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    A new technique to simplify the minimally invasive parathyroidectomy: Ultrasound-assisted guided wire localization for solitary parathyroid adenomas
    (Pakistan Medical Assoc, 2016) Ozkul, Faruk; Arik, Muhammed Kasim; Eroglu, Mustafa; Faydaci, Umut; Toman, Huseyin; Tas, Sukru; Ukinc, Kubilay
    Objective: To investigate the benefits of ultrasound-assisted guided wire localization in MIP for selected cases. Methods: In this prospective, nonrandomised study, we included 36 patients with solitary parathyroid adenomas diagnosed preoperatively by 99m Tc sesta MIBI scintigraphy and/or neck ultrasonography. An ultrasound-guided wire was placed in the solitary parathyroid adenoma preoperatively. MIPs were performed under local anaesthesia plus sedation. After the excision, the parathyroidectomy was confirmed with postoperative ultrasonography. Results: There were 36 patients included in our study. The mean age was 54.89 +/- 11.28 years, and 30 patients were females (83.3%). Preoperative PTH and calcium (Ca) levels were 269.5 pg/mL (83.5-5,000 pg/mL) and 12.2 mg/dL (11.1-20 mg/dL), respectively. Postoperative serum PTH and Ca levels were 42.04 +/- 26.65 pg/mL and 8.95 +/- 0.74 mg/dL, respectively. The mean operation time was 21.69 +/- 6.4 minutes and the average hospitalisation time was 18 hours (range: 10-72 hours). Conclusions: Ultrasound-assisted guided wire localization may be useful in selected MIP cases. The MIP advantages include higher success rates and being easy to learn and practise.
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    Serum ischemia modified albumin levels in subclinical cushing's syndrome
    (A. CARBONE Editore, 2016) Ozkul, Faruk; Turkon, Hakan; Cakir, Dilek Ulker; Eroglu, Mustafa; Tutunculer, Funda Kirtay; Faydaci, Umut; Ukinç, Kubilay
    Introduction: Subclinical Cushing's syndrome (SCS) is defined as biochemical overt cortisol excess in the absence of the classical signs and symptoms of Cushing's disease. The prevalence of SCS is reported as between approximately 5% and 24% in patients with adrenal incidentalomas (AI). SCS has increased cardiovascular and metabolic risk factors, and metabolic syndrome. Recently some studies demonstrated oxidative stress enhancement in Cushing's disease. Ischemia-modified albumin (IMA) is a marker of ischemia and oxidative stress and is increased in different clinical conditions such as cardiovascular diseases and metabolic syndrome. However, it has not been investigated in the patients with SCS. We aimed to evaluate serum IMA levels in the patients with SCS. Materials and methods: A total of 128 patients with AI were included in this study (17 patients with SCS and 111 patients with non-functional adenomas (NFA)). All patients were evaluated for the presence of adrenal masses using adrenal computed tomography (CT) scans. Serum IMA levels were measured by using a colorimetric method. Results: Serum IMA levels were significantly higher in SCS patients than in NFA patients (p < 0.05). Serum IMA was significantly correlated with waist circumference, low-density lipoprotein (LDL) levels and SCS. Furthermore, regression analysis revealed that serum IMA levels are independent and positively associated only with SCS. Conclusion: We concluded that elevated serum IMA levels might be accepted as a useful marker in patients with SCS. In order to reveal the pathological role of IMA levels in patients with SCS more studies are required.
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    Öğe
    SERUM ISCHEMIA MODIFIED ALBUMIN LEVELS IN SUBCLINICAL CUSHING'S SYNDROME
    (Carbone Editore, 2016) Ozku, Faruk; Turkon, Hakan; Cakir, Dilek Ulker; Eroglu, Mustafa; Tutunculer, Funda Kirtay; Faydaci, Umut; Ukinc, Kubilay
    Introduction: Subclinical Cushing's syndrome (SCS) is defined as biochemical overt cortisol excess in the absence of the classical signs and symptoms of Cushing's disease. The prevalence of SCS is reported as between approximately 5% and 24% in patients with adrenal incidentalomas (AI). SCS has increased cardiovascular and metabolic risk factors, and metabolic syndrome. Recently some studies demonstrated oxidative stress enhancement in Cushing's disease. Ischemia-modified albumin (IMA) is a marker of ischemia and oxidative stress and is increased in different clinical conditions such as cardiovascular diseases and metabolic syndrome. However, it has not been investigated in the patients with SCS. We aimed to evaluate serum IMA levels in the patients with SCS. Materials and methods: A total of 128 patients with AI were included in this study (17 patients with SCS and 111 patients with non-functional adenomas (NFA)). All patients were evaluated for the presence of adrenal masses using adrenal computed tomography (CT) scans. Serum IMA levels were measured by using a calorimetric method. Results: Serum IMA levels were significantly higher in SCS patients than in NFA patients (p < 0.05). Serum IMA was significantly correlated with waist circumference, low-density lipoprotein (LDL) levels and SCS. Furthermore, regression analysis revealed that serum IMA levels are independent and positively associated only with SCS. Conclusion: We concluded that elevated serum IMA levels might be accepted as a useful marker in patients with SCS. In order to reveal the pathological role of IMA levels in patients with SCS more studies are required.