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      • Slide Session : OS-END-25 ; Endocrinology : Is There a Relation Between Thyroid Autoantibodies and MPV in Hypothyroidism ?

        ( Serkan Yucesan ),( Meral Mert ),( Zeynep Erturk ),( Selcuk Sezikli ),( Yildiz Okuturlar ),( Ozlem Harmankaya ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Hypothyroidism is a prevalent endocrine disorder. The most common cause of hypothyroidism is autoimmune thyroid disorder. A possible prothrombotic effect of elevated thyrotropin (TSH) has been suggested. MPV can be used as a marker of platelet activity. The objective of the present study was to determine if there is an association between the MPV, serum TSH and auto-antibody(anti-TPO and anti-TG) concentrations. Methods: We studied 145 adults with hypothyroidism (TSH >5 mlU/L ). We evaluate the mean values MPVs and their relation with auto-antibody and TSH levels. Results: 126 female and 19 male patients were in enrolled in our study retrospectively. The mean level of the MPV in all patients was 8.41 femtoliters (fL) and the mean level of TSH was 13.41 mlU/L. Negative correlation (r:0.015) between MPV, age, and anti-TPO ve TG was found. There was no correlation between MPV and TSH. There was no statistically significant difference between TSH, MPV, auto-antibody levels and age. Conclusions: MPV is reported to be increased in vascular events like atherosclerotic thrombosis and to be decreased in acute infl ammation. The main pathophysiological process is inflammation in autoimmune thyroid disease, so the possible explanation of negative correlation between MPV and autoantibodies is autoimmunity.

      • Slide Session : OS-END-46 ; Endocrinology : A Rare Cause of Secondary Hypertension: An Unusual Case of Conn`s Syndrome

        ( 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.

      • Adjuvant Chemotherapy and Prognostic Factors in Stage II Colon Cancer - Izmir Oncology Group Study

        Kucukzeybek, Yuksel,Dirican, Ahmet,Demir, Lutfiye,Yildirim, Serkan,Akyol, Murat,Yildiz, Yasar,Bayoglu, Ibrahim Vedat,Alacacioglu, Ahmet,Varol, Umut,Salman, Tarik,Yildiz, Ibrahim,Can, Huseyin,Tarhan, M Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.6

        Background: Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Materials and Methods: One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Results: Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. Conclusions: The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.

      • KCI등재

        Renal tubular P-glycoprotein expression is reduced in plasma cell disorders

        ( Cihan Heybeli ),( Mehmet Asi Oktan ),( Hayri Ustun Arda ),( Serkan Yildiz ),( Mehtat Unlu ),( Caner Cavdar ),( Aykut Sifil ),( Ali Celik ),( Sulen Sarioglu ),( Taner Camsari ) 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.2

        Background: P-glycoprotein (P-gp) transports many chemicals that vary greatly in their structure and function. It is normally expressed in renal proximal tubular cells. We hypothesized that P-gp expression influences light chain excretion. Therefore, we investigated whether renal tubular P-gp expression is altered in patients with plasma cell disorders. Methods: We evaluated renal biopsy specimens from patients with plasma cell disorders (n = 16) and primary focal segmental glomerulosclerosis (the control group, n = 17). Biopsies were stained with an anti-P-gp antibody. Loss of P-gp expression was determined semi-quantitatively. Groups were compared for loss of P-gp expression, and clinical variables. Results: P-gp expression loss was more severe in patients with plasma cell disorders than it was in those with glomerulonephritis (P = 0.021). In contrast, clinical and histological parameters including serum creatinine, level of urinary protein excretion, and interstitial fibrosis/tubular atrophy grade were not significantly different between the groups. P-gp expression loss increased with age in patients with plasma cell disorders (P = 0.071). This expression loss was not associated with serum creatinine, the level of urinary protein excretion or the interstitial fibrosis/tubular atrophy grade. There was no significant association between the severity of P-gp expression loss with the types and serum levels of light chains, isotypes and serum immunoglobulin levels. Conclusion: Renal tubular P-gp expression is significantly down-regulated in patients with plasma cell disorders characterized by nephrotic range proteinuria. Additional studies are needed to determine whether reintroduction of renal tubular P-gp expression would mitigate the proximal tubular injury that is caused by free-light chains.

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