Morfološka istraživanja štitaste žlezde čoveka i njihov klinički značaj

Abstract

Ciljevi ove doktorske disertacije su bili: 1) istražiti učestalost, položaj, pružanje, odnose i veličinu piramidnog lobusa (PL), tiroidnog vezivnog snopa (TVS) i mišića podizača štitaste žlezde (LGT), 2) proceniti mogući klinički značaj PL, TVS i LGT na osnovu morfoloških nalaza, 3) istražiti prisustvo, odnose i veličinu istmusa tiroidne žlezde, 4) istražiti prisustvo, odnose i veličinu lateralnih režnjeva štitaste žlezde, i 5) istražiti lobarnost štitaste žlezde. Dobijeni rezultati bi doprineli sigurnijem hirurškom lečenju bolesti štitaste žlezde. Istraživanja štitaste žlezde su izvedena na zbirci od 106 ljudskih post-mortem preparata (61 preparat osoba muškog i 45 preparata osoba ženskog pola). Preparati su predstavljali tkivne blokove u čiji su sastav ulazili: jezik, hioidna kost sa pridruženim mišićima, larinks, traheja, tiroidna žlezda, distalni deo farinksa i proksimalni deo ezofagusa. Nakon fiksacije u neutralnom formalinu istraživani preparati su disekovani pod uveličanjem uz upotrebu stereo lupe a sve istraživane strukture su identifikovane i fotografisane. Merenja struktura štitaste žlezde su izvedena direktno, uz upotrebu digitalnog kalipera. Histološka istraživanja su izvedena na 13 preparata (9 preparata TVS i 4 preparata LGT). Rezovi preparata su bojeni hematoksilin eozinom (HE) i trihromnim bojenjem po Massonu. Takođe, sproveli smo i iminohistohemijska bojenja uz upotrebu specifičnih antitela na kolagen IV i aktin prisutan u poprečnoprugastom i glatkom mišićnom tkivu kako bismo dokazali građu TVS i LGT. Histološki preparati od značaja su fotografisani digitalnom kamerom uz upotrebu svetlosnog mikroskopa. Histološka istraživanja su potvrdila da su TVS i LGT dve različite strukture štitaste žlezde. Za statističku obradu podataka korišćen je softverski program dostupan na Institutu za statistiku i informatiku Medicinskog fakulteta u Beogradu. Prisustvo PL je nađeno u 55.2% slučajeva, on se češće nalazio na levoj strani vrata i češće je bio prisutan kod osoba muškog pola...

extent, relationships to neighboring structures, size and structure of the pyramidal lobe (PL), thyroid fibrous band (TFB) and levator glandulae thyroideae muscle (LGT) of the human thyroid gland, 2) to evaluate potential clinical significance of PL, TFB and LGT according to their morphological characteristics, 3) to investigate the presence, relationships and size of the isthmus of the thyroid gland, 4) to investigate the presence, relationships and size of the lateral thyroid lobes, and 5) to investigate the lobarity of the thyroid gland. Such information can be used to perform safer and more effective thyroid surgery. Investigation of the thyroid gland was performed in 106 human post-mortem specimens (61 male and 45 female). The post-mortem specimens were blocks of tissues including the tongue, hyoid bone with related muscles, larynx, trachea, thyroid gland, distal portion of the pharynx and proximal portion of the esophagus. After fixation in buffered formalin, the post-mortem specimens were carefully dissected under a dissecting magnifier and the structures of the thyroid gland were identified and photographs were taken. Measurements of the thyroid structures were performed directly, using a digital electronic caliper. The histological examination was performed in 13 specimens following the microdissection (9 specimens of TFB and 4 specimens of LGT). Sections were stained with hematoxylin and eosin (H&E) and according to the Masson’s trichrome staining. In addition, the basic immune-histochemical protocol was performed using the primary antibodies against the collagen IV, striated and smooth muscle actin in order to visualize and prove the nature of TFB and LGT. Higher magnification images of the histological sections were captured with the digital color camera, mounted on the research microscope. Histological examination confirmed that TFB and LGT are two different structures. Statistical analyses were performed using an in-house program (Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade)...