Person: CANDER, SONER
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CANDER
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Publication Risk factors and outcomes of the post-liver transplantation diabetes mellitus(Aves, 2022-09-01) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Göktuğ, Mehmet Refik; Cander, Soner; Ersoy, Canan Özyardımcı; Aydemir, Ensar; Ateş, Coşkun; Ünsal, Oktay; Kıyıcı, Murat; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; GÖKTUĞ, MEHMET REFİK; CANDER, SONER; Ersoy, Canan Özyardımcı; AYDEMİR, ENSAR; ATEŞ, COŞKUN; KIYICI, MURAT; ERTÜRK, ERDİNÇ; Tıp Fakültesi; Dahiliye Ana Bilim Dalı; 0000-0001-8519-784X ; GBT-4320-2022; CSJ-5407-2022; CJH-1319-2022; JMT-8992-2023; AAB-6671-2022; CDO-0747-2022; FHW-0015-2022; AAJ-6536-2021Objective: We aimed to identify the risk factors for the development of diabetes mellitus after transplantation in liver recipients.Methods: Two hundred twenty-seven patients with a follow-up period >8 months after liver transplantation were included in the study. The clinical and laboratory data of patients with post-liver transplantation diabetes mellitus and without post-liver transplantation diabetes mellitus were compared.Results: Of the 227 patients, 61 patients were diagnosed with diabetes mellitus in the pretransplantation period. Twelve percent of the patients (20 patients) were diagnosed with post-liver transplantation diabetes mellitus and 146 patients were not diagnosed with diabetes mellitus. We found that post-liver transplantation diabetes mellitus was associated with advanced age (95% CI: 1.002-1.142). Male liver recipients were diagnosed with a higher rate of post-liver transplantation diabetes mellitus than female recipients (15.5% and 5.4%, respectively; P =.045). Pretransplantation fasting plasma glucose levels were higher in patients with post-liver transplantation diabetes mellitus than without post-liver transplantation diabetes mellitus, which was not statistically significant (P =.097). While 22.2% of patients with post-liver transplantation diabetes mellitus had complications after transplantation, 14.2% of the patients without post-liver transplantation diabetes mellitus had complications after transplantation (P =.370).Conclusion: As post-liver transplantation diabetes mellitus is associated with graft failure and increased mortality and morbididy, candidates for liver transplantation should be screened for risk factors of diabetes, and blood work for diabetes mellitus should be done regularly in these patients. Since patients with advanced age, male gender, and higher fasting plasma glucose levels in the pretransplantation period have higher risk for the development of post-liver transplantation diabetes mellitus, these cases should be screened more carefully.Publication Answer regarding comment on: Risk factors and outcomes of the post-liver transplantation diabetes mellitus(Aves, 2023-01-01) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Göktuğ, Mehmet Refik; Cander, Soner; Ersoy, Canan Özyardımcı; Aydemir, Ensar; Ateş, Coşkun; Ünsal, Oktay; Kıyıcı, Murat; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; GÖKTUĞ, MEHMET REFİK; CANDER, SONER; ERSOY, CANAN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; KIYICI, MURAT; ERTÜRK, ERDİNÇ; Tıp Fakültesi; Endokrinoloji ve Metabolizma Hastalıklar Ana Bilim Dalı; 0000-0001-8519-784X ; GBT-4320-2022; CSJ-5407-2022; CJH-1319-2022; JMT-8992-2023; AAB-6671-2022; CDO-0747-2022; FHW-0015-2022; AAJ-6536-2021Publication Two opposite phenotypes of glucose disorders in a family with heterozygous p.ser453leu (c.1358c> t) mutation in the glucokinase (gck) gene: Maturity onset diabetes in young and insulinoma(Editura Acad Romane, 2022-10-01) Demiral, Meliha; Çelebi, Hamide Betül Çelebi; Demirbilek, Hamza; CANDER, SONER; YERCİ, ÖMER; Yerci, Ömer; EREN, ERDAL; Eren, Erdal; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; 0000-0001-5218-7880; 0000-0002-1684-1053; 0000-0002-1684-1053; HUR-0563-2023; EGD-8703-2022; JPK-3909-2023Background. Heterozygous gain-of-function mutations in the glucokinase (GCK) gene cause hyperinsulinaemic hypoglycaemia (GCK-HI), while loss-of-function mutations lead to a monogenic type of diabetes (GCK-MODY). We, herein, report a heterozygous GCK gene mutation in a large family with GCK-MODY and insulinoma in one individual from the same family.Patients and methods. The proband, an 11-year-old male, was referred for asymptomatic mild hyperglycemia (fasting glucose:121 mg/dL) and HbA1c of 6.1%. Segregation analysis of the family revealed multiplex members with asymptomatic fasting hyperglycaemia or non-insulindependent diabetes and 33-year-old maternal uncle of the proband case had a history of distal pancreatectomy due to the diagnosis of insulinoma. His preoperative investigations were revealed fasting glucose of 31 mg/dL, insulin: 7 mu U/mL, C-peptide: 2.6 mg/dL, and a low HbA1c(4.0%) which was suggestive for recurring hypoglycaemia episodes. Post-pancreatectomy he developed mild fasting hyperglycemia (115-136 mg/dL).Results. Genetic analysis revealed heterozygous p.Ser453Leu(c.1358C> T) mutation in the GCK gene in the proband. In segregation analysis, the identical heterozygous p.Ser453Leu(c.1358C> T) GCK gene mutation was detected in all of the other affected family members for whom a DNA analysis was applicable. The maternal uncle was first diagnosed with insulinoma and underwent a pancreatectomy. He also had an identical mutation in a heterozygous state.Conclusion. We, to the best of our knowledge, firstly identified these two entirely distinct phenotypes of glucose metabolism, GCK-MODY and GCK-HI, due to an identical heterozygous p.Ser453Leu (c.1358C> T) mutation in the GCK. Further studies required to elucidate this new phenomenon and understanding the genotype-phenotype relationship of GCK gene mutations.Publication Can diabetes insipidus be used as a marker for multisystemic and progressive disease in langerhans cell histiocytosis?(Kuwait Medical Assoc, 2021-12-01) Koca, Nizameddin; Cander, Soner; CANDER, SONER; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Tıp Fakültesi; Endokrinoloji Ana Bilim Dalı; 0000-0003-1457-4366; 0000-0002-1332-4165; V-9228-2017Langerhans cell histiocytosis (LCH) is a rare disease with an yearly incidence of nine cases per a million in children and 1-2 cases per a million adults. 68.6% of LCH presented with multisystem involvement. A 40-year-old woman who was admitted to endocrinology outpatient clinic with symptoms of polyuria, polydipsia and headache was diagnosed with diabetes insipidus (DI). Desmopressin treatment was initiated, but six months after therapy, re-evaluation revealed progression in hypophyseal mass. Thoracoscopic biopsy shows LCH with multisystemic involvement. She did not respond clinically to systemic chemotherapy and external radiotherapy and died due to pneumonia.LCH should be taken into consideration in patients diagnosed with DI. DI is almost always the hallmark of hypothalamic pituitary axis involvement and a sign of multisystemic involvement.Publication Differences between atypical parathyroid tumors and parathyroid adenomas in patients with primary hyperparathyroidism(Springer India, 2023-09-29) Aydemir, Ensar; AYDOĞAN ÜNSAL, YASEMİN; ÖZ GÜL, ÖZEN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; Ateş, Coşkun; CANDER, SONER; Cander, Soner; Saraydaroğlu, Özlem; SARAYDAROĞLU, ÖZLEM; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinc; ERTÜRK, ERDİNÇ; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; 0000-0003-4300-2965; 0000-0003-4565-9848; 0000-0002-1332-4165; AAJ-6536-2021; AAB-6671-2022; AAA-7171-2022Atypical parathyroid tumor is a rare disease that can be challenging to distinguish from parathyroid adenoma. Atypical parathyroid tumor shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic, and histopathological characteristics in atypical parathyroid tumor and parathyroid adenoma. This was a retrospective study based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with atypical parathyroid tumor were matched by age and gender to controls with parathyroid adenoma. Clinical, laboratory, radiologic, and characteristics were obtained from the hospital database. Forty-five (54.8%) of primary hyperparathyroidism patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture, and 3 (7.5%) had hypercalcemic crisis. Atypical parathyroid tumor patients present with significantly increased serum calcium, parathormone, and alkaline phosphatase levels (P < .001, all). No significant difference was observed in the results of bone mineral density, T-scores, and Z-scores. The size of adenoma was significantly greater in the atypical parathyroid tumor group (24 (8.8-70) mm vs. 12 (3.8-32) mm, P = 0.005). Our study revealed that increased preoperative serum calcium, parathormone, alkaline phosphatase concentrations, and parathyroid adenoma size on ultrasound may have predicted the atypical parathyroid tumor.Publication Adrenocortical carcinoma: Single center experience(Aves, 2017-12-01) Şişman, Pınar; Şahin, Ahmet Bilgehan; Peynirci, Hande; Cander, Soner; Gül, Özen Öz; Ertürk, Erdinç; Ersoy, Canan; ŞAHİN, AHMET BİLGEHAN; CANDER, SONER; ÖZ GÜL, ÖZEN; ERTÜRK, ERDİNÇ; ERSOY, CANAN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0002-7846-0870; AAI-1005-2021; AAH-8861-2021; AAJ-6536-2021; HUR-0563-2023; AAM-4927-2020Objective: Adrenocortical carcinoma is an aggressive endocrine malignancy with an annual incidence of 0.5-2 cases per million. The most important factors that determine prognosis are tumor stage at the time of diagnosis and the success of surgery. However, advanced age, large tumor size, hormone secretion, high Ki-67 index (>10%), tumor necrosis and high mitotic activity are other factors associated with poor prognosis. In the present study, we aimed to evaluate the contribution of the patient and treatment-related factors to the prognosis in adrenocortical carcinoma.Material and methods: We included 15 adrenocortical carcinoma patients who were followed in our center between 2005 and 2015. The effects of age, gender, tumor size, type of operation, postoperative resection status and adjuvant treatment on disease-free survival and overall survival were analyzed.Results: Disease-free survival was 23.32+/-3.69 months and overall survival was 36.60+/-10.78 months. Gender, tumor size, tumor stage, type of operation, hormonal activity, presence of necrosis, recurrence and development of metastasis were not found to be associated with disease-free survival and overall survival (p>0.05). Postoperatively applied adjuvant treatments including mitotane, chemotherapy and radiotherapy did not significantly affect disease-free survival in our study, but statistically significant increase in overall survival was observed in patients getting adjuvant treatments (p=0.006).Conclusion: Adrenocortical carcinoma has poor prognosis and short overall survival, and in its clinical course, recurrence and development of metastasis can be commonly observed even after complete resection of the tumor. Therefore, the patients should be evaluated carefully while determining the surgical procedure during the preoperative period, and the operation and post-operative follow-up should be performed in experienced centers. However, due to the positive effects of adjuvant treatments on survival, all patients should be evaluated postoperatively for the necessity of adjuvant treatments, especially mitotane.Publication Comparison of the effects of medical and surgical treatments in giant prolactinoma: A single-center experience(Springer, 2021-07-08) Hakyemez, Bahattin; Cander, Soner; CANDER, SONER; Oz Gul, Ozen; ÖZ GÜL, ÖZEN; Eylemer, Eda; Gunes, Elif; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Gullulu Boz, Elif; GÜLLÜLÜ BOZ, SAİDE ELİF; Yilmazlar, Selcuk; YILMAZLAR, SELÇUK; Ersoy, Canan; ERSOY, CANAN; Tıp Fakültesi; AAA-3274-2019Purpose Giant prolactinomas, which have extremely large sizes and high prolactin (PRL) values, are rarely seen. Although medical therapy is effective, surgical treatment is more frequently applied due to slightly lower response rates and compression symptoms. This study aimed to compare the medical and surgical treatment results in giant prolactinomas. Methods Thirty-nine patients who were followed up in our center for giant prolactinoma were included in the study, and the response rates of the patients were evaluated after the medical and surgical treatments. The treatment responses were compared in terms of tumor volume, PRL level, visual field, and pituitary function. Results The outcomes of the 66 treatment periods (medical n = 42; surgical n = 24) in 39 patients (mean age, 47.2 years; men, 89.7%) were evaluated. The most common presentations were hypogonadism and visual defects. The mean longest tumor diameter at diagnosis was 52.2 +/- 11.8 mm, and the median PRL levels were 5000 ng/mL. PRL level normalization was achieved in 69% with medical therapy, and a curative response was obtained in only two patients with surgery. Tumor volume reduction was 67% (no cure) in the medical and 75% (13% cure) in the surgical groups (p = 0.39). Improvement of visual field was 70.8% in the medical and 84.2% in the surgical group (p = 0.12). Conclusion In our study, it was observed that medical therapy was effective and safe in patients with giant prolactinomas. The use of surgical treatment should be limited to prolactinomas with compression or post-resistance to medical treatment in serious cases.Publication A rare cause of hypopituitarism: Pituitary tuberculosis(Aves, 2012-01-01) Gül, Özen Öz; Ertürk, Erdinç; Cander, Soner; Ünal, Oğuz Kaan; Hakyemez, Bahattin; İmamoğlu, Şazi; ÖZ GÜL, ÖZEN; ERTÜRK, ERDİNÇ; CANDER, SONER; Ünal, Oğuz Kaan; HAKYEMEZ, BAHATTİN; İmamoğlu, Şazi; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; AAI-1005-2021; AAI-2318-2021; AAJ-6536-2021; HUR-0563-2023; GGN-5983-2022; FCO-4676-2022Pituitary tuberculosis is a rare condition that can present with hypopituitarism even without any evidence of systemic tuberculosis and is easily confused with pituitary adenomas. Headache and hypopituitarism are the most common presenting symptoms. We report the case of pituitary tuberculosis in a 39-year-old male patient who presented with panhypopituitarism. Although it is rare and difficult to diagnose, pituitary tuberculosis should be considered in every nonfunctional sellar masses, especially in fairly small ones with unexpected hypopituitarism.Publication Central venous sampling and magnetic resonance imaging in the diagnosis of acth-dependent cushing's syndrome(Sage Publications Inc, 2022-09-08) Ünsal, Yasemin Aydoğan; Gül, Zen Z.; Aydemir, Ensar; AYDEMİR, ENSAR; Ate, Co Kun; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Cander, Soner; CANDER, SONER; Ersoy, Canan; ERSOY, CANAN; Özpar, Rıfat; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0003-4300-2965; AAB-6671-2022; AAA-7171-2022; AAJ-6536-2021; HCI-4522-2022Objectives: Central venous sampling (CVS) with corticotropin-releasing hormone (CRH) stimulation is a crucial technique in evaluating adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS). We evaluated central venous sampling (CVS) and magnetic resonance imaging (MRI) findings in predicting the localization and lateralization of pituitary microadenomas.Methods: We analyzed 29 patients with CS who underwent CVS with CRH stimulation and examined with MRI retrospectively. Catheterization to central sinuses was successfully performed in 26 patients. Three patients with variant anatomy or inability to cannulate were diagnosed with CD after examination of pathology.Results: After CVS, among 26 patients, 23 patients were determined to have CD (88.4%) and 2 (7.7%) patients were diagnosed with ectopic ACTH syndrome. One patient was diagnosed with CD postoperatively. While the sensitivity of the CVS was 95.6%, sensitivity of the preoperative pituitary MRI was lower (69.5%). Also, the negative predictive value ratio was higher in CVS than in MRI (66% versus 22%). Diagnostic accuracy in the lateralization of the tumor was high as in CVS as in MRI (76.4% versus 73.9%).Conclusion: Central venous sampling with higher sensitivity in the localization of pituitary microadenoma, also has approximately similar diagnostic accuracy in lateralizing the tumor with MRI.Publication Effect of rosiglitazone and insulin combination therapy on inflammation parameters and adipocytokine levels in patients with Type 1 DM(Hindawi, 2015-03-17) Güçlü, Metin; Gül, Özen Öz; Cander, Soner; Ünal, Oğuzkaan; Özkaya, Güven; Sarandöl, Emre; Ersoy, Canan; Güçlü, Metin; ÖZ GÜL, ÖZEN; CANDER, SONER; Ünal, Oğuzkaan; ÖZKAYA, GÜVEN; SARANDÖL, EMRE; ERSOY, CANAN; Tıp Fakültesi; Endokrinoloji ve Metabolizma Ana Bilim Dalı; 0000-0001-5082-9894; 0000-0003-0297-846X; A-4421-2016; ABE-1716-2020; AAI-1005-2021; ABI-4847-2020; AAH-8861-2021; HUR-0563-2023; IPU-7626-2023Aim. To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM). Material and Methods. A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4mg/day (n - 30) or insulin alone (n = 31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications. Results. Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 +/- 3.06 to 4.99 +/- 2.64, P = 0.006; leptin 25.8 +/- 17.6 to 20.1 +/- 12.55, P = 0.006; group 2: resistin 7.16 +/- 2.30 to 5.57 +/- 2.48, P = 0.031; leptin 16.72 +/- 16.1 to 14.0 +/- 13.4, P = 0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 +/- 1.98 to 13.16 +/- 1.98, P = 0.015, and fibrinogen 4.00 +/- 1.08 to 3.46 +/- 0.90, P = 0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower. Discussion. The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion.
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