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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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    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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    Lingual Thyroid, A Rare Embryological Aberration of Thyroid Gland and Primary Hypothyroidism
    (Galenos Yayincilik, 2007) Bahceci, Selen; Tuzcu, Alpaslan; Kemec, Zeki; Tuzcu, Sadiye
    Lingual thyroid is an abnormal formation appearing as the result of a deficient descent during embryological development of the thyroid gland through the thyroglossal duct to its normal pretracheal location, and it is a rare embryological aberration. A 32yr old woman was admitted to endocrinology clinic for hypothyroidism with foreign-body-feeling, swallowing difficulties, dyspnea, hoarseness, constipation, cold intolerance, dry skin, fatigue and lethargy. Oropharyngeal examination showed a spherical, fixed, red fleshy and hard basilingual tumor. The thyroid gland was nonpalpable and patient was diagnosed as primary hypothyroidism. Neck ultrasound showed a heterogeneous, smooth contoured, hypoechoic solid nodular mass on the base of the tongue. Computerized tomography also confirmed this finding. Thyroid scan with technetium 99m revealed isotope uptake in the base of tongue area and no uptake in the normal thyroid location. With these findings lingual thyroid was diagnosed, and the lingual thyroid mass was resected. Biopsy revealed thyroid tissue with noduler colloidal goiter containing hyperplastic nodule. Levothyroxine treatment was started and there was no complication in the postoperative period. We present here a case of lingual thyroid and hypothyroidism in a 32 year old female patient