The relationship between LH and thyroid volume in patients with PCOS.

BACKGROUND: Thyroid volume (TV) has been found to be associated with age, anthropometry, smoking, iodine status and hyperinsulinemia. Hyperinsulinemia is frequent finding in patients with PCOS and has associations with TV. However, the TV has been evaluated only a few studies in patients with PCOS. Therefore, the aim of this study was to evaluate the biochemical and hormonal variables in patients with PCOS comparing with the controls and their relationships between TV. METHODS: This was a case-control study conducted in a training and research hospital. The study population consisted of 47 reproductive-age PCOS women and 30 control subjects. We evaluated anthropometric, biochemical and hormonal parameters as well as thyroid volume in PCOS patients and controls. Insulin resistance was calculated using the homeostasis model assessment insulin resistance index (HOMA-IR). RESULTS: Mean age, BMI, thyroid stimulant hormone (TSH) levels and TV were similar between groups (p<0.05). The HOMA-IR and free T4 levels were higher in patients with PCOS. However, hyperinsulinemia and insulin resistance were not found to be associated with TV. Thyroid volume was positively correlated with the LH and anti TPO levels. The participants were divided into 2 groups according to HOMA-IR levels. The mean TV measurement was higher in group with higher HOMA-IR levels, but the difference was not significant in young age PCOS patients. CONCLUSION: In early age PCOS patients it was observed that insulin resistance had no effect on TV. In this case, anti TPO and LH have dominant effect on TV. Chronic stimulation with LH and insulin may lead to increase in TV in later stages of the PCOS diseases.

Serum S100B protein: a useful marker in obstructive sleep apnea syndrome.

BACKGROUND AND PURPOSE: We aimed to underline the importance of serum S100B protein as a useful biochemical marker in patients with obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: Forty-three newly diagnosed patients with OSAS (median apnea-hypopnea index [AHI, events/ hour]: 37.5 [range 11.3-137]) and 25 subjects with AHI < 5 (median AHI: 4.4 [range 0.7-4.8]) were included in the study. Serum S100B protein level was tested in serum samples taken after polysomnography in both groups and the difference between OSAS patients and the control group regarding that level was assessed. In addition, the association of S100B protein serum level with age, body mass index, AHI, mean O2 saturation percentage during sleep, minimum O2 saturation value (%) at the end of the apneas, and the time spent at an O2 saturation less than 90% were analyzed in the OSAS patient group. RESULTS: Median serum S100B protein level was 133.7 pg/ mL (range 20.97-230.70 pg/mL) in patients with OSAS and 16.1 pg/mL (range 10.1-22.9 pg/mL) in the control group (p < 0.005). Serum S100B protein level did not correlate with any studied variable (p > 0.05 for each correlation coefficient). CONCLUSIONS: Serum S100B protein level is increased in patients with OSAS and may be a useful biochemical marker in those patients.

Parathyroid adenoma screening efficacies of different imaging tools and factors affecting the success rates.

PURPOSE: We aimed to compare the efficacy of three different parathyroid adenoma screening tools--high-resolution ultrasonography (USG), technetium Tc 99m-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy, and magnetic resonance imaging (MRI)--and we evaluated the factors affecting the detection success rates. METHODS: Parathyroid imaging was evaluated by USG, double-phase 99mTc-MIBI parathyroid scintigraphy, and cervical MRI in patients with hyperparathyroidism (n=39). RESULTS: Among the 39 patients, USG, parathyroid scintigraphy, and MRI correctly identified 35 adenomas (89.7%), 28 adenomas (71.8%), and 26 adenomas (66.7%), respectively. Positive predictive values for USG (34/35), scintigraphy (27/28), and cervical MR (26/26) imaging were 97.1%, 96%, and 100%, respectively. Parathyroid adenomas were detected with 92.3% (36/39) certainty when both USG and scintigraphy modalities were applied together. Minimally invasive parathyroidectomy under local anesthesia with unilateral incision was successfully performed in 24 (61.5%) patients. CONCLUSIONS: Minimally invasive surgery for parathyroid adenomas has been developed and has equal success with traditional surgery. However, accurate localization of adenomas should be obtained prior to surgery. In this study, ultrasound was found to be effective in localizing adenomas for successful surgery. Adding other imaging modalities does not improve localizing the parathyroid adenomas.

Modulation of the immune response to HBV vaccination by hemodialysis membranes.

INTRODUCTION: Seroconversion response to Hepatitis B virus (HBV) vaccination is limited in uremic patients because of impaired humoral and cellular immune activity. Recent studies show that high-flux (HF) hemodialysis (HD) membranes can improve T cell functions and decrease the proinflammatory cytokine activation more effectively than low-flux (LF) membranes. In regard to HF membranes may have immune modulator effects; we compared the antibody responses to hepatitis B vaccination between HF HD and LF HD membranes. METHODS: One thousand four hundred and eight patients on HD programmed for 4 h three times a week at three different centers with HF or LF membranes were scanned. Anti-HBs levels of these patients who were vaccinated with recombinant DNA HBV vaccine on the 0, 1st, 2nd and 6th month from the beginning were recorded on the 0, 3rd, 6th, 9th and 12th month of vaccination schedule. RESULTS: Seroconversion rate was 84.2% in HF group and 52.7% in LF group on the 6th month (P < 0.01). Ratio of the patients who had >100 IU/l antibody titers in HF group was 22.8%, while it was 10.9% in LF group (P < 0.01). Also on the 9th, 12th and 24th month; seroconversion rates in HF group were higher than LF group: 91.1-70.9% (P < 0.05), 95.0-81.8% (P < 0.05), 92.1-83.7% (P > 0.05), respectively. Ratio of the patients who did not show any seroconversion was higher in LF group than HF group; on the 6th month as 15.8-47.3% (P < 0.001), on the 9th month 8.9-29.1% (P < 0.05), on the 12th month as 5.0-18.2% (P < 0.05), and on the 24th month as 7.9-16.4% (P > 0.05), respectively. CONCLUSION: We showed that ratio of anti-HBs seroconversion response to hepatitis B vaccination in patients receiving HD with HF membranes was higher than LF membranes. This finding suggests that HF membranes may improve immune modulator effects.