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Öğe Early changes in parameters of bone and mineral metabolism during therapy for hyper- and hypothyroidism(Marcel Dekker Inc, 2001) Sabuncu, T; Aksoy, N; Arikan, E; Ugur, B; Tasan, E; Hatemi, HThe effects of thyroid hormones on various organs and metabolic systems have been the focus of intensive research. In this study we investigated the mechanisms of the changes in some parameters of bone and mineral metabolism before and during treatment off hyper- and hypothyroidism. Our study groups were as follows; 1) Untreated hyperthyroid patients (n = 38), 2) Hyperthyroid patients treated fbr three months (n = 21), 3) Untreated hypothyroid patients (n = 27), 4) Hypothyroid patients treated for three months (n = 20), and 5) Euthyroid control subjects (age, weight, sex and menopausal status matched) (n = 47). As expected, the mean serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and urinary Ca/creatinine and deoxypyridinoline (D-Pyr)/creatinine levels were higher in group-1 than in the control group. Serum PTH level was lower in group-1 than in group-5. However, after treatment for three months (group-2) we found that the serum and urinary levels of these parameters (except ALP) were not different than in the control group. Group-3 and group-4 did not show any differences in these parameters compared with group-5. Covariance analysis showed that urinary D-Pyr excretion had a positive, independent relationship to the serum free T3 level and age (P < 0.001 and P = 0.02, respectively). These results suggest that both bone formation and resorption markers increase in hyperthyroid patients, and with the treatment, particularly, in the period of first three months the bone resorption markers decrease rapidly, if the treatment is maintained the decrease slows, becoming more gradual. However, bone formation markers like ALP remain high in hyperthyroid patients during the treatment. In the light of this data, it is possible to conclude that osteoblastic activity lasts longer in hyperthyroidism. On the other hand, we demonstrated that these bone formation and resorption markers do not seem to be different in hypothyroid patients, even during the treatment, compared to the euthyroid controls.Öğe Effect of verapamil sustained-release on the sympathetic nervous system response to isometric stress in patients with essential hypertension: A pilot study in Turkish patients(Excerpta Medica Inc, 2001) Bicik, Z; Akcan, Y; Ugur, BBackground: Stress and sympathetic nervous system activation play a major role in the pathogenesis of essential hypertension. Recent data suggest that the calcium channel blocker verapamil, in addition to its antihypertensive effects, can alter the level of norepinephrine released during stress. Objective: The purpose of this study was to examine the effects of verapamil sustained-release (SR) on the sympathetic nervous system response to stress in patients with essential hypertension. Methods: Patients with essential hypertension (diastolic blood pressure >90 mm Hg and systolic blood pressure >140 mm Hg) whose blood pressure was inadequately controlled or uncontrolled were enrolled in the study. Secondary hypertension was ruled out by routine biochemical, endocrine, and radiologic tests. After a 15-day washout period during which all previous antihypertensive medication was discontinued, blood pressure, heart rate, and serum norepinephrine levels were measured at rest and in response to stress (ie, isometric exercise). Patients began treatment with verapamil SR at dosages recommended in the Sixth Report of the Joint National Committee for the Prevention, Diagnosis, Evaluation, and Treatment of High Blood Pressure (240 mg/d for stage I hypertension and 480 mg/d for stage II and stage III hypertension). After 4 weeks of treatment, blood pressure, heart rate, and norepinephrine levels were measured again at rest and in response to stress. Results: Thirteen patients (9 women and 4 men) were enrolled; 9 patients completed the study. Three patients were lost to follow-up and 1 was noncompliant. Verapamil SR significantly lowered norepinephrine levels both at rest and in response to stress (P<0.01), and reduced the increase in norepinephrine levels after isometric exercise. Conclusion: These results suggest that in this small sample of Turkish patients, verapamil SR significantly diminished the sympathetic nervous system response to stress by decreasing norepinephrine levels. This property may make verapamil SR especially useful when there is a need for decreased sympathetic activity (and thereby, a reduction in oxygen consumption) as well as other antihypertensive effects, such as in patients with coronary heart disease.Öğe Incidental detection of single vertebral osteomyelitis in a patient operated on for parathyroid hyperplasia(Lippincott Williams & Wilkins, 2001) Çermik, TF; Yüksel, M; Yalniz, E; Kaya, M; Ugur, B; Tugrul, A; Berkarda, S[Abstract Not Available]Öğe Ventricular repolarization changes during thyrotropin releasing hormone test(Elsevier Sci Ireland Ltd, 2001) Altun, A; Ugur, B; Akdemir, O; Altun, GD; Öztekin, E; Birsin, A; Özbay, GWe investigated the ventricular repolarization changes during thyrotropin-releasing hormone (TRH) test in 20 euthyroid healthy subjects. TSH elevation was observed in 14 subjects (age: 29 +/- 5 years). TSH increased at 20 min (baseline: 1.91 +/- 1.18 muU/ml vs. 20 min: 13.7 +/- 7.2 muU/ml, P < 0.0001) and slightly decreased at 40 min (baseline vs. 40 min: 11.6 6.7 muU/ml P < 0.0001). Many dispersions prolonged at 20 and 40 min (P < 0.05). At baseline, 20 and 40 min, positive linear correlations were observed between TSH levels and TTd and TTcd, These data shows: that ventricular repolarization and regional inhomogeneity of ventricular repolarization increase during the TRH test. Neural and receptor-mediated mechanisms on repolarization kinetics of myocardial cells may act on this effect. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
