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Öğe Adrenal İnsidentalomalı Hastalarda Metabolik Parametreler(2015) Turan, Elif; Kulaksızoğlu, Mustafa; Karakurt, Feridun; Kaya, AhmetAmaç: İnsidental olarak tespit edilen adrenal kitlesi olan hastalarda metabolik durumu belirlemek. Gereç ve Yöntemler: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim dalında Ocak 2010 ve Şubat 2014 tarihleri arasında yatırılarak fonksiyonel tarama yapılan adrenal insidentaloması olan 67 hasta çalışmaya dahil edildi. Bulgular: 67 hastanın 34ü erkek, 33ü kadındı. Hastaların yaş ortalaması 57.1 12, tüm hastaların vücut kütle indeksi 29.16 kg/m2 idi. Çalışmaya dahil edilen hastalara fonksiyonel tarama olarak; Cushing Sendromu, feok- romasitoma ve primer hiperaldesteronizme yönelik tarama testleri uygulandı. 67 hastanın 8 tanesi fonksiyone olarak (6 feokromasitoma, 1 Cushing Sendromu, 1 primerhiperaldesteronizm) tespit edildi. Hastaların 38 tane- sinde bozulmuş açlık glikozu veya tip 2 Diabetes Mellitus tespit edildi. Tüm hastaların ortalama glukoz değeri 127.618 mg/dl, fonksiyone olmayan hastaların ortalama glukozu 12962 mg/dl, fonksiyone olan hastaların glukoz ortalaması ise 117.232 mg/dl olarak ölçüldü. Tüm hastalarda sistolik kan basıncı 12518 mm/Hg, dias- tolik kan basıncı ise 7710.9 mm/Hg olarak ölçüldü. Fonksiyone hastaların ortalama sistolik basıncı 13510.4 mm/Hg iken, fonksiyone olmayan hastalarda 12419 mm/Hg tespit edildi. Tüm hastaların trigliserit, HDL, LDL kolesterol ölçümleri alındı. Sırasıyla ortalama değerleri; 157.583 mg/dl (normal 150mg/dl), 39.39.5 mg/dl (normal 40mg/dl), 120.137 mg/dl (normal 100mg/dl) bulundu. Sonuç: Çalışmamızda sürrenal insidentaloma hastalarının % 56sında insülin direncini gösteren bozulmuş açlık glukozu ve Tip 2 DM tespit edilmiştir. Klinik olarak fonksiyonel olmayan adrenal adenomların neden olduğu hafif kortizol fazlalığı tam olarak cushingoid görüntü gelişmesi için yeterli değilse de, insülin direnci ve bunun klinik sonuçlarına neden olabilmektedir. Bu artmış vücut kütle indeksi ve/veya insidentalomalı hastalarda subk- linik cushing sendromu sıklığı ile de ilişkili olabilir.Öğe Aggravation of Acute Adrenal Crisis Due to Varenicline in a Patient with Adrenal Insufficiency(2016) Turan, Elif; Turan, Yaşar; Savut, Bülent; Kulaksızoğlu, Mustafa; Karakurt, FeridunBiz bu çalışmada primer adrenal yetmezliği olan erkek olguyu sunduk. Sigara bırakmak için vareniklin kullanılan hastamızda adrenal kriz gelişti. Hasta muhtemel adrenal kriz nedenleri ile ilgili dikkatlice tetkik edildi. Tek farklılık bir hafta önce vareniklin tedavisi başlamasıydı. Vareniklin tedavisi altında akut adrenal kriz gelişen ilk olgu sunumunu rapor ettik. Anaktar kelimeler: Vareniklin, adrenal, yetersizlik.Öğe The Effect of Blood Glucose Value on the Short-term Mortality of Acute Ischemic Stroke(Galenos Publ House, 2021) Tokgoz, Osman Serhat; Karakurt, Feridun; Bugrul, AhmetAim: This study aimed to examine the relationship between short-term mortality and blood glucose values (BGV) obtained during the first week of ischemic stroke, when neurological causes, such as increased intracranial pressure, are mainly predominant in mortality prediction. Materials and Methods: This is a retrospective study that includes 417 patients with acute ischemic stroke (AIS), who were admitted to our hospital within the first 24 hours of the stroke. Data were recorded using the International Classification of Diseases Code. On the first, third, fifth, and seventh days of the stroke, the effect of BGV on the patient's functional outcome was evaluated. Results: Of 417 patients, 90 (21.58%) died within a one-month follow-up period. There was no difference between the mortality and survival groups in terms of diabetes mellitus (DM) history (chi 2=0.783; p=0.224). On the first, third, fifth, and seventh day of the stroke, BGV were significantly higher in the mortality group (130.5 mg/dL, 124.5 mg/dL, 133.5 mg/dL, and 132.5 mg/dL, respectively, according to the receiver operating characteristic analysis) than in the survival group (p<0.05). BGV of the fifth day (133.5 mg/dL) was an independent predictor for mortality (hazard ratio: 3.001; 95% confidence interval (1.43-6.3); p=0.004), while BGV of the other days were dependent on a coma scale. Conclusion: Hyperglycemia predicting short-term AIS mortality might be a DM-independent stress hyperglycemia. Although hyperglycemia is predominantly a coma-scale-dependent [modified Rankin Scale (mRS)] predictor during the first week of blood glucose monitoring, BGV of the fifth day may be an independent predictor of short-term mortality.Öğe Expression of endocan and vascular endothelial growth factor and their correlation with histopathological prognostic parameters in pheochromocytoma(Springer, 2023) Kocabas, Muhammet; Can, Mustafa; Karakose, Melia; Esen, Haci Hasan; Kulaksizoglu, Mustafa; Karakurt, FeridunObjectiveEndocan and vascular endothelial growth factor (VEGF) are markers expressed in various cancer types that are highly vascular, and they have prognostic significance for these cancers. In this study, we aimed to show the expression of endocan and VEGF in pheochromocytoma tumor tissues and to evaluate their correlations with histopathological parameters.Material and methodsThirty-eight patients who had been operated for pheochromocytoma were included in the study. As the control group, 28 subjects whose specimens contained normal adrenal medulla tissue were included. The formalin-fixed paraffin-embedded specimens of pheochromocytoma patients were evaluated for Pheochromocytoma of the Adrenal gland Scaled Score (PASS). Sections were then stained for immunohistochemical analysis. The degree of endocan and VEGF positivity was determined by the proportion of stained cells on a negative to strong scale.ResultsEndocan (p < 0.001) and VEGF (p = 0.004) expressions were found to be significantly higher in the pheochromocytoma group than in the control group. In the pheochromocytoma group, total PASS score (r = 0.714; p < 0.001) and most of the PASS score components were positively correlated with the level of endocan expression. Median Ki-67 index (p = 0.010), total PASS score (p < 0.001), tumor cell spindling (p = 0.048), and nuclear pleomorphism (p = 0.030) were higher in pheochromocytoma with VEGF expression than in those without.ConclusionIf our findings are supported by studies with a larger sample size, we think that endocan has the potential to be used both as a tumor marker and in predicting malignancy potential in patients with pheochromocytoma, and that the detection of VEGF expression in these tumors is also associated with an increase in malignancy potential.Öğe Expression of the angiogenesis markers endocan in Cushing's syndrome due to cortisol producing adenoma(Springer, 2023) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Esen, Haci Hasan; Kulaksizoglu, Mustafa; Karakurt, FeridunPurpose In this study, we aimed to investigate the endocan expression in tissue samples of patients diagnosed with Cushing's syndrome (CS) due to Cortisol-Producing-Adenoma (CPA) and compare it with normal adrenal cortex tissue, and also to evaluate the correlations of endocan expression with clinical and histopathological features. Methods 11 patients who were operated for CS due to CPA between 2009-2021 and 14 control subjects with normal adrenal cortex were included in the study. Demographic, laboratory and clinicopathological data of the patients were recorded. Sections of 4-5 mu m thickness were taken from paraffin blocks of patients diagnosed with CS due to CPA and control subjects with normal adrenal cortex tissue. The sections were then stained in a closed system automatic immunohistochemical staining device to perform immunohistochemical analysis. The endocan positive grade were determined based on the proportion of stained cells on a scale of negative to strong. Results The number of subjects with positive endocan expression and the mean endocan expression level in the CS group were significantly higher than the control group (p = 0.005, p < 0.001, respectively). No correlation was found between endocan expression and clinical and histopathological features. Conclusion According to the results of our study, endocan overexpression in CPA tissues may be related to the hormonal functionality of CPA.Öğe HDR Syndrome Accompanying Type 1 Diabetes Mellitus and Hypopituitarism(Hindawi Ltd, 2019) Can, Mustafa; Karakurt, Feridun; Kocabas, Muhammed; Cordan, Ilker; Karakose, Melia; Kulaksizoglu, MustafaHDR (Hypoparathyroidism, Deafness, and Renal Dysplasia) syndrome is an autosomal dominant disorder characterized by the triad of hypoparathyroidism, sensorineural deafness, and renal disease. Approximately 65% of patients with HDR syndrome have all three of these features, while others have different combinations of these features. We aimed to present a case with primary hypoparathyroidism, hearing loss, and nondiabetic chronic kidney disease and diagnosed as HDR syndrome while being followed up for type 1 diabetes mellitus and hypopituitarism.Öğe Incidence of second primary malignancies in patients with thyroid cancer in the Turkish population(Tubitak Scientific & Technological Research Council Turkey, 2019) Karakose, Melia; Cordan, Ilker; Can, Mustafa; Kocabas, Muhammet; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: Thyroid cancer is the most common endocrine malignancy. Recently the incidence has been increasing faster compared to other malignancies. Different studies have shown that the incidence of breast cancer in patients followed due to thyroid cancer has increased, and vice versa. The aim of this study was to evaluate the frequency of second primary cancers in the follow-up of patients with thyroid cancer. Materials and methods: In this study, 1196 patients with thyroid cancer were evaluated in the Necmettin Erbakan University Meram Medical School's Department of Endocrinology between 2004 and 2018. Demographic characteristics and radiological and pathological results of the patients were recorded. The presence of accompanying second malignancies in patients with thyroid cancer was investigated. Results: In our study, 985 (82.4%) women (mean age: 46.1 +/- 13.3 years) and 211 (17.6%) men (mean age: 49.9 +/- 14.2 years) were evaluated. The median follow-up was 63 months (2-164 months). Of the 1196 patients, 1126 (94.1%) had no additional cancer and 70 (5.9%) patients had a second malignancy. The accompanying second malignancies were breast cancer in 24 (2%) patients, skin cancer in 8 (0.7%) patients, renal cell cancer in 5 (0.4%) patients, lung cancer in 5 (0.4%) patients, colon cancer in 5 (0.4%) patients, lymphoma in 5 (0.4%) patients, endometrial cancer in 4 (0.3%) patients, and 14 cases of other rare types of cancer. Conclusion: In our study, it was found that the most common second primary malignancy in patients with thyroid cancer was breast cancer. However, other cancers (skin cancer, renal cell cancer, lymphoma, and colon, lung, or endometrial cancer) may occur in patients with thyroid cancer.Öğe Increased incidence of malignancy in patients with primary hyperparathyroidism(Tubitak Scientific & Technological Research Council Turkey, 2021) Karakose, Melia; Kocabas, Muhammet; Can, Mustafa; Caliskan Burgucu, Hatice; Cordan, Ilker; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: Primary hyperparathyroidism (PHPT) is a disease that is diagnosed more frequently and generally in the asymptomatic period, with widely available biochemical tests. Evidence suggesting an association between PHPT and malignancy risk is increasing. Clarification of this association will be useful in PHPT for malignancy screening and management of patients with PHPT. In this study, we aimed to investigate the frequency of cancer in PHPT patients. Materials and methods: A total of 775 PHPT patients were included in the retrospective study. Demographic, clinical and laboratory data of the patients were evaluated retrospectively. Results: Malignancy was detected in 128 (16.50%) of 775 PHPT patients (female/male: 625/150). The mean age at diagnosis of PHPT was 57.99 +/- 10.86 years, and the mean age at diagnosis of malignancy was 57.46 +/- 11.17 years. Of the 128 patients with malignancy, 53 (41.40%) were diagnosed in the same year as PHPT. In terms of malignancy types, 51 (6.50%) of 775 PHPT patients had thyroid cancer. Thyroid cancer was followed by breast cancer (2.30%) and stomach cancer (1%) in order of frequency. Conclusion: We think that PHPT patients should be examined more carefully in terms of cancer risk, especially thyroid cancer. More comprehensive studies are needed to clarify the relationship between PHPT and cancer.Öğe Prevalence of comorbidities and associated factors in acromegaly patients in the Turkish population(Tubitak Scientific & Technological Research Council Turkey, 2021) Can, Mustafa; Kocabas, Muhammet; Cordan, Ilker; Caliskan Burgucu, Hatice; Karakose, Melia; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: The presence of comorbidities in patients with acromegaly causes an increase in morbidity and/or mortality and a decrease in quality of life. In this study, we aimed to investigate the demographic, clinical and laboratory features, prevalence of acromegaly-related comorbidities, and factors associated with these comorbidities in patients with acromegaly. Materials and methods: In the study, 96 patients who were followed up with the diagnosis of acromegaly were included. Clinical, laboratory and imaging features, and accompanying comorbidities of the patients were recorded from the patient files. Results: Of the patients included in the study, 63 (65.6%) were female and 33 (34.4%) were male. The mean age of diagnosis was 42.61 +/- 12.08, and the mean follow-up period was 9.97 +/- 7.26 years. Median insulin-like growth factor 1 level was 238.16 ng/mL (30.5-820), median growth hormone level was 2.05 ug/L (0.1-29.4). A total of 60 (62.5%) of the patients were in the well-controlled group, and 36 (37.5%) had active disease at the time of inclusion. Diabetes mellitus (DM) was detected in 30 (31.3%) patients, prediabetes in 19 (28.8%) patients, hypertriglyceridemia in 38 (42.2%) patients, hypertension (HT) in 41 (42.7%) patients, cardiovascular disease in 5 (5.2%) patients, malignancy in 9 (9.4%) patients, obstructive sleep apnea syndrome in 8 (8.3%) patients, carpal tunnel syndrome in 11 (11.5%) patients, arthropathy in 5 (5.2%) patients, hearing loss in 7 (7.3%) patients, thyroid nodule in 56 (67.5%) patients, thyroid cancer in 4 (4.2%) patients, colonic polyp in 19 (38.8%) patients. Conclusion: In this study, we revealed that the most common comorbidities in acromegaly patients in the Turkish population are thyroid nodules, low high-density lipoprotein (HDL cholesterol (HDL-C) level, hypertriglyceridemia, HT, colonic polyps, DM, and prediabetes, and female sex and age at diagnosis are the most important factors associated with comorbidities.Öğe The Relationship between Pre-operative Anti-thyroglobulin Antibody Level and Lymph Node Metastasis and Recurrence in Differentiated Thyroid Cancer(Kare Publ, 2023) Kaynak, Hulya; Kocabas, Muhammet; Can, Mustafa; Cordan, Ilker; Karakose, Melia; Karakurt, Feridun; Kulaksizoglu, MustafaOBJECTIVE We aimed to investigate the relationship between positivity and level of pre-operative anti-thyroglobulin antibody (TgAb) and stage, recurrence, and metastasis in differentiated thyroid cancer (DTC). METHODS Three hundred and thirty-one patients who underwent total thyroidectomy and whose TgAb was measured in the pre-operative and post-operative period were included in the study. The laboratory and clinicopathological data of the patients were recorded from patient files. RESULTS Of the 331 patients enrolled, 253 (76.4%) were female and 78 (23.6) were male, and the mean age was 46.7 +/- 15.4. The final histopathology results were DTC in 126 (38.1%) patients and benign in 205 (61.9%) patients. TgAb was positive in 26 (20.6%) of 126 patients in the DTC group, while it was positive in 29 (14.1%) of 205 patients in the benign group. In patients with DTC, having lymph node metastasis, recurrence, and receiving radioactive iodine (RAI) ablation were found to be associated with higher pre-operative TgAb levels (p=0.023, p=0.032 and p=0.022, respectively). The TSH level at the time of diagnosis was significantly higher in the DTC group compared to the benign group (p<0.001). CONCLUSION In our study, pre-operative TgAb levels were found to be significantly higher in DTC patients with lymph node metastasis or recurrence. We found that pre-operative TgAb level significantly correlated with recurrence and lymph node metastasis.Öğe Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity(Georg Thieme Verlag Kg, 2021) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Burgucu, Hatice Caliskan; Yarar, Zeliha; Kulaksizoglu, Mustafa; Karakurt, FeridunPurpose: In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. Methods: A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. Results: Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.271.43 and 0.48 +/- 0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. Conclusion: In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.
