Hayati Ayakta | Istanbul University (original) (raw)
Papers by Hayati Ayakta
PubMed, Sep 1, 2004
Purpose: Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases ... more Purpose: Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. Materials and methods: Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. Results: Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a homogeneous enhancement in the venous phase. However, two small lesions, four and five mm in diameter respectively, showed homogeneous contrast enhancement in the arterial phase unlike the larger lesions which displayed a hypodense center in this phase. Conclusion: Dynamic scanning with multidetector computed tomography after contrast administration may be helpful in characterizing parathyroid adenomas.
Turkish journal of haematology : official journal of Turkish Society of Haematology, 2001
Leptin is a recently found hormone regulating body weight. In human obesity, this weight-regulati... more Leptin is a recently found hormone regulating body weight. In human obesity, this weight-regulating hormone level is in a positive correlation with FMI (fat mass index) and BMI (body mass index). In this study, we aimed to investigate the relation between serum leptin levels and BMI, PF (percentage fat), LMI (lean mass ındex), FMI and some other parameters of patients with haematologic malignant diseases. Fourty-four patients with haematologic malignant diseases and 25 healthy control group were taken into the study. In the comparison, there were no significant difference between the PF and FMI values of both groups, while the mean BMI and LMI values of the control group were significantly higher than that of the patient group. There was a positive correlation between leptin levels and BMI and FMI among parameters studied in our control group, whereas we couldn't demostrate any such correlation in patient group. We estimate that the alteration may be due to disturbances in the f...
International journal of clinical practice, 2001
Polyglandular autoimmune (PGA) syndromes (types I and II) may affect various endocrine and non-en... more Polyglandular autoimmune (PGA) syndromes (types I and II) may affect various endocrine and non-endocrine organs in the body. In the commoner PGA type II, primary adrenal insufficiency, autoimmune thyroid disease and type I diabetes mellitus are the most frequent manifestations. Serositis with pericardial or pleural involvement is not a well known component of the disease. Here, we report a 21-year-old man who first presented with a pleuropericardial effusion and Graves' disease, and who then developed type I diabetes mellitus.
Clinical and Laboratory Haematology, 2005
Cancer antigen (CA 125) is a glycoprotein commonly used as a tumor marker. In this study, CA 125 ... more Cancer antigen (CA 125) is a glycoprotein commonly used as a tumor marker. In this study, CA 125 levels were measured in 149 patients and 26 healthy control subjects. The study group included 69 non-Hodgkin lymphomas (NHL), 25 Hodgkin disease (HD), 20 acute myelocytic leukemia (AML), 14 chronic lymphocytic leukemia (CLL), 12 chronic myelocytic leukemia (CML), and nine multiple myeloma (MM) patients. CA 125 was elevated in 37 of the patients and in none of the control subjects. Average CA 125 level in NHL patients was significantly higher than the controls (56.2 +/- 9.2 U/ml, 7.99 +/- 1.05 U/ml respectively) (P < 0.05). CA 125 levels were significantly higher in NHL patients with abdominal involvement (113.6 +/- 23.4 U/ml), with B-symptoms (72.3 +/- 13.2 U/ml), higher stage of the disease (stages III and IV -75.3 +/- 14.9 U/ml), bulky disease (99.9 +/- 30.4 U/ml) and in those with serosal involvement (103.1 +/- 18.5 U/ml) (P < 0.05 for all). CA 125 levels were also elevated in seven patients with HD and in a patient with CLL with pleural effusion. In conclusion, for patients with NHL, high levels of CA 125 were associated with B-symptoms, advanced stage, bulky disease, abdominal, and serosal involvement. Therefore, CA 125 might be used as a marker to predict prognosis and to detect advanced disease in NHL.
journalagent.com
Inflammatory pseudotumor is an often forgotten entity in the differential diagnosis of masses in ... more Inflammatory pseudotumor is an often forgotten entity in the differential diagnosis of masses in the lung, despite the fact that, they are the most common benign primary pulmonary growths in children [1-3]. Inflammatory pseudotumor is a broad histological term including organizing pneumonia type, fibrohistiocytic type and plasma cell granuloma type [4] depending on the predominant cellular element. In 1939 Brunn [5] reported an example of this lesion in a five year-old girl. In reports, up to 35 percent of them have occurred in
Clinical and Experimental Dermatology, 2006
Werner’s syndrome (WS) is a rare genetic disorder presenting with multisystem manifestations of p... more Werner’s syndrome (WS) is a rare genetic disorder presenting with multisystem manifestations of premature ageing from the second decade of life. We describe a sister and brother with typical features of this striking condition that may present to dermatologists. A 41-year-old woman (patient 1, height 1.42 m, weight 30 kg, body mass index 14.8 kg ⁄ m) presented with an infected heel ulcer on the left foot. She reported polyuria, polydypsia and weight loss over the past 2 years. She had undergone a bilateral cataract operation 5 years previously. She was found to have diabetes, and her foot ulcer regarded as a diabetic complication. The patient had some peculiar features for her age, i.e. a high-pitched voice, and thin facial appearance with a beak-shaped nose and progerioid features. She carried all major and most minor signs of WS such as bilateral cataracts, atrophic skin changes, short stature, parental consanguinity, premature loss and thinning of scalp hair, diabetes mellitus, hypogonadism, osteoporosis, articular deformities and vocal changes (Fig. 1). Biochemical examination revealed mild elevation of c-glutamyl transferase, alkaline phosphatase, triglycerides and creatinine phosphokinase. There was a mild anaemia consistent with chronic disease and leukocytosis with neutrophilia. Her hormonal profile revealed hypogonadotropic hypogonadism with normal thyrotrophic and corticotrophic axes. She had had two spontaneous, second trimester miscarriages, and her last menstruation had occurred about 6 years prior to presentation. Ultrasonography demonstrated an atrophic uterus and ovaries, and grade 1 hepatosteatosis. Skin biopsy from the lesion was consistent with chronic inflammation and necrosis. The calcaneous was spared from the deep infected heel ulcer (grade I in Wagner classification). X-ray examination demonstrated advanced osteoporosis in trabecular bone, with osteoarthritic changes. Sacroiliac computed tomography (CT) demonstrated a unilateral focal area of sclerosis in the sacroiliac joint (Fig. 2b). She was treated for the heel ulcer and diabetes. Biopsy taken from a vegetative lesion on the right heel revealed malignant melanoma; metastasis to the liver and the abdominal lymph nodes was discovered soon after. She was given palliative chemotherapy and died of rapidly progressing metastatic disease within 1 month. The second case, a 37-year-old man, was the brother of patient 1, and had similar clinical features. He also had extensive tendon calcifications (Fig. 2a) but sacroiliac CT demonstrated no pathology. Both patients were HLA-B27(–) with normal levels of inflammatory markers. He was treated for foot ulcer. WS was named after Otto Werner, who described the condition as scleroderma-like thinning and stiffening of the skin and bilateral cataracts. WS is an autosomal PD
Acta Chirurgica Belgica, 2003
In recent years, many surgeons dealing with endocrine surgery have increasingly performed total t... more In recent years, many surgeons dealing with endocrine surgery have increasingly performed total thyroidectomy for benign thyroid disease. However, total excision of the thyroid in the treatment of benign lesions has been surrounded by even more controversy than its role in cancer treatment. The complication rate appears to be higher when the operation is done by inexperienced surgeons who have no special skills in endocrine surgery using proper techniques. The aim of this study is to determine whether surgeons experience and the refinement of surgical techniques are associated with postoperative recurrent laryngeal nerve (RLN) palsy or hypocalcemia after total thyroidectomy for benign thyroid disease. A total of 68 consecutive patients who underwent total thyroidectomy for benign thyroid disease were reviewed. Twenty-six of these were from between January 1998 and June 1999 (first period) and 42 from between June 1999 and September 2000 (second period). Patients were divided into two subgroups according to different periods and different surgical techniques to identify the RLNs and the parathyroid glands. RLNs function was evaluated pre- and postoperatively by an otolaryngologist, and serum calcium levels were measured at the postoperative follow-up. During the first period of the study, transient hypocalcaemia was determined in 8 (31%) patients. Hypocalcaemia was clinically symptomatic in 5 (19%) patients. Transient RLN palsy developed in 4 (15%) patients. Unilateral permanent RLN palsy due to operative injury was observed in 1 (4%) patient. During the second period, we noted transient hypocalcemia in 11 (26%) patients and symptomatic hypocalcemia in 6 (4%) patients. Serum calcium levels returned to normal within 4 weeks after operation in all patients. Neither transient nor permanent RLN palsy was observed during this period. Complications of total thyroidectomy can be minimized with increasing experience and the refinement of surgical technique.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003
Turkish Journal of …, 1999
Summary The prevalence of Helicobacter pylori (H. pylori) infection was assessed in endoscopic bi... more Summary The prevalence of Helicobacter pylori (H. pylori) infection was assessed in endoscopic biopsies of 39 patients with gastric cancer (23 male, 16 female). Biopsies were taken both from the cancerous and peripheal sites of the cancer (Ca) tissues and ...
European Journal of Radiology, 2003
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.
International Journal of Diabetes in Developing Countries, 2021
The efficacy of dapagliflozin has been less extensively studied in the real-life context, limitin... more The efficacy of dapagliflozin has been less extensively studied in the real-life context, limiting the comparability of observational real-world evidence with results from dapagliflozin clinical trials. This study aimed to evaluate HbA1c, blood pressure (BP), and weight outcomes in dapagliflozin-treated patients with type 2 diabetes (T2D) treated in a real-world setting. A total of 1683 T2D patients (mean (SD) age: 54.6 years (9.1), 56.6% were females) initiating dapagliflozin were included in this multicenter retrospective observational cohort study. Data on patient demographics, comorbidities, duration of diabetes, and concomitant antidiabetic treatment were recorded. Change in glycated hemoglobin (HbA1c), body weight, body mass index (BMI), and BP levels with dapagliflozin treatment and dapagliflozin discontinuation rates were evaluated based on baseline, 3rd-month, and 6th-month data. At the end of 6-month dapagliflozin treatment (discontinued in 4.3% of patients), HbA1c levels ...
PURPOSE Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases w... more PURPOSE Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. MATERIALS AND METHODS Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. RESULTS Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a...
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behcet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behcet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy. # 2003 Elsevier Science Ireland Ltd. All rights reserved.
Journal of endocrinological investigation
MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes ... more MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes parathyroid adenoma. In affected members of the family, the risk of MTC is about 100%. Biochemical screening allows tumors to be detected early but even at this stage treatment is not always curative. Missense mutations in exon 10 and 11 of the RET proto-oncogene are associated with MEN-2A. Early detection of this mutation by DNA analysis allows the identification of the carriers of the gene. We performed genetic screening in 88 members of an extended family with MEN-2A and found 18 members positive for RET mutation (Cys634Gly). Only three of these 18 RET positive cases had a previous diagnosis of medullary cancer and/or pheochromocytoma. Up to now, 12 of the RET positive cases have undergone thyroidectomy. There was extended disease with cervical lymph node metastasis in 6 of them, bilateral medullary microcancer in 3 and c-cell hyperplasia in the remaining 3. Three of the 18 RET positi...
The Turkish Journal of Endocrinology and Metabolism
Background and Aims: The present study aimed to describe characteristics of patients with type 2 ... more Background and Aims: The present study aimed to describe characteristics of patients with type 2 diabetes (T2D) initiated on dapagliflozin in routine outpatient clinical care in Turkey, post-dapagliflozin changes in glycated hemoglobin (HbA1c), body weight and blood pressure. Materials and Methods: Descriptive retrospective observational cohort study using data from Turkish patient medical records from 79 different internal medicine or endocrinology clinics. Study cohort will include T2D patients who received at least one prescription for dapagliflozin for the first time between July 2016 and June 2017 and who have been registered in that centre for at least 6 months prior to the first dapagliflozin prescription. Results: In total, 1683 patients were identified. The mean age of the patients (56.6% female) included in the analysis was 54.9 years (Table 1). At baseline, mean HbA1c was 9.1% and the mean weight was 89.2 kg. The mean time since T2D diagnosis was 9.1 years and 26.4% of patients had a history of retinopathy, 11.3% a history of neuropathy and 8.3% a history of nephropathy. HbA1c values were recorded in 815 patients, body weight was recorded in 851 and blood pressure in 799 patients before the first prescription of dapagliflozin and during dapagliflozin treatment, 6 months after starting dapagliflozin. HbA1c declined by mean of-1.33% (95% CI-1.44 to-1.20, p<0.001), weight declined by mean of-4.18 kg (95% CI-4.65 to 3.71, p<0.001), and systolic and diastolic blood pressure decreased by means of-8.68 (95% CI-9.53 to-7.83, p<0.001) and-4.92 (95% CI-5.54 to-4.29, p<0.001) mmHg, respectively from baseline (Table 2). Results were consistent across subgroups. Conclusion: This real world evidence study showed significant and clinically meaningful reductions in HbA1c, body weight and blood pressure after initiation of dapagliflozin in patients with T2D in Turkey, and these results support changes observed with dapagliflozin treatment in randomized clinical trials.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were eval... more Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a homogeneous enhancement in the venous...
European Journal of Radiology Extra, 2004
ABSTRACT Persistent trigeminal artery (PTA) is a relatively frequent type of carotid-basilar anas... more ABSTRACT Persistent trigeminal artery (PTA) is a relatively frequent type of carotid-basilar anastomosis. Most of PTA has no symptoms and are noticed incidentally. We report a case of PTA compressing the right side pituitary gland, in a patient with hormonal disorder. In this report, we emphasize importance of MR imaging and MR angiography on demonstrating the relationship between the pituitary gland and PTA.
European Journal of Radiology, 2002
A 43-year-old male with history of trauma was admitted to our clinic for the further evaluation o... more A 43-year-old male with history of trauma was admitted to our clinic for the further evaluation of a blunted left costophrenic angle on chest roentgenograms. Computed tomographic (CT) scans demonstrated a crescent, fat-dense, extra-pleural mass on the left lateral hemi-thorax. Vertical funicular densities consistent with blood vessels were identified in this extra-pleural lesion on enhanced CT scans. T1-weighted axial and
European Journal of Radiology, 2003
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy. #
PubMed, Sep 1, 2004
Purpose: Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases ... more Purpose: Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. Materials and methods: Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. Results: Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a homogeneous enhancement in the venous phase. However, two small lesions, four and five mm in diameter respectively, showed homogeneous contrast enhancement in the arterial phase unlike the larger lesions which displayed a hypodense center in this phase. Conclusion: Dynamic scanning with multidetector computed tomography after contrast administration may be helpful in characterizing parathyroid adenomas.
Turkish journal of haematology : official journal of Turkish Society of Haematology, 2001
Leptin is a recently found hormone regulating body weight. In human obesity, this weight-regulati... more Leptin is a recently found hormone regulating body weight. In human obesity, this weight-regulating hormone level is in a positive correlation with FMI (fat mass index) and BMI (body mass index). In this study, we aimed to investigate the relation between serum leptin levels and BMI, PF (percentage fat), LMI (lean mass ındex), FMI and some other parameters of patients with haematologic malignant diseases. Fourty-four patients with haematologic malignant diseases and 25 healthy control group were taken into the study. In the comparison, there were no significant difference between the PF and FMI values of both groups, while the mean BMI and LMI values of the control group were significantly higher than that of the patient group. There was a positive correlation between leptin levels and BMI and FMI among parameters studied in our control group, whereas we couldn't demostrate any such correlation in patient group. We estimate that the alteration may be due to disturbances in the f...
International journal of clinical practice, 2001
Polyglandular autoimmune (PGA) syndromes (types I and II) may affect various endocrine and non-en... more Polyglandular autoimmune (PGA) syndromes (types I and II) may affect various endocrine and non-endocrine organs in the body. In the commoner PGA type II, primary adrenal insufficiency, autoimmune thyroid disease and type I diabetes mellitus are the most frequent manifestations. Serositis with pericardial or pleural involvement is not a well known component of the disease. Here, we report a 21-year-old man who first presented with a pleuropericardial effusion and Graves' disease, and who then developed type I diabetes mellitus.
Clinical and Laboratory Haematology, 2005
Cancer antigen (CA 125) is a glycoprotein commonly used as a tumor marker. In this study, CA 125 ... more Cancer antigen (CA 125) is a glycoprotein commonly used as a tumor marker. In this study, CA 125 levels were measured in 149 patients and 26 healthy control subjects. The study group included 69 non-Hodgkin lymphomas (NHL), 25 Hodgkin disease (HD), 20 acute myelocytic leukemia (AML), 14 chronic lymphocytic leukemia (CLL), 12 chronic myelocytic leukemia (CML), and nine multiple myeloma (MM) patients. CA 125 was elevated in 37 of the patients and in none of the control subjects. Average CA 125 level in NHL patients was significantly higher than the controls (56.2 +/- 9.2 U/ml, 7.99 +/- 1.05 U/ml respectively) (P &amp;lt; 0.05). CA 125 levels were significantly higher in NHL patients with abdominal involvement (113.6 +/- 23.4 U/ml), with B-symptoms (72.3 +/- 13.2 U/ml), higher stage of the disease (stages III and IV -75.3 +/- 14.9 U/ml), bulky disease (99.9 +/- 30.4 U/ml) and in those with serosal involvement (103.1 +/- 18.5 U/ml) (P &amp;lt; 0.05 for all). CA 125 levels were also elevated in seven patients with HD and in a patient with CLL with pleural effusion. In conclusion, for patients with NHL, high levels of CA 125 were associated with B-symptoms, advanced stage, bulky disease, abdominal, and serosal involvement. Therefore, CA 125 might be used as a marker to predict prognosis and to detect advanced disease in NHL.
journalagent.com
Inflammatory pseudotumor is an often forgotten entity in the differential diagnosis of masses in ... more Inflammatory pseudotumor is an often forgotten entity in the differential diagnosis of masses in the lung, despite the fact that, they are the most common benign primary pulmonary growths in children [1-3]. Inflammatory pseudotumor is a broad histological term including organizing pneumonia type, fibrohistiocytic type and plasma cell granuloma type [4] depending on the predominant cellular element. In 1939 Brunn [5] reported an example of this lesion in a five year-old girl. In reports, up to 35 percent of them have occurred in
Clinical and Experimental Dermatology, 2006
Werner’s syndrome (WS) is a rare genetic disorder presenting with multisystem manifestations of p... more Werner’s syndrome (WS) is a rare genetic disorder presenting with multisystem manifestations of premature ageing from the second decade of life. We describe a sister and brother with typical features of this striking condition that may present to dermatologists. A 41-year-old woman (patient 1, height 1.42 m, weight 30 kg, body mass index 14.8 kg ⁄ m) presented with an infected heel ulcer on the left foot. She reported polyuria, polydypsia and weight loss over the past 2 years. She had undergone a bilateral cataract operation 5 years previously. She was found to have diabetes, and her foot ulcer regarded as a diabetic complication. The patient had some peculiar features for her age, i.e. a high-pitched voice, and thin facial appearance with a beak-shaped nose and progerioid features. She carried all major and most minor signs of WS such as bilateral cataracts, atrophic skin changes, short stature, parental consanguinity, premature loss and thinning of scalp hair, diabetes mellitus, hypogonadism, osteoporosis, articular deformities and vocal changes (Fig. 1). Biochemical examination revealed mild elevation of c-glutamyl transferase, alkaline phosphatase, triglycerides and creatinine phosphokinase. There was a mild anaemia consistent with chronic disease and leukocytosis with neutrophilia. Her hormonal profile revealed hypogonadotropic hypogonadism with normal thyrotrophic and corticotrophic axes. She had had two spontaneous, second trimester miscarriages, and her last menstruation had occurred about 6 years prior to presentation. Ultrasonography demonstrated an atrophic uterus and ovaries, and grade 1 hepatosteatosis. Skin biopsy from the lesion was consistent with chronic inflammation and necrosis. The calcaneous was spared from the deep infected heel ulcer (grade I in Wagner classification). X-ray examination demonstrated advanced osteoporosis in trabecular bone, with osteoarthritic changes. Sacroiliac computed tomography (CT) demonstrated a unilateral focal area of sclerosis in the sacroiliac joint (Fig. 2b). She was treated for the heel ulcer and diabetes. Biopsy taken from a vegetative lesion on the right heel revealed malignant melanoma; metastasis to the liver and the abdominal lymph nodes was discovered soon after. She was given palliative chemotherapy and died of rapidly progressing metastatic disease within 1 month. The second case, a 37-year-old man, was the brother of patient 1, and had similar clinical features. He also had extensive tendon calcifications (Fig. 2a) but sacroiliac CT demonstrated no pathology. Both patients were HLA-B27(–) with normal levels of inflammatory markers. He was treated for foot ulcer. WS was named after Otto Werner, who described the condition as scleroderma-like thinning and stiffening of the skin and bilateral cataracts. WS is an autosomal PD
Acta Chirurgica Belgica, 2003
In recent years, many surgeons dealing with endocrine surgery have increasingly performed total t... more In recent years, many surgeons dealing with endocrine surgery have increasingly performed total thyroidectomy for benign thyroid disease. However, total excision of the thyroid in the treatment of benign lesions has been surrounded by even more controversy than its role in cancer treatment. The complication rate appears to be higher when the operation is done by inexperienced surgeons who have no special skills in endocrine surgery using proper techniques. The aim of this study is to determine whether surgeons experience and the refinement of surgical techniques are associated with postoperative recurrent laryngeal nerve (RLN) palsy or hypocalcemia after total thyroidectomy for benign thyroid disease. A total of 68 consecutive patients who underwent total thyroidectomy for benign thyroid disease were reviewed. Twenty-six of these were from between January 1998 and June 1999 (first period) and 42 from between June 1999 and September 2000 (second period). Patients were divided into two subgroups according to different periods and different surgical techniques to identify the RLNs and the parathyroid glands. RLNs function was evaluated pre- and postoperatively by an otolaryngologist, and serum calcium levels were measured at the postoperative follow-up. During the first period of the study, transient hypocalcaemia was determined in 8 (31%) patients. Hypocalcaemia was clinically symptomatic in 5 (19%) patients. Transient RLN palsy developed in 4 (15%) patients. Unilateral permanent RLN palsy due to operative injury was observed in 1 (4%) patient. During the second period, we noted transient hypocalcemia in 11 (26%) patients and symptomatic hypocalcemia in 6 (4%) patients. Serum calcium levels returned to normal within 4 weeks after operation in all patients. Neither transient nor permanent RLN palsy was observed during this period. Complications of total thyroidectomy can be minimized with increasing experience and the refinement of surgical technique.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003
Turkish Journal of …, 1999
Summary The prevalence of Helicobacter pylori (H. pylori) infection was assessed in endoscopic bi... more Summary The prevalence of Helicobacter pylori (H. pylori) infection was assessed in endoscopic biopsies of 39 patients with gastric cancer (23 male, 16 female). Biopsies were taken both from the cancerous and peripheal sites of the cancer (Ca) tissues and ...
European Journal of Radiology, 2003
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.
International Journal of Diabetes in Developing Countries, 2021
The efficacy of dapagliflozin has been less extensively studied in the real-life context, limitin... more The efficacy of dapagliflozin has been less extensively studied in the real-life context, limiting the comparability of observational real-world evidence with results from dapagliflozin clinical trials. This study aimed to evaluate HbA1c, blood pressure (BP), and weight outcomes in dapagliflozin-treated patients with type 2 diabetes (T2D) treated in a real-world setting. A total of 1683 T2D patients (mean (SD) age: 54.6 years (9.1), 56.6% were females) initiating dapagliflozin were included in this multicenter retrospective observational cohort study. Data on patient demographics, comorbidities, duration of diabetes, and concomitant antidiabetic treatment were recorded. Change in glycated hemoglobin (HbA1c), body weight, body mass index (BMI), and BP levels with dapagliflozin treatment and dapagliflozin discontinuation rates were evaluated based on baseline, 3rd-month, and 6th-month data. At the end of 6-month dapagliflozin treatment (discontinued in 4.3% of patients), HbA1c levels ...
PURPOSE Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases w... more PURPOSE Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. MATERIALS AND METHODS Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. RESULTS Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a...
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behcet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behcet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy. # 2003 Elsevier Science Ireland Ltd. All rights reserved.
Journal of endocrinological investigation
MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes ... more MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes parathyroid adenoma. In affected members of the family, the risk of MTC is about 100%. Biochemical screening allows tumors to be detected early but even at this stage treatment is not always curative. Missense mutations in exon 10 and 11 of the RET proto-oncogene are associated with MEN-2A. Early detection of this mutation by DNA analysis allows the identification of the carriers of the gene. We performed genetic screening in 88 members of an extended family with MEN-2A and found 18 members positive for RET mutation (Cys634Gly). Only three of these 18 RET positive cases had a previous diagnosis of medullary cancer and/or pheochromocytoma. Up to now, 12 of the RET positive cases have undergone thyroidectomy. There was extended disease with cervical lymph node metastasis in 6 of them, bilateral medullary microcancer in 3 and c-cell hyperplasia in the remaining 3. Three of the 18 RET positi...
The Turkish Journal of Endocrinology and Metabolism
Background and Aims: The present study aimed to describe characteristics of patients with type 2 ... more Background and Aims: The present study aimed to describe characteristics of patients with type 2 diabetes (T2D) initiated on dapagliflozin in routine outpatient clinical care in Turkey, post-dapagliflozin changes in glycated hemoglobin (HbA1c), body weight and blood pressure. Materials and Methods: Descriptive retrospective observational cohort study using data from Turkish patient medical records from 79 different internal medicine or endocrinology clinics. Study cohort will include T2D patients who received at least one prescription for dapagliflozin for the first time between July 2016 and June 2017 and who have been registered in that centre for at least 6 months prior to the first dapagliflozin prescription. Results: In total, 1683 patients were identified. The mean age of the patients (56.6% female) included in the analysis was 54.9 years (Table 1). At baseline, mean HbA1c was 9.1% and the mean weight was 89.2 kg. The mean time since T2D diagnosis was 9.1 years and 26.4% of patients had a history of retinopathy, 11.3% a history of neuropathy and 8.3% a history of nephropathy. HbA1c values were recorded in 815 patients, body weight was recorded in 851 and blood pressure in 799 patients before the first prescription of dapagliflozin and during dapagliflozin treatment, 6 months after starting dapagliflozin. HbA1c declined by mean of-1.33% (95% CI-1.44 to-1.20, p<0.001), weight declined by mean of-4.18 kg (95% CI-4.65 to 3.71, p<0.001), and systolic and diastolic blood pressure decreased by means of-8.68 (95% CI-9.53 to-7.83, p<0.001) and-4.92 (95% CI-5.54 to-4.29, p<0.001) mmHg, respectively from baseline (Table 2). Results were consistent across subgroups. Conclusion: This real world evidence study showed significant and clinically meaningful reductions in HbA1c, body weight and blood pressure after initiation of dapagliflozin in patients with T2D in Turkey, and these results support changes observed with dapagliflozin treatment in randomized clinical trials.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were eval... more Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a homogeneous enhancement in the venous...
European Journal of Radiology Extra, 2004
ABSTRACT Persistent trigeminal artery (PTA) is a relatively frequent type of carotid-basilar anas... more ABSTRACT Persistent trigeminal artery (PTA) is a relatively frequent type of carotid-basilar anastomosis. Most of PTA has no symptoms and are noticed incidentally. We report a case of PTA compressing the right side pituitary gland, in a patient with hormonal disorder. In this report, we emphasize importance of MR imaging and MR angiography on demonstrating the relationship between the pituitary gland and PTA.
European Journal of Radiology, 2002
A 43-year-old male with history of trauma was admitted to our clinic for the further evaluation o... more A 43-year-old male with history of trauma was admitted to our clinic for the further evaluation of a blunted left costophrenic angle on chest roentgenograms. Computed tomographic (CT) scans demonstrated a crescent, fat-dense, extra-pleural mass on the left lateral hemi-thorax. Vertical funicular densities consistent with blood vessels were identified in this extra-pleural lesion on enhanced CT scans. T1-weighted axial and
European Journal of Radiology, 2003
We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior ... more We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy. #