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Ozemir IA, Gurbuz B, Bayraktar B, Aslan S, Başkent A, Yalman H, Yigitbasi R, Alimoglu O. The Effect of Thyroid-Stimulating Hormone on Tumor Size in Differentiated Thyroid Carcinoma. Indian J Surg 2016; 77:967-70. [PMID: 27011492 DOI: 10.1007/s12262-014-1084-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 11/28/2022] Open
Abstract
We evaluated the correlation between serum thyroid-stimulating hormone (TSH) levels and tumor size and other invasiveness parameters of tumor in patients with differentiated thyroid carcinoma (DTC). Several clinical studies have reported that TSH may also have a role as a regulator of the development and function of the thyroid gland. It is currently not clear whether TSH is involved in the existence of thyroid cancer or progression of thyroid cancer or both. Patients with DTC who underwent thyroid surgery between 2003 and 2008 were included this study. Preoperative serum T3, T4, and TSH levels were compared with the size and invasiveness of cancer, retrospectively. DTC was observed in 110 patients over the 5-year period. Seventy-seven (70 %) of them were euthyroid and classified as the "normal-TSH group" (NTG), and 33 (30 %) have an overt or subclinical hyperthyroidism, classified as the "low-TSH group" (LTG). The mean tumor diameter in the LTG was found to be 8.91 ± 8.03 mm; however, it was found to be 18.19 ± 16.24 mm in the NTG. There were significantly differences among the groups related to the diameter of tumor (p = 0.001). Microcarcinoma was determined in 36 patients (46.8 %) in the NTG and 23 patients (69.7 %) in the LTG (p = 0.027). Although there were no significant differences, tumor capsule invasion (33.8 vs. 18.2 %, p = 0.099) and lymphovascular invasion (16.9 vs. 6.1 %, p = 0.130) rates were higher in the NTG. These findings suggest that TSH has effects on growing and proliferation of not only normal thyroid cells but also cancer cells in DTC. This study revealed that serum TSH level can be explored as an important factor that affects the size and invasiveness of tumor in DTC.
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Affiliation(s)
- I A Ozemir
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey ; Küçüksu Mah., Asma Sok, Eston Kandilli Evleri Sitesi, A-12 Blok, Kandilli, Üsküdar, 34684 Istanbul Turkey
| | - B Gurbuz
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - B Bayraktar
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - S Aslan
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - A Başkent
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - H Yalman
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - R Yigitbasi
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - O Alimoglu
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
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Ozden S, Yildirim G, Basaran T, Gurbuz B, Dayicioglu V. Analysis of 59 cases of emergent peripartum hysterectomies during a 13-year period. Arch Gynecol Obstet 2004; 271:363-7. [PMID: 15205986 DOI: 10.1007/s00404-004-0647-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2004] [Accepted: 04/23/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective was to investigate the incidence, indications, and risk factors of peripartum emergent hysterectomy. METHOD Fifty-nine cases of emergent peripartum hysterectomy performed at Zeynep Kamil Women and Children's Education and Research Hospital during a 13-year period between January 1990 and January 2003 were evaluated retrospectively. Emergent peripartum hysterectomy was defined as that performed for haemorrhage unresponsive to other therapeutic interventions within the first 24 h of delivery. RESULT Emergent peripartum hysterectomy was performed in 59 cases of 234,958 women (25.1/100,000). Total and subtotal hysterectomy was performed in 25 and 34 cases respectively. The rates of emergent peripartum hysterectomy after vaginal and caesarean deliveries were 8.7/100,000 and 104.5/100,000 respectively. Uterine atony was the most frequent indication (62.7%). The rates of emergent peripartum hysterectomy due to uterine atony in primiparous and multiparous women were 61.1 and 65.2% respectively. The rate of maternal mortality was 8% (5 cases). CONCLUSION Uterine atony was the most common indication for emergent peripartum hysterectomy.
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Affiliation(s)
- Selçuk Ozden
- Zeynep Kamil Women and Children Education and Research Hospital, Istanbul, Turkey.
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Abstract
Our objective was to investigate the first-pass effect to the uterus of progesterone gel administered vaginally. This was a prospective, randomized study of 32 postmenopausal women, attending our menopause clinic. All women used transdermal estradiol (50 microg/day, a patch each week) for 2 weeks. They used either vaginal progesterone gel or intramuscular progesterone in oil 50 mg after 24 h to oppose the transdermal estradiol. Serum progesterone levels and endometrial tissue progesterone levels were determined. Serum progesterone levels were higher in women who used the intramuscular rather than the vaginal route. Although serum progesterone levels in the vaginal group were lower than in the intramuscular group, the endometrial tissue concentration of progesterone was higher. It is concluded that progesterone gel, used vaginally, has a high local effect on the endometrium, without any systemic side-effects due to high plasma progesterone levels.
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Affiliation(s)
- C Ficicioglu
- Reproductive Endocrinology and Infertility Department, Zeynep Kamil Women and Children's Hospital, Istanbul, Turkey
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Abstract
There are numerous literature reports of oral contraceptive-induced (estrogen and progesterone) ischemic bowel disease. However, Premarin-induced (equine conjugated estrogen) intestinal ischemia has rarely been reported. We describe three cases of Premarin-induced ischemic colitis. In contrast to oral contraceptive-induced ischemic colitis, Premarin-induced ischemia is restricted to the colon, has not required surgical therapy, can have a chronic or chronic intermittent course, may be reversible despite continued usage of Premarin, and may present with nonspecific abdominal and colonic symptoms.
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Affiliation(s)
- A K Gurbuz
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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