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    A rare presentation of subclinical Cushing’s syndrome as a pubic fracture
    (Japanese Society of Internal Medicine, 2014) Arduç, Ayşe; Ayçiçek Doğan, Berçem; Akbaba, Gülhan; Dağdelen, İffet; Küçükler, Ferit Kerim; Işık, Serhat; Özu?uz, Ufuk; Berker, Dilek; Güler, Serdar
    Osteoporosis and bone fractures are commonly seen in patients with Cushing’s syndrome (CS). Fractures usually occur in the vertebrae and ribs whereas pubic fractures are less common. Similar to obvious hypercortisolemia, subclinical hypercortisolemia can increase the risk of fractures. However, in subclinical cases, bone fractures are very rarely seen as the presenting symptom. We herein report the case of a 62-year-old postmenopausal woman who was presented with a pubic fracture. During the evaluation of the fracture, thoracoabdominal magnetic resonance imaging of the patient demonstrated an adrenal mass. Although the patient did not show any signs of overt hypercortisolism, an endocrinologic evaluation revealed hypercortiso-lism due to an adrenal tumor. Adrenalectomy was performed, which resulted in a cure of the disease. During the orthopedic follow-up, the patient’s pubic area pain gradually improved, and the pubic fracture healed without any accompanying new bone fractures. One year after the surgery, a remarkable improvement was detected in the patient’s bone density in spite of the lack of administration of any medications for osteoporosis. Subclinical CS can present as a pubic fracture, and awareness of this relationship can help physicians to diagnose the disease. © 2014 The Japanese Society of Internal Medicine.
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    Acute monocytic leukemia with pituitary involvement: a case report
    (Galenos Yayıncılık, 2015) Tuna, Mazhar Müslüm; Afacan Öztürk, Berna; Nasıroğlu İmga, Narin; Ayçiçek Doğan, Berçem; Işık, Serhat; Dağtaş, Simten; Özet, Gülsüm; Berker, Dilek; Güler, Serdar
    Central nervous system involvement is rare in acute myeloid leukemia (AML) cases. Pituitary involvement seems much more rarely with unknown frequency. A 29-year-old male patient was admitted to our clinic with the complaints of visual disturbance and poor performance status. His medical history revealed AML- M5 diagnosed fve years ago and allogeneic hematopoietic stem cell transplantation performed in 2010. During follow-up in remission, his complaints had begun. In our clinic, the patient was diagnosed with AML M5 relapse associated with panhypopituitarism and central diabetes insipidus. Chemoradiotherapy was initiated immediately and hormone replacement therapy started due to hypopituitarism. His complaints partially resolved. He is still being followed up with intermittent intrathecal and systemic chemotherapy. Although rare, leukemic infltration of the pituitary gland should be evaluated in leukemic patients with visual disturbance, hypopituitarism or central diabetes insipidus. © 2015 Galenos Yayincilik, All rights reserved.
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    Adrenal schwannoma: a very rare cause of adrenal incidentaloma
    (Galenos Yayıncılık, 2015) Ünal, Mustafa; Işık, Serhat; Berker, Dilek; Arduç, Ayşe; Güreşçi, Servet; Güler, Serdar
    Adrenal schwannomas are very rare tumors. They originate from the myelin sheath of the nerves in the adrenal medulla. While adrenal schwannomas can rarely cause some clinical symptoms, such as abdominal pain and back pain, most of them present as a nonsecretory adrenal mass in an asymptomatic patient. We here in report a 41-year-old male who was referred to our endocrinology outpatient clinic due to an adrenal mass detected on abdominal ultrasound during evaluation of abdominal pain. Triphasic computed tomography of the abdomen demonstrated a 29x26 mm right adrenal mass with a density of 24 HU which did not show washout. Hormonal work-up revealed that adrenal tumor was nonsecretory. Since the radiological characteristics of the lesion were suspicious for a malignant tumor, the patient underwent right adrenalectomy, and the pathological examination demonstrated adrenal schwannoma. © 2015 Galenos Yayincilik. All rights reserved.
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    Are there any causes for increased thyroid volume in women with prolactinoma?
    (Elsevier Masson SAS, 2015) Ayçiçek Doğan, Berçem; Taşçı, Tuğba; Arduç, Ayşe; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, Serdar
    Purpose: The aim of this study was to evaluate thyroid volume in women with prolactinoma and investigate the relationship between anabolic hormones [insulin, insulin like growth factor (IGF-1), estrogen] and thyroid volume in the patients. Material-method: Sixty-three euthyroid women with prolactinoma and 60 healthy euthyroid women were included. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), thyroxine (free T4), free tri-iodothyronine (free T3), insulin resistance (IR) which was estimated by the homeostasis model assessment, thyroidal microsome (anti-TPO), antithyroglobulin antibodies (TgAb), estradiol (E2), and insulin like growth factor (IGF-1) were evaluated, and thyroid volume was calculated by B-mode doppler USG. Results: The mean thyroid volume was significantly higher in women with prolactinoma (82.5 ± 15.1 mL) than in healthy women (76 ± 15.1 mL)(P = 0.014), but no correlation was found between thyroid volume and serum PRL levels (P = 0.967). There were also no differences between thyroid volume, anabolic hormones (E2, IGF-1), and insulin resistance in women with prolactinoma (P = 0.776, P = 0.786, P = 0.647, respectively). Conclusions: Our study did not show an association between anabolic hormones and increased thyroid volume in women with prolactinoma. © 2015 Elsevier Masson SAS.
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    Assessing the relationship between serum ghrelin levels and metabolic parameters and autoimmunity in patients with euthyroid Hashimoto's thyroiditis
    (American Association of Clinical Endocrinologists, 2014) Bıyıklı, Halil Hüseyin; Arduç, Ayşe; Işık, Serhat; Özu?uz, Ufuk; Caner, Sedat Sevkan; Doğru, Fatma; Shorbagi, Ali İbrahim; Erden, Gönül; Berker, Dilek; Güler, Serdar
    Objective: Hashimoto's thyroiditis (HT) may affect metabolic parameters and increase predisposition to obesity. In this study, we aimed to assess the relationships among serum ghrelin concentrations, metabolic parameters, and thyroid autoimmunity in euthyroid HT patients.Methods: The study included 48 euthyroid HT patients and 41 age- and sex-matched healthy controls. We assessed serum ghrelin, free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO), thyroglobulin antibody (anti-Tg), fasting blood glucose (FBG), insulin, lipid levels, and homeostasis model assessment insulin resistance (HOMA-IR) in all subjects.Results: Sex distribution, mean age, and body mass index (BMI) were similar in HT patients and controls (female/male, 42/6 vs. 33/8, 46.8 ± 14.7 vs. 45 ± 12.5 years, 28.5 ± 6.1 vs. 28.4 ± 4.9 kg/m2, respectively; P>.05 for all). The mean waist circumference (WC) of the HT group was significantly higher than that of the control group (100.6 ± 14.6 vs. 93.2 ± 13.2 cm, P = .015). While FBG, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels in the HT group were significantly higher than in the control group, insulin levels and HOMA-IR were similar. Ghrelin levels were lower in HT patients compared to controls (416.9 ± 224.4 and 689.9 ± 191.6 pg/mL, respectively; P<.001). Ghrelin levels were similar in patients with low and high anti-TPO titers. Negative correlations were observed between ghrelin levels and BMI, WC, and anti-TPO levels. Regression analysis revealed that HT was the most important predictor of ghrelin levels.Conclusion: Euthyroid HT is associated with a decrease in plasma ghrelin levels. Altered body fat distribution and increased anti-TPO levels do not seem to be directly involved in lower ghrelin levels in euthyroid HT patients.
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    Autoimmune fibrotic adverse reactions in one-year treatment with cabergoline for women with prolactinoma
    (Bentham Science Publishers B.V., 2016) Ayçiçek Doğan, Berçem; Arduç, Ayşe; Tuna, Mazhar Müslüm; Berker, Dilek; Demirci, Nilgün; Demirtaş, Semra; Çiçekcioğlu, Hülya; Güler, Serdar
    Aim: Cabergoline is related to an elevated risk of fibrotic adverse reactions including cardiac valvular and pleuropulmonary fibrosis. We investigated pulmonary and cardiac valve fibrosis and immunological markers before and after 3 and 12 months of treatment with cabergoline in women with prolactinoma. Material-Methods: The study included thirty-two women with newly diagnosed prolactinoma and 28 healthy women. CAB cumulative dose was 7.8±5.5 mg after 3-month therapy, and 31±22 mg after 12-month follow-up. The risk of autoimmune adverse fibrotic reactions related to CAB treatment including cardiac valvulopathy and pulmonary fibrosis were assessed by a transthoracic echocardiography and pulmonary function tests, respectively. Immunological markers including Antistreptolysin O, Rheumatoid factor, Immunglobuline E, Antinuchlear antibody were also evaluated. Results: Before the start of CAB therapy, the total prevalence of trace grade of mitral, aortic, pulmonic, and tricuspid valve regurgitations were found as 34%, 3%, 6.3%, and 39 % respectively in women with prolactinoma. After improving of prolactin levels with CAB treatment, no change was found in the prevalence of the all valve regurgitations. There was no deterioration in pulmonary function tests. Rheumatoid factor was found higher in newly diagnosed women with prolactinoma than in healthy women (p=0.01), and this was improved by CAB therapy (p=0.005). Conclusion: The prospective study indicated that sufficient cabergoline doses for a period of one year treatment of prolactinoma were not found to be related to fibrotic adverse reactions including cardiac valvular and pulmonary fibrosis or increased levels of immunological marker, apart from rheumatoid factor. For the first time Rf was found higher in newly diagnosed women with prolactinoma and was improved after cabergoline therapy. © 2016 Bentham Science Publishers.
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    Changes in the before and after thyroxine treatment levels of adipose tissue, leptin, and resistin in subclinical hypothyroid patients
    (Springer-Verlag Wien, 2016) Akbaba, Gülhan; Berker, Dilek; Işık, Serhat; Tuna, Mazhar Müslüm; Koparal, Suha; Vural, Murat; Yılmaz, Fatma Meriç; Topçuoğlu, Canan; Güler, Serdar
    Background: Subclinical hypothyroidism (SH) occurs when serum thyroid stimulating hormone (TSH) concentrations are raised and serum thyroid hormone concentrations are normal. The effect of SH on the proinflammatory adipose cytokine releasing visceral adipose tissue (VAT) is not clear. The aim of this study is to identify the difference between the pre and posttreatment levels of VAT, leptin, and resistin in SH patients. Methods: There were 51 SH patients and 43 age- and gender-matched healthy subjects included in the study. Thyroid functions, biochemical tests, leptin, resistin, and visceral and subcutaneous fat measurements were made. The measurements were repeated in the SH group in the third month following L-thyroxin treatment. Results: Initially, high sensitivity C-reactive protein, carotid artery intima-media thickness (mm), leptin, and resistin levels were significantly higher in the SH group compared to the controls, while the other parameters were similar. While no correlation was observed between TSH levels and adipokines, a positive correlation was detected between waist circumference and leptin levels (r = 0.549, p < 0.01). Visceral adipose tissue was positively correlated to age, waist circumference, and leptin levels, but negatively correlated to free thyroxin (T4) levels (r = 0.419, p = 0.009; r = 0.794, p < 0.01; r = 0.515, p < 0.01 and r = - 0.416, p = 0.009, respectively). A significant decrease was observed in VAT volume, leptin, and resistin levels of SH patients following levothyroxine treatment. Conclusion The reduced VAT volume, leptin, and resistin levels in SH patients following treatment may support the idea that TSH affects adipose tissue functions. © 2015, Springer-Verlag Wien.
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    Changes in the Charactersitics of Paratracheal Lymph Nodes in Patients with Chronic Autoimmune Thyroiditis for Five Years Follow-up
    (Oxford Univ Press Inc, 2014) Akbaba, Gülhan; Berker, Dilek; Işık, Serhat; Nasiroğlu İmga, Narin; Küçükler, Kerim; Tütüncü, Yasemin; Güler, Serdar
    [Abstract Not Available]
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    Characterization of V804M-mutated RET proto-oncogene associated with familial medullary thyroid cancer, report of the largest Turkish family
    (Springer International Publishing, 2015) Navdar Başaran, Mehtap; Tuna, Mazhar Müslüm; Karakılıç, Ersen; Ayçiçek Doğan, Berçem; İmga Nasıroğlu, Narin; Berker, Dilek; Güler, Serdar
    Purpose: Analysis of the RET proto-oncogen is very important for diagnosis and prognosis of medullary thyroid cancer (MTC). Genotype-phenotype correlation is also well known. Here we report features of the largest known family in Turkey with the V804M-mutated RET proto-oncogene. Methods: Thirty members from three generations were evaluated. A RET proto-oncogen mutation, calcitonin (Ct) measurement and thyroid ultrasound were performed on all individuals. Seventeen members had V804M mutation. Fourteen of these patients underwent total thyroidectomy and additional central lymph node dissection for five subjects. Results: The mean age of patients with MTC was 46.5 (30-61) years. The mean calcitonin level of RET positive members was 13.27 pg/mL (1-49.8 pg/mL). Three had a basal Ct level above normal limits. Seven of the 14 patients were diagnosed with MTC, and two were diagnosed with papillary thyroid cancer without MTC. One patient had central neck metastasis. Hyperparathyroidism or pheochromocytoma was not detected in any case. Patients who were RET negative, had normal Ct levels and no suspected nodule on ultrasound examination. Conclusions: Our study revealed a relatively good prognosis in patients with V804M mutation. Despite the surgery was performed in older age no advance disease was observed. © 2014 Italian Society of Endocrinology (SIE).
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    Ciddi kalp yetmezliği ve vertebra kırıkları ile tanı alan cushing sendromu olgusu
    (Galenos, 2015) Arduç, Ayşe; Işık, Serhat; Akbaba, Gülhan; Küçükler, Ferit Kerim; Berker, Dilek; Güler, Serdar
    Cushing sendromunda (CS) kardiyovasküler hastalıklar ve osteoporoz nedeni ile mortalite ve morbidite artmaktadır. Klinik bulgular ve mortalite hiperkortizoleminin şiddeti ve süresi ile ilişkilidir. Biz CS tanısının gecikmesinden kaynaklanan ciddi komplikasyonlarla başvuran bir olguyu sunduk. Elli iki yaşındaki erkek hasta bacaklarda şişlik, nefes darlığı ve bel ağrısı şikayetleri ile başvurdu. Özgeçmisinde 2 yıldır çoklu antihipertansif tedavi ve yoğun insülin tedavisine rağmen kontrol altına alınamayan hipertansiyon ve diyabet ile 6 aydır kalp yetmezliği mevcuttu. Fizik muayenede pletore, bufalo hörgücü, abdominal obezite, karında mor strialar, pretibial ödem saptandı. Laboratuvar incelemesinde adrenokortikotropik hormon (ACTH) <5 pg/ml, sabah plazma kortizolü 26,33 ?g/dl, gece plazma kortizolü 26,38 ?g/dl, idrar kortizolü 272 ?g/24 saat saptandı. Klasik 2 mg ve 8 mg deksametazon supresyon testlerinde plazma kortizolünde baskılanma yoktu (sırası ile 30,7 ?g/dl ve 35,54 ?g/dl). Ekokardiyografide ejeksiyon fraksiyonu düşük (%40) ölçüldü, direkt grafide vertebralarda kompresyon fraktürleri mevcuttu. Adrenal CT’de sol sürrenalde 4x4 cm boyutlarında adenom ile uyumlu lezyon mevcuttu. Adrenal kaynaklı CS tanısı ile sol surrenalektomi yapıldı ve patolojik incelemede adrenokortikal adenom saptandı. Operasyon sonrası hastanın diyabet, hipertansiyon ve osteoporozunda kısmi düzelme oldu. Vertebra fraktürlerine yönelik operasyon planlandı. Diyabet ve hipertansiyon gibi hastalıkların daha şiddetli seyretmesi ve tedaviye dirençli olmaları durumunda klinisyenin CS varlığı açısından uyanık olması gerekmektedir. Tanının gecikmesi mortalite ile sonuçlanabilecek ağır komplikasyonlara yol açabilir.
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    Comparison of alendronate and raloxifene for the management of primary hyperparathyroidism
    (2013) Akbaba, Gülhan; Işık, Serhat; Ateş Tütüncü, Yasemin; Özu?uz, Ufuk; Berker, Dilek; Güler, Serdar
    Aim: To evaluate and compare the efficacy of alendronate sodium (ALN) and raloxifene (RLX) for the management of primary hyperparathyroidism (PHPT) in postmenopausal female patients (pts) with osteoporosis. Methods: Twenty-four postmenopausal women with osteoporosis who were diagnosed with PHPT, but refused the option of surgery, were enrolled. Participants were sequentially randomized into two groups: an ALN-group of 12 pts (70 mg/week) and a RLX-group of 12 pts (60 mg/day). The control group consisted of 10 pts with PHPT who did not have any indications for surgery. Results: The decrease in ionized calcium levels was significantly more pronounced in the ALN group compared to the RLX and control groups (p<0.001). In terms of difference from baseline in bone mineral density (BMD) of the lumbar area in percentages over a period of 12 months, pts in the ALN and RLX groups both showed statistically significant improvements compared to pts in the control group (control vs ALN, p<0.001; control vs RLX, p<0.001). BMD measurements of the femoral and radial areas were comparable in all three groups. Conclusions: ALN and RLX may improve bone density in the lumbar area of osteoporotic post-menopausal women with PHPT. The more significant decrease in serum calcium levels which was observed in the ALN group compared to both RLX and control groups, suggests that ALN could be used for the short-term control of calcium levels in patients awaiting surgery. ©2013, Editrice Kurtis.
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    Cushing Sendromu İle Ortaya Çıkan Metastatik Dev Adrenokortikal Karsinom Olgusu
    (2018) Arduç, Ayşe; Gökay, Ferhat; Akbaba, Gülhan; Berker, Dilek; Güler, Serdar
    Adrenokortikal karsinom nadir görülen kötü prognozlu bir tümördür. En sık klinik prezentasyonu Cushing Sendromu’dur ama bunun tersine Cushing sendromunun nadir sebeplerindendir. Biz bu makalede nadir görülmesi nedeniyle kortizol salgılayan metastatik dev adrenokortikal karsinom tanıları olan bir vakayı sunduk. Kilo alımı, kıllanma artışı, adet düzensizliği ile başvuran 46 yaşındaki kadın hasta 15 yıl önce malign melanom tanısı almış, cerrahi ve kemoterapi sonrası kür kabul edilmişti. Hastada abdominal obezite, hirsutismus ve akneiform döküntüler mevcuttu. Gece serum kortizolü, 24 saatlik idrar kortizolü artmış, adrenokortikotropik hormon baskılı idi. Deksametazon 2mg ve 8mg supresyon testlerinde baskılanma olmadı. Adrenal Cushing sendromu tanısı ile çekilen surrenal magnetik rezonans görüntüleme sağ sürrenalde 7x8x9cm kitle saptandı. Sürrenalektomi patolojik incelemesinde adrenokortikal karsinom saptandı. Sisplatin, etoposid, mitotan kemoterapisi verilen hasta 36 ay sonra yaygın metastazlar nedeni ile öldü.
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    Diabetes insipidus and anterior pituitary insufficiency due to breast cancer metastasis
    (Türkiye Klinikleri, 2016) Arduç, Ayşe; Alımlı, Ayşe Gül; Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, Serdar
    Metastases from breast cancer to the pituitary gland are uncommon. We present a 35-year-old woman with diabetes insipidus and anterior pituitary insufficiency resulting from breast cancer metastases to the pituitary gland. The patient presented with reduced consciousness, fatigue, polyuria, and polydipsia. Hypernatremia (sodium: 154 mmol/L), hypostenuria (urine density: 1001), and hypopituitarism were present on laboratory evaluation. Magnetic resonance imaging (MRI) revealed heterogeneous pituitary gland, thickened pituitary stalk (8mm), and loss of normal hyperintense signal of the posterior pituitary. Based on the clinical, laboratory, and MRI findings, the patient was diagnosed with diabetes insipidus and anterior pituitary insufficiency due to pituitary metastases from breast cancer. She received desmopressin, L-thyroxine, and prednisolone, which resulted in improvement of her symptoms and laboratory results. The patient, who also received Gamma Knife radiosurgery and chemotherapy, died six months later due to disseminated metastases. Although pituitary metastasis is rare, it should be kept in mind in patients with breast cancer since early detection and treatment can improve symptoms of patients. © 2016, Galenos Yayincilik. All rights reserved.
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    Does acquired hypothyroidism affect the hearing functions?
    (Galenos Yayıncılık, 2015) Arduç, Ayşe; Işık, Serhat; Alluşoğlu, Serpil; İriz, Ayşe; Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Göçer, Celil; Berker, Dilek; Güler, Serdar
    Purpose: It is well known that congenital hypothyroidism can cause hearing loss. However, conflicting results were found in studies investigating hearing functions in acquired hypothyroidism. Therefore, we evaluated the audiometric findings in patients with acquired hypothyroidism. Material and Method: The study included 58 patients with hypothyroidism and age- and gender-matched 34 healthy controls. Twenty eight (48.27%) patients had subclinical hypothyroidism, and 30 (51.73%) had obvious hypothyroidism. All subjects had a normal otoscopic examination and tympanometry. Pure tone audiometry at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz) was performed in both groups. Blood pressure measurements and the levels of plasma electrolytes, lipids and vitamin B12 were available in all subjects. Results: Hypothyroidism group and control group were similar with respect to systolic and diastolic blood pressures and plasma glucose, lipid, vitamin B12, calcium, sodium, potassium, and chloride levels. Significantly higher audiometric thresholds (dB) at 250 (10 (0-45) vs. 5 (0-15), p<0.001) and 500 Hz (10 (0-40) vs. 10 (-5-15), p=0.003) were recorded in hypothyroid patients compared to that in healthy controls. Hearing thresholds at 250 and 500 Hz correlated positively with thyroid-stimulating hormone (TSH), and negatively with free triiodothyronine and free thyroxine. Subclinical hypothyroid patients had a higher hearing threshold at 250 Hz than healthy controls (p=0.001). Discussion: Our study demonstrated that hearing ability decreases in hypothyroidism, even in subclinical hypothyroidism. The changes in TSH and thyroid hormone levels seem to be directly related to the hearing loss in this population of patients. © 2015, Galenos Yayincilik. All rights reserved.
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    Effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with idiopathic hypogonadotropic hypogonadism
    (Blackwell Publishing Ltd, 2015) Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Tuna, Mazhar Müslüm; Arduç, Ayşe; Berker, Dilek; Güler, Serdar
    Objective: Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with this disorder. Design and methods: Forty-three male patients aged 30 (range: 24-39 years) who were newly diagnosed with idiopathic hypogonadotropic hypogonadism and 20 age-, sex- and weight-matched controls (range: 26-39 years) were included in the study. Androgen replacement therapy was given according to the Algorithm of Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes (2010; Journal of Clinical Endocrinology and Metabolism, 95, 2536). The patients were assessed at a pretreatment visit and 3 and 6 months after the treatment. Inflammatory markers and lipid parameters were evaluated. Endothelial function was assessed with brachial flow-mediated dilation of a brachial artery and high-resolution ultrasonography of the carotid intima-media thickness. Results: The carotid intima-media thickness (P < 0·001) was higher and the brachial flow-mediated diameter (P = 0·002) was lower in patients with idiopathic hypogonadotropic hypogonadism compared to the control subjects at the pretreatment visit. There was a negative correlation between the total testosterone level and carotid intima-media thickness (r = -0·556, P = <0·001). The carotid intima-media thickness and per cent flow-mediated diameter were significantly improved in the patient group 6 months after the androgen replacement therapy (P = 0·002 and 0·026, respectively). Conclusions: This study indicated that low total testosterone levels can be considered a significant marker of atherosclerosis in patients with idiopathic hypogonadotropic hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months. © 2014 John Wiley & Sons Ltd.
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    Epicardial Fat Thickness and Left Ventricular Mass in Subjects with Adrenal Incidentaloma
    (Endocrine Soc, 2014) Nasıroğlu İmga, Narin; Uçar Elalmış, Özgül; Tuna, Mazhar Müslüm; Ayçiçek Doğan, Berçem; Şahin, Deniz; Berker, Dilek; Güler, Serdar
    [Abstract Not Available]
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    Evaluation of adipocytokine levels and vascular functions in young aged to middle aged men with idiopathic hypogonadotrophic hypogonadism
    (Maghira and Maas Publications, 2014) Tuna, Mazhar Müslüm; Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Arduç, Ayşe; Işık, Serhat; Yılmaz, Fatma Meriç; Topçuoğlu, Canan; Berker, Dilek; Güler, Serdar
    OBJECTIVE: Hypogonadism has major effects on the urogenital system, in addition to other systems, the cardiovascular system in particular. There have been few studies conducted on markers of atherosclerosis, such as flow mediated dilatation (% FMD), carotid intima-media thickness (CIMT) and adipocytokine levels in idiopatic hypogonadotropic hypogonadal (IHH) males mostly in adult patients. The aim of this study was to evaluate the relationship between androgens and adipocytokines and parameters of vascular functions in hypogonadal men. j MATERIALS AND METHODS: The study population consisted of 11 treatment naive IHH patients (group 1) and 15 age-matched healthy control males (group 2). A fasting blood sample was obtained for leptin, adiponectin and resistin. The endothelial functions were evaluated by studying % FMD and CIMT by high resolution B-mode ultrasound. RESULTS: No significant differences in age, body mass index, systolic and diastolic blood pressure were recorded between the two groups. The leptin level was significantly higher in group 1, whereas adiponectin and resistin levels were same between two groups. There was a negative correlation between total testosterone and carotid intima-media thickness (r=-0.656, p=0.008), and a negative correlation between total testosterone and leptin level (r=-0.794, p<0.001). No correlation was found between leptin and CIMT (p=0.184). CONCLUSION: Testosterone deficiency in hypogonadal men is associated with vascular parameters of atherosclerosis. The findings may establish indications for testosterone replacement therapy in hypogonadal men. © 2014 Neuroendocrinology Letters.
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    Evaluation of Atherosclerosis after Cessation of Cabergoline Therapy in Patients with Prolactinoma: Preliminary Results of a Prospective Cohort Study
    (Endocrine Soc, 2014) Ayçiçek Doğan, Berçem; Arduç, Ayşe; Tuna, Mazhar Müslüm; Nasıroğlu İmga, Narin; Işık, Serhat; Berker, Dilek; Güler, Serdar
    [Abstract Not Available]
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    Evaluation of hearing functions in patients with euthyroid Hashimoto’s thyroiditis
    (Humana Press Inc., 2015) Arduç, Ayşe; Işık, Serhat; Alluşoğlu, Serpil; İriz, Ayşe; Ayçiçek Doğan, Berçem; Göçer, Celil; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, Serdar
    Sensorineural hearing loss has been reported in various autoimmune diseases. The relationship between Hashimoto’s thyroiditis (HT) and the auditory system has not been previously evaluated. In this study, we investigated the effect of euthyroid HT on the hearing ability of adult patients. The study included 30 patients with newly diagnosed euthyroid HT and 30 age- and gender-matched healthy controls. All subjects had a normal otoscopic examination and tympanometry, and they were negative for rheumatoid factor, antinuclear, anti-smooth muscle, antimitochondrial, antineutrophilcytoplasmic, and antigliadin antibodies. Pure tone audiometry exams at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz) were performed in both groups. Thyroid peroxidase antibody and thyroglobulin antibody (anti-Tg) levels were higher in HT group while TSH, free T4, free T3, plasma electrolytes, glucose, lipid profile, vitamin B12, and blood pressure measurements were similar between the two groups. Higher audiometric thresholds and a higher prevalence of hearing loss at 250, 500, and 6000 Hz were detected in the HT patients than in the healthy controls (P < 0.05). Hearing levels at 250 and 500 Hz correlated positively with anti-Tg levels (? = 0.650, P = 0.002; ? = 0.719, P < 0.001, respectively), and this association remained significant in linear regression analysis. Anti-Tg-positive HT patients had higher hearing thresholds at 250 and 500 Hz than anti-Tg-negative HT patients. Hearing thresholds were similar between anti-Tg-negative HT patients and the control subjects. This study demonstrated that hearing functions are impaired in HT patients. Thyroid autoimmunity seems to have an important impact on a decreased hearing ability, particularly at lower frequencies, in this population of patients.
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    Feokromositomanın nadir bir sebebi; nörofibromatozis tip 1-noonan sendromu
    (Galenos, 2014) Tuna, Mazhar Müslüm; Navdar Başaran, Mehtap; Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Çavdarlı, Büşranur; Tütüncü, Yasemin; Berker, Dilek; Güler, Serdar
    Nörofibromatozis Tip 1 (NF-1); otozomal dominant geçişli ve yaklaşık 1/3000 sıklığında görülen bir hastalıktır. Hastalık cafe au lait lekeleri, nörofibromlar, optik gliom, lisch nodülleri ve diğer sistem tutulumları ile giden nörokutan bir sendromdur. Noonan sendromu dismorfik yüz bulguları, konjenital kalp hastalığı, boy kısalığı, boyun anomalileri ve göğüs deformiteleri ile karakterize heterojen bir sendromdur. NF-Noonan sendromu ise her iki klinik tablonun bir arada bulunduğu oldukça nadir görülen bir durumdur. Feokromositoma eşlik etmesi nadir görülmekle birlikte tedavi edilmediğinde mortal seyretmektedir. Sağ üst kadranda kitle nedeni ile başvuran ve feokromositoma ve NF 1-Noonan sendromu birlikteliği tanısı alan hastayı sunduk.