Biomedical subjects

Neslihan B Tutuncu

Publications and source records attributed to Neslihan B Tutuncu.

2 recordsLinked to original sources

PubMed2006

Ultrasound-guided fine-needle aspiration biopsy and ultrasonographic features of infracentimetric nodules in patients with nodular goiter: correlation with pathological findings.

We evaluated the usefulness of ultrasound-guided fine-needle-aspiration biopsy (US-FNAB) for infracentimetric nodules. In addition, we used sonography to assess the risk of malignancy of thyroid nodules, and we evaluated the extent of disease in infracentimetric cancers. The cytopathological results of 472 US-FNABs from 207 nodular goiter patients (170 women, 37 men; mean age, 51.5 +/- 13.1 yr) seen between 1999 and 2004 were categorized into five groups: inadequate, benign, suspicious, follicular neoplasm, and malignant. There were 145 infracentimetric nodules and 327 supracentimetric nodules. All patients underwent surgery. Final histopathological results correlated with cytologic results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-FNAB for infracentrimetric nodules were 96.3%, 71.2%, 44.8%, 98.8%, and 76.1%; and for supracentimetric nodules, these values were 98.1%, 63.1%, 35.6%, 99.4, and 69.1%, respectively. There were no significant differences between infracentimetric and supracentimetric nodules. More thyroid cancer could be detected in infracentimetric nodules that were hypoechoic or had fine calcification on ultrasonography (which may be helpful in discriminating which nodules are appropriate for FNAB) than in supracentimetric nodules. However, logistic regression analyses showed that no single variable was predictive of malignancy in infracentimetric nodules. The malignancy rate in infracentimetric nodules was 21.4%. In this subgroup, 4 of 31 patients (12.9%) had multifocal tumors at surgery, 3 of 31 had extrathyroidal invasion, and 1 had a metastasis to the lung. In addition, at surgery, 11 of 55 tumors (20%) larger than 1 cm were multifocal. In conclusion, small tumor size does not guarantee a low risk of thyroid cancer, and US-FNAB may be useful tool for diagnosing malignant infracentimetric nodules.

Biopsy, Fine-Needle↗

PubMed2005

Melatonin levels decrease in type 2 diabetic patients with cardiac autonomic neuropathy.

The present study has been designed to determine melatonin levels in type 2 diabetic patients and test the relationship between the autonomic nervous system and melatonin dynamics. Thirty-six type 2 diabetic patients and 13 age-matched healthy subjects were recruited for the study. Circadian rhythm of melatonin secretion was assessed by measuring serum melatonin concentrations between 02:00-04:00 and 16:00-18:00 hr. Melatonin dynamics were re-evaluated with respect to autonomic nervous system in diabetic patients with autonomic neuropathy who were diagnosed by the cardiovascular reflex tests, heart rate variability (HRV), and 24-hr blood pressure monitoring. Nocturnal melatonin levels and the nocturnal melatonin surge were low in the diabetic group (P = 0.027 and 0.008 respectively). Patients with autonomic neuropathy revealed decreased melatonin levels both at night and during day when compared with healthy controls (P < 0.001 and 0.004 respectively) while the melatonin dynamics were similar to controls in patients without autonomic neuropathy. Nocturnal melatonin level was positively correlated with nocturnal high and low frequency components of HRV (P = 0.005 and 0.011 respectively) and systolic and diastolic blood pressures at night (P = 0.002 and 0.004 respectively) in patients with autonomic neuropathy. We found a negative correlation between nocturnal melatonin levels and the degree of systolic blood pressure decrease at night (r = -0.478, P = 0.045). As a conclusion this study has shown that circadian rhythm of melatonin secretion is blunted in type 2 diabetic patients and there is a complex relationship between various components of autonomic nervous system and melatonin secretion at night. Among the patients with autonomic neuropathy those with more preserved HRV and the systolic nondippers (<10% reduction in blood pressure during the night relative to daytime values) have more pronounced melatonin surge at night.

Autonomic Nervous System Diseases↗