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Aim There are many preanalytical variables affecting routine coagulation tests. Increased hematocrit (Htc) levels are one of these variables. However, no study has been conducted to determine the effect of low Htc values on coagulation tests. Therefore, in this study, we aimed to evaluate whether low Htc values affect coagulation tests besides high Htc values. Methods Standard human plasma was injected into coagulation tubes containing 3.2% sodium citrate to reflect hematocrit rates of 5% to 75% and prothrombin time (PT), active partial thromboplastin time (aPTT), thrombin time (TT) and fibrinogen measurements were performed. Results Three groups were formed according to Htc levels: A (5-25%), B (30-50%) and C (55-75%). PT (s) were found 13.7±0.30 in group A, 14.88±0.57 s in group B, 20.16 ±4.66 s in group C respectively. aPTT (s) results were 35.79±1.39 s in group A, 42.48 ± 3.51 s in group B and 76.47 ± 31.55 in group C. TT (s) results were found to be 26.42 ± 0.77 s (group A), 28.24±1.17 s (group B) and 32.02±2.60 (group C). Fibrinogen levels (g/L) were measured as 2.30 ± 0,05, 2.21 ± 0,07 and 1.90 ± 0.20 in groups A, B, C, respectively. For all measured parameters, group A reflecting low Htc was significantly (P < 0 ,0001) different from the other groups. Conclusion Previous studies have reported that high Htc (> 55%) levels affected routine coagulation tests. In our study, low Htc (5-25%) values were also shown to cause errors in the test results.

Objective Iodine deficiency (ID) continues to be a problem around the world. This study investigated the prevalence of ID and goiter among school-age children in the city center of Antalya, Turkey. The aim was to investigate the effect of an iodization program, which had been running for sixteen years, on nutritional iodine status in this population. Methods A total of 1,594 school children, aged 6-14 years, were included in this cross-sectional study. ID was evaluated based on median [interquartile range (IQR)] urine iodine/creatine (UI/Cr) (μg/g) ratio and median (IQR) UI concentrations (UIC) (μg/L). UICs were measured using the Sandell-Kolthoff method. Goiter was determined by palpation and staged according to World Health Organization classification. Results Median (IQR) UIC was found to be 174.69 (119.17-242.83) μg/L, and UIC was found to be lower than 50 μg/L in 6.5% of the population. The median UI/Cr ratio increased from 62.3 to 163.3 μg/g and goiter rates had decreased from 34% to 0.3% over the 16 years of the program. However, 19% were still classified as ID (mild, moderate or severe) and, furthermore, 11.5% were classified as excessive iodine intake. Conclusion Comparison of two cross-sectional studies, carried out 16-years apart, showed that Antalya is no longer an ID region. However, surveillance should be continued and the percentage of ID and iodine excess individuals in the population should be monitored to avoid emerging problems.

Amaç: Hipofizer tiroid hormon (TH)direnci düşünülen ve klinik bulguların ayırdettirici olmadığı çocuk olgulardaperiferik direnç eşliğinin değerlendirilmesi ve TH β reseptörü (TRβ) mutasyonsıklığının belirlenmesi amaçlanmıştır. Gereçve Yöntem: Hipofizer TH direnci tanısı ile izlenen ve yeterli dozdalevotiroksin (L-T4) tedavisi almalarına rağmen izlem süreçlerinde tiroidstimülan hormon (TSH) düzeyleri baskılanamayan, 20 olgu (13 kız, ort yaş7.03±2.72 yıl,) çalışmaya alınmıştır. TH periferik etkileri, suprafizyolojikdoz levotriiodotironin (L-T3) uygulaması öncesi ve sonrası serbest T3 (sT3),serbest T4 (sT4), TSH, seks hormon bağlayıcı globulin (SHBG), total kolesterol,alkalen fosfataz (ALP), osteokalsin, anjiotensin konverting enzim (ACE)düzeyleri ve kreatin fosfokinaz (CPK), M-mod ve Doppler ekokardiyografi (EKO)tetkikleri ile değerlendirilmiş ve TRβ gen analizleri yapılmıştır.Bulgular: Olguların L-T3 öncesi vesonrası biyokimyasal ölçütleri karşılaştırıldığında SHBG, osteokalsin, ACEdüzeylerinde anlamlı artış, total kolesterol ve CPK düzeylerinde ise anlamlıölçüde azalma olduğu gözlenmiştir (pA değişimi saptanmıştır. Sonuç:Olgularımızda suprafizyolojik L-T3 konsantrasyonlarına değişik derecelerdeperiferik doku yanıtının gözlenmesi, yüksek T3 düzeylerine yanıtın korunduğunungöstergesidir ve en yüksek yanıtın oluştuğu SHBG ve CPK değişimleri yolgösterici olabilir. TRβ gen analizinde saptanan iki değişimin dirençpatogenezinde rolü olmadığı düşünülmüştür. Yeterli tedavi kriterleritaşımalarına rağmen TSH düzeyleri ısrarlı yüksek seyreden doğumsal hipotiroidolgularda genetik bir anomali eşliğinden çok, hipotalamus-hipofiz-tiroidekseninin intrauterin dönem olgunlaşma sürecindeki fonksiyonel bir hatanınsorumlu olduğu düşünülebilir.Aim:This trial was designed to assess the concomitant peripheral resistance inpediatric cases, who were considered to have pituitary thyroid hormone (TH)resistance and exhibited indistinguishable clinical results and determine theincidence of TH β receptor (TRβ) mutation in the “investigational group”. Matherials and Methods: 20 patients, monitoredwith the diagnosis of pituitary TH resistance, in whom thyroid stimulatinghormone (TSH) level could not be suppressed during monitoring despite anadequate dose of levothyroxine (L-T4) administered, were included in the trial(13 girls, mean age: 7.03±2.72 years). TH peripheral effects were assessedbefore and after liothyronine (L-T3) administration using free T4 (fT4), TSH,sex hormone-binding globulin (SHBG), total cholesterol, alkalen fosfatase(ALP), osteocalcin, anjiotensin coverting enzyme (ACE) levels and creatinephosphokinase (CPK), M-mod and Doppler ECHO investigations and TRβ geneanalyses were performed.Results:The comparison of the pre-L-T3 and post-L-T3 biochemical measurements revealeda significant increase in SHBG, osteocalcin and ACE levels and a significantreduction in total cholesterol and CPK levels (pA changesin 2 and 7 patients, respectively.Conclusion:Achievement of various degrees of peripheral tissue response to supraphysiologicalL-T3 concentrations indicates that the response to high T3 levels is maintainedand the SHBG and CPK changes exhibiting the highest responses may be guiding.The two changes detected in the TRβ gene analysis were considered not to be involvedin the pathogenesis of resistance. In patients with congenital hypothyroidism,who sustain high levels of TSH despite meeting adequate therapeutic criteria,the condition may be attributed to a functional defect in the intrauterinegrowth process of the hypothalamic- pituitary-thyroid axis rather than aconcomitant genetic abnormality.

AIM In this study, we aimed to investigate the soluble endoglin (sEng) levels in pregnant women with fetal growth restriction (FGR) and to examine the possible relation of the sEng levels with the time remaining to delivery and maternal and fetal complications. METHODS A total of 42 pregnant women diagnosed with FGR were retrospectively reviewed. Using the maternal blood samples it is at the collected 24-37 gestational weeks, the sEng levels were measured. Fetal biometry measurements, umbilical artery, uterine artery, middle cerebral artery Doppler indices were documented. RESULTS Of all patients, 17 (40%) were diagnosed with early-onset FGR, while 25 (60%) were diagnosed with late-onset FGR. Abnormal Doppler findings were present in 25 (60%) patients. Of 42 newborns, 18 (42%) were hospitalised in the neonatal unit. The mean sEng level calculated by taking the average of the first and second blood samples was 63.24 ± 49.83 ng/mL. There was no statistically significant difference in the mean sEng levels between those who gave birth within four, three, and two weeks after the diagnosis of FGR and those who did not. There was a positive significant correlation between the mean sEng levels and systolic blood pressure (r = 0.319, P = .04). CONCLUSIONS We did not find a statistically significant relationship between the sEng level and the time remaining to the time of delivery in pregnant women with FGR. We found no statistically significant difference in sEng level between the groups in pregnant women with fetuses with FGR with or without maternal and fetal complications.

This study aims to evaluate the vitamin D receptor (VDR) expression and intracellular amounts of VDRs in CD4+ and CD8+ lymphocytes of renal transplant (RT) recipients with chronic allograft dysfunction (CAD). A total of 43 patients (Group 1:RT patients=29 patients, 15 patients CAD proven by renal biopsy (Group 1a), 14 patients stable renal function (Group 1b), Group 2:Control group=14 healthy individuals) have been enrolled in this study. 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels were measured. The number of cells expressing VDR among the CD4+ and CD8+ type T lymphocytes of the subjects was determined as % of those cell groups. The mean VDR molecule contents per cell have been measured and expressed as mean fluorescence intensities (MFI). No difference was found between Group 1 and Group 2 in terms of their 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels, and the percentages of the cells expressing VDR in CD4+ and CD8+ cells (p>0.05). CD4+/VDR(MFI) and CD8+/VDR(MFI) values were higher in RT patients than healthy subjects (p0.05). This study showed VDR in T lymphocytes of patients who had RT did not change, but the VDR content in the cells increased due to reasons independent of serum 25-hydroxycholecalciferol and 1.25 dihydroxycholecalciferol levels., Bu çalışma, kronik allogreft disfonksiyonu (KAD) olan böbrek nakli (BN) alıcılarının CD4+ ve CD8+ lenfositlerinde D vitamini reseptörü (VDR) ekspresyonunu ve hücre içi VDR miktarlarını değerlendirmeyi amaçlamaktadır.Toplam 43 hasta (Grup 1:BN hastaları=29 hasta, böbrek biyopsisi ile KAD kanıtlanmış 15 hasta (Grup 1a), böbrek fonksiyonu stabil 14 hasta (Grup 1b), Grup 2:Kontrol grubu=14 sağlıklı birey) bu çalışmaya dahil edilmiştir. 25-hidroksikolekalsiferol, 1.25 dihidroksikolekalsiferol seviyeleri ölçüldü. Deneklerin CD4+ ve CD8+ tip T lenfositleri arasında VDR eksprese eden hücre sayısı, bu hücre gruplarının %'si olarak belirlendi. Hücre başına ortalama VDR molekülü içeriği ölçülmüş ve ortalama floresan yoğunlukları (MFI) olarak ifade edilmiştir.Grup 1 ve Grup 2 arasında 25-hidroksikolekalsiferol, 1.25 dihidroksikolekalsiferol düzeyleri ve CD4+ ve CD8+ hücrelerinde VDR eksprese eden hücrelerin yüzdeleri açısından fark bulunmadı (p>0.05). BN hastalarında CD4+/VDR(MFI) ve CD8+/VDR(MFI) değerleri sağlıklı kişilere göre daha yüksekti (p0.05).Bu çalışma, BN uygulanan hastaların T lenfositlerinde VDR'nin değişmediğini, ancak hücrelerdeki VDR içeriğinin serum 25-hidroksikolekalsiferol ve 1.25 dihidroksikolekalsiferol düzeylerinden bağımsız nedenlerle arttığını gösterdi.

Background To evaluate the association of parathormone with vitamin D and to find a threshold value for vitamin D. Material and methods This descriptive study included 11,753 (2352 males, 9401 females) patients from University hospital and 25-OH vitamin D and PTH levels were evaluated. Results The mean parathormone level was 49.33 ± 22.39 pg/mL. 18.7% of the patients had hyperparathyroidism. 77.4% of the patients had low 25-OH D vitamins. There was a negative correlation between serum parathormone levels and 25-OH vitamin D levels. The minimum 25-OH vitamin D level to keep PTH below 65 pg/mL was 18.5 ng/mL. Conclusion For determining the threshold value of 25 OH vitamin D, serum PTH levels should be assessed with 25-OH vitamin D levels.

Serum 17α- hydroxyprogesterone (17OHP) and bilateral adrenal sizes are pivotal for clinical practice in both diagnosis and treatment of congenital adrenal disorders during the first month of life. Our aims were to determine the reference ranges for serum 17OHP and bilateral adrenal gland sizes according to sex and age groups in healthy term newborns.A total of 156 healthy newborns, aged 4-7 days (Group 1) or 26-30 days old (Group 2) were included in the study. Serum 17OHP concentration was measured in the morning by radioimmunoassay. The right and left adrenal glands' width, length, and depth were measured with ultrasonography by the same radiologist and the volumes were calculated.The clinical characteristics and serum 17OHP concentrations were similar in male and female newborns. Percentiles for serum 17OHP concentration and the volume of adrenal glands according to age groups and sexes were obtained. Mean 17OHP concentration was 4.67 ± 2.6 ng/ml and 4.49 ± 2.7 ng/ml at the first and fourth week of life, respectively (p .05). There was a significant decrease in adrenal sizes during the fourth week of life. There was no significant correlation between serum 17OHP concentration and adrenal gland sizes.We have determined reference intervals for serum 17OHP concentration and bilateral adrenal gland sizes for healthy newborns. Although serum concentrations of 17OHP did not change significantly through the first month of life, our reference intervals for serum 17OHP concentration and adrenal sizes may improve clinical approach toward newborns who are suspected of adrenal disorder. We conclude that our reference intervals can guide for congenital adrenal screening regarding serum 17OHP concentration besides diagnosis of adrenal hypoplasia or hyperplasia with ultrasonographic adrenal gland sizes.

Background Incretin hormones may influence the effects of thyroid hormones on insulin secretion, insulin resistance, and glucose metabolism. Thyroid hormones regulate insulin secretion, and the risk of diabetes was found to be associated with thyroid hormones. Objectives To determine whether incretin hormones influence the effects of thyroid hormones on insulin resistance and glucose metabolism. Methods A total of 26 patients were included in 2 groups consisting of 13 patients with hypothyroidism and 13 healthy controls. Levels of glucose, insulin, glucagon-like peptide 1 (GLP-1), and gastric inhibitory polypeptide (GIP) levels were measured in 0, 30, 60, 90, and 120th min during the oral glucose tolerance test in the control group and before and after thyroxine treatment in the hypothyroid group. Results In the hypothyroid group, waist circumference decreased after the euthyroid state was achieved (P = 0.026). No statistically significant differences were detected in the GLP-1 and GIP levels at baseline and 30, 60, 90, and 120 min between the hypothyroidism and control groups or after ensuring the euthyroid state in patients with hypothyroidism. Peak GLP-1 levels were observed at 30 min in the control group, whereas peak GLP-1 and GIP levels were detected at 90 min in the hypothyroidism group. After achieving the euthyroid state, peak GLP-1 and GIP levels were detected at 30 min as well. Conclusion In patients with hypothyroidism, the incretin hormones, especially the peak response of the incretin system, are significantly affected. Significant changes were observed in the incretin system by correcting hypothyroidism.

Objective Many studies have investigated lower 25-hydroxyvitamin D (25[OH]D) levels in patients with Alzheimer’s disease (AD) compared with those in control patients. In the present study, we aimed to evaluate serum free and bioavailable 25(OH)D levels in patients with AD and in healthy control patients. Methods The AD group consisted of 85 patients aged >60 years who were diagnosed with possible AD according to National Institute on Aging-Alzheimer’s Association criteria and 85 healthy control patients. Serum levels of total 1,25-dihydroxyvitamin D, total 25(OH)D, vitamin D binding protein (VDBP), parathormone, calcium, phosphorus and albumin, free 25(OH)D, bioavailable 25(OH)D, and the bioavailable 25(OH)D/total 25(OH)D ratio were compared in both groups. Results Total 25(OH)D, free 25(OH)D, bioavailable 25(OH)D, and the bioavailable 25(OH)D/total 25(OH)D ratio were significantly lower (P Conclusion Free and bioavailable 25(OH)D detected at lower levels in patients with AD limit the target central effects of 25(OH)D; this result suggests that reduced levels of the active free form of vitamin D may be a risk factor for AD and dementia.

Immunosuppressive drugs used in transplantation patients, may contribute to the development of post-transplant diabetes mellitus through their possible adverse effects on incretins. We aimed to compare the effects of different immunosuppressive drugs used in renal transplantation patients on glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) levels.Forty five subjects were enrolled in the study (cyclosporine-treated 15 and tacrolimus-treated renal transplant patients 15, and healthy volunteers as a control group 15). Oral glucose tolerance test with 75 gr glucose was performed. GLP-1 and GIP levels were measured at 0 (baseline), 30, 60, 90, 120 min using ELISA method.A statistically significant level of difference was detected in GLP-1 levels at the baseline, 30th and 120th minutes among all three groups (p 0,001, p = 0,026 and p = 0,022, respectively). Baseline GLP-1 levels in cyclosporine-treated renal transplant patients were higher than in both tacrolimus-treated renal transplant patients (p = 0,016) and control groups (p 0,001). GLP-1 levels at the 30th minute were higher in tacrolimus-treated renal transplant patients when compared to the cyclosporine-treated renal transplant patients (p = 0,024). GLP-1 levels at the 120th minute were higher in tacrolimus-treated renal transplant patients than the control group (p = 0,024). The areas under the curve of GLP-1 was higher in tacrolimus-treated renal transplant patients when compared to the control group (p = 0,018). GIP levels at 120th was lower in cyclosporine-treated renal transplant patients when compared to control group (p = 0,003).These findings showed a temporally affected incretin hormones in renal transplant patients, a preserved GLP-1 response to an oral glucose load in renal transplant patients on cyclosporine and increased GLP -1 response to an oral glucose load in those on tacrolimus.

A new adipocytokine, visfatin is expressed in perivascular adipose tissue (PVAT) and exerts effects on vascular system in addition to its relationship with various pathological conditions. The present study aimed to investigate the functional effects of visfatin and the possible underlying mechanism(s) of the effects of visfatin in isolated rat mesenteric small resistance arteries. The study was conducted in small resistance arterial rings isolated from rat mesenteric vascular beds. While visfatin incubation did not produce significant alterations in contractile responses of mesenteric arterial rings to noradrenaline, relaxation responses to acetylcholine but not to sodium nitroprusside (SNP) were significantly reduced in endothelium-intact rings. The inhibitory effect of visfatin on responses to acetylcholine was not observed in endothelium-denuded preparations. Incubation of tissues with nicotinamide phosphoribosyl transferase (NAMPT) inhibitor FK866 or superoxide dismutase (SOD) reversed the inhibitory effects of visfatin on relaxation responses to acetylcholine. Co-incubation of visfatin with Nω-nitro-L-arginine methylester (L-NAME) did not produce a significant alteration in vascular responses to acetylcholine compared to L-NAME incubation alone. Mesenteric PVAT visfatin levels were significantly higher than and correlated positively with plasma visfatin levels. The results of our study indicated that visfatin-induced reductions in endothelium-dependent relaxations of rat isolated small resistance arteries are mediated by oxygen free radicals and a reduction in nitric oxide (NO) bioavailability. It was suggested that increment in systemic and/or local visfatin levels due to various pathologies including obesity and excessive weight gain may play a substantial role in initiation and/or propagation of vascular dysfunctions.

The present study was designed to evaluate the cardioprotective effects of nesfatin-1, a novel peptide with anorexigenic properties, in rats with isoproterenol (ISO)-induced myocardial infarction (MI), and to further investigate the role of Akt/GSK-3β signaling pathway in the protective effect of nesfatin-1. To induce MI, ISO was subcutaneously injected into the rats for two consecutive days at a dosage of 85mg/kg/day. ISO-induced myocardial damage was indicated by elevated levels of cardiac specific troponin-T, enhanced myocardial expression of proinflammatory cytokines (interleukin-1β, interleukin-6 and tumor necrosis factor-α), and increased number of cells with apoptotic and necrotic appearance in the myocardial tissue. Levels of p-Akt/Akt and p-GSK-3β/GSK-3β significantly decreased in heart tissue after ISO-induced MI. However, intraperitoneal administration of nesfatin-1 (10μg/kg/day) elicited a significant cardioprotective activity by lowering the levels of cardiac troponin-T and proinflammatory cytokines, indicating the protective effect of nesfatin-1 against ISO-induced MI. The biochemical findings were further confirmed by histopathological examination, which was demonstrated by reduced number of apoptotic and necrotic cells. Moreover, expressions of p-Akt/Akt and p-GSK-3β/GSK-3β in the myocardium of MI group rats were significantly increased by nesfatin-1 administration, suggesting that nesfatin-1, which appears to possess anti-apoptotic and anti-inflammatory properties, may confer protection against ISO-induced MI via an Akt/GSK-3β-dependent mechanism.

Background:Incretin hormones (glucagon-like peptide-1 [GLP-1] and gastric inhibitory polypeptide [GIP]) may play a role in the development of glucose intolerance and hyperglycemia in patients with hyperthyroidism. Objective: We aimed to assess both incretin levels and treatment-induced changes in incretin levels in those with hyperthyroidism. Methods: A total of 24 subjects (12 with hyperthyroidism and 12 healthy) were enrolled in the study. Oral glucose tolerance test was performed and serum glucose, insulin GLP1, and GIP levels were evaluated at 0 (baseline), 30, 60, 90, and 120 minutes using ELISA. Measurements were repeated after euthyroidism was reached in subjects with hyperthyroidism. Results: The baseline glucose level was higher in those with hyperthyroidism compared with controls ( P = 0.03). GLP-1 and GIP responses to oral glucose load did not differ significantly between those with hyperthyroidism and controls. Peak GLP-1 and GIP levels were reached in both groups at 60 and 90 minutes, respectively. Areas under the curve (AUCs) for GLP1 and GIP were similar in those with hyperthyroidism and controls. Although GLP-1 and GIP levels did not change before and after antithyroid treatment in subjects with hyperthyroidism, time to peak GLP-1 and GIP levels were reached at 30 minutes after euthyroid state was achieved. Reversal of hyperthyroid to euthyroid status did not induce significant changes in AUCs for incretins. Conclusion: The findings of the present study suggest that the total incretin response to oral glucose load is preserved in patients with hypertyhroidism, but peak incretin responses may change after achieving euthyroid state.

In this study, we aimed to evaluate the effects of pregnancy on the serum level of HE4. Forty-six singleton pregnant women in the study group and 40 premenopausal women in the control group were included. HE4 and Ca125 levels were measured longitudinally at each trimester of pregnancy in the study group and once in the control group at the recruitment. In total 46, 38 and 33 pregnant patients blood samples were analysed in the first, second and third trimester of pregnancy, respectively. The analysis was performed in 31 of the pregnant patients (31/46, 67.4%) in each trimester of pregnancy. A comparison of the median HE4 levels of control and study group revealed that the first and second trimester levels were significantly lower than the control group (

Objective: The aims of this study are first to evaluate the association between urine iodine levels and thyroid Tc99m pertechnetate uptake TcPU levels in multinodular goiter MNG patients, second to evaluate TcPU levels in euthyroid, subclinical and clinical hyperthyroid patient groups, and third to compare TcPU and I-131 uptake levels to decide whether TcPU can be use instead of I-131 uptake.Material and Methods: Twenty-nine patients who were newly diagnosed multinodular goiter were included in the study. After taking blood and urine samples, TcPU tests and thyroid scintigraphies were done. By performing I-131 uptake measurements 4th and 24th hour uptake levels were calculated.Results: Twenty-one patients 72% had a urinary iodine level above 100 μg/g creatinine that indicates sufficient iodine intake. There was a significant negative correlation between TcPU levels and urine iodine levels. According to TSH levels, while 18 patients were euthyroid, 11 were hyperthyroid. The TcPU levels were found to be higher in hyperthyroid patients compared to the euthyroid ones, but this difference was not statistically significant. There was a significant positive correlation between the patients’ TcPU and I-131 4th and 24th hour uptake values.Conclusion: TcPU, which is a more practical method, can be used instead of I-131 uptake values. Our results suggest that it would be important to evaluate the relationship between urinary iodine and TcPU levels in larger series of MNG patients after mandatory iodinization, Amaç: Çalışmada amaç, 1. multinodüler guatr hastalarında MNG idrar iyot düzeyleri ile tiroid Tc99m perteknetat uptake TcPU düzeyleri arasındaki ilişkiyi belirlemek, 2. ötiroid, klinik ve subklinik hipertiroidi hasta gruplarında TcPU düzeylerinin değerlendirmek, 3. TcPU ile I-131 uptake düzeylerini karşılaştırarak TcPU’in I-131 uptake yerine kullanılıp kullanılamayacağını belirlemektedir.Gereç ve Yöntemler: Çalışmaya yeni tanı almış MNG olan 29 hasta dahil edildi. Hastalardan kan ve idrar örnekleri alındıktan sonra TcPU ve tiroid sintigrafisi yapıldı. I-131 uptake ölçümleri yapılarak 4. ve 24. saat uptake değerleri ölçüldü. Bulgular: Yirmi bir hastanın %72 idrar iyot düzeyi yeterli iyot alımını gösteren 100 μg/g kreatinin’den yüksek idi. TcPU düzeyleri ile idrar iyot düzeyleri arasında negatif korelasyon saptandı. TSH düzeylerine göre 18 hasta ötiroid, 11 hasta hipertiroid idi. TcPU düzeyleri hipertiroid hastalarda ötiroid olanlardan yüksekti fakat istatistiksel anlamlı değildi. TcPU düzeyleri ile I-131 4. saat ve 24. saat uptake’leri arasında pozitif korelasyon saptandı. Sonuç: Daha pratik bir yöntem olan TcPU değerleri I-131 uptake yerine kullanılabilir. Zorunlu iyodinasyon sonrası MNG hastalarında idrar iyot düzeyleri ile TcPU düzeyleri arasındaki ilişki daha geniş hasta serilerinde değerlendirilmelidir

Our aim was to compare the short- and long-term clinical outcomes of hepatitis B surface antigen–positive (HbsAg+) renal transplant recipients with HbsAg− recipients. A total of 204 patients who underwent renal transplantation in our center between 2001 and 2014 were included in the study. The patients were divided into 2 groups. Group 1 was the HbsAg− group (n = 136), and group 2 was the HbsAg+ group (n = 68). There was no significant difference between the groups in terms of lymphocyte crossmatches, numbers of mismatches, immunosuppressive treatment protocols, and induction treatments. In the HbsAg+ group, 51 patients were hepatitis B virus DNA+, 64 patients were HbeAg−, and 4 patients were HbeAg+. A total of 57 patients (83.8%) were treated with lamivudine, 4 patients (5.9%) with entecavir, and 7 patients (10.3%) with tenofovir for hepatitis B infection. Graft and patient survival rates, graft functions, acute hepatitis rates, acute rejection rates, and other clinical outcomes of the groups were compared. Demographic data and immunologic risk profiles of the groups were similar. Acute rejection rates, graft survival rates, and patient survival rates were similar. Acute hepatitis rates, glomerular filtration rates on the last controls, and delayed graft function rates were higher in group 2, whereas chronic allograft dysfunction and new-onset diabetes mellitus after transplantation rates were similar between the groups. Our study revealed that graft and patient survival, and acute rejection rates were similar between HbsAg+ and HbsAg− recipients, whereas acute hepatitis rate was higher in HbsAg+ recipients.

The aim of this study was to investigate the effect of resveratrol (RVT) on sildenafil-induced relaxations of isolated corpus cavernosum in non-diabetic and diabetic aged rats. A total of 13 male aged rats (72–80 weeks old) were randomized into two groups including non-diabetic aged rats and diabetic aged rats. Diabetes was induced in aged rats by streptozotocin (single i.p. dose of 45 mg/kg body weight) administration. At the end of the 12th week, corpus cavernosum strips of rats were suspended in an organ bath system. The corpus cavernosum relaxation was evaluated by sildenafil in the presence or absence of RVT (10−4 M) for 45 min. Induction of diabetes resulted in significant inhibition of sildenafil-induced corpus cavernosum relaxation in aged rats. The diminished relaxation in response to sildenafil was significantly improved by acute RVT incubation in both non-diabetic and diabetic aged rats; however, the magnitude of potentiation induced by RVT was more pronounced in diabetic aged rats. The potentiating effect of RVT was significantly inhibited by L-NG-nitroarginine methyl ester (L-NAME, 10−4 M, for 30 min) incubation in both groups. After the L-NAME incubation, the relaxation response of corporal tissues evoked by sildenafil was found to be similar in diabetic and non-diabetic aged rats. RVT improves sildenafil-induced relaxations of corpus cavernosum in both diabetic and non-diabetic aged rats probably by potentiating the activity of NOS, and this effect seems to be more manifest in diabetic aged group.

Background The aim of this study was to observe the differences in serum 25-hydroxyvitamin D(3) levels in nondiabetic healthy control subject and type 2 diabetic patients, and to investigate the differences in serum 25-hydroxyvitamin D(3) levels in type 2 diabetic patients with normo-, micro- and macroalbuminuria. Patients and methods Total 140 nondiabetic healthy controls and 384 type 2 diabetic patients (156 normoalbuminuric, 152 microalbuminuric and 76 macroalbuminuric) were included in the study. 25-hydroxyvitamin D(3) levels were measured in sera with the method of electrochemiluminescence using modular immunoassay analyzer. Results Vitamin D deficiency was detected in 70.85% and 22.9% of type 2 diabetic patients and nondiabetic healthy controls, respectively. Serum 25-hydroxyvitamin D(3) levels were significantly lower in type 2 diabetic patients compared to nondiabetic healthy controls (16.4 ± 9.5 ng/mL vs. 28.2 ± 11.6 ng/mL, p=0.0001). Serum 25-hydroxyvitamin D(3) levels were lower in albuminuric and nonalbuminuric diabetic patients (14.3 ± 7.9 ng/mL vs. 19.6±10.9 ng/mL, respectively, p=0.013). Serum 25-hydroxyvitamin D(3) levels were 19.6 ± 10.9 ng/mL in normoalbuminuric, 14.9 ± 8.8 ng/mL in microalbuminuric and 12.9 ± 5.8 ng/mL in macroalbuminuric diabetic patients. While lower serum 25-hydroxyvitamin D(3) levels were detected both in microalbuminuric (p=0.028) and macroalbuminuric diabetic patients (p=0.014) compared to normoalbuminuric diabetic patients, 25-hydroxyvitamin D(3) levels did not change significantly between microalbuminuric and macroalbuminuric diabetic patients (p=0.67). Serum 25-hydroxyvitamin D(3) levels correlated negatively with urinary albumin excretion (r=-0.24, p=0.016) in patients with diabetes mellitus. Conclusion Findings of the present study demonstrated reduced serum 25-hydroxyvitamin D(3) levels which were significantly related with albuminuria in type 2 diabetic patients.

Background: Facioscapulohumeral muscular dystrophy (FSHD) occurs as a consequence of genetic deletion of D4Z4 repeats on chromosome 4q35. Onset of FSHD is earlier in males, suggesting that testosterone may trigger the disease. In accordance, the rapid progression of disease in women after menopause suggests a protective role for estrogen and progesterone. No studies have examined levels of all these hormones in relation with the severity of FSHD. Aims: To evaluate the possible correlation between the severity of FSHD with sex hormones, age, and genetic deletion on chromosome 4q35. Subjects and Methods: D4Z4 repeat units were investigated in 33 patients (19 males/14 females) with FSHD. In the blood samples, luteinizing hormone, follicle-stimulating hormone, free estriol, estradiol, free testosterone and total testosterone, progesterone, 17-OH progesterone, prolactin, albumin, and fibrinogen were measured. The severity of FSHD was identified using a Clinical Severity Score (CSS) scaling system. Spearman's correlation and regression analyses were performed as statistical analyses. Results: Age (P = 0.001, r = 0.541) and total testosterone (P = 0.045, r = 0.351) were positively correlated, and the progesterone/total testosterone (P = 0.025, r = −0.390) and estradiol/total testosterone ratios (P = 0.025, r = −0.389) were negatively correlated with the severity of FSHD. Conclusions: Our results indicate that age, total testosterone, ratios of estradiol and progesterone to total testosterone, but not deletion on chromosome 4q35, have a significant relation with the severity of FSHD. Given that both estrogen and testosterone treatment are considered in therapy, our results suggest that estrogen and progesterone but not testosterone are likely to be more effective on the severity of FSHD.

Objective The aim of this study was to investigate the effect of chronic exendin-4 (Ex-4) treatment on corpus cavernosum (CC) dysfunction in methylglyoxal (MGO) administered rats. Methods Male rats were divided into four groups as control, MGO (75 mg/kg/day in drinking water for 12 weeks), MGO + low-dose Ex-4 (0.1 μg/kg twice daily subcutaneously for 12 weeks concomitant with MGO), and MGO + high-dose Ex-4 (1 μg/kg twice daily subcutaneously for 12 weeks concomitant with MGO). Nitric oxide (NO)-mediated endothelium-dependent and neurogenic CC relaxations were evaluated by acetylcholine (ACh) and electrical field stimulation (EFS), respectively. Apoptosis was determined by TUNEL. Endothelial nitric oxide synthase (eNOS), phosphorylated eNOS (p-eNOS), NADPH oxidase subunit gp91phox (NOX2), and Rho kinase (ROCK2) expressions in CC were investigated by immunohistochemistry. Levels of the malondialdehyde (MDA) and advanced oxidation protein products (AOPP) were also measured. Results In MGO administered rats, both endothelium-dependent and neurogenic CC relaxations were significantly impaired as compared to controls. Apoptotic cell death and levels of MDA and AOPP increased significantly in MGO administered rats. eNOS and p-eNOS expressions decreased significantly in MGO group, while gp91phox expressions increased significantly. The diminished relaxation in response to ACh or EFS as well as the changes in expression of proteins in MGO groups were significantly improved by exendin-4 treatment. TUNEL-positive cells, and levels of MDA and AOPP in MGO group rats were also significantly reduced by exendin-4. Conclusion Exendin-4 treatment improves NO-mediated CC relaxations in MGO administered rats probably by inhibiting NADPH oxidase.

Late-night salivary cortisol (LNSaC) is an easy-to-use test reflecting the free cortisol level in the serum and does not require hospitalization. Controlled studies reported that LNSaC has a high sensitivity and specificity, but have not set a clearly defined cut-off value to be used in the diagnosis of Cushing's syndrome. In this study, we aimed to evaluate the diagnostic performance of LNSaC in patients with clinical Cushing's syndrome (CCS) and subclinical Cushing's syndrome (SCS). The data of 543 patients, whose LNSaC levels were assessed using electrochemiluminescence immunoassay method, were retrospectively evaluated. The study included a total of 324 patients: 58 patients with CCS, 53 patients with SCS, and 213 patients without Cushing's syndrome (NoCS). The cause of the Cushing's syndrome was hypophyseal in 26 patients (45%), adrenal in 24 patients (41%), and ectopic in 8 patients (14%) in the CCS group. Median LNSaC levels were 0.724 (0.107–33) μg/dL in CCS group, 0.398 (0.16–1.02) μg/dL in SCS group, and 0.18 (0.043–0.481) μg/dL in NoCS group (p=0.001). Accordingly, LNSaC had 89.6% sensitivity and 81.6% specificity at a cut-off value of 0.288 μg/dL in the diagnosis of CCS; and had 80.7% sensitivity and 85.1% specificity at a cut-off value of 0.273 μg/dL in the diagnosis of SCS. In the present study, a lower sensitivity and specificity than previously reported was found for LNSaC in the diagnosis of CCS. Moreover, the diagnostic performance of LNSaC in patients with SCS was close to its diagnostic performance in patients with CCS. Each center should determine its own cut-off value based on the method adopted for LNSaC measurement, and apply that cut-off value in the diagnosis of Cushing's syndrome.

SummaryObjective Although an International Workshop has suggested that cardiovascular assessment in asymptomatic primary hyperparathyroidism (PHPT) patients is not necessary, improvements in risk factors of subclinical atherosclerosis have been shown following parathyroidectomy. The objectives of this study were to determine whether parathyroidectomy in asymptomatic PHPT patients causes any change in carotid intima-media thickness (CIMT), arterial stiffness [pulse wave velocity (PWV)] and soluble CD40 ligand (sCD40L) levels. Design Prospective study evaluating female patients diagnosed with asymptomatic PHPT in a single centre over a 6-month period. Patients A total of 48 subjects were included: 17 hypercalcaemic (HC, mean age: 51 ± 8 years, Ca: 2·73 ± 0·17 mmol/l) and 16 normocalcaemic (NC, mean age: 58 ± 7 years, Ca: 2·30 ± 0·10 mmol/l) PHPT patients, and 15 healthy controls (mean age: 52 ± 4 years, Ca: 2·27 ± 0·07 mmol/l). Measurements Biochemical tests, CIMT, PWV and sCD40L levels were compared at baseline and 6 months after parathyroidectomy (PTx). Results At baseline, CIMT and PWV values in the HC and NC patients were higher than in the control group. While there was a significant reduction in CIMT (601 ± 91 μm vs 541 ± 65 μm, P = 0·006) and PWV (9·6 ± 1·8 vs 8·4 ± 1·5 m/s, P = 0·000) in the hypercalcaemic group at the end of the 6th month after PTx, no change was observed in normocalcaemic group (P = 0·686 and P = 0·196 respectively). No differences were observed in sCD40L levels between patient and control groups or between baseline and 6 months in patients undergoing parathyroidectomy. Conclusion Parathyroidectomy leads to an improvement in the structural and functional impairment associated with atherosclerosis in the vascular wall in asymptomatic hypercalcaemic PHPT patients.

The aim of the present study was to evaluate the variations of some major bone metabolism markers with reference to klotho gene polymorphism (KGP) and bone mineral density (BMD) values in patients on chronic peritoneal dialysis (CPD).In 51 CPD patients and 40 healthy persons, assays for intact parathormone (iPTH), fibroblast growth factor 23 (FGF-23), osteoprotegerin (OPG), osteocalcin (OC), procollagen type-1 N terminal propeptide (PINP), beta- crosslaps (beta CTx), tartrate resistant acid phosphatase (TRAP5b), bone alkaline phosphatase (BAP), 1,25(OH)D3, and 25(OH)D3 and α-klotho gene mutations were performed.In CPD patients, 1,25(OH)D3 and 25(OH)D3 deficiency rates were 96% and 94% respectively. iPTH (249 pg/mL vs 39 pg/mL) and FGF-23 (1089 RU/mL vs 153 RU/mL), OPG, OC, PINP, beta CTx, TRAP5b levels were significantly higher in patients. iPTH levels and whole-body BMD values were negatively correlated in patients. The rate of KGP was similar in all groups.In CPD patients, besides vitamin D deficiency, high levels of OPG, OC, PINP, beta CTx, TRAP5b were evident. Positive correlation between iPTH levels and BAP and PINP levels suggested a diagnostic value for those markers during the management of CKD MBD. On the other hand, high serum TRAP5b concentrations did not seem to be affected by neither calcitriol treatment nor the severity of hyperparathyroidism. iPTH and FGF-23 levels and whole-body BMD values showed a significant negative correlation. We were unable to show any correlation between KGP and any of the CKD-MBD parameters measured in this study.Çalışmamızda kronik periton diyalizi (KPD) hastalarında klotho gen polimorfizmi (KGP) ve kemik mineral yoğunluğu (KMY) ile bazı major kemik metabolizma belirteçleri arasındaki ilişkinin araştırılması amaçlanmıştır.Çalışmaya dahil edilen 51 KPD hastası ve 40 sağlıklı kontrol grubunda intakt parathormon (iPTH), fibroblast büyüme faktör (FGF-23), osteoprotogerin (OPG), osteokalsin (OK), prokollajen tip-1 N terminal propeptid (PINP), beta- crosslaps (beta KTx), tartarate resistan asid fosfataz (TRAF5b), kemik alkalen fosfataz (KAF), 1,25(OH)D3, 25(OH)D3 ve α-klotho gen mutasyonları ölçüldü.51 KPD hastasında 1,25(OH)D3 ve 25(OH)D3 eksikliği oranı sırasıyla %96 ve %94 olarak tespit edildi. iPTH (249 pg/mL ve 39 pg/mL) ve FGF-23 (1089 RU/mL ve 153 RU/mL), OPG, OK, PINP, beta CTx, TRAP5b seviyeleri hastalarda istatistiksel olarak anlamlı derecede daha yüksek bulundu. Hastalarda iPTH seviyeleri ve tüm vücut KMY arasında negatif korelasyon tespit edildi. KGP oranı gruplar arasında benzer bulundu.Kronik periton diyalizi hastalarında D vitamin eksikliğine ek olarak, OPG, OK, PINP, beta CTx, TRAP5b düzeyleri yüksek saptandı. iPTH seviyeleri ile KAF ve PINP arasındaki pozitif korelasyon bu belirteçlerin kronik böbrek hastalarındaki (KBH) kemik mineral hastalıklarının (KMH) tedavisinde tanısal değerinin olduğunu göstermiştir. Diğer taraftan yüksek serum TRAP5b konsantrasyonunun kalsitriol tedavisi ve hiperparatiroidinin şiddetinden etkilenmediği de gösterilmiştir. iPTH ve FGF-23 düzeyleri ile tüm vücut KMY arasında anlamlı negatif korelasyon tespit edilmiştir. Çalışmamızda klotho gen polimorfizmi ile KBH-KMH’nın hiçbir belirteci arasında anlamlı korelasyon gösterilememiştir.

Objective To investigate ovarian reserve in complete mullerian agenesis (CMA) patients and to compare the ovarian reserve of CMA patients with that of age-matched fertile and infertile controls. Design Prospective cohort study. Setting University gynecology outpatient clinic. Patient(s) Fifty-eight typical CMA (type A) patients, 8 atypical CMA (type B) patients, 39 fertile patients, and 38 infertile patients were compared for ovarian reserve. Intervention(s) Ovarian reserve was evaluated via antimullerian hormone (AMH) levels and antral follicle counts (AFCs). Main Outcome Measure(s) Investigation of ovarian reserve in CMA patients and a comparison of the ovarian reserve of the CMA patients with that of age-matched fertile and infertile controls. Result(s) Fifty-eight type A and eight type B CMA patients and 39 fertile and 38 infertile control patients were assessed for ovarian reserve. The mean (±SD) ages of the type A and type B CMA patients and the fertile and infertile groups were 25.8 ± 5.3, 33.3 ± 5.9, 32.6 ± 4.8, and 33.9 ± 3.3 years, respectively. After age standardization of the groups, AMH levels and AFCs were found to be lower in the atypical CMA group. The differences in AMH levels and AFC were found to be highly significant. Conclusion(s) The present study showed that atypical CMA patients had decreased ovarian reserve compared with age-matched fertile and infertile controls.

Cardiovascular (CV) disease remains the most common cause of mortality in chronic kidney disease (CKD).In this cross-sectional study, 43 pediatric patients with CKD were divided into two groups according to their estimated glomerular filtration rate (eGFR): groups 1 and 2 (eGR; 29-75 and 15-29 mL/min/1.73 m(2), respectively). M - mode, conventional pulsed wave Doppler (cPWD) echocardiography and tissue Doppler imaging (TDI) were performed in all patients and 16 healthy controls. Maximal early (E wave) and late (A wave) diastolic flow velocities were assessed by cPWD. Using TDI, the early (E') and late (A') diastolic filling velocities were recorded. Early and late diastoles were evaluated using E' values and E/E' ratios, respectively.Left ventricular hypertrophy (LVH) was determined in 19/43 (44.2%) patients. The E/E' ratio was significantly higher in group 2 than in group 1 and controls. E/E' was found to be positively correlated with left ventricular mass (LVM) index, and negatively with hemoglobin (Hb) levels. Low Hb levels were only independent predictor of E/E' (p = 0.001, β: -0.470, 95% CI: -0.764; -0.196). E' ratio was significantly lower in both patient groups compared to the controls.LVH and diastolic dysfunction are already present in early stages of CKD. Treatment of risk factors, such as anemia, is important to improve the clinical outcome.

Background: Bone disorders are next to cardiovascular problems in frequency in renal transplant (RT) recipients. Reduction in 1,25-dihydroxycholecalciferol (1,25D) levels is among the reasons causing bone loss in these patients. Klotho (KL) serves as a co-receptor for fibroblast growth factor 23 (FGF23), and functions in vitamin D metabolism. KL polymorphisms have been identified in several studies, and phenylalanine to valine substitution at amino acid position 352 seemed to be important to KL function. We investigated KL F352V polymorphism and its relation with 1,25D levels in RT recipients. Methods: The study included 25 RT recipients (8 female, 17 male) and 26 (14 female, 12 male) healthy control subjects who were wild (FF) phenotypes in terms of KL F352V polymorphism. RT recipients with (FV, n = 11) and without (FF, n = 14) a heterozygote polymorphism were determined with high resolution DNA melting analysis of KL F352V polymorphism. Serum 1,25D levels were measured using the RIA method. Results: RT recipients with FV phenotype had significantly lower 1,25D levels (17.58 ± 18.38 pg/ml) compared to recipients with FF phenotype (44.91 ± 24.68 pg/ml) and control subjects (28.24 ± 12.13 pg/ml). 1,25D levels in RT recipients with FF phenotype were significantly higher than control subjects. Conclusions: KL F352V polymorphism may increase the expression of FGF23 co-receptor, KL protein and thus may decrease renal expression of 1α-hydroxylase, and/or stimulate 24-hydroxylase in RT recipients. The resultant decrease 1,25D levels may participate in bone loss in these patients.

Early diagnosis and treatment of cardiovascular diseases, the most frequent cause of morbidity and mortality in acromegaly, may be an efficient approach to extending the lifespan of affected patients. Therefore, it is crucial to determine any cardiovascular diseases in the subclinical period. The study objectives were to determine markers of subclinical atherosclerosis and asses heart structure and function.This was a cross-sectional, single-center study of 53 patients with acromegaly and 22 age- and sex-matched healthy individuals. Carotid intima-media thickness (CIMT), pulse-wave velocity (PWV), and echocardiographic data were compared between these groups.CIMT and PWV were higher in the acromegaly group than in the healthy group (P = .008 and P = .002, respectively). Echocardiography showed that left ventricular diastolic dysfunction was present in 11.3% of patients. Left ventricular mass index and left atrial volume index were higher in the patients (P = .016 and P.001, respectively). No differences in the CIMT, PWV, or echocardiographic measurements were identified between the patients with biochemically controlled and uncontrolled acromegaly and the control group.Our results showed that subclinical atherosclerosis (i.e., CIMT and PWV markers) and heart structure and function were worse in patients with acromegaly than in healthy individuals. Because there were no differences in these parameters between patients with controlled and uncontrolled acromegaly, our results suggest that the structural and functional changes do not reverse with biochemical control.AA = active acromegaly BSA = body surface area CA = biochemically controlled acromegaly CH = concentric hypertrophy CIMT = carotid intima-media thickness DBP = diastolic blood pressure DM = diabetes mellitus ECHO = echocardiography EDV = enddiastolic volume EF = ejection fraction ESV = endsystolic volume GH = growth hormone HC = healthy control HL = hyperlipidemia HT = hypertension IGF-1 = insulin-like growth factor 1 LA = left atrial LAV = left atrial volume LAVI = left atrial volume index LV = left ventricular LVDD = left ventricular diastolic dysfunction LVEF = left ventricular ejection fraction LVH = left ventricular hypertrophy LVMI = left ventricular mass index PWV = pulse-wave velocity RWT = relative wall thickness.

WOS: 000344525600003 PubMed ID: 25223839 BackgroundSeveral studies have shown that obstructive sleep apnea increases incidence of cardiovascular morbidity and mortality. The high systemic oxidative stress in obstructive sleep apnea has been considered as a major pathogenic mechanism leading to cardiovascular disease. Oxidative stress-related lipid and DNA oxidation in obstructive sleep apnea have been reported in the previous studies. In contrast, there is limited and contradictory information regarding protein oxidation in obstructive sleep apnea patients such as ischaemia-modified albumin and advanced oxidation protein products. Therefore, we aimed to investigate plasma ischaemia-modified albumin and advanced oxidation protein products and their correlation with total oxidative status and total antioxidative capacity in the obstructive sleep apnea patients. MethodsPlasma ischaemia-modified albumin, advanced oxidation protein products, total oxidative status and total antioxidative capacity were measured in 25 healthy volunteers and 59 obstructive sleep apnea patients diagnosed with polysomnography. ResultsPlasma total antioxidative capacity was significantly lower (P=0012) and total oxidative status was significantly higher (P

Obstructive sleep apnea (OSA) is characterized by recurrent respiratory disorders associated with increased cardiovascular morbidity and mortality. The increment of systemic inflammation in OSA has been considered as the major pathogenic mechanism leading to cardiovascular diseases. There is limited and conflicting information in the literature investigating myeloperoxidase (MPO) activity and soluble tumor necrosis factor receptor-1 (sTNF-R1) levels in OSA patients. The aim of our study is to assess the clinical utility of plasma MPO activity and sTNF-R1 levels as risk markers for systemic inflammation and development of cardiovascular diseases in OSA patients.59 OSA patients diagnosed with polysomnograhpy for Apnea-Hypopnea index (AHI), and 26 healthy volunteers enrolled into the study. Plasma MPO activity was measured using a spectrophotometric method. An enzyme-linked immunosorbent assay (ELISA) method was used to detect plasma sTNF-R1 levels.Plasma MPO activity and sTNF-R1 levels were significantly higher (43.2 ± 21.65 vs. 30.44 ± 8.05 p = .0046; 2.379 ± 1.2 vs. 1.086 ± 0.86 p.0001, respectively) in the total OSA patients compared to the control group. There was a significant weak correlation between MPO activity and disease severity indicator AHI (p = .03 r = .27).Elevated plasma MPO activity and sTNF-R1 levels in the OSA patients indicate increased systemic inflammation and oxidative stress which might contribute to the higher incidence of cardiovascular diseases. Therefore, we recommend measurement of plasma MPO activity and sTNF-R1 levels in the OSA patients as potential risk predictors for cardiovascular diseases.

Aim To review the medical charts of women who applied for the uterine transplant project from June 2008 to June 2011 in our hospital retrospectively (18–40 years). Methods The data for 144 women were retrieved, and information was collected on the etiology of uterine factor infertility(UFI); ovarian reserve tests; and accompanying anatomic, infectious, genetic and endocrinological problems. Results There were 119 patients with primary amenorrhea and uterovaginal agenesis and 25 patients with a history of hysterectomy. The complete Mullerian agenesis patients formed the largest group of the UFI patients with better anti-Mullerian hormone levels and antral follicle count. Anatomical anomalies such as a solitary pelvic kidney may accompany Mayer–Rokitansky–Kuster–Hauser syndrome (MRKH) and impede surgery. The mean ages in MRKH, hysterectomy and complete androgen insensitivity syndrome (CAIS) cases were 24.7, 35.0 and 34.4 years, respectively. The karyotype analysis showed 46XX (MRKH) in 109 patients and 46XY (CAIS) in 10 of the primary amenorrhea patients. Conclusion Hysterectomy may deteriorate ovarian blood flow and decrease ovarian reserve. Fertility preservation may be considered in young woman undergoing hysterectomy.

Intrauterine growth restriction (IUGR) is one of the most common problems in obstetrics. Ischaemia-modified albumin (IMA), a product deriving from albumin as a result of the modification by oxidative free radicals in response to hypoxia, was previously used as a marker of ischaemia in acute coronary syndrome. We performed this study to determine whether umbilical venous IMA levels are associated with IUGR. A total of 40 pregnancies with IUGR were compared with 40 of normal fetal development. Blood samples were obtained from the umbilical vein after delivery. IMA levels in the IUGR group were higher than in the control group (78.74 ± 6.87 vs 74.43 ± 7.84 U/ml, respectively, p = 0.011). An elevated IMA level was associated with IUGR (OR: 1.079, 95% CI: 1.000-1.163, p = 0.049). We suggest that IMA, which was formerly proved to arise in ischaemic conditions, may also be a valuable marker in perinatal hypoxia and IUGR detection.

Background Endothelial dysfunction, which is characterized by an imbalance between relaxing and contracting factors, procoagulant and anticoagulant substances, and between pro-inflammatory mediators, may play a particularly significant role in the pathogenesis of atherosclerosis. Numerous experimental and clinical reports suggest that a high von Willebrand factor (vWF) level reflects endothelial damage or dysfunction. Hypertensive retinopathy (HR) is a condition characterized by a spectrum of retinal vascular signs in people with elevated blood pressure. The pathophysiological mechanism of HR is not completely understood. Elevated blood pressure alone does not fully account for the extent of retinopathy. Endothelial dysfunction and mechanisms known to be involved in vascular lesions may be involved in the pathophysiological mechanism of HR. Therefore, this study was designed to answer the following questions: (i) Do vWf levels change in HR? and (ii) Is there any relation between degree of HR and vWf levels? Material/Methods This study included 80 hypertensive patients with HR. Group 1 comprised 40 patients with grade I HR, and group 2 comprised 40 patients with grade II HR. We selected 40 healthy subjects for the control group. Results Level of vWf in group 2 was significantly higher than in group 1 (p=0.017) and the control group (p

Convulsions are one of the frequently seen problems for a neurologist in the daily routine. It is difficult to distinguish the seizure from pseudo-seizure because of lack of conclusive tests. The aim of this study is to investigate the relationship between seizure types and seizure periods by studying IMA serum levels in children having seizure. Two groups were included (patients and control) in our study. The patient group consisted of the children admitted to Pediatric Emergency Care during January 2008–January 2010 with seizure and the control group consisted of healthy children. Serum Ischemia modified albumin (IMA) level in the group having seizures was 99.7 and 83.2 U/ml in the control group. In the comparison of the patient and control groups, significant differences were found between their IMA values (p = 0.000). There was a significant difference between IMA values of the group having generalized tonic–clonic seizures and those of the control group (p = 0.001). In comparison of the IMA values of the group having febrile convulsions and those of the control group, a significant difference was determined (p = 0.011). It has been shown that if the seizure was prolonged over 5 min, IMA level increased, and there was a significant difference between the groups experiencing over 5 min of seizures and the groups experiencing less than 5 min of seizures (p = 0.001). An increase in IMA levels in febrile convulsion supports the hypoxia development in the brain during the seizure. Serum IMA levels increased with the elongation of the seizure period and may be an indicator for status epilepticus. 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The purpose of this study was to investigate the effect of melatonin administration on muscle glycogen concentration during recovery after exhaustive swimming exercise in sedentary and trained rats. Male Wistar rats were assigned to one of four groups: sedentary control (C), sedentary melatonin-injected (M), exercise-trained (T), and trained and melatonin-injected (MT) groups. Exercise-trained groups were subjected to six weeks of swimming exercise. All rats completed an exhaustive swimming exercise. Two daily subcutaneous injections of melatonin at a dose of 3 mg·kg−1 were given to the rats in the M and MT groups immediately after the exhaustive exercise. Plasma melatonin, glucose and lactate concentrations, and glycogen concentrations of the soleus and epitrochlearis muscle tissues were measured after exhaustive exercise. Plasma lactate concentration was significantly lower in the T and MT groups than in the C group. Plasma melatonin concentration was higher in the supplemented groups than in t...

Aflatoxin B1 (AFB1) is the most potent of the mycotoxins and is widely observed in nutrition abnormalities. There are some studies suggesting oxidative stress-induced toxic changes on liver related to AFB1 toxicity. The aim of the present study was to evaluate whether antioxidant caffeic acid phenethyl ester (CAPE) relieves oxidative stress in AFB1-induced liver injury in rat. Twenty-four male rats were equally divided into three groups. The first group was used as a control. The second group received three doses of AFB1. The three doses of CAPE were given to constitute the third group with doses of AFB1. After 10 days of experiment, liver and serum samples were taken from all animals. Serum gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), glutathione s-transferase (GST), nitric oxide (NO) and sulfhydryl values were higher in the AFB1 group than in control, whereas serum GGT, ALP, GST and NO values were decreased by in the AFB1 + CAPE group than in AFB1 group. Liver GST, total oxidant capacity, sulfhydryl, apoptosis index and ischemia-modified albumin values were higher in the AFB1 group than in control, whereas the GST activity and apoptosis index were lower in the AFB1 + CAPE group than in the AFB1 group. There were histopathological degeneration and apoptosis in hepatocytes of AFB1 group. The findings were totally recovered by CAPE administration. In conclusion, we observed that AFB1 caused oxidative and nitrosative hepatoxicity to hepatocytes in the rat. However, CAPE induced protective effects on the AFB1-induced hepatoxicity by modulating free radical production, biochemical values and histopathological alterations. Copyright © 2013 John Wiley & Sons, Ltd.

Introduction: Data regarding cardiovascular risk in patients with non-functional adrenal incidentaloma (NFAI) are limited. The objectives of this study are to investigate markers of subclinical cardiovascular disease like carotid intima media thickness (CIMT), pulse wave velocity (PWV), augmentation index (AIx), soluble CD40 ligand (sCD40L) and leptin levels in NFAI patients without traditional cardiovascular risk factors and healthy control group. Methods: This study involved 35 patients with NFAI (11 males, 24 females; mean age, 52.4±7.7 years) and 35 healthy subjects as control group (11 males, 24 females; mean age, 51.8±7.2 years). CIMT was evaluated by ultrasonographical methods. PWV and AIx were measured with TensioClinic arteriograph system. Serum leptin and sCD40L levels were measured by ELISA. Results: In NFAI patients group; CIMT (p

The aim of our study was to determine the effectiveness of immunoglobulin, rituximab and plasmapheresis in renal transplant patients with antibody mediated rejection (AMR).Fourteen renal transplant patients with AMR were included in this study. The mean age of the patients was 33.9 ± 10.3 years and 10 (71.4%) of them were male. Lymphocyte cross match was negative for all patients and 10 (71.4%) of them were living donor transplants. Six patients were administered tacrolimus, three patients cyclosporine, two patients everolimus, and three patients sirolimus for immunosuppression. The patients with AMR were administered IVIG, rituximab and plasmapheresis.Patient survival rate was 100%, graft survival rate after AMR was 50% in the first year and 33% in the 2nd and third years. AMR developed 31.9 ± 25.9 months after transplantation. Seven (50%) patients lost their grafts. Delayed graft function was observed in 28.6%, chronic allograft dysfunction in 78.5%, diabetes after transplantation in 14.3%, and cytomegalovirus infection in 7.1% of the patients. At the last follow-up, the mean blood creatinine was 3.1 ± 1.4, the mean proteinuria was 2300 (1300-3300) mg/day and the mean GFR was 34.5 ± 17.6 ml/min. C4d was positive in peritubullar capillaries in all patients, while neutrophil accumulation in peritubular and glomerular capillaries was observed in 8 patients. Chronic allograft vasculopathy was observed in 12 patients.AMR leads to progressive loss of renal function and has low graft survival. More effective treatment alternatives are needed for this clinical issue.

We investigated the endosulfan-induced alterations and the effect of vitamin C supplementation on endosulfan-induced alterations in serum biochemical markers of oxidative stress and antioxidant capacity in rabbits. Basal, 4th and 6th week serum levels of total oxidant status (TOS), thiobarbituric acid reactive substances (TBARS), advanced oxidation protein products (AOPP), total antioxidant capacity (TAC), total protein sulfhydryl (T-SH) and glutathione-S-transferase (GST) were measured in rabbits administered endosulfan (1 mg/kg) alone or in combination with vitamin C (20 mg/kg) for 6 weeks. Control rabbits received either vehicles or vitamin C. Serum TOS, TBARS and AOPP levels at 4th and 6th week were significantly higher whereas T-SH levels were significantly lower than basal values in endosulfan-administered rabbits. GST increased significantly at 4th week but decreased below basal value at 6th week. Similarly, TAC decreased significantly at 6th week. Vitamin C supplementation increased TAC at 4th and 6th weeks in controls and increased T-SH and GST and decreased TOS, TBARS and AOPP at 4th week in endosulfan-administered rabbits. TAC increased significantly at 6th week by vitamin C supplementation in endosulfan-administered rabbits. There were significant increments in TBARS and decrements in TAC and GST levels at 6th week compared to 4th week in endosulfan-administered rabbits. Present findings indicated to an increased and progressively uncompensated oxidant stress in endosulfan-administered rabbits that was substantially ameliorated by vitamin C supplementation through an improvement in antioxidant capacity. It was suggested that vitamin C supplementation might be helpful in preventing the detrimental effects of increased oxidative stress caused by endosulfan exposure.

Simsek A, Turan O, Ciftel M, Kardelen F, Durmaz E, Ozdem S, Akcurin G, Ertug H. Evaluation of left ventricular functions with twodimensional speckle-tracking echocardiography (2D-STE) and N-terminal ProBNP in diabetic children. Turk J Pediatr 2018; 60: 633-641. The purpose of this study was to examine the existence of subclinical left ventricular dysfunction by using 2D-STE and NT-ProBNP levels in children and adolescent patients with type 1 diabetes mellitus. Furthermore, it was also aimed to investigate the effects of the diabetes duration and the metabolic control of the disease on cardiac functions. The patient group was composed of 63 children who were being followed up for the type 1 diabetes mellitus. The control group was composed of 36 healthy children who were of the similar age. Patients with type 1 diabetes mellitus were divided into groups; according to the duration of the disease; group 1: 3-5 years, group 2: 6-10 years of follow-up. The conventional echocardiography and 2D-STE were applied to all of the patients and control individuals. NT-Pro BNP level was measured in the diabetes group. In the conventional echocardiographic examination; there was no difference between the patient and control groups in terms of left ventricular systolic functions, left ventricular diastolic functions; late-diastolic flow velocity in mitral valve (A) values increased and E-wave/A-wave ratio (E/A ) values decreased in diabetes mellitus patients. According to the 2D-STE results; global longitudinal strain, (-17.28±2.24 vs. -19.49±2.22; p < 0.05) and circumferential strain (-12.86±3.19 vs. -17.71±4.62; p < 0.05) were lower in diabetic patients compared to the parameters of control group individuals. There was no difference between levels of NT-ProBNP of the group 1 and group 2 diabetes mellitus patients. Our study showed that there was a dysfunction on the left ventricular systolic functions of the patients with type 1 diabetes mellitus. NT-Pro BNP levels were not considered as a distinguishing factor for the early stages of diabetes mellitus.

We aimed at investigating insulin resistance in children with Helicobacter pylori (H. pylori) infection. Fasting serum insulin and glucose levels were determined in 31 children with H. pylori (+) (H. pylori-infected group, 20 girls and 11 boys, median age 12 yr, range 6-17) and 29 H. pylori (-) (control group, 18 girls and 11 boys, median age 13 yr, range 5-16). Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) score. Fasting serum glucose levels did not differ significantly between H. pylori (+) and (-) children. Both HOMA-IR score and serum insulin levels were significantly higher in H. pylori-infected compared to control children. The findings of the present study suggested that there is a certain relation between H. pylori infection and insulin resistance in children.

We sought to explore the relationship between Helicobacter pylori infection and serum ferritin, vitamin B(12), folate, and zinc status among children. Fifty patients aged 5-18 years who underwent upper gastrointestinal endoscopy because of dyspeptic symptoms, were studied, prospectively. Patients were grouped as H. pylori positive (group 1, n=32) or H. pylori negative (group 2, n=18) by histopathologic examination and rapid urease test. Fasting serum ferritin, vitamin B(12), folate, and zinc levels of patients were measured. Both groups were indifferent according to age, gender, height standard deviation score (H(SDS)), and weight standard deviation score (W(SDS)). Serum ferritin levels were 33+/-26 and 50+/-46 ng/mL (P=.098), vitamin B(12) levels were 303+/-135 and 393+/-166 pg/mL (P=.042), folate levels were 9.64+/-3.2 and 9.61+/-2.8 ng/mL (P=.979), and zinc levels were 95+/-48 and 87+/-31 mug/dL (P=.538), in groups 1 and 2, respectively. Ferritin levels of 14 (43.8%) patients in group 1 and 6 (33.3%) patients in group 2 were below the normal range (P=.470). Serum vitamin B(12) levels of 9 children (28%) in group 1 and 2 children (11%) in group 2 were below the normal range (P=.287). The findings of the present study suggest that H. pylori infection has a negative effect on serum ferritin and vitamin B(12) levels in children. This negative effect on vitamin B(12) levels is rather marked in contrast to that on ferritin levels. H. pylori infection has no significant effect on serum folate or zinc levels among children.