Medical Nutrition Therapy for Special Groups with Diabetes Mellitus

The prevalence of diabetes mellitus (DM) is increasing worldwide. Medical nutrition therapy increases the success of diabetes treatment and provides an appropriate glycemic control that decreases diabetes complications. The requirement of energy and nutritional elements may differ according to specific conditions including age, the presence of pregnancy, or comorbidities. Therefore, these specific conditions should be taken into account in the planning of medical nutrition therapy. Ensuring continuity of children and young growth and development, providing requirements based on comorbidities and physiological alterations in older adults, and protection of fetal development and maternal glycemic and nutrient balance in pregnancy should be aimed in the determination of energy and nutritional elements requirements. Here, we will discuss the medical nutrition therapy in special groups with diabetes mellitus

Evaluation of Residual Thyroid Tissue with Tc-99m MIBI in Differential Thyroid Carcinoma Patients: A Case Report

Tc-99m pertechnetate thyroid scintigraphy is used in the routine for the evaluation of residual tissue after total thyroidectomy operations in differentiating thyroid carcinoma. Tc-99m methoxy isobutyl isonitrile (Tc99m MIBI) was first developed as a myocardial perfusion agent and is also used for tumor imaging. Tc-99m MIBI is taken up by the functioning thyroid tissue and washed-out fast. We present a case of differentiated thyroid carcinoma where uptake out the thyroid bed was not detectable by Tc-99m pertechnetate thyroid scintigraphy but with Tc-99m MIBI scintigraphy in the postoperative period

The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement.

Comparative Analysis of Minimum Chip Thickness, Surface Quality and Burr Formation in Micro-Milling of Wrought and Selective Laser Melted Ti64

Selective laser melting (SLM) is a three-dimensional (3D) printing process that can manufacture functional parts with complex geometries as an alternative to using traditional processes, such as machining wrought metal. If precision and a high surface finish are required, particularly for creating miniature channels or geometries smaller than 1 mm, the fabricated parts can be further machined. Therefore, micro milling plays a significant role in the production of such miniscule geometries. This experimental study compares the micro machinability of Ti-6Al-4V (Ti64) parts produced via SLM compared with wrought Ti64. The aim is to investigate the effect of micro milling parameters on the resulting cutting forces (F-x, F-y, and F-z), surface roughness (R-a and R-z), and burr width. In the study, a wide range of feed rates was considered to determine the minimum chip thickness. Additionally, the effects of the depth of cut and spindle speed were observed by taking into account four different parameters. The manufacturing method for the Ti64 alloy does not affect the minimum chip thickness (MCT) and the MCT for both the SLM and wrought is 1 ; mu;m/tooth. SLM parts exhibit acicular ; alpha; martensitic grains, which result in higher hardness and tensile strength. This phenomenon prolongs the transition zone of micro-milling for the formation of minimum chip thickness. Additionally, the average cutting force values for SLM and wrought Ti64 fluctuated between 0.072 N and 1.96 N, depending on the micro milling parameters used. Finally, it is worth noting that micro-milled SLM workpieces exhibit lower areal surface roughness than wrought ones

Low plasminogen activator inhibitor-1 levels in thyroid carcinoma: uPA/PAI-1 paradox in cancer proggression

Amaç: Plazminojen aktivatör inhibitor-1 (PAI-1) hücre migrasyon ve apoptozisinin güçlü inhibitörüdür. Çoğu kanser türünde yüksek PAI-1 düzeyleri tespit edilmiştir. Bir çok çalışmada tiroid kanserlerinde artmış PAI-1 ekspresyonu ve bunun kötü klinik sonuçlarla ilişkili olduğu gösterilmiştir. Bu çalışmada papiller tiroid kanserlerinde(PTK) serum PAI-1 düzeylerini ve bunun PTK gelişimi ve boyutu üzerine etkisini araştırmak amaçlanmıştır.Materyal ve Metod: Elli dört papiller tiroid kanser hastası (7 erkek, 47 kadın) ve 24 sağlıklı kontrol (6 erkek, 18 kadın) çalışmaya dahil edilmiştir.  Gruplar dermografik, antropometrik ve biyokimyasal veriler ile serum PAI-1 düzeyleri açısından  karşılaştırılmıştır. Serum PAI-1 düzeyleri enzim-bağlı immünabsorban kit (ELİZA) ile çalışılmıştır.Results: Ortalama yaş PTK ve kontrol grubunda benzerdi (42.4 ± 10.1 ile 42.5 ± 8.9, p:0.794). Serum PAI-1 düzeyleri sağlıklı kontrollerle karşılaştırıldığında PTK hastalarında düşük olarak saptandı (241.34 ± 107.82 ile 327.24 ± 138.51, p:0.011). Vücut kitle indeksi (VKİ), Homa-IR, TSH, sT4, anti-TPO, anti-Tg, total kolesterol, trigliserid, HDL-kolesterol, LDL-kolesterol, kalsiyum, fosfor, 25-OH-VitD, parathormon, glukoz, insülin düzeyleri gruplar arasında benzer olarak bulundu (p>0.05). PTK hastalarında PAI-1 düzeyleri ile parathormon(PTH) dışında klinik, biyokimyasal ve hormonal parametreler arasında korelasyon bulunamadı (r:-0.446, p:0.0027).Conclusions: Papiller tiroid kanserli hastalarda serum PAI-1 düzeyleri düşük olarak bulunmuştur. Bizim sonuçlarımız ürokinaz plazminojen aktivatör aktivitesini inhibisyon kapasitesinden dolayı kanser ilerlemesini baskılaması beklentisi tezini destekleyebilir