Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Relationship Between Thyroid Volume and Malignant Thyroid Disease(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Altundag, Ozden; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0003-0998-8388; https://orcid.org/0000-0003-0197-6622; https://orcid.org/0000-0002-1816-3903; 24338169; AAA-2743-2021; W-9219-2019; ABG-5027-2020The present retrospective study aimed to investigate the relationship between thyroid volume and prevalence of thyroid cancer. We investigated the data of 3,850 patients who underwent fine-needle aspiration biopsy (FNAB). Biopsy results were evaluated as diagnostic or nondiagnostic, and diagnostic results were classified as benign, malignant, and indeterminate. We included 2,672 patients who underwent FNAB firstly in our hospital and evaluated as diagnostic biopsy except subgroup of indeterminate. We obtained cytologic data, levels of serum thyroid-stimulating hormone (TSH), and thyroid volumes of those patients retrospectively. Among 2,672 patients with thyroid nodule, 2,562 (95.9 %) patients had benign cytology and 110 (%4,1) patients had malignant cytology. There was no correlation between the malignancy and gender (p = 0.935), and patients with malignant cytology were younger (52 vs 59, p < 0.001). Also, TSH levels were higher in patients with malignant than benign cytology (p = 0.017). Median volume of right part, left part, and total thyroid for patients who had malignant cytology was significantly lower than patients who had benign cytology (8.3, 7.1, 15.9 vs 10.8 ml, 9.0 mml, 20.6 ml, respectively, p <= 0.001 for all parameters). The results demonstrated that thyroid cancer prevalence was higher in patients with low thyroid volume. According to our results, thyroid volume should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.Item Low Prevalence of Periodontitis and Preserved Vertebral Bone Density in Acromegaly: Excess GH May Not Impact Negatively on Trabecular Bone(2014) Ertorer, Melek Eda; Serinsoz, Hulya Karaoglu; Bascil, Sibel; Bakiner, Okan Sefa; Bozkirli, Emre; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0001-7357-8709; https://orcid.org/0000-0002-1644-6790; https://orcid.org/0000-0002-1816-3903; ABI-3705-2020; AAA-8309-2021; AAK-5525-2021; E-9887-2014; ABG-5027-2020Item Beta-Cell Golgi Stress Response to Lipotoxicity and Glucolipotoxicity: A Preliminary Study of a Potential Mechanism of Beta-Cell Failure in Posttransplant Diabetes and Intraportal Islet Transplant(2022) Tutuncu, Neslihan Bascil; Verdi, Hasibe; Yalcin, Yaprak; Cebi, Pinar Baysan; Kinik, Sibel; Tutuncu, Tanju; Atac, Fatma Belgin; 0000-0002-1816-3903; 0000-0002-9337-9106; 0000-0002-9141-9987; 35791832; ABG-5027-2020; ABB-4078-2020Objectives: Lipotoxicity and glucolipotoxicity are among the most important triggers of beta-cell failure in patients with type 2 and posttransplant diabetes. Because the Golgi apparatus is a vital organelle in secretory cells like beta cells, its behavior under stress conditions determines the cell's functional capacity.Materials and Methods: To mimic lipotoxicity and glucolipotoxicity as metabolic stresses for beta-cell failure, rat insulinoma INS-1E cells were treated with palmitic acid, glucose, or both. Cells were cultured in the presence of 5.0, 16.7, or 33 mM glucose with or without 0.5 mM palmitic acid for 8, 16, 24, and 48 hours. Incubation in the presence of any of the 3 concentrations of glucose with 0.5 mM palmitic acid provided glucolipotoxicity. In addition to the endop-lasmic reticulum stress marker (Hspa5), we evaluated changes in Golgi function under experimental metabolic stresses. In doing this, we measured expression levels of the genes coding Golgi structural proteins (Acbd3, Golga2, and Arf1), Golgi glycosylation enzymes sialyltransferaz10 and sialyltransferase 1 (St3gal1), and Golgi stress mediators (Creb3 and Arf4).Results: Golgi responded to lipotoxicity and glucolipotoxicity by increasing the expression of St3gal1 (P = .05 in both conditions) and Creb3 (P = .022 and P = .01, respectively). The Arf4 gene transcript also increased in glucolipotoxic media (P = .03). Glucotoxicity alone did not induce a change in the transcript levels of Creb3 and Arf4. Lipotoxicity and glucolipotoxicity induced Creb3 and Arf4 expression, which are important Golgi stress response mediators leading to apoptosis.Conclusions: This preliminary study showed that the Golgi stress response is important in lipotoxic and glucolipotoxic conditions in terms of beta-cell failure. Solving the mystery of intracellular molecular mechanisms leading to beta-cell dysfunction is crucial to understanding the pathophysiology of posttrans-plant diabetes and most probably the failure of intraportal islet transplants in the long term.Item Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study(2021) Iyidir, Ozlem Turhan; Rahatli, Feride Kural; Bozkus, Yusuf; Ramazanova, Lala; Turnaoglu, Hale; Nar, Asli; Tutuncu, Neslihan Bascil; 0000-0001-5305-6807; 0000-0002-6976-6659; 0000-0003-0998-8388; 0000-0002-1816-3903; 30786314; K-7904-2019; AAA-5419-2021; AAA-2743-2021; ABG-5027-2020Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy. Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness. Results Achilles tendon thicknesses were similar between groups (p = 0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p = 0.01; group II vs control p = 0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p = 0.993). Shear Wave Velocity was significantly lower in group I than group II and control group (p < 0.001). Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.Item Risk Factors and Treatment Options for Persistent Hyperparathyroidism After Kidney Transplantation(2020) Kirnap, Nazli Gulsoy; Kirnap, Mahir; Sayin, Burak; Akdur, Aydincan; Tutuncu, Neslihan Bascil; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-1816-3903; 0000-0001-8287-6572; 31924405; AAA-3068-2021; AAJ-8097-2021; ABG-5027-2020; J-3707-2015Background. Kidney transplantation (KT) corrects secondary hyperparathyroidism. However, persistent hyperparathyroidism (pHPT) may be observed in some patients post-KT. This study aims to evaluate the risk factors and treatment options for pHPT. Materials and methods. The study population comprises 1054 patients who underwent KT between January 2001 and May 2019. Serum samples were analyzed for calcium (Ca), phosphorus, creatinine, intact parathyroid hormone (iPTH) and estimated glomerular filtration rate. Results. The prevalence of pHPT following KT is 14%. Ninety pHPT patients were compared with 550 non-pHPT patients. The median duration of pre-KT dialysis was longer, and pre-KT serum Ca, P, and iPTH levels were significantly higher in the pHPT group than the non-HPT group. The pHPT of 46 patients (51%) received medical treatment. The remaining 44 patients (49%) had parathyroidectomy (PTx) if symptoms or signs (or both) of pHPT continued. Subtotal PTx was performed in 35 patients, and minimally invasive PTx was performed in 9 patients. Conclusion. Based on our study results, the most important risk factors for post-KT pHPT are long dialysis duration and high pre-KT iPTH levels. In patients who underwent KT, if pHPT lasts longer than 1 year, surgical treatment is the recommended approach. Based on our experience, the treatment method to be performed in pHPT should be 3+1/2 PTx.Item POST-TRANSPLANT DIABETES MELLITUS INCIDENCE AND RISK FACTORS IN ADULT LIVER TRANSPLANTATION RECIPIENTS(2020) Kirnap, Nazli Gulsoy; Sultanov, Pulat; AlShalabi, Omar; Kirnap, Mahir; Tutuncu, Neslihan Bascil; Haberal, Mehmet A.Item THYROID CANCER RECURRENCE RISK AFTER TRANSPLANTATION: SINGLE CENTER EXPERIENCE(2020) Iyidir, Ozlem Turhan; Altay, Pinar; Kirnap, Mahir; Kirnap, Nazli Gulsoy; Tutuncu, Neslihan Bascil; Haberal, Mehmet A.Item The curative treatment of familial hypercholesterolemia: Liver transplantation(2019) Kirnap, Nazli Gulsoy; Kirnap, Mahir; Tutuncu, Neslihan Bascil; Moray, Gokhan; Haberal, Mehmet; 31626710; AAH-9198-2019Background Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by premature mortal cardiovascular complications. Liver transplantation (LT) is the only curative treatment option. In this study, the long-term clinical follow-up data of 8 patients who underwent LT with a diagnosis of FH in our center are presented. Materials and Methods A total of 638 LT were performed between December 1985 and June 2019 at Baskent University, of which 8 patients underwent LT with a diagnosis of FH and were evaluated retrospectively. Results Of the 8 patients, 4 underwent deceased donor and 4 living donor transplantation. Five patients had preoperative cardiovascular disease and consequent interventional operations. There was significant reduction in postoperative LDL-C and TC levels starting from the first week, and stabilizing at the first month and first year. The median survival time of patients was 5 years (2-12 years). All patients are still alive. None of the complications of patients with preoperative cardiovascular complications had progressed. Conclusion Liver transplantation is the preferred curative treatment for the pathophysiology of FH. In our study, LDL-C levels were brought under control with LT performed on patients with FH. Median 5-year follow-up of patients showed that the progression of cardiac complications was abated.