Ayse Nur Torun

Serum total antioxidant status and lipid peroxidation marker malondialdehyde levels in overt and subclinical hypothyroidism

Background  Mitochondria are the main production site of free oxygen radicals, which can cause organ dysfunction by oxidation of cellular macromolecules such as carbohydrates, lipids and proteins. Oxidative stress may result from either overproduction of these species or from failure of the antioxidant defence systems. Thyroid hormones have well‐known effects on mitochondrial oxygen consumption, but data about how hypothyroidism affects oxidative stress are controversial, and little is known about oxidative stress in subclinical hypothyroidism. Total antioxidant status (TAS) gives information about all of the antioxidants in the organism, while malondialdehyde (MDA) is a lipid peroxidation marker used to assess lipid peroxidation due to increased oxidative stress. We aimed to determine how hypothyroidism and subclinical hypothyroidism affect serum MDA and TAS.

Intrasellar epidermoid cyst presenting as pituitary apoplexy.

We herein present a patient with intrasellar epidermoid cyst presenting as pituitary apoplexy, who was operated upon with a trans-sphenoidal approach. The clinical presentation, radiological and histological differential diagnosis and type of surgical intervention for intrasellar epidermoid cysts are discussed.

Can first-trimester screening program detect women at high risk for gestational diabetes mellitus?

This study was designed to compare first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency in pregnancies complicated by gestational diabetes mellitus and those of a control group. The study included 60 gestational diabetic and 60 control women who attended the first-trimester combined screening program for Down syndrome between 11 and 14 gestational weeks with complete follow-up data and delivered in our institution. Maternal serum free β-human chorionic gonadotropin, pregnancy-associated plasma protein-A and fetal nuchal translucency were investigated. The combined risks, double test risks and age risks were calculated by PRISCA software version 4.0. Comparison of the results between the two groups yielded no significant differences in serum levels of free β-human chorionic gonadotropin and fetal nuchal translucency. However, women who developed gestational diabetes mellitus had significantly lower pregnancy-associated plasma protein-A. And also, the combined risks and double test risks calculated by PRISCA software were statistically higher in gestational diabetic women than normal pregnant women. These results suggest that differences can be seen between diabetic and healthy pregnant women in first-trimester maternal serum biochemical markers of aneuploidy.

49,XXXXY syndrome with autoimmune diabetes and ocular manifestations.

Objective: We report a rare case of 49,XXXXY syndrome with autoimmune diabetes (requiring insulin therapy), bilateral cataracts and unilateral glaucoma. Clinical Presentation and Intervention: A 25-year-old man with mental retardation presented with multiple skeletal abnormalities, polyuria and polydipsia. He had high glucose concentrations, without ketonuria, and hypergonadotropic hypogonadism. Ophthalmic examination revealed a polar cataract in both eyes and increased intraocular pressure in the left eye. The anti-islet cell antibody test was positive, and anti-glutamic acid decarboxylase autoantibody levels were elevated. Karyotype analysis revealed 49,XXXXY. Intensive insulin therapy and testosterone replacements were started. Conclusion: The autoimmune nature of diabetes that we observed in our patient seems to be predisposed by hypogonadism. Cataract and glaucoma in this case seem to be the result of diabetes, and an association of these ocular manifestations with the syndrome 49,XXXXY seems unlikely.

İnsülin kullanan tip 2 diabetes mellitus hastalarında mikrovasküler komplikasyonlar ile depresyonun ilişkisi

Objective: This study aimed to assess the relationship between Type 2 Diabetes Mellitus (DM) and its complications with the severity of depression. Methods: Eighty diabetics under the age of 65 using insulin were enrolled and clinical and biochemical data were recorded. The severity of neuropathy was determined by the “United Kingdom neuropathy screening score” (UKNS) whereas the severity of depression was determined by the “Beck depression scale” (BDS). Nephropathy and retinopathy were assessed by the microalbumin-creatinine ratio in spot urine samples and by detailed examination of the retina with an ophthalmoscope, respectively. Results: There were more patients who has high neuropathy severity in the group with the highest Beck depression scale score (p<0.001). In the correlation analyses, positive correlation was found between the severity of depression determined by the BDS and UKNS (r=0.231, p=0.039). No relationship was found between nephropathy, retinopathy and severity of depression. Conclusion: There was significant relationship between the severity of neuropathy and that of depression. Hence, cases with a diagnosis of Type 2 DM require screening in terms of neuropathy and the presence of depression. Appropriate approach towards such conditions associated with each other may be crucial in the context of increasing the quality of life. J Clin Exp Invest 2013; 4 (1): 34-39

Incretin System in the Pathogenesis of Type 2 Diabetes and the Role of Incretin Based Therapies in the Management of Type 2 Diabetes

Discovery of incretin hormones and their role on glucose metabolism and pathogenesis of type 2 diabetes mellitus (T2 DM) are current interests of diabetology. Incretin hormones are secreted from intestinal endocrine cells in response to food ingestion and potentiate pancreatic insulin secretion when compared with iv glucose administration. Since malfunction of incretin hormones has been found to have role in T2 DM pathogenesis, incretin based therapies have been developed. Incretin effect, incretine hormones, functions, their role in pathogenesis of T2 DM and management of T2 DM with incretin-based drugs are discussed in this chapter.

A Healthy Newborn Delivered From an Active Acromegalic Woman Receiving High-dose Long-acting Octreotide During her Entire Pregnancy

Pregnancy rarely occurs during the course of acromegaly, and if present it is associated with comorbidities. The data about medical therapy with somatostatin analogs during pregnancy are limited. Although discontinuation of somatostatin analogs is recommended in the event of pregnancy, there are reported cases of pregnant acromegaly treated generally with a short-acting formulation of octreotide. We report herein a case of acromegaly in whom the entire pregnancy course was uneventful with 40 mg of long-acting octreotide use, resulting in a healthy infant birth. To our knowledge, this is the highest dose to be used during pregnancy, which has not been reported previously. The natural course and management of acromegaly during pregnancy are discussed.

Spontaneous and Uneventful Pregnancy Occurring in a Case of Macroprolactinoma Diagnosed With Subclinical Pituitary Apoplexy

Pregnancy frequently occurs after treatment of hyperprolactinemia, and prolactinomas may grow during pregnancy. We describe a case in which pregnancy occurred without treatment with a tumor diagnosed just after delivery during an evaluation for headache. A 25 × 20 ×20 mm adenoma with central hemorrhage and/or necrosis was found. The prolactin level was within normal ranges and the adenoma shrank to 10 × 5 mm with a 1-year treatment. The hypothalamic-pituitary-gonadal axis should be evaluated in cases of prolonged postpartum amenorrhea. Although amenorrhea, galactorrhea, and infertility are the most common presenting symptoms of macroprolactinomas, headache due to apoplexy of adenoma causing enlargement of the tumor may rarely lead to the patient’s referral.

Contents Vol. 18, 2009

493 Abstracts of Award-Winning Posters, 14th Annual Health Sciences Poster Conference, Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, April 21–23, 2009 498 Abstracts of Theses Approved for the MSc and PhD Degrees at the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait 504 Announcement 505 List of Reviewers 507 Author Index Vol. 18, 2009 510 Subject Index Vol. 18, 2009