Yazar "Tuzcu, Alpaslan" seçeneğine göre listele

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    An acromegalic patient with low Insulin-Like Growth Factor-1 levels: it may not be found to be elevated during diagnosis of acromegaly each time
    (2015) Bahceci, Mithat; Tuzcu, Alpaslan; Durmaz, Şenay Arıkan; Gökalp, Deniz; Ayağ, Hatice; Güzel, Aslan
    Akromegali tanısı aşırı GH ve Insulin-Like Growth Factor-1 (IGF-1) sekresyonunun gösterilmesine dayanır. IGF-1 akromegalinin aktivasyonunun en güvenilir göstergesidir. Bununla birlikte plazma IGF-1 düzeylerinin değişikliklerinin yorumlanmasında bazı tuzaklar vardır. Biz kötü kontrollü tip 2 diabetes mellitus ve malnütrisyon ile ilişkili olarak düşük IGF-1 ve artmış GH düzeyleri olan bir akromegalili olguyu sunmayı amaçladık.Otuzsekiz yaşındaki kadın hasta hiperglisemi, halsizlik, öksürük, dispne, yüksek ateş yakınmaları yüzünden acil servise baş vurdu. On yıldır ellerinde ve ayaklarında büyüme olmasından yakınmaktaydı ve uzun zamandır kaşektikti. OGTT sırasında serum growth hormon düzeyleri yaş ve cinsiyete göre olan normal sınırlardan yüksek bulundu. Fakat IGF 1 and IGFBP-3 normal referans aralığından düşük ölçüldü. Hipofizin manyetik rezonans görüntülemesinde 3x2.5 cm çaplı bir pituiter makroadenom saptandı. Sonuç olarak, artmış IGF-1 düzeyleri akromegali tanı ve aktivitesinde çok önemlidir, ancak tip 2 diyabetli akromegalilerde IGF-1' in dikkatli yorumlanması gereklidir
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    Adipocyte volumes and levels of adipokines in diabetes and obesity
    (Elsevier Sci Ltd, 2008) Gokalp, Deniz; Bahceci, Mithat; Ozmen, Sehmus; Arikan, Senay; Tuzcu, Alpaslan; Danis, Ramazan
    Aim: Obesity is a major risk factor for insulin resistance, type 2 diabetes, heart disease, and many other chronic diseases. The factors regulating cytokine production seem to have a role on the determination of adipocyte volume. We aimed to investigate the association of plasma adiponectin and resistin concentrations with adipocyte volumes in obese, diabetic, obese-diabetic and control groups. Methods: Plasma adiponectin, resistin and lipid levels and adipocyte volumes were investigated in obese, non-diabetic, non-obese diabetic, obese diabetic and control groups consisting 100 subjects who planned to undergo elective surgery. Differences in clinical or laboratory parameters among groups were compared by using one-way ANOVA test. Chi-square test was used for comparing the frequencies. Results: The lipid values in all three groups were higher than the control group. A negative correlation was found between adiponectine levels and adipocyte volumes. When adipocyte volumes were compared with other groups, adipocyte volumes were significantly higher in the obese diabetic group (p = 0.000). The adipocyte volumes in the obese group were determined to be higher than the control group. Conclusions: Although a positive correlation was found between adipocyte volumes and adiponectin in literature, adiponectin concentrations in our study were lower. These conditions can be explained by the effect of insulin resistance on the adiponectin levels in obese diabetic groups. Moreover, adiponectin levels are mostly associated with subcutaneous adipose tissue which may have been less. Resistin levels may play an important role in the development of obesity, insulin resistance and diabetes. (C) 2008 Diabetes India. Published by Elsevier Ltd. All rights reserved.
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    Aggressive natural killer cell leukemia in a patient with common variable immunodeficiency syndrome
    (Parthenon Publishing Group, 2006) Ayyildiz, Orhan; Altintas, Abdullah; Isikdogan, Abdurrahman; Tuzcu, Alpaslan
    [Abstract Not Available]
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    Analysis of thrombophilic genetic mutations in patients with Sheehan's syndrome: is thrombophilia responsible for the pathogenesis of Sheehan's syndrome?
    (Springer, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Yurt, Murat; Celik, Yusuf; Alpagat, Gulistan
    The gene mutations of Factor V R506Q (FV-Leiden), prothrombin (FII G20210A), methylene tetrahydrofolate reductase (MTHFR) C677T and A1298C and PAI-1 4G/5G are well-established risk factors for thrombosis. We aimed to investigate the prevalence of these gene mutations and their possible impact on the development of pathogenesis in patients with Sheehan's syndrome (SS). 40 female patients with SS compared to a control group of 45 healthy women. The presence of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G gene mutations were assessed by polymerase chain reaction analysis with a light cycler analyzer. An odds ratio of greater than one is considered to increase the risk of SS disease as found in Factor V Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G polymorphism, as follows respectively: 1.13, 1.85, 6.00, 8.14 and 1.45. MTHFR C677T and MTHFR A1298C polymorphism were found significantly higher in SS patients than the control group (P < 0.001), however FV-Leiden, FII G20210A and PAI-1 4G/5G polymorphism showed no significant difference (P > 0.05). The level of plasma total homocysteine (tHcy) was significantly higher in patients with SS than in the control group (P < 0.001). We suggest that the genetic mutations of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G increase the risk of SS. Also, high plasma tHcy levels may be a risk factor for the development of SS.
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    Assessment of bleeding disorders in Sheehan's syndrome: Are bleeding disorders the underlying cause of Sheehan's syndrome??
    (Informa Healthcare, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Erdemoglu, Mahmut; Alpagat, Gulistan
    Sheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P < 0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.
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    Audiological Findings in Acromegaly Patients
    (Mediterranean Soc Otology & Audiology, 2011) Baylan, Muzeyyen Yildirim; Gokalp, Deniz; Celik, Yusuf; Tuzcu, Alpaslan; Meric, Faruk; Topcu, Ismail
    Objective: The aim of this study was to evaluate otologic problems in patients with acromegaly. Materials and Methods: This retrospective study was performed on 26 patients with acromegaly and 27 age-matched healthy controls. Otoscopic examination, pure tone odiometry, tympanometry, otoacoustic emissions, and stapes reflex were performed in all cases. Hearing thresholds of air and bone conduction (AC and BC), middle ear function, cochlear function, tympanic membrane compliance, gradient, peak pressure, and external ear canal volume were researched in patients with acromegaly. Results: The hearing thresholds for all frequencies except Right-AC 4000 frequencies were found to be significantly higher in patients with acromegaly as compared to the control group (p<0.05). Also significant correlation coefficients were calculated among disease duration, hearing thresholds, and tympanometric variables (p<0.05). There was a significant difference in tympanometry results between the two groups in regard to external ear canal volumes of the right and left ears (p <= 0.05). No differences were observed between the two groups in their type of tympanometry, stapes reflex, and otoacoustic emissions (OAE) (p>0.05). Conclusions: We have determined that patients with acromegaly have lower levels of hearing in both bone and air conduction compared with the normal population. This may be ascribed to deformation of hearing physiology related to hypertrophy in the temporal bone.
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    Auricular muscormycosis: A case report
    (2007) Topçu, İsmail; Tuzcu, Alpaslan; Oktay, Faruk M.; Kılınç, Nihal; Aşkar, İbrahim
    Mukormikozis nadir görülen safrofitik bir hastalıktır; invaziv ve hızlı bir seyir gösterir. Diabetes mellitus ya da kan diskrazileri gibi immün sistemin bozulduğu hastalarda ya da immünosupresif tedavi alanlarda görülür. Kontrol edilemeyen diyabetik ketoasidozlu 17 yaşındaki kadın hastada, sağ auriküla ve dış kulak yolunda siyah renkli lezyon oluşumu gözlendi. Fizik muayenede dış kulak yolu, auriküla ve buna komşu deri bölgesinde nekroz vardı. Hastada aynı zamanda lezyonla eşzamanlı sağ fasyal sinir paralizisi izlendi. Nekrotik dokular debride edildikten sonra, alınan doku örneklerinde yapılan mikrobiyolojik ve histopatolojik incelemede non-septat hif saptandı. Ameliyat sonrasında sistemik amfoterisin B tedavisi uygulandı. Hasta yedinci gün kaybedildi.
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    Blue rubber bleb nevus syndrome
    (2003) Dursun, Mehmet; Canoruç, Fikri; Tuzcu, Alpaslan; Yılmaz, Şerif; Bilici, Aslan
    Amaç: Blue rubber bleb nevus sendromu (BRBNS) gastrointestinal sistem ve deride hemanjiomlarla karakterize nadir bir durumdur. Bu hemanjiomlar gastrointestinal kanama ve anemiye neden olabilirler. Olgu: On dokuz yaşında bir erkek hasta kliniğimize anemiyle başvurdu. Fizik muayenede konjonktival solukluk, auri-kulada insizyon skarı ve sağ el sırtı, sağ ayak baş parmağı ve gluteal bölgede hemanjiomlar mevcuttu. Laboratuvarda demir eksikliği anemisi saptandı. Kolonoskopik bakıda kolon ve rektumun tüm alanlarında histolojik olarak ispatlanan hemanjiomlar mevcuttu. BRBNS'u demir eksikliği anemisinde nadir sebep olarak göz önünde bulundurulmalıdır.
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    Can long-term exposure to chromium improve insulin sensitivity in chromium mine workers?
    (Wiley-Liss, 2004) Tuzcu, Alpaslan; Bahçeci, Mithat; Dursun, Mehmet Emin; Parmaksız, Y.; Ertem, Melikşah; Dalgıç, A.; Turgut, Cengiz; Kale, Ebru
    The purpose of this work was to evaluate insulin sensitivity in chromium mine workers exposed to chromium chronically. Body mass index, waist circumference, fat mass and percent, lipid levels, serum glucose, insulin, leptin and chromium levels, HOMA (%S), and HOMA (%B) values were measured in 93 male workers and 94 age- and body mass index-matched healthy controls. Fat mass and fat percent of workers were higher than control subjects (P < 0;01 and P < 0.0001, respectively). Mean insulin level of the workers was lower than control subjects (6.2 +/- 4.9 muU/mL and 9.38 +/- 5, respectively, P < 0.0001). Mean serum leptin levels was also lower than the control group (8.47 +/- 6.5 ng/mL and 19.0 +/- 10.8, respectively, P < 0.0001). Serum chromium was higher than the control subjects (407.7 +/- 224.2 nmol/L and 4.45 +/- 3.9, respectively, P < 0.00001). Mean HOMA (%S) index of workers was higher than control subjects (114.4 +/- 55.6 and 55.7 +/- 40.6, P < 0.001). Serum high-density lipoprotein cholesterol levels of the workers were significantly higher than the control group (P < 0.02). In conclusion, long-term exposure to chromium may improve insulin sensitivity and beta-cell function. This improvement appears to be a result of low body fat mass and fat percent in body composition. In addition chromium usage may have useful effects in the insulin sensitivity and therefore in development of type 2 diabetes mellitus.
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    A Case with Lipoid Proteinosis Intersected with Diabetes Mellitus
    (Galenos Yayincilik, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Yildirm, Muzeyyen; Akdeniz, Sedat; Ozekinci, Selver; Urakci, Zuhat
    Lipoid proteinosis (LP) is a rare disorder inherited as an autosomal recessive trait. LP is characterized by deposition of hyaline-like material in the skin, mucous membranes, and other tissues. LP has been mapped to chromosome 1q21, the locus for the extracellular matrix protein 1 (ECM1) gene. In this case report, we aimed to present a case with LP accompanied by diabetes mellitus, and to discuss the possible mechanisms of diabetes in LP. A 16-year-old girl presented to the endocrinology department with hyperglycemia. She reported a history of progressive hoarseness of her voice since she was two years old. Our patient meets the clinical and histopathological criteria for the diagnosis of LP. Her fasting glucose was 310 mg/dl. Plasma insulin and C-peptide levels were 5.1 uU/ml and 1.57 ng/ml, respectively. Hemoglobin A1c was 12.3%. HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) ratio was 3.1 (normal range <3.7). Serum islet cell antibodies, anti-GAD antibodies and anti-insulin antibodies were negative. Diabetes mellitus was diagnosed and insulin treatment was initiated. In conclusion, possible mechanism of diabetes mellitus may be result of the diffuse deposition of amorphous material into the capillary vessels or in pancreas. The other possible mechanism responsible for the association of diabetes mellitus and insulin resistance in LP patients may be sharing a mutation at 1q21 locus. Future studies which aimed screening of insulin resistance and diabetes mellitus in LP patients may be helpful to explain this association.
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    Diabetik retinopatili olguda etambutole bağlı toksik optik nöropati
    (2003) Çakmak, Söker Sevin; Tuzcu, Alpaslan; Ünlü, Kaan; Bilek, Kubilay
    Etambutol hidroklorid tüberküloz tedavisinde rutin olarak kullanılan birinci basamak ilaçtır. Okülotoksik etkisi doza bağımlıdır. Diabetes mellitus, böbrek yetmezliği, alkolizm, ateroskleroz ve çok yaşlı kişilerde okülotoksik etki riski ve etkisi artmaktadır. Bu nedenle bu risk faktörlerine sahip hastalarda, tüberküloz tedavisinde başka alternatif ilaçlar düşünülmeli veya hastalar sık aralıklarla oftalmolojik muayeneden geçirilmelidir.
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    The effects of flutamide on lipid profile, insulin sensitivity, hirsutism and gonadotropins in women with polycystic ovary syndrome
    (1999) Ertem, Melikşah; Tuzcu, Alpaslan; Yükselen, Vahit; Bahceci, Mithat; Dursun, Mehmet
    In this study, we evaluated metabolic changes and the effects of flutamide in 22 women with PCOS. Flutamide was administered for a 6-month period in a dose of 750 mg/day. The basal and after treatment body mass index, waist: hip ratio, blood glucose, insulin, lipids, Ferriman-Gallwey scoring (FGS), gonadotropins, testosterone, trasaminazed and glucose: insulin (G:I) ratio were measured. For comparison, ANOVA was used. The sixth month mean FGS was significantly lower than the basal values (18.5±7.4 and 12.5±4.5, P<0.01). The mean basal G:I ratio was 3.31±1.12 and 6.21±2.53 at the sixth month. The sixth month G:I ratio was significantly higher (P<0.001). The total and LDL-cholesterol were decreased by flutamide (from 144±23 to 123±23 and from 88±32 to 60±25 mg/dl respectively. P<0.02 and P<0.01), whereas, the HDL-cholesterol level was increased with flutamide (from 44.8±3.9 to 46.5±3.2 mg/dl and P<0.001). LH (from 14.7±6.7 to 8.4±3 mlU/ml), LH/FSH ratio (from 3.4±1.7 to 1.9±0.6), total testosterone (from 0.87±0.29 to 0.61±0.18 ng/ml) and free testosterone (from 4.29±1.18 to 2.14±0.9 pg/ml) were decreased by flutamide (P<0.05). Thus, we reached three conclusions:1-Flutamide may improve insulin insensitivity. 2-In PCOS, flutamide decreases total and LDL-cholesterol, and increases HDL-cholesterol. 3-Flutamide may improve the LH/FSH ratio and induce a decrease in testosterone.
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    An Embryological Cause of Primer Hypothyroidism, Lingual Thyroid
    (Galenos Yayincilik, 2006) Arikan, Senay; Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Bahceci, Selen
    Lingual thyroid is a rare developmental thyroid abnormality usually affecting females. It is often found in the region of the foramen caecum as a lingual thyroid at the base of the tongue in patients whose gland fails to descend. A 16-year-old female patient with severe hypothyroidism applied to our outpateint clinic. She was complaining from growth retardation, primary amenorrhea, weakness, decreases of school performance and short stature. No thyroid tissue was seen at the usual site with ultrasonography. Scintigrapy with 99mTC pertechnetate showed an ectopic functioning thyroid in the lingual area. CT scan showed a mass in the base of lingular region. The thyroid profile implied severe hypothroidism (free T3: 0,142 ng/ dl, free T4: 0,741 ng/dl, and TSH: 100 mu IU/ml). Patient was accepted as primary hypothyrodism due to ectopic thyroid tissue (lingual thyroid) and substitution treatment with L-thyroxine was started at the dose of 2-3 mu gr/kg. Surgical treatment did not consider because of patient was asymptomatic in terms of pressure. As a result we reported a rare cause of primary hypothyroidism due to ectopic thyroid gland (lingual) in a young female patient.
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    Evaluation of Bone Mineral Density in Terms of Veiling, Socioeconomiical Status and Educatiional Level in Turkish Women Over 40 Years. Veiling May Be A Risk Factor For Osteoporosis
    (Galenos Yayincilik, 2006) Bahceci, Mithat; Ertem, Meliksah; Saka, Gunay; Gokalp, Deniz; Karacomak, Zuhre; Akdeniz, Nurten; Tuzcu, Alpaslan
    Background and aims: Headscarf is a mild kind of veiling, worn for various intentions. We aimed to evaluate effect of veiling, educational status, living area and nutrition on BMD in women over 40 years. Subjects and methods: Four hundred thirty nine moslem women, living in different region (suburb and house provided to workers) of Diyarbakir, aged over 40 years (with mean age 48,9+ 11,3 years) were included to study. The predicted factors influencing BMD were investigated by using a questionnaire. Body weights and heights were measured. BMI was expressed as weight (kilograms) per height (meters) squared. Body fat percent and fat mass were determined by bioelectric impedance. Bone Mineral Density (BMD) was determined with radiographic absorptiometry (RA) in three middle fingers. Results: Living in suburban region (p=0.0001), family history of osteoporosis (p<0.002), low education level (p=0.0001), insufficient calcium intake (p<0.001), parity over 4 (p=0.0001), low body height (p=0.0001), veiling (p=0.0001) and low body weight (p< 0.002) and height (p=0.0001) and duration of menopause (p=0.0001) were the factors with negative effects on BMD. Prevalence of osteoporosis was also higher in illiterate women (p=0.0001), women living in slum (p=0.0001), veiled women (p=0.0001), insufficient nutritional status (p< 0.03) and positive family history for osteoporosis (p< 0.002). Conclusions: In addition to well known factors for osteoporosis such as living in slum, illiteracy, high parity number, insuficient nutrition, and duration of menopause; veiling may also be an important factor for low BMD. Veiled women should be screened for low BMD and osteoporosis regularly.
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    The evaluation of endothelial function with flow-mediated dilatation and carotid intima media thickness in young nonobese polycystic ovary syndrom patients; existence of insulin resistance alone may not represent an adequate condition for deterioration of endothelial function
    (Elsevier Science Inc, 2009) Arikan, Senay; Akay, Hatice; Bahceci, Mithat; Tuzcu, Alpaslan; Gokalp, Deniz
    Objective: To evaluate endothelial function with flow-mediated dilatation (FMD) and carotid intima media thickness (IMT) in young nonobese polycystic ovary syndrome (PCOS) patients. Design: Prospective case-control study. Setting: Healthy volunteers and nonobese young PCOS patients in clinical research. Patient(s): Thirty-nine PCOS patients with mean age of 22.82 +/- 5.53 years and 30 body mass index- and age-matched healthy controls were evaluated. Intervention(s): Insulin resistance was calculated with area under the curve, quantitative insulin sensitivity check, and the Matsuda index. Endothelial function was assessed with FMD and carotid IMT by ultrasonography. Main Outcome Measure(s): Antropometric, hormonal, biochemical (insulin and glucose, tumor necrosis factor-alpha, hs-c-reactive protein, and homocysteine levels, and so forth), FMD, and IMT were measured. Result(s): There was a significant insulin resistance in PCOS patients. Serum FSH, total and free testosterone, cortisol, androstenedione, and DHEA-S levels of PCOS patients were also higher than control subjects, but we could not find any significant difference in terms of endothelial function determined with FMD. Conculsion(s): Existence of insulin resistance alone may not bean adequate factor for deterioration of endothelial function and carotid IMT in young, nonobese patients with PCOS. Other factors such as duration of insulin resistance, older age, presence of obesity, and inflammatory markers may play an important role in this process. (Fertil Steril (R) 2009;91:450-5. (C)2009 by American Society for Reproductive Medicine.)
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    Evaluation of insulin sensitivity in hyperprolactinemic subjects by euglycemic hyperinsulinemic clamp technique
    (Springer, 2009) Tuzcu, Alpaslan; Yalaki, Serkan; Arikan, Senay; Gokalp, Deniz; Bahcec, Mithat; Tuzcu, Sadiye
    The background and aim of the study is to evaluate insulin sensitivity in hyperprolactinemic subjects via euglycemic hyperinsulinemic clamp technique. Sixteen hyperprolactinemic subjects and 12 healthy subjects were included in the study. HOMA-B and HOMA-IR values of groups were calculated. Euglycemic hyperinsulinemic clamp technique was performed in both groups, and the M value of the groups was defined. Mann-Whitney U and chi-square tests were used in statistical analysis. Basal insulin level of hyperprolactinemic patients were higher than the control group (6.85 +/- A 4.68; 3.66 +/- A 0.88 mu U/ml respectively; P < 0.05). Mean HOMA-IR and HOMA-B values of patients were higher than control group (1.49 +/- A 1.30; 0.78 +/- A 0.27 respectively; P = 0.02 and 136.28 +/- A 72.53; 64.77 +/- A 23.31, respectively, P < 0.001). M values of the patients were statistically lower than the control group (5.64 +/- A 2.36; 7.05 +/- A 1.62 kg/mg/min respectively; P < 0.05). (1) Hyperprolactinemic patients were more insulin resistant than control subjects. (2) Insulin resistance in hyperprolactinemic patients is not associated with obesity or anthropometric parameters such as fat content, waist circumference and BMI.
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    Flow-mediated dilatation in polycystic ovary syndrome women Reply
    (Elsevier Science Inc, 2009) Arikan, Senay; Akay, Hatice; Bahceci, Mithat; Tuzcu, Alpaslan; Gokalp, Deniz
    [Abstract Not Available]
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    Four decades without diagnosis: Sheehan's syndrome, a retrospective analysis
    (Taylor & Francis Ltd, 2016) Gokalp, Deniz; Alpagat, Gulistan; Tuzcu, Alpaslan; Bahceci, Mithat; Tuzcu, Sadiye; Yakut, Fatime; Yildirim, Azad
    Aim: Sheehan's syndrome (SS) remains a frequent cause of hypopituitarism in undeveloped and developing countries, but due to improvements in obstetric care, it is rare in developed countries. We aimed to share the results of a retrospective study analyzing the demographic, clinical, imaging, and hormonal characteristics of a large group of patients with SS, and also increase awareness of this syndrome especially in developed countries. Methods: The medical records of 124 patients with SS patients who were followed up in the Endocrinology Department of Dicle University between 1995 and 2015 were assessed retrospectively. Results: The mean period of diagnostic delay was 20.37 +/- 8.34 years on average. 5.7% of patients with SS were literate; 62% of patients delivered at home. Anemia was identified in 64.5% of SS patients. Mean blood sodium levels were 129.8 +/- 11.3 mEq/L. The mean urine densities were 1013 +/- 6.5. Osteoporosis and osteopenia were found in 44 (35.4%) and 71 (57.2%) patients, respectively, According to pituitary magnetic resonance imaging (MRI) analyses, 92 (74.2%) patients with SS had completely empty sella, 29 (23.3%) had partially empty sella, and 1 patient had microadenoma, and 2 had normal pituitary MRI results. Conclusions: Improved obstetric care and effective interventions for postpartum hemorrhage have limited the prevalence of SS in developed countries. However, in developing countries like Turkey, SS due to postpartum bleeding remains common. Thus, physician's awareness of the symptoms of SS is urgently required to avoid the associated morbidity and mortality.
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    Hipertrigliseridemi nedenli akut pankreatit tedavisinde heparin ve insülin rejimi uygulanan bir olgu
    (Türk Gastroenteroloji Vakfı, 2005) Yılmaz, Şerif; Dursun, Mehmet; Canoruç, Fikri; Tuzcu, Alpaslan; Akay, Hatice; Danış, Ramazan; Parmaksız, Ergün
    Hipertrigliseridemi, akut nonbiliyer pankreatitin önemli ve gözardı edilen sebeplerindendir. Bu hastaların tedavisinde halen standart bir protokol yoktur. Hastamız, hipertrigliseridemi zemininde gelişen bir akut nek-rotizan pankreatit olgusu idi. Hastaya, lipoprotein lipaz aktivitesini arttırmaya yönelik insülin ve heparin kombinasyonundan oluşan bir tedavi protokolü verdik. Tedavi sonunda hastanın tüm verileri düzeldi. Amacımız hipertrigliseridemiye sekonder gelişen bu akut pankreatit olgusunu, ayırıcı tanı ve tedavi yaklaşımını sunmak idi.
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    Horizontal transmission of HBV among students in the Southeastern Anatolia
    (2000) Değertekin, Halil; Tuzcu, Alpaslan; Yalçın, Kendal
    Amaç: Bu çaılşmada HBV seropozitifliğinin yüksek olduğu Diyarbakır il merkezinde ilkokul ve lise öğrencileri arasında HBsAg taşıyıcılığı ve horizontal bulaşın rolü araştırılmış ve sonuçlar sekiz yıl önce yapılan benzer çalışma ile beraber değerlendirilmiştir. Yöntem: Çaışmada ilkokul birinci sınıftan 150, beşinci sınıftan 150, lise üçüncü sınıftan 200 ve erişkin 200 vaka araştırıldı. Toplanan serumlarda mikroelisa yöntemi ile HBsAg ve Anti-HBs tetkikleri yapıldı. Bulgular: HBsAg pozitifliği ilkokul birinci, beşinci ve lise üçüncü sınıflarda sıra ile % 2.7, % 6.1 ve % 6.2 bulundu. Anti-HBs ise % 14, % 20 ve % 21 tespit edildi. Erişkinlerde bu oranlar % 10 ve % 49' du. Öğrencilerde bulunan sonuçlar sekiz yıl önce aynı okullarda yapılan çalışma ile benzerlik gösterdi, aradaki fark anlamsızdı (p>0,05). Öğrencilerdeki HBsAg sonuçları beraberce değerlendirildiğinde ilkokul birinci ve beşinci sınıflar arasında (% 2.1 - % 6.1) anlamlı fark olduğu (p<0,05), bu farkın lise döneminde kaybolduğu (% 6.2, p>0.05) görülmektedir. Benzer durum Anti-HBs için geçerli görülmektedir. Sonuç: Sonuç olarak Diyarbakır il merkezinde ve muhtemelen ülkemizin her yerinde HBV'nin horizontal bulaşında en önemli dönemin 7-11 yıl arası olduğu görülmektedir. Lise döneminde ise bu risk azalmaktadır. HBV'nin önlenmesinde yeni doğana aşının yanı sıra, önümüzdeki 7-8 yıl ilkokul birinci sınıf öğrencilerine HBV aşısı yapılması yararı olacaktır.