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    A CASE OF PAGET'S DISEASE OF THE BONE PRESENTED WITH HEARING LOSS AS THE FIRST SYMPTOM
    (GUNES KITABEVI LTD STI, 2014) Baldane, Suleyman; Ipekci, Suleyman H.; Bulut, Serap; Baldane, Emine Gul; Gedik, Gonca Kara; Kebapcilar, Levent
    A 67-year-old woman presented to the audiology clinic with a complaint of bilateral hearing loss over the past two years. Routine biochemical screening showed an alkaline phosphatase level of 381 U/L, and she was referred to our endocrinology unit. Her vitamin D and parathyroid hormone levels, as well as thyroid, liver and kidney function test results, were within normal ranges. Cranial x-ray radiography showed an increase in the diploe distance and a sclerotic pattern in the calvarium; while whole body bone scintigraphy demonstrated a diffuse increase in radioactive substance involvement of the calvarium. Serum osteocalcin and spot urinary deoxypyridinoline levels were increased. The patient was diagnosed with Paget's disease with hearing loss as the first symptom, and she was started taking zoledronic acid treatment. Three months later, her alkaline phosphatase level had returned to the normal range, and audiologic examination showed a mild improvement in hearing.
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    A CASE OF PAGET'S DISEASE OF THE BONEPRESENTED WITH HEARING LOSS AS THEFIRST SYMPTOM
    (2014) Baldane, Süleyman; İpekçi, Süleyman H; Bulut, Serap; Baldane, Emine Gül; Gedik, Gonca Kara; Kebapcılar, Levent
    Altmış yedi yaşında kadın hasta, her iki kulakta işitme kaybı nedeniyle odyoloji polikliniğinebaşvurdu. İki yıldır şikayeti olan hastanın rutin serum biyokimya incelemesinde alkalen fosfataz değerinin 381 U/L olması üzerine endokrinoloji ünitemize yönlendirildi. Hastanın vitamin D,parathormon, tiroid fonksiyon testleri, karaciğer fonksiyon testleri, böbrek fonksiyon testleri normal sınırlar içindeydi. Hastanın kranial grafisinde; diploe mesafesinde artış, kalvaryumda sklerotikgörünüm ve tüm vücut kemik sintigrafisinde; kalvaryumda diffüz tarzda artmış radyoaktif maddetutulumu izlendi. Serum osteokalsin ve spot idrarda deoksipridinolin düzeyleri yüksek saptandı.İşitme kaybının ilk semptom olarak görüldüğü hastaya mevcut bulgular ile kemiğin paget hastalığıtanısı ile zolendronik asit tedavisi verildi. Tedaviden üç ay sonraki kontrolünde, alkalen fosfatazdeğerinde normal düzeye gerileme ve odyolojik incelemede hafif düzeyde bir düzelme izlendi
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    Giant papillary carcinoma arising in the ectopic buccal thyroid tissue
    (WILEY, 2013) Elsurer, Cagdas; Ozturk, Kayhan; Baba, Fusun; Yavas, Cagdas; Bulut, Serap
    BackgroundEctopic thyroid tissue very rarely occurs in the buccal region. Even more rarely encountered is the papillary carcinoma arising in the ectopic tissue. Methods and ResultsWe herein present a 78-year-old female patient admitted with a giant, buccal mass that developed within the previous 2 years. Physical examination revealed a vegetative mass on the left buccal region without any cervical lymphadenopathy. Magnetic resonance imaging scan showed an 8- x 6-cm solid mass with cystic components in the left buccal region and thoracic computed tomography scanning revealed pulmonary metastasis. A successful surgery including lower lip splitting was performed, and the mass was totally excised with its surrounding capsule. Histopathologic examination revealed follicular variant of papillary carcinoma of the ectopic thyroid tissue. ConclusionsTo our knowledge, our case is the first case of papillary carcinoma arising from ectopic thyroid tissue in the buccal region in the literature. (c) 2012 Wiley Periodicals, Inc. Head Neck 35: E308-E309, 2013
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    Is the Use of Topical Fluorescein Helpful for Management of CSF Leakage?
    (Wiley, 2012) Öztürk, Kayhan; Karabağlı, Hakan; Bulut, Serap; Eğilmez, Meryem; Duran, Mutlu
    Objectives/Hypothesis: We aimed to evaluate the effectiveness of topical intranasal fluorescence application together with high-resolution computed tomography and magnetic resonance imaging and/or magnetic resonance cisternography for the preoperative diagnosis of cerebrospinal fluid (CSF) leakage and for intraoperative localization of CSF fistulas. We also assessed postoperative recurrence. Study Design: Descriptive study. Methods: Twenty-four cases underwent endonasal endoscopic repair for CSF leakage. Following intranasal topical application of fluorescein 10% to the middle turbinate-cribriform plate region and anterior wall of the sphenoid sinus, a color change of the fluorescein from yellow-brown to green was accepted as evidence of CSF leakage. A nasoseptal flap, collagen matrix, or fascia lata and septal cartilage graft were used for reconstruction of the CSF fistula. Results: The use of topical fluorescein application was helpful in diagnosing CSF rhinorrhea preoperatively and locating the CSF fistula intraoperatively. One case had both ethmoid roof and sphenoid sinus defects, and this case underwent a second operation for closure of the sphenoid defect. All CSF leakages were successfully repaired by endoscopic endonasal surgery using a nasoseptal flap. Conclusions: Cases with traumatic CSF leakage pose a higher risk of meningitis than the cases with spontaneous CSF leakage. Topical application of fluorescein is highly specific and sensitive in identifying preoperative, intraoperative, and postoperative CSF leakage. It is a simple, quick, and sensitive technique. The surgeon should be vigilant for multiple defects.
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    Release of NT-pro brain natriuretic peptide in children before and after adenotonsillectomy
    (ELSEVIER IRELAND LTD, 2013) Oran, Bulent; Ozturk, Kayhan; Cimen, Derya; Vatansev, Husamettin; Bulut, Serap; Arslan, Derya
    Objectives: To measure serum B-type natriuretic peptide, especially N-terminal segment of its prohormone (NT-proBNP) and pulmonary arterial pressure levels and to determine whether NT-proBNP concentrations correlate with pulmonary arterial pressure levels in children before and after adenotonsillectomy. Methods: Twenty children with adenoid and tonsil hypertrophy and 20 healthy subjects were included in the study. Transthoracic echocardiography was performed in all patients to assess pulmonary artery systolic and diastolic pressure with cardiac dysfunction. The NT-proBNP was analyzed for correlation with pulmonary artery pressure. Results: Our results showed that prohormone serum concentrations and pulmonary arterial pressures were significantly higher in the study group than in the control group at the preoperative evaluation. A significant decrease was detected among patients after surgery (p < 0.05). There was no significant difference between the study and control groups for prohormone serum concentration and pulmonary arterial pressure at the postoperative evaluation (p > 0.05). Conclusion: We found increased serum prohormone levels and height pulmonary artery pressures in the children with adenoid and tonsil hypertrophy when comparing with healthy subjects. Our study supported that increased serum prohormone levels and pulmonary artery pressures as a result of adenoid and tonsil hypertrophy are reversible. Pediatric cardiologs and otolaryngologs should keep in mind an increased pulmonary artery pressure during management of children with adenoid and tonsil hypertrophy. Furthermore, Doppler echocardiography may be useful in the monitoring of pulmonary arterial pressure and in the follow-up of surgical outcome of children with adenoid and tonsil hypertrophy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.