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- 저자 : ( A Baki Kumbasar ) (검색결과 3 건)
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( Meral Mert ),( Yildiz Okuturlar ),( Ozlem Soyoyluk ),( Didem Acarer ),( Pinar Karakaya ),( Savas Tuna ),( Ozlem Harmankaya ),( A Baki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Adrenal neoplasms are common and are incidentally discovered in 4-10% of abdominal imaging studies. Most of them are not cancerous and nonfunctional. Every adrenal incidentaloma is evaluated with function tests for functionality. In our study we aimed to investigate the relation of tumor markers which were measured for other reasons and function tests in nonfunctional adrenal adenomas retrospectively. Methods: Patients diagnosed with nonfunctional adrenal adenoma in the last three years in our research hospital were evaluated retrospectively. Data of 133 patients including function tests (renin -aldosterone-17OHprogesterone-testosterone-dehydroepiandrosteronesulphate levels, 24 hour urinary metanephrine and normetanephrine levels, overnight dexamethasone supression test) were evaluated. Fortyfi ve of these 133 patients had tumor markers (CEA, alpha-fetoprotein, CA 19-9, CA15-3, CA125) recorded. The relation between function tests and tumor markers are examined. Results: The data of 31 women and 16 men with mean age 55,54±10,64 years and 56,06±11,41 years respectively were evaluated. There was a negative correlation between age and CA-125 levels. A negative correlation was also found between testosterone and CA15-3. There was a positive correlation between urinary cortisole and CEA and also between aldosterone and CA19-9 levels. Conclusions: Tumor markers may be used as alternative tests for function tests. But future studies with big sample size are needed to confi rm this hypothesis.
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( Yildiz Okuturlar ),( Meral Mert ),( Ozlem Soyluk ),( Ozlem Harmankaya ),( Pinar Karakaya ),( Samet Sayilan ),( Didem Acarer ),( A Baki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: It was shown that there is a correlation between low testosterone level and insulin resistance. Insulin resistance is related with metabolic syndrome and type 2 diabetes which represent a risk factor for cardiovascular disease. Obesity has become an important public health problem and it is known that it has an adverse effect on reproductive system and fertility. In our study it was aimed to investigate the relation between testosterone level and insulin resistance in overweight male and female patients. Methods: In our study total number of 2699 female and 377 male patients who admitted to our hospital because of weight problem and had BMI>25 were evaluated retrospectively. Correlation analyses between total testosterone level and parameters like fasting blood glucose, insulin level, Alc and HOMA values were performed. Results: While average age was 41.38±12.50 years in female patients it was detected 39.15±13.73 years for male patients. While negative correlations were found between testosterone level and age, testosterone level and glucose, testosterone level and Alc in the female group there were no correlations between testosterone level and HOMA, testosterone level and insulin in the same group. Whereas in the male group negative correlations were found between testosterone level and glucose, testosterone level and insulin, testosterone level and Alc and testosterone level and HOMA in the male group (Table 1). Conclusions: The correlation between testosterone level and insulin was reported in female patients with polycystic ovary syndrome. In our study glucose and A1c levels may increase while testosterone level decreases in both male and female groups. In addition to this finding insulin level and HOMA also increases with the decrease of testosterone in male patients. This may be explaned by the metabolic effect of testosterone.
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( Samet Sayilan ),( Yildiz Okuturlar ),( Meral Mert ),( Ozlem Soyluk ),( Serkan Enki ),( Yesim Ozden Inan ),( Ozlem Harmankaya ),( A Baki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Primary hyperaldosteronism (PHA) is a syndrome arising from autonomous aldosterone secretion from the adrenal gland and suppression of plasma renin activity. PHA is usually seen due to unilateral adenoma or bilateral hyperplasia. We present a case of Conn`s syndrome with bilateral adrenal lesions but unilateral functioning adenoma. Methods: A 43 years old female admitted to the emergency service due to inability to walk for 3 days, fatigue and generalised pain. She had a history of diabetes mellitus and hypertension for 15 years. She was receiving angiotensin receptor blocker with thiazide, calcium channel blocker, beta-blocker and insulin treatment. Her blood tests revealed alkalosis and severe hypokalemia with normal renal function. In the examinations for the causes of secondary hypertension; 24-hour urinary cortisol, metanephrine, normetanephrine and VMA levels were normal. Results: After cessation of diuretic treatment plasma renin activity (PRA) was measured 0.17 ng / mL/ h while plasma aldosterone level (PAL) was measured 71 ng / dl. The ratio of PAL / PRA was very high. Her abdominal MRI revealed bilateral adrenal lesions with 23x14 mm and 12x8 mm in diameters in the right and left adrenal gland respectively compatible with adenoma. On the other hand adrenal venous sampling (AVS) showed lateralisation for the right side. Conclusions: Most common causes of PHA are unilateral aldosterone secreting adenoma and bilateral adrenal hyperplasia. Although the appearance of bilateral adrenal lesions in MRI in our case, results of AVS were compatible with autonomous aldosteron production on the right side. According to these findings we accepted the case as a unilateral functioning adenoma with an incidentaloma on the other side.
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