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Approximately 90% of thyroid cancers are differentiated thyroid cancers (DTCs), originating from follicular epithelial cells. Out of these, 90% are papillary thyroid cancer (PTC), and 10% are follicular thyroid cancer (FTC). The standard care procedure for PTC includes surgery, followed by radioiodine (RAI) ablation and thyroid-stimulating hormone (TSH) suppressive therapy. Globally, treating radioiodine-refractory DTC poses a challenge. During malignant transformation, thyroid epithelial cells often lose their ability to absorb radioiodine due to impaired membrane targeting or lack of NIS (sodium/iodide symporter) expression. Recent reports show an increase in PD-L1 (programmed death ligand 1) expression in thyroid cancer cells during dedifferentiation. However, no research exists wherein NIS and PD-L1 expression are analyzed together in thyroid cancer. Therefore, we aimed to investigate and correlate PD-L1 and NIS expression within primary tumor samples of lymph node metastatic PTC. We analyzed the expression of hNIS (human sodium/iodide symporter) and PD-L1 in primary tumor samples from metastatic PTC patients using immunohistochemistry. Immunohistochemistry analysis of PD-L1 and NIS was conducted in 89 and 86 PTC cases, respectively. Any subcellular NIS localization was counted as a positive result. PD-L1 expression was absent in 25 tumors, while 58 tumors displayed PD-L1 expression in 1–50% of their cells; in 6 tumors, over 50% of the cells tested positive for PD-L1. NIS immunohistochemistry was performed for 86 primary papillary carcinomas, with 51 out of 86 tumors showcasing NIS expression. Only in seven cases was NIS localized in the plasma membrane; in most tumors, NIS was primarily found in the intracytoplasmic membrane compartments. In the case of PD-L1 staining, cells showing linear membrane positivity of any intensity were counted as positive. The evaluation of NIS immunostaining was simpler: cells showing staining of any intensity of cytoplasmic or membranous fashion were counted as positive. The number of NIS positive cells can be further divided into cytoplasmic and membrane positive compartments. There was no observed correlation between PD-L1 and NIS expression. We can speculate that the manipulation of the PD-1/PD-L1 axis using anti-PD-L1 or anti-PD-1 antibodies could reinstate the functional expression of NIS. However, based on our study, the only conclusion that can be drawn is that there is no correlation between the percentage of NIS- or PD-L1-expressing tumor cells in the primary tumor of lymph node metastatic PTC.

Positron annihilation lifetime and Doppler-broadening measurements were performed on n-dotriacontane (n-C32H66) and n-tritriacontane (n-C33H68) between 80 K and their melting points. The annihilation parameters plotted as a function of temperature show irregularities above the room temperature, which reflect solid–solid phase transitions in these materials. The transition temperatures derived from the positron annihilation measurements are in excellent agreement with literature values determined by other techniques. In the case of n-C32H66 additional phase transitions not reported previously in the literature were observed. The lifetime vs temperature curves could be reasonably well interpreted within the framework of the free volume model taking into account the effect of special types of molecular motions and structural defects. On the basis of our measurements, linear dependence of ortho-positronium (o-Ps) lifetime on the size of the cavity around o-Ps could be expected. The proposed empirical relationship proved to fit well to lifetime data for molecular crystals as a function of their molecular volume. The o-Ps yield showed an abrupt decrease with increasing temperature at 190 and 165 K in the case of n-C32H66 and n-C33H68, respectively. This effect was attributed to the onset of rotation of the methyl end groups of the paraffin chains. [ABSTRACT FROM AUTHOR]

The thymus derives from the third branchial pouch, which migrates to the mediastinum through the central region of the neck. During the migration, particles split off and develop separately. The prevalence of ectopic thymus is 20-40%. The purpose of this retrospective case series study was to investigate the prevalence of embryological tissue remnants in the central region, in patients treated for thyroid lesions. Between January 1 2018 and September 1 2020, 84 patients who underwent central neck dissection were selected. Clinicopathological data as age, gender, histopathological result and TNM stage were analyzed. Ectopic tissue in the central neck region was discovered in 28 cases. The prevalence of ectopic lesions showed increase in Stage I thyroid carcinomas. There was no significant correlation with patients' age, gender, or with the stage. We emphasize the clinicopathological role of ectopic tissues, which can occur in the central region of the neck.

A korai és lokálisan előrehaladott colontumorok esetében a megfelelő onkológiai minőségű sebészi resectio a kezelés központi eleme. Jobb oldali vastagbél tumorok sebészi ellátásában - a kedvezőbb hosszú távú onkológiai eredmények elérése céljából - egyre szélesebb körben elfogadott a Hohenberger által 2009-ben elsőként publikált "complett mesocolicus-excisio" (CME) és centrális érlekötés (CVL).Esetünkben egy 78 éves nőbeteg jobb alhasi faeculens váladékozása miatt indult kivizsgálása során a hasfalat szélesen infiltráló coecum tumor igazolódott. Az Onkoterápiás Bizottság - tekintettel az egyértelmű távoli áttét hiányára, a beteg jó általános állapotára, a fennálló colo-cutan sipolyra és egyértelmű irresecabilitási jelek hiányára - műtétet javasolt. A kuratív intenció és kellő radikalitás érdekében, komplett mesocolicus excisio és kiterjesztett hasfali resectio mellett döntöttünk. A műtét során a kialakult hasfali defektus rekonstrukciójához a jobb comb lateralis felszínéről tensor fasciae lateae musculocutan (TFL) lebenyt preparáltunk. A hasfali defektust, mind a fascia, mind a subcutis-cutis rétegében helyreállítottuk, a donor területet primeren zártuk. A posztoperatívumban a lebeny distalis végén vénás pangás jelei majd felületes necrosis mutatkozott. Sorozatos necrectomia és negatívnyomás-terápia (NPWT) mellett a hasfal végig intakt maradt és per secundam gyógyult.Megfelelő betegszelekció esetén, centrumokban elvégezve - onkosebész és helyreállító plasztikai sebész szoros együttműködésével - a radikális műtét kiterjesztett hasfali resectiót igénylő jobb colonfél tumoroknál is biztonsággal elvégezhető.

Primary squamous cell carcinoma (SCC) of the thyroid gland is now considered as a member of the anaplastic thyroid carcinoma group based on the latest version of the WHO tumor classification. It is a very rare entity, the prognosis is adverse with a short survival time. The aim of this article is to emphasize the therapeutic complexity of this disease. A 68-year-old woman presented with rapidly growing right-sided neck mass with hoarseness and compressive symptoms. Physical examination revealed a hard fixed tumor with right-sided vocal cord palsy. Fine-needle aspiration cytology revealed a case of SCC in the location of the thyroid gland, imaging studies excluded the possibility of other primary malignancies. Surgical intervention was performed aiming the total removal of the tumor. Histopathological result confirmed the diagnosis of SCC of the thyroid. Finally the patient died during the palliative radiation therapy. SCC of the thyroid gland is a great challenge for both the surgeon and the multidisciplinary team to come up with the best treatment option which is suitable for the patient due to its unfavorable prognosis. Because of the poor response to the radiation and chemotherapy, complete surgical removal and the identification of any possible targetable molecular pathological change play a unique role in the therapy. Orv Hetil. 2023; 164(39): 1556-1559.

Objective: The aim of this study was to investigate how polarized sodium iodide symporter (NIS) expression may regulate iodide metabolism in vivo ., Materials and Methods: Polarized NIS expression was analyzed in tissues that accumulate iodide by the use of immunohistochemistry and polyclonal antibody against the C-terminal end of human NIS (hNIS)., Results: Iodide absorption in the human intestine occurs via NIS expressed in the apical membrane. Iodide is secreted into the lumen of the stomach and salivary glands via NIS expressed in the basolateral membrane and then circulates back from the small intestine to the bloodstream via NIS expressed in the apical membrane., Conclusion: Polarized NIS expression in the human body regulates intestinal-bloodstream recirculation of iodide, perhaps prolonging the availability of iodide in the bloodstream. This leads to more efficient iodide trapping by the thyroid gland. Understanding the regulation and manipulating gastrointestinal iodide recirculation could increase radioiodine availability during theranostic NIS applications.

Introduction: The presence of a substernal goiter which compresses the adjacent structures is per se an indication for resection, mostly total thyreoidectomy should be performed either by a head and neck or general surgeon. In about 1-10% of the cases the goiter is located behind the sternum, and the removal requires different surgical technique., Materials and Methods: Authors operated 182 patients between 2000-2014 with substernal goiter which all reached the level of the jugulum. The 182 cases were examined retrospectively., Results: All the patients were symptomatic with choking and dyspnea. In 31 cases neck ultrasound were performed, in 7 cases neck MRI and in 138 cases neck-upper mediastinal CT scan were indicated to discover the real situation of the lobes. 15 patients had previous partial thyreoidectomy. Acervical approach was used in 175 cases, 7 patients required median sternotomy to complete the operation. Transient recurrent laryngeal nerve palsy occurred in 1 patient, permanent RLNP in 3. Nine lesions were malignant, 173 were benign., Conclusion: Choking and dyspnea are the most common symptoms of substernal goiter. CT scan is an important preoperative evaluation, while it helps not only to define the position of the thyroid lobes, but also put the right operating team together. Although most of the retrosternal goiters can be removed by a cervical approach, some of them need additional incisions. Hence, it is important to have a thoracic surgeon available. Reviewing the Hungarian literature the authors have not found any other study examining so many patients.

Purpose: This prospective, non-randomised follow-up study was designed to compare the health-related quality of life (HRQoL), perceived social support (PSS) and overall life satisfaction (OLS) in female patients receiving standard medical care for malignant diseases with or without additional belly dancing., Method: The patients were recruited in the Outpatient Department of the National Institute of Oncology, Budapest, Hungary during the period of 2008-2009. 55 patients joined the one-year-long rehabilitation program (research group, RG) while 59 age-matched patients who received only standard medical care volunteered for clinical assessment (control group, CG). HRQoL, PSS and OLS were assessed using validated questionnaires: EORTC QLQ-C30, F-SozU-K14, and Campbell's OLS, respectively. The scores obtained in RG and CG were controlled for baseline socio-demographic characteristics and evaluated by ANCOVA analysis., Results: It was found that patients of the RG scored better at both the baseline and follow-up than the CG, and the differences between the two groups' measured parameters increased further during the course of the study. The respective baseline values in RG and CG were 56.6 ± 10.3 vs 63.5 ± 12 for HRQoL, 65.2 ± 5.5 vs 57.4 ± 8.8 for PSS and 57.4 ± 8.1 vs 48.4 ± 10.7 for OLS. The corresponding follow-up scores were 51.9 ± 4.4 vs 59.9 ± 11.2 (F = 10.637, p = 0.001) for HRQoL, 67.5 ± 2.7 vs 53.9 ± 10.5 (F = 2.646, p = 0.000) for PSS and 59.5 ± 9.6 vs 45.0 ± 11.5 (F = 2.402, p = 0.001) for OLS., Conclusions: Belly dance intervention can be applied as a complementary rehabilitation method to improve HRQoL, PSS and OLS in female patients treated for malignant diseases., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In recent years, laparoscopic cholecystectomy (LC) has become the standard surgical practice for the treatment of cholecystolithiasis. As a recognized technical difficulty, it may be associated with the mechanical injury of the gallbladder and/or spilling some of the gallstones into the abdominal cavity. The actual incidence of the latter complication is ~10%. The removal of lost stones from the abdominal cavity is rather elaborate if not infeasible. There is little information about the behaviour of retained gallstones in the free abdominal cavity. Publications report on subsequent intraperitoneal abscesses and fistulas or on the extreme localization of the impacted gallstones. This paper presents two cases with late complications of the abandoned gallstones or gallbladder. Case 1: A 56-year-old female patient underwent an LC 7 years ago. She was recently admitted with a chronic septic condition and suspected autoimmune disease. Preoperative examinations indicated hepatic abscess. Surgery showed gallstones impacted in the gallbladder bed. Case 2: A 59-year-old male patient underwent an LC a year before his admission. His operation was followed by the development of a septic condition and a subphrenic abscess was identified. During his reoperation, a remnant gallbladder containing bile stones was found and removed. Special attention should be paid to careful revision of residual stones during LC.

Introduction: Complications caused by lost gallstones within the abdominal cavity are well known. Abscesses, perforation of the gastro-intestinal tract were all described in the literature, but gallstones were found in hernial sac, or even in sputum after it penetrated through the diaphragm into the respiratory tract. These complications can develop between several weeks to several years postoperatively. Most complications can be treated surgically only., Materials and Methods: Fifty gallstones and bile samples were collected from 50 patients who underwent cholecystectomy (36 female / 14 male, avarge age: 60.8 ± 6.8 years). All samples were sent for microbiological examination., Results: bacterial colonization of the gallstone and the bile were found in 16 cases. Four of them showed acute inflammation in the gallbladder while pathological signs of chronic inflammation in the gallbladder wall were detected in eight cases. Empyema was found in four cases. Bacteria from enteral origin (Esherichia coli, Enterococcus faecalis, Enterobacter cloacae) was detected in 13 cases, while non-enteral (Klebsiella penumoniae, Streptococcus alfa-haemoliticus) colony were detected in three cases. Positive bacterial cultures were identified in twelve female and fourmale patients., Conclusions: Different types of bacteria can be found in the gallstones, which may cause various complications.

A huge number of factors play a significant role in the process of adhesion formation, like bleeding, the presence of foreign bodies, tissue injury, tissue destruction, ischemia and hypoxia. Adhesions are present in 95% of the cases following abdominal surgery. As a result of adhesions a large number of postoperative complications can occur, such as abdominal pain, bowel motility disturbances and infertility. Hence, it is important to know the precise mechanism of adhesion formation process and establish a suitable animal model to investigate the underlying mechanisms. Molecules which play a part in the process of adhesion formation were collected from the international literature. Male Wistar rats were used to create the adhesion model. Bleeding, implantation of foreign bodies, creation of ischemic areas and tissue destructions were carried out. Within this experiment the tiny bleeding and ischemic areas did not result in adhesion formation. The adhesion formation due to foreign body implantation depends on the type of the materials. Due to the inhibitory mechanism of adhesion formation there was no adhesion detectable due to tiny peritoneal destruction. The most reliable model was the one when gross tissue destruction of the abdominal wall was applied and the resulting bleeding initiated the adhesion formation process. It is also extremely important to know the key participants in the complex process of adhesion formation. This reliable model can help to work out the proper method of prevention.

Case Report: Invasive aspergillosis is a life threatening complication in immune-compromised patients causing lung tissue destruction. Aspergillus empyema requires aggressive multimodality treatment., Material and Method: We present a case of Aspergillus empyema treated by thoracic and plastic surgery preserving the lung function in an 18 year-old male patient suffering dermatomyositis and treated with steroids for a long time. After open window thoracostomy (OWT) we used pedicled musculus latissimus dorsi (MLD) flap and mobilised the anterior serratus muscle to close the pleural cavity., Conclusion: The intrathoracic use of muscle flaps after OWT in case of chronic Aspergillus empyema can preserve the underlying lung tissue. Cooperation of thoracic and plastic surgeons - as in the cases presented - provides an excellent opportunity to treat successfully of otherwise hopeless patients.

Authors present a case of a 52-year-old female patient, who underwent an emergency tracheostomy due to life threatening dyspnoea caused by an external compression of a large goiter. Total thyreoidectomy needed to be carried out later, too. Since the atypical tracheostomy did not close spontaneously a reconstruction was planned. A part of the anterior wall of the trachea needed to be replaced, which was done by an osteocutaneous flap on raised on the supraclavicular artery. An island on the artery was harvested with a thin bone chip taken from the coracoid process of the clavicle, which was rotated into the defect then. The bone chip was sutured to the trachea wall and the donor site was closed primarily. Having reviewed the literature the authors propose the application of this flap in a wide range of cases. The advantages of this flap are the satisfactory functional and cosmetic results, as well as the fact that the donor site does not need skin grafting.

Objective: Approximately 30% of malignant, primary bone tumors are chondrosarcomas, which occur on the anterior chest wall most frequently. Patients who are treated with adequate surgical intervention recover well, 10 years survival rate is 97%. Besides the aesthetic outcome, preservation of breathing and loading are crucial., Methods: Authors present a case of a 44-year-old male patient who worked as a sport masseur operated on Grade II chondrosarcoma of the manubrium. Concerning the age of the patient, an immediate reconstruction was carried out. The involved part of the sternum was resected with wide margins. The reconstruction was performed with Dual Mesh covered by a pedicled left sided pectoral major muscle. As a unique technique, authors used the tendons of the semitendinous and gracilis muscles to fix both claviculas together to give the proper stability and function for the shoulder girdle., Result: After an uneventful postoperative period the patient had a fast recovery., Conclusion: There are no data in the literature for such a method of fixation of the anterior chest wall. The method is suggested by the authors.

Introduction: The procedure of the ETS is carried out by two ports, a videothoracoscop and a diathermy instrument are introduced into the pleural cavity. After the identification of the sympathetic chain, the relevant ganglia are divided or excised., Materials and Methods: 22 patient underwent bilateral video assisted thoracoscopic T2-T4 sympathectomy in a half-way sitting position for palmar and axillary hyperhydrosis between December 2008 and January 2011., Results: 5 male and 17 female patients with a mean age of 39.9 years, (19-63) underwent the above procedure. The mean operation time was 36 minutes, (30-61 minutes)., Conclusion: No postoperative complications were detected. The authors believe that two port VATS sympathectomy is a safe and effective method for the treatment of hyperhydrosis even as one day surgical procedure.

Introduction: Pseudomyxoma Peritonei (PMP) is a rare condition, which arises from the abdominal cavity and it may also involve the pleural cavity occasionally. Concomitant involvement of both cavities is rare. The disease is characterized by production of mucinous ascites, and a low-grade carcinoma deriving mostly from the appendix. Pleural seeding may be due to diaphragmatic perforation during surgical intervention, tumour progression, or persistent congenital malformation between the abdominal and pleural cavities., Case Report: A 44 year-old female patient was treated with pleuropulmonary involvement of pseudomyxoma. Since both the lungs and pleura were involved, radical resection could not have been carried out, and cytoreduction with intraoperative chemotherapy was applied only., Discussion: Pleural progression of pseudomyxoma is uncommon and carries a poor prognosis. Management is similar to abdominal PMP, which involves aggressive cytoreduction and local and/or systemic chemotherapy, if possible., Conclusion: PMP is a very uncommon disease with poor prognosis. Extra-abdominal manifestation is rare, too. However, early recognition of the condition may enhance treatment options.

Secondary chest wall infections after previous surgical procedures are well known but the primary form of this is a relatively rare entity. We present a case of a 34-year-old man who suffered from primary suppurative costochondritis diagnosed by ultrasound and chest CT scan. The patient underwent a wide necrosectomy with a muscle flap reconstruction.

The role alcohol abuse plays in criminality has been a matter of primary concern for scholars for decades, as indicated by numerous studies and research projects. Most of these studies focus on determining the presence of a relationship between criminal behaviour and alcohol use, and whether criminal inclinations increase with the consumption of alcohol. Research shows that alcohol use indeed increases the risk of criminal behaviour, and that there is an especially strong and consistent correlation between alcohol abuse and violent crimes. However, researchers still disagree on the exact extent to which alcohol use effects criminality, and on the mechanisms causing alcohol to induce violent behaviour. A significant proportion of studies have focused in recent years on aggressive behaviour as a result of drinking alcohol. One of the most important means of measurement is the study of violent behaviour in places where alcohol is on sale. Studying the forms and frequency of violence in pubs and near off-licence stores greatly enables experts to understand the general context of the problem. This is the reason for the increasing interest in the topic throughout the past few decades. The present study focuses mainly on the literature published in English and German in leading journals of criminology since 1980, as well as on the most recent and fundamental publications on the topic, with special regard to results concerning drinking habits, and the relationship between drinking alcohol and violent or criminal behaviour, respectively.