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Omega-3 fatty acids inhibit oxidative stress in a rat model of liver regeneration
Ozgur Firat,Ozer Makay,Levent Yeniay,Goksel Gokce,Cigdem Yenisey,Ahmet Coker 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.93 No.1
Purpose: Lipid peroxidation and consequent reactive oxygen species in the setting of oxidative stress have crucial roles in liver regeneration, which may adversely affect the regeneration itself and lead to liver failure. The aim of the current study is to investigate whether omega-3 fatty acid supplementation inhibits oxidative stress in an experimental model of liver regeneration. Methods: Forty rats were allocated to four groups. Rats in group A received a sham operation. Rats in group B were subjected to right portal vein ligation (RPVL) and saline infusion. Rats in groups C and D were subjected to RPVL and total parenteral nutrition (TPN) with an all-in-one admixture containing a soybean oil based lipid emulsion. Rats in group D were additionally supplemented with omega-3 fatty acid infusion. Oxidative stresses in the blood and liver were measured by glutathione, superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and nitric oxide. Results: Omega-3 supplementation to the TPN solution significantly corrected alterations in the blood and tissue concentrations of oxidants and anti-oxidants during regeneration (P < 0.05). Conclusion: Omega-3 fatty acid supplementation to the TPN solution revealed promising results in removal of oxidative stress that emerges during liver regeneration.
Routine calcitonin measurement in nodular thyroid disease management: is it worthwhile?
Yigit Turk,Ozer Makay,Murat Ozdemir,Gozde Ertunc,Batuhan Demir,Gokhan Icoz,Mahir Akyildiz,Mustafa Yilmaz 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.4
Purpose: To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. Methods: Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10–100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. Results: Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10–100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10–100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease. Conclusion: Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.
Technical Instructions for Continuous Intraoperative Neural Monitoring in Thyroid Surgery
Hoon Yub Kim,Young Jun Chai,Marcin Barczynski,ozer Makay,Che-Wei Wu,Antonio Giacomo Rizzo,Vincenzo Bartolo,Hui Sun,Gianlorenzo Dionigi,the Korean Intraoperative Neural Monitoring Society (KINMoS) 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.1
One of the most significant advancements in neural monitoring for thyroid surgery is currently the permanent recording of the vagus nerve (VN) in order to prevent intraoperatively recurrent laryngeal nerve (RLN) iatrogenic injuries. Continuous intraoperative neuromonitoring (CIONM) seems to be superior to intermitted intraoperative neural monitoring (I-IONM) because it enhances standardization, and it provides entire and constant RLN function surveillance as the surgeon dissects the thyroid gland. It also has to be highlighted that the surgical maneuvers for the CIONM probe placement must be accurate in order to avoid a potential iatrogenic morbidity on the VN function. With this review article the Korean Intraoperative Neural Monitoring Society (KINMoS) provides a comprehensive analyses of CIONM technique.
Cost-Effectiveness Estimate for Neural Monitoring in Thyroid Surgery
Hoon Yub Kim,Young Jun Chai,Francesco Freni,ozer Makay,Bruno Galletti,Francesco Galletti,Hui Sun,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.1
There is growing evidence for the importance of more detailed cost evaluation of new technologies used in surgery. The innovative impact of technology holds the potential to achieve transformative clinical improvements. Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. Cost-effectiveness studies have been the most established and studied methods for evaluation in surgical patients. Limited information exists regarding the cost-effectiveness of new surgical strategies for monitored thyroid surgeries. We describe the recent evidence regarding methods of evaluation of cost-effectiveness structures and function for intraoperative neural monitoring (IONM) in thyroid surgery. Our findings suggest that health economics modeling to inform the design of a cost-effectiveness studies looking at IONM has been demonstrated to be feasible as a method for improving research efficiency.
Intraoperative Neural Monitoring in Thyroid Surgery: Role and Responsibility of Surgeon
Hoon Yub Kim,Ralph P. Tufano,Young Jun Chai,Marcin Barczynski,ozer Makay,Che-Wei Wu,Eren Berber,Hui Sun,Gianlorenzo Dionigi,the Korean Intraoperative Neural Monitoring Society (KINMoS) 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.1
Surgeons who introduce intraoperative neural monitoring (IONM) or a new IONM accessory, or related procedure in their practice should have completed relevant surgical training, possess operating privileges in the affected endocrine system, and be able to address anticipated complications. Surgeon responsibility in monitoring is dual component. First, technical component is using and setting up the IONM equipment correctly and understanding the inherent properties of the system to avoid an erroneous setup (e.g., no muscle relaxation, correct electrode placement, low impedance, etc.). Second, interpretive component is performing the monitoring able to distinguish between a true response versus an artifactual one. Organizations such as the International Neural Study Group and the Korean Intraoperative Neural Monitoring Society provide training courses for surgeon, as well as a means to certify levels of monitoring interpretative competence.
Prevention, Identification and Management of Postoperative Hypoparathyroidism
Salvatore Lazzara,Alberto Barbera,Guido Nicola Zanghì,Francesco Freni,Grazia Pagano,Andrea Cogliandolo,Ozer Makay,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.2
The objective of this article is to detail and present our experience on the incidence and management of parathyroid dysfunction after thyroid surgery. Selective evaluation of original articles and reviews that were retrieved by a PubMed search over the years 1990 to 2018, as well as of the recommendations of medical societies including the American, European and Asian Thyroid/Endocrine Associations. The literature presents several contributions, with controversial results. The recommended management for the diagnosis and treatment of parathyroid dysfunction after bilateral thyroid surgery or recurrent surgery consists of an intact parathyroid hormone (iPTH) determination 12–24 hours after surgery and calcium substitution in iPTH <15 pg/mL, no substitution with iPTH ≥15 pg/mL. This procedure is safe for the patient and is accepted by patients and social insurances (for short hospital stay).