Endocrinology
Endocrinology
Endocrinology is a branch of medicine that focuses on the study of diseases related to the endocrine system in the body. The endocrine system consists of glands responsible for producing hormones that regulate various bodily functions and help maintain balance for the body’s adaptation to external environments. This field deals with disorders such as diabetes, metabolic disorders, pituitary, thyroid, adrenal gland disorders, sex hormone deficiencies, and metabolic bone diseases. The goal of endocrinology is to understand and treat the functioning systems of these glands and the effects of the hormones they produce on the body.
FUE (Follicular Unit Extraction):
FUE is one of the most common and popular methods in hair transplantation. In this technique, individual follicular units are extracted from the donor area and carefully placed in the area to be transplanted. FUE is preferred due to its minimally invasive nature and quick recovery process. Additionally, the risk of scarring is very low, allowing patients to achieve a natural appearance.
FUT (Follicular Unit Transplantation):
FUT is considered an older method in hair transplantation. In this technique, a strip of skin is taken from the donor area, and follicular units are separated from this strip and transplanted into the target area. FUT can be preferred, especially in cases where hair transplantation is needed for larger areas. However, this method may leave a thin scar in the donor area.
DHI (Direct Hair Implantation):
DHI is one of the most innovative and advanced techniques in hair transplantation. In this method, hair follicles are directly implanted into the target area using a special pen (Choi Implanter Pen). The main advantage of DHI is minimizing the time the hair follicles spend outside the body, which increases the survival rate of the follicles. Additionally, this method allows for denser implantation, resulting in a more natural and fuller appearance.
Sapphire FUE:
Sapphire FUE is an advanced version of the classic FUE technique. In this method, sapphire blades are used for the channel opening process. Sapphire blades create finer and more precise cuts compared to metal blades, which accelerates the healing process and reduces the risk of scarring. Sapphire FUE is an ideal choice for those who want a natural hairline and a faster recovery process post-transplant.
Pituitary Treatment
Pituitary Treatment
Pituitary tumors develop in the pituitary gland, which is responsible for hormone production in the body, and can affect its functions. These tumors are usually benign, but some may cause excessive hormone production or hormone deficiency. Four main treatment methods are used for tumors: surgery, radiotherapy, medication, and chemotherapy.
Surgery:
The surgical method is chosen based on the tumor's size and location. The tumor is removed during surgery to allow the gland to return to its normal functions. Common methods include transsphenoidal surgery, endoscopic transsphenoidal surgery, and craniotomy.
Radiotherapy:
In the treatment of pituitary tumors, radiotherapy is used to kill cancer cells or stop their growth. Stereotactic radiosurgery focuses radiation on the targeted tumor tissue, preventing damage to healthy tissue.
Medication:
Medications used to control hormone production can reduce the effects of pituitary tumors. These are particularly preferred in functional tumors to stop excessive hormone production.
Chemotherapy:
Chemotherapy is used for rarer and more aggressive tumors, such as pituitary carcinomas. It halts the growth of cancer cells, alleviating symptoms and improving the patient's quality of life.
Causes:
The exact causes of pituitary tumors are not well understood, but genetic factors and certain hereditary syndromes are considered risk factors. As tumors grow, symptoms like headaches, vision problems, hormonal imbalances, and fatigue may arise. If treatment is not started on time, tumors can severely affect the functions of the pituitary gland.
These treatment methods are personalized according to the size, location, and hormonal effects of the tumor. After treatment, patients are typically monitored regularly, and hormone levels are checked.
Gastric Banding
Radioactive Iodine Therapy
Radioisotope Therapy
Radioisotope Therapy
Radioisotope therapy is a method that uses radioisotopes to target and destroy cancer cells. As a branch of radiotherapy, this treatment has gained increasing attention in recent years.
What is Radioisotope Therapy?
Radioisotope therapy is used to treat various types of cancer, including thyroid cancer, bile duct cancer, liver cancer, bone metastases, and neuroblastoma. The specific radioisotopes used during the treatment vary depending on the type of cancer. For example, I-131 radiotherapy is commonly preferred for thyroid cancer, while radium Ra 223 dichloride may be used for prostate cancer. Additionally, radioisotope therapy can be combined with other cancer treatments.
This treatment method does not require surgery. Radiation is delivered in two ways: orally (in the form of a drink or capsule) or through intravenous injection. Many types of cancer, such as thyroid cancer, non-Hodgkin lymphoma, prostate cancer, and osteoblastic metastatic bone lesions, benefit from radioisotope therapy.
How is Radioisotope Therapy Applied?
Radiopharmaceuticals contain a radioisotope and a drug marker, allowing the radioisotope to target a specific tissue or region of the body. Once the radioisotope starts to decay, it affects the targeted tissue or tumor. Cancer cells absorb the radioisotope more than non-cancerous cells, allowing a higher radiation dose to destroy the cancer cells. The amount of radiopharmaceutical applied is carefully determined based on the type of tumor, its location, and other factors.
What Happens After Radioisotope Therapy?
After the treatment, special instructions must be followed to minimize radiation exposure to others at home. The body may release small amounts of radiation through urine, bowel movements, saliva, and sweat. To reduce radiation exposure, the following precautions should be taken:
- Do not share cups, food, towels, or sleeping areas.
- Bed linens, towels, and clothing should be washed separately for a few days.
- Avoid physical contact with others for a week.
- Maintain at least a three-foot distance from others.
- Avoid caring for small children for one week.
- Avoid physical contact with pregnant women for at least one week after treatment.
Thyroid Function Tests
Thyroid Function Tests
Thyroid hormone is one of the most important hormones in the body, and thyroid function tests are used to assess whether this hormone is functioning properly.
What Are Thyroid Function Tests?
Thyroid function tests are blood tests performed to analyze the function of the thyroid gland. These tests measure plasma TSH (Thyroid Stimulating Hormone), free T4 (thyroxine), and total T3 (triiodothyronine) levels. Normal TSH levels typically range from 0.37 to 4.7 mIU/L, though this range may vary between laboratories. Plasma T4 levels range from 60 to 150 nmol/L, and T3 levels typically range from 1.2 to 2.7 nmol/L.
Changes in the thyroid gland may be caused by autoimmune diseases. In these cases, measuring levels of autoantibodies, such as anti-thyroglobulin, anti-thyroid peroxidase, or anti-TSH receptor antibodies, is important.
When Are Thyroid Function Tests Done?
The function of the thyroid gland is controlled by the pituitary gland, which is located at the base of the skull and produces TSH. TSH is sensitive to changes in the circulating levels of T4 and T3 hormones. A small increase in free T4 concentration can cause a significant decrease in TSH concentration, and vice versa.
These tests are used to diagnose the following conditions:
- Goiter
- Hyperthyroidism
- Hypothyroidism
- Thyroid nodules
How Are Thyroid Function Tests Performed?
Thyroid hormone tests are simple and are usually performed in a healthcare facility as a blood test, typically ordered by a doctor. A blood sample is taken from the patient, and TSH, free T4, and total T3 levels are measured. These tests are recommended to be performed in the morning and on an empty stomach.
These tests are especially useful for patients showing signs of goiter and thyroid disorders. They are also evaluated in routine blood tests and check-ups. Monitoring these values during pregnancy is important, as thyroid hormones affect all body functions. Therefore, regular thyroid function tests are essential.
Thyroidectomy
Thyroidectomy
Thyroidectomy is the primary surgical method typically used in the treatment of thyroid cancer. After the diagnosis of thyroid cancer is made through fine needle aspiration (FNA) biopsy, surgery is recommended to remove the tumor and the whole thyroid gland or part of it. However, thyroidectomy is a broad treatment option, except for some anaplastic thyroid cancers.
What is Thyroidectomy?
During thyroidectomy, the thyroid gland is removed, and this procedure is the most common surgical method for treating thyroid cancer. The surgery is usually performed through an incision several inches in length on the front of the neck. After the surgery, a small scar may remain on the front of the neck, but this scar generally becomes less noticeable over time.
If the thyroid gland is completely removed, it is called total thyroidectomy. If almost the entire thyroid is removed, it is referred to as near-total thyroidectomy. In some cases, the surgeon may not be able to remove the entire thyroid, so near-total thyroidectomy might be performed instead of total thyroidectomy.
When is Thyroidectomy Performed?
Thyroidectomy is indicated for both benign and malignant conditions. Among benign conditions, symptomatic goiter cases are prominent. In goiter cases, thyroidectomy may also be preferred for aesthetic reasons, as a large mass on the front of the neck can be noticeable. Additionally, thyroidectomy can be applied in cases of diseases resistant to medical treatment, such as Graves' disease or hyperthyroidism. In thyroid cancer cases, surgical treatment is typically based on the histological diagnosis made before the surgery, using fine needle aspiration.
How is Thyroidectomy Performed?
Both hemithyroidectomy and total thyroidectomy are surgeries performed under general anesthesia. Nowadays, these surgeries can be performed through a small incision on the front of the neck using an open approach or as minimally invasive procedures with endoscopic surgery or robot-assisted surgery.
During this process, the thyroid gland is removed through an incision made from the upper part of the neck or under the arm. The goal is to remove the gland from its bed, control bleeding, and preserve the function of the parathyroid glands. The parathyroid glands, located on the back of the thyroid gland, regulate calcium metabolism.
Furthermore, it is crucial to identify and preserve the integrity of the recurrent laryngeal nerve, which innervates the intrinsic muscle system of the larynx and is located on the posterior surface of the thyroid gland.
