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The presence of cryptic microbes has been widely documented in animal healthy deep tissues.
The thyroid gland is an organ specifically exposed to the microbial environment due to its close location to the mouth microbiome. A number of bacterial phenotypes has been detected in the inflamed thyroid gland. A question raises as to whether bacteria have not already been present in the thyroid gland before the clinical symptoms of goiter became evident.
A problem in thyroid surgery, relatively uncommon but difficult for control, is prolonged thyroidectomy wound healing with skin flap, gland bed inflammation and fibrosis. The causative bacteria may belong to the strains persistently present in the thyroid gland parenchyma. Our objective is to answer questions: a) do the goiter tissue structures contain bacteria, b) if so, which bacterial phenotypes can be identified, c) what are the genetic similarities of the thyroid and periodontal bacterial strains.
Studies are carried out in patients with non-toxic multinodular goiter, toxic multinodular goiter, Graves' disease, single adenoma, Hashimoto's disease, thyroid cancer and recurrent thyroid disease. Tissue harvested during surgery is dissected immediately after thyroidectomy into fragments of parenchyma, arteries, veins and lymph nodes and cultured on Columbia blood agar base for up to 3 weeks. In this method bacteria present in the tissue grow in their natural environment, slowly proliferate and then form the on-plate colonies. It enables detection of even single bacteria usually difficult to be identified in planktonic media. Identification of the isolated bacteria is performed. Their DNA patterns are also compared.
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| Measure | Description | Time Frame |
|---|---|---|
| In vivo transferred to ex vivo bacteria culturing in thyroid tissue fragments. The percentage of positive bacterial growth | Thyroid tissue specimens placed on Columbia agar with sheep blood plate and cultured for up to 30 days. Measurement of the percentage of positive bacterial growth. | 30 days |
| In vivo transferred to ex vivo bacteria culturing in thyroid tissue fragments. Time lapse to the first bacterial colonies appearance | Thyroid tissue specimens placed on Columbia agar with sheep blood plate and cultured for up to 30 days. Optical assessment of colonies growth kinetic. Measurement of time lapse in days to the first bacterial colonies appearance. | 30 days |
| Identification of bacterial strains isolated from cultured thyroid tissue fragments | Isolates identification by standard procedures using the Analytical Profile Identification (API) System (Biomerieux). Assessment of the percentage of bacterial strains cultured from thyroid fragments. | 3 days |
| Antibiotic sensitivity of bacterial strains isolated from cultured thyroid tissue fragments | Assessment of the sensitivity of isolated bacterial strains to antibiotics using the ATB system and the ATB-Plus reader (Biomerieux, Paris, France). The percentage of isolated strains sensitive to tested antibiotics. | 4 days |
| Isolated bacteria Polymerase Chain Reaction Melting Profiles (PCR MP) | The comparison of DNA patterns of strains isolated from thyroid and oral cavity. The analysis of similarity of the genetic pattern as percentage using the GeneTools program (Syngene, Cambridge, United Kingdom). | 3 days |
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Inclusion Criteria:
Exclusion Criteria:
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All patients with thyroid disease who require surgery. Preoperative clinical diagnosis: 1) non-toxic multinodular goiter, 2) toxic multinodular goiter, 3) Graves disease, 4) single adenoma, 5) Hashimoto's disease, 6) thyroid cancer and 7) recurrent thyroid disease.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sergiusz Durowicz, MD, PhD | Contact | +48226217173 | sdurowicz@wp.pl | |
| Waldemar L. Olszewski, MD, PhD | Contact | waldemar.l.olszewski@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Sergiusz Durowicz, MD, PhD | Centre of Postgraduate Medical Education, Warsaw, Poland | Principal Investigator |
| Marzanna Zaleska, PhD | Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of General, Oncological and Gastrointestinal Surgery, Centre of Postgraduate Medical Education | Recruiting | Warsaw | 00-416 | Poland |
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| Waldemar L. Olszewski, MD, PhD | Central Clinical Hospital Ministry Interior Administration, Warsaw, Poland | Principal Investigator |
| Wiesław Tarnowski, Md, PhD | Centre of Postgraduate Medical Education, Warsaw, Poland | Principal Investigator |
| Ewa Swoboda-Kopeć, MD, PhD | Medical University of Warsaw, Warsaw, Poland | Principal Investigator |
| Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences | Recruiting | Warsaw | 02-106 | Poland |
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