---

  Background & Objective : Palpable thyroid nodules are found in almost 5% of the adults. Regarding the high prevalence of this condition, recognizing and evaluating them are important for physicians. Fine Needle Aspiration (FNA) is the first easy and cost-effective way for recognizing pathologic nature of the nods. The present research was an attempt to investigate the epidemiology and evaluate the pathological findings among patients using FNA.

  Methods : This is a descriptive study conducted on all 145(113 female and 32 male) patients referring to the endocrinology clinic of Ardabil in the period between October 1999 to October 2002. The data were collected using a questionnaire, the physical examination of the patients, noting down the clinical finding, doing FNA and its report presented by a pathologist. The data were then analyzed with descriptive statistics and frequency tables using SPSS software.

  Results : Most of the patients (36.5%) were 30-40 years old. FNA of 115 patients (79.4%) was reported as benign and that of 6 patients (4.1%) was malignant, 16 patients (11%) had a doubtful FNA, and in 8 patients (5.5%) the sample was not enough. Among patients with benign FNA, 102 cases (70.6%) had nodular goiter, 8 cases (5.5%) had colloid cyst, 3 cases (2%) had follicular adenoma and 2 cases (1.3%) had thyroiditis. Among patients with malignant FNA 1 case (0.7%) had follicular carcinoma and 5 cases (3.4%) had papillary carcinoma.

  Conclusions : The results indicated that most of the malignant lesion is papillary carcinoma, which has a lower prevalence compared to similar studies. Regarding the higher prevalence of thyroid carcinoma in middle ages it seems necessary to investigate the thyroid nodules in this age- group.

---

 Background and Objectives: Iodine deficiency disorders have been one of the main health-nutritional problems in Iran for many years. Prior to the iodine-supplementation program, Ardabil province was one of the regions with endemic goiter in Iran. The program of control and prevention of iodine deficiency has been performed here since 1989 through production, distribution and consumption of iodized salt. This study was performed in 2001 on 7-10 years-old pupils of Ardabil as a part of national monitoring survey of iodine deficiency control.

 Methods: In a cross sectional- descriptive study, 1200 students (equal number of boys and girls) were selected randomly. The prevalence of goiter was determined by clinical examination and according to WHO classification. Urinary iodine content was determined in one tenth of the cases using digestion method.

 Results: Total goiter rate was 9.3 in all the subjects (10.7% in girls and 7.9% in boys). Median urinary iodine was 18.8µg/dl. In 80.7% of the cases urinary iodine was above 10µg/dl and was less than 5µg/dl in 4.2%. Urinary iodine below 2µg/dl was not observed.

 Conclusion: The results showed that the rate of goiter among pupils has significantly decreased since 1996 and urinary iodine levels in schoolchildren of Ardabil complied with WHO index. So, Ardabil province can be considered as an “iodine deficiency free” zone.

---

 Background & Objectives: Goiter prevalence in school age children is an indicator of the severity of iodine deficiency disorders (IDD_S) in the society and a goiter prevalence ≥5 % in school age children indicates a public health problem. In area of mild to moderate IDD_S, measurement of thyroid volume by ultrasonography through observation is preferrable to population for grading goiter. Considering the importace of this issue, because of being mountainous and lack of this method's application for determining the incidence of goiter this study was desinged.

 Methods: In this descriptive – analytical study, thyroid volumes of 230 boys between 12 to 15 years old were measured by portable ultrasonograph in Tabriz. Also urinary iodine concentrations were determined by method A (Sandell-kolthoff reaction).

 Results: Mean of subjects’ thyroid volume was 8.12 ±2.21 ml and with latest references of Iran and WHO/NHD, goiter prevalence was taken based age 51.7 % and based surface body 81.1 %. Urinary iodine median of tested samples was 15.2µg/dl and iodine deficiency prevalence was 29.1 % . There was no significant correlation between urinary iodine and thyroid volume.

 Conclusion: Large thyroid volume of middle school boys in Tabriz is probably due to iodine intake deficiency in the first years of their life. Also, the role of goitrogenic factors and effect of climate condition on thyroid volume and goiter prevalence of middle school boys in Tabriz shouldn't be ignored. Further studies are recommended for determination of a local reference for thyroid volume Also it is necessary to be sure from consumption of iodine salt and its standardization.

---

  Background & objectives: Hypocalcaemia is one of the severe complications of total thyroidectomy. This complication occurs due to parathyroid glands damage during operation. The aim of this study was to evaluate the frequency of transitory and permanent hypocalcaemia in patients who were subjected to total thyroidectomy and the role of the parathyroid autotransplantation on permanent hypocalcaemia .

  Methods: In this retrospective study, one hundred patients who suffered from malignant ( group I, 46 persons) and benign (group II, 54 persons) thyroid diseases and subjected to total thyroidectomy were included and preventing role of parathyroid autotransplantation�on hypocalcaemia (permanent and transitory) was studied. Of 37 individuals of the group I who were treated with total thyroidectomy, 3 patients (subgroup A) were autotranspalnted with parathyroid glands and the rests (9 persons) who their neck lymph nodes were dissected radically and then undergone total thyroidectomy , 4 patients (subgroup B) were accomplished the autotranspalntation . In group II, just 2 patients were autotranspalnted. In overall, only in 9% of cases the autotranspalntations were done into sternocleidomastoid and deltoid muscle fibers.

  Results: Sixty seven percent of the patients were female with average age of 39.9 ± 10.8 years and 33% were male with average age of 37.2 ± 8.8 years. Seventeen percent of the patients showed transitory hypocalcaemia (13 persons in group I: 8 persons in subgroup A and 5 persons in subgroup B, 4 persons in group II). They were treated with intravenous and oral calcium supplements. None of patients progressed to permanent hypocalcaemia. The recovery rate obtained by the autotransplantation was significant statistically between two groups (p=0.006) and two subgroups (p=0.04). Temporary recurrent laryngeal nerve paresis also occurred in 2% of patients but no paralysis was observed.

  Conclusion: The autotransplantation of injured or incidentally removed parathyroid glands into sternocleidomastoid or deltoid muscle fibers can prevent the permanent hypocalcaemia.

---

  Thyroid hormones play an important role in the growth and function of the kidneys. Hypothyroidism has known role in kidney filtration system disorders. We reported hypothyriod patients with nephrotic syndrome recruited by hypothyroidism treatment. Although hypothyroidism coincidence with nephrotic syndrome has been recognized but often is missed in regard with nephrotic syndrome.

---

  Backgrounds & objectives: In addition to their genomic actions, thyroid hormones (THs) can modulate the immune responses through cell surface receptors. One of these is the antiviral effect of THs. Methimazole, as an anti-thyroid compound, is widely used to treat hyperthyroid patients. It also reduces blood leukocytes, granulocytes in particular, and thereby may affect the immune response. Recently, we reported that methimazole-induced hypothyroidism intensifies herpes simplex virus-1(HSV-1) infectivity. To determine whether the effect is mediated through alterations in circulating leukocytes, we assessed the HSV-1 infectivity and circulating leukocytes in methimazole-induced hypothyroid rat.

  Methods: Male Sprague Dawley rats received methimazole (200 μg/ml) in their drinking water for 2 weeks. Rats were then inoculated with a non-lethal single dose of HSV-1, and sacrificed 3 days later to harvest their spleen. Spleen extract was prepared, and virus yield was determined by evaluation of cytopathic effects (CPE) induced by the extract in a Vero cell culture system. For quantitative analysis, standard method of Reed-Muench was employed. The routine Wright’s staining protocol was used for blood leukocytes differential count.

  Results: The CPE development was significantly increased in the cell cultures exposed to the spleen extract of methimazole-treated animals (P < 0.05), indicating a higher virus yield and intensified virus infectivity. However, the effect of methimazole on blood leukocytes was minimal.

  Conclusion: Our data suggest that methimazole increases the susceptibility to HSV-1 infection, at least in part, by blocking THs synthesis but not alterations in circulating leukocytes.

---

Background & objectives: According to the new theory of cancer stem cells, interruption in the self-renewal pathway of tissue stem cells can cause cancerous tumors. Current work has evaluated the role of self-renewal Oct-4 gene in thyroid tumors.

Methods: In this case-control study, the expression of Oct-4 gene has comparatively assessed between cancerous specimens, marginal tissues of tumors and non-tumoral nodules of thyroid using RT-PCR technique.

Results: Statistical analysis of data by one-way ANOVA showed that Oct-4 gene is significantly expressed in thyroid papillary carcinomas in comparison with tumor margin and non-tumoral nodules (p<0.05).

Conclusion: In conclusion, the dominant expression of Oct-4 gene in thyroid tumoral cells not only demonstrates the cancer stem cell theory but also shows its role in thyroid cancer appearance that can be used in differentiating thyroid papillary carcinomas from non-tumoral nodules as well as demarcation of tumors.

---

Background & objectives: 10 year survival rates for thyroid cancer is about 90%, but papillary thyroid cancer often spread to regional lymph nodes resulting in survival rate falls below 90%. In patients with thyroid cancer, cervical lymph node metastasis risk is about 20 to 50 percent. The aim of this study was to evaluate the association between ultrasound results and the involvement of lymph nodes before thyroidectomy and compare it with the pathologic response after thyroidectomy in patients with non-medullary thyroid cancer.
Methods: 60 patients with thyroid cancer were randomly selected and entered into the study. Ultrasonographic examination of cervical lymph nodes was performed by two radiologists using an ultrasound machine in all patients diagnosed with thyroid cancer. Patients underwent total thyroidectomy and neck lymph node dissection by surgeon.
Results: In papillary thyroid cancer, there was a significant relationship between ultrasonographic results and pathologic outcomes in determining the presence of cervical lymph node metastasis before thyroidectomy. And also, there was a significant relationship between the results of ultrasonography and pathologic findings in determining the location of affected lymph nodes.
Conclusion: Compared to histological examination, ultrasonography can be a useful tool in determining the location of affected cervical lymph node in thyroid cancers before surgery.