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    A case of parathyroid carcinoma presenting with bone metastasis: Brief review of the literature
    (2012) Altun, Betül Uğur; Bilir, Betül Ekiz; Sezer, Atakan; Torun, Neşe; Atile, Neslihan Soysal; Çalık, Arzu; Güldiken, Sibel
    Primer hiperparatiroidinin (PHP) en nadir nedenlerinden olan paratiroid karsinom (PK) (<%1) az rastlanan bir malignitedir. PKun yol açtığı hiperparatiroidi sıklıkla metabolik kemik hastalığı ve renal komplikasyonlara yol açar ve mortaliteyi yükseltir. Lokal servikal invazyon, servikal lenf nodlarına yayılım ve akciğer ve kemik metastazları sık görülür. Olgu: 56 yaşında kadın hasta sağ kalçada ağrı yakınmasıyla başvurdu. Çekilen düz grafisinde pelviste kırık hattı izlendi. Muayenede boyun sol yanda kitle palpe edildi. Tetkiklerinde düzeltilmiş Ca=15,5 mg/dl, P=2,1 mg/dl, iPTH=880,2 pg/ml olması üzerine servisimizde interne edilen hastanın boyun US ve MIBI ile paratiroid adenomu saptandı. Kalçaya yönelik MRda metastazla uyumlu kemik lezyonları saptanması nedeniyle MIBI tüm vücuda yönelik yapıldı ve iskelet sisteminde yaygın malign hastalık olarak raporlandı. PET-BT ile değerlendirilen hastada organ metastazı saptanmadı ancak kemik metastazları doğrulandı. PK ön tanısıyla hastaya paratiroidektomi yapıldı. Post-op aç kemik sendromu gelişen hastanın Ca replasman tedavisi düzenlendi. Kemik metastazlarına yönelik radyoterapisi yapılmaktadır. PK nadir ancak agresif bir malignitedir ve PK öntanısıyla yapılan agresif cerrahi eksizyon hastanın kür şansını arttıran önemli etkenlerdendir. Yüksek Ca ve PTH düzeyleri ve boyunda palpabl kitle malignite açısından uyarıcı olmalıdır. Postoperatif hipokalsemi krizi sıklıkla beklenmelidir. PK için bilinen bir medikal tedavi yoktur. Radyoterapi hem lokal nüks hem metastaz için kullanılan tedavi modalitesidir.
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    Coexistence of Hyperthyroidism and Pulmonary Hypertension
    (Elmer Press Inc, 2011) Ayhan, Mediha; Atile, Neslihan Soysal; Guney, Engin
    We diagnosed pulmonary hypertension concomitant with hyperthyroidism in two female patients referred to our clinic. In both patients' etiology of hyperthroidism were Graves disease. As a result of management of hyperthroidism with antithyroid medical treatment, decline of pulmonary artery pressures were observed. Association of hyperthroidism with pulmonary hypertension has been notified as case reports in the literature. Current classifications do not give place to hyperthyroidism as a cause of secondary pulmonary hypertension. Primary pulmonary hypertension is however an exclusion diagnosis. We report our cases to point to the need of search for hyperthyroidism before diagnosing primary pulmonary hypertension.
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    A Metabolic Syndrome Case Presenting with Lymphocytic Mastitis
    (Karger, 2012) Bilir, Betul Ekiz; Atile, Neslihan Soysal; Bilir, Bulent; Guldiken, Sibel; Tuncbilek, Nermin; Puyan, Fulya Oz; Sezer, Atakan
    Background: Lymphocytic mastitis is a disease of premenopausal women, and its association with type 1 diabetes mellitus is the basis for its alternative name 'diabetic mastopathy'. It is a benign condition but must be considered in the differential diagnosis of breast cancer, especially in diabetic patients. Case Report: We present the case of an overweight 50-year-old dyslipidemic woman with metabolic syndrome presenting with lymphocytic mastitis. Conclusion: Although lymphocytic mastitis is usually regarded as an autoimmune disease seen mostly in diabetic patients, it may also be seen in nondiabetic patients with metabolic syndrome who do not have an autoimmune disease.
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    Prevalence of Metabolic Syndrome in Primary Hyperparathyroidism
    (Galenos Yayincilik, 2017) Cevik, Gokcen Tugba; Guldiken, Sibel; Atile, Neslihan Soysal; Celik, Huseyin; Celik, Mehmet; Ayturk, Semra; Sut, Necdet
    Aim: In this study, we aimed to evaluate the prevalence of metabolic syndrome (MetS), metabolic abnormalities and independent predictors of MetS in primary hyperparathyroidism and to contribute to long-term follow-up and management of these patients. Methods: Seventy-eight non-pregnant patients aged 18 years and over without renal or hepatic failure and other systemic diseases, who were diagnosed with primary hyperparathyroidism, between January 2005 and December 2014 were included in the study. Results: Sixty-two (79.5%) subjects were female and 16 (20.5%) were male. The mean age of the patients was 55.3 +/- 12.6 years. Fifty eight patients were classified as symptomatic and 20 as asymptomatic. Thirty-two patients (41%) were found to have primary hyperparathyroidism in accordance with the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. The frequency of urinary tract stone disease was significantly higher in patients with hyperparathyroidism with MetS than in those with primary hyperparathyroidism without MetS (p=0.018). Conclusion: In our study, the prevalence of MetS in patients with primary hyperparathyroidism was found to be similar to that demonstrated in epidemiological studies performed in the general population of the same age. However, in these patients higher prevalence of hypertension, increased waist circumference, lipid disorders such as some syndrome abnormalities that may lead to the increased cardiovascular morbidity and mortality were observed.
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    PREVENTIVE EFFECTS OF ALPHA-LIPOIC ACID ON DIABETIC NEPHROPATHY IN A RAT MODEL
    (Carbone Editore, 2014) Ayhan, Medina; Guney, Engin; Atile, Neslihan Soysal; Serter, Mukadder; Meteoglu, Ibrahim
    Objective: Diabetic nephropathy is the major cause of chronic renal failure, and oxidative stress has an important role in its etiology. Aim of this study is to investigate the effects of the antioxidant alpha-lipoic acid (ALA) treatment on proteinuria, antioxidant enzyme and inflammatory cytokine levels in the renal tissue and renal histopathology in diabetes. Design: Thirty male Wistar rats were divided into three groups: normal control group (n=10), diabetic control group (n=10), and ALA treated diabetic group (n=10). Diabetes was induced by a single ultra venouse injection of streptozotocin. Rats which completed 4 weeks of the study period were sacrificed after 24 hour urine collection for albuminuria detection. Histopathological examination was performed. Antioxidant enzyme and inflammatory marker levels in renal tissue were measured. Results: The 24 hour urinary albumin levels were significantly reduced in the ALA-treated diabetic group compared with the diabetic control group. In ALA administered rats, histopathological findings such as tubular dilation, tubular epithelium necrosis, glomerular focal necrosis, and interstitial inflammation were observed at a lesser extent than the diabetic control group. Any difference was not detected between the diabetic control group, and the ALA group with respect to the levels of GSH, GSH-r, MDA, TNF-alpha and IL-6. Conclusion: ALA administration led to regression of histopathologic and morphologic lesions in extracted rat kidney. Also positive effect of ALA on albuminuria was detected. However, no positive effect of ALA was found for antioxidant parameters at the tissue level.
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    Primer Hiperparatiroidili Hastalarda Metabolik Sendrom Sıklığı
    (2017) Çevik, Gökçen Tuğba; Güldiken, Sibel; Atile, Neslihan Soysal; Çelik, Hüseyin; Çelik, Mehmet; Salt, Semra Aytürk; Süt, Necdet
    Amaç: Çalışmamızda primer hiperparatiroidizm olgularında metabolik sendromun (MetS) sıklığının tespiti, metabolik sendrom parametrelerinin incelenmesi ve primer hiperparatiroidizmde MetS belirleyicilerinin tayini ile bu hastaların uzun dönem takibine ve yönetimine katkıda bulunmayı hedefledik.Yöntemler:­Kliniğimizde Ocak 2005 ile Aralık 2014 tarihleri arasında takip edilen, primer hiperparatioidizm olarak tanımlanan, 18 yaşını doldurmuş, gebe olmayan, böbrek ve karaciğer yetmezliği ve diğer sistemik hastalıkları olmayan 78 hasta çalışmaya dahil edildi. Bulgular: Hastaların 62'si (%79,5) kadın, 16'sı (%20,5) erkek, K/E: 3,87, yaş ortalamaları 55,3±12,6 yıl olarak saptandı. Hastalardan 58 tanesinin primer hiperparatiroidizme ait semptom taşıdığı, 20 tanesinin semptomatik olmadığı tespit edildi. Hastalar "National Cholesterol Education Program-Adult Treatment Panel III" metabolik sendrom tanı kriterlerine göre değerlendirildiğinde, 32 hastada (%41) MetS tespit edildi. MetS'li primer hiperparatiroidi hastalarında üriner sisteme ait taş hastalığı sıklığı, MetS olmayanlara göre istatiksel olarak anlamlı düzeyde yüksek tespit edildi (p=0,018). Sonuç: Çalışma grubumuzdaki primer hiperparatiroidizmli hastalarda metabolik sendrom sıklığının epidemiyolojik çalışmalardaki genel toplumun aynı yaş grubu bireylerindeki metabolik sendrom sıklığı ile benzer olduğu görüldü. Ancak bu hastalarda kardiyovasküler morbidite ve mortalite artışına neden olabilecek hipertansiyon, artmış bel çevresi, lipid profili bozukluğu gibi sendrom anormallikleri sıklıklarında artış olduğu saptandı.