Young Kun Kim

Predictive value of the preablation serum thyroglobulin level after thyroidectomy Is combined with postablation 131I whole body scintigraphy for successful ablation in patients with differentiated thyroid carcinoma

Objectives:To investigate the clinical importance of the combined use of serum thyroglobulin (Tg) levels measured just before ablation (ablation-Tg) and postablation 131I whole body scintigraphy (WBS) patterns for predicting ablation success in patients with differentiated thyroid carcinoma who received total thyroidectomy and 131I ablation therapy. Methods:We retrospectively studied the early clinical outcomes for 81 differentiated thyroid carcinoma patients treated with total thyroidectomy and high-dose 131I ablation therapy between June 2001 and July 2004. Results:Ablation success was achieved in 42 (97.7%) of the 43 patients with uptake in the thyroid bed only and ablation-Tg levels less than 10 ng/mL, whereas successful ablation was achieved in 9 (75.0%) of the 12 patients with uptake in the thyroid bed only and ablation-Tg levels equal to or greater than 10 ng/mL (P = 0.029). Among 15 patients with uptake including a lymph node and ablation-Tg levels less than 10 ng/mL, 14 patients (93.3%) showed ablation success, whereas successful ablation was achieved in only 2 (18.2%) of the 11 patients with uptake including a lymph node and ablation-Tg levels equal to or greater than 10 ng/mL (P < 0.001). Conclusions:These data indicate that the combined use of serum Tg levels measured just before ablation and the 131I WBS patterns after ablation may be an early predictor of ablation success in patients with differentiated thyroid carcinoma who received total thyroidectomy and high-dose 131I ablation therapy.

Effects of Pinitol on Glycemic Control, Insulin Resistance and Adipocytokine Levels in Patients with Type 2 Diabetes Mellitus

Background: Pinitol is thought to mediate insulin action and improve insulin resistance. We evaluated the effects of pinitol on glycemic control, insulin resistance and adipocytokine levels in type 2 diabetic patients. Material and Method: A total of 66 patients with type 2 diabetes who had been taking oral hypoglycemic agents for at least 3 months were enrolled and randomized to receive pinitol (n = 33) or matching placebo (n = 33). All subjects took 1,200 mg pinitol or placebo and maintained their current oral hypoglycemic agents throughout the study. Results: Mean HbA1c, fasting plasma glucose, and HOMA-IR were significantly lowered more in patients taking pinitol than in those given a placebo. Patients who had an HbA1c over 8.0% showed a greater reduction (p < 0.01) than those who had an HbA1c below 8.0% (p =0.16). In addition, in the group of patients with a HOMA-IR over 2.5, there was a significant decrease in HbA1c compared to that in the group of patients with a HOMA-IR below 2.5. There were no differences in the changes in adiponectin, FFA and CRP between the two groups. Conclusions: Pinitol can mediate insulin action to improve glycemic control and insulin sensitivity in patients with type 2 diabetes mellitus, especially in patients with insulin resistance.

Minimum anesthetic concentration and cardiovascular dose-response relationship of isoflurane in cinereous vultures (Aegypius monachus).

Abstract:  This study aimed to determine the minimum anesthetic concentration (MAC) and dose-related cardiovascular effects of isoflurane during controlled ventilation in cinereous vultures (Aegypius monachus). The MAC was determined for 10 cinereous vultures as the midpoint between the end-tidal isoflurane concentration that allows gross purposeful movement and that which prevents the movement in response to clamping a pedal digit. Immediately after the MAC was determined, the cardiovascular effects of isoflurane at 1.0, 1.5, and 2.0 times the MAC were investigated in seven of the 10 birds. The MAC of isoflurane for 10 cinereous vultures during controlled ventilation was 1.06 ± 0.07% (mean ± SD). When the isoflurane concentration was increased to 1.5 and 2.0 times the MAC, there was significant dose-dependent decrease in the arterial blood pressure. However, the heart rate did not change over a range of 1.0 to 2.0 times the MAC.