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Aim: The current study was purposed to examine the association between NLR and the control of glucose in patients with T2DM. We also aimed to reveal correlations between microalbuminuria, Mean Platelet Volume (MPV), Red Blood Cell Distribution (RDW), and glycosylated hemoglobin (HbA1c). Materials and Methods: It was a retrospective study arranged in Ege University, in Endocrinology Department. We collected the fields of 198 patients having type 2 diabetes mellitus (T2DM), and they were categorized into two groups, patients with controlled T2DM (Hba1c≤7%) (n=82) and uncontrolled T2DM (Hba1c>7%) (n=116). Results: There were no statistically significant differences between NLR, RDW and MPV in two groups (p=0.123, p=0.298, p=0.595 respectively). Duration of T2DM 5 years and below and after 5 years between two groups was statistically important (p=0.002). NLR was found higher in uncontrolled T2DM than controlled T2DM, but not statistically significant. Receiver operating characteristic curve of NLR, RDW, MPV, WBC were not found significant (p>0.05). Conclusion: Our study revealed that duration of T2DM may predict microalbuminuria, and evaluated the relationship between RDW, MPV, NLR and Hba1c, microalbuminuria levels together in the patients with T2DM. According to NLR, RDW and MPV levels, we did not detect any statistically differences between uncontrolled T2DM than controlled T2DM.

Purpose: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer and accounts for 85–90% of all thyroid cancers. Metastatic differentiated thyroid cancer, radioiodine-refractory thyroid cancer, and anaplastic thyroid cancer still lack effective therapeutic options. Here, we aimed to assess HDAC9 and P300 expression in the papillary thyroid carcinoma cell line and compare them with normal thyroid cells. Methods: Nthy-ori-3–1, a normal thyroid cell line, and BCPAP, a PTC cell line, were cultured for 24 and 48 h and immunofluorescence staining was used to determine the levels of HDAC9 and P300 protein expression. HDAC9 paracrine release was assessed using an ELISA assay. Results: HDAC9 protein expression was higher in both cell groups at the 48th hour than at the 24th hour; however, P300 protein expression was lower in BCPAP cells at the 48th hour than at the 24th hour. In comparison to Nthy-ori-3–1, BCPAP expressed more HDAC9 and P300 proteins. HDAC9 secretion slightly increased in Nthy-ori-3–1 cells from 24 to 48 h. Furthermore, HDAC9 secretion in BCPAP cells dramatically decreased from 24 to 48 h. Conclusion: Our findings revealed that the expression of HDAC9 and P300 was higher in the PTC cell line than in normal thyroid cells. This indicates that the acetylation mechanism in thyroid cancer cells is not the same as it is in healthy cells. Epigenetic studies may reveal the mechanisms underlying PTC with further analysis.

Aim: Thyroid follicular cell derived cancers are classified into three groups such as papillary thyroid cancer (85%), follicular thyroid cancer (12%) and anaplastic (undifferentiated) thyroid cancer (ATC) (3%). ATCs have very rapid course, poor treatment outcomes and they are very aggressive. The aim of current study was to assess the analysis of the morphological differences of ATC cell line with the normal thyroid cell line (NTC). Materials and Methods: NTH and ATC cells were examined with haematoxylin and eosin, the nucleus: cytoplasm (N:C) ratios were detected, and cell cycles were investigated. These cell lines were compared according to their N:C ratio and their abundance in cell cycle phases. Results: The N:C ratio was higher in ATC than NTC. Both cell groups were mostly found in G0/G1 phase (68.4; 82.8) and have statistical difference in both G0/G1 and S phases. Conclusion: The rapid course and the rarity of ATC are significant barriers for clinical trials. Cultured cell lines are very important to explore the behaviour in the biology of ATC cells (such as the cell cycle), to understand the course of the disease, and to find an effective target for treatment.

Introduction Pituicytoma is a rare tumor of the pituitary gland derived from neurohypophyseal pituicytes. Case 1 A 58-year-old female presented with decreased vision; she was admitted to the neurosurgery department of Ege University after the detection of a pituitary macroadenoma. Magnetic resonance imaging (MRI) showed a 28 * 18 * 17-mm suprasellar mass, and laboratory tests revealed hypopituitarism. Hydrocortisone and L-thyroxine treatment were initiated, and the patient underwent resection through the endoscopic endonasal approach (EEA). The histopathological examination revealed a pituicytoma. The recurrence of tumor was detected during the 1-year follow-up, and the patient is awaiting surgery. Case 2 A 70-year-old woman presented with visual changes; she had a past medical history of hypophyseal macroadenoma and pituicytoma resected through an EEA in 2012 and 2017, respectively. During follow-up, 2 years after the second surgery, MRI showed progression of the pituicytoma then measuring 38 x 23 x 22 mm; it had invaded the cavernous sinus and was causing hydrocephaly and panhypopituitarism. The patient underwent the third resection through the transcranial approach in order to minimize bleeding. After this surgery, the patient developed diabetes insipidus and underwent treatment with desmopressin. Histopathological examination revealed a pituicytoma. At 6-month follow-up, imaging showed a sellar suprasellar mass 37 x 22 x 24 mm invading the cavernous sinus, indicative of recurrence. In the postoperative period, the patient applied to the department of radiation oncology to have fractionated radiotherapy. Discussion Pituicytomas are known to be low-grade tumors; because of their rarity, they are a real challenge. These patients should be followed up closely.

Purpose Hashimoto's thyroiditis (HT) is one of the most prevalent autoimmune endocrine diseases and caused by the loss of immune tolerance for the thyroid gland. Many pathophysiological mechanisms were speculated about the development of HT. In our study, we aimed to reveal the relationship between HT and IL-10, MCP-1, IFN gamma, and PD1 levels and compare them with control subjects. Methods We collected 37 patients with HT and 25 controls referred to our outpatient clinic. The diagnosis of HT was based on the detection of circulating antibodies to thyroid antigens and decreasing echogenicity on thyroid USG in patients with appropriate clinical characteristics. Serum IL-10, MCP-1, IFN gamma, and PD1 levels were detected using an ELISA KIT (96 T) method according to the manufacturer's instructions. Results All subjects were euthyroid (median TSH level was 1.68 mU/L in HT vs 1.83 mU/L in the controls, p = 0.672). Twenty-three of 37 patients with HT were taking L-thyroxin replacement. Levels of serum IL-10, IFN gamma, and PD1 in patients with HT were higher than the controls, but the differences were not statistically significant (p = 0.393, p = 0.495, and p = 0.052 respectively). The serum levels of MCP-1 in HT patients were statistically different and higher than the controls (p = 0.018). Correlation analysis displayed significant associations between IL-10, MCP-1, IFN gamma, and PD1 levels. Conclusion Our study demonstrated that serum MCP-1 levels in HT patients were significantly increased; on the other hand, significant difference was not found between HT patients and the controls in terms of serum IL-10, IFN gamma, and PD1 levels., Ege University Scientific Research Projects Coordination Unit [TGA-2022-23376], This project was supported by Ege University Scientific Research Projects Coordination Unit through Project Number: TGA-2022-23376.

Purpose Acromegaly is associated with oxidative stress and inflammation parameters. Chitotriosidase (CHITO) is a marker of macrophage activation and plays a pivotal role in the activation of inflammatory and immunological responses. Our study aimed to determine CHITO,YKL-40, advanced glycation end product (AGE), and high-sensitivity C-reactive protein (hsCRP) levels to investigate malondialdehyde (MDA), catalase, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities and to evaluate any association of these parameters with carotid intima media thickness (cIMT) in patients with controlled acromegaly. Methods Thirty controlled acromegaly patients and 41 age- and sex-matched control cases were studied. We obtained demographic data, hormonal and metabolic parameters, and cIMT. CHITO activity was measured with the fluorometric method of Chamoles et al. YKL-40 and hsCRP levels were measured using ELISA. AGEs were measured based on spectrofluorimetric detection. GSH-Px activity was determined by a colorimetric assay. MDA, SOD, and catalase activities were determined in hemolysis. Results Higher CHITO, AGE, and hsCRP concentrations were observed in patients with acromegaly compared to controls. SOD levels were non-significantly higher in the acromegaly group, while catalase activities were lower in patients with acromegaly. Correlation analyses of CHITO, AGEs, YKL-40, hsCRP, MDA, catalase, GSH-Px, and SOD with metabolic, anthropometric, and laboratory parameters did not demonstrate any significant correlation (p > 0.05). There was no significant difference between groups with regard to cIMT levels. Conclusion This is the first study investigating CHITO and AGE levels in patients with acromegaly. Serum CHITO, AGE, and hsCRP levels in acromegalic patients were significantly increased. It may be important to evaluate CHITO, AGE, and hsCRP levels in acromegalic patients who are already under cardiometabolic surveillance due to risk of developing cardiovascular disease., Ege University Scientific Research Projects Coordination Unit [TGA-2021-23122], This project was supported by the Ege University Scientific Research Projects Coordination Unit through Project Number: TGA-2021-23122.

The aim of this study was to assess vitamin D serum levels in autoimmune thyroid disease, Hashimato thyroiditis in the Turkish population. the subjects with Hashimato thyroiditis (HT, n=67, mean age 45.1±10.9,F/M-61/6), control subjects (mean age 42.1±15.7, n=29, F/M-26/3) were recruited for the study. Thyroid function tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultrasound features, demographic and antropometric variables were recorded. Vitamin D level was not different between the HT and the control groups (53.1±24.7 nmol/L and 54.1±19.8 nmol/L, as mean, respectively, p = 0.482) in the HT group, 35.8% of subjects had vitamin D insufficiency, only 16.4% of subjects with HT were vitamin D sufficient. There was no significant difference between the HT and the control groups according to the vitamin D classification status (p = 0.666). Vitamin D levels were significantly higher in the subjects who were taking replacement compared to subjects who were not (58.7 ± 26.0 vs. 46.0 ± 23.3, as mean, respectively, p = 0.033). There was no significant correlation between vitamin D levels and TgAb and TPOAb levels in HT group (p = 0.754 r = -0.039, p = 0.134 r = -0.290, respectively). in both HT and control groups, vitamin D levels were significantly correlated only with the fT4 levels (p

WOS: 000435845900008, Ganglioneuromas are rarely occurring benign tumors characterized by hyperplasia of mature ganglia and satellite cells. They are well-differentiated, slow growing, and autonomous nervous system neoplasms, which are usually asymptomatic and do not release any hormones. A male patient aged 26 years was evaluated for secondary hypertension six months ago. Ultrasonography of the abdomen revealed a mass lesion around the right kidney. An analysis of the 24-hour urine sample of the patient revealed the following parameters: 5-HIAA=3.9 mg/day (2-7), metanephrine=56.3 mu g/day (52-341), and normetanephrine=146.1 mu g/day (88-444). The computed tomography scan of the abdomen showed a retroperitoneal mass of 10 cm in size, containing minute calcified foci in the right retroperitoneal region. The mass was excised through general surgery and was classified as ganglioneuroma. The blood pressure of the patient returned to normal level after surgery, and he needed no further antihypertensive treatment. Besides, the metanephrine and normetanephrine levels in the 24-hour urine were also observed to be normal as in the preoperative period. Retroperitoneal masses can actually be ganglioneuromas and an accurate diagnosis can be achieved only through postoperative histopathological evaluation. After the operation, blood pressure of the patient returned to normal. This suggests that retroperitoneal ganglioneuroma could possibly secrete dopamine, epinephrine, or norepinephrine.

Diabetic foot infections are an important cause of morbidity. In humans, Fusarium causes external infections. A male obese patient at the age of 56 who had been getting treatment in various clinics due to ulceration and lymphedema. Treatment started with tigecycline 50 mg vial 2x1. Alcaligenes faecalis and Proteus vulgaris reproduced. Tigecycline treatment was stopped on the 4th day and piperacillin/tazobactam 4,5 gr vial 3x1 and liposomal amphotericin B 3 mg/kg/day were initiated. In direct microscopic examination, hypes were seen and Fusarium spp. reproduction was detected. Liposomal amphotericin treatment was stopped on the 15th day and voriconazole 200 mg tb po 2x1 was initiated. At the end of one month, the lesions were regressed entirely. It should not be forgotten that despite its scarcity, fungus factors might give rise to diabetic foot infections and patients should be evaluated in terms of fungus infections. J Microbiol Infect Dis 2017; 7(1): 42-45

Congenital adrenal hyperplasia is one of the most common autosomal recessive genetic disorders. Testicular adrenal tumors are significant complications of congenital adrenal hyperplasia. We would like to present two patients of testicular adrenal rest tumors. Patient 1 24 year-old male, he was diagnosed with congenital adrenal hyperplasia at the age of 8 due to precocious puberty. He received hydro-cortisone treatment until the age of 18. Testicular mass had been detected and right radical orchiectomy had been applied 6 months ago and reported as testicular adrenal rest tumor. In scrotal ultrasound, a mixed type mass lesion (6 × 4x3 cm) covering a large part of left testis was observed. The imaging findings were consistent with adrenal rest tumor. The patient took adrenocorticotropic hormone supressive therapy with dexamethasone 0.75 mg once a day. Patient 2, 38 year-old male, he had been followed-up as adrenal insufficiency for 35 years. He underwent right orchiectomy operation due to the testicular mass in 2010 and the pathological examination revealed Leydig cell tumor. In scrotal ultrasound, small multifocal lesions were detected on the left testis and resection was done. It was reported as testicular adrenal rest tumor. He is being followed-up with glucocorticoid treatment according to androgen and adrenocorticotropic hormone levels. Early diagnosis of testicular adrenal rest tumor is significant in preventing irreversible testicular damage and infertility. In the differential diagnosis, we should keep in mind that testicular adrenal rest tumor can mimic other testicular tumors such as primary germ cell tumors.

[No abstract available]

Introduction. Fahr's syndrome is an infrequent disorder characterized by bilateral symmetrical calcification of basal ganglia and the cerebral cortex. It can be seen genetic, idiopathic, or secondary to endocrine diseases. This disease is related to different metabolic disorders particularly with diseases of the parathyroid gland. Case 1. A 63-year-old female patient applied to our clinic due to having hypoparathyroidism with bilateral basal ganglia calcification in head computed tomography(CT). She had subtotal thyroidectomy 25 years ago. in the neurological examination, mild symmetrical parkinsonism was determined. in laboratory examination Ca:8 mg/dL (8.6- 10.2), P:5.1 mg/dL (2.3-4.5), PTH:9.53 pg/mL (15-65) were detected. Calcitriol 0.25 mu/day was added to her treatment. Her parkinsonism disappeared after the treatment. Case 2. A 49-year-old male patient was consulted when he was admitted to the department of neurology in our hospital. the physical examination demonstrated the characteristics of Albright's hereditary osteodystrophy. the neurological examination shows bilateral symmetrical bradykinesia, dysphagia, and moderate dysarthria. in the laboratory examination PTH: 46.5 ng/L(15-65), Ca:8.6 mg/dL (8.6-10.2), P:2.7 mg/dL (2.3-4.5) were detected and were all within the normal ranges. Consequently, pseudopseudohypoparathyroidism was decided as a diagnosis. G protein alpha subunit mutation (Gs alpha) was not detected due to technical limitations. Conclusion. When a patient is diagnosed as Fahr's syndrome, we should keep in mind parathyroid disorders. Fahr's syndrome must be evaluated in patients showing intracranial calcification accompanied by parathyroid diseases.

Antifosfolipid antikor (AFA) varlığında arteriyel ya da venöz tromboz görülebilir. Antifosfolipid sendromunda görülen tromboza yönelik değişik patogenetik mekanizmalar ileri sürülmüştür. Burada 62 yaşında AFA'nın eşlik ettiği adrenal hemorajiye bağlı adrenal yetmezlik vakası sunulmaktadır. AFA sendromlarında daha sık görülen pulmoner emboli ve derin ven trombozunun yanı sıra adrenal venlerde de trombotik sürecin olabileceği akılda tutulmalıdır., Arterial or venous thrombosis can be seen in the presence of antiphospholipid antibody. Various pathogenetic mechanisms are put forward in case of antiphospholipid syndrome. Herein a case of 62-year-old male patient who developed adrenal hemorrhage leading to adrenal insufficiency was presented. It should be kept in mind that thrombotic process of antiphospholipid syndrome could be seen in adrenal veins in addition to pulmonary and deep vein thrombosis.

Purpose: The growing prevalence of obesity has become a major concern. The efficacy of medical treatment, diet and behavior therapy in morbidly obese patients is limited. Obesity surgery is a treatment option for selected morbidly obese patients. Material and Method: Data of 47 patients (n=39 women, 8 men) who underwent bariatric surgery were investigated. Results: Out of 47 patients, 20 underwent Roux-en-Y gastric bypass (RYGB) (43%) and 27 had sleeve gastrectomy (SG) (57%). The mean age of the patients was 37±9.5 (19-59) years. 17% of patients were men and 83% were women. In the analysis of data on weight that could be found for 31 out of 47 patients, we detected preoperative and postoperative (1st and 3rd month) mean weight values as 125.4±15.9 kg, 112.7±13.2 kg (p

Tutuncu, Neslihan Bascil/0000-0002-1816-3903; Gonen, Mustafa Sait/0000-0002-1089-623X; CORAPCIOGLU, DEMET/0000-0003-0940-9147; Satman, Ilhan/0000-0001-8613-1797; nuhoglu, irfan/0000-0003-0650-3242; Sahin, Ibrahim/0000-0002-6231-0034; Demirci, Ibrahim/0000-0003-0498-3115; Altuntas, Seher Cetinkaya/0000-0002-9733-9443; Yildiz, Bulent O./0000-0003-1797-7662; BALCI, Mustafa Kemal/0000-0002-6494-3249; Araz, Mustafa/0000-0001-6741-7474; Saydam, Basak Ozgen/0000-0001-9457-8919; Bozkus, Yusuf/0000-0002-6976-6659; Sabuncu, Tevfik/0000-0001-6504-5355; SELEK, ALEV/0000-0002-0646-8697; Ozturk, Feyza Yener/0000-0001-5584-4954; Salman, Serpil/0000-0003-4867-3725; AKBAS, EMIN MURAT/0000-0002-3033-0073; KIRIK, Ali Murat/0000-0002-5771-4843; Sonmez, Alper/0000-0002-9309-7715; Cesur, Fazil Mustafa/0000-0002-1029-2604, WOS:000452704800016, PubMed: 30244051, Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c, Turkish Society of Endocrinology and Metabolism, The TEMD study has been funded by the Turkish Society of Endocrinology and Metabolism. Automated blood pressure monitors were provided by Sanovel A/S. The funding agencies had no role in the design and conduct of the study; the collection, management, analysis and interpretation of the data; or the preparation, review or approval of the manuscript.

Background: Triple-negative breast cancer (TNBC) has none of the targeted treatment choices due to its distinct biological property, making this subtype a unique disease. In this study, we evaluated the impact of obesity on clinical outcomes of TNBC. Methods: The data of breast cancer patients admitted to our department were collected. TNBC was defined as lack of estrogen receptor (ER), progesterone receptor (PR) and HER-2. The body mass index (BMI) of 112 TNBC patients was calculated with weight at the time of diagnosis and height. The patients were classified into groups with a BMI of < 25 (normal/underweight), 25-29.9 (overweight) or ≥ 30 (obese). After a mean follow-up of 23.2 ± 15.5 months, there were 12 recurrences (10.71%) and 6 deaths (5.35%). Disease-free survival (DFS) and overall survival (OS) were assessed. Results: The survival analyses of all the patients did not demonstrate any differences in OS or DFS in obese as compared to non-obese patients. However, we showed that obesity was associated with a poorer OS for postmenopausal TNBC patients (p < 0.05). Conclusion: Obesity is related to a poorer OS in postmenopausal TNBC patients. Due to the heterogeneous disease profile of TNBC, larger randomized studies will be needed to clarify the exact role of obesity in TNBC.

Diabetic foot infections are an important cause of morbidity. In humans, Fusarium causes external infections. A maleobese patient at the age of 56 who had been getting treatment in various clinics due to ulceration and lymphedema.Treatment started with tigecycline 50 mg vial 2x1. Alcaligenes faecalis and Proteus vulgaris reproduced. Tigecyclinetreatment was stopped on the 4th day and piperacillin/tazobactam 4,5 gr vial 3x1 and liposomal amphotericin B 3mg/kg/day were initiated. In direct microscopic examination, hypes were seen and Fusarium spp. reproduction wasdetected. Liposomal amphotericin treatment was stopped on the 15th day and voriconazole 200 mg tb po 2x1 wasinitiated. At the end of one month, the lesions were regressed entirely. It should not be forgotten that despite itsscarcity, fungus factors might give rise to diabetic foot infections and patients should be evaluated in terms of fungusinfections. J Microbiol Infect Dis 2017; 7(1): 42-45

Aim: Primary hyperparathyroidism (PHP) is the most common cause of hypercalcemia based on outpatient clinic. The diagnosis of PHP is generally straightforward with high intact parathyroid hormone (iPTH) and hypercalcemia. But, PHP does not always exhibit those biochemical features. Less known phenotype of PHP is the hypercalcemia with normal level of iPTH. We report a case of parathyroid adenoma with low normal peripheral iPTH and high jugular PTH levels presenting as hypercalcemia. Our aim was to discuss the different mechanisms of such an entity with the guidance of the literature. Case: A thirty-six year old woman who has type 2 diabetes mellitus was admitted to the hospital with the diagnosis of acute pancreatitis. On laboratory examination serum calcium and iPTH levels were as follows: 10.6, 10.7, 10.9 mg/dL and 28.8, 33.3, 31.7 pg/mL, respectively. Twenty-four hour calcium excretion was 403 mg/day; serum phosphor was 2.3 mg/dL. Based on the findings of hypercalcemia, hypercalciuria, positive sonographic and scintigraphic images, operation was performed with the possible diagnosis of PHP. PTH measurement was taken from the right jugular vein. Intraoperative PTH was 634 pg/mL. Histopathological examination revealed as parathyroid adenoma. Postoperative hypocalcemia didn’t occur and postoperative calcium and iPTH levels were normal. Conclusion: Clinicians should be aware of the presence of low-normal iPTH in PHP. If the clinical suspicion of PHP is high as in our case, surgery should be performed after exclusion of other causes of hypercalcemia.

Silent somatotropinomas are not rare. On the contrary to that, the absence of GH immunostaining in acromegaly has not been well defined. So, we would like to to draw the clinician’s attention to such an entity through a case of acromegaly with negative GH staining.

Thyroid nodule is seen commonly in clinical practice. Thyroid scintigraphy should be performed for the evaluation of thyroid nodules in case of suppressed TSH. We would like to present a case of toxic adenoma with the diagnosis of papillary thyroid carcinoma. Forty-four-year-old female patient had applied to the hospital with the diagnosis of thyroid nodule. Thyroid fine needle aspiration biopsy (FNAB) was performed for the evaluation of thyroid nodule measured as 47x12 mm. This nodule was in mixed solid form bearing cystic components. FNAB revealed that the thyroid nodule was benign. Our ultrasonographic evaluation was consistent with a thyroid nodule located at right lobe with a diameter of 43x18x28 mm. The patient underwent right thyroid lobectomy. Pathology report revealed macrofollicular variant of papillary thyroid carcinoma. The tumor was 3.5 cm in diameter with regular margin and 0.2 cm away from the surgical border. The tumor didn’t spread out of the thyroid capsule. Second thyroid surgery was performed due to remaining thyroid tissue. After that ablative radioactive iodine therapy was applied. Guidelines in Endocrine literature report that hyperfunctioning nodules are almost always benign. However, the risk of malignancy was reported as a weighted rate of 3.1%. As follicular lesions are seen in high percentage in hot nodules, surgery should be recommended in case of the cytological results of a follicular neoplasm of a hyperfunctioning nodule. So, hyperfunctioning thyroid nodules warrants careful evaluation and appropriate therapy. We wanted to draw attention of the clinicians for this rare issue.