objective: Thyroidal production of triiodothyronine (T(3)) is absent in patients who have undergone total thyroidectomy. Therefore, relative T(3) deficiency may occur during postoperative levothyroxine (L-T(4)) therapy. The objective of this study was to evaluate how the individual serum T(3) level changes between preoperative native thyroid function and postoperative L-T(4) therapy.

Clinical trial of weekly paclitaxel chemotherapy for papillary thyroid carcinoma with squamous cell carcinoma component.

Papillary thyroid carcinoma (PC) can occasionally include a squamous cell carcinoma (SCC) component. In this study, we evaluated the effect of weekly paclitaxel chemotherapy in 3 patients with PC including an SCC component. None of these patients had lesions of anaplastic carcinoma on pathological examination.

Prognostic value of poorly differentiated carcinoma in Japanese Society of Thyroid Surgery in a series of papillary thyroid carcinoma patients: comparison with risk classification system in Kuma Hospital.

Papillary thyroid carcinoma (PTC) often has poorly differentiated components, and it is discriminated from others and classified as an independent entity in the General Rules for the Description of Thyroid Cancer by Japanese Society of Thyroid Surgery (JSTS). In this study, we compared the prognostic significance between this type of poorly differentiated carcinoma (PDC-JSTS) and our risk classification system based on pre- and intraoperative findings in a series of PTC patients. The 10-year lymph node- and distant organ recurrence-free survival (LN-DFS and DRFS) and cause-specific survival (CSS) of high-risk patients were much poorer than in PDC-JSTS patients.

The regulatory roles of apoptosis-inducing factor in the formation and regression processes of ocular neovascularization.

The role of apoptosis in the formation and regression of neovascularization is largely hypothesized, although the detailed mechanism remains unclear. Inflammatory cells and endothelial cells both participate and interact during neovascularization. During the early stage, these cells may migrate into an angiogenic site and form a pro-angiogenic microenvironment.

The impact of obesity on perioperative outcomes of pancreaticoduodenectomy.

Background/aims: The purpose of this study was to evaluate the impact of obesity on pancreaticoduodenectomy (PD) outcomes.

Methodology: Subjects were 97 patients undergoing PD at our institution between April 2005 and April 2011. All patients had data including body mass index (BMI).

Strategies to prevent pancreatic fistula after pancreaticoduodenectomy.

Background/aims: We evaluated the prevention of pancreatic fistula after pancreaticoduodenectomy in a retrospective clinical study.

Methodology: Eighty patients undergoing pancreaticoduodenectomy between April 2007 and August 2011 were recruited.In all patients, the pancreas was reconstructed first,followed by reconstruction of the hepatic duct and the duodenum or stomach.

Prognosis and prognostic factors of papillary thyroid carcinoma in patients under 20 years.

Age is an important prognostic factor of papillary thyroid carcinoma (PTC). In this study, we investigated the prognosis and prognostic factors of PTC in patients younger than 20 years. We enrolled 110 patients who underwent initial surgery at Kuma Hospital between 1987 and 2008.

Investigation of the prognosis of patients with papillary thyroid carcinoma by tumor size.

In papillary thyroid carcinoma (PTC), extrathyroid extension (Ex) and clinical lymph node metastasis (N) significantly affect the prognosis. We investigated the prognosis of patients with PTC 1 cm or less (1,220 patients), 1.1-2 cm (2,101 patients), 2.

Frequency and risk factors for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy.

Purpose: To investigate the rate and risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR).

Methods: Five hundred and twelve patients (512 eyes) with PDR who underwent vitrectomy between January 1, 2003 and June 30, 2009 at Kumamoto University Hospital, Japan, were retrospectively evaluated. Postoperative NVG was defined as neovascularization in the anterior segment and intraocular pressure (IOP) ≥ 22 mm Hg after vitrectomy.

Clinicopathological feature of extrahepatic cholangiocarcinoma without jaundice: a single-center experience.

Background/aims: The prognosis remains unsatisfactory even if the patient undergoes extensive surgery, which is the only curative treatment for these tumors. Therefore, early detection and diagnosis are needed to improve long-term survival. To investigate the clinicopathological feature of extrahepatic cholangiocarcinoma in patients presenting without jaundice compared with the features of tumors in patients presenting with jaundice.

Laryngeal approach to the recurrent laryngeal nerve involved by thyroid cancer at the ligament of Berry.

Background: Thyroid cancer often involves the RLN at the ligament of Berry, which makes preservation of the nerve difficult. If the portion of RLN is resected, finding the peripheral RLN for reconstruction is difficult. Here we describe a laryngeal approach performed before dissecting the RLN to overcome these problems.

Validity of 6(th) edition of UICC TNM classification system for medullary thyroid carcinoma: a proposal for intraoperative evaluation of T category.

Medullary thyroid carcinoma (MTC) accounts for 1.4% of all thyroid malignancies in Japan. Here, we studied the validity of a staging system evaluated preoperatively (Stage), intraoperatively (intra-Stage), and pathologically (pStage) based on the 6(th) and 7(th) UICC TNM classifications.

Relationship between prognosis of papillary thyroid carcinoma patient and age: a retrospective single-institution study.

Age is an important prognostic factor in papillary thyroid carcinoma (PTC). In this study, we investigated the difference in prognosis of 7 subsets of PTC patients without distant metastasis at presentation or a history of radiation exposure (20 years or younger, 21-30 years, 31-40 years, 41-50 years, 51-60 years, 61-70 years, and older than 70 years). The lymph node recurrence rate was high in patients 20 years or younger and those older than 60 years.

Microflora profiling of infected root canal before and after treatment using culture-independent methods.

This study aimed to profile the microflora in infected root canals before and after root canal treatment using culture-independent methods. Six infected root canals in single-rooted teeth with periapical lesions from five subjects were included. Quantification of total bacteria was performed by real-time PCR with primers targeting 16S rRNA genes.