Intrathorasic parathyroid carcinoma

Paratiroid karsinomu primer hiperparatiroidizmin oldukça nadir nedenlerindendir. Bütün primer hiperparatiroidilerin % 0,41inin nedenini paratiroid karsinomları oluşturur. 64 yaşında bayan hasta primer hiperparatiroidizm tanısı ile opere edilmek üzere kliniğimize yatırıldı. Yapılan klinik incelemelerde intratorasik uzanım gösteren paratiroide ait kitle tespit edildi. Hastaya yapılan paratiroid eksizyonu sonrasında patolojik inceleme sonrasında paratiroid kanseri tespit edilmesi üzerine sağ tiroid lobektomi ve santral boyun diseksiyonu uygulandı ve hasta sorunsuz olarak taburcu edildi.Parathyroid carcinoma is one of the extremelly rare causes of primary hyperparathyroidism. These tumors account for 0.4-1% of all cases of primary hyperparathyroidism. A 64-year-old female patient admitted to our clinic with primary hyperparathyroidism for the operation. Clinical examination revealed a right parathyroid mass towards intra thorasic region. After parathyroidectomy, the pathological investigation revealed parathyroid carcinoma. Rigth thyroid lobectomy and santral neck dissction were performed and the patient was discharged uneventful

Short-term impact of glycaemic control and intravitreal ranibizumab treatment on serum cytokine levels and diabetic macular edema in patients with unregulated blood glucose

Objective: To evaluate the short-term effect of glycaemic control and intravitreal ranibizumab treatment on diabetic macular edema (DME) and to assess the correlation between HbA1c and certain serum cytokines. Design: A prospective study of 43 participants with HbA1c levels exceeding 53 mmol/mol (7%) and with DME, as detected by spectral domain optical coherence tomography (SDOCT). Subjects: Participants were grouped according to their initial best corrected distance visual acuity (BCVA). Group 1 was treated with three monthly doses of intravitreal ranibizumab (0.5 mg) injections, and Group 2 was followed without treatment. Methods: Serum cytokine levels, including interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1(MCP-1), and vascular endothelial growth factor (VEGF) were analysed at the beginning and at the end of 3 months, using enzyme-linked immunosorbent assays (ELISA). Results: A significant decrease in macular thicknesses (except for one quadrant) was observed in Group. Changes in serum cytokine levels were not correlated with HbA1c decrease. Serum VEGF level was significantly increased in Group 1, despite the intravitreal treatment. Conclusion: Short-term glycaemic control alone had limited value in the treatment of DME. The therapeutic effect of intravitreal treatment on DME supports the role of the local cytokine milieu in the pathophysiology

Evaluation of subclinical atherosclerosis in obese patients with three noninvasive methods: Arterial stiffness, carotid intima-media thickness, and biomarkers of endothelial dysfunction

ABSTRACT Objective: In this study, we aimed to evaluate subclinical atherosclerosis in patients with obesity who had cardiovascular disease risk indicators such as arterial stiffness, which is evaluated using pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and biomarkers of endothelial dysfunction such as endocan, ADAMTS97, and ADAMTS9. Subjects and methods: Sixty obese subjects, including 23 subjects with body mass index (BMI) ≥ 40, 37 subjects with BMI ≥ 30 but < 40, and 60 age-and sex-matched control subjects, were included in our study. Serum endocan, ADAMTS97, and ADAMTS9 levels as well as PWV and CIMT measurements of the subjects in the obese and control groups were performed. Results: In the obesity group, PWV levels were significantly higher than they were in the control group and endocan levels were significantly lower than they were in the control group. When we compared the obese group with BMI ≥ 40 and the control group, the BMI ≥ 40 group had significantly higher PWV and CIMT levels than the control group had, whereas endocan, ADAMTS7, and ADAMTS9 levels were similar to those of the control group. When we compared the obese group with BMI ≥ 30 < 40 to the control group, endocan levels were lower in the group with BMI ≥ 30 < 40, and PWV and CIMT levels were similar to the control group. Conclusions: We found that arterial stiffness and CIMT increased in obese patients with BMI ≥ 40 and that increased arterial stiffness was associated with age, systolic blood pressure, and HBA1C. In addition, we found that the endocan levels were lower in obese patients than they were in nonobese control individuals

Beta-talasemi major komplikasyonu olarak gelişen diabetes mellitus ve hipoparatiroidi

Beta-talasemi major ilk defa Cooley ve Lee tarafından tanımlanmış olup, β-globin zincir sentezinde azalma ile giden, resesif karakterli bir hemoglobin bozukluğudur. Homozigot olgular düzenli kan transfüzyonu gerektiren ağır anemi ile seyreder. Şelasyon ve transfüz- yon tedavisi kombinasyonu yaşam beklentisini 40-50’li yaşlara kadar dramatik olarak uzatır. Diğer yandan sık kan transfüzyonları vücutta fazla demir birikimine yol açarak hipogonadizm, diabetes mellitus, hipotiroid, hipoparatiroid ve diğer endokrin bozukluklara neden olabilir. Bu yazıda talasemi major komplikasyonu olarak diabetes mellitus ve hipoparatiroidi gelişen bir olgu sunumu takdim edilmişti

Toksik Multinodüler Guatrda Çok Uzun Süreli Propiltiourasil Kullanımına Bağlı Nötropeni

Tirotoksikoz çeşitli yollarla hemtopoezi etkiler ve tionamidlerle birlikte miyelosupresyona neden olabilir. Toksik multinodüer guatra bağlı 20 yıl gibi uzun bir süre propiltiourasil kullanan ve febril nötropeni nedeniyle hastaneye yatışı yapılan hipertirodili bir hasta sunduk. Total tiroidektomi olduktan sonra hasta ötiroid iken nötropenisi düzeldi. Postoperatif patoloji ise mikropapiller tiroid karsinomu olarak değerlendirildi.Thyrotoxicosis affects hematopoiesis in several ways and thioamides may cause myelosuppression. We report a case of febrile neutropenia in a patient with hyperthyroidism who was using propylthiouracil for nearly 20 years for the treatment of toxic multinodular goitre. After surgery, the patient was euthyroid and neutropenia resolved. Postoperative pathology was evaluated as micropapillary thyroid carcinoma

Three Cases of Fahr Disease due to Idiopathic Hypoparathyroidism

Bazal ganglionlarda bilateral kalsifikasyona bağlı nörolojik belirtiler Fahr hastalığı olarak bilinmektedir. Fahr hastalığının etiyolojisinde; idiopatik, konjenital, kalsiyum bozuklukları; ağırlıklı olarak hipoparatiroidiler, infeksiyonlar yer almaktadır. Bizim yazımızda hipoparatiroidiye bağlı bazal ganglionlarda bilateral kalsifikasyon ve ekstrapiramidal semptomları olan üç vakadan bahsedilecekBilateral calcifications in the basal ganglia associated with neurological manifestations have been diagnosed as Fahr disease. The most frequent etiology of this syndrome is, together with idiopathic causes and congenital, infections, calcium disorders, mainly primary hypoparathyroidism. We present the cases of three patients with bilateral calcifications in the basal ganglia who presented hypoparathyroidism and extra-pyramidal syndrom