The endoscopic endonasal transsphenoidal approach is a widely-used method for the surgical treatment of pituitary adenomas. We aimed to evaluate the results of endoscopic surgery by comparing preoperative classification methods and investigating their relationship with postoperative resection and remission rates and complications. Methods : We retrospectively reviewed the medical records of 236 patients (118 males) who underwent surgery for pituitary adenomas. Preoperative Knosp classification, tumor size (TS), suprasellar extension (SSE), postoperative resection and remission rates, and complications were evaluated. Results : The follow-up period was 3 months to 6 years. The patients' ages ranged between 16 and 84 years. Endocrinologically, 114 patients (48.3%) had functional adenoma (FA), and 122 patients (51.7%) had non-functional adenoma (NFA). Among the FA group, 92 (80.7%) showed remission. A statistically significant difference was found between patients with and without remission in terms of the Knosp, TS, and SSE classifications (p<0.01). Knosp, TS, and SSE classification grades were found to be correlated with the resection rates (p<0.01). Meningitis was seen in seven patients (3.0%), diabetes insipidus in 16 (6.9%; permanently in two [0.9%]), and rhinorrhea in 19 (8.1%). Thirty-six patients (15.3%) developed pituitary insufficiency and received hormone replacement therapy. Conclusion :The resection categories and remission rates of FAs were directly proportional to the adenoma sizes and Knosp grades, while the degree of suprasellar growth further complicated resection and remission rates. Adenoma sizes less than 2 cm and SSEs less than 1 cm are associated with favorable remission and resection rates.

Introduction. Congenital adrenal hyperplasia (CAH) autosomal recessive disorders characterized by impaired adrenal steroid hormone synthesis. The most common form is 21-hydroxylase deficiency (21OHD). Testicular adrenal rest tumors (TARTs) are benign intratesticular masses that occur in male patients with CAH. TARTs are quite common in patients with 21OHD who were diagnosed late.Case report. A 41-year-old male patient with CAH secondary to 21OHD. The patient was referred to our endocrinology department from the andrology clinic for bilateral adrenal masses. Bilateral orchiectomy had been performed due to bilateral testicular masses and azoospermia two years ago. The pathology was reported as Leydig cell tumor. In hormonal assessment, baseline cortisol levels were low, 17-hydroxyprogesterone levels with baseline and after cosyntropin stimulation test were high. As a result of clinic and laboratory assessment, the patient was diagnosed with simple virilising CAH due to 21OHD and adrenal insufficiency. Then, prednisolone replacement was initiated. Bilateral orchiectomy tissue blocks of the patient were reassessed and were considered TART. Magnetic resonance imaging revealed bilateral adrenal masses with 88x55 mm on the right and 41x22 mm on the left. Laparoscopic right adrenalectomy was applied and pathology was reported as myelolipoma. Follow-up of the mass on the left adrenal gland is ongoing. The patient is monitored under prednisolone and testosterone replacement therapy. Early diagnosis of CAH is very important because of the complications it causes. It should be considered especially for bilateral testicular and/ or adrenal masses. Both fertility and adrenal glands can be protected with an early diagnosis and an early glucocorticoid replacement.

Aim: The prevalence of diabetes is increasing in our country and all over the world. Dyslipidemia has an important role in the development of coronary artery disease in patients with type-2 diabetes. The risk of complications is increased in diabetic patients with poor glycemic control and high HbA1c levels. Therefore dyslipidemia screening and treatment is important. The effect of variations in normal thyroid function on dyslipidemia and cardiovascular risk is not clear. So, in this study, we investigated the assosiation between HbA1c, TSH and triglyceride levels in euthyroid type 2 diabetic patients.

The purpose of the study was to compare serum visfatin levels between patients with acromegaly and healthy controls and to evaluate the relationships between visfatin levels and epicardial fat thickness (EFT), carotid intima media thickness (cIMT), and ankle brachial index (ABI). We conducted a cross-sectional case-control study of 54 patients with acromegaly (37 females and 17 males) and 34 healthy controls (22 females and 12 males). Serum visfatin was measured by ELISA. Acromegalic and control participants and those with active or controlled acromegaly were compared with respect to their serum visfatin, clinical and metabolic parameters, EFT, cIMT, and ABI. Linear correlation was used to identify associations between these parameters and visfatin in all participants. Serum visfatin and glycated hemoglobin (HbA1c) were higher in the acromegaly group than in the control group (p<0.001 and p=0.007, respectively). There was no difference in visfatin between the active and controlled acromegaly groups, but HbA1c was higher in the active than the controlled acromegaly group (p<0.04). EFT, cIMT, and ABI were similar between the acromegaly and control groups and between the active and controlled acromegaly groups. Serum visfatin positively correlated with HbA1c, growth hormone (GH), and insulin-like growth factor-1 (IGF-1)/upper limit of normal ratio (r=0.245, p=0.024; r=0.259, p=0.017; and r=0.282, p=0.009, respectively). This study has revealed that a high visfatin level is associated with glycemic dysregulation and higher levels of GH and IGF-1 in acromegalic patients.

Effective treatment and follow-up for type 1 diabetics have resulted significant increase in the number of adult type 1 diabetic patients. Psychological adaptation problem and impairment in glycemic control have been observed Type 1 diabetic patients that have been referred from pediatric endocrinology clinics to adult endocrinology clinics. Type 1 and Type 2 diabetes are clinically different from each other in terms of age of onset, ketosis tendencies, family history and metabolic differences. We investigated whether there was a difference between glycemic controls of type 1 and type 2 diabetic patients who were referred to our hospital endocrinology and diabetes outpatient clinics, and probable causes for his condition. 17,985 patients who applied to our hospital for the last 5 years were included. Age, sex, glucose, A1C, triglyceride, total cholesterol, LDL, HDL and TSH levels of all patients were recorded retrospectively. Patients were divided into two groups, Type 1 and Type 2 diabetes. Glucose (p=0.0001) and A1C (p=0.0001) values were found to be statistically higher in type 1 diabetic patients. In Type 2 diabetic patients total cholesterol, LDL cholesterol and triglycerides (TG) levels were significantly higher, while there was no statistically significant difference in HDL and TSH levels. Oral anti-diabetic use rather than frequent insulin injections in our Type 2 diabetes group may be one of the factors that increase treatment compliance. Relative high incidence of hypoglycemia due to absolute insulin deficiency in type 1 diabetics may lead to weight problems and increase in A1C as the dose of insulin may be skipped. In type 1 diabetics, prolonged duration of the disease may be one of the factors that leads to impaired glycemic control and increased diabetic complications