In situ preservation of parathyroid glands during thyroid surgery for prevention of hypoparathyroidism

Background: Hypoparathyroidism is one of the most frequent complications of thyroid surgery, especially when associated with lymph node dissection in cases of thyroid cancer. Fluorescence-guided surgery is an emerging tool that appears to help reduce the rate of this complication. The present review aims to highlight the utility of fluorescence imaging in preserving parathyroid glands during thyroid cancer surgery. Methods: We performed a systematic review of the literature according to PRISMA guidelines to identify published studies on fluorescence-guided thyroid surgery with a particular focus on thyroid cancer. Articles were selected and analyzed per indication and type of surgery, autofluorescence or exogenous dye usage, and outcomes. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess the methodological quality of the included articles. Results: Twenty-five studies met the inclusion criteria, with three studies exclusively assessing patients with thyroid cancer. The remaining studies assessed mixed cohorts with thyroid cancer and other thyroid or parathyroid diseases. The majority of the papers support the potential benefit of fluorescence imaging in preserving parathyroid glands in thyroid surgery. Conclusions: Fluorescence-guided surgery is useful in the prevention of post-thyroidectomy hypoparathyroidism via enhanced early identification, visualization, and preservation of the parathyroid glands. These aspects are notably beneficial in cases of associated lymphadenectomy for thyroid cancer.

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A Full-Ocean-Depth Sampler for Hadal Microbes Based on Multistage Membrane Filters With In-Situ Preservation

Marine Technology Society Journal ◽

10.4031/mtsj.55.2.10 ◽

2021 ◽

Vol 55 (2) ◽

pp. 25-34

Author(s):

Jiawang Chen ◽

Weitao He ◽

Peng Zhou ◽

Jiasong Fang ◽

Dahai Zhang ◽

...

Keyword(s):

Ribonucleic Acid ◽

Gene Pool ◽

Special Structure ◽

High Quality ◽

Mariana Trench ◽

Membrane Filters ◽

In Situ Preservation ◽

Microbial Samples ◽

Flow Pump

Abstract In order to obtain high-quality microbial samples from the hadal zone, which has a depth of over 6,000 m, a full-ocean-depth sampler with the function of in-situ filtration and preservation was developed. A flow pump and several membrane filters were used for in-situ filtration under the sea. With a multistage filtering structure, the microbes can be initially screened according to their sizes. To avoid the degradation of microbial ribonucleic acid (RNA), a special structure was designed to inject the RNAlater solution into the samples immediately after the filtration. The sampler was tested in our laboratory and deployed during Mariana TS-15 in 2019. It was installed on a hadal lander of Shanghai Ocean University and deployed at MBR02 (11.371°N, 142.587°E, 10,931 m) in the Mariana Trench. A total of 20 L of in-situ seawater was filtered, and membranes with pore sizes of 3 and 0.2 μm were preserved. The study is expected to provide important support for the establishment of a hadal microbial gene pool.

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