1
|
Aydogan Unsal Y, Oz Gul O, Goktug MR, Cander S, Ozyardimci Ersoy C, Aydemir E, Ates C, Unsal O, Kiyici M, Erturk E. Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turk J Endocrinol Metab 2022. [DOI: 10.5152/tjem.2022.22053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
2
|
Calapkulu M, Gul OO, Cander S, Sagiroglu MF, Saraydaroglu O, Erturk E, Ersoy C. Co-existence of Papillary and Medullary Thyroid Carcinoma: Reports of Three Cases. J Coll Physicians Surg Pak 2022; 32:S156-S158. [PMID: 36210680 DOI: 10.29271/jcpsp.2022.supp2.s156] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/27/2020] [Accepted: 11/29/2020] [Indexed: 06/16/2023]
Abstract
Medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) are two different types of thyroid carcinoma. They have different features in terms of cellular origin, histopathology, clinical features, prevalence, and prognosis. PTC originates from follicular cells, while MTC from parafollicular cells. MTC and PTC co-existence is a rare phenomenon and occurs in less than 1% of all thyroid tumors. We report three cases with coexistent MTC and PTC in the same thyroid. The papillary component was dominant in two cases and the medullary in one case. While the first case was given radioactive iodine therapy, the third was treated with vandetanib. The second case was followed up postoperatively and did not receive treatment other than levothyroxine replacement. The co-existence of these tumors requires a different clinical approach in treatment and follow-up, depending on which type is dominant. Key Words: Mixed thyroid carcinoma, Papillary thyroid carcinoma, Medullary thyroid carcinoma.
Collapse
Affiliation(s)
- Murat Calapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ozen Oz Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - Soner Cander
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - Muhammed Fatih Sagiroglu
- Department of Medical Oncology, Faculty of Medicine, Baskent University Medical School, Ankara, Turkey
| | - Ozlem Saraydaroglu
- Department of Pathology, Uludag University Medical School, Bursa, Turkey
| | - Erdinc Erturk
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| |
Collapse
|
3
|
Gul OO, Sisman P, Cander S, Sarandol E, Ersoy C, Erturk E. PLASMA NEPRILYSIN LEVELS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME. Acta Endocrinol (Buchar) 2022; 18:35-39. [PMID: 35975244 PMCID: PMC9365417 DOI: 10.4183/aeb.2022.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT Insulin resistance has been detected in a majority of patients with polycystic ovary syndrome (PCOS). Elevated neprilysin levels are associated with insulin resistance. OBJECTIVE The present study aims to investigate plasma neprilysin and its relationship with endocrine and metabolic characteristics in patients with PCOS. SUBJECTS AND METHODS Thirty-five premenopausal PCOS patients and 35 healthy volunteers of similar age were included in the study. Demographic characteristics, biochemical and hormonal findings and also plasma neprilysin levels were determined in these patients and healthy controls. RESULTS In our study, HOMA-IR values were significantly higher in PCOS patients (3.3 ± 1.8) compared with the controls [(1.6 ± 1), p<0.01]. Plasma neprilysin levels were significantly higher in the PCOS group compared to the control group (1502.1 ± 1641.2 vs. 764.6 ± 562.6 pg/mL). There was no difference in plasma neprilysin levels when PCOS patients were classified as overweight-obesity (BMI≥25kg/m2) or non-obesity (BMI<25kg/m2). CONCLUSION Our findings revealed significantly higher levels for plasma neprilysin and HOMA-IR values in PCOS patients when compared to controls. No significant differences were noted between obese PCOS patients and non-obese PCOS patients in terms of plasma neprilysin levels.
Collapse
Affiliation(s)
- O. Oz Gul
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - P. Sisman
- Medicana Hospital, Endocrinology and Metabolism Clinic, Bursa, Turkey
| | - S. Cander
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - E. Sarandol
- Uludag University Medical School, Department of Biochemistry, Bursa, Turkey
| | - C. Ersoy
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - E. Erturk
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| |
Collapse
|
4
|
Sisman P, Polat I, Aydemir E, Karsi R, Gul OO, Cander S, Ersoy C, Erturk E. How the COVID-19 outbreak affected patients with diabetes mellitus? Int J Diabetes Dev Ctries 2021; 42:53-61. [PMID: 34539126 PMCID: PMC8432957 DOI: 10.1007/s13410-021-00992-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/28/2021] [Indexed: 01/02/2023] Open
Abstract
Background Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients. Methods This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression. Results Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level. Conclusions It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.
Collapse
Affiliation(s)
- Pinar Sisman
- Medicana Hospital, Endocrinology and Metabolism Clinic, Bursa, Turkey
| | - Irmak Polat
- Istanbul Faculty of Medicine Department of Psychiatry, Istanbul University, Istanbul, Turkey
| | - Ensar Aydemir
- Medical School Department of Endocrinology and Metabolism, Uludag University, Bursa, Turkey
| | - Remzi Karsi
- School of Health Science, KTO Karatay University, Konya, Turkey
| | - Ozen Oz Gul
- Medical School Department of Endocrinology and Metabolism, Uludag University, Bursa, Turkey
| | - Soner Cander
- Medical School Department of Endocrinology and Metabolism, Uludag University, Bursa, Turkey
| | - Canan Ersoy
- Medical School Department of Endocrinology and Metabolism, Uludag University, Bursa, Turkey
| | - Erdinc Erturk
- Medical School Department of Endocrinology and Metabolism, Uludag University, Bursa, Turkey
| |
Collapse
|
5
|
Sisman P, Gul OO, Dirican M, Bal AS, Cander S, Erturk E. Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Marker of Diabetic Nephropathy in Type 1 Diabetic Patients. Clin Lab 2020; 66. [PMID: 32013365 DOI: 10.7754/clin.lab.2019.190326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Glomerular and tubulointerstitial damage plays a role in renal function failure in diabetic patients. While both serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) show significantly increased levels in acute renal pathologies, the NGAL increase in active phase indicates a reversible condition in chronic cases. MATERIALS AND METHODS 52 type 1 diabetic patients and 30 healthy volunteers participated in the study. The diabetic participants were separated into two groups as follows: a normoalbuminuria group consisting of those with an albumin/creatinine ratio less than 30 mg/g and an albuminuria group consisting of those with an albumin/ creatinine ratio equal or greater than 30 mg/g. Albumin, creatinine and NGAL were measured in all participants. RESULTS Urinary NGAL median level was 21.1 ng/mL for diabetic patients and 11.9 ng/mL for healthy controls, and the difference between the two groups was statistically significant. When diabetic patients were compared as those with and without albuminuria, the median urinary NGAL levels of normoalbuminuria and albuminuria were 24.7 and 16.1 ng/mL, respectively, but the difference was not statistically significant. Statistically similar results were obtained through evaluation of the ratio of urinary NGAL excretion to creatinine excretion. The NGAL/Cr ratio was significantly higher in diabetic patients than in healthy controls, but no statistically significant difference was found between the diabetic patients with and without albuminuria. CONCLUSIONS Urinary NGAL excretion in type 1 diabetic patients is found to be increased over a wide range, but it does not correlate with urinary albumin excretion. In this regard, urinary NGAL excretion should not be used as an alternative to microalbuminuria in detecting diabetic nephropathy. The greater amount of NGAL excretion among diabetic patients may be due to diabetic nephropathy with possible tubulointerstitial damage pathologies.
Collapse
|
6
|
Saraydaroglu O, Ozsen M, Narter S, Kirdak T, Erturk E. A close look at our cases with parathyroidectomy: 11 years of experience. MINERVA ENDOCRINOL 2020. [PMID: 33103869 DOI: 10.23736/s0391-1977.20.03171-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hyperparathyroidism is caused by parathyroid adenoma, hyperplasia or carcinoma. Parathyroid adenomas are the most common cause of parathyroid disease (85-88%) while atypical parathyroid adenomas and carcinomas are the least frequently seen parathyroid neoplasms which cause diagnostic difficulty. This series aims to identifiy lesions of parathyroidectomy specimens in our center and draw attention to borderline cases in between parathyroid adenoma and carcinoma. METHODS 638 parathyroidectomy materials diagnosed in our center between the years 2005 and 2016 were examined retrospectively and all were included in the study. RESULTS In all the 638 parathyroidectomy cases evaluated, 427 were diagnosed with adenoma, 117 with hyperplasia, 54 with normal parathyroid tissue, 32 with parathyroid neoplasm with uncertain malignant potential, 7 with parathyroid carcinoma and 1 with normal thyroid tissue. CONCLUSIONS Parathyroid neoplasm with uncertain malignant potential defines cases with suspicious histopathological features of carcinoma but doesn't meet the criteria for parathyroid carcinoma. In our series, these cases are identified as atypical parathyroid adenoma. We present clinical and morphological features of our parathyroidectomy cases in an 11-year period and aim to raise concern about borderline cases in between adenoma and carcinoma. We think that such tumors, similar to the thyroid neoplasm classification, should be defined as parathyroid neoplasms with uncertain malignant potential and should be followed closely.
Collapse
Affiliation(s)
- Ozlem Saraydaroglu
- Department of Surgical Pathology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey -
| | - Mine Ozsen
- Department of Surgical Pathology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Selin Narter
- Department of Surgical Pathology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Turkay Kirdak
- Department of General Surgery, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Erdinc Erturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| |
Collapse
|
7
|
Sisman P, Bicer B, Gul OO, Cander S, Ersoy C, Saraydaroglu O, Erturk E. May hemocytometer parameters be a biomarker in distinguishing between adrenal adenomas and carcinomas and in prognosis of adrenocortical carcinomas? Acta Clin Croat 2020; 59:439-444. [PMID: 34177053 PMCID: PMC8212649 DOI: 10.20471/acc.2020.59.03.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Recently, studies have reported that inflammatory response and elevated platelet counts are associated with several cancers. In the present study, we aimed to evaluate hemocytometer parameters in differentiating adrenal adenoma and carcinoma, and the prognostic utility of hemocytometer parameters in adrenocortical carcinoma (ACC). We included 30 patients with nonfunctional adrenal adenoma and 13 patients with ACC having undergone surgery between 2005 and 2017 and followed up postoperatively at our centre. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), red blood cell distribution width (RDW), mean platelet volume (MPV) and plateletcrit (PCT) were evaluated preoperatively in all patients included in the study. There was a significant difference between the adrenal adenoma and ACC groups in terms of neutrophil and lymphocyte counts, NLR and PLR. There was no significant difference between the two groups in terms of platelet count and MPV, but PCT levels were significantly lower in ACC group. There was no statistically significant difference between recurrent and/or metastasis positive patients and negative ones according to NLR, PLR, RDW and MPV. There was a statistically significant difference in RDW levels and tumor diameter between the groups. Our study is the first to evaluate hemocytometer parameters in differentiating adrenal adenomas and carcinomas, and also in the prognosis of ACC. The present study suggested that the hemocytometer parameters may be a marker in the differential diagnosis of adrenal adenomas and carcinomas. However, our study also showed that these parameters had no prognostic value in ACC.
Collapse
Affiliation(s)
| | - Buket Bicer
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| | - Ozen Oz Gul
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| | - Soner Cander
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| | - Canan Ersoy
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| | - Ozlem Saraydaroglu
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| | - Erdinc Erturk
- 1Medicana Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey; 2Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey; 3Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; 4Uludag University Medical School, Department of Pathology, Bursa, Turkey
| |
Collapse
|
8
|
Çalapkulu M, Gul OO, Cander S, Ersoy C, Erturk E, Sagiroglu MF, Saraydaroglu O. Control of Refractory Hypercalcemia with Denosumab in a Case of Metastatic Parathyroid Carcinoma. J Coll Physicians Surg Pak 2020; 30:757-759. [PMID: 32811610 DOI: 10.29271/jcpsp.2020.07.757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 07/21/2019] [Indexed: 11/11/2022]
Abstract
Parathyroid carcinoma is a rare cause of hyperparathyroidism and leads to severe hypercalcemia. The etiology is not fully known. Parathyroid cancer should be considered in the differential diagnosis, if serum calcium and parathyroid hormone levels increase, and parathyroid gland is palpable. Severe hypercalcemia is the most common cause of death in patients diagnosed with parathyroid carcinoma. Fluid replacement, diuretic therapy, bisphosphonates, and calcimimetic agents are the main treatment steps in the control of life-threatening hypercalcemia. Surgery is the primary treatment option, while denosumab is a treatment option for refractory hypercalcemia caused by parathyroid carcinoma, or for patients who are not eligible for surgery. There are few case reports in literature about denosumab treatment for parathyroid carcinoma. Herein, we report a case of a patient who presented with the complaint of leg pain and was diagnosed with parathyroid carcinoma. The elevated calcium level of the patient was controlled with denosumab. Key Words: Parathyroid carcinoma, Denosumab, Hypercalcemia, Hyperparathyroidism.
Collapse
Affiliation(s)
- Murat Çalapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ozen Oz Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Turkey
| | - Soner Cander
- Department of Endocrinology and Metabolism, Uludag University Medical School, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, Turkey
| | - Erdinc Erturk
- Department of Endocrinology and Metabolism, Uludag University Medical School, Turkey
| | | | | |
Collapse
|
9
|
Sisman P, Pekgoz M, Bayrakci I, Sisman M, Cander S, Oz Gul O, Erturk E, Ersoy C. Evaluation of upper gastrointestinal system in acromegaly. Ann Endocrinol (Paris) 2019; 80:196-201. [PMID: 31227172 DOI: 10.1016/j.ando.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/11/2018] [Accepted: 03/15/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Acromegaly causes multiple comorbidities, including gastrointestinal disorders. The present study evaluated the frequency of hiatal hernia and other upper gastrointestinal pathologies in patients with acromegaly, given that visceromegaly and reduced nitric oxide levels in acromegaly may impact diaphragm and lower esophageal sphincter function and thus possibly the development of hiatal hernia. METHODS Thirty-nine acromegaly patients followed our center for the previous 6months were recruited. Upper gastrointestinal endoscopy was performed once in all patients to evaluate hiatal hernia, esophagitis, gastroduodenitis and ulcer. RESULTS Twenty-three patients were male and 16 female. Upper gastrointestinal endoscopy found hiatal hernia, esophagitis and gastroduodenitis or gastric ulcer in 3 (7.6%), 2 (1.7%) and 31 (79.4%) patients, respectively. Pathologic examination of gastric antrum biopsy found intestinal metaplasia in 12 (30.7%) patients, and Helicobacter pylori was positive in 13 (33.3%). There were no significant correlations between age, gender, disease duration or preoperative adenoma size on the one hand and hiatal hernia or other endoscopic findings on the other. Similarly, neither surgical success nor recurrence was associated with endoscopic findings. CONCLUSIONS The study showed that prevalence of gastritis, duodenitis, peptic ulcer and intestinal metaplasia is higher and prevalence of hiatal hernia lower in acromegaly patients than in the healthy population. Various unknown disease-related pathophysiological conditions may play a role; there is a need for further studies.
Collapse
Affiliation(s)
- Pinar Sisman
- Medicana Hospital, Endocrinology and Metabolism Clinic, Bursa, Turkey.
| | - Murat Pekgoz
- Izzet Baysal State Hospital, Gastroenterology Clinic, Bolu, Turkey.
| | - Ismail Bayrakci
- Viransehir State Hospital, Internal Medicine Clinic, Urfa, Turkey.
| | - Mete Sisman
- Muradiye State Hospital, General Surgery Clinic, Bursa, Turkey.
| | - Soner Cander
- Uludag University Medical School, Department Of Endocrinology and Metabolism, Bursa, Turkey.
| | - Ozen Oz Gul
- Uludag University Medical School, Department Of Endocrinology and Metabolism, Bursa, Turkey.
| | - Erdinc Erturk
- Uludag University Medical School, Department Of Endocrinology and Metabolism, Bursa, Turkey.
| | - Canan Ersoy
- Uludag University Medical School, Department Of Endocrinology and Metabolism, Bursa, Turkey.
| |
Collapse
|
10
|
Peynirci H, Taskiran B, Erturk E, Sisman P, Ersoy C. Is Parenteral Levothyroxine Therapy Safe in Intractable Hypothyroidism? J Natl Med Assoc 2018; 110:245-249. [PMID: 29778126 DOI: 10.1016/j.jnma.2017.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/25/2017] [Revised: 05/07/2017] [Accepted: 05/17/2017] [Indexed: 10/19/2022]
Abstract
CASE A 32-year old woman was admitted to the hospital due to intractable hypothyroidism refractory to high dose of oral l-thyroxine therapy. She underwent total thyroidectomy and radioactive iodine therapy due to papillary thyroid cancer. After excluding poor adherence to therapy and malabsorption, levothyroxine absorption test was performed. No response was detected. Transient neurologic symptoms developed during the test. She developed 3 attacks consisting of neurologic symptoms during high dose administration. The patient was considered a case of isolated l-thyroxine malabsorption. She became euthyroid after intramuscular twice weekly l-thyroxine therapy. DISCUSSION There are a few case reports regarding isolated l-thyroxine. We report successful long term results of twice weekly administered intramuscular l-thyroxine therapy. We also draw attention to neurologic side effects of high dose l-thyroxine therapy.
Collapse
Affiliation(s)
- Hande Peynirci
- Kastamonu State Hospital, Department of Endocrinology, Turkey
| | - Bengur Taskiran
- Yunus Emre State Hospital, Department of Endocrinology, Turkey.
| | - Erdinc Erturk
- Uludag University, Department of Endocrinology and Metabolic Disorders, Turkey
| | - Pınar Sisman
- Uludag University, Department of Endocrinology and Metabolic Disorders, Turkey
| | - Canan Ersoy
- Uludag University, Department of Endocrinology and Metabolic Disorders, Turkey
| |
Collapse
|
11
|
Sisman P, Avci M, Akkurt A, Sahin AB, Gul OO, Ersoy C, Erturk E. The effect of primary hyperparathyroidism on pancreatic exocrine function. J Endocrinol Invest 2018; 41:293-298. [PMID: 28770447 DOI: 10.1007/s40618-017-0727-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels. METHODS 75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study. Renal function tests, lipid parameters, bone mineral density, and serum calcium, phosphorus, vitamin D, parathormone, glucose, and thyroid stimulating hormone levels as well as fecal elastase concentrations, were determined in these patients and controls. RESULTS The mean fecal elastase level was 335.3 ± 181.4 μg/g in the PHPT group and 317.4 ± 157.3 μg/g in the control group. There was no significant difference in fecal elastase levels between the two groups (p = 0.5). CONCLUSIONS Chronic hypercalcemia in primary hyperparathyroidism did not decrease the fecal elastase level, which is an indirect indicator of chronic pancreatitis; therefore, chronic hypercalcemia in PHPT may not cause chronic pancreatitis.
Collapse
Affiliation(s)
- P Sisman
- Endocrinology and Metabolism Clinic, Harakani State Hospital, Kars, Turkey.
| | - M Avci
- Department Of Internal Medicine, Uludag University Medical School, Bursa, Turkey
| | - A Akkurt
- Endocrinology and Metabolism Clinic, Muradiye State Hospital, Bursa, Turkey
| | - A B Sahin
- Department Of Internal Medicine, Uludag University Medical School, Bursa, Turkey
| | - O O Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - C Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - E Erturk
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| |
Collapse
|
12
|
Ongen Z, Erturk E, Kilickiran Avci B, Kucur M, Karadag B. P908Evaluation of pre and post-procedure high sensitive cardiac troponin T values in patients undergoing elective coronary angiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
13
|
Gul OO, Sisman P, Cander S, Gozden E, Kurt M, Saraydaroglu O, Kirdak T, Ersoy C, Erturk E. An unusual case of adult-onset multi-systemic Langerhans cell histiocytosis with perianal and incident thyroid involvement. Endocrinol Diabetes Metab Case Rep 2017; 2017:EDM160087. [PMID: 28458889 PMCID: PMC5404461 DOI: 10.1530/edm-16-0087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/12/2017] [Indexed: 12/17/2022] Open
Abstract
Summary Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography–computed tomography (PET/CT) scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 × 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED) and vinblastine (VBL) has been planned by the hematology department. Learning points:
Collapse
Affiliation(s)
| | | | | | | | | | | | - Turkay Kirdak
- Department of Surgery, Uludağ University Medical School, Bursa, Turkey
| | | | | |
Collapse
|
14
|
Cander S, Dizdar OS, Oz Gul O, Guclu M, Unal OK, Tuncel E, Erturk E, Imamoglu S, Ersoy C. Comparison of efficacy and safety of once- versus twice-daily insulin detemir added on to oral antidiabetics in insulin-naive type 2 diabetes patients: 24-week, crossover, treat to target trial in a single center. Prim Care Diabetes 2014; 8:256-264. [PMID: 24522170 DOI: 10.1016/j.pcd.2014.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 11/22/2022]
Abstract
AIM To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive type 2 diabetes patients in terms of efficacy and safety. METHODS An open-label study performed at a single center, comprised a randomized, crossover 24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24 week. RESULTS A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8% (±2.0) and 1.5% (±1.4) within the first 12 weeks (p<0.01), whereas increased by 0.21% (±0.7) and 0.14% (±0.8) in the second 12 weeks (p>0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first 12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily dose. Within the first and second periods, the body weight of the patients was observed an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period. CONCLUSION Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose use of insulin did not provide a prominent glycemic control advantage on 1.5-fold higher use of insulin.
Collapse
Affiliation(s)
- Soner Cander
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey.
| | - Oguzhan Sitki Dizdar
- Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey
| | - Ozen Oz Gul
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Metin Guclu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Oguz Kaan Unal
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Ercan Tuncel
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Erdinc Erturk
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Sazi Imamoglu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Canan Ersoy
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| |
Collapse
|
15
|
Tanriverdi F, Dokmetas HS, Kebapcı N, Kilicli F, Atmaca H, Yarman S, Ertorer ME, Erturk E, Bayram F, Tugrul A, Culha C, Cakir M, Mert M, Aydin H, Taskale M, Ersoz N, Canturk Z, Anaforoglu I, Ozkaya M, Oruk G, Hekimsoy Z, Kelestimur F, Erbas T. Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from Pituitary Study Group database. Endocrine 2014; 47:198-205. [PMID: 24366641 DOI: 10.1007/s12020-013-0127-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/13/2013] [Indexed: 02/02/2023]
Abstract
Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndrome is still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries.
Collapse
Affiliation(s)
- F Tanriverdi
- Department of Endocrinology, Erciyes University Medical School, 38039, Kayseri, Turkey,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Erturk E, Cecener G, Egeli U, Tunca B, Tezcan G, Gokgoz S, Tolunay S, Tasdelen I. 398: Evaluation of microRNA expression profiles in triple-negative (ER, PR and Her2/neu) breast cancer patients with and without germ-line BRCA mutations. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50355-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Cander S, Karkucak M, Gul OO, Sag SO, Yakut T, Ersoy C, Tuncel E, Erturk E. Association between p16(CDKN2A) C540G polymorphism and tumor behavior in prolactinoma: A single-center study. Biomed Rep 2014; 2:589-595. [PMID: 24944814 DOI: 10.3892/br.2014.281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 02/12/2014] [Accepted: 05/02/2014] [Indexed: 12/16/2022] Open
Abstract
Pituitary tumors usually originate as benign sporadic adenomas and develop into invasive and aggressive tumors such as prolactinomas, which are common functioning pituitary adenomas. The aim of the present study was to examine the association between the tumor behavior in prolactinomas and the p16(CDKN2A) gene polymorphism occurring at the 3'-untranslated region of exon 3 (C540G). A total of 104 patients with prolactinoma were included and assigned to two groups based on invasive vs. non-invasive tumor behavior. Ki67 indices were recorded according to histopathology results. Genotypic analysis of the p16(CDKN2A) C540G polymorphism was carried out using a modified polymerase chain reaction-restriction fragment length polymorphism assay. The corresponding frequencies for CC, CG and GG genotypes in non-invasive vs. invasive tumors were 61.5, 30.8, 7.7 and 64.1, 28.2, 7.7%, respectively (not significant). The observed CG genotype frequency was higher compared with previous studies. In addition, the patients with giant adenomas or a high Ki67 index had a higher frequency of the CG genotype as compared with the other subgroups, although the differences were not significant (46.2 and 42.9%, respectively). In conclusion, a higher frequency of the C540G CG genotype of the CDKN2A gene was found among patients with prolactinoma in comparison with previous studies. These frequencies were also higher in the subgroups with elevated Ki67 or giant adenomas. Further studies are required to improve the definition of the role of the CG genotype in the development and progression of tumors in prolactinomas.
Collapse
Affiliation(s)
- Soner Cander
- Department of Endocrinology and Metabolism, Uludag University Medical School, Gorukle, Bursa 16059, Turkey ; Department of Endocrinology and Metabolism, Sevket Yilmaz Education and Research Hospital, Osmangazi, Bursa 16230, Turkey
| | - Mutlu Karkucak
- Department of Medical Genetic, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Ozen Oz Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Sebnem Ozemri Sag
- Department of Medical Genetic, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Tahsin Yakut
- Department of Medical Genetic, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Ercan Tuncel
- Department of Endocrinology and Metabolism, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| | - Erdinc Erturk
- Department of Endocrinology and Metabolism, Uludag University Medical School, Gorukle, Bursa 16059, Turkey
| |
Collapse
|
18
|
Cakmak HA, Erturk E, Ikitimur B, Karadag B. The rare complication of Behcet's syndrome: concomitance of coronary slow flow with acute coronary syndrome. Case Reports 2012; 2012:bcr-2012-006388. [DOI: 10.1136/bcr-2012-006388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Erturk E, Cecener G, Tunca B, Egeli U, Tezcan G, Gokgoz S, Tasdelen I, Tolunay S, Alder H, Huebner K. 426 Distinct MiRNA Expression Patterns in Among Breast Tumors of Patients Carried and Non-carried Germ-line BRCA Mutations. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71107-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Cakmak H, Erturk E, Cimci M, Ikitimur B, Karadag B, Vural V. VP-002 CONCOMITANCE OF CORONARY SLOW FLOW AND ACUTE CORONARY SYNDROME IN A PATIENT WITH BEHCET'S SYNDROME. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70225-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
21
|
Kiyici S, Cander S, Oz Gul O, Sigirli D, Kaan Unal O, Duran C, Saraydaroglu O, Ersoy C, Tuncel E, Erturk E, Imamoglu S. Preoperative parathyroid hormone levels are correlated with parathyroid adenoma volume and bone mineral density but not serum calcium levels. MINERVA ENDOCRINOL 2011; 36:123-128. [PMID: 21519321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim of this study was to determine the relationship between biochemical parameters, parathyroid adenoma volume, and bone mineral density with respect to intact parathyroid hormone (iPTH) levels in patients with primary hyperparathyroidism. METHODS Data were collected retrospectively from patients with primary hyperparathyroidism who were diagnosed and followed in our clinic between 2005 and 2008. Forty-eight (female/male=42/6) patients with a mean age of 52.8±13.1 years were enrolled into the study. RESULTS Bone pain was the most common presenting feature, seen in 41.7% of patients, while 29.1% of patients were asymptomatic. The mean serum calcium and iPTH concentrations were 2.9±0.6 mmol/L and 657.1±682 ng/L, respectively. The mean total Z/T scores of dual-energy X-ray absorptiometry (DEXA) scan at the femur and lumbar spine were -0.4±1.6/-1.0±1.7 and -1.4±1.6/-2.2±1.5, respectively. Preoperative iPTH levels were correlated with serum phosphate (r=-0.412, P=0.005), alkaline phosphatase (r=0.698, P=0.0001), and femur (r=-0.402, P=0.020) and lumbar spine total Z scores (r=-0.441, P=0.013), whereas parathyroid adenoma volume was correlated with iPTH (r=0.367, P=0.036) and alkaline phosphatase (r=0.570, P=0.001). There was no correlation between iPTH, serum calcium levels and total T scores at the femur and lumbar spine. After excluding patients with 25-OHD insufficiency, there was still no correlation between serum iPTH and calcium levels. Parathyroid adenoma volume, serum iPTH and calcium levels were also not different between patients with and without 25-OHD insufficiency. CONCLUSION These results suggest that serum iPTH level may be useful in predicting parathyroid adenoma volume and it is also well correlated with femur and lumbar spine Z scores.
Collapse
Affiliation(s)
- S Kiyici
- Department of Endocrinology and Metabolism, Uludag University, Medical Faculty, Bursa, Turkey.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Affiliation(s)
- Metin Guclu
- Department of Endocrinology and Metabolism, School of Medicine, Uludag University, Bursa, Turkey
| | | | | | | | | |
Collapse
|
23
|
Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, Tuncel E, Erturk E, Imamoglu S. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010; 33:234-8. [PMID: 19820295 DOI: 10.1007/bf03345785] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6+/-5.7 yr, body mass index 33.9+/-5.1 kg/m(2). Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1+/-4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9+/-16 ng/ml to 37.1+/-14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assessment (HOMA)-IR significantly decreased from 4.41+/-1.38 to 3.67+/-1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a beneficial effect on IR in obese women with PCOS.
Collapse
Affiliation(s)
- H Selimoglu
- Division of Endocrinology, Malatya State Hospital, Malatya, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Kiyici S, Gul OO, Baskan EB, Hacioglu S, Budak F, Erturk E, Imamoglu S. Effect of levothyroxine treatment on clinical symptoms and serum cytokine levels in euthyroid patients with chronic idiopathic urticaria and thyroid autoimmunity. Clin Exp Dermatol 2009; 35:603-7. [DOI: 10.1111/j.1365-2230.2009.03642.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Kiyici S, Ersoy C, Kaderli A, Fazlioglu M, Budak F, Duran C, Gul OO, Sigirli D, Baran I, Tuncel E, Erturk E, Imamoglu S. Effect of rosiglitazone, metformin and medical nutrition treatment on arterial stiffness, serum MMP-9 and MCP-1 levels in drug naive type 2 diabetic patients. Diabetes Res Clin Pract 2009; 86:44-50. [PMID: 19674806 DOI: 10.1016/j.diabres.2009.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Revised: 07/07/2009] [Accepted: 07/13/2009] [Indexed: 11/29/2022]
Abstract
The aim of the study was to evaluate the long-term effect of rosiglitazone and metformin monotherapy with medical nutrition treatment (MNT) and of MNT alone on arterial stiffness, serum monocyte chemoattractant protein (MCP)-1 and matrix metalloproteinase (MMP)-9 in drug naive patients with type 2 diabetes mellitus. Fifty type 2 diabetic patients were randomized to receive rosiglitazone 4 mg/day (n=19) or metformin 850 mg/day (n=16) with MNT or MNT alone (n=15), for 52 weeks. Arterial stiffness was assessed by using large and small artery elasticity index (SAEI and LAEI, respectively). SAEI, LAEI, serum MCP-1 and MMP-9 levels were measured at baseline and following 52 weeks of treatment. SAEI was improved only in the rosiglitazone group, and the difference was still statistically significant when the three groups were compared (p=0.024). There were no differences in LAEI in inter- and intragroup comparisons at the end of the study. Serum MMP-9 levels were decreased in the metformin (-13.5+/-34.8%, p=0.02) and rosiglitazone (-27.2+/-51.0%, p=0.023) groups compared with baseline values, whereas no significant change was seen in serum MCP-1 levels. These results suggest that rosiglitazone monotherapy has favorable effects on arterial stiffness compared with metformin monotherapy independent of glycemic control.
Collapse
Affiliation(s)
- Sinem Kiyici
- Uludag University, Medical Faculty, Department of Endocrinology and Metabolism, Bursa 16059, Turkey.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Selimoglu H, Duran C, Kiyici S, Guclu M, Ersoy C, Ozkaya G, Erturk E, Tuncel E, Imamoglu S. Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects. Endocrine 2009; 36:299-304. [PMID: 19598007 DOI: 10.1007/s12020-009-9213-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 06/01/2009] [Accepted: 06/18/2009] [Indexed: 01/23/2023]
Abstract
Apart from fasting blood glucose (FBG) and insulin (FBI), oral glucose tolerance test (OGTT) is also used in calculating insulin sensitivity. During OGTT, insulin secretion may not reflect normal physiological insulin secretion. Based on this idea, hepatic and whole body insulin sensitivity rates were tested during OGTT and mixed meal test (MMT) in obese subjects. Thirty-one women with Quantitative Insulin Sensitivity Check Index (QUICKI) values below 0.350 and body mass index (BMI) >or=30 were included into the study. OGTT with 75-g glucose and MMT 300 kcal were applied to all cases. Data obtained from OGTT and MMT were used in the assessment of insulin sensitivity with Hemostasis of Model Assessment-Insulin Resistance (HOMA-IR) and Matsuda's Composite Whole Body Insulin Sensitivity Index (Matsuda's ISI). Mean BMI, FBG, and FBI were 36.8 +/- 3.9 kg/m(2), 100.5 +/- 0.10 mg/dl, 16.2 +/- 5.3 microg/ml, respectively. QUICKI was 0.31 +/- 0.01 and HOMA-IR was 3.71 +/- 0.88. Matsuda's ISI derived from OGTT was 6.96 +/- 3.35 and from MMT was 11.32 +/- 6.61. In analysis, it was demonstrated that there was a correlation between HOMA-IR, QUICKI, and Matsuda's ISIs derived from OGTT and MMT. Comparing the time periods separately, it was detected that despite similar increment in insulin levels, glucose levels were higher in OGTT than MMT at 15 and 30 min. Consequently, Matsuda's ISI was demonstrated to be effectively used with the data of MMT, as used with OGTT. Moreover, MMT was shown to be in parallel to physiologic insulin secretion and reflect pancreatic functions better compared to OGTT.
Collapse
Affiliation(s)
- Hadi Selimoglu
- Division of Endocrinology, Malatya State Hospital, Malatya, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Kiyici S, Ersoy C, Oz Gul O, Sarandol E, Demirci M, Tuncel E, Sigirli D, Erturk E, Imamoglu S. Total and Acylated Ghrelin Levels in Type 2 Diabetic Patients: Similar Levels Observed after Treatment with Metformin, Pioglitazone or Diet Therapy. Exp Clin Endocrinol Diabetes 2009; 117:386-90. [DOI: 10.1055/s-0029-1220936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
Cekic B, Geze S, Ulusoy H, Coskun I, Erturk E. Postoperative repeated respiratory insufficiency and thyrotoxicosis in molar pregnancy. Ir J Med Sci 2009; 181:281-3. [PMID: 19350345 DOI: 10.1007/s11845-009-0328-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 03/11/2009] [Indexed: 12/01/2022]
Abstract
Following the removal of a hydatiform mole in a 34-year-old, 14-week pregnant patient, thyrotoxicosis and respiratory insufficiency attacks were twice unexpectedly repeated. The symptoms were resolved with the administration of plasmapheresis, antithyroid and β-blocker drugs and non-invasive mechanical ventilation; however, she was again operated due to prolonged elevated β-hCG.
Collapse
Affiliation(s)
- B Cekic
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, 61080, Trabzon, Turkey
| | | | | | | | | |
Collapse
|
29
|
Duran C, Tuncel E, Ersoy C, Ercan I, Selimoglu H, Kiyici S, Guclu M, Erturk E, Imamoglu S. The investigation of the efficacy of insulin glargine on glycemic control when combined with either repaglinide or acarbose in obese Type 2 diabetic patients. J Endocrinol Invest 2009; 32:69-73. [PMID: 19337019 DOI: 10.1007/bf03345682] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Combinations of insulin and oral antidiabetic drugs (OAD) are often prescribed instead of insulin alone. In this study, the effects of insulin glargine (IG) in combination with repaglinide or acarbose on glycemic parameters were investigated. Obese Type 2 diabetic patients with fasting blood glucose (FBG) levels >or= 7.7 mmol/l [corrected] and hemoglobin glycated (A1C) >or=9% under maximal OAD combination therapy were enrolled. Previous therapies were discontinued, and patients were randomized into 2 groups. The combinations of IG and repaglinide were administered to group 1, and of IG and acarbose to group 2 for 13 weeks. Twenty patients in group 1 and 18 patients in group 2 completed the study. A1C levels were significantly decreased from 10.9+/-1.4% to 7.7+/-1.1% in group 1 and 11.0+/-1.4% to 8.1+/-1.4% in group 2. FBG levels were significantly decreased from 11.9+/-2.7 to 7.1+/-2.3 mmol/l in group 1 and 11.1+/-2.5 to 6.8+/-1.4 mmol/l in group 2. Post-prandial glucose levels were significantly decreased from 15.3+/-3.8 to 10.3+/-3.0 mmol/l in group 1 and 14.0+/-3.1 to 8.9+/-2.2 mmol/l in group 2. Intergroup comparisons indicated no significant differences. More weight gain was detected in group 1, compared to the baseline. Symptomatic hypoglycemia incidence was similar in both groups. Severe hypoglycemic attacks were seen in two patients in group 1. Flatulence incidence was higher in acarbose group. Conclusively, repaglinide and acarbose were equally effective when combined with IG for obese Type 2 diabetic patients controlled inadequately with OAD alone. Furthermore, acarbose seems to have advantages over repaglinide concerning weight gain and severe hypoglycemic attacks.
Collapse
Affiliation(s)
- C Duran
- Division of Endocrinology, Konya Education and Research Hospital, Meram Konya 42000, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Haberal I, Kaplan M, Zorman Y, Aksoy T, Erturk E, Akyildiz M. Carotid artery disease development after traumatic injury inflicted by a Ram's Horn. Heart Surg Forum 2008; 11:E260-2. [PMID: 18782709 DOI: 10.1532/hsf98.20081020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 36-year-old man presented for treatment of headache, paresthesis, and weakness of his right arm and leg. Examination revealed an atherosclerotic plaque in the left common carotid artery, lying to the left internal carotid artery and resulting in 99% stenosis. The plaque was removed successfully by carotid endarterectomy. Pathological examination of the tissue confirmed the diagnosis of an atherosclerotic plaque. Detailed investigation of risk factors led to the conclusion that the stenosis of the carotid artery was due to blunt trauma caused by an injury that had occurred 30 years previously when the patient was gored by a ram's horn.
Collapse
Affiliation(s)
- I Haberal
- Maltepe University School of Medicine, Maltepe, Turkey.
| | | | | | | | | | | |
Collapse
|
31
|
Senel A, Ukinc O, Erturk E. 725. Comparison of Ropivacaine Versus Ropivacaine + Tramadol or Ropivacaine + Ketamine on Axillary Approach Brachial Plexus Block Anesthesia. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Cengiz M, Erturk E, Dogan A, Ulger S, Colak F, Ozyigit G, Yildiz F, Selek U, Zorlu F. Stereotactic Body Radiosurgery versus Intracavitary Brachytherapy for Cervical Cancer: A Dosimetric Comparison Study. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Cardin AL, Marshall J, Bhatt S, Erturk E, Wu G, Dogra VS. Antopol-Goldman lesion of the kidney diagnosed by radiology: a case report of observation. Acta Radiol 2008; 49:715-7. [PMID: 18568566 DOI: 10.1080/02841850802056009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antopol-Goldman lesions are extremely rare and are characterized by subepithelial hematoma in the renal pelvis. There have been at least 28 case reports in the literature, with all being diagnosed histologically after partial or total nephrectomy for a presumed malignancy. We report the first case in the literature to be diagnosed by radiological imaging and followed on an observatory basis.
Collapse
Affiliation(s)
- A. L. Cardin
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - J. Marshall
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - S. Bhatt
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - E. Erturk
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - G. Wu
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - V. S. Dogra
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| |
Collapse
|
34
|
Ersoy C, Kiyici S, Budak F, Oral B, Guclu M, Duran C, Selimoglu H, Erturk E, Tuncel E, Imamoglu S. The effect of metformin treatment on VEGF and PAI-1 levels in obese type 2 diabetic patients. Diabetes Res Clin Pract 2008; 81:56-60. [PMID: 18358555 DOI: 10.1016/j.diabres.2008.02.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 02/07/2008] [Indexed: 10/22/2022]
Abstract
The aim of the study was to evaluate the effect of metformin on markers of endothelial function, vascular inflammation and factors of thrombosis in obese type 2 diabetic patients. Twenty-four type 2 diabetic patients (15 female, 9 male) previously under medical nutrition treatment (MNT)+regular exercise programme (REP) without chronic micro or macrovascular complications with the mean age of 50.5+/-1.5 years, diabetes duration of 17.9+/-6.3 months and body mass index (BMI) of 31.7+/-0.8 kg/m(2) were enrolled in the study. In the first 4 weeks, all the patients continued MNT+REP. In the following 12 weeks, metformin (mean daily dosage of 1381+/-85 mg) was added. After the first period with MNT+REP, BMI, waist circumference, fat percentage, blood pressure and HDL cholesterol decreased significantly. After metformin addition, there was a significant decrement in BMI, waist circumference, fat percentage, fasting and postprandial plasma glucose, hemoglobin A1C, plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF) and increment in beta cell reserve values of the patients. Our results indicated that, metformin addition had beneficial effect on VEGF and PAI-1 levels in obese type 2 diabetic patients under MNT+REP, independent from its' favourable effects on BMI and glycemic control.
Collapse
Affiliation(s)
- Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, 16059 Görükle-Bursa, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Duran C, Ediger D, Ersoy C, Coskun NF, Selimoglu H, Ercan I, Kiyici S, Guclu M, Saglam DA, Erturk E, Tuncel E, Imamoglu S. Frequency of atopy and allergic disorders among adults with Type 1 diabetes mellitus in the southern Marmara region of Turkey. J Endocrinol Invest 2008; 31:211-5. [PMID: 18401202 DOI: 10.1007/bf03345592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. METHODS Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. RESULTS Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. CONCLUSION We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.
Collapse
Affiliation(s)
- C Duran
- Division of Endocrinology and Metabolism, Konya Education and Research Hospital, Konya, Turkey.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Unal O, Erturk E, Ozkan H, Kiyici S, Guclu M, Ersoy C, Yener F, Imamoglu S. Effect of levothyroxine treatment on QT dispersion in patients with subclinical hypothyroidism. Endocr Pract 2008; 13:711-5. [PMID: 18194926 DOI: 10.4158/ep.13.7.711] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the effect of levothyroxine treatment in patients with subclinical hypothyroidism on electrocardiographic variables, especially on ventricular repolarization-related factors. METHODS Sixteen women (mean age, 48.2 years) with subclinical hypothyroidism were treated with levothyroxine for 16 weeks. All standard 12-lead electrocardiographic recordings were scanned and transferred to a computer, and the QT intervals were measured on 300 times magnified recordings. QT dispersion, which reflects the heterogeneity of the ventricular repolarization, was calculated by the difference between the QT maximum and the QT minimum. RESULTS We found that, after 16 weeks of levothyroxine treatment, the QT interval decreased from 387.2 +/- 10.8 ms to 345.6 +/- 13.0 ms (P<0.0001). The study patients exhibited a significant reduction of QT dispersion from 46.5 +/- 5.3 ms to 30.7 +/- 5.8 ms (P<0.0001). On linear regression analysis, a positive relationship was found between QT dispersion and logarithmic serum TSH levels (r = 0.492; P<0.0001). CONCLUSION We conclude that serum TSH concentration has a role in ventricular inhomogeneity and, therefore, that subclinical hypothyroidism may predispose to ventricular arrhythmias. A large-scale, multicenter, randomized trial should be undertaken to address the benefit-to-risk ratio of levothyroxine treatment on cardiac inhomogeneity in patients with subclinical hypothyroidism.
Collapse
Affiliation(s)
- Oguzkaan Unal
- Department of Endocrinology, Uludag University School of Medicine, Bursa, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Erturk E, Bostan H, Geze S, Saracoglu S, Erciyes N, Eroglu A. Total intravenous anesthesia for evacuation of a hydatidiform mole and termination of pregnancy in a patient with thyrotoxicosis. Int J Obstet Anesth 2007; 16:363-6. [PMID: 17459690 DOI: 10.1016/j.ijoa.2006.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 09/01/2006] [Accepted: 12/01/2006] [Indexed: 02/07/2023]
Abstract
Clinical hyperthyroidism is found in approximately 5% of women with a hydatidiform mole, as human chorionic gonadotropin secreted by molar tissue is structurally similar to thyroid-stimulating hormone. A hydatidiform mole occasionally presents with a co-existing viable fetus. Surgical evacuation may be indicated for significant hemorrhage or preeclampsia. Perioperative management in the presence of hyperthyroidism may be complicated by a thyroid storm. We report a case of total intravenous anesthesia with propofol and remifentanil, combined with an esmolol infusion, to control sympathetic hyperactivity during surgery.
Collapse
Affiliation(s)
- E Erturk
- Karadeniz Technical University, Medical Faculty, Department of Anesthesiology, Trabzon, Turkey.
| | | | | | | | | | | |
Collapse
|
38
|
Erturk E, Senel A, Ukinc O, Duman E. 575 COMPARISON OF THE EFFECTS OF ROPIVACAINE VERSUS ROPIVACAINE + TRAMADOL OR ROPIVACAINE + KETAMINE ON AXILLARY APPROACH BRACHIAL PLEXUS BLOCK IN HAND SURGERY. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
39
|
Joseph JV, Rosenbaum R, Madeb R, Erturk E, Patel HRH. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol 2006; 175:945-50; discussion 951. [PMID: 16469589 DOI: 10.1016/s0022-5347(05)00340-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [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: 05/02/2005] [Indexed: 11/15/2022]
Abstract
PURPOSE Laparoscopic radical prostatectomy with or without a robot has been increasingly performed worldwide, primarily using a transperitoneal approach. We report our experience with daVinci(R) robot assisted extraperitoneal laparoscopic radical prostatectomy. MATERIALS AND METHODS A total of 325 patients underwent robot assisted extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer at our center during a 2-year period. Perioperative data, and oncological and functional results were prospectively recorded. RESULTS Perioperative demographics included mean age, PSA and Gleason score, which were 60 years (range 42 to 76), 6.6 ng/ml (range 0.6 to 26) and 6 (range 5 to 9), respectively. Preoperative clinical stage was 81%, 16% and 3% for T1c, T2a and T2b, respectively. Average total operative time was 130 minutes (range 80 to 480). Intraoperative data included a mean blood loss of 196 cc with no open conversions. Bilateral, unilateral and nonnerve sparing prostatectomy was performed in 70%, 24% and 6% of patients, respectively. Of the patients 96% were discharged home within 8 to 23 hours of surgery. Pathological stage was pT2a, pT2b, pT3a and pT3b in 18%, 63%, 14% and 5% of all radical prostatectomy specimens, respectively, with an overall positive surgical margin rate of 13%. Two of 92 patients had positive nodal disease after lymph node dissection. Continence and erectile function were measured. CONCLUSIONS The extraperitoneal approach offers the advantages of improved dexterity and visualization of the robot, while avoiding the abdominal cavity and potential associated morbidity. As surgeons gain more experience with this new technology, the extraperitoneal approach simulating the standard open retropubic technique is likely to gain popularity.
Collapse
Affiliation(s)
- J V Joseph
- Section of Laparoscopic and Robotic Surgery, Department of Urology, University of Rochester Medical Center, Rochester, New York 14642-8656, USA.
| | | | | | | | | |
Collapse
|
40
|
Erturk E, Keskin M, Ersoy C, Kaleli T, Imamoglu S, Filiz G. Metacarpal brown tumor in secondary hyperparathyroidism due to vitamin-D deficiency. A case report. J Bone Joint Surg Am 2005; 87:1363-6. [PMID: 15930550 DOI: 10.2106/jbjs.d.02250] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Erdinc Erturk
- Department of Endocrinology, Uludag University School of Medicine, Gorukle 16059 Bursa, Turkey.
| | | | | | | | | | | |
Collapse
|
41
|
Ersoy C, Imamoglu S, Tuncel E, Erturk E, Ercan I. Comparison of the factors that influence obesity prevalence in three district municipalities of the same city with different socioeconomical status: a survey analysis in an urban Turkish population. Prev Med 2005; 40:181-8. [PMID: 15533527 DOI: 10.1016/j.ypmed.2004.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To evaluate the obesity status, factors and comorbidities related to it in three district municipalities (DM) that compose city center of Bursa with inhabitants of different socioeconomic status. METHODS A total of 1632 inhabitants >/=18 years of age were interviewed. The number of sample in each DM was obtained proportional to their populations by stratified sampling method. Among 1632, a total of 1543 subjects were included by random sampling and a questionnaire was filled in including demographic, social and behavioral features. RESULTS The participants living in DM with the highest socioeconomical status (SES) score and level of education had the lowest body mass index (BMI) and body fat percentage (%BF) compared to other DMs. The lowest obesity prevalence (30.8% vs. 36.4% and 39.3%) in that DM was possibly due to younger age, lower female ratio, more active professional, higher percentage of smoking, more consumption of vegetables, olive or corn oil, and less carbohydrate. For the evaluation of the factors that may influence obesity risk, we investigated the effects of these factors in men and women separately with logistic regression model. Sedentary life style and dyslipidemia (DL) in men, being unemployed, having lower level of education and having hypertension (HT) in women and familial obesity in both gender were found to be related to increased obesity risk. CONCLUSIONS The prevalence of obesity in Bursa is increasing although inhabitants are taking some precautions parallel to their socioeconomical and educational levels. Obesity is becoming a more alarming public health problem in Bursa and Turkey like in most other parts of the world, which forces us to invent new prevention policies. Besides, the results of our study highlight the fact that especially female education requires more attention for decreasing obesity prevalence in coming generations.
Collapse
Affiliation(s)
- Canan Ersoy
- Department of Endocrinology and Metabolism, Uludağ University Medical School, 16059, Görükle Bursa, Turkey.
| | | | | | | | | |
Collapse
|
42
|
Abstract
AIM The aim of this study was to evaluate transsphenoidal surgery results in acromegalic patients which were performed not by a single surgeon but by different surgeons. METHODS The study included 30 (M/F: 13/17) patients whose follow-up data were available. Basal or nadir postglucose growth hormone levels of less than 2 ng/ml were accepted as cure criteria. Six of them underwent a further operation due to previous surgical failure. RESULTS Cure was achieved in 33% of patients while hypopituitarism was observed in 10% (3/30) of patients after the first operation. The cure rates were 63% and 15% in patients with microadenomas (n = 11) and macroadenomas (n = 19) respectively (p = 0.042). Only one of the patients (16%) who underwent a second operation achieved remission, while hypopituitarism was observed in five of them (83%). There was no significant difference in the cure rates between the first and second operation, but the risk of hypopituitarism was significantly higher in patients who underwent further surgery (p = 0.008). CONCLUSION The cure rate following surgery is significantly lower in acromegalic patients with macroadenomas than in patients with microadenomas. Cure probability decreases with a further operation, while complication risk increases significantly. Octreotide therapy, which could be used as an alternative therapy to the surgery, revealed high success rates in both microadenomas and macroadenomas. The low cure rates found in this study compared with published series could be attributed to the fact that operations were performed by inexperienced surgeons.
Collapse
Affiliation(s)
- Erdinc Erturk
- Department of Endocrinology, Uludag University, School of Medicine, 16059, Bursa, Turkey.
| | | | | | | | | | | |
Collapse
|
43
|
Erturk E, Kuru N, Savci V, Tuncel E, Ersoy C, Imamoglu S. Serum leptin levels correlate with obesity parameters but not with hyperinsulinism in women with polycystic ovary syndrome. Fertil Steril 2004; 82:1364-8. [PMID: 15533361 DOI: 10.1016/j.fertnstert.2004.04.049] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [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: 10/28/2003] [Revised: 04/12/2004] [Accepted: 04/12/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine serum leptin concentrations in obese and lean patients with polycystic ovary syndrome (PCOS) to assess whether the changes in leptin levels are due to obesity or hormonal alterations. DESIGN Controlled clinical study. SETTING Academic research environment. PATIENT(S) Obese and lean women with PCOS. INTERVENTION(S) Blood samples were collected before and after food consumption. MAIN OUTCOME MEASURE(S) Serum leptin and insulin levels. RESULT(S) Serum leptin concentrations were significantly correlated with body mass index (r = 0.649) and also with HOMA (r = 0.535). However, after controlling for body mass index in a partial correlation analysis, no significant correlation was found between serum leptin levels and HOMA or hyperinsulinemia. While lean patients with PCOS had a significant correlation between leptin concentrations and obesity parameters, they did not show any significant correlation with insulin resistance parameters. CONCLUSION(S) Although leptin concentrations in women with PCOS correlate with insulin resistance/hyperinsulinemia, this is related only to obesity.
Collapse
Affiliation(s)
- Erdinc Erturk
- Department of Endocrinology, Uludag University Hospital, Bursa, Turkey
| | | | | | | | | | | |
Collapse
|
44
|
Tuncel E, Erturk E, Ersoy C, Kiyici S, Duran C, Kuru N, Imamoglu S. Physical activity alters urinary albumin/ creatinine ratio in type 1 diabetic patient. J Sports Sci Med 2004; 3:49-54. [PMID: 24497821 PMCID: PMC3896114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2003] [Accepted: 12/11/2003] [Indexed: 06/03/2023]
Abstract
While the best way to identify microalbuminuria is to determine albumin excretion rate (AER) in a 24 h urine sample. Published data have shown that calculation of an albumin/creatinine ratio (ACR) in a spot urine sample has reasonable rate of sensitivity and specificity. We aimed to evaluate the effect of daily exercise on ACR and estimate the best time for the examination of the ACR in a spot urine sample. Sixteen eligible patients with Type 1 diabetes mellitus were asked to perform varying degree of exercise periods. Urinary albumin and creatinine excretion rates during each period were determined. ACR and AER of timed urinary samples were compared with the 24 hour urinary AER. We found significant correlations between timed and 24 hour urinary AER. According to diagnostic performance tests, ACR and AER of timed urine samples were both found to be significantly more sensitive during resting period when compared with mild or moderate active periods. It is concluded that ACR and AER of a timed urine sample are sensitive and specific methods for determining microalbuminuria, while overnight resting samples give the impression of being more diagnostic. Key PointsTimed urine samples can predict microalbuminuria but because of the erroneous urine collections, microalbuminuria measurement should be calculated with creatiniuria measurement.With increasing physical activity during urine collection diagnostic performances of the cut-off values go downhill.For detecting microalbuminuria best results are reached with the early-morning urine samples.
Collapse
Affiliation(s)
- Ercan Tuncel
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Erdinc Erturk
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Canan Ersoy
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Sinem Kiyici
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Cevdet Duran
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Nesrin Kuru
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| | - Sazi Imamoglu
- Uludag University School of Medicine, Department of Endocrinology , Bursa, Turkey
| |
Collapse
|
45
|
|
46
|
Abstract
PURPOSE To characterize the effect of operator experience and type of anesthesia on treatment outcome when switching from the Dornier HM3 to the third-generation Dornier U/50 lithotripter. PATIENTS AND METHODS A population of 370 consecutive patients treated by 15 urologists was divided into two groups. Group I (N = 225) included patients treated during the initial 3 months with our new lithotripter. Group II (N = 145) included patients treated during the last 3 months. Changes were made during the intervening 6 months in focusing technique, anesthesia type, coupling technique, and shockwave delivery. Information was collected regarding success of stone treatment (defined as complete clearance of stone or fragments < 3 mm at 1 month). RESULTS There were no differences between the two groups with regard to age, sex, fluoroscopic time or maximal shockwave intensity used. Group I had a slightly higher percentage of upper ureteral stones (20% v 13%); however, the difference was not significant. Upper ureteral stones in Group II were on average significantly larger (9.4 mm v 7.3 mm; P = 0.003). Intravenous sedation was used frequently in Group I (111 patients; 49%) and not at all in Group II. General anesthesia was used more frequently in Group II than in group I (34% v 24%; P < 0.02). Spinal anesthesia also was utilized more frequently in Group II patients (66% v 28%; P < 0.0001). Overall, general or regional anesthesia was received by 100% of the patients in Group II but only 52% of the patients in group I. The success rate of stone treatment was much better for Group II than for Group I (78% v 51%; P < 0.0001). CONCLUSION The transition from a Dornier HM3 lithotripter to a third-generation lithotripter can be difficult, but if adequate anesthesia is given to minimize patient movement and balloon pressures are optimized, stone targeting can be accurate and similar stone clearance rates can be obtained.
Collapse
Affiliation(s)
- L Eichel
- Department of Urology, University of Rochester School of Medicine, New York 14642, USA
| | | | | |
Collapse
|
47
|
McNally ML, Erturk E, Oleyourryk G, Schoeniger L. Laparoscopic cyst decortication using the harmonic scalpel for symptomatic autosomal dominant polycystic kidney disease. J Endourol 2001; 15:597-9. [PMID: 11552783 DOI: 10.1089/089277901750426364] [Citation(s) in RCA: 22] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Management of acute and chronic pain in patients with autosomal dominant polycystic kidney disease (ADPKD) has, until recently, been limited to oral narcotic regimens, percutaneous drainage, open decortication, or nephrectomy. PATIENTS AND METHODS Five women and two men with a mean age of 44 (range 20-55) years underwent laparoscopic cyst decortication with the Harmonic Scalpel. All patients had end-stage renal disease secondary to ADPKD and pain attributed to their cyst disease. Two patients had simultaneous bilateral, one had staged bilateral, and remaining four patients had unilateral decortication. The mean follow-up was 14 months (range 2-29 months). Preoperative and postoperative pain was assessed using a standardized scale. RESULTS There were no intraoperative complication, and visible cysts were decorticated in a total of 10 renal units. There was a significant reduction in the pain scale, from a mean of 7.4/10 preoperatively to 2.3/10 on follow-up for the entire group (P < 0.0001). One patient reported recurrence of pain at 4 months, and bilateral nephrectomy was performed. Major complications included postoperative bleeding in two patients and readmission for ileus in one. CONCLUSION Laparoscopic decortication of painful renal cysts in ADPKD patients is a feasible procedure for symptomatic relief. The Harmonic Scalpel is a useful tool; however, it may not be adequate in preventing delayed bleeding.
Collapse
Affiliation(s)
- M L McNally
- Department of Urology, University of Rochester School of Medicine, New York 14642, USA.
| | | | | | | |
Collapse
|
48
|
Zand MS, Strang J, Dumlao M, Rubens D, Erturk E, Bronsther O. Screening a living kidney donor for polycystic kidney disease using heavily T2-weighted MRI. Am J Kidney Dis 2001; 37:612-9. [PMID: 11228187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) accounts for approximately 8% of those awaiting renal transplantation. Living related kidney donors for these patients require screening for ADPKD, most commonly by ultrasonography. Ultrasound has a negative predictive value (NPV) of 100% in patients aged older than 30 years, but only 96% for donors aged 20 to 30 years. This case shows that heavily T2-weighted magnetic resonance imaging (HT2MRI) may be a more sensitive screening method for ADPKD in younger kidney donors. Despite a normal screening ultrasound result, a kidney donor with a family history of ADPKD was found to have renal cysts intraoperatively, and the transplantation was canceled. Afterward, the donor was imaged with HT2MRI. In addition, the mathematical relationship between sensitivity, specificity, and NPV for ADPKD screening tests was derived. After the canceled transplantation, a second ultrasound still could not identify renal cysts. However, HT2MRI showed multiple small ( approximately 3-mm) cysts in both kidneys and a 2.5-cm cyst on the right kidney. Mathematical analysis showed that the NPV of a screening test for ADPKD was most closely related to sensitivity and that only tests with 100% sensitivity would have a 100% NPV. We conclude that ultrasound is not a sufficiently sensitive screening test for ADPKD in younger living related renal donors. HT2MRI has improved sensitivity and may be the best screening test for ADPKD in this population.
Collapse
Affiliation(s)
- M S Zand
- Department of Medicine, Nephrology Unit, Division of Solid Organ Transplantation, University of Rochester Medical Center, Rochester, NY, USA.
| | | | | | | | | | | |
Collapse
|
49
|
Affiliation(s)
- L Eichel
- Department of Urology, University of Rochester School of Medicine, New York, USA
| | | | | |
Collapse
|
50
|
Maines MD, Mayer RD, Erturk E, Huang TJ, Disantagnese A. The oxidoreductase, biliverdin reductase, is induced in human renal carcinoma--pH and cofactor-specific increase in activity. J Urol 1999; 162:1467-72. [PMID: 10492239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE Biliverdin reductase is an oxidoreductase unique among all enzymes characterized to date in having dual pH/dual cofactor requirement - NADH and NADPH at 6.7 and 8.7, respectively. The protein shows extensive microheterogeneity that is caused by post-translational modification. The reductase converts the heme degradation product, biliverdin, to bilirubin. Bilirubin has been shown to inhibit responses of human lymphocytes, including phytohemagglutinin-induced proliferation, interleukin-2 production, and antibody dependent and independent cell mediated cytotoxicity. In addition to acting as an antioxidant, it inhibits protein phosphorylation and activity of enzymes such as protein kinase C and NADPH oxidase. This research was to evaluate whether renal cell carcinoma differs from normal tissue in regard to the expression and activity of the reductase. MATERIALS AND METHODS Kidney tissue with or without visible renal carcinoma and normal kidney tissue from a brain dead patient were frozen at -80C shortly after removal. Ten microm. tissue sections were used for immunostaining of biliverdin reductase, pooled isolated tumors and surrounding tissue that did not contain visible tumor were used for Northern blot analysis of mRNA and Western blot analysis of protein. Enzyme activity was also measured in these preparations at pH 6.7 with NADH, and at pH 8.7 with NADPH. Ten additional formalin fixed specimens of renal cell carcinoma were also used for immunostaining. RESULTS There was a striking increase in the reductase protein levels, as visualized by immunostaining in tumor tissue cells. The increase was also evident by Western blotting, and involved in increased transcription of biliverdin reductase as suggested by Northern blot analysis. The protein would also be detected in the infiltrating monocytes, macrophages, T cells and neutrophils as well as in circulating lymphocytes. The enzyme activity was nearly doubled in the tumor tissue, but selectively with NADH as the cofactor. CONCLUSION Increases in biliverdin reductase expression and activity only with NADH is found in renal cell carcinoma. The net effects of this change are uncertain at present but several pathways, which could be affected by the reductase, may alter local physiology. Biliverdin reductase as a zinc metalloprotein may directly interact with other regulatory proteins, generation of increased bilirubin may alter immune function and increased enzyme activity may deplete NADH with contrasting consequence of blocking free radical formation and depleting cellular ATP. To the benefit of the host, the latter could culminate in tumor cell death.
Collapse
Affiliation(s)
- M D Maines
- Department of Biochemistry and Biophysics, University of Rochester School of Medicine, New York 14642, USA
| | | | | | | | | |
Collapse
|