Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism

This study had been presented at the 6th ESES Biennial Scientific Meeting held in Cardiff (15-17 May 2014).Address for Correspondence: Dr. Özer Makay, Department of General Surgery, Division of Endocrine Surgery, Ege University School of Medicine, İzmir, TurkeyPhone: +90 232 390 50 50 Received: 13 July 2015 e-mail: [email protected]: 27 January 2016 o DOI: Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT.Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease.Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria.Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT

46,XX Karyotype in a Male with Ambigious Genitalia: A Case Report

40 days old case who were diagnosed with ambigious genitalia were sentto laboratory of cytogenetics. Mother was 26 years old and have to alivechildren and case were the second child and applied to Child SurgeryDepartment due to continiously vomiting and uneasy conditions. Sexualdevelopment were as male on physical examinations. Cell culture wasapplied for chromosomal analysis. Slides were stained with GiemsaBanding Staining (GTG) and 100 cells were totaly counted and karyotypingwere done with 15 metaphase. Chromosome with 46,XX karyotype. Casewere taken under consideration of congenital adrenel hyperplasia afterevalution of karyotype. Case were discussed according to by information ofpresents literatures

Oncoplastic Breast-Conserving Surgery According to Tumor Location

The use of oncoplastic breast surgery is an essential cornerstone for breast cancer management. The main aim of breast cancer surgery is to obtain an adequate oncological safety margin. Still, the cosmetic outcome also seems important for social and psychological wellbeing and quality of life. After breastconserving surgery, the remaining breast may be reconstructed with volume displacement or volume replacement techniques. A better cosmetic outcome can be achieved by selecting appropriate surgical techniques according to tumor location. In this review, we show each technique step-by-step based on the tumor’s location for each quadrant. The most important thing is to select the technique first for oncological safety and then for better cosmesis

A case with deletion of De Novo balanced 18pter

In this study, we are presenting the results of cytogenetic analysis and molecular cytogenetic analysis (FISH) of the couple and their family, who were referred to our ge-netic diagnostic laboratory and had bad obstetrics his-tory. We found a normal karyotype (46,XY) in male, and A de novo complex chromosome rearrangement found in a phenotypically normal female was characterized by G-bands, FISH with probes. Her chromosome structure was 46,XX,der(18;22)(18pter→p11.1::22p11.1→qter) del(18)(:p11.1→qter).To determine the parental origin of translocation, we ex-amined the individuals of the family, and we found that the translocation was de novo. We concluded that this carrier family might be due to the unbalanced distribution of translocation, during gamete formation and prenatal diagnosis recommended for their future pregnancies

A Case with 46,XX,dup(X)(q21.3q24) karyotype

The relationship between phenotype and Xq duplicationsin females remains unclear. Some females are normal;some have short stature; and others have features suchas microcephaly, developmental delay/mental retardation,body asymmetries, and gonadal dysgenesis. Somefeatures in these females resemble those in Turner syndrome.We, herein, presented a 15 years-old girl withshort stature and primary amenorrhea, who was referredto cytogenetic laboratory. Through karyotipe analysis performedby Giemsa banding technique, the patient wasdetermined to have positive Barr body and 46,XX,dup(X)(q21.3q24) chromosomal constitution. Case was discussedaccording to information of present literatures

Künt Dalak Yaralanmalarında Cerrahi Tedavi ile Nonoperatif Yaklaşımın Klinik Sonuçlarının Karşılaştırılması

Objective: Nonoperative management is the preferred treatment option of blunt splenic injury in appropriate conditions. İncreasing success is achieved with the help of advanced imaging techniques and angioembolization procedure. We aimed to compare clinical outcomes of Nonoperative Management and Surgical Intervention in patients with blunt splenic injury. Methods: Records of 56 patients who were treated by nonoperative management or surgical intervention in our clinic were reviewed retrospectively. Patients were evalu­ated in terms of age, gender, grade of injury, mortality, length of hospital stay, complications, presence of addi­tional injuries and concomitant disease in both groups. Results: There were 29 patients (51.78%) in the surgery group and 27 patients (48.2%) in the nonoperative man­agement group. Grade of injury was determined signifi­cantly higher in surgical treatment group (p<0.001). Addi­tional injury was observed more in the group treated with surgery (p: 0.033). Infectious complication rate was found higher in surgically treated group (<0.001). There was no significant difference between the groups in terms of age, gender, mortality, length of hospital stay, presence of con­comitant disease. Conclusion: Nonoperative management is the appropri­ate method in treatment of blunt splenic injury in patients who were hemodinamically stable and have no signs of peritoneal irritation. Nonoperative management is increas­ingly being implemented in conjunction with improvements in imaging methods. Angioembolization is a treatment that increases the success rate of nonoperative management and implementation of this method in trauma centers is an important target. Surgical intervention is inevitable in cas­es when the nonoperative management is inappropriate

Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism

This study had been presented at the 6th ESES Biennial Scientific Meeting held in Cardiff (15-17 May 2014).Address for Correspondence: Dr. &Ouml;zer Makay, Department of General Surgery, Division of Endocrine Surgery, Ege University School of Medicine, İzmir, TurkeyPhone: +90 232 390 50 50 Received: 13 July 2015 e-mail: [email protected]: 27 January 2016 o DOI: Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT.Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease.Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria.Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT.This study had been presented at the 6th ESES Biennial Scientific Meeting held in Cardiff (15-17 May 2014).Address for Correspondence: Dr. &Ouml;zer Makay, Department of General Surgery, Division of Endocrine Surgery, Ege University School of Medicine, İzmir, TurkeyPhone: +90 232 390 50 50 Received: 13 July 2015 e-mail: [email protected]: 27 January 2016 o DOI: Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT.Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease.Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria.Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT