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Öğe 33 Questions about Triglycerides and Cardiovascular Effects: Expert Answers(Turkish Soc Cardiology, 2017) Cetinkalp, Sevki; Koylan, Nevrez; Ozer, Necla; Onat, Altan; Ozgen, A. Gokhan; Koldas, Z. Lale; Guven, Gulay Sain; Ozdogan, Oner; Karsidag, Kubilay; Yigit, Zerrin; Kayikcioglu, Meral; Tokgozoglu, Lale; Can, Levent H.; Tartan, Zeynep; Kultursay, Hakan; Karpuz, Baris; Kirilmaz, Bahadir; Ersanli, Murat; Ural, Dilek; Erbakan, Ayse Naciye; Oguz, Aytekin; Kayikcioglu, Ozcan R.; Temizhan, Ahmet; Sansoy, Vedat; Ceyhan, Ceyhun; Ongen, Zeki; Bayram, Fahri; Orem, Cihan; Sonmez, Alper; Beyaz, Sengul; Ukinc, Kubilay; Yurekli, Banu Sarer; Coker, Mahmut; Canda, Ebru; Simsir, Ilgin YildirimÖğe An acromegaly case treated with clomiphene citrate: add-on treatment in primary medical therapy(Springer Int Publ Ag, 2022) Koroglu, Esma Pehlivan; Soyaltin, Utku Erdem; Yeral, Sena; Yurekli, Banu SarerIntroduction Acromegaly is a disease with various comorbidities and hypogonadism is a common comorbidity in patients with acromegaly. Herein, we aim to present our experience with clomiphene citrate in a patient with acromegaly accompanied by hypogonadism, who declined surgery. Case report A 40-year-old male patient with impaired fasting glucose, hyperlipidemia, and psychosis and who complained of increasing tongue growth, snoring, enlargement of the hands, spacing between the teeth, and loss of libido for the last 6 years was followed up. Acromegaly was diagnosed, with high levels of insulin-like growth factor-1 (IGF-1) and a pituitary neuroendocrine tumor measuring 11 mm; the patient had concomitant hypogonadism. Lanreotide was started as the initial primary medical treatment. Clomiphene citrate was added to the patient's treatment. The patient, whose IGF-1 level was high during follow-up, did not want to use the intramuscular testosterone esters for hypogonadism. In the third month of clomiphene citrate treatment, IGF-1 normalization was achieved and the patient's total testosterone level increased. Discussion Biochemical control is not always achieved with somatostatin receptor ligands and dopamine agonists in the treatment of acromegaly. Therefore, we support the use of clomiphene citrate (CC) as a cost-effective oral add-on treatment option in selected hypogonadal acromegaly cases.Öğe Acute pancreatitis occurring after COVID-19 vaccine: a case report and literature review(SpringerNature, 2024) Kabaoglu, Ceren; Ozisik, Hatice; Kocabas, Gokcen Unal; Yurekli, Banu Sarer; Erdogan, MehmetBackgroundVaccines are uncommon causes of pancreatitis, and only a few case reports have described COVID-19 vaccine-related pancreatitis.Case presentationA 45-year-old male patient applied to the emergency department due to having serious abdominal pain. Pfizer-BioNTech COVID-19 vaccine, the last dose was administered 1 week ago. One week after vaccination, he experienced abdominal pain. Laboratory tests demonstrated elevated C-reactive protein, amylase, and lipase levels, and Ig G4 levels were normal. Abdominal computer tomography (CT) displayed acute edematous pancreatitis and peripancreatic inflammatory changes. The patient was diagnosed with acute pancreatitis due to the vaccine.ConclusionWe should be aware that acute pancreatitis induced by the vaccine may occur a few days or weeks after the vaccine, especially in patients who have risk factors for acute pancreatitis.Öğe Adult Nesidioblastosis With Hypoglycemia Mimicking an Insulinoma: A Challenging Case(Int College Of Surgeons, 2017) Yurekli, Banu Sarer; Kutbay, Nilufer Ozdemir; Altun, Ilker; Cetinkalp, Sevki; Nart, Deniz; Coker, Ahmet; Ozgen, GokhanIntroduction: Nesidioblastosis is the primary cause of persistent hyperinsulinemic hypoglycemia in infants but it is a rare entity for the adults. Nesidioblastosis is defined as an increase of pancreatic beta cells in number and in size. Case Presentation: We describe a rare case of nesidioblastosis with positive endoscopic ultrasonography result mimicking an insulinoma. A 35-year-old female patient had hypoglycemic episodes with high insulin level. Her investigation revealed low venous plasma glucose, high insulin and C-peptide level with positive 72-hour fasting test suggestive of hyperinsulinemic hypoglycemia. Abdominal computed tomography did not show any mass lesion. Endoscopic ultrasonography revealed a mass lesion sized as 1 cm in diameter in the pancreas. But, insulinoma like lesion couldn't be found intra-operatively. It was decided to perform distal pancreatectomy. After distal pancreatectomy, nesidioblastosis was diagnosed histopathologically. The patient was free from her symptoms after surgery. Conclusion: This case illustrates difficulties and limitations of imaging modalities and false positive result of EUS in a case of nesidioblastosis. When there is no insulinoma like lesion during operation, operation should be performed as gradient guided pancreatectomy by the way of selective arterial calcium injection test.Öğe Assessment of pituitary function in patients with nasopharyngeal carcinoma: the effect of radiotherapy(2019) Akagunduz, Ozlem Ozkaya; Yurekli, Banu Sarer; Simsir, Ilgin Yildirim; Esassolak, MustafaRadiotherapy (RT) plays a very important role in nasopharyngeal carcinoma (NPC). the pituitary gland can be affected by radiation due to its proximity to the nasopha-ryngeal cavity. Our aim is to demonstrate the effect of radiotherapy given for NPC on anterior pituitary function with basal pituitary hormones and provocative tests. Patients with NPC that were treated with definitive chemoradioherapy were reviewed retrospectively. Serum ACTH, GH, PRL, FSH, LH, TSH and cortisol, DHEAS, IGF-1, E2, testosterone, fT3, fT4 levels were recorded to evaluate pituitary function. Insulin tolerance test was performed to investigate hypothalamic-pituitary-adrenal axis and GH -IGF-1 axis. Comparison between early tumor stage and advanced tumor stage for pituitary dysfunction was done. the median time interval between the RT and endocrinologic evaluation was 4.0 (1-13) years. ACTH deficiency was found to be most common hormonal problem with a frequency of 73.7%. of these 71.4% were mild adrenal deficiencies. GH deficiency was seen in 60% of patients. fT3, TSH, GH and IGF-1 levels were significantly lower in patients with advanced tumor stage compared with early tumor stage (p = 0.033, p = 0.022, p = 0.043, p = 0.022, respectively). Growth hormone deficiency was found in all of advanced and in 43% of early tumor stage patients (p = 0.017). We found higher rates of ACTH and GH deficiencies followed by gonadotropin, corticotropin and thyrotropin deficiency. Basal pituitary hormones will not be sufficient to evaluate anterior pituitary failure. Annual and systematic dynamic tests together with basal anterior pituitary hormones would be neededÖğe A case of dyskeratosis congenita associated with hypothyroidism and hypogonadism(Hellenic Endocrine Soc, 2016) Kutbay, Nilufer Ozdemir; Yurekli, Banu Sarer; Erdemir, Zehra; Karaca, Emin; Unal, Idil; Yaman, Banu; Özkınay, Ferda; Saygili, FusunÖğe A case of familial partial lipodystrophy caused by a novel lamin A/C (LMNA)mutation in exon 1 (D47N)(Elsevier Science Bv, 2016) Kutbay, Nilufer Ozdemir; Yurekli, Banu Sarer; Onay, Huseyin; Altay, Canan Tuncer; Atik, Tahir; Hekimsoy, Zeliha; Saygili, Fusun; Akinci, BarisBackground: Familial partial lipodystrophy (FPL) is a rare genetic disorder characterized by selective lack of subcutaneous fat which is associated with insulin resistant diabetes. The Dunnigan variety (FPL2) is caused by several missense mutations in the lamin A/C (LMNA) gene, most of which are typically located in exon 8 at the codon position 482. Case report: Here, we report on a Turkish family with FPL2 which is caused by a novel heterozygous missense LMNA mutation in exon 1 (D47N, c. 139G N A), in the rod domain of lamins A/C. Fat distribution and metabolic features of LMNA D47N mutation were similar to typical codon 482 mutation. Metabolic abnormalities were observed as a form of insulin resistant diabetes, hypertriglyceridemia, low HDL cholesterol and hepatic steatosis. There was no evidence for neuromuscular and cardiac involvement. Conclusion: Although it is previously known that alterations in the rod domain of type A lamins are involved in cardiac and neuromuscular diseases, our current observation shows that exon 1 LMNA mutationsmay be associated with partial lipodystrophy without any cardiac and neurological abnormalities, at least at the time of the presentation. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.Öğe A case of idiopathic granulomatous hypophysitis(Hellenic Endocrine Soc, 2017) Kutbay, Nilufer Ozdemir; Berker, Mustafa; Soylemezoglu, Figen; Ozisik, Hatice; Yurekli, Banu SarerÖğe A Case of Plurihormonal Pituitary Giant Macroadenoma(Turkiye Klinikleri, 2021) Ozisik, Hatice; Yurekli, Banu Sarer; Ertan, Yesim; Eraslan, Cenk; Ozgiray, Erkin; Saygili, FusunWe would like to draw the attention of the readers to Pit-1 positive giant macroadenomas in this work. A 62-year-old male patient was admitted to the hospital due to his vision loss and blurred vision in the left eye. His pituitary magnetic resonance imaging revealed the presence of a diffuse and homogeneous mass lesion originating from the pituitary gland having grade 4 invasion into the bilateral cavernous sinus and eroding the base of the sella. He consulted our department before his operation in 2016. Laboratory examination revealed that pituitary hormone levels were within normal ranges while the testosterone level [total testosterone 0.27 ng/mL (2.8-8)] was low. Pathological findings revealed a pituitary adenoma that displayed focal immunoreactivity to thyrotrophin, growth hormone, and prolactin. While the main prevalence and the basic mechanism of plurihormonal pituitary adenomas are not clear, one of the hypotheses is based on the role of divergent transcription factors such as Pit-1. According to this condition, we should perform a complete biochemical and histologic evaluation in patients with pituitary adenomas.Öğe A Case of Thyroid Hemiagenesis: An Exceptional Case(Galenos Yayincilik, 2018) Yurekli, Banu Sarer; Kutbay, Nilufer Ozdemir; Erdogan, Mehmet; Makey, Ozer; Icoz, Gokhan; Ozgen, GokhanThyroid hemiagenesis is a rare congenital anomaly in which one thyroid lobe fails to develop. We recently observed a case of thyroid hemiagenesis accompanied by parathyroid adenoma and papillary thyroid microcarcinoma in a 51-years-old woman. The patient's serum calcium level was 10.9 mg/dL and that of intact parathyroid hormone was 218 pg/mL. Although she had a history of thyroid hemiagenesis, the patient was in a euthyroid state without thyroxine replacement. Thyroid ultrasonography detected no right lobe and four nodules of varying sizes in the left thyroid lobe. Tc-99m scintigraphy also demonstrated the absence of the right thyroid lobe. In addition, MIBI-parathyroid scintigraphy showed a parathyroid adenoma at the lower pole of the right cervical region. Based on the diagnosis, parathyroid adenoma excision and thyroidectomy were performed. Postoperative pathological diagnosis revealed parathyroid adenoma and papillary thyroid microcarcinoma in the form of a 0.4 cm sized tumor in the left thyroid lobe. The coexistence of thyroid hemiagenesis, primary hyperparathyroidism, and papillary thyroid microcarcinoma is truly exceptional and has never been reported in the literature before.Öğe Characteristics and Treatment Results of 5 Patients with Fibrous Dysplasia and Review of the Literature(Hindawi Publishing Corp, 2015) Kutbay, Nilufer Ozdemir; Yurekli, Banu Sarer; Baykan, Emine Kartal; Sahin, Serap Baydur; Saygili, FusunAim. Fibrous dysplasia is a rare bone disease caused by missense mutation leading to abnormal fibroblast and osteoblast proliferation and increased bone resorption. FD can present in monostotic or polyostotic forms. About 3% of FD could be in association with McCune-Albright syndrome (MAS). Because FD is a rare disease, there is limited data in the literature about characteristics of disease and response to treatment. Methods. We present our five cases of FD with general properties and their responses to medical treatment. Results. Two of our patients had polyostotic and three had monostotic FD. One of the polyostotic patients had MAS. One of our patients had surgery for femur fractures, facial asymmetry, and findings of compression. Four patients were given pamidronate; one was given zoledronic acid as bisphosphonate treatment. Bone pain was relieved in all patients with medical treatment. Conclusion. There was a decrease in bone turnover markers to some degree with medical treatment but no radiological improvement was observed.Öğe Clinical presentations, metabolic abnormalities and end-organ complications in patients with familial partial lipodystrophy(W B Saunders Co-Elsevier Inc, 2017) Akinci, Baris; Onay, Huseyin; Demir, Tevfik; Savas-Erdeve, Senay; Gen, Ramazan; Simsir, Ilgin Yildirim; Keskin, Fatma Ela; Erturk, Mehmet Sercan; Uzum, Ayse Kubat; Yaylali, Guzin Fidan; Ozdemir, Nilufer Kutbay; Atik, Tahir; Ozen, Samim; Yurekli, Banu Sarer; Apaydin, Tugce; Altay, Canan; Akinci, Gulcin; Demir, Leyla; Comlekci, Abdurrahman; Secil, Mustafa; Oral, Elif AriogluObjective. Familial partial lipodystrophy (FPLD) is a rare genetic disorder characterized by partial lack of subcutaneous fat. Methods. This multicenter prospective observational study included data from 56 subjects with FPLD (18 independent Turkish families). Thirty healthy controls were enrolled for comparison. Results. Pathogenic variants of the LMNA gene were determined in nine families. Of those, typical exon 8 codon 482 pathogenic variants were identified in four families. Analysis of the LMNA gene also revealed exon 1 codon 47, exon 5 codon 306, exon 6 codon 349, exon 9 codon 528, and exon 11 codon 582 pathogenic variants. Analysis of the PPARG gene revealed exon 3 p.Y151C pathogenic variant in two families and exon 7 p.H477L pathogenic variant in one family. A non-pathogenic exon 5 p.R215Qvariant of the LMNB2 gene was detected in another family. Five other families harbored no mutation in any of the genes sequenced. MRI studies showed slightly different fat distribution patterns among subjects with different point mutations, though it was strikingly different in subjects with LMNA p.R349W pathogenic variant. Subjects with pathogenic variants of the PPARG gene were associated with less prominent fat loss and relatively higher levels of leptin compared to those with pathogenic variants in the LMNA gene. Various metabolic abnormalities associated with insulin resistance were detected in all subjects. End-organ complications were observed. Conclusion. We have identified various pathogenic variants scattered throughout the LMNA and PPARG genes in Turkish patients with FPLD. Phenotypic heterogeneity is remarkable in patients with LMNA pathogenic variants related to the site of missense mutations. FPLD, caused by pathogenic variants either in LMNA or PPARG is associated with metabolic abnormalities associated with insulin resistance that lead to increased morbidity. (C) 2017 Elsevier Inc. All rights reserved.Öğe Could Retroperitoneal Ganglioneuroma be a Dopamine Secreting Ganglioneuroma?(Galenos Yayincilik, 2018) Ozisik, Hatice; Yurekli, Banu Sarer; Kutbay, Nilufer Ozdemir; Eker, Baris; Ertan, Yesim; Saygili, FusunGanglioneuromas are rarely occurring benign tumors characterized by hyperplasia of mature ganglia and satellite cells. They are well-differentiated, slow growing, and autonomous nervous system neoplasms, which are usually asymptomatic and do not release any hormones. A male patient aged 26 years was evaluated for secondary hypertension six months ago. Ultrasonography of the abdomen revealed a mass lesion around the right kidney. An analysis of the 24-hour urine sample of the patient revealed the following parameters: 5-HIAA=3.9 mg/day (2-7), metanephrine=56.3 mu g/day (52-341), and normetanephrine=146.1 mu g/day (88-444). The computed tomography scan of the abdomen showed a retroperitoneal mass of 10 cm in size, containing minute calcified foci in the right retroperitoneal region. The mass was excised through general surgery and was classified as ganglioneuroma. The blood pressure of the patient returned to normal level after surgery, and he needed no further antihypertensive treatment. Besides, the metanephrine and normetanephrine levels in the 24-hour urine were also observed to be normal as in the preoperative period. Retroperitoneal masses can actually be ganglioneuromas and an accurate diagnosis can be achieved only through postoperative histopathological evaluation. After the operation, blood pressure of the patient returned to normal. This suggests that retroperitoneal ganglioneuroma could possibly secrete dopamine, epinephrine, or norepinephrine.Öğe Effects of metformin and pioglitazone combination on apoptosis and AMPK/mTOR signaling pathway in human anaplastic thyroid cancer cells(Wiley, 2020) Kutbay, Nilufer Ozdemir; Avci, Cigir Biray; Yurekli, Banu Sarer; Kurt, Cansu Caliskan; Shademan, Behrouz; Gunduz, Cumhur; Erdogan, MehmetAnaplastic cancer constitutes 1% of thyroid cancers, and it is one of the most aggressive cancers. Treatment options are external radiation therapy and/or chemotherapy. the success rate with these treatment modalities is not satisfactory. We aimed to evaluate the effects of metformin (MET) and pioglitazone (PIO) combination on apoptosis and AMP-activated protein kinase/mammalian target of rapamycin (mTOR) signaling pathway in human anaplastic thyroid cancer cells. in this study, we evaluated the effects of MET and PIO individually and the combination of the two drugs on the cellular lines SW1736 and C643 ATC. Genes contained in the mTOR signaling pathway were examined using human mTOR Signalization RT(2)Profiler PCR Array. in C643 and SW1736 cell lines, IC(50)doses of MET and PIO were found out as 17.69 mM, 11.64 mM, 27.12 mu M, and 23.17 mu M. Also, the combination of MET and PIO was determined as an additive according to isobologram analyses. We have found the downregulation of the expression levels of oncogenic genes:AKT3, CHUK, CDC42, EIF4E, HIF1A, IKBKB, ILK, MTOR, PIK3CA, PIK3CG, PLD1, PRKCA, andRICTORgenes, in the MET and PIO combination-treated cells. in addition, expression levels of tumor suppressorgenes, DDIT4, DDIT4L, EIF4EBP1, EIF4EBP2, FKBP1A, FKBP8, GSK3B, MYO1C, PTEN, ULK1, andULK2, were found to have increased significantly. the MET + PIO combination was first applied to thyroid cancer cells, and significant reductions in the level of oncogenic genes were detected. the decreases, particularly, inAKT3, DEPTOR, EIF4E, ILK, MTOR, PIK3C, andPRKCAexpressions indicate that progression can be prevented in thyroid cancer cells and these genes could be selected as therapeutic targets.Öğe High chitotriosidase and AGE levels in acromegaly: a case-control study(Springer Int Publ Ag, 2022) Ozisik, Hatice; Yurekli, Banu Sarer; Suner, Asli; Copur, Oznur; Sozmen, Eser Yildirim; Ozbek, Suha Sureyya; Karabulut, Ahmet KasimPurpose Acromegaly is associated with oxidative stress and inflammation parameters. Chitotriosidase (CHITO) is a marker of macrophage activation and plays a pivotal role in the activation of inflammatory and immunological responses. Our study aimed to determine CHITO,YKL-40, advanced glycation end product (AGE), and high-sensitivity C-reactive protein (hsCRP) levels to investigate malondialdehyde (MDA), catalase, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities and to evaluate any association of these parameters with carotid intima media thickness (cIMT) in patients with controlled acromegaly. Methods Thirty controlled acromegaly patients and 41 age- and sex-matched control cases were studied. We obtained demographic data, hormonal and metabolic parameters, and cIMT. CHITO activity was measured with the fluorometric method of Chamoles et al. YKL-40 and hsCRP levels were measured using ELISA. AGEs were measured based on spectrofluorimetric detection. GSH-Px activity was determined by a colorimetric assay. MDA, SOD, and catalase activities were determined in hemolysis. Results Higher CHITO, AGE, and hsCRP concentrations were observed in patients with acromegaly compared to controls. SOD levels were non-significantly higher in the acromegaly group, while catalase activities were lower in patients with acromegaly. Correlation analyses of CHITO, AGEs, YKL-40, hsCRP, MDA, catalase, GSH-Px, and SOD with metabolic, anthropometric, and laboratory parameters did not demonstrate any significant correlation (p > 0.05). There was no significant difference between groups with regard to cIMT levels. Conclusion This is the first study investigating CHITO and AGE levels in patients with acromegaly. Serum CHITO, AGE, and hsCRP levels in acromegalic patients were significantly increased. It may be important to evaluate CHITO, AGE, and hsCRP levels in acromegalic patients who are already under cardiometabolic surveillance due to risk of developing cardiovascular disease.Öğe Is it the time for metformin to take place in adjuvant treatment of Her-2 positive breast cancer? Teaching new tricks to old dogs(Churchill Livingstone, 2009) Yurekli, Banu Sarer; Karaca, Burcak; Cetinkalp, Sevki; Uslu, RuchanBreast cancer is the most common malignancy diagnosed among women. According to the new molecular subclassification, basal like and Her-2 positive breast cancers have the worst outcome and these are the ones in which chemotherapy is a must as a part of adjuvant treatment. New treatment options that could be used as an adjuvant maintenance treatment are still being investigated. Insulin hormone is one of the reasons of breast cancer recurrence and death in breast cancer survivors. Targeting insulin as a therapeutic modality in breast cancer could be an option in the adjuvant treatment of breast cancer. It seems that insulin may signal to activate a cascade of proliferative and anti-apoptotic events in the cancer cell. Metformin, an oral anti-diabetic known for 50 years, may also have direct effects on cancer cells. Metformin causes Her-2 suppression via the inhibition of mTOR in breast cancer cells. Thus, we believe that the time has arrived both to target insulin reduction and to alter Her-2 oncogene based molecular pathogenetic steps in breast cancer by using metformin as an adjuvant therapy in breast cancer patients. (C) 2009 Elsevier Ltd. All rights reserved.Öğe Is it the time for metformin to take place in adjuvant treatment of Her-2 positive breast cancer? Teaching new tricks to old dogs(Churchill Livingstone, 2009) Yurekli, Banu Sarer; Karaca, Burcak; Cetinkalp, Sevki; Uslu, RuchanBreast cancer is the most common malignancy diagnosed among women. According to the new molecular subclassification, basal like and Her-2 positive breast cancers have the worst outcome and these are the ones in which chemotherapy is a must as a part of adjuvant treatment. New treatment options that could be used as an adjuvant maintenance treatment are still being investigated. Insulin hormone is one of the reasons of breast cancer recurrence and death in breast cancer survivors. Targeting insulin as a therapeutic modality in breast cancer could be an option in the adjuvant treatment of breast cancer. It seems that insulin may signal to activate a cascade of proliferative and anti-apoptotic events in the cancer cell. Metformin, an oral anti-diabetic known for 50 years, may also have direct effects on cancer cells. Metformin causes Her-2 suppression via the inhibition of mTOR in breast cancer cells. Thus, we believe that the time has arrived both to target insulin reduction and to alter Her-2 oncogene based molecular pathogenetic steps in breast cancer by using metformin as an adjuvant therapy in breast cancer patients. (C) 2009 Elsevier Ltd. All rights reserved.Öğe Langerhans cell histiocytosis of the thyroid together with papillary thyroid carcinoma(Springer International Publishing Ag, 2020) Ozisik, Hatice; Yurekli, Banu Sarer; Demir, Derya; Ertan, Yesim; Simsir, Ilgin Yildirim; Ozdemir, Murat; Saygili, Fusun[No abstract available]Öğe The low levels of bone morphogenic protein-4 and its antagonist noggin in type 2 diabetes(Springer International Publishing Ag, 2018) Yurekli, Banu Sarer; Kocabas, Gokcen Unal; Aksit, Murat; Kutbay, Nilufer Ozdemir; Suner, Asli; Yurekli, Ismail; Cakir, Habib; Bozkaya, Giray; Cetinkalp, SevkiObjective Bone morphogenic protein-4 (BMP-4) is a proinflammatory cytokine which is controlled by BMP-4 antagonists. Our aim was to investigate the levels of BMP-4 and its antagonists, noggin and matrix Gla protein (MGP), in prediabetes and diabetes. Design One hundred and forty-two type 2 diabetic, 32 prediabetic, and 58 control subjects participated in this cross-sectional study. BMP-4, noggin, and MGP were measured with the ELISA method. Results There was a significant difference between the three groups in relation to sex, hypertension, fasting plasma glucose, HbA1c, lipid profiles, and diastolic blood pressure (p < 0.05). BMP-4 levels were significantly lower in the diabetic group compared to the control group (108.5 and 127.5 ng/mL, respectively, p < 0.001 diabetes vs. control). Noggin levels were significantly lower in the diabetic group compared to the prediabetic and control groups (10.5, 11.5, and 12.0 ng/mL, as median, respectively, p < 0.001; diabetes vs. control, p = 0.002; diabetes vs. prediabetes). BMP-4 was associated significantly with noggin in the entire study population (beta coefficient = 0.796, p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve was 0.708 (95% CI 0.551-0.864, p = 0.011) for BMP-4 levels. The optimal cutoff value of BMP-4 for detecting albuminuria was 118.5 ng/mL for which sensitivity was 71.4% and specificity was 66.4%. Conclusions BMP-4 and noggin levels were lower in the diabetic group. High BMP-4 levels were significantly associated with albuminuria. Further studies are warranted to determine the role of BMP-4 in the pathogenic processes underlying albuminuria and hyperglycemia in patients with type 2 diabetes.Öğe MAPK pathway and NIS in B-CPAP human papillary thyroid carcinoma cells treated with resveratrol(Elsevier GMBH, 2024) Unal Kocabas, Gokcen; Blatti, Asli Kisim; Berdeli, Afig; Ozgen, Ahmet Gokhan; Yurekli, Banu SarerBackground: Resveratrol, a herbal phytoalexin, is known to have anti-tumor effects in several tumors including thyroid cancer cells. Aim: The aim of this study was to determine the effects of resveratrol on the expression of BRAF, ERK and NIS mRNA levels and protein expression in B-CPAP human thyroid papillary cancer cell line. Methods: B-CPAP cells were treated with resveratrol at concentrations of 10-100 mu M for 24-48-72 h. Cell viability was assessed by XTT Cell Proliferation Assay. BRAF, ERK and NIS mRNA levels were evaluated by rtPCR method. Protein expressions were evaluated by Western Blot method. Results: Resveratrol was found to inhibit cell proliferation in a time and dose dependent manner. The IC50 values of resveratrol were 18.7 mu M and 56.8 mu M after 48 h and 72 h respectively. Resveratrol treatment of B-CPAP cells resulted in up to 1.5-fold reduction in BRAF mRNA and up to 5.5 fold reduction in ERK mRNA levels. NIS mRNA levels showed up to 3-fold increase. Western Blot studies confirmed the rt- PCR results with a decrease in BRAF and ERK, and increase in NIS protein expressions. Conclusion: This study demonstrated that resveratrol inhibits thyroid papillary carcinoma cell proliferation and reduces poor prognostic BRAF and ERK mRNA and protein expressions, while increasing NIS mRNA and protein expression suggesting a redifferentiating effect. More studies are needed to evaluate resveratrol as a novel therapeutic agent in the treatment of papillary thyroid cancer.
