The effects of body ıron stores on metabolic control, ınsulin resistance and microalbuminuria in patients with type 2 diabetes mellitus

Objective: Free iron is involved in processes including oxidative stress, inflammation and insulin resistance which play key roles in the development of type 2 diabetes. The aim of this study is to investigate the role of body iron stores in metabolic control, insulin resistance and microalbuminuria. Materials and Methods: Our study included 50 patients with newly diagnosed type 2 diabetes mellitus and 50 healthy subjects as controls. Groups were compared for sex, age, body mass index, various biochemical and metabolic parameters. Correlation between these parameters with mean ferritin levels of patients was also calculated. Diabetic patients were grouped according to metabolic control, insulin resistance and microalbuminuria and the correlation between these paremeters and ferritin level was analyzed. Results: There was no difference in mean ferritin levels between two groups In the patient group, significant correlation was determined between mean ferritin level and fasting blood glucose, hemoglobin A1c, C-peptide, insulin andHOMAscore. There was no difference in mean ferritin levels between diabetic patients with good or bad metabolic control. The mean ferritin level was significantly higher in diabetic patients with insulin resistance than non-insulin resistant diabetics. Mean ferritin level was significantly higher in microalbuminuric patients. Conclusion: Our findings support that body iron stores are involved in the pathogenesis of type 2 diabetes

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (βhCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. βhCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for βhCG. Serum βhCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, βhCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. βhCG expression may be associated with aggressive clinical course and increased risk of recurrence, also βhCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma

Metastasis of Gastric Signet-Ring Cell Carcinoma to the Urinary Bladder: A Case Report and Review of the Literature

Although signet-ring cell (SRC) adenocarcinoma is commonly seen in the stomach, it is a very rarely seen histologic entity in the bladder. It is difficult to distinguish primary SRC adenocarcinoma of the bladder from bladder metastasis of SRC carcinoma of the stomach only based on histological findings. In such cases, clinical findings and immunohistochemical studies may be helpful. We present here a 48-year-old male patient presenting with hematuria and abdominal pain. Computerised tomography of the patient revealed a gastric mass, peritoneal involvement, and thickening of the bladder wall, and histopathological analysis revealed SRC adenocarcinoma in both of the endoscopic biopsies taken from the stomach and bladder. Immunohistochemical analyses confirmed the diagnosis of SRC adenocarcinoma of the bladder secondary to gastric cancer

EMPHYSEMATOUS PYELONEPHRITIS CAUSED BY KLEBSIELLA OXYTOCA IN A PATIENT WITH DIABETIC NEPHROPATHY

WOS: 000281404900020A 50-year-old woman with a 30 years history of diabetes mellitus and has been diagnosed with diabetic nephropathy for the last 4 years presented with abdominal pain, nausea and vomiting. Abdominal ultrasonography revealed a hyperechogenic air image at right kidney and with the aid of subsequently performed abdominal tomography type 2 emphysematous pyelonephritis diagnosis was made. Klebsiella oxytoca was isolated in blood culture and with appropriate antibiotic therapy and subsequent percutenous drainage the patient made a full recover

Interstitial lung disease caused by everolimus treatment

Altmış yedi yaşında kadın hasta bir aydır halsizlik, nefes darlığı ve öksürük yakınması ile başvurdu. Hasta 2007 yılında sağ memede invaziv duktal karsinom nedeniyle cerrahi ve radyoterapi tedavisi gördüğünü ve dört ay önce de akciğerde multipl metastatik lezyonların saptanması üzerine everolimus tedavisine (10 mg/gün) başlanmış. Tedaviden sonra hastada everolimusa bağlı intersitisyel akciğer hastalığı saptandı.. Everolimus nispeten güvenli bir oral anti-kanser ajanıdır ancak interstisyel akciğer hastalığı ciddi bir yan etki olarak bildirilmiştir. Bu olgu Everolimusa bağlı ciddi akciğer toksisitesini göstermek için sunulmuşturSixty seven years old female patient was admitted with complaints of fatigue, shortness of breath and cough, for one month. In 2007, the patient was treated with surgery and radiotherapy because of invasive ductal carcinoma in the right breast. Four months ago, after the identification of multiple metastatic lesions in lung, a treatment of everolimus 10mg/day began. After treatment the patient was diagnosed as everolimus-induced interstitial lung disease. Everolimus is a relatively safe oral anti-cancer agent, but as a serious side effect of interstitial lung disease have been reported. This case was presented to show the serious pulmonary toxicity related to Everolimu

Metastasis-Induced Acute Pancreatitis Successfully Treated with Chemotherapy and Radiotherapy in a Patient with Small Cell Lung Cancer

Although involvement of pancreas is a common finding in small cell lung cancer (SCLC), metastasis-induced acute pancreatitis (MIAP) is very rare. A 50-year-old female with SCLC who had limited disease and achieved full response after treatment presented with acute pancreatitis during her follow-up. The radiologic studies revealed a small area causing obliteration of the pancreatic duct without mass in the pancreatic neck, and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) confirmed the metastasis of SCLC. The patient was treated successfully with systemic chemotherapy and radiotherapy delivered to pancreatic field. In SCLC, cases of MIAP can be encountered with conventional computed tomography with no mass image, and positron emission tomography and EUS-FNA can be useful for diagnosis of such cases. Aggressive systemic and local treatment can prolong survival, especially in patients with good performance status

Cetuximab tedavisine bağlı trikomegali: 4 olgu sunumu

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Amaç: Cetuximab, kolorektal kanserler ve baş-boyun kanserlerinin tedavisinde kullanılan, epidermal büyüme faktörü reseptörüne (EGFR) karşı geliştirilmiş bir monoklonal antikordur. En önemli yan etkisi cilt toksisitesidir. Cetuximab ile ilişkili kıllanma değişiklikleri ise trikomegali (kaş ve kirpiklerde anormal uzama, kıvrılma, kalınlaşma) ve hipertrikozisdir. Çalışmamızda 4 kolorektal kanser olgusunda cetuximaba bağlı trikomegali yan etkisi sunulmuştur. Hastaların genel özellikleri Tablo 1' de gösterilmiştir