The significance of short-term preoperative calcium and activated vitamin D3 supplementation in thyroidectomy: a randomized trial and prospective study.

Objective: The aim was to explore the effects of preoperative calcium and activated vitamin D3 supplementation on post-thyroidectomy hypocalcemia and hypo-parathyroid hormone-emia (hypo-PTHemia). Methods: A total of 209 patients were randomly divided into control group (CG) and experimental group (EG). Oral calcium and activated vitamin D3 supplementation were preoperatively administered to EG, whereas a placebo was administered to CG. Data on serum calcium, phosphorus, and PTH concentrations before operation, on postoperative day 1 (POPD1), at postoperative week 3 (POPW3), and on the length of postoperative hospitalization were collected. Results: The serum calcium, phosphorus, and PTH concentrations, as well as the incidence of postoperative hypocalcemia and hypo-PTHemia, did not significantly differ between EG and CG. Subgroup analysis revealed that the serum calcium concentrations of the experimental bilateral thyroidectomy subgroup (eBTS) on POPD1 and POPW3 were higher than that of the control bilateral thyroidectomy subgroup (cBTS) (P < 0.05); the reduction of serum calcium in eBTS on POPD1 and POPW3 was less than those in cBTS (P < 0.05). However, significant differences were not observed between the unilateral thyroidectomy subgroups (UTS) (P > 0.05). Moreover, the incidence of postoperative hypocalcemia in cBTS on POPD1 was significantly higher than that in eBTS (65.9% vs 41.7%) (P < 0.05). The length of hospitalization in cBTS (3.55 ± 1.89 days) was significantly longer than that (2.79 ± 1.15 days) in eBTS (P < 0.05). Conclusion: Short-term preoperative prophylactic oral calcium and activated vitamin D3 supplementation could effectively reduce the incidence of postoperative hypocalcemia and decrease the length of postoperative hospitalization in patients who have undergone bilateral thyroidectomy.

Improved capsulotomy for refractory Tourette's syndrome.

The effects of bilateral anterior capsulotomy were analyzed in 12 patients with Tourette's syndrome (TS). All of the patients underwent bilateral anterior capsulotomy. In 7 patients, the target was the anterior one third of the anterior limb of the capsula interna, while in 5 patients, the posterior one third of this structure was targeted. Radiofrequency thermolesions were created at 80 degrees C for 60 s. These surgeries resulted in a reduction in TS symptoms (motor and vocal tics and/or obsessive-compulsive behavior) of >50% in all patients, regardless of the target. A comparison of the two lesion sites suggests that patients with lesions of the posterior one third of the anterior limb have a greater reduction in TS symptoms (>80%) than patients receiving lesions of the anterior one third of the anterior limb (>50%). No severe, permanent side effects were observed in any patient.

[Experimental study on apoptosis induced by elemene in glioma cells].

BACKGROUND & OBJECTIVE: Elemene, isolated from the Chinese medicinal herb Rhizoma Zedoariae, was shown to exhibit antitumor activity. Our previous studies showed that elemene had a markedly antineoplastic activity on glioma. This study was designed to investigate the proliferation inhibitory effect and the apoptosis-inducing activity of elemene on glioma cells. METHODS: The effects of elemene on cell proliferation were studied in vitro by using (3)H-TdR incorporation. The morphological alterations were confirmed by Hoechst 33258/PI staining. The apoptosis was evaluated by flow cytometry analysis and agarose gel electrophoresis. RESULTS: Elemene exhibited a marked antiproliferative effect on rat glioma cell C6 and human glioma cell SHG-44. The fifty percent inhibition concentration (IC(50)) of elemene against glioma cell lines at different time points (D1-D4) by (3)H-TdR incorporation was C6 7.33-11.02 mg/L, SHG-44 13.29-27.16 mg/L. At the same concentration, human glioma cell line SHG-44 was found to be less sensitive to elemene compared to rodent cell line C6. The characteristic nucleolus alternations under fluorescent microscope included condensation of chromatin arranged under the nuclear membrane and apoptotic bodies, with a low nuclear/cytoplasmic ratio. In flow cytometry analysis, a typical subdiploid peak before Phase G(0)/G(1) (apoptotic peak) was detected in DNA frequency distribution histograms. Also the apoptosis in glioma cells was confirmed by DNA ladder formation on gel electrophoresis. CONCLUSION: Elemene exhibited a marked antiproliferative effect on glioma cells, and it could induce apoptosis in vitro.