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Abstract
The coexistence of Cushing's syndrome (CS) and pregnancy is uncommon due to the suppression of gonadotropin secretion in CS. Adrenocorticotropic hormone (ACTH) dependent CS in pregnancy is less frequent than adrenal causes. The diagnosis of CS during pregnancy is difficult since physiological changes in the hypothalamo-pituitary-adrenal axis may cause dynamic tests to be misinterpreted. Radiological imaging is limited. We report the case of a 27-year old woman with Cushing's disease (CD) diagnosed in the 5th-week of pregnancy. The mild symptoms of hypercortisolism did not lead to serious complications for the mother or the fetus, so insulin was the only treatment used. The pregnancy was completed without any complications, and at 38 weeks of gestation a healthy female infant was delivered vaginally. Complications, such as hypocortisolemia and hypoglycemia, were not observed in the infant. Postpartum tests were consistent with CD. Contrast-enhanced pituitary magnetic resonance imaging revealed a microadenoma which was removed with transsphenoidal surgery. Histopathology revealed a pituitary adenoma with positive immunohistochemical staining for ACTH. Biochemical remission required prednisolone treatment, but the insulin requirement decreased significantly over time. As a conclusion, CD with mild features can be well tolerated during pregnancy, but the mother and the fetus must be monitored closely.
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Affiliation(s)
- S Ciftci Dogansen
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - B Canbaz
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - B Canbaz
- Istanbul University, Istanbul Faculty of Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - S Yarman
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
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2
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Yalin GY, Dogansen SC, Canbaz B, Gul N, Bilgic B, Uzum AK. INCIDENTAL PAGET'S DISEASE DISGUISED AS BONE METASTASIS IN A PATIENT WITH ENDOMETRIUM CARCINOMA. Acta Endocrinol (Buchar) 2017; 13:111-114. [PMID: 31149157 DOI: 10.4183/aeb.2017.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Paget's disease is a disorder of aging bone which occurs in the setting of accelarated bone remodelling. In the presented case we discuss the difficulties in the diagnosis of Paget's disease in a 77 year old patient with coexisting endometrium carcinoma. The patient was initially diagnosed with metastatic bone disease due to endometrium adenocarcinoma when she was admitted to oncology clinic with pelvic pain. Bone scintigraphy with Tc99 and (18)F fluorodeoxyglucose positron emission tomography/CT revealed an increased uptake on the bone lesions which were reported as metastatic bone involvement. Although the (18)F-FDG uptake was much higher than the levels that would generally be anticipated in a case with Paget's disease, high levels of bone turnover markers indicated further evaluation in the differential diagnosis and the definitive diagnosis of Paget's disease was established with the pathological evaluation of bone biopsy.
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Affiliation(s)
- G Y Yalin
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Turkey
| | - S C Dogansen
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Turkey
| | - B Canbaz
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Turkey
| | - N Gul
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Turkey
| | - B Bilgic
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Turkey
| | - A K Uzum
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Turkey
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3
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Yarman S, Yalın GY, Dogansen SC, Canbaz B, Tanrıkulu S, Akyuz F. Double benefit of long-acting somatostatin analogs in a patient with coexistence of acromegaly and ulcerative colitis. J Clin Pharm Ther 2016; 41:559-62. [DOI: 10.1111/jcpt.12412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/02/2016] [Indexed: 11/30/2022]
Affiliation(s)
- S. Yarman
- Department of Internal Medicine; Division of Endocrinology and Metabolic Diseases; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - G. Y. Yalın
- Department of Internal Medicine; Division of Endocrinology and Metabolic Diseases; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - S. C. Dogansen
- Department of Internal Medicine; Division of Endocrinology and Metabolic Diseases; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - B. Canbaz
- Department of Internal Medicine; Division of Endocrinology and Metabolic Diseases; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - S. Tanrıkulu
- Department of Internal Medicine; Division of Endocrinology and Metabolic Diseases; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
| | - F. Akyuz
- Department of Internal Medicine, Division of Gastroenterohepatology; Istanbul Faculty of Medicine; Istanbul University; Istanbul Turkey
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4
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Kaloglu A, Canbaz B, Kara O, Arik G, Sengul Aycicek G, Sumer F, Ulger Z. Low serum levels of vitamin D are associated with post-stroke depression. Eur J Neurol 2016; 23:e27. [DOI: 10.1111/ene.12938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 11/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- A. Kaloglu
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - B. Canbaz
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - O. Kara
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - G. Arik
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - G. Sengul Aycicek
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - F. Sumer
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
| | - Z. Ulger
- Department of Geriatrics; Gazi University Faculty of Medicine; Ankara Turkey
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Sengul Aycicek G, Sumer F, Canbaz B, Kara O, Ulger Z. Sarcopenia evaluated by fat-free mass index in patients with chronic heart failure. Eur J Intern Med 2015; 26:e34. [PMID: 26054657 DOI: 10.1016/j.ejim.2015.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/16/2022]
Affiliation(s)
- G Sengul Aycicek
- Gazi University, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey.
| | - F Sumer
- Gazi University, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - B Canbaz
- Gazi University, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - O Kara
- Gazi University, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - Z Ulger
- Gazi University, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
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Canbaz B, Akar Z, Ciplak N, �z�inar G, Sayin E, Kuday C, Akcura S. Tumors of the Sellar-Parasellar Region: Analysis of 328 Cases. Skull Base Surg 2015. [DOI: 10.1159/000429857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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7
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�z�inar G, Canbaz B, Akar Z, Ak H, Kuday C, Sarioglu AC, Sayin E. Sellar Macroadenomas: Analysis of 97 Cases. Skull Base Surg 2015. [DOI: 10.1159/000429876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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8
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Tuzgen S, Hanimoglu H, Tanriverdi T, Kacira T, Sanus GZ, Atukeren P, Dashti R, Gumustas K, Canbaz B, Kaynar MY. Relationship Between DNA Damage and Total Antioxidant Capacity in Patients with Glioblastoma Multiforme. Clin Oncol (R Coll Radiol) 2007; 19:177-81. [PMID: 17359903 DOI: 10.1016/j.clon.2006.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Revised: 11/09/2006] [Accepted: 11/21/2006] [Indexed: 10/23/2022]
Abstract
AIMS To assess oxidative DNA damage and total antioxidant capacity (TAC) in glioblastoma multiforme (GBM) and to compare the results with normal brain tissues. MATERIALS AND METHODS Oxidative DNA damage and TAC were evaluated in GBM tissues extracted from 26 patients and in normal brain tissues of 15 subjects who underwent autopsy within the first 4h of death. Oxidative DNA damage was assessed by measuring 8-hydroxy-2-deoxyguanosine (8-OH-dG) using the 8-OH-dG enzyme immunoassay kit, a quantitative assay for 8-OH-dG, and TAC was analysed using the ImAnOx colorimetric test system for the determination of antioxidative capacity. The results were compared between two groups and any correlation between 8-OH-dG and TAC was sought. RESULTS The median level of TAC in GBM (121.5 nmol/g wet tissue) was remarkably lower than that in normal brain tissue (298 nmol/g wet tissue). The difference was statistically significant (P=0.00001). In contrast, oxidative DNA damage was significantly higher in patients with GBM (74.9 ng/g wet tissue) than in controls (34.71 ng/g wet tissue). Again, the difference was statistically significant (P=0.00001). We also found a negative correlation between oxidative DNA damage and TAC (P<0.001). CONCLUSIONS These findings indicate that the degree of oxidative DNA damage is increased and TAC is decreased in GBM. Oxidative DNA damage is correlated with the levels of TAC.
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Affiliation(s)
- S Tuzgen
- Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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9
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Abstract
Neuromas arising from the distal branches of the trigeminal nerve with extracranial extension are unusual. Here, we present the clinical features, diagnosis and treatment of 28-year-old woman with trigeminal neuroma with extension to the infratemporal fossa.
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Affiliation(s)
- A M Kafadar
- Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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10
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Yanardag H, Uygun S, Yumuk V, Caner M, Canbaz B. Cerebral tuberculosis mimicking intracranial tumour. Singapore Med J 2005; 46:731-3. [PMID: 16308650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Cerebral tuberculoma is a rare entity and is one of the causes of intracerebral mass lesions. A rapid diagnosis based on pathological findings improves its prognosis. We describe two cases where the tuberculoma was located in the cavernous sinus and prepontine cistern, respectively. The first case was a 36-year-old man who was admitted with progressive headache, left ptosis and diplopia. Computed tomography showed a solid enhancing mass in the left cavernous sinus. Diagnosis of meningioma was proposed and a left pterional craniotomy was performed. Histopathological examination revealed granulomatous inflammation with areas of caseation necrosis. The second case was a 20-year-old man who presented with headache, new-onset strabismus, diplopia, malaise, weight loss and low-grade fever. The lesion mimicked an aggressive meningioma on imaging. The patient was operated for primary diagnosis of cerebral tumour. The histopathological examination of the excised lesion revealed a tuberculoma. Although the incidence of tuberculosis is decreasing, a high index of suspicion must be maintained for the diagnosis of intracranial masses in the presence of risk factors for tuberculosis.
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Affiliation(s)
- H Yanardag
- Department of Lung Diseases, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
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11
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Tuzgen S, Canbaz B, Kaya AH, Sanus GZ, Kuday C, Memis M, Oz B. Experimental study of rapid versus slow sagittal sinus occlusion in dogs. Neurol India 2003; 51:482-6. [PMID: 14742927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND Clinical, radiological, postmortem and experimental studies are not enough for the definition of pathophysiological differences between rapid and slow-progressing cerebral venous system obstruction. AIMS An experimental study was conducted to set some physiopathological differences between rapid and slow occlusion of the superior sagittal sinus. SETTINGS AND DESIGN Eighteen dogs categorized into 3 groups were chosen as test subjects. The three groups were the rapid occlusion, slow occlusion and the control study groups and each group had six subjects. MATERIAL AND METHODS Intracranial pressure values, histopathological findings, and the degree of cerebral edema formation, estimated by measuring the water content ratio of the brain and the angiographic results in the 2 different groups of subjects that underwent rapid and slow superior sagittal sinus obstruction were compared with that of the control subjects. STATISTICAL ANALYSIS Statistical analysis was performed using GraphPad Prisma V.3 statistical software. Variables of the 3 groups were compared using non-parametric Kruskal Wallis ANOVA test and multiple comparisons were made using Dunn's multiple test. The comparison of initial and terminal intracranial pressure values obtained before and after the sinus occlusion, was made using the Wilcoxon test. A probability value of less than 0.05 was regarded as significant. RESULTS AND CONCLUSIONS Comparison of the water content ratio of the brain in the 3 groups, the difference between the initial and terminal intracranial pressure values of the rapid occlusion study group, and the difference between the terminal intracranial pressure values of the 3 groups was statistically significant (P<0.05). Dunn's Multiple Comparison Test yielded significant differences in the water content ratio of the brain and in the intracranial pressure values between the rapid occlusion study group and the control group (P<0.05). Moreover, histopathological and radiological examination disclosed more prominent brain edema findings, and less apparent collateral venous flow in the rapid occlusion study group than in the slow occlusion one. To conclude, the clinical severity of sinus occlusion seems directly related to the quickness of the occlusion and the capacity of the collateral venous system.
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Affiliation(s)
- S Tuzgen
- Department of Neurosurgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey
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12
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Erdinçler P, Kaynar MY, Canbaz B, Koçer N, Kuday C, Ciplak N. Iniencephaly: neuroradiological and surgical features. Case report and review of the literature. J Neurosurg 1998; 89:317-20. [PMID: 9688130 DOI: 10.3171/jns.1998.89.2.0317] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Iniencephaly is a rare congenital anomaly characterized by spina bifida of the cervical vertebrae, fixed retroflexion of the head on the cervical spine, and occipital bone defect. There are only five reports of surviving patients with iniencephaly. The authors report the case of a newborn who presented with iniencephaly and an encephalocele that were surgically treated in our service. Neurological examination of the patient yielded normal results except for a moderate psychomotor retardation. The neuroradiological and surgical findings of the case suggested that the trigger of the anomaly was the occipital bone defect and rachischisis of the posterior vertebral arches.
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Affiliation(s)
- P Erdinçler
- Department of Neurosurgery, Cerrahpaşa Medical Faculty, Istanbul University, Turkey
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13
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Abstract
Reduction cranioplasty is required in selected patients when macrocephaly interferes with head control, seating, locomotion, and social acceptance. Two different surgical techniques for reduction cranioplasty in two cases of older hydrocephalic patients are described. Emphasis is placed on the basic stages of the procedure.
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Affiliation(s)
- P Erdinçler
- Department of Neurosurgery, Cerrahpaşa Medical School, Istanbul University, Turkey
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14
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Abstract
Two achondroplastic children with ventriculomegaly are reported. The patients had no signs of increased intracranial pressure, but in one blindness had previously been detected by the parents. Neuroradiological examinations showed ventriculomegaly in both. Intracranial pressure remained at high levels (20-55 mmHg) preoperatively; ventriculo-peritoneal shunting was performed in both cases, and postoperatively levels fell to normal (5-16 mmHg). The need for the treatment of ventriculomegaly seen in achondroplastic children is analyzed on the basis of these two patients, with a brief review of literature.
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Affiliation(s)
- P Erdinçler
- Department of Neurosurgery, Cerrahpasa Medical School, Istanbul University, Turkey
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15
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Abstract
Although hydatid disease is the most common human disease caused by helminths, cerebral and spinal involvement in hydatid disease is rare. Recurrence is common when cysts rupture during surgical removal. The authors present the results of combined treatment with surgery and mebendazole in four cerebral and five spinal cases of hydatid disease. The patients' ages ranged between 4 and 55 years with a mean of 26 years. In three of the four cranial patients who received mebendazole treatment, the cysts ruptured during surgical removal. Four of the five spinal cases had recurrent disease at the time of admission. Mebendazole was started immediately after surgery and continued over 12 months. All cases but one are stable clinically or radiologically at a mean 27 months follow-up period.
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Affiliation(s)
- P Erdinçler
- Instabul University, Cerrahpaşa Medical School, Department of Neurosurgery, Turkey
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16
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Abstract
The case of a newborn who had ocular, cerebral and cerebellar dysgenesis with hydrocephalus, which represents very rarely occurring Warburg syndrome, is described. Clinical, radiographic, and histopathological features are detailed.
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Affiliation(s)
- B Canbaz
- Department of Neurosurgery, Istanbul University Cerrahpasa Medical Faculty, Turkey
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