Person: TURGUT, SEDA
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Publication Open Access Investigation of the Vitamin D Receptor Polymorphisms in Acromegaly Patients(2015-01-01) Ilhan, MAHMUT MUZAFFER; TOPTAS-HEKIMOGLU, Bahar; YAYLIM, Ilhan; Turgut, SEDA; TURAN, Saime; Karaman, Ozcan; Tasan, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULObjective. The genetic structural alterations in the majority of somatotroph adenomas are not clarified and the search for novel candidate genes is still a challenge.We aimed to investigate possible associations between vitamin D receptor (VDR) polymorphisms and acromegaly. Design, Patients, and Methods. 52 acromegaly patients (mean age 45.7 ± 1.9 years) and 83 controls (mean age 43.1 ± 2.6 years) were recruited to the study. VDR polymorphism was determined by polymerase chain reaction-based restriction fragment length polymorphism methods. Results. The distribution of VDR genotypes showed a significant difference in the frequencies of VDR FokI genotypes between patients and controls (𝑃 = 0.034). VDR FokI ff genotype was significantly decreased in acromegaly patients (𝑃 = 0.035) and carriers of FokI Ff genotype had a 1.5-fold increased risk for acromegaly (OR: 1.5, 95% CI: 1.07–2.1; 𝑃 = 0.020). IGF1 levels after treatment were significantly higher in patients carrying the Ff genotype compared to carrying ff genotype (𝑃 = 0.0049). 25(OH)D3 levels were significantly lower in acromegaly patients (𝑃 < 0.001). Conclusions. Our study suggests that VDR FokI genotypes might affect the development of acromegaly and VDR polymorphisms may play a role in the course of acromegaly as a consequence of altering hormonal status.Publication Open Access DOES GRAVES- DISEASE AFFECT ESOPHAGEAL MOTILITY?(2018-07-01) Senturk, H; Karaman, Ö; İlhan, M; Turgut, SEDA; Arabaci, E; Taşan, E; TURGUT, SEDA; ŞENTÜRK, HAKANContext: The gastrointestinal tract is one of the most affected systems in hyperthyroidism. Although thyrotoxicosis is thought to be associated with gastrointestinal dysmotility, there are limited studies focused on motility disorders in hyperthyroidism. Objectives: We aimed to investigate the manometric measurements to determine if esophageal motility is affected in Graves' disease. Materials and methods: Thirty patients with Graves' disease (18 female and 12 male) and 30, age and sex matched, healthy controls (22 female and 8 male) were recruited to the study between 2015 and 2016. Esophageal manometry was performed using MMS (Medical Measurement Systems bv. The Netherlands) Solar GI - Air Charged Intelligent Gastrointestinal Conventional Manometry. Results: The mean lower esophageal sphincter pressure (LESP) was 16.9 ± 5.3 mmHg in hyperthyroid patients and 20.1 ± 8.8 mmHg in the control group and there was no significant difference (p>0.05). It was observed that the duration of contraction was 3.9 ± 0.7 s in healthy subjects and, significantly shorter 3.2 ± 0.5 s in hyperthyroid patients (p<0.001). Duration of contraction was negatively correlated with TSH receptor Ab titer in patients (p=0.006, r= -0.48). Also, it was observed that the duration of relaxation was negatively correlated with fT4 levels in the patient group (p<0.05, r= -0.46). Conclusion: In this study, we observed that esophageal motility can be affected via shortened duration of contraction in Graves' disease. The gastrointestinal symptoms due to possible motility dysfunctions should be considered in the evaluation of hyperthyroid patients.Publication Open Access Effects of Weight Loss with Bariatric Surgery on Platelet Count and Volume(2018-07-01) Ilhan, Muzaffer; KARAMAN, ÖZCAN; Yasin, Ayse Irem; TURGUT, SEDA; TAŞAN, ERTUĞRUL; KARAMAN, ÖZCAN; YASİN, AYŞE İREM; TURGUT, SEDA; TAŞAN, ERTUĞRULObjective: Obesity is a chronic metabolic disorder that leads to the increased risk of cardiovascular diseases. This study aims to investigate the effect of weight loss on the platelet count and volume, which is associated with cardiovascular diseases. Methods: In total, 56 obese patients were recruited for the study. The parameters were retrospectively evaluated before and after 6 months of surgery. Results: The mean weight of the patients was 126.2±23.1 kg before surgery and 91.8±20.5 kg after surgery (p<0.001). The mean platelet counts were 292.5±58.6×10³/µL before surgery and 246.8±59.1×10³/µL after surgery (p<0.001). The mean platelet volumes were 10.4±1.0 fL and 11.6±0.9 fL before and after surgery, respectively (p<0.001). The mean platelet counts before surgery were correlated with the mean platelet volume, mean weight, and mean body mass index (p<0.01, r=−0.39, p<0.01, r=0.35, p<0.01, r=0.41, respectively). The mean platelet counts after surgery were correlated with the mean platelet volume (p<0.001, r=−0.68). Conclusion: This study demonstrated decreased platelet counts and increased platelet volume at 6 months after surgery in obese patients. Further long-term and prospective studies are warranted to clarify these results and pathopsychological mechanisms involved.Publication Open Access The Role of p16 and MDM2 Gene Polymorphisms in Prolactinoma: MDM2 Gene Polymorphisms May Be Associated with Tumor Shrinkage(2017-05-01) Turgut, SEDA; Ilhan, Muzaffer; Turan, Saime; Karaman, Ozcan; Yaylim, Ilhan; Kucukhuseyin, Ozlem; Tasan, ERTUĞRUL; TURGUT, SEDA; İLHAN, MAHMUT MUZAFFER; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULAim: Prolactinomas are thought to arise from clonal expansion of a single mutated cell which is subjected to growth stimuli of several permissive factors, although the pathogenetic mechanisms underlying tumorigenesis remain unclear. The present study aimed to investigate the role of p16 (540C→G and 580C→T) and mouse double minute 2 (MDM2) (SNP309T→G) gene polymorphisms in tumorigenesis and characteristics of prolactinoma. Patients and methods: A total of 74 patients with prolactinoma and 100 age- and gender-matched healthy individuals were enrolled in the study. Serum prolactin levels were measured by enzyme-linked immunosorbent assay (ELISA). p16 and MDM2 polymorphisms were determined by polymerase chain reaction-restriction fragment polymorphism and agarose gel electrophoresis. Results: p16 540C→G genotype distribution was found to be: CC: 66.2%, CG: 28.4%, GG: 5.4%; p16 580C→T genotype distribution was found to be: CC: 82.4%, CT: 17.6%, TT: 0% and MDM2 genotype distribution was found to be: TT: 31.1%, TG: 47.3%, GG: 21.6% in patients with prolactinoma. Tumor diameter before treatment was correlated with prolactin levels before treatment and percentage of prolactin decrease with treatment (r=0.719, p<0.001, p=0.034 r=0.256, respectively). The number of patients with tumor size decrease of more than 50% in those with homozygous genotype (TT+GG) of MDM2 SNP309T→G was significantly higher than in heterozygous genotype (TG) carriers (odds ratio(OR)=0.18, 95% confidence interval(CI)=0.06-0.58; p=0.003). Conclusion: This study showed that p16 and MDM2 polymorphisms do not play a decisive role in tumorigenesis, but some genotypes of these polymorphisms might be associated with follow-up characteristics of prolactinoma.Publication Open Access Investigation of Survivin Promoter -31 G/C Polymorphism and Survivin Levels in Acromegaly(2021-03-01T00:00:00Z) Ilhan, Muzaffer; Turan, Saime; Turgut, Seda; Korkmaz, Gurbet; Ozkan, Nazli Ezgi; KARAMAN, Özcan; Yaylim, Ilhan; TAŞAN, ERTUĞRUL; TURGUT, SEDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULObjevtive: Acromegaly is a rare disease characterized by growth hormone hypersecretion generally arising from pituitary adenomas. Survivin, an apoptosis inhibitor protein, plays an important role in cell cycle regulation and possibly involves hypophysis gland proliferation mechanisms. However, the underlying causes of somatotroph adenomas with different behaviors and useful prognostic markers are still not fully understood. We investigated possible associations between survivin gene promoter -31 G\C genotypes and serum survivin level and clinical prognostic factors in acromegaly. Material and Methods: Sixty-eight acromegaly patients and 171 age-sex matched control subjects were enrolled in the study. Survivin -31 G\C polymorphism was performed by using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Blood GH and IGF1 levels were assayed using a chemiluminescence immunometric assay. Serum survivin levels were determined by ELISA. Results: Acromegaly patients had significantly higher serum survivin levels than controls (p=0.001). We found no significant association between acromegaly patients and controls in terms of survivin gene promoter -31 G\C genotype distribution and allele frequencies. No correlation was found between disease characteristics and survivin gene polymorphisms. Conclusion: Our study suggests that serum survivin levels might be associated with acromegaly, but survivin -31 G\C polymorphisms do not modify individual susceptibility to acromegaly in the Turkish population.Publication Open Access Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus Treated with Double Filtration Plasmapheresis(2018-07-01) KARATOPRAK, CUMALİ; Cetin, GÜVEN; OZKAN, Tuba; Turgut, SEDA; Kazancioglu, RÜMEYZA; ÇETİN, GÜVEN; TURGUT, SEDA; KARATOPRAK, CUMALİ; KAZANCIOĞLU, RÜMEYZADiffuse alveolar hemorrhage is a rare and life-threatening complication developed in systemic lupus erythematosus (SLE). We report a case of diffuse alveolar hemorrhage in a patient with lupus nephritis. The patient presented with acute respiratory and renal failure. Therefore, she was assessed as an activation of systemic lupus erythematosus. Despite pulse methylprednisolone, immunosuppressant drugs, and intravenous immunoglobulin (IVIG) therapy, the disease progressed. The patient participated in a plasmapheresis program, and double filtration plasmapheresis (DFPP) therapy was performed for six sessions in 6 days. Soon after the initiation of DFPP, she recovered with resolution of the radiological changes within 6 days and was successfully extubated. Thus, DFPP therapy should be considered for the treatment of diffuse alveolar hemorrhage, particularly in patients of systemic lupus erythematosus with lupus nephritis.Publication Open Access The assessment of total antioxidant capacity and superoxide dismutase levels, and the possible role of manganese superoxide dismutase polymorphism in acromegaly.(2018-01-30) ILHAN, MAHMUT MUZAFFER; Turgut, SEDA; TURAN, S; Demirci, Cekic; ERGEN, HA; Korkmaz, Dursun; MEZANI, B; KARAMAN, O; YAYLIM, I; APAK, MR; TASAN, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULOxidative status is attributed to endothelial dysfunction and might be one of the key mechanisms of endothelial dysfunction in acromegaly. In this study, we aimed to investigate the effect of acromegaly on superoxide dismutase (SOD) and total antioxidant capacity (TAC) levels, and the possible influence of human manganese superoxide dismutase (MnSOD) polymorphism on these levels. 51 acromegaly patients and 57 age and sex matched healthy subjects were recruited to the study in Bezmialem Vakif University Hospital between 2011 and 2014. The median SOD and TAC levels were 42.7 (33-60) pg/mL and 1,313.7 (155-1,902) μM in acromegaly; and 46.3 (38-95) pg/mL and 1,607.3 (195-1,981) μM in healthy subjects (p < 0.001, p < 0.001). SOD levels were decreased in controlled and uncontrolled patients compared to healthy subjects (p = 0.05 and p = 0.002, respectively). Controlled and uncontrolled acromegaly displayed significantly decreased levels of TAC compared to healthy subjects (p < 0.05 and p < 0.001, respectively). SOD levels were not associated with MnSOD polymorphisms in acromegaly. In conclusion, this study showed that acromegaly was associated with decreased levels of SOD and TAC, and controlling the disease activity could not adequately improve these levels.Publication Open Access Acromegaly can be associated with impairment of LES relaxation in the oesophagus(2015-09-01) Ilhan, MAHMUT MUZAFFER; DANALIOGLU, Ahmet; Turgut, SEDA; Karaman, Ozcan; Arabaci, ELİF; Tasan, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; ARABACI, ELİF; TAŞAN, ERTUĞRULIntroduction: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. Material and methods: The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex- and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI — Air Charged Intelligent Gastrointestinal Conventional Manometry. Results: In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049). Conclusions: Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly