Thyroid Function after Subtotal Thyroidectomy in Patients with Graves' Hyperthyroidism

Background. Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy. Aim. To evaluate thyroid function after subtotal thyroidectomy for Graves' hyperthyroidism. Subjects and Methods. We retrospectively reviewed the medical records of all patients (n = 62) who underwent subtotal thyroidectomy for recurrent Graves' hyperthyroidism between 1992 and 2008 in our hospital. Thyroid function was defined according to plasma TSH and free T4 values. Results. Median followup after operation was 54.6 months (range 2.1–204.2 months). Only 6% of patients were euthyroid after surgery. The majority of patients (84%) became hypothyroid, whereas 10% of patients had persistent or recurrent hyperthyroidism. Permanent recurrent laryngeal nerve palsy and permanent hypocalcaemia were noted in 1.6% and 3.2% of patients, respectively. Conclusion. In our series, subtotal thyroidectomy for Graves' hyperthyroidism was associated with a high risk of postoperative hypothyroidism and a smaller, but significant, risk of persistent hyperthyroidism. Our data suggest that subtotal thyroidectomy seems to provide very little advantage over total thyroidectomy in terms of postoperative thyroid function

Global occurrence, chemical properties, and ecological impacts of e-wastes (IUPAC technical report)

The waste stream of obsolete electronic equipment grows exponentially, creating a worldwide pollution and resource problem. Electrical and electronic waste (e-waste) comprises a heterogeneous mix of glass, plastics (including flame retardants and other additives), metals (including rare earth elements) and metalloids. The e-waste issue is complex and multi-faceted. In examining the different aspects of e-waste, informal recycling in developing countries has been identified as a primary concern due to widespread illegal shipments, weak environmental as well as health and safety regulations, lack of technology and inadequate waste treatment structure. For example, Nigeria, Ghana, India, Pakistan and China have all been identified as hotspots for the disposal of e-waste. This article presents a critical examination on the chemical nature of e-waste and the resulting environmental impacts on, for example, microbial biodiversity, flora and fauna in e-waste recycling sites around the world. It highlights the different types of risk assessment approaches required when evaluating the ecological impact of e-waste. Additionally, it presents examples of chemistry playing a role in potential solutions. The information presented here will be informative to relevant stakeholders to devise integrated management strategies to tackle this global environmental concern

Influence of Receptor Polymorphisms on the Response to alpha-Adrenergic Receptor Blockers in Pheochromocytoma Patients

Background: Presurgical treatment with an α-adrenergic receptor blocker is recommended to antagonize the catecholamine-induced α-adrenergic receptor mediated vasoconstriction in patients with pheochromocytoma or sympathetic paraganglioma (PPGL). There is, however, a considerable interindividual variation in the dose-response relationship regarding the magnitude of blood pressure reduction or the occurrence of side effects. We hypothesized that genetically determined differences in α-adrenergic receptor activity contribute to this variability in dose-response relationship. Methods: Thirty-one single-nucleotide polymorphisms (SNPs) of the α1A, α1B, α1D adrenoreceptor (ADRA1A, ADRA1B, ADRA1D) and α2A, α2B adrenoreceptor (ADRA2A, ADRA2B) genes were genotyped in a group of 116 participants of the PRESCRIPT study. Haplotypes were constructed after determining linkage disequilibrium blocks. Results: The ADRA1B SNP rs10515807 and the ADRA2A SNPs rs553668/rs521674 were associated with higher dosages of α-adrenergic receptor blocker (p < 0.05) and with a higher occurrence of side effects (rs10515807) (p = 0.005). Similar associations were found for haplotype block 6, which is predominantly defined by rs10515807. Conclusions: This study suggests that genetic variability of α-adrenergic receptor genes might be associated with the clinically observed variation in beneficial and adverse therapeutic drug responses to α-adrenergic receptor blockers. Further studies in larger cohorts are needed to confirm our observations

The N2D+/N2H+ ratio as an evolutionary tracer of Class 0 protostars

Deuterated ions are abundant in cold (T=10 K), dense (n=10^5 cm^-3) regions, in which CO is frozen out onto dust grains. In such environments, the deuterium fractionation of such ions can exceed the elemental abundance ratio of D/H by a factor of 10^4. In this paper we use the deuterium fractionation to investigate the evolutionary state of Class 0 protostars. In a sample of 20 protostellar objects, we found a clear correlation between the N2D+/N2H+ ratio and evolutionary tracers. As expected, the coolest, i.e. the youngest, objects show the largest deuterium fractionation. Furthermore, we find that sources with a high N2D+/N2H+ ratio show clear indication for infall.Comment: 19 pages, 12 figures, accepted by A&

The chemistry of C3 & Carbon Chain Molecules in DR21(OH)

(Abridged) We have observed velocity resolved spectra of four ro-vibrational far-infrared transitions of C3 between the vibrational ground state and the low-energy nu2 bending mode at frequencies between 1654--1897 GHz using HIFI on board Herschel, in DR21(OH), a high mass star forming region. Several transitions of CCH and c-C3H2 have also been observed with HIFI and the IRAM 30m telescope. A gas and grain warm-up model was used to identify the primary C3 forming reactions in DR21(OH). We have detected C3 in absorption in four far-infrared transitions, P(4), P(10), Q(2) and Q(4). The continuum sources MM1 and MM2 in DR21(OH) though spatially unresolved, are sufficiently separated in velocity to be identified in the C3 spectra. All C3 transitions are detected from the embedded source MM2 and the surrounding envelope, whereas only Q(4) & P(4) are detected toward the hot core MM1. The abundance of C3 in the envelope and MM2 is \sim6x10^{-10} and \sim3x10^{-9} respectively. For CCH and c-C3H2 we only detect emission from the envelope and MM1. The observed CCH, C3, and c-C3H2 abundances are most consistent with a chemical model with n(H2)\sim5x10^{6} cm^-3 post-warm-up dust temperature, T_max =30 K and a time of \sim0.7-3 Myr. Post warm-up gas phase chemistry of CH4 released from the grain at t\sim 0.2 Myr and lasting for 1 Myr can explain the observed C3 abundance in the envelope of DR21(OH) and no mechanism involving photodestruction of PAH molecules is required. The chemistry in the envelope is similar to the warm carbon chain chemistry (WCCC) found in lukewarm corinos. The observed lower C3 abundance in MM1 as compared to MM2 and the envelope could be indicative of destruction of C3 in the more evolved MM1. The timescale for the chemistry derived for the envelope is consistent with the dynamical timescale of 2 Myr derived for DR21(OH) in other studies.Comment: 11 Pages, 6 figures, accepted for publication in A&

Microbiome and environment explain the absence of correlations between consumers and their diet in Bornean microsnails

Classical ecological theory posits that species partition resources such that each species occupies a unique resource niche. In general, the availability of more resources allows more species to co‐occur. Thus, a strong relationship between communities of consumers and their resources is expected. However, correlations may be influenced by other layers in the food web, or by the environment. Here we show, by studying the relationship between communities of consumers (land snails) and individual diets (from seed plants), that there is in fact no direct, or at most a weak but negative, relationship. However, we found that the diversity of the individual microbiome positively correlates with both consumer community diversity and individual diet diversity in three target species. Moreover, these correlations were affected by various environmental variables, such as anthropogenic activity, habitat island size, and a possibly important nutrient source, guano runoff from nearby caves. Our results suggest that the microbiome and the environment explain the absence of correlations between diet and consumer community diversity. Hence, we advocate that microbiome inventories are routinely added to any community dietary analysis, which our study shows can be done with relatively little extra effort. Our approach presents the tools to quickly obtain an overview of the relationships between consumers and their resources. We anticipate our approach to be useful for ecologists and environmentalist studying different communities in a local food web

The effect of carbohydrate and fat variation in euenergetic diets on postabsorptive free fatty acid release

Diet composition and energy content modulate free fatty acid (FFA) release. The aim of this study was to evaluate the dose-response effects of euenergetic variations in dietary carbohydrate and fat content on postabsorptive FFA release. The rate of appearance (R-a) of palmitate was measured by infusion of [2,2-H-2(2)]palmitate after an overnight fast in six healthy men on three separate occasions, i.e. after 7 d on euenergetic control, high-carbohydrate and high-fat diets. The protein content and composition was identical for each diet. Postabsorptive plasma fatty acid concentrations were not different between the high-carbohydrate and control diets (0.36 (se 0.07) v. 0.43 (se 0.04) mmol/l), but were increased after the high-fat diet (0.75 (se 0.09) mmol/l, (

Short-Course Radiotherapy Followed by Neoadjuvant Bevacizumab, Capecitabine, and Oxaliplatin and Subsequent Radical Treatment in Primary Stage IV Rectal Cancer:Long-Term Results of a Phase II Study

Background. In a Dutch phase II trial conducted between 2006 and 2010, short-course radiotherapy followed by systemic therapy with capecitabine, oxaliplatin, and bevacizumab as neoadjuvant treatment and subsequent radical surgical treatment of primary tumor and metastatic sites was evaluated. In this study, we report the long-term results after a minimum follow-up of 6 years. Methods. Patients with histologically confirmed rectal adenocarcinoma with potentially resectable or ablatable metastases in liver or lungs were eligible. Follow-up data were collected for all patients enrolled in the trial. Overall and recurrence-free survival were calculated using the Kaplan-Meier method. Results. Follow-up data were available for all 50 patients. After a median follow-up time of 8.1 years (range 6.0-9.8), 16 patients (32.0%) were still alive and 14 (28%) were disease-free. The median overall survival was 3.8 years (range 0.5-9.4). From the 36 patients who received radical treatment, two (5.6%) had a local recurrence and 29 (80.6%) had a distant recurrence. Conclusions. Long-term survival can be achieved in patients with primary metastatic rectal cancer after neoadjuvant radio- and chemotherapy. Despite a high number of recurrences, 32% of patients were alive after a median follow-up time of 8.1 years