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Öğe 18f-fluorodeoxyglucose pet/ct can be an alternative method to assessment of insulin resistance(Acta Endocrinologica Foundation, 2019) Tuzcu, Şadiye Altun; Çetin, F. A.; Pekkolay, Zafer; Tuzcu, Alpaslan KemalBackground. Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT. Materials and method. Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m2, Group 2: BMI>25kg/ m2). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis. Results. Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005) Conclusion. 18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.Öğe 46,XX,dup(X)(q21.3q24) karyotipli olgu sunumu(Dicle Üniversitesi Tıp Fakültesi, 2010) Şimşek, Selda; Tuzcu, Alpaslan Kemal; Oral, Diclehan; Budak, TurgayX kromozomu uzun kolunun duplikasyonu ile fenotipik bulgular arasındaki ilişki kızlarda tam olarak aydınlatılamamıştır. Daha önce bildirilen vakalardaki fenotipik bulgular; bazı kızlarda normal görülürken, bazılarında ise kısa boy, mikrosefali, mental motor retardasyon, vücut asimetrisi ve gonadal disgenezi şeklindedir. Turner sendromunda görülen dismorfik bulgular da bu hastalarda görülebilmektedir. Bu çalışmada, sitogenetik laboratuvarımıza kısa boy ve primer amenore nedeniyle gönderilen 15 yaşındaki bir kız olgu tartışılmıştır. Olgunun Barr cisimciği pozitif bulunmuş ve Giemza bantlama tekniği ile yapılan karyotip analizinde 46,XX,dup(X)(q21.3q24) kromozom kuruluşu saptanmıştır. Konu mevcut literatür bilgileri ışığında tartışılmıştırÖğe 5-Alpha Reductase Deficiency: A Review of Five Cases Diagnosed with Ambiguous Genitalia(Galenos Yayincilik, 2017) Pekkolay, Zafer; Kilinc, Faruk; Tuzcu, Sadiye Altun; Soylu, Hikmet; Tuzcu, Alpaslan Kemal5-alpha reductase is an enzyme which is responsible for the conversion of testosterone to dihydrotestosterone (DHT) in the peripheral tissues. It plays a key role in the development of male external genitalia. The present study was carried to make a clinical presentation of five male patients diagnosed with 5-alpha reductase deficiency resulting in the developmental disorder of male sexuality as well as to draw attention to the patients' medical history, physical examination and laboratory features. A test group comprising of five male subjects previously diagnosed with 5-alpha reductase deciency after being hospitalized and a series of examinations between April 2007 and July 2014, were enrolled in the study. Physical examination, hormonal profiles, radiological findings and karyotype analyses of the patients were carried out and their previous medical history was recorded. All the patients with karyotype 46 XY were raised as a female. They had external genitalia similar to each other and expressed a lower level of DHT. The patients with a disorder of male sex development, who expressed lower levels of dihydrotestosterone, must be checked for 5-alpha reductase deficiency.cÖğe 68Ga-DOTATATE PET/CT Can Be an Alternative Imaging Method in Insulinoma Patients(Soc Nuclear Medicine Inc, 2017) Tuzcu, Sadiye Altun; Pekkolay, Zafer; Kilinc, Faruk; Tuzcu, Alpaslan KemalInsulinomas are the most common cause of hypoglycemia, resulting from endogenous hyperinsulinism. The diagnosis of insulinoma is established by demonstrating inappropriately high serum insulin concentrations during a spontaneous or induced episode of hypoglycemia. Most insulinomas are islet-cell tumors. They are often small (<2 cm), benign, and difficult to localize with current imaging techniques. Insulinomas can be detected using either noninvasive procedures (e.g., transabdominal ultrasonography, spiral CT, MRI, In-111-pentetreotide imaging, and F-18-L-dihydroxyphenylalanine PET) or invasive procedures (e.g., endoscopic ultrasonography) or a selective arterial calcium stimulation test with hepatic venous sampling. Methods: We performed Ga-68-DOTATATE PET/CT on 3 patients with insulinoma. Results: All patients' insulinomas were shown clearly with Ga-68-DOTATATE PET/CT. Conclusion: Ga-68-DOTATATE PET/CT imaging may be a useful noninvasive imaging technique to localize insulinomas preoperatively.Öğe Adrenal İnsidentalomalı 78 Hastanın Demografik ve Klinik Özellikleri(2015) Kılınç, Faruk; Pekkolay, Zafer; Tuna, Mazhar Müslüm; Soylu, Hikmet; Tuzcu, Alpaslan Kemal; Barutçu, SezginAdrenal insidentalomalar (AI); adrenal bezde herhangi bir hastalık kuşkusu yokken görüntüleme yöntemleri veya abdominal laparotomide tesadüfen saptanan kitlelerdir. Abdominal ultrasonografi, BT ve MR kullanımının artması ile adrenal insidentalomaların tespit edilme sıklığı da artmıştır. Bu çalışmamızda, AI nedeniyle takip edilen hastalarmızın demografik ve klinik verilerini sunmayı amaçladık. Bu çalışmaya 2007-2013 yılları arasında Dicle Üniversitesi Tıp Fakültesi Endokrinoloji Anabilim Dalı'na başvuran 78 hasta ( 53 kadın; 25 erkek) dahil edildi. Hasta dosyalarından hastalara ait fizik muayene, USG, BT sonuçları kaydedildi. Serum kortizolü, idrar metanefrini, idrar normetanefrini, idrar VMA, serum aldosteronu ve serum renin değerleri kaydedildi. Hastaların yaş ortalaması 48.6 ± 14.9 idi. Tespit edilen kitlelerin lokalizasyonu açısından anlamlı farklılık saptanmadı. Hastaların vücut kitle indeksi 28.54 ± 5.82 idi. 45 hastada (% 57.7) non-fonksiyonel adenom, 10 hastada (% 12.8) subklinik cushing, 11 hastada (% 14.1) feokromasitoma, 3 hastada (% 3.8) adrenal karsinom, 2 hastada (% 2.6) hiperaldosteronizm, 2 hastada (% 2.6) ganglionörom, 1 hastada (% 1.3) myelolipom, 1 hastada adrenal adenom, 1 hastada adrenal kist, 1 hastada schwannom ve 1 hastada da küçük yuvarlak hücreli tümör tespit edildi. Radyolojik görüntüleme sıklığı arttıkça adrenal insidentaloma olgularının sayısı da artmaktadır. Her adrenal insidentaloma, malign olup olmadığı ve hormonal işlevi olup olmadığı açısından değerlendirimelidir.Öğe Akromegali hastalarında Growth hormon ve insülin like growth faktör-1 düzeyi ile aterosklerotik risk belirteçleri arasındaki ilişki(Dicle Üniversitesi Tıp Fakültesi, 2023) Bodakçi, Erdal; Kılınç, Faruk; Tuna, Mazhar Müslüm; Pekkolay, Zafer; Karabulut, Aziz; Tuzcu, Alpaslan KemalAmaç: Akromegali hastalarında büyüme hormonu (BH) ve insülin benzeri büyüme faktörü- 1(IGF-1) düzeyi ile hastalık süresi ile aktif ve remisyonda bulunan hastaların epikardiyal yağ kalınlığı ve karotis intima-media kalınlığı arasındaki ilişkiyi araştırmayı amaçladık. Yöntemler: Bu çalışmaya 40 akromegalik hasta (23 kadın, 17 erkek) ve 40 kontrol grubu (23 kadın, 17 erkek) dahil edildi. Hastaların kilo, boy, vücut kitle indeksi, bel çevresi, sistolik ve diastolik kan basınçları, lipid paneli, insülin, glukoz, üre, kreatinin, BH, IGF-1 düzeyi ölçüldü ve tam kan sayımı yapıldı. Ekokardiyografik olarak epikardiyal yağ kalınlığı ve doppler ultrasonografi ile karotis intima-media kalınlığına bakıldı. Bulgular: Hastaların yaş ortalaması 39.5 ± 10.1, kontrol grubunun yaş ortalaması 39.3 ± 10.1 yıldı. Tüm hastaların BH ve IGF-1 düzeyi kontrol grubundan yüksekti(p<0.001). Hastaların epikardiyal yağ kalınlığı kontrol grubundan anlamlı düzeyde yüksekti(p<0.001). Hastaların karotis intima-media kalınlığı kontrol grubundan daha kalındı(p<0.001). Hastaların epikardiyal yağ kalınlığı ve karotis intima-media kalınlığı arasında pozitif bir korelasyon vardı(R2 linear: 0,495). Sonuç: Akromegali hastalarında kontrol sağlıklı grubuna göre epikardiyal yağ ve karotis intima-media kalınlığının daha yüksek bulunması akromegalide aterosklerozun erken gelişebileceğinin göstergesi olabilir.Öğe Akromegali hastalarının metabolik özelliklerinin değerlendirilmesi(Modestum Publishing Ltd., 2015) Kılınç, Faruk; Pekkolay, Zafer; Gözel, Nevzat; Uslu, Hikmet; Yılmaz, Ahmet; Yıldırım, Yaşar; Şahpaz, Fatih; Tuzcu, Alpaslan KemalAmaç: Akromegali aşırı miktarda büyüme hormonu (BH) ve insülin benzeri büyüme faktörü (IGF-1) salınımı ile karakterize bir sendromdur. Bu çalışmada, kliniğimizde akromegali tanısı ile takip edilen hastalarda tespit edilen metabolik bozuklukların paylaşılması amaçlanmıştır. Yöntemler: Çalışmamıza 2010 ile 2015 yılları arasında polikliniğimizde akromegali tanısıyla izlenen 105 hasta alındı. Hastaların yaş, cinsiyet, tutulum özelliği, ek sistemik ve metabolik hastalıkları ve laboratuvar bulguları retrospektif olarak kaydedildi. Bulgular: Çalışmaya alınan 105 hastanın 56'sı kadın (%53,3), 49'u erkek (%46,7) idi. Hastaların yaşları 23-78 yıl (ortalama 42,1±16,7) arasındaydı. Hastaların 34'ünde (%32,3) hipertansiyon, 20'sinde (%19,04) diyabetes mellitus, ve 11'inde (%10,4) bozulmuş glukoz toleransı saptandı.Sonuç: Somatik bozukluklar (el ve ayaklarda büyüme gibi) hastalığın ana özelliğidir ancak prognozu belirleyen kardiyovasküler, respiratuvar ve metabolik komplikasyonlardır. Akromegalide hipertansiyon ve diyabet sıktır, kardiyovasküler hastalıklar ölüm nedenleri arasında ilk sıradadır. Çalışmamızın bu açıdan ülkemize ait verilerin oluşmasına katkıda bulunacağını düşünmekteyiz.Öğe Alternative methods for the diagnosis of macroprolactinemia: urine prolactin level and serum / urine prolactin ratio(Dicle Üniversitesi Tıp Fakültesi, 2019) Pekkolay, Zafer; Tuna, Mazhar Müslüm; Güven, Mehmet; Tuzcu, Şadiye Altun; Kaplan, İbrahim; Akkuş, Zeki; Tuzcu, Alpaslan KemalObjective: The aim of this study was to investigate the urine prolactin and serum/urine prolactin ratio for accuracy diagnosis of macroprolactinemia. Methods: In the retrospective cross-sectional analysis, prolactin levels (high or normal) in the reproductive period of men and women were included in the study. Polyethylene glycol (PEG) precipitation method was used for the detection of macroprolactinemia. Then, patients were divided into three groups as macroprolactinemia, prolactinoma and healthy control group. In patients, prolactin values in spot urine with simultaneous serum prolactin values were calculated. The non-parametric Kruskal-Wallis test was used to compare the groups. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive power of serum/urine prolactin ratio Results: A total of 41 patients were included in the study. Female/male:36 (87.8%)/ 5 (12.2%). Urinary prolactin median(minimum-maximum) values were macroprolactinemia, prolactinoma and control group, respectively; 0.06(0.05-0.10), 0.11(0.02-0.95), 0.08(0.05-0.25) ng/ml. Serum/urine ratio median (minium-maximum) values were macroprolactinemia, prolactinoma, and control group, respectively; 633(51-1032), 990(104-9635), 395.5(138-953). When the groups were compared, the patients with prolactinoma had higher urinary prolactin levels(p <0.01). Serum/urine prolactin ratio was found to be the highest in prolactinoma patients and the lowest in the control group and a significant difference was observed in groups (p <0.01). ROC analysis(control-macroprolactin) for serum/urine prolactin ratio (Sensitivity 84.6 specificity 93.7 cut off >549,5 AUC=0.83) p<0.01 Conclusion: Urinary prolactin level and serum/urine prolactin ratio may be used in diagnosis of macroprolactinemia.Öğe Are there differences in the management of acute pancreatitis cases due to severe hypertriglyceridemia in pregnant women?(International Scientific Information, Inc., 2018) Kılınç, Faruk; Şenateş, Ebubekir; Demircan, Fatih; Pekkolay, Zafer; Gözel, Nevzat; Güven, Mehmet; Bahçecioǧlu, İbrahim Halil; Tuzcu, Alpaslan KemalBackground: The aim of this study was to determine the prognosis of severe disease and treatment approaches of both normal and pregnant, especially in patients with severe pancreatitis due to hypertriglyceridemia. Material/Methods: We included 30 patients (20 females and 10 males) in this study whose follow-ups and treatments were performed after a diagnosis of hypertriglyceridemia-induced acute pancreatitis between January 2011 and May 2017. Patient personal information, such as age, sex, pre-treatment and post-treatment triglyceride levels, receipt of anti-hyperlipidemic treatments or plasmapheresis, and family history, were collected from hospital records and patient files. Patients with severe pancreatitis history, score, and prognosis were included to increase the value of our study. Mild and moderate cases were excluded. Results: The mean age of the patients was 35±6 years. Twenty-four patients (80%) received an anti-hyperlipidemic treatment before their pancreatitis attacks. Plasmapheresis was performed on 8 patients before their pancreatitis attacks. Eighteen patients (60%) had a family history suggesting familial hypertriglyceridemia. Twelve patients (40%) were pregnant. Conclusions: The treatment of hypertriglyceridemia-induced acute pancreatitis was mostly confined to supportive, palliative treatments. However, plasmapheresis is a possible treatment option and should be used in the early stages of this disease. The response to medical treatment and support treatment was better in pregnant patients than in the other patient group, and pregnant patients did not require plasmapheresis.Öğe Association of clinical and laboratory parameters with ambulatory arterial stiffness index in acromegaly patients(Professional Medical Publications, 2018) Kilinc, Faruk; Pekkolay, Zafer; Demircan, Fatih; Gozel, Nevzat; Tuzcu, Alpaslan KemalObjective: In this study, we determined the relationship between the ambulatory arterial stiffness index (AASI) and clinical and laboratory parameters in patients with acromegaly. Methods: Sixty-five patients with acromegaly, who visited to Dicle University Medical Faculty Department of Endocrinology (33 females and 32 males), were included in this study. The study control group consisted of 65 subjects. Demographic and clinical data were recorded. Laboratory data (complete blood count, blood urea nitrogen, creatinine, electrolytes, albumin, lipid profile, growth hormone [GH], insulin-like growth factor-1, and the 75-g oral glucose tolerance test) performed over the last year were evaluated. The AASI was obtained from 24-hour ambulatory blood pressure monitoring records of all patients. This study was completed in 15 months from 2013 to 2015. Results: Twelve patients (18.4%) had diabetes and 21 patients (32%) had hypertension. The mean AASI value was 0.41 +/- 0.14. The mean AASI value in the control group was 0.25 +/- 0.09. Growth hormone (GH) levels were positively correlated with the AASI values. AASI values tended to be higher in hypertensive subjects than that in normotensive individuals. Conclusions: Our results show that the AASI value increased in patients with acromegaly, independent of the increase in blood pressure. The AASI was strongly dependent on the degree of the GH increase in patients with acromegaly and may have an important role predicting cardiovascular risk in patients with acromegaly.Öğe Bir üniversite hastanesi endokrinoloji kliniğinde eksenatid verilen hastaların klinik ve laboratuvar özellikleri(Dicle Üniversitesi Tıp Fakültesi, 2014) Kılınç, Faruk; Alpağat, Gülistan; Demircan, Fatih; Pekkolay, Zafer; Gözel, Nevzat; Tuzcu, Alpaslan KemalAmaç: Eksenatid, GLP-1 reseptörlerine yüksek afinitede bağlanmakta ve endojen GLP-1 etkisi olan glikoz bağımlı insülin sekresyonu, gastrik boşalmanın geciktirilmesi, glukagon süpresyonu, iştah baskılanması ve β-hücre kitlesini artırıcı etkilerini göstermektedir. Tip 2 diyabet tedavisinde metformin ve sulfonilüre veya her ikisinin beraber kullanılmasıyla glisemik kontrol sağlanamayan özellikle obez hastalarda kullanılmaktadır. İyi glisemik kontrol ve kilo kaybı sağlaması nedeniyle kan şekerleri yüksek seyreden oral antidiyabetik tedavinin yetersiz kaldığı vakalarda insülin tedavisine eklenmiştir. Çalışmamızda; kliniğimizde en az 4 ay ve daha fazla süreyle eksenatid tedavisi alan hastaların biyokimyasal ve klinik parametrelerini paylaşmayı planladık. Yöntemler: Çalışmaya Temmuz 2011 ile Aralık 2013 tarihleri arasında eksenatid başlanan ve en az 4 (ort: 7,3) ay takipleri tamamlanan 26 (2 erkek, 24 kadın) hasta alındı. Hastaların hepsi tedavi öncesi metformin yanında kombine oral antidiyabetik tedavi altında iken, 6 hasta metformin tedavisine ek olarak insülin tedavisi almaktaydı. Bulgular: Çalışmaya alınan hastalarda tedavi sonrası Hemoglobin A1c düzeylerinde kadınlarda %0.98, erkeklerde % 1.4, vücut ağırlığında (kg) kadınlarda % 0.64, erkeklerde % 0.57, beden kitle indeksi ölçümlerinde kadınlarda % 0.61, erkeklerde % 0.56 düşme gözlendi. Sonuç: İnsülin, metformin veya oral antidiyabetik tedaviyi kombine veya tek başına alan obez hastalarda tedaviye eksenatide eklenmesi ile hastalarda kilo kaybı ve Hemoglobin A1c düzeylerinde düşme tespit edilmiştirÖğe A case of mediastinitis accompanied with hyperosmolar nonketotic coma(Kare Publ, 2016) Tuna, Mazhar Muslum; Kilinc, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalMediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum. The needle aspirat culture failed to show bacterial growth. After five days of antibiotic treatment the patient's symptoms resolved. The abscess formation and pleural effusion almost disappeared on control tomography. No similar case presentation was seen in the current literature. Apart from this case, mediastinit should be keep in mind when a patient suffered from dysphagia, fever and cervical swelling. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe A case report of allgrove syndrome with neurological involvement(Society of TURAZ BİLİM, 2015) Pekkolay, Zafer; Kılınç, Faruk; Tuna, Mazhar Müslüm; Soylu, Hikmet; Ateş, Kenan; Tuzcu, Alpaslan KemalAllgrove syndrome is a very rare seen disorder with an autosomal recessive trait. The three characteristics of disease are alacrima, achalasia and adrenal failure. Alacrimia is the first manifestation in most cases. Achalasia and adrenal failure are seen later. Neurological involvement is rare and usually occurs in older age. A woman 22 years old admitted to our hospital with adrenal failure crisis. She had alacrimia and used teardrop for many years. Achalasia was diagnosed after evaluation of her dysphagia. Thus, diagnosis of Allgrove syndrome was done. Autonomic cardiac dysfunction and peripheral motor neuropathy were detected. In conclusion, Allgrove syndrome is rare and has life threatening potential due to adrenal failure. Early diagnosis and appropriate treatment may improve life quality and expectancy. Patients with relevant symptoms should be evaluated for autonomic neuropathy.Öğe A Case Report of Allgrove Syndrome with Neurological Involvement(2015) Tuzcu, Alpaslan Kemal; Soylu, Hikmet; Kılınç, Faruk; Tuna, Mazhar Müslüm; Ateş, Kenan; Pekkolay, ZaferAllgrove syndrome is a very rare seen disorder with an autosomal recessive trait. The three characteristics of disease are alacrima, achalasia and adrenal failure. Alacrimia is the first manifestation in most cases. Achalasia and adrenal failure are seen later. Neurological involvement is rare and usually occurs in older age. A woman 22 years old admitted to our hospital with adrenal failure crisis. She had alacrimia and used teardrop for many years. Achalasia was diagnosed after evaluation of her dysphagia. Thus, diagnosis of Allgrove syndrome was done. Autonomic cardiac dysfunction and peripheral motor neuropathy were detected. In conclusion, Allgrove syndrome is rare and has life threatening potential due to adrenal failure. Early diagnosis and appropriate treatment may improve life quality and expectancy. Patients with relevant symptoms should be evaluated for autonomic neuropathyÖğe Comparison of C-peptide levels in monogenic forms of diabetes with other types of diabetes: A single-center study(Acta Endocrinologica Foundation, 2023) Geneş, Dilek; Pekkolay, Zafer; Şimşek, Mehmet; Saraçoğlu, H.; Turgut, M.; Tekeş, Selahattin; Tuzcu, Alpaslan KemalObjective. This study aimed to evaluate the utility of C-peptide levels in the differentiation of monogenic forms of diabetes from type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in clinical practice. Subjects and Methods. A total of 104 patients aged >16 who visited the Dicle University’s Faculty of Medicine between April 2011 and December 2020 and were diagnosed with monogenic diabetes by genetic analysis or with T1DM and T2DM were randomly selected for retrospective evaluation. The C-peptide levels of these patients at the time of diagnosis of diabetes were compared. Results. Of the 104 patients, 24 (23%) were diagnosed with maturity-onset diabetes of the young (MODY), 40 (38.5%) with T1DM, and 40 (38.5%) with T2DM. Median C-peptide levels (ng/mL) (interquartile range) were 1.78 (1.24-2.88) in MODY group, 0.86 (0.34- 1.22) in T1DM group, and 2.38 (1.58-4.27) in T2DM group. Conclusions. There was a difference in C-peptide levels between MODY and T1DM groups but not between MODY and T2DM groups. As per clinical evaluations, although C-peptide levels of patients with MODY are similar to those of patients with T2DM patients, the possibility of C-peptide levels being similar to those required for T1DM diagnosis should also be considered.Öğe Diyarbakır il merkezinde HBV'nin horizontal bulaşımının yıllar içindeki değişimi(2018) Tuzcu, Alpaslan Kemal; Değertekin, HalilHepatitis B virüs enfeksiyonu bütün dünyada ve ülkemizde en önemli akut ve kronik karaciğer hastalığı yapan nedenler arasında gelmektedir. Ülkemizde ve özellikle Güneydoğu Anadolu bölgesinde akut viral hepatitler, kronik hepatitler, karaciğer sirozu ve hepatosellüler karsinoma etyolojisinde HBV'nin büyük önemi yapılan çalışmalarla anlaşılmıştır. HBV'nin horizontal bulaşımı konusunda yapılan araştırmalar, okul döneminin özellikle önemli olduğu göstermektedir. Bu çalışmada Diyarbakır il merkezinde HBV seropozitifliğinin ilkokul ve lise öğrencilerindeki durumu ve bunların erişkinlerle karşılaştırılması ve ortaya çıkan bulguların aynı bölgede yapılan 7 yıl önceki çalışma ile karşılaştırılması amaçlanmıştır. Çalışma sonuçlarına göre HBV seropozitifliği yönünde taranan 146 ilkokul 1. sınıf 146 ilkokul 5.sınıf 193 lise 3 'üncü sınıf öğrencisinde HBsAg pozitifliği sırasıyla %2.7, %6.1, %6.2 bulunmuştur. Kontrol grubu olan 100 erişkinde ise HBsAg %10 AntiHBs %49 olarak tespit edilmiştir. Bu sonuçlar 7 yıl önce aynı bölgede yapılan çalışmaların sonuçlarına uygunluk göstermektedir. Buna göre Diyarbakır il merkezi ve bölgemizde HBV'nin horizontal bulaşımı halen önemini korumaktadır. En riskli yaşlar 1-5 sınıf arasıdır. HBV'nin önlenmesi açısından HBV aşısının doğumda veya mutlaka ilkokul 1. sınıflarda yapılması en sağlam önlem olarak görülmektedir.Öğe The effect of high-fat diet on the development of obesity and serum leptin level in rats(Springer International Publishing, 1999) Bahçeci, Mithat; Tuzcu, Alpaslan Kemal; Akkuş, Murat; Yaldız, Mehmet Sadık; Özbay, A.Ten male Wistar-albino rats were overfed with high-fat diet (margarine at the dose 40 g/kg body weight/day in addition to standard rat diet) during six months from the age of between 8-12 weeks. Ten male rats received a standard chow for the same period. The body weights of the overfed rats increased time dependently (basal 171.5±5, at sixth month 268±19 g), whereas those of the rats fed with standard chow did not increase significantly (basal 177±6.4, at sixth month 220±10 g). At the sixth month, mean body fat percentages were 36.3±6.7% and 24.2±5.4% respectively. Both total cholesterol-triglyceride levels and mean serum leptin levels were also higher than in the overfed rats (p<0.01 and p<0.05 respectively). The livers of all rats were histopathologically normal. Conclusion: high-fat diet resulting in an increased body fat percentage in rats is associated with hyperleptinemia, hypercholesterolemia and hypertriglyceridemia.Öğe The effect of venlafaxine HCl on painful peripheral diabetic neuropathy in patients with type 2 diabetes mellitus(Elsevier Science Inc, 2008) Kadiroglu, Ali Kemal; Sit, Dede; Kayabasi, Hasan; Tuzcu, Alpaslan Kemal; Tasdemir, Nebahat; Yilmaz, M. EminObjective: The objective of this study was to evaluate the efficacy of venlafaxine HCl in the symptomatic treatment of painful peripheral diabetic neuropathy (PPDN) among patients with type 2 diabetes mellitus (DM). Design: This study was designed as a prospective, randomized, and controlled trial. Setting: This study was conducted at the Dicle University Medical Faculty (Diyarbakir, Turkey). Patients: Sixty type 2 DM outpatients (47 females and 13 males) with PPDN who had a minimum visual analog scale (VAS) score of 40 mm were enrolled in this study. Interventions: Patients randomized to the treatment group (n=30) received venlafaxine HCl, whereas those randomized to the control group (n=30) received a combination of vitamins B-1 and B-6 tablets. Measures: Severity of pain was measured by VAS, Short-Form McGill Pain Questionnaire, and numerical analog scale scores at admission and at the second, fourth, and eighth weeks of the study. Polyneuropathy was supported by electromyelography. Outcome: In the treatment group, severity of pain was measured as 70.0+/-13.0 in the VAS, as 24.9+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.2+/-1.1 in the numerical analog scale. In the control group, it was measured as 73.0+/-8.0 in the VAS, as 26.8+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.4+/-0.8 in the numerical analog scale (P>.05). Results: The most common form of PPDN was distal symmetrical sensorimotor polyneuropathy in both groups (46.8% vs. 50.0%). At the end of the study, there was a significant difference in severity of pain between the groups. In the treatment group, scores were 8.5+/-5.2 and 3.1+/-1.6 in the Short-Form McGill Pain Questionnaire and numerical analog scale, respectively; in the control group, these were 20.5+/-7.0 and 5.5+/-1.6, respectively (P<.001). Conclusions: Venlafaxine HCl is a safe and well-tolerable analgesic drug in the symptomatic treatment of PPDN; however, it has minimal adverse effects. It showed its efficacy markedly in the second week of therapy. (C) 2008 Elsevier Inc. All rights reserved.Öğe Effects of oral fat and glucose tolerance test on serum lipid profile, apolipoprotein, and CRP concentration, and insulin resistance in patients with polycystic ovary syndrome(2007) Bahçeci, Mithat; Aydemir, Mehmet; Tuzcu, Alpaslan Kemal; 0000-0002-1814-9773Objective: To evaluate serum lipid responses and insulin resistance to a high-fat content meal in patients with polycystic ovary syndrome (PCOS). Design: Controlled clinical study. Setting: Healthy volunteers and patients with PCOS in clincial research. Patient(s): Twenty women with PCOS (22.7 ± 4 years, body mass index [BMI]: 23.5 ± 2.6 kg/m2) and 20 age- and BMI-matched control women (22.8 ± 4, BMI: 23.1 ± 3.1 kg/m2) were included in the study. Waist circumference, BMI, fat mass, fat percent, and fat-free mass were measured. Intervention(s): A standard oral glucose tolerance test (75 g of glucose, 2 hours) was performed, and the area under the curve-glucose (AUCglu) and homeostasis model assessment of insulin resistance (HOMA-IR) were used for insulin resistance. An oral fat tolerance test (OFTT) with 500 mL standard fat meal (1493 kcal) was performed. With OFTT, both timely (at 0, second, fourth, sixth, and eighth hours) and AUCtriglyceride, AUCtotal-cholesterol, AUCVLDL-cholesterol, AUCHDL-cholesterol, AUCLDL-cholesterol, AUCinsulin, AUCglucose, AUChs-CRP, AUCLP(a), AUCApoA1, and AUCApoB responses were evaluated. Main Outcome Measure(s): Plasma lipid, insulin, and C-reactive protein levels. Result(s): Waist circumference, fat percent, and HOMA-IR values of PCOS patients were higher than those of control subjects. AUCglu values were also higher in patients with PCOS. After OFTT, AUCtriglyceride, AUCtotal cholesterol, and AUCVLDL values were higher in patients with PCOS. Conclusion(s): Patients with PCOS have insulin resistance and prolonged lipid response to OFTT. These exaggerated responses may cause early atherogenesis in these patients.Öğe Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis(Mattioli 1885, 2018) Kilinc, Faruk; Ergun, Yakup; Pekkolay, Zafer; Tuzcu, Sadiye Altun; Gozel, Nevzat; Tuna, Mazhar Muslum; Tuzcu, Alpaslan KemalSubacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. The neutrophil-lymphocyte ratio (NLR), determined from peripheral blood, is accepted as an available and practical indicator of the systemic inflammation. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with SAT and to compare these values with those from healthy subjects. A total of 150 participants were included in the study, 75 SAT patients and 75 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institution's database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases and hematologic disorders were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of SAT patients were the baseline values obtained at the time of SAT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. A total of 75 subacute thyroiditis patients 54 (72%) were female and 21 (28%) were males and 50 (66.6%) were female and 25 (33.3%) were male and 75 were healthy adults were included. The mean age was 39.95 +/- 14.2, years for patients with SAT and 37.53 +/- 13.45 years for the control group. There was no significant difference between the age for groups (P = 0.13). NLR levels were found to be 3,56 +/- 2,64 in patients with SAT; NLR levels were found to be 1.41 +/- 0.9 in the control group. NLR levels were significantly higher in patients with SAT compared to the control group. Our study showed that increased NLR may be useful as an indicator of the presence of SAT, especially in complicated cases. The assessment of neutrophil-lymphocyte ratio in conjunction with radiological and clinical findings will assist in the achievement of an accurate diagnosis. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in SAT patients.
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