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The Etiopathogenesis of Autoimmunity
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Howard Amital, Yehuda Shoenfeld
One cannot ignore the common denominator that ties microchimerism and autoimmunity. These two phenomena are prevalent among females during their reproductive period of life. Therefore, it has been postulated that the traffic of immune cells in female patients with systemic sclerosis might have a role in the pathogenesis of the disease. Systemic sclerosis is much more prevalent among women and reaches the ratio of 14:1 between the ages of 35-54.93 Since the disease has many characteristics that resemble graft versus host disease, it is tempting to associate a graft versus host reaction inflicted by immune fetal cells that settled in maternal organs. Cells of fetal origin have been isolated from maternal blood and were detected in skin specimens taken from female patients.94,95 New data indicate that microchimerism takes part also in the pathogenesis of primary biliary cirrhosis as well as in nonautoimmune liver disease and Sjogren’s syndrome, and even in the very prevalent autoimmune disorder, Hashimoto’s thyroiditis.96-98 Surgical specimens that were obtained from women who underwent thyroidectomy for various thyroid disorders were examined for the presence of male fetal cells. The frequency of microchimerism in women with a male child was highest in those with Hashimoto’s thyroiditis (five of six; 83%), however it was noted also in lower frequencies in other thyroidal diseases, both benign and malignant. No similar findings were detected in control specimens.9
Tissue Fabrication and Regeneration by Cell Sheet Technology
Published in Gilson Khang, Handbook of Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine, 2017
Yuji Haraguchi, Tatsuya Shimizu, Masayuki Yamato, Teruo Okano
The symptoms of some patients suffering from hormonal deficiency caused by the surgical excision of endocrine organs may be improved by continuous oral hormone administration. However, oral administration has some limitations concerning complex homeostatic mechanisms between hormones. Arauchi et al. have developed a cell therapy with cell sheet technology for an endocrine disorder, hypothyroidism.169 A rat hypothyroidism model is made by total thyroidectomy, and thyroid cell sheets are fabricated from rat thyroid gland–derived cells. During in vitro cultivation, thyroid cell sheets have typical thyroid follicle structures, which have thyroid transcription factor-1–positive epithelial cells on their inner surfaces, and there are spherical structures having numerous microvilli on the surfaces of thyroid follicles on the apical side of the sheets. In addition, after the transplantation into hypothyroidism models, the thyroid cell sheet having functional blood vessels becomes thicker than the in vitro cultured cell sheet and shows native thyroid–like morphological characters, including honeycomb-like structures of thyroid follicles and the inner surface of the follicles covered with follicular epithelial cells. While hypothyroidism models show a significant decrease of the serum levels of free triiodothyronine (fT3) and free thyroxine (fT4), the serum concentrations of fT3 and fT4 significantly decrease at 1 week after the transplantation of the thyroid cell sheet, and the improvement of the thyroid function is maintained for at least 1 month. These results suggest that cell sheet technology is suitable for treating hormonal deficiency caused by multifunctional endocrine organs.
Radiopharmaceuticals for Radionuclide Therapy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Meltem Ocak, Emre Demirci, Jessie R. Nedrow, Rebecca Krimins
The most frequently diagnosed endocrinopathy in feline geriatric patients is hyperthyroidism associated with benign thyroid adenoma [57]. It is estimated that hyperthyroidism is diagnosed in 1.5–11.4 per cent of geriatric cats worldwide [58]. Feline hyperthyroidism is similar to toxic nodular goitre in humans [59]. Common historical signs, physical examination signs, and laboratory findings in hyperthyroid cats may include a palpable thyroid nodule, muscle wasting, thin body condition, dental disease, tachycardia, cardiac murmur, high alanine aminotransferase, high alkaline phosphatase, high aspartate aminotransferase, elevated hematocrit, high serum T4, high serum fT4, high serum T3, and low serum TSH [60]. Treatment of feline hyperthyroidism can include any or a combination of the following: medical management with methimazole or carbimazole, nutritional management (low-iodine diet), surgical thyroidectomy, and radioactive iodine treatment (131I) [61]. Radioactive iodine is generally considered the optimal treatment for hyperthyroidism in cats because of its safety and efficacy [62]. During the 1990s, multiple studies were published lauding the benefits of 131I treatment in cats. Radioactive iodine treatment has also been used to treat feline thyroid carcinomas and canine thyroid tumours [63, 64]. Radioactive iodine treatment in cats is currently offered throughout the United States in local veterinary clinics (i.e., general practitioner offices), specialty referral veterinary settings, and some veterinary academic institutions. Veterinary hospital requirements for offering 131I treatment to pets include an active radioactive materials license, proper evaluation of each veterinary case, facilities built for conducting treatments with radioactive agents (most facilities will hospitalize each patient for 5–8 days before sending the animal home), review of safety discussions with the pet owners, maintaining paperwork and more.
Single-session high-intensity focused ultrasound (HIFU) ablation for benign thyroid nodules: a systematic review
Published in Expert Review of Medical Devices, 2020
Eleftherios Spartalis, Sotirios P. Karagiannis, Nikolaos Plakopitis, Maria Anna Theodori, Dimosthenis Chrysikos, Stavroula A. Paschou, Georgios Boutzios, Dimitrios Schizas, Michael Spartalis, Theodore Troupis, Nikolaos Nikiteas
Surgery may be considered a therapeutic option for growing, cytologically benign nodules larger than 4 cm, causing obstructive or compressive symptoms or clinical concern [1]. However, thyroid resection is associated with postoperative complications, including re-bleeding (2.1%); infection (1.6%); unilateral (3.9%) or bilateral (0.2%) paresis of the recurrent laryngeal nerve; and transient or even permanent hypocalcemia and hypoparathyroidism (9.9%), after total or near-total thyroidectomy [4–6]. The last two complications might sometimes be irreversible. Furthermore, specific medical conditions preclude the administration of general anesthesia [4].
Effect of energy-based devices on post-operative parathyroid function and blood calcium levels after total thyroidectomy
Published in Expert Review of Medical Devices, 2021
Eleftherios Spartalis, Alexios Giannakodimos, Afroditi Ziogou, Ilias Giannakodimos, Stavroula A. Paschou, Michael Spartalis, Dimitrios Schizas, Theodore Troupis
Thyroid disorders are common and represent a major part of the everyday clinical practice [59]. A considerable number of these disorders demands surgical resection of the thyroid gland, rendering thyroidectomy a frequently applied operation [60]. The thyroid gland comprises a highly vascularised organ and is proximal to vital structures such as the parathyroid glands and the recurrent laryngeal nerve [10]. Therefore, a cautious hemostatic method is required in order to avoid intraoperative uncontrolled bleeding and inadvertent damage to the surrounding tissues [61].