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Öğe A case of recurrent silent thyroiditis [Tekrarlayan sessiz tiroidit olgusu](Turkiye Klinikleri, 2011) Ipekci S.; Cakir M.Silent thyroiditis constitutes approximately 1% all of thyroiditis. Rarely, silent thyroiditis can present with recurrent attacks. Here, we present the case of a patient who had four episodes of painless (silent) thyroiditis.Öğe Differential diagnosis of hyperthyroidism -- 2(Nova Science Publishers, Inc., 2010) Cakir M.Thyrotoxicosis is the term given to any condition that causes exposure of the tissues to high serum concentrations of free thyroxine (T4), free triiodothyronine (T3), or both that results with hypermetabolism and hyperactivity. Hyperthyroidism is the term given to the subgroup of diseases in which the reason of thyrotoxicosis is increased thyroid hormone synthesis and secretion by the thyroid gland. © 2010 by Nova Science Publishers, Inc. All rights reserved.Öğe The effect of extracoporeal schock waves on intestinal anastomosis(2011) Pekin C.; Tekin S.; Kucukkartallar T.; Cakir M.; Tekin A.; Kartal A.Background and Objectives: To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis. Materials and Methods: Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3 rd, 5 th and 7 th days in three session each of which included 400 impulse with 14KV. On the 10 th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied. Results: The mean anastomoses explosion pressure for group III was 272±7.895 and the average anastomose explosion pressure was 220±6.831. The difference between the pressure means was significant (P < 0.05). Histological fibroblast/collagen ratio were 14.50±5.66, 274±66.21 and 416±52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80±3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (P < 0.05). Conclusion: From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing.Öğe Reproducibility of fasting and OGTT-derived insulin resistance indices in normoglycemic women(Canadian Diabetes Association, 2006) Cakir M.; Sari R.; Tosun O.; Saka O.; Karayalcin U.OBJECTIVE: To determine the reproducibility of fasting and oral glucose tolerance test (OGTT) -derived insulin-resistance (IR) indices in obese and nonobese women. METHODS: Twenty-one obese (BMI 37.7±6.3 kg/m2) and 14 nonobese (BMI 21.5±1.0 kg/m2) age-matched, healthy, premenopausal women were included in the study. An OGTT was performed twice, with a 1-week interval between tests. IR was calculated from both fasting and post-load glucose and insulin values, using some of the more well-known indices. RESULTS: When the 2 groups were evaluated separately, all indices were found to be reproducible in obese subjects, but some indices were not reproducible in nonobese healthy controls. When results were analyzed in the study population as a whole, all indices were reproducible. CONCLUSIONS: In this study, although reproducibility was noted for all IR indices in obese subjects, reproducibility was not observed for some of the indices in nonobese women. Reasons for this finding may have been the small patient population of nonobese subjects or increased variability of the measures in low IR states. The observed reproducibility in the evaluation of the entire group supports the former reason, but studies with larger patient populations and different levels of IR are needed to confirm these results.Öğe Spontaneous remission of acromegaly following subclinical pituitary apoplexy [Subklinik hipofizer apopleksiyi takiben spontan remisyona giren akromegali](Turkiye Klinikleri, 2011) Ipekci S.; Cakir M.Pituitary apoplexy is a rare and sometimes underdiagnosed complication of pituitary adenomas. We present here the case of a patient who was referred to our endocrinology outpatient clinic for his acromegalic appearance. Endocrinological evaluation revealed low basal growth hormone and normal insulin-like growth factor 1 levels, secondary hypothyroidism and adrenal insufficiency. A haemorrhagic adenoma was detected on pituitary MRI scan. In the light of clinical and laboratory evidences, probably, our patient had a previous somatotroph pituitary adenoma which caused acromegaly but further developed subclinical pituitary apoplexy which ended up with hypopituitarism.Öğe Water and salt metabolism disorders following transsphenoidal pituitary surgery [Transsfenoidal hipofiz cerrahisi sonrası görülen sıvı elektrolit bozuklukları](Turkiye Klinikleri, 2011) Cakir M.Transsphenoidal pituitary surgery is frequently complicated with mild to severe water and electrolyte disturbances in the postoperative period. These disorders are: transient diabetes insipidus, early or delayed hyponatremia, diabetes insipidus followed by hyponatremia (biphasic pattern), diabetes insipidus-hyponatremia-diabetes insipidus (triphasic pattern), permanent diabetes insipidus, and cerebral salt-wasting syndrome. Close monitoring of water intake, urine output, thirst, volume status and serum electrolytes is imperative, and a dynamic treatment plan according to the changing status of the patient is mandatory. This review will focus on the types, course and treatment of water and electrolyte disturbances observed after transsphenoidal pituitary surgery.
