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Öğe Comparison of Salivary Cortisol, Serum Cortisol, Plasma ACTH and Urinary Free Cortisol Levels in Thyrotoxic and Hypothyroid Patients(Turkiye Klinikleri, 2012) Gönen, Mustafa Sait; Özkaya, Emin; Kurban, Sevil; İpekçi, Süleyman Hilmi; Duran, Cevdet; Kulaksızoğlu, SevsenHypothalamo-pituitary-adrenal (HPA) axis is affected by thyroid hormones. The present study was designed to compare the level of salivary cortisol, serum cortisol, plasma ad-renocorticotropic hormone (ACTH) and urinary free cortisol (UFC) levels in patients with subcli- nical and overt thyrotoxicosis and hypothyroidism. Material and Methods: W e analyzed the salivary cortisol, serum cortisol, plasma ACTH and UFC levels in 123 patients with thyroid dysfunction. The patients were classified into four groups; overt thyrotoxicosis (n= 32), subclinical thyrotoxico-sis (n= 29), overt hypothyroidism (n= 28) and subclinical hypothyroidism (n= 34). Results: There we-re no significant differences in terms of salivary cortisol, serum cortisol, plasma ACTH and UFC levels in patients with subclinical and overt thyrotoxicosis (p> 0.05). Similarly, no significant dif-ferences could be detected in terms of salivary cortisol, serum cortisol, plasma ACTH and UFC le-vels in patients with subclinical and overt hypothyroidism (p> 0.05). The comparison of patients with hypothyroidism and thyrotoxicosis also did not yield any significant difference in terms of sa-livary cortisol, serum cortisol, plasma ACTH and UFC levels (p> 0.05). Conclusion: Similar salivary cortisol, serum cortisol, plasma ACTH and UFC levels were detected in patients with hypothyroi-dism and thyrotoxicosis. Thus, we may suggest that thyroid hormone status does not play a role in the HPA axis. The major limitation of this study was the absence of a healthy control group. Furt-her studies with large numbers of patients are required to clarify the association between thyroid hormone dysfunction and glucocorticoid levels.Öğe Effect of Lipoprotein Apheresis on Oxidative Stress and Antioxidant Status in Familial Hypercholesterolemic Patients(Wichtig Editore, 2003) Kurtoğlu, E.; Uğur, A.; Gönen, Mustafa Sait; Kısakol, G.Extracorporeal low-density lipoprotein (LDL) apheresis is an established and highly effective therapy for the patients with familial hypercholesterolemia (FH) not adequately responding to diet and drug therapy alone. This study was designed to measure the effect of lipid apheresis on oxidant and antioxidant status in a patient with FH. The levels of plasma lipid peroxidation were determined as thiobarbituric acid-reactive substances. The activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were established in one subject with FH before and after lipid apheresis. The pre- and post lipid apheresis procedures witness a significant decrease in oxidative stress (p<0.05) but the erythrocyte levels of CAT SOD and GPx were unchanged.Öğe Frequency of Thyroid Nodules Among Patients with Colonic Polyps(Hindawi Publishing Corporation, 2012) Duran, Cevdet; Göktürk, Hüseyin Savaş; Kulaksızoğlu, Mustafa; Bakdık, Süleyman; Ünler, Gülhan Kanat; Erbayrak, Mustafa; Özkaya, Güven; Pamuk, Barış Önder; Gönen, Mustafa SaitAim. Colonic polyps and thyroid nodules are common diseases and their frequency increases with age. In the literature, there is no study investigating the coexistence of colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule prevalence in patients with colonic polyps. Material and Methods. Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled into the study. Age and sex matched control group was composed from patients without colonic polyps. Colonoscopic examinations, thyroid ultrasonographies were performed in all patients, and TSH were measured. Results. Male/female ratio in polyp and control groups were 40/26 versus 68/78, respectively (P = 0.058). Mean ages were similar in both groups (53.3 +/- 11.4 versus, 51.8 +/- 11.4, P = 0.373). Thyroid nodule was detected in 44 (66.7%) patients with polyps and in 61 (41.8%) controls (P = 0.001). Patients with adenomatous polyps had 5 or more thyroid nodules compared to patients with hyperplastic polyps (P = 0.03). Thyroid nodules were more prevalent among patients aged 50 or older compared to 50 years or less (P = 0.023). Conclusion. Thyroid nodules were detected more common in patients with colonic polyps. Further studies are needed to clarify this coexistence.Öğe Konya bölgesi popülasyonunda CAPN10 genindeki SNP-43 polimorfizmi Tip 2 Diabetes riski ile ilişkilidir(Selçuk Üniversitesi, 2021) Turhan, Ahmet Bülent; Gönen, Mustafa Sait; Uçaryılmaz, Hülya; Kaya, Dudu Erkoç; Arıkoğlu, HilalAmaç: Kalpain-10 (CAPN10), Ca+2 bağımlı intrasellüler sistein proteazlar ailesinin atipik bir üyesidir. Birçok dokuda eksprese edilir ve başta insülin sekresyonu ve aktivitesi olmak üzere çok çeşitli hücresel fonksiyonlar için gereklidir. Tanımlanan ilk Tip 2 diyabet (T2D) yatkınlık genidir. Çalışmamızda bir Türk popülasyonunda CAPN10 gen polimorfizmleri (SNP-44, -43 ve -137) ile artmış T2D riski arasındaki ilişkinin analiz edilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 149 T2D’li hasta ve 48 sağlıklı birey dahil edildi. Genotiplendirme PCR-SSCP tekniği kullanılarak yapıldı, dizi analizi ile doğrulandı. CAPN10 genotiopleri ile T2D gelişimi ve klinik özellikler arasındaki ilişki istatistiksel olarak analiz edildi. Bulgular: Hastalıkla genotip arasındaki ilişkiyi belirlemek için yapılan odds analizi sonuçlarına göre; SNP-44 ile hastalık arasında ilişki gözlenmezken (OR: 1.417 CI:0.452-4.436, P=0.740), SNP-43 ile hastalık arasında anlamlı ilişki bulundu (OR: 0.455 CI:0.235-0.881, P=0.028). SNP-137 genotip dağılımı tüm hasta ve kontrol bireylerde C/C olarak tespit edildi. Taranan SNP’ler ile klinik parametreler arasında herhangi bir ilişki bulunmadı (P>0.05).Öğe Minimally invasive ultrasonography guided parathyroidectomy(2011) Erikoğlu, Mehmet; Tavlı, Süleyman Şakir; Ayhan, Barış; Çakır, Mehtap; Gönen, Mustafa SaitAmaç: Primer hiperparatiroidizm olgularının %85- 90’ının nedeni tek adenomdur ve bu adenomun çıkarılması ile tedavi sağlanabilir. Bu tek adenomlu hastaların teşhisinde yaygın olarak paratiroid ultrasonografi (US) ve Tc-99m sestamibi sintigrafi kullanılır. Bu çalışmanın amacı; paratiroid adenomunu belirlemede ultrason rehberliğinde minimal invaziv paratiroidektomi tekniğinin etkinliğini göstermektir. Gereç ve yöntem: Bu retrospektif çalışmada 2006-2009 yılları arasında paratiroid adenomektomi için genel cerrahi kliniğine yönlendirilmiş 16 hastaya minimal invaziv ultrason rehberliğinde paratiroidektomi (MIUGP) uygulandı. Paratiroid US ve Tc-99m sestamibi sintigrafi ile paratiroid adenom teşhisi konan hastalar cerrahiye hazırlandı. Bulgular: Operasyon gününün sabahında adenomun lokalizasyonu tekrar US ile doğrulandı ve cilt üzerine kalem ile işaretlendi. Lokal anestezi ile işaretli alandan yapılan küçük bir insizyonla adenom çıkarıldı. Tartışma: Bu makalede, uyguladığımız MIUGP’nin uygulaması kolay, maliyeti düşük, hastanın işaretlemeden hemen sonra ameliyata alınabilmesi, radyasyon içermemesi ve lokal anestezi ile yapılabilmesi gibi avantajları sebebiyle deneyimli paratiroid cerrahları tarafından uygun bir teknik olarak güvenle yapılabileceğini düşünmekteyiz.Öğe Multiorgan Dysfunction Accompanied With Metimazole and Thyroid Storm(Pergamon-Elsevier Science Ltd, 2012) Kulaksızoğlu, Mustafa; Gönen, Mustafa Sait; Kebapçılar, Levent; Şahin, Fatih; Açıkgöz, Burcu; Demir, Tarık; Dinçtürk, EkremA 41-year-old man with a history of hyperthyroidism had been treated with methimazole and propranolol for the past 2 months. He developed multiorgan dysfunction with acute liver failure, severe lactic acidosis, disseminated intravascular coagulation, heart failure and acute pulmonary edema with rapid deterioration of renal function. The patient had no history of alcoholism, drug abuse, blood transfusion, or exposure to hepatitis A, B, or C. Extrahepatic obstruction was ruled out with an abdominal ultrasonogram. Serologic studies and immunologic tests were negative. This case illustrates the sudden and abrupt deterioration of multiorgan dysfunction due to antithyroid drug administration and thyroid storm. The thyroid storm score of Burch and Wartofsky was 90/140. The multiorgan dysfunction was reversed by discontinuation of the methimazole and treat with hemodialysis, steroids, cholestyramine, nonselective beta-blocker, fresh frozen plasma infusion and supportive management in the intensive care unit. The patient was discharged from the hospital with normal coagulation parameters, renal and liver function tests. (C) 2012 Elsevier Ltd. All rights reserved.Öğe The Risk of Severe Hypoglycemia in Patients with type 2 Diabetes Mellitus Starting Insulin Therapy with Premixed Insulin Analogues Taken Twice Daily: An Observational Study in Turkish Patients(Turkiye Klinikleri, 2013) Gönen, Mustafa Sait; Yürümez, Adem; Hersek, Ömer; Altunoğlu, Esma; Rakıcı, Halil; Scism-Bacon, Jamie; Abdulnabi, RadhiPurpose: To assess the risk of severe hypoglycemia in Turkish patients with type 2 diabetes mellitus (T2DM) starting insulin therapy with premixed insulin analogues alone or in combination with oral antihyperglycemic medications. Material and Method: Data from a subset of Turkish patients who participated in a 1-year, multinational, multicenter, prospective observational study were evaluated. Insulin treatment was initiated using commonly prescribed premixed regimens: insulin lispro mixture 25/75 (25% insulin lispro, 75% insulin lispro protamine suspension) or biphasic insulin aspart 30/70 (30% insulin aspart, 70% insulin aspart protamine suspension) twice daily. Results: Of the 154 patients treated, 61 (39.6%) were male with a mean age of 56 years and a T2DM duration of 8.9 years. Twelve patients (7.8%) experienced ?1 episode of severe hypoglycemia, but all recovered. The severe hypoglycemic rate was 0.14 episodes/patient-year. The mean glycated hemoglobin decreased by 2.7% (10.4% to 7.8%) and fasting plasma glucose by 115.9 mg/dL (265.3 mg/dL to 157.6 mg/dL) (p<0.0001). Self-monitored blood glucose (2-hour post morning meal) decreased by 163.3 mg/dL (327.0 mg/dL to 216.2 mg/dL; p<0.0001). Self-monitored blood glucose level was low, particularly at the 2-hour post evening meal. Body mass index increased by 1.4 kg/m2, and total daily insulin dose by 4.2 IU. Discussion: In Turkish patients with T2DM, initiation of premixed insulin analogues during routine clinical care significantly improves glycemic control during the first year of treatment, but comes with a risk for severe hypoglycemia. Improvements in physician and patient education within the Turkish population regarding hypoglycemia management may be of benefit.
