Obesity: a normal response to an abnormal situation?
Jenny Radcliffe in Cut Down to Size, 2013
The thyroid gland is a small gland sitting underneath the Adam's apple at the front of the neck. It produces the hormone, thyroxine, that helps control your metabolic rate. In hypothyroidism, the thyroid gland doesn't make enough thyroxine, the metabolic rate slows down, you burn fewer calories and are likely to gain weight. Some women develop hypothyroidism after having a baby (known as postpartum thyroiditis). Symptoms include loss of muscle tone; tiredness; increased sensitivity to cold; joint pain; muscle cramp; depression; carpal tunnel syndrome; thinning hair; osteoporosis; itchy skin; changes in the menstrual cycle; and irritability. Less commonly people with hypothyroidism can experience problems with memory and concentration.
Tracheostomy
Raymond W Clarke in Diseases of the Ear, Nose & Throat in Children, 2023
The author’s preference is for a transverse incision, securing haemostasis with bipolar diathermy. Remove a pad of subcutaneous fat (Figure 25.2) and continue the dissection staying in the midline, down to the pretracheal fascia. The isthmus of the thyroid gland may be in the way and can be divided, but it is often easy simply to displace it. When the fascia is cleared from the tracheal cartilage, you should be able to see the rings clearly. Be certain you have identified the rings; check with your assistant and feel the ET tube by rolling it gently between finger and thumb before placing two ‘stay sutures’ just lateral to the midline, one on either side (Box 25.2). You can then use these to help open the tracheotomy and to facilitate insertion of a tracheostomy tube (Figure 25.3).
Head, neck and vertebral column
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
A 35-year-old woman has a severe allergic reaction to a bee sting and tissues in her pharynx swell rapidly and severely. In the Emergency Department it is decided that swelling will soon cause an obstruction to her airway and an emergency cricothyrotomy is performed. During this procedure there is copious bleeding that is difficult to control. Which of the following is the most likely cause of this bleeding?The superior thyroid artery was inadvertently cut.The inferior thyroid artery was inadvertently cut.An inferior thyroid vein was cut.The isthmus of the thyroid gland was incised.A pyramidal lobe was incised.
Surgical Outcomes and Efficacy of Isthmusectomy in Single Isthmic Papillary Thyroid Carcinoma: A Preliminary Retrospective Study
Published in Journal of Investigative Surgery, 2021
Hee Won Seo, Chang Myeon Song, Yong Bae Ji, Jin Hyeok Jeong, Hye Ryoung Koo, Kyung Tae
Differentiated thyroid cancer is the most common malignancy of the endocrine tumor, accounting for about 33% of all head and neck malignant tumors.1 The annual prevalence of differentiated thyroid cancer has been rapidly increasing over the last 20 years, with a female-to-male ratio of 3:1.2 Papillary thyroid carcinoma (PTC) is the most common histologic type of differentiated thyroid cancer, which accounts for 80-85% of cases and has an excellent prognosis with a 10-year survival exceeding 90%.1,3 Although the majority of PTC occurs in the thyroid lobes, approximately 1% to 9% is limited to the thyroid isthmus.4–6 The thyroid isthmus is the central part of the thyroid gland that connects the bilateral thyroid lobes. It is located just anterior to the trachea and just posterior to the strap muscles and skin. Lesions of the thyroid isthmus are known to have a higher incidence of multifocality and local invasion compared to lesions presenting in the thyroid lobes.7
Microwave ablation for papillary thyroid cancer located in the thyroid isthmus: a preliminary study
Published in International Journal of Hyperthermia, 2021
Xiao-Jing Cao, Zhen-Long Zhao, Ying Wei, Li-Li Peng, Yan Li, Jie Wu, Ming-An Yu
The thyroid is an endocrine gland composed of right and left lateral lobes connected by a strip of thyroid tissue called the isthmus. The thyroid isthmus is located anterior to the trachea and is covered by the strap muscles, fascia, and skin in the middle of the neck. Isthmic papillary thyroid cancer (PTC) is defined as thyroid cancer in which the tumor center is located between two lines perpendicular to the surface of the skin from the most lateral points of the trachea [1]. Previous studies have reported incidence rates for PTC arising in the thyroid isthmus of 1–12.3% [2–4]. To date, the American Thyroid Association, National Comprehensive Cancer Network, European Thyroid Association, and British Thyroid Association have not provided specific guidelines for managing isthmic PTC yet. According to previous reports, total thyroidectomy is the mainstream management for isthmic PTC [2,5–7]. However, this treatment is associated with some complications, such as hypothyroidism, hypoparathyroidism, and recurrent laryngeal nerve (RLN) injury, all of which can be detrimental to the patient’s quality of life.
Effects of Thyroid Hormone Therapy on Cut-Surface Healing of the Remnant Stomach with Short-Term Weight Loss Alterations after Sleeve Gastrectomy
Published in Journal of Investigative Surgery, 2018
Suleyman Orman, Kerem Karaman, Banu Isbilen Basok, Ucler Kisa, Ayse Bahar Ceyran, Erdal Birol Bostanci
Thyroid hormones act on almost all organs of the body and regulate the basal metabolism of organism. At the same time, hypothalamic–pituitary–tyhroid (HPT) axis is directly affected by drastic changes in energy stores. It is well known that excess reduction in fat mass, whether by dietary restriction or bariatric procedures, results in a decrease in circulating leptin, ultimately inhibiting the HPT axis [10, 11]. This leads to a fall in thyroid hormone volume as well as reduction in the peripheral conversion of FT4 to active form FT3 [12, 13]. Although the literature shows contradictory results regarding the relationship between weight loss and thyroid volume and function, the majority of studies report that a weight reduction of >10% leads to a long-term decrease in peripheral thyroid hormones, even when these changes are clinically insignificant [4–6, 12, 14, 15]. Furthermore, the calorigenic effect of thyroid hormone is still not fully clarified. There are certain clinical and theoretical reasons for administering low-dose thyroid hormones (T3) in selected obese patients: to improve hyperlipidemia; prevent hypoglycemia due to low caloric intake; and improve hormonal profile without major influence on either body weight or basal metabolic rate [16]. These views led us to investigate the effects of T3 hormone treatment on weight loss alterations in an animal model, particularly in the early postoperative period after sleeve gastrectomy.
Related Knowledge Centers
- Endocrine Gland
- Neck
- Lobe
- Connective Tissue
- Adam'S Apple
- Thyroid Follicular Cell
- Parafollicular Cell
- Colloid
- Thyroid Hormones
- Triiodothyronine