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Öğe Can Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study(Elsevier Inc, 2022) Zuhur, Sayid Shafi; Aggul, Hunkar; Celik, Mehmet; Avci, Ugur; Erol, Selvinaz; Kilinc, Faruk; Akbaba, GulhanObjective: Although the age at diagnosis has been suggested as a major determinant of disease-specific survival in the recent TNM staging system, it is not included in the recent American Thyroid Association (ATA) guidelines to estimate the risk of recurrence. Nevertheless, the effect of sex on differentiated thyroid carcinoma (DTC) recurrence is controversial. Therefore, this multicenter study was conducted to assess whether age at diagnosis and sex can improve the performance of the ATA 3-tiered risk stratification system in patients with DTC with at least 5 years of follow-up. Methods: In this study, the computer-recorded data of the patients diagnosed with DTC between January 1985 and January 2016 were analyzed. Only patients with proven structural persistent/recurrent disease were selected for comparisons. Results: This study consisted of 1691 patients (female, 1367) with DTC. In Kaplan-Meier analysis, disease-free survival (DFS) was markedly longer in females only in the ATA low-risk category (P = .045). Nevertheless, a markedly longer DFS was observed in patients aged <45 years in the ATA low- and intermediate-risk categories (P = .004 and P = .009, respectively), whereas in patients aged <55 years, DFS was markedly longer only in the ATA low-risk category (P < .001). In the Cox proportional hazards model, ages of >45 and >55 years at diagnosis and the ATA risk stratification system were all independent predictors of persistent/recurrent disease. Conclusion: Applying the age cutoff of 45 years in the ATA intermediate- and low-risk categories may identify patients at a higher risk of persistence/recurrence and may improve the performance of the ATA risk stratification system, whereas sex may improve the performance of only the ATA low-risk category. (c) 2021 AACE. Published by Elsevier Inc. All rights reserved.Öğe Can myocardial performance index predict early cardiac risks in erectile dysfunction?(Taylor & Francis Ltd, 2020) Ardahanli, Isa; Celik, MehmetAim: Myocardial performance index (MPI) is an easy-to-apply and non-invasive method that shows both systolic and diastolic functions of the heart. In this study, it was aimed to evaluate the relationship between erectile dysfunction (ED) and MPI. Methods: The study included 45 male patients admitted to the urology outpatient clinic for ED and 48 healthy male volunteers. Echocardiographic evaluation of all participants was performed. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured. MPI was calculated using the IVCT + IVRT/ET formula. Results: The average age of the study population was 50 +/- 5.3. Early diastolic mitral inflow (E)/late diastolic mitral inflow (A) ratio was significantly lower in the ED group (p <= 0.05). In the TDI evaluation between the groups, while early diastolic mitral annular velocity (Em) was significantly higher in the ED group, there was no significant difference in late diastolic mitral annular velocity (Am) and systolic peak velocities (Sm) (p < 0.01 and p = 0.417 and p = 0.092, respectively). While IVRT was significantly lower in the ED group (p < 0.05), there was no significant difference in IVCT and ET (p = 311 and p = 0.261, respectively). MPI was statistically significantly higher in the ED group (p < 0.05). Conclusion: ED has been found to affect MPI. This parameter, which is easily and non-invasively measured, can be used to predict the risk of CVDs in ED.Öğe COMPARISON OF CLINICO PATHOLOGICAL FEATURES IN INCIDENTAL AND NONINCIDENTAL PAPILLARY THYROID CARCINOMAS IN 308 PATIENTS(Vesalius Univ Medical Publ, 2017) Can, Nuray; Ozyilmaz, Filiz; Celik, Mehmet; Sezer, Atakan Y.; Sut, Necdet; Tastekin, Ebru; Ayturk, SemraIncidental papillary thyroid carcinomas (IPTCs) consist of a significant portion of increasing incidence in papillary thyroid carcinomas. This study investigated the clinicopathological features of IPTCs from different perspectives and by comparing nonincidental PTCs (NIPTCs) in patients who underwent total thyroidectomy and lymph node dissection. Basic results were as follows. IPTC was present in 27.9% of 308 patients. IPTCs were significantly accompanied by lymphocytic thyroiditis (LT), particularly, multinodular hyperplasia (MNH). IPTCs were more common in older patients (51.3 years vs. 47.2 years) and in female patients. IPTCs significantly differed from NIPTCs in terms of smaller tumour size, lymphatic vessel invasion (2.6% vs. 97.4%), extrathyroidal extension (4.3% vs. 95.7%), lymph node metastasis (3.6% vs. 96.4%), multifocality (21.2% vs. 78.8%), bilaterality (5.3% vs. 94.7%), and BRAFV600 mutation (6.7% vs. 93.3%). Older age, bilaterality, encapsulation, and radioactive iodine (RAI) were significantly more common in IPTCs > 5 mm than in those <= 5 mm. In conclusion, IPTCs are more commonly associated with LT and MNH. IPTCs may have a more favourable prognosis than NIPTCs, and tumour size > 5 mm may predict bilaterality and need for RAI. Nevertheless, the patient-based clinical approach in IPTCs may have benefits in the management of IPTCs.Öğe Comparison of clinicopathological features in patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features and follicular variant papillary thyroid cancer(Medycyna Praktyczna Sp K Sp Zoo, 2020) Celik, Mehmet; Bulbul, Buket Y.; Can, Nuray; Ayturk, Semra; Tastekin, Ebru; Sezer, Atakan; Ustun, FundaINTRODUCTION Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a newly defined entity accepted as a tumor precursor. OBJECTIVE We aimed to examine the features of patients diagnosed with follicular variant papillary thyroid carcinoma (FVPTC), which are classified as NIFTP in the recent classification. This study compares clinical, radiological, histopathological, and molecular features of NIFTP and FVPTC. PATIENTS AND METHODS A total of 247 patients with FVPTC were retrospectively examined and pathology specimens were reviewed. RESULTS Patients were divided into 2 groups (NIFTP group: 107 patients; FVPTC group: 140 patients). There was a difference in terms of the percentage of pathologic nodules with irregular borders detected on preoperative neck ultrasonography (NIFTP group: 6.5%, FVPTC group: 15.7%; P = 0.02). Central lymph node dissection specimens of 50 patients in the NIFTP group were normal, while 4 of 70 patients (5.7%) in the FVPTC group had lymph node metastasis (P = 0.14). In addition, multivariable analysis (binary logistic regression) showed that FVPTC was positively associated only with irregular borders and extrathyroidal extensions (P = 0.02 and P <0.001, respectively). CONCLUSIONS We suggest that patients diagnosed with NIFTP according to the new classification are considered low risk, and margin characteristics of the nodule detected on preoperative ultrasonography may be helpful in the differential diagnosis.Öğe The Effect of Serum Magnesium Level on Stable Anticoagulation in Patients Using Warfarin for Various Cardiac Indications(Springernature, 2022) Ardahanli, Isa; Akhan, Onur; Celik, MehmetWarfarin is a vitamin K antagonist agent that inhibits clotting factors used for long-term anticoagulation. Time in therapeutic range (TTR) in patients using warfarin is one of the primary treatment effectiveness requirements. We aim to investigate the relationship between serum magnesium levels, the international normalized ratio (INR) values, and TTR values in people using warfarin for various indications. Our study is a single-center, cross-sectional, and retrospective study that included 169 patients between 18 and 70 who used warfarin for various indications. Demographic data, biochemical analysis, and coagulation parameters, including TTR calculation, were evaluated for all patients. Those with a TTR value below 60 were defined as labile INR, and those with 60 and above as stable INR group and compared. The mean INR value was higher in the labile INR group than the stable INR group (3.7 +/- 2.9, 3.2 +/- 0.3, respectively; p = 0.030). The Mg values are significantly lower in the labile INR group than the stable group (1.8 +/- 0.2 mg/dL, 2.0 +/- 0.1 mg/dL, respectively; p < 0.001). In binary multivariate logistic regression analysis, magnesium value was the most influential INR stabilization factor (p < 0.001). As a result of our study, it was concluded that magnesium levels are an influential factor in stabilizing INR. We can state that we have contributed to the literature and can be a reference for future studies.Öğe Evaluation of acute alterations in electrocardiographic parameters after cryoballoon ablation of atrial fibrillation and possible association with recurrence(Turkish Soc Cardiology, 2021) Uslu, Abdulkadir; Kup, Ayhan; Demir, Serdar; Gulsen, Kamil; Kanar, Batur Gonenc; Celik, Mehmet; Taylan, GokayObjective: This study aimed to evaluate the acute effect of cryoballoon ablation (CB-A) on electrocardiographic parameters that have been suggested to reflect heterogeneity in atrial conduction and ventricular repolarization. Methods: A total of 67 patients (52.6 +/- 13.2 years, 43 men) without any exclusion criteria who had undergone CB-A for atrial fibrillation (AF) between January 01, 2015, and December 31, 2018, constituted our study population. Electrographic recordings obtained before and after the ablation procedure on the same day were retrospectively evaluated for the P-wave dispersion, QTc dispersion, Tp-Te interval, and Tp-Te/QT ratio. The pre- and post-ablation values were tested for significant differences. The association of the possible CB-A-related changes in these parameters with AF recurrence during follow-up was evaluated. Results: P dispersion (30.1 +/- 6.8 vs. 35.9 +/- 9.4 ms, p<0.001), QT dispersion (20.7 +/- 7.5 vs. 24.0 +/- 8.8 ms, p<0.001), Tp-Te duration (on V5 83.6 +/- 8.1 vs. 110.2 +/- 9.5 ms, p<0.001), and Tp-Te/QT ratio (on V5 0.22 +/- 0.03 vs. 0.28 +/- 0.02, p<0.001) were observed to increase significantly after CB-A. There was no association between the magnitudes of change in any parameter and AF recurrence. Conclusion: CB-A had significant effects on electrocardiographic parameters related to atrial conduction and ventricular repolarization in the acute phase after CB-A. Further prospective studies are required to examine the time-related course of these alterations and their impact on clinical outcomes.Öğe Falsely Elevated Thyroid Stimulating Hormone in Two Cases Requiring Special Follow-up(Galenos Publ House, 2023) Colak, Serpil Yanik; Ozgun, Eray; Andac, Burak; Okur, Mine; Bulbul, Buket Yilmaz; Celik, MehmetInappropriate thyroid stimulating hormone (TSH) refers to an elevation in TSH levels that does not match the clinical findings and free T3 and free T4 levels. Several conditions can cause this, such as pituitary tumors that produce TSH, resistance to thyroid hormones, macro-TSH, and antibody interference. Macro-TSH is a condition that causes TSH to be measured high in the blood for a long time by forming a complex with immunoglobulins, mostly IgG. However, patients are clinically euthyroid because macro-TSH is not a bioactive complex. It is essential to exclude the diagnosis of falsely elevated TSH to protect patients from unnecessary or high -dose levothyroxine therapy. In our first case, we presented a patient in whom subclinical hypothyroidism was detected during in vitro fertilization treatment, and levothyroxine was started. The other case was an operated papillary thyroid cancer patient. In both cases, although the dose of levothyroxine was increased, insufficient TSH response to increased fT4/fT3 levels suggested inappropriate TSH elevation. The polyethylene glycol (PEG) precipitation method was used to detect the assay variability. TSH recovery after PEG was 0.96016 and 21016, respectively, supporting the diagnosis of macro-TSH. In both cases, detecting Macro-TSH was crucial in preventing thyrotoxicosis caused by excessive levothyroxine dosage. In addition, delay in treatment for infertility was prevented in the first case.Öğe Follicular morphological characteristics may be associated with invasion in follicular thyroid neoplasms with papillary-like nuclear features(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2017) Can, Nuray; Celik, Mehmet; Sezer, Yavuz Atakan; Ozyilmaz, Filiz; Ayturk, Semra; Tastekin, Ebru; Sut, NecdetThe newly proposed nomenclature and diagnostic criteria for encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC), the noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), could improve the consistency and accuracy of diagnosing this entity. Diagnosis of NIFTP requires evaluation of the complete tumor border or capsule. The presence of tumor invasion in follicular thyroid neoplasms with papillary-like nuclear features has been recently discussed by many authors. In this study, we examined the predictive value and association of follicular morphological characteristics with the tumor invasion. In addition, we analyzed the association between tumor encapsulation and molecular profile in EFVPTC/NIFTP cases. A total of 106 cases of FVPTC were included in the study. The tumors were grouped based on the presence of tumor capsule and characteristics of tumor border, as 1) completely encapsulated tumors without invasion, 2) encapsulated tumors with invasion, 3) infiltrative tumors without a capsule. Clinicopathological features, histomorphological features [ nuclear criteria, minor diagnostic features, follicles oriented perpendicular to tumor border/capsule (FOPBC)] and molecular alterations in BRAF, NRAS, and KRAS genes were evaluated. FOPBC were significantly more frequently seen in encapsulated tumors with invasion (p = 0.008). The nuclear features were not associated with the presence of encapsulation and characteristics of tumor border. BRAF mutation was more frequent in infiltrative tumors, while NRAS mutation was more frequent in encapsulated tumors, but the results were not statistically significant (p = 0.917). In conclusion, FOPBC histomorphological feature may be associated with tumor invasion in EFVPTC/NIFTP. Additionally, BRAF/KRAS/NRAS mutation analysis may prevent inadequate treatment in these patients.Öğe Gastric damage related to radioactive iodine treatment and the protective effect of amifostine.(Scientific Publishers India, 2017) Sezer, Atakan; Celik, Mehmet; Usta, Ufuk; Altun, Gulay DurmusIntroduction: The aim of this study was to evaluate the gastric damage related to high dose radioactive iodine treatment during thyroid cancer treatment in an experimental rat model and evaluate histopathologically the radioprotective effect of amifostine. Methods and findings: 40 adult rats were enrolled into the study. Radioactive iodine treatment with 30 mCi/kg I-131 was applied via orogastric tube simulating radioiodine ablation treatment (RAI) in thyroid cancer in all rats. After RAI subjects were divided into 2 groups: Group Orogastric RAI (Group OG, n: 20): Rats received no radioprotective agent but serum physiologic. Group Amifostine RAI (Group AP, n: 20): Rats received 200 mg/kg amifostine intraperitoneally 30 minutes before I-131 application. On the 1st, 3rd, 5th and 7th days of experiment rats were sacrificed for histopathological evaluation. Gastric tissues were excised and tissue damage was assessed by using histopathological scoring. Total pathology score revealed a significant change on the 7th day. The subjects in Group OG had histopathological changes, while only one subject in Group AP was found to have pathologic changes (X2=39.7 df (28), p=0.04). The common histopathological findings were striking mucosal and intraepithelial leucocytic infiltration together with thinning of the mucosa, regenerative changes, and reactive atypia. Conclusions: RAI treatment causes gastric mucosal injury and amifostine was found to decrease radioactive iodine treatment related gastric damage.Öğe HISTOLOGICAL PERSPECTIVE ON THE EFFECTS OF TUMOR-ASSOCIATED MACROPHAGES IN THE TUMOR MICROENVIRONMENT SURROUNDING PAPILLARY THYROID CARCINOMA(Vesalius Univ Medical Publ, 2016) Can, Nuray Y.; Ayturk, Semra; Celik, Mehmet; Sezer, Yavuz A.; Ozyilmaz, Eiliz; Tastekin, Ebru; Sut, NecdetTumor-associated macrophages (TAMs) are one of the most noticeable elements of the tumor microenvironment. The present study investigated the relationships between the density of CD163 immunolabeled M2-like TAMs with other histological properties of the tumor microenvironment and clinipathological features in 90 patients with papillary thyroid carcinomas (PTC). The percentage of TAMs was higher in tumors with significant lymphocytic tumor response (p = 0.020), in tumors with a significant degree of stromal tumor response (p = 0.014), those with infiltrative tumor borders (p = 0.029), in conventional variant papillary carcinoma (p = 0.032), and in patients with autoantibodies for thyroid peroxidase (p = 0.014). The tumors associated with lymphocytic thyroiditis had lower numbers of TAMs (p = 0.027). In conclusion, for the first time, the present study attempts to establish a full assessment of interactions of CD163 expressing M2-like TAMs with the triad of primary tumor-tumor microenvironment-tumor behavior and above all, with markers of autoimmunity. Thus, these alternatively polarized macrophages may act in tumor progression and dissemination according to their various products, which may be ordered by tumor cells or neighboring immune cells. The molecular studies may reveal their roles in various tumors and may improve the therapy strategies targeting TAMs in various malignant tumors, including PTCs.Öğe Iatrogenic Cushing's Syndrome After Topical Steroid Therapy for Psoriasis(Medknow Publications & Media Pvt Ltd, 2016) Sahip, Birsen; Celik, Mehmet; Ayturk, Semra; Kucukarda, Ahmet; Mert, Onur; Dincer, Nejla; Guldiken, SibelGlucocorticoids are used for the treatment of many diseases, such as inflammatory, allergic, autoimmune, and neoplastic diseases. They can be used in the form of topical, oral, inhalable, rectal, and intra-articular agents. Many topical steroid-related iatrogenic Cushing's syndrome cases affecting especially children have been reported in the literature. Topical steroid-related Cushing's syndrome is rarely seen in adults. In this report, we present the case of a 32-year-old male patient with iatrogenic Cushing's syndrome related to long-term clobetasol propionate treatment for psoriasis. In the context of such treatment, the glucocorticoid withdrawal problem has to be overcome. At present there is no consensus on steroid withdrawal. Patients on long-term glucocorticoid treatment must be evaluated for potential adverse effects and withdrawal symptoms by their physician and their endocrinologist.Öğe The Impact of Total Tumor Diameter on Lymph Node Metastasis and Tumor Recurrence in Papillary Thyroid Carcinomas(Mdpi, 2024) Can, Nuray; Bulbul, Buket Yilmaz; Ozyilmaz, Filiz; Sut, Necdet; Mercan, Meltem Ayyildiz; Andac, Burak; Celik, Mehmet(1) Introduction: The impact of multifocality/bilaterality on the prognosis of papillary thyroid carcinoma (PTC) is a matter of debate. In order to clarify this debate, several studies have attempted to identify additional parameters associated with poor prognosis, including total tumor diameter (TTD), in the context of multifocal PTCs. In this context, this study was carried out to investigate the impact of TTD on tumor recurrence and lymph node metastasis (LNM) in PTCs. (2) Materials and Methods: The sample of this single-center retrospective study consisted of 706 patients diagnosed with PTC. TTD was calculated as the sum of the largest diameters of tumor foci in multifocal tumors. The resulting TTDs were grouped into TTDs <= 10 mm, TTDs > 10 mm, TTDs <= 20 mm, and TTDs > 20 mm, using 10 mm and 20 mm as cutoff values. (3) Results: There was no significant difference between multifocal papillary microcarcinomas (PTMCs) with a TTD of >10 mm and unifocal PTCs with a primary tumor diameter (PTD) of >10 mm except for advanced age and lymphovascular invasion (LVI). In addition, perineural invasion (PNI) and TTD > 10 mm were found to be significant risk factors for LNM, and PNI, TTD > 10 mm, TTD > 20 mm, and bilaterality were found to be significant risk factors for recurrence. LVI, and TTD > 10 mm were found to be independent significant predictors for recurrence, and LVI and extrathyroidal extension (ETE) were found to be independent significant predictors for LNM. (4) Conclusions: Considering TTD > 10 mm in recurrence risk categorization models and adopting a clinical approach that takes into account multifocal PTMCs with TTD > 10 mm along with unifocal PTCs with PTD > 10 mm may be more useful in terms of clinical management of the disease.Öğe Indocyanine green fluorescence angiography-guided transoral endoscopic thyroidectomy and parathyroidectomy: First clinical report(Elsevier, 2020) Turan, Mehmet Ilker; Celik, Mehmet; Ertuerk, Mehmet SercanBackground: Indocyanine green fluorescence (ICG) angiography has been used for many purposes including as part of a focused parathyroidectomy technique. Concomitant fluorescence of thyroid tissue may cause challenges defining parathyroid tissue during surgery, since ICG is not a selective fluorescent agent. On the other hand, cosmesis is still a big problem for patients due to the visible neck scars produced by the standard surgical technique. In this study, we described a novel technique to solve both these handicaps. Materials and methods: Seven patients who underwent ICG fluorescence angiography-guided transoral endoscopic thyroidectomy and parathyroidectomy vestibular approach between February 2018 and July 2019 were included. Serum parathyroid hormone (PTH) levels were measured intraoperatively and on postoperative day 1. Fluorescent images were confirmed with intraoperative quick-PTH levels. Results: All operations were done successfully without conversion to open surgery. Intense and isolated parathyroid fluorescent images were achieved in all operations. All patients had a 50 % decrease between the baseline and final quick-PTH levels and the final quick-PTH levels were in the normal range in all. One of 7 patients had epistaxis due to nasotracheal intubation. One of 7 patients had seroma on post-operative day 5. None of patients had mental nerve injury, permanent hypocalcemia and temporary or permanent recurrent laryngeal nerve injury. Conclusion: ICG-guided transoral endoscopic thyroid and parathyroid surgery can be used in select patients to increase operative success in focused parathyroidectomy with excellent cosmetic outcome also noted.Öğe Investigation of the Relationship Between Genome Wide Association Studies-derived Polymorphisms and Differentiated Thyroid Cancer Risk in a Turkish Population(Gazi Univ, Fac Med, 2021) Demir, Selma; Gurkan, Hakan; Celik, Mehmet; Sezer, Atakan; Eker, Damla; Guldiken, Sibel; Sut, NecdetBackground: Thyroid cancer is the most common malignancy of endocrine system. Genome Wide Association Studies (GWAS) revealed a number of common variants associated with thyroid cancer risk. In this study, we aimed to investigate the association of these known variants with thyroid cancer risk in a Turkish population living in Trakya region. Methods: The study included 97 cases of differentiated thyroid cancer and 379 healthy controls. Real-Time Polymerase Chain Reaction (RT-PCR) method was used for the genotyping of rs965513, rs944289, rs966423 rs2439302 polymorphisms. Results: There was no statistically significant difference between patients and controls in terms of SNP genotype and allele frequencies. The distribution of cumulative genetic risk scores between patients and controls was also not significantly different. In the multiple logistic regression analysis (MLR), it was observed that the relationship of rs2439302 polymorphism GG genotype with thyroid cancer risk has a trend to be significant ((p = 0.067, 95%CI: 2.947 (0.928-9.357)). Conclusion: We suggest that the confirmation of the association of common variants with thyroid cancer in different populations will contribute to make a consensus on global risk alleles. The marginal significance of the association of rs2439302 with thyroid carcinoma risk shown in our study supports the need for functional studies on the role of this polymorphism in thyroid carcinoma.Öğe Macitentan in the treatment of pulmonary hypertension in Gaucher's disease(Turkish Soc Cardiology, 2020) Taylan, Gokay; Aktoz, Meryem; Celik, Mehmet; Yilmaztepe, Mustafa[Abstract Not Available]Öğe Microwave ablation of autonomously functioning thyroid nodules: a comparative study with radioactive iodine therapy on the functional treatment success(Via Medica, 2021) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, Mehmet; Uguz, Isil DemirayIntroduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and to investigate the functional treatment success of the used modalities for its remission. Material and methods: Treatment outcomes - thyroid hormone levels and nodule characteristics - of 30 patients (23:7 F:M; 52.77 +/- 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 +/- 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistical significance (p > 0.05). Thyroid hormone levels of patients treated with two different methods were measured after 9 months, and the obtained results were compared. Results: Although there was no statistically significant difference in the nodule volume (p > 0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (p < 0.05) at the end of the follow-up. In the MWA group, there was a higher increase in FT3 than in the RAI group (p < 0.05). Furthermore, no statistically significant difference in TSH (p = 0.124) and FT4 (p = 0.144) levels of the patients as treatment outcomes was observed. The therapeutic success was accomplished in 18/30 (60%) of the MWA group and in 24/35 (68.6%) of the RAI group. Conclusions: Therapeutic success of MWA and RAI did not show any statistically significant difference (p = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post-treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative to RAI due to its advantages in terms of non-exposure to radiation and lower risk of post-treatment hypothyroidism.Öğe Microwave Ablation of Benign Thyroid Nodules: Effects on Systemic Inflammatory Response(Coll Physicians & Surgeons Pakistan, 2020) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, MehmetObjective: To explore the alterations of neutrophil-to-lymphocyte ratio (NLR) as a systemic inflammatory marker after microwave ablation for benign thyroid nodules. Study Design: A descriptive study. Place and Duration of Study: Department of Radiology, Antalya Training and Research Hospital, from December 2018 to June 2019. Methodology: Demographic data of the patients, ultrasonographic features of the nodules, thyroid function tests of the patients, leukocyte, neutrophil, lymphocyte values, and thyroid nodule volumes of the patients before and after the procedure were recorded. NLR and volume reduction ratio (VRR %) of 35 patients with thyroid nodules were compared before and after microwave ablation therapy of the thyroid nodules. Results: The nodule volume decreased from 23.89 +/- 15.44 cc to 11.57 +/- 8.65 cc at two months and to 7.79 +/- 5.74 cc at six months. The VRR% increased from 38.65 +/- 16.82 to 63.16 +/- 14.19 at three months and to 68.29 +/- 11.80 at six months. The mean value of NLR decreased from 2.28 +/- 0.86 to 1.78 +/- 0.54. ROC curve analysis suggested that the optimum pre-NLR cut-off point for 50% VRR success was 2.50 with the specifity and sensitivity of 0.67 and 0.50. Conclusion: After ultrasound-guided microwave ablation of benign thyroid module, VRR percentage increased significantly, while the inflammatory marker NLR value decreased.Öğe Microwave ablation of symptomatic benign thyroid nodules: Short- and long-term effects on thyroid function tests, thyroglobulin and thyroid autoantibodies(Wiley, 2021) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, Mehmet; Ucar, HavvaObjective Microwave ablation therapy has been attracting great attention due to its advantages such as low complication rate, good cosmetic results and effective nodule shrinking. Although the effect of thermal ablation therapy on the nodule volume reduction rate has been shown several studies, a limited number of papers have been reported for the effects of microwave ablation (MWA) on thyroid function tests. The aim of this study was to investigate the short- and long-term effects of MWA therapy on thyroid function tests (TFTs), thyroglobulin (Tg) and thyroid autoantibodies in euthyroid patients. Design, patients and measurements Demographic data of the patients, TFTs, Tg, thyroid autoantibodies and thyroid volume of the nodules were recorded before the procedure and follow-up. Any differences in serum thyroid hormone levels were investigated in pre-, post- and 6-month follow-up periods before and after MWA. Results The difference between all thyroid hormone levels at pre MWA and 24 h after MWA was statistically significant (p < .001). FT3 (4.62) pmol/L and FT4 (10.81) pmol/L median levels increased significantly (p < .001), while thyrotropin (TSH) levels decreased at 24 h after MWA (p < .001). Thyroid antibodies levels were not statistically different at 6-month (p > .05), whereas Tg levels decreased (p < .001) compared to pre MWA. Conclusions While no significant effect was observed at 6 month, the effect of MWA on thyroid function tests was prominent at 24 h.Öğe Nasal hemangiopericytoma presenting with oncogenic osteomalasia: A case report and literature review(Mosby-Elsevier, 2021) Gokyer, Ali; Sayin, Sezin; Kucukarda, Ahmet; Celik, Mehmet; Guldiken, Sibel; Cicin, IrfanSinonasal type hemangiopericytoma is a rare soft tissue tumor. Oncogenic osteomalacia (tumor-induced osteomalacia) is a rare syndrome that develops especially due to benign mesenchymal tumors. Nonspecific general bone pain and weakness delay the diagnosis and treatment of oncogenic osteomalacia, and it is difficult to determine the localization of the primary tumor causing oncogenic osteomalacia. A 43-year-old male patient with nasal hemangiopericytoma with symptoms of oncogenic osteomalacia is presented. The patient had musculoskeletal complaints at first and was diagnosed with lumbar disc herniation and surgery was performed. When his complaints recurred 1 year later, he was re-evaluated and diagnosed with hypophosphatemic osteomalacia. Despite the various treatments he received, his complaints did not decrease but increased, so a detailed examination was decided. When the positive PHEX mutation and very high fibroblast growth factor 23 level were detected, PET-CT imaging was performed with a pre diagnosis of possible oncogenic osteomalacia, but no finding was found. Then he was evaluated with Ga68 DOTATATE, and the soft tissue mass filling the right ethmoidal sinus was detected. Due to the relation of the mass with surrounding structures, it was considered unsuitable for total excision and incomplete surgical excision was performed. Pathologic evaluation revealed sinonasal type hemangiopericytoma (glomangiopericytoma). A significant remission in the patient's complaints was observed after the operation. Young patients with osteomalacia with unknown causes should be evaluated for malignancy, and screening and further examinations should be performed. (c) 2020 Elsevier Inc. All rights reserved.Öğe Prevalence of Metabolic Syndrome in Primary Hyperparathyroidism(Galenos Yayincilik, 2017) Cevik, Gokcen Tugba; Guldiken, Sibel; Atile, Neslihan Soysal; Celik, Huseyin; Celik, Mehmet; Ayturk, Semra; Sut, NecdetAim: In this study, we aimed to evaluate the prevalence of metabolic syndrome (MetS), metabolic abnormalities and independent predictors of MetS in primary hyperparathyroidism and to contribute to long-term follow-up and management of these patients. Methods: Seventy-eight non-pregnant patients aged 18 years and over without renal or hepatic failure and other systemic diseases, who were diagnosed with primary hyperparathyroidism, between January 2005 and December 2014 were included in the study. Results: Sixty-two (79.5%) subjects were female and 16 (20.5%) were male. The mean age of the patients was 55.3 +/- 12.6 years. Fifty eight patients were classified as symptomatic and 20 as asymptomatic. Thirty-two patients (41%) were found to have primary hyperparathyroidism in accordance with the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. The frequency of urinary tract stone disease was significantly higher in patients with hyperparathyroidism with MetS than in those with primary hyperparathyroidism without MetS (p=0.018). Conclusion: In our study, the prevalence of MetS in patients with primary hyperparathyroidism was found to be similar to that demonstrated in epidemiological studies performed in the general population of the same age. However, in these patients higher prevalence of hypertension, increased waist circumference, lipid disorders such as some syndrome abnormalities that may lead to the increased cardiovascular morbidity and mortality were observed.
