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    A case of double parathyroid adenoma mimicing intrathoracic tumor
    (Lippincott Williams & Wilkins, 2008) Taskiran, Bengur; Altun, Betul Ugur; Usta, Ufuk; Guldiken, Sibel; Arikan, Ender; Van Tue-Rul, Arina
    Adenoma is the leading pathologic entity in primary hyperparathyroidism (85%-90%). Although brown tumors are rarely seen, they may be the initial presentation and confused with tumors of the contiguous structures. Bilateral neck exploration by an experienced surgeon is the preferred approach. However, computed tomography, magnetic resonance imaging, ultrasonography, and isotope scanning can delineate most cases (75%-85%). We present a man with 2 adenomas. The second tumor was not recognized until the first one was removed. Combined imaging modalities and the measurement of intraoperative parathormone did not help in identifying the second adenoma. We review the common problems associated with diagnosis and treatment of multiple parathyroid adenomas.
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    Effect of obesity on TAFI in postmenopausal period
    (Elsevier Sci Ltd, 2010) Taskiran, Bengur; Guldiken, Sibel; Demir, Ahmet M.; Okman, Tulay K.; Arikan, Ender; Turgut, Burhan; Tugrul, Ayse A.
    Aim: The aim of the study was to evaluate how obesity effects the coagulation and fibrinolytic system in the postmenopausal period. Method: Forty-eight obese (body mass index (BMI) >= 30 kg/m(2)) and 38 nonobese (BMI < 30 kg/m(2)) postmenopausal women were enrolled in the study. Fat mass and insulin resistance were calculated. Plasma levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA), D-dimer, thrombomodulin, and thrombin activatable fibrinolysis inhibitor (TAFI) antigen were determined by ELISA method. TAFI activity was measured using the chromogenic assay. Results: Obese subjects had higher PAI-1 (73.5 +/- 35.7 ng/mL vs. 57.1 +/- 34.2 ng/mL, p < 0.05) levels but lower tPA/PAI-1 ratio (0.59 +/- 0.50 vs. 38 +/- 0.21, p < 0.05) than their nonobese counterparts. Obesity was not statistically significant for other haemostatic variables. BMI and fat mass were positively correlated with PAI-1 (r = 0.312, p = 0.003; r = 0.381, p = 0.005, respectively) and negatively correlated with tPA/PAI-1 ratio (r = -0.273, p = 0.01; r = -0.545, p = 0.01, respectively). HOMA scores were also positively correlated with PAI-1 levels (r = 0.236, p = 0.04). Conclusion: We found that tendency to hypercoagulability in the postmenopausal women was due to increased PAI-1 rather than TAFI levels, which may contribute to adverse cardiovascular outcomes in this cohort. Further studies should be undertaken to evaluate effects of weight loss on the coagulation and fibrinolytic system. (C) 2010 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
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    Fatal Lactic Acidosis Due to Metformin
    (Aves, 2010) Kavalci, Cemil; Guldiken, Sibel; Taskiran, Bengur; Kavalci, Gulsum
    [Abstract Not Available]
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    Migraine in Metabolic Syndrome
    (Lippincott Williams & Wilkins, 2009) Guldiken, Baburhan; Giddiken, Sibel; Taskiran, Bengur; Koc, Gonul; Turgut, Nilda; Kabayel, Levent; Tugrul, Armagan
    Objectives: Recent studies suggest that insulin resistance is In ore common in patients with migraine. Insulin resistance underlies the pathogenesis of obesity, diabetes. and hypertension that are components of metabolic syndrome. As migraine is associated with an increased risk of vascular disorders, such as stroke. and migraine patients have higher diastolic blood pressure than healthy individuals, we aimed to investigate the I-year prevalence of migraine in metabolic syndrome. Methods: Two hundred ten patients with metabolic syndrome were enrolled in the study. Migraine was diagnosed according to International Classification of Headache Disorders-II criteria. Results: Migraine prevalence was estimated its 11.9% in men and 22.5% in women with metabolic syndrome. Of the metabolic syndrome Components, diabetes, increased waist circumference, and body mass index were significantly more frequent in patients with migraine in contrast to those without migraine (P <0.05). Hypertension and dyslipidemia frequencies showed no difference between 2 groups. Conclusions: Our results demonstrate that migraine prevalence it) metabolic syndrome was higher than in file general population.
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    Soluble endothelial protein C receptor level in obesity
    (Editrice Kurtis S R L, 2009) Taskiran, Bengur; Guldiken, Sibel; Demir, Ahmet Muzaffer; Okman, Tulay Kilic
    Background and aims: Obesity is a common disorder and is a known risk factor for vascular thrombotic events. The protein C anticoagulant system serves many anti-inflammatory functions. The soluble form of endothelial protein C (sEPCR) circulating in plasma precludes protein C activation and inhibits the anticoagulant activity of activated protein C. The aim of the study is to determine high sensitive C-reactive protein (CRP) and soluble EPCR levels among obese women. Methods: Seventy five postmenopausal women were enrolled in to one of two groups according to body mass index (BMI), 45 obese (BMI >= 30 kg/m(2)) and 30 non-obese (BMI<30 kg/m(2)). Plasma levels of soluble EPCR and hsCRP were determined by ELISA. Results: HsCRP was significantly higher in the obese subjects compared to their non-obese counterparts (0.90 +/- 1.25 mg/l vs 0.46 +/- 0.45 mg/l, p=0.006). Soluble EPCR levels did not differ between the obese and non-obese groups (p=0.494). HsCRP was positively correlated with BMI and waist circumference (r=0.341, p=0.004; r=0.348, p=0.04, respectively). Soluble EPCR showed no significant correlation with these measures. Conclusions: We also detected a wide range of interindividual variability in sEPCR level (40.77-892.82 ng/ml for non obese, 6.09-1339.25 ng/ml for obese). Although the obese had higher sEPCR, the difference was not statistically significant. A well-established inflammatory marker, hsCRP was significantly higher in the obese. There was no relation between hsCRP and sEPCR. Consequently we suggest that sEPCR does not contribute to the inflammation and increased propensity for coagulation in the postmenopausal stage. Obesity and Metabolism 2009; 5: 134-138.
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    Spontaneous Cure of an Apoplectic Somatotropinoma in the Setting of Coronary Angiography
    (Galenos Yayincilik, 2008) Taskiran, Bengur; Guldiken, Sibel; Altun, Betul Ugur; Tuncbilek, Nermin; Tugrul, Armagan
    Pituitary apoplexy, which results from spontaneous hemorrhage into a pituitary adenoma, may be associated with a number of clinical settings including head trauma, hypertension, diabetes mellitus, acute hypovolemic shock, contrast media usage, and anticoagulation therapy. Clinical manifestations are due to the mechanical compression of the optic apparatus and cavernous sinus content, and pituitary insufficiency. Pituitary insufficiency does not recover in most of the cases. Ophthalmoplegia may resolve spontaneously over time or after surgery. Rarely, pituitary apoplexy may be followed by an endocrinologic cure. We present an apoplectic somatotropinoma in the setting of coronary angiography and unstable angina pectoris, which was spontaneously cured after pituitary apoplexy. This is one of few reports of pituitary apoplexy in association with contrast medium and anticoagulant-antiaggregant drug administration.