[Show abstract][Hide abstract] ABSTRACT: Carotid artery intima-media thickness (CIMT), hyperhomocysteinemia, microalbuminuria, and nitric oxide reflect subclinical atherosclerosis and predict the risk of future cardiovascular events. We aimed to evaluate the presence of subclinical atherosclerosis and endothelial dysfunction in normotensive patients with gestational diabetes mellitus (GDM) noninvasively.
We enrolled 41 normotensive patients with GDM and 44 healthy gravidae in the study. Serum homocysteine and nitric oxide levels, urinary albumin excretion (microalbuminuria), and CIMT were evaluated along with lipid parameters and anthropometric measurements.
Patients with GDM had significantly higher levels of serum homocysteine, urinary albumin excretion, and increased CIMT (p < 0.001, p=0.005, and p < 0.001, respectively). Nitric oxide levels were significantly reduced in the patient group (p < 0.001). There was a significant difference between groups in terms of low-density lipoprotein (LDL) but not of high-density lipoprotein (HDL) and triglyceride levels. A significant correlation was observed between CIMT and serum LDL, HDL, homocysteine, nitric oxide levels, and urinary albumin excretion. Microalbuminuria was significantly correlated with serum homocysteine levels (p=0.03) but not with nitric oxide.
Independent of elevated blood pressure, subclinical atherosclerosis and endothelial dysfunction exist in normotensive patients with GDM. Further studies with a large number of participants are required to clarify these data.
[Show abstract][Hide abstract] ABSTRACT: Hemangiomas are benign vascular tumors that usually involve the liver, skin, eyes and central nervous system. Hemangioma of the bone is unusual and is generally observed in the vertebrae or skull while hemangioma of the costae is extremely rare. Hemangioma of the rib and chest wall tuberculosis may be misdiagnosed as chest wall tumors. We herein report a case of hemangioma of the rib with a tuberculosis infection of the pleura.
Internal Medicine 06/2013; 52(11):1263-1265. DOI:10.2169/internalmedicine.52.9212 · 0.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate patients with chronic hepatitis B virus (HBV) infection and low-level viraemia in terms of determining HBV DNA cut-off values and levels of alanine aminotransferase (ALT) and other possible markers for discriminating between chronic hepatitis B e-antigen (HBeAg)-negative patients and hepatitis B surface antigen (HBsAg) inactive carriers.
HBV-infected patients who were HBeAg-negative with undetectable HBV DNA by standard hybridization assay and high (HBeAg-negative group, n = 81) or normal (HBsAg inactive carrier group, n = 77) ALT levels were enrolled. Quantitative polymerase chain reaction assay using a COBAS Amplicor HBV monitor test was performed to detect low HBV DNA levels.
The HBV DNA level was found to be significantly higher in the HBeAg-negative chronic HBV group (mean ± SD 94 477 ± 167 528 copies/ml) compared with the HBsAg inactive carrier group (mean ± SD 19 215 ± 57 970 copies/ml).
A low level of viral replication may persist in chronic HBV-infected patients who are HBeAg-negative, and the level of HBV DNA was higher in the HBeAg-negative group than in the inactive HBsAg carrier group. Necroinflammation also persisted in the HBeAg-negative group and these patients had a higher level of ALT than the inactive HBsAg carriers.
The Journal of international medical research 10/2012; 40(5):1891-6. DOI:10.1177/030006051204000529 · 1.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nitric oxide (NO) contributes to vasodilatation that is observed during normal pregnancy. Hyperhomocysteinaemia (HHcy) is a vascular risk factor associated with placental microvascular diseases and pre-eclampsia. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide synthase (NOS) has been linked to endothelial dysfunction. Maternal ADMA has been reported to be higher in women with pre-eclampsia and HHcy leads to accumulation of ADMA. The aim of this presented study is to evaluate the alterations of plasma homocysteine, ADMA and NO levels in mild pre-eclampsia. A total of 40 pre-eclamptic women and 40 healthy controls were included into the study. Mean systolic and diastolic blood pressure, mean serum homocysteine and ADMA levels were significantly higher and NO level was lower in patients. Serum homocysteine, ADMA and NO levels found to be correlated among them and with blood pressure. In conclusion, we found that homocysteine and ADMA levels were increased and NO levels decreased in pre-eclampsia.
Journal of Obstetrics and Gynaecology 08/2012; 32(6):525-8. DOI:10.3109/01443615.2012.693985 · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by hamartomatous involvement of multiple organs such as the skin, central nervous system, kidneys, lungs, and heart. A linkage has been found with a locus on the long arm of chromosome 9 (9q34) and with a locus on the short arm of chromosome 16 (16p13). TSC has a birth incidence of 1/6000. Children with TSC are almost universally born with normal kidneys, but cystic disease and angiomyolipomas develop with increasing age. Angiomyolipomas, renal cysts, and renal cell carcinoma are classical features of renal involvement in TSC. Renal complications are the most common cause of death in adult TSC patients, thus renal involvement has a crucial importance on the course of this disease. We present a 27-year-old patient previously diagnosed as tuberous sclerosis complex and referred with acute renal failure and polycystic kidney disease.
Archives of Iranian medicine 06/2012; 15(6):384-6. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigated the severity of hirsutism and its correlation with serum total testosterone (tT) levels in 87 patients with polycystic ovary syndrome (PCOS) and 85 healthy control subjects from the south-eastern region of Turkey. A wide range of variability exists in both hirsutism and modified Ferriman-Gallwey (mFG) scores. Similar mFG scores and serum tT levels were found compared with previous studies of general populations, but lower scores than those previously reported from Turkey. The incidence of hirsutism was lower in hyperandrogenic PCOS patients compared with non-hyperandrogenic PCOS patients. There was no correlation between serum tT levels and the rate of hirsutism in patients with PCOS. Heritability, testosterone receptor sensitivity, 5α reductase activity or environmental/socioeconomic factors may play a role in the development of clinical hirsutism. Larger scale studies are needed to clarify which other factors may be responsible and to confirm these results.
The Journal of international medical research 08/2011; 39(4):1529-35. DOI:10.1177/147323001103900443 · 1.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We aimed to investigate morphologic and functional alterations of common carotid arteries (CCA) and femoral arteries and the anteroposterior diameter of the abdominal aorta in patients with polycystic ovary syndrome (PCOS).
Fifty consecutive females with the complaint of oligoamenorrhea, infertility or hirsutismus, diagnosed with PCOS and 50 healthy females admitted to the Department of Gynecology and Obstetrics, Ergani State Hospital between January 2010 and January 2011 were included in the study.
The mean BMI of 50 patients with PCOS was higher than control subjects (CS) (25.89 +/- 3.3 vs 22.52 +/- 2.7 kg/m2, p < 0.0001). The mean arterial blood pressure was 88.93 +/- 6.4 mmHg in the patient group and was it 85.73 +/- 7.6 mmHg in CS (p = 0.02). The mean plasma glucose level (74.04 +/- 6.7 vs 70.5 +/- 6.4 mg/dl), total cholesterol level (167.88 +/- 30.1 vs 153.38 +/- 27.8 mg/dl), low density lipoprotein level (101.28 +/- 27.0 vs 79.56 +/- 25.5 mg/dl) and triglyceride level (121.22 +/- 49.2 vs 102.54 +/- 36.6 mg/dl) were higher; also the mean high density lipoprotein level (44.56 +/- 8.1 vs 50.90 +/- 12.3 mg/dl) was lower in patients with PCOS than CS (p = 0.009, p = 0.014, p < 0.0001, p = 0.034 and p = 0.003, respectively). CCA-IMT (0.63 +/- 0.2 vs 0.52 +/- 0.1 mm), and CCA-PI (1.44 +/- 0.3 vs 1.28 +/- 0.22) were higher in patients with PCOS (p = 0.018 andp = 0.005, respectively). Femoral-IMT (0.62 +/- 0.6 vs 0.41 +/- 0.1 mm) and anteroposterior diameter of the infrarenal aorta (12.34 +/- 1.5 vs 11.4 +/- 1.0 mm) were higher in patients with PCOS (p = 0.024 and p = 0.001, respectively).
The present study showed that IMT and PI of CCA, and anteroposterior diameter of the infrarenal abdominal aorta and femoral-IMT were higher in patients with PCOS. These results are probably related with increased androgens, their effects on insulin resistance and lipid profile, increased BMI and blood pressure. Detection of these functional and/or structural abnormalities are important in predicting prognosis. Larger scale prospective studies are needed to determine the effects of PCOS on the mortality and morbidity, and to clarify the relation between the duration of the disease and development of these alterations.