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Association Between Plasma Adrenomedullin Levels and Bone Mineral Density in Patients with Polycystic Ovary Syndrome
(Galenos Yayincilik, 2005) Uçar, Banu; Noyan, Volkan; Yücel, Aykan; Sağsöz, Nevin; Çağlayan, Osman
Objective: The aim of the study was to compare bone mineral density measurements between patients with polycystic ovary syndrome (PCOS) and age and body mass index matched healthy controls, and to examine whether plasma adrenomedullin concentration was associated with bone mineral density. Design: Prospective study. Setting: Department of Obstetrics and Gynecology, Kirikkale University School of Medicine. Patients: Twenty women with PCOS and 13 healthy control subjects were enrolled in the study. Interventions: Plasma adrenomedullin, serum androstenedione, free testosterone, testosterone, DHEAS, SHBG, FSH, LH, estradiol, fasting insulin and fasting glucose were measured in each subject. Bone mineral density (lumbar spine 2-4 (L2-4), femoral neck, ward's triangle, great trochanter) measurements were measured using dual energy X-ray absorptiometry. Insulin resistance was estimated by fasting insulin level, fasting glucose: insulin ratio and 75 g of glucose tolerance test for 2 hours. Main Outcome Measures: Bone mineral density and correlation between bone mineral density and plasma adrenomedullin. Result: Bone mineral density measurements did not differ between the groups. There were no correlations between plasma adrenomedullin and bone mineral density measurements. Conclusions: Further studies are needed to evaluate the relation between bone mineral density and plasma adrenomedullin.
The association of serum androgens and insulin resistance with fat distribution in polycystic ovary syndrome
(Elsevier Science Bv, 2006) Yücel, Aykan; Noyan, Volkan; Sagsöz, Nevin
Objective: The aim of the study was to compare the body fat distribution of women with polycystic ovary syndrome (PCOS) with age and body mass index matched healthy controls and to investigate if androgens and insulin resistance associated with fat distribution. Study design: Thirty-three PCOS and 21 age and body mass index (BMI) matched healthy control women were evaluated in terms of body fat distribution with dual X-ray absorpsiometry (DEXA). Blood samples were obtained for follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEA-S), free testosterone, sex hormone binding globulin (SHBG), insulin and glucose levels. A 75 g 2 h glucose tolerance test was performed for each woman. Insulin resistance was estimated by fasting insulin level, fasting glucose/insulin ratio and 75 g 2 h glucose tolerance test. The Student's t-test and Mann-Whitney U-test were used to compare the groups. Pearson and Spearman rank correlation coefficients were calculated for normally and normormally distributed variables, respectively. Partial correlation coefficients were calculated using age and BMI as covariates. Results: Fat mass in trunk and arms were significantly higher in patients with PCOS (p < 0.043 and 0.036, respectively). The ratio of fat mass in trunk to fat mass in legs were significantly higher in patients with PCOS (p < 0.011). Free testosterone was found to be positively correlated with fat mass in arms (r = 0.401, p < 0.05). There was still significant correlation between free testosterone and fat mass in arms (r = 0.5964, p < 0.05) after controlling for age and BMI. Conclusion: Free testosterone level is positively correlated with the fat mass in arms in women with PCOS. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
Doğal menopozda hormon replasman tedavisinin renal arter doppler indekslerine etkisi: Ön çalışması
(2006) Yücel, Aykan; Kara, Simay Altan; Noyan, Volkan; Sağsöz, Nevin; Çil, Aylin Pelin
Objektif: Bu çalışmanın amacı doğal menopozdaki hastalarda üç farklı hormon replasman tedavisinin (HRT) renal damarlar üzerine etkisini renal arter Doppler indeksleri ölçümü ile araştırmaktı. Planlama: Otuz üç postmenapozal hastaya randomize olarak sırasıyla 0.625 mg konjuge equine östrojen (CEE) 5 mg medroksiprogesteron asetat (MPA) (Grup I), 2 mg estradiol valerat (Grup II) ya da 2.5 mg Tibolon (Grup III) başlandı. Tedavi başlamadan önce ve başlangıçtan 70 gün sonra her hastaya sol interlobar renal arter Doppleri yapıldı. Ortam: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ve Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı Değerlendirme parametreleri: HRT başlangıç ve tedavi sonrasında interlobar renal arter Doppler indeksleri ölçümü SONUÇ: Toplam 33 hastadan grup I’ den 11, grup II’ den 7 ve grup III’ den 9 hasta çalışmaya dahil edildi. Bu 27 hastanın yaş ortalaması 49.44 4.07 idi. Tüm hastaların bazal pulsatilite (PI) ve resistivite indeks (RI) değerleri benzerdi. Yetmiş günlük tedavi sonrasında grup III’ teki hastaların RI (p0.001), grup II’ deki hastaların RI (p0.047) ve PI (p0.028) değerlerinde anlamlı düşüş izlendi. Grup I’ deki hastaların bazal ve tedavi sonrası RI ve PI değerlerinde ise anlamlı değişiklik olmadı. YORUM: Az sayıda hastayla yapılmış olan bu çalışmanın sonuçları Tibolon ve estradiol valerat’in renal kan akımı üzerine olumlu etkileri olabileceği ve östrojenle kombine kullanıldığında MPA’ ın östrojenin vasküler etkilerini azaltıcı etki yaratabileceğini düşündürmekte ise de, bu yargıyı destekleyecek iyi planlanmış daha fazla hastayla yapılmış, uzun süreli çalışmalara gereksinim vardır.
The Effect of Adipose Tissue-Derived Mesenchymal Stem Cells on Regeneration of Uterine Scars
(2017) Bender, R. Ada; Yücel, Aykan; Noyan, Volkan; Gürpınar, Aylin; Atasoy, Pınar; Comu, Faruk M.
OBJECTIVE: The mesenchymal stem cell application to uterine healing scars may provide better tissuestrength.STUDY DESIGN: Hysterectomy was performed on rats, and the wound recovery as a result of primarysuturing was evaluated as tissue stretching and the positive histopathological effects. The mesenchymalstem cells originating from the adipose tissue were used during the healing period of the wound and woulddifferentiate to mesenchyme-originated cells present in intact tissue for an optimum level of healing.RESULTS: The weights of non-incised uterine horns in the control group were found to be significantlyhigher than the weights of the incised uterine horns (z2.52, p0.012). In the experiment group, theweights of the incised uterine horns were found to be significantly higher than the non-incised uterinehorns (z2.52, p0.012). In the control group, the non-incised uterine horns withstood the stretching testto a higher extent than the incised horns, and a significant difference was found between the stretchingvalues (z2.5, p0.012). In the experiment group, the incised uterine horns withstood the stretching teststo a higher extent than the non-incised uterine horns; however, there was no significant difference between the stretching tests (z1.540, p0.123).CONCLUSION: Adipose tissue-originated mesenchyme stem cells were observed to increase the tissue stretching during wound healing.
Effects of hormone replacement therapy on renal artery Doppler indices in women with natural menopause
(Galenos Yayincilik, 2006) Yucel, Aykan; Kara, Simay Altan; Noyan, Volkan; Sagsoz, Nevin; Cil, Aylin Pelin
Objective: The aim of our study was to evaluate the effects of three different hormone replacement therapy (HRT) regimens on renal vasculature determined by renal artery Doppler ultrasonography indices in natural menopause. Design: Thirty three postmenopausal women were randomly assigned to receive 0.625 mg conjugated equine estrogen (CEE) + 5 mg medroxyprogesterone acetate (MPA) (Group I), 2 mg estradiol valerate (Group II) or 2.5 mg Tibolon (Group III), respectively. Doppler ultrasound of the left renal interlobar artery was performed for each patient before the beginning and after 70 days of each hormone replacement therapy (HRT). Setting: Kirikkale University, School of Medicine, Department of Gynecology and Obstetrics, and Department of Radiology, Kirikkale, Turkey. Main outcome measures: Renal interlobar artery Doppler indices before and after therapy. Results: Of the thirty three patients, there were 11, 7 and 9 patients who completed the study in group I, II and III, respectively. The mean age of 27 patients who completed the study was 49.44 +/- 4.07. The baseline pulsatility index (PI) and resistivity index (RI) values of the three groups were similar. After 70 days of treatment, there were statistically significant decrease in RI values of group III (p< 0.001) and RI (p=0.047) and PI (p=0.028) values of group II while statistically significant change was not obtained in group I after treatment. Conclusion: Although we may conclude from the results of this small sample sized study that tibolon and estradiol valerate may have favorable effects on renal blood flow and MPA combined with CEE may attenuate the estrogen-induced vascular effects in natural menopause, well designed studies with more patients and long term follow-up are needed to strengthen this judgment.
The effects of hormone therapy, estrogen therapy and tibolone on apoptosis and cyclin D-1 expression in postmenopausal vaginal epithelium
(Elsevier Science Bv, 2005) Sağsöz, Nevin; Yücel, Aykan; Noyan, Volkan; Bozdoğan, Önder
Objective: To investigate the effects of hormone therapy, estrogen therapy and tibolone on markers of apoptosis including bcl-2, and bax and cyclin D, expression in postmenopausal vaginal epithelium. Study design: Thirty postmenopausal women were randomized to the treatment protocols (0.625 mg conjugated equine estrogen (CEE) + 2.5 mg medroxyprogesterone acetate (MPA); 2 mg estradiol valerate; 2.5 mg tibolone). After baseline vaginal biopsy, control biopsies were performed after 70 days following the initiation of the therapy. Bcl-2, bax, Bcl-2/bax ratio, cyclin D, measurements were performed immunohistochemically. Data were analyzed by Kruskal-Wallis, Mann-Whitney U and Wilcoxon tests. Results: After the treatment period the above-mentioned parameters were not different among the groups except for cyclin D-1 levels. Cyclin D-1 expression was found to be strong in patients with treated estradiol valerate. Conclusions: The effects of estrogen on cyclin D-1 expression were not detected with tibolone or with the addition of progesterone to estrogen in the vaginal epithelium. Cyclin D, appeared to have stronger effects on the estrogen related proliferation compared to apoptotic markers in vaginal epithelial cells. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
Effects of L-carnitine on oxidative stress parameters in oophorectomized rats
(Taylor & Francis Ltd, 2017) Canbolat, Emel Peri; Sagsoz, Nevin; Noyan, Volkan; Yucel, Aykan; Kisa, Ucler
Aims: The aim of this study was to investigate the antioxidant effects of L-carnitine on the oxidative stress parameters in oophorectomized rats. Methods: Twenty-four female albino Wistar rats were used. Rats were divided into four groups: laparotomy-only (LOSALINE) group, oophorectomy plus L-carnitine 100 mg/kg/day (OXL100) group, oophorectomy plus L-carnitine 500 mg/kg/day (OXL500) group, and oophorectomy-only (OXSALINE) group. Experimental protocol was started on day 21 post-castration. Various dosage forms of L-carnitine or isotonic saline were administered intraperitoneally for 14 consecutive days. Nitric oxide (NO), malondialdehyde (MDA), total antioxidant status (TAS), total oxidative stress (TOS) and oxidative stress index (OSI) were evaluated in the tissues including kidney, liver and heart, and sera. Result(s): In the heart tissue samples, there was no difference in the levels of NO, OSI and TOS between the groups. However, MDA levels in OXSALINE group were significantly higher than OXL500 group. On the other hand, there was no statistically significant differences between the groups in terms of levels of NO, MDA, TAS, TOS and OSI in liver, kidney and sera samples. Conclusion(s): Levels of MDA in the heart tissue were significantly higher in OXSALINE group compared to OXL500 group. Thus, it may be suggested that L-carnitine reduces oxidative stress at least in the heart of oophorectomized rats. (C) 2016 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin end ghrelin on polycystic ovary syndrome
(Elsevier Science Inc, 2009) Sağsöz, Nevin; Orbak, Zerrin; Noyan, Volkan; Yücel, Aykan; Uçar, Banu; Yıldız, Leyla
Objective: To evaluate short-term leptin and ghrelin concentrations in women with polycystic ovary syndrome (PCOS) who use low-dose oral contraceptives containing drospirenone. Design: Prospective study. Setting: Department of obstetrics and gynaecology in a university hospital. Patient(s): Twenty women with PCOS were enrolled in the study. Intervention(s): A low-dose oral contraceptive containing ethinyl estradiol and drospirenone was given for three cycles. Main Outcome Measure(s): Serum androstenedione, free T, T, dehydroepiandrosterone sulphate, sex hormone-binding globulin, FSH, LH, E-2, lipid profiles, leptin, and ghrelin levels were measured in each subject. Insulin resistance was estimated by the homeostasis model assessment-insulin resistance (HOMA-IR). Result(s): While leptin concentrations did not change with therapy, ghrelin levels increased statistically. Baseline leptin concentrations were correlated positively with body mass index, waist-to-hip ratio, insulin, and HOMA-IR and negatively with ghrelin. After controlling for body mass index and waist-to-hip ratio in a partial correlation analysis, leptin levels were not correlated with these parameters. Ghrelin was inversely correlated with body mass index, waist-to-hip ratio, insulin, HOMA-IR, and free T. Conclusion(s): In patients with PCOS, an oral contraceptive containing ethinyl estradiol and drospirenone increases ghrelin levels but not leptin levels in a 3-month period. Ghrelin might be related to the metabolic and androgenic changes in patients with PCOS. (Fertil Steril (R) 2009;92:660-6. (C)2009 by American Society for Reproductive Medicine.)
Laparoscopic ultrasonography in the management of ovarian cysts
(Karger, 2005) Noyan, Volkan; Tiras, M. Bülent; Öktem, Mesut; Güner, Haldun
Background. The aim of the study was to determine the role of laparoscopic ultrasonography in the management of ovarian cysts extirpated by means of endoscopic surgery. Methods: Laparoscopic ultrasonography was used during endoscopic surgery in 14 consecutive patients with an adnexal mass. The diagnostic accuracies of transvaginal and laparoscopic ultrasonography were compared according to the final pathological diagnosis. Estimations of the exact location of the ovarian mass by means of laparoscopic visualization and laparoscopic ultrasonography were compared. The presence of residual tumor tissue after cyst extirpation was monitored with laparoscopic ultrasonography. Results: Using laparoscopic ultrasound and transvaginal ultrasound the correct diagnosis was made in 12 of 14 (85.7%) and 9 of 14 (64.3%) patients, respectively (not significantly different). With laparoscopic visualization, the exact location of the ovarian tumor could be demonstrated in 57.1% (8/14) of the cases, while with laparoscopic ultrasonography precise visualization of the ovarian mass was achieved in all cases (not significantly different). Two patients were found to have residual tumor tissue in the ovary when laparoscopic ultrasonography was performed again after tumor extirpation. Conclusion: Laparoscopic ultrasonography seems to be useful in patients with an adnexal mass managed by endoscopic surgery, in terms of evaluating the internal characteristics and predicting the histological diagnosis of the ovarian cyst, deciding on the correct placement of the incision to prevent unnecessary trauma to the ovary, and evaluation of the ovary after cyst extirpation to expose any residual tumor tissue. Copyright (C) 2005 S. Karger AG, Basel.
Pitfalls in the assessment of PON1 status in clinical populations Reply
(Elsevier Science Inc, 2011) Noyan, Volkan
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Plasenta Previa ve Uzamış Membran Rüptürü Olan Olguda İhmal Edilmiş Mentum Posterior Yüz Geliş
(Kırıkkale Üniversitesi, 2013) Bender, Rukiye Ada; Yücel, Aykan; Noyan, Volkan; Serbest, Gülsüm Yıldız; Sağsöz, Nevin; Bölgen, Çağatay
Face presentation is a rare kind of malpresentation that has an incidence between 1/600-1/800. The diagnose is made by vaginal examination and ultrasonography (US). Etiologically anencephaly, multiparity, contacted pelvis, small or large fetus, plasenta previa, polyhdramnios, uterin anomalies and nuchal cord are responsible factors. Mentum anterior face presentations can be delivered vaginally, however cesarean sectio is the preferred route for fetus presenting with mentum posterior. We aimed to present a case and review the litreture of a mentum posterior face presentation complicated with premature rupture of membranes (PROM) for 72 hours which has arrested in labour in a multiparous placenta previa pregnant.
Plasma adrenomedullin levels in patients with polycystic ovary syndrome
(Elsevier Science Inc, 2006) Uçar, Banu; Noyan, Volkan; Cağlayan, Osman; Yücel, Aykan; Sagsöz, Nevin
Objective: To evaluate adrenomedullin levels in patients. with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Department of obstetrics and gynecology in a university hospital. Patient(s): Thirty-eight women with PCOS and 29 healthy control subjects were enrolled in the study. Intervention(s): Plasma. adrenomedullin, serum androstenedione, free T, T, DHEAS, SHBG, thyrotropin, PRL, FSH, LH, and E-2 were measured in each subject. Insulin resistance was estimated by fasting insulin level, fasting glucose:insulin ratio and 75-g glucose tolerance test for 2 hours. Main Outcome Measure(s): Plasma adrenomedullin levels and, correlations among adrenomullin and gonadotropins , female sex steroids, androgens, and insulin resistance. Result(s): There was no significant difference concerning plasma adrenomullin concentrations between the groups. In patients with PCOS, fasting glucose, fasting insulin, body mass index, and free T were inversely 179 y correlated with glue correlated with the plasma adrenomedullin. Plasma adrenomedullin was significantly correlated with glucose: insulin ratio. After controlling for, body mass index, there were no significant correlations between the above-mentioned parameters. Conclusion(s): Adrenomedullin may play a role in regulating the insulin metabolism in patients with PCOS.
Plasma lipocalin-2 levels in pregnancy
(Wiley-Blackwell, 2012) Cesur, Semra; Yucel, Aykan; Noyan, Volkan; Sagsoz, Nevin
Objective. To evaluate plasma levels of lipocalin-2, which is a novel adipokine associated with obesity and insulin resistance, in pregnant women. Design. Prospective casecontrol study. Setting. University hospital. Population. Pregnant women with pre-pregnancy body mass index >25kg/m2 (overweight; n=29) and body mass index <25kg/m2 (n=27), whose gestational ages were between 24 and 28weeks, as study groups and nonpregnant control women with body mass index <25kg/m2 (n=29). Methods. Plasma lipocalin-2 levels, fasting plasma glucose and fasting plasma insulin levels; homeostasis model assessment insulin resistance index and fasting plasma glucose/fasting plasma insulin ratio were measured for each subject. Main Outcome Measures. Comparisons among the groups and correlations for lipocalin-2 and the parameters of insulin resistance. Results. Plasma lipocalin-2 levels among the pregnant women were significantly higher than those of the control group (p<0.001 for both group comparisons). Lipocalin-2 levels were significantly higher in the group with pre-pregnancy body mass index >25kg/m2 compared with the group with pre-pregnancy body mass index <25kg/m2 (p=0.003). Lipocalin-2 levels were positively correlated with homeostasis model assessment insulin resistance index and fasting plasma insulin and negatively correlated with fasting plasma glucose/fasting plasma insulin ratio in both pregnant groups. Conclusions. Lipocalin-2 was found to be higher in pregnant women, especially when pre-pregnancy body mass index was >25kg/m2, and it was correlated with markers of insulin resistance.
Polikistik over sendromunda gözyaşı testleri ve meybomiyan bez fonksiyonları
(2012) Oğurel, Reyhan; Yıldız, Gülsüm Serbest; Gökçınar, Nesrin Büyüktortop; Örnek, Kemal; Yücel, Aykan; Noyan, Volkan; Sağsöz, Nevin
Amaç: Polikistik over sendrom’lu (PKOS) hastalarda gözyaşı testleri ve meibomian bez fonksiyonlarını değerlendirmek. Gereç ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniği’nde PKOS tanısı almış 53 hasta ve 25 sağlıklı birey sırasıyla PKOS ve kontrol gruplarını oluşturmak üzere çalışmaya alındı. İki grupta gözyaşı film stabilitesini değerlendirmek amacıyla gözyaşı kırılma zamanı (BUT) ölçümü ve lakrimal bez fonksiyonlarını değerlendirmek amacıyla Schirmer I testi kullanıldı. Ayrıca meibomianit bulguları not edilerek tüm veriler istatistiksel olarak karşılaştırıldı. Bulgular: İki grup arasında meibomianit görülme sıklığı, ortalama BUT skoru, düşük BUT (10 saniye) skorlu olgu oranı ve ortalama Schirmer test sonuçları açısından istatistiksel olarak anlamlı farklılıklar saptandı. Meibomianit görülme oranı PKOS grubunda %22,6, kontrol grubunda %10 oranında tespit edildi. BUT skoru ortalaması PKOS grubunda 12,123,47 saniye, kontrol grubunda 14,143,85 saniye idi (p0,002). Düşük BUT skoruna sahip olgu oranı PKOS grubunda %28,3 iken, kontrol grubunda %10 idi (p0,007). Schirmer I testinde filtre kağıdı ıslanma düzeyi PKOS grubunda ortalama 20,127,41 mm iken, kontrol grubunda ortalama 15,884,65 mm idi (p0,001). Polikistik over sendrom grubunda Schirmer sonuçları %3,8 olguda anormal, %3,8 olguda şüpheli, %92,5 olguda normal iken kontrol grubunda bu oranlar sırasıyla %2, %4, %94 idi (p0,05). Sonuç: Polikistik over sendromda hormonal dengesizliğin tetiklediği kuru göz bulgularına azımsanmayacak oranda rastlanılmaktadır. Bu nedenle PKOS tanısı alan hastaların göz polikliniğine yönlendirilip kuru göz açısından değerlendirilmesi önerilmelidir.
Postkoital kanamalı hastalarda servikal sitoloji, kolposkopi ve histopatolojik sonuçların değerlendirilmesi
(2003) Noyan, Volkan; Yücel, Aykan
Amaç: Postkoital kanamalı hastalarda servikal sitoloji, kolposkopi ve kolposkopiyle yönlendirilmiş biyopsi sonuçlarının değerlendirilmesi. Çalışmanın Yapıldığı Yer: Kırıkkale Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı. Materyal ve Metod: Postkoital kanama yakınması olan 74 hasta prospektif olarak incelendi. Hastalar servikal sitoloji, kolposkopi ve gereken olgularda kolposkopi ile yönlendirilmiş biyopsi sonuçlarıyla değerlendirildi. Servikal sitolojinin epiteliyal hücre anomalilerini belirlenre açısından sensitivite, spesifisite, pozitif ve negatif prediktif değerleri hesaplandı. Bulgular: Hastaların servikal sitoloji sonuçlan değerlendirildiğinde %91.9 (n68) inflamatuar değişiklikler, %5.4 (n4) düşük gradeli skuamoz intraepiteliyal lezyon ve %2.7 (n2) atrofik smear bulundu. Kolposkopi ve kolposkopi ile yönlendirilmiş biyopsi sonuçlarına göre olguların % 87.9'unda, en sık inflamatuar değişiklikler ya da metaplazi olmak üzere tamamen benign bulgular saptandı. ÇINI, HPV değişiklikleri ve CIN2 olmak üzere epiteliyal hücre anomalileri saptanan 9 hasta (%12.1) mevcuttu. Postkoital kanamalı hastalarda sitolojinin epiteliyal hücre anomalilerini belirleme açısından spesifisitesi %100, sensitivitesi %44.4, pozitif prediktif değeri %100, negatif prediktif değeri ise %92.9 olarak saptandı. Sonuç: Postkoital kanama, sıklıkla inflamatuar değişiklikler, metaplazi ya da servikal ektropion gibi benign durumlarla ilişkili olmasına karşın, serviksin premalign ve malign lezyonlarımn atlanmaması açısından servikal sitolojinin yanı sıra kolposkopi ve gereken olgularda kolposkopiyle yönlendirilmiş biyopsi ile değerlendirilmesi gereken bir semptomdur.
Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri
(2005) Uçar, Banu; Sağsöz, Nevin; Noyan, Volkan; Yücel, Aykan
Amaç: Bu çalışmada postmenopozal sağlıklı kadınlarda intranazal kalsitonin ile kombine verilen tibolon, konjuge estrojen, konjuge estrojen ve medroksiprogesteron asetat kullanımının kemik mineral yoğunluğuna etkisinin prospektif araştırılmasını amaçladık. Gereç ve Yöntem: Ekim 2002-Mart 2003 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum polikliniğine başvuran 37 postmenopozal sağlıklı kadın çalışmaya alındı. L2-L4 vertebra t skoru -1.5'den küçük olan kadınlar çalışmaya dahil edildi. Hastalar 3 gruba ayrıldı. Grup I'deki 14 kadına 2.5 mg/gün tibolon, grup II'deki 15 kadına 0.625 mg/gün konjuge estrojen (CEE)2.5 mg/gün medroksiprogesteron asetat (MPA), grup III'deki histerektomize 8 kadına 0.625 mg/gün konjuge estrojen verildi. Tedavilerine günlük intranazal 200 İÜ/gün salmon kalsitonin ile 1500 mg/gün elementer kalsiyum ve 400 İÜ/gün vitamin D eklendi. Hastaların tedavi öncesi ve tedaviden 1 yıl sonraki dual-energy X-ray absorptiometry ile kemik mineral yoğunluğu (gr/cm²) ölçüldü. İstatistiksel analizler için paired t-test, one-way analysis of variance test, Kruskal-Wallis test kullanıldı. Bulgular: Lumbar vertebra kemik mineral yoğunluğunda tedavi başlangıcına göre grup I'de L2-L4: %0.22, L3 %0.46; grup II'de L2-L4: %0.38, L3: %0.46; grup III'de L2-L4: %0.30, L3: %0.63 anlamlı artış bulundu. Femur boynu kemik mineral yoğunluğunda tedavi başlangıcına göre grup I'de %0.12, grup II'de %0.12, grup III'de %0.10 anlamlı olmayan artış tesbit edildi. Başlangıca göre lumbar vertebra ve femur boynu kemik mineral yoğunluğundaki artışta gruplar arasında anlamlı fark tesbit edilmedi. Sonuç: Bu çalışmada, erken postmenopozal dönemde tibolon, CEEMPA veya sadece CEE'nin, kalsitonin ile kombine kullanımda kemik mineral yoğunluğuna etkilerinin birbirlerine üstünlüğü gösterilememiştir.
Serum leptin levels in patients with polycystic ovary syndrome
(2002) Telli, Muhittin H.; Yıldırım, Mulazim; Noyan, Volkan
Objective: To determine whether polycystic ovary syndrome (PCOS) is related to leptin dysregulation. Design: Prospective study. Setting: Department of Obstetrics and Gynecology in a university hospital. Patient(s): Fifty patients with PCOS (33 nonobese and 17 obese) and 32 control women (19 nonobese and 13 obese) were included in the study. Intervention(s): Serum leptin levels were measured in patients with PCOS and the controls. Correlations between leptin levels and serum hormone levels (FSH, LH, free testosterone, androstenedione, DHEA-S and fasting insulin) were studied. Main Outcome Measure(s): Serum leptin levels and correlations between leptin levels and the hormonal parameters. Result(s): Mean serum leptin levels were not significantly higher in patients with PCOS compared to the control group. Leptin levels were found to be significantly higher in the obese subgroups both in patients with PCOS and in the control women. Leptin levels were found to be higher in obese patients with PCOS compared to obese controls; however, when the levels were evaluated again with covariance analysis excluding body mass index, there was no statistically significant difference. Leptin levels had a positive correlation with body mass index, both in patients with PCOS and the controls. Conclusion(s): Leptin levels were not higher in patients with PCOS compared to the control group; the leptin level was correlated with the amount of fat tissue not only in patients with PCOS but also in healthy women. © 2002 by American Society for Reproductive Medicine.
Serum paraoxonase 1 activity, asymmetric dimethylarginine levels, and brachial artery flow-mediated dilatation in women with polycystic ovary syndrome
(Elsevier Science Inc, 2011) Soyman, Zeynep; Noyan, Volkan; Tulmac, Murat; Yucel, Aykan; Sagsoz, Nevin; Bayrak, Tulin; Cakir, Erdinc
Objective: To evaluate endothelial function via serum asymmetric dimethylarginine (ADMA) levels, paraoxonase 1 (PON1) activity, and brachial artery flow-mediated dilatation (FMD) in women with polycystic ovary syndrome (PCOS). Design: Prospective case-control study. Setting: University hospital. Patient(s): Thirty patients with PCOS with a mean age of 24.33 +/- 4.50 years and 30 healthy controls matched for body mass index (BMI) and age. Intervention(s): Endothelial function was assessed biochemically with serum ADMA levels and serum PON1 activity and functionally with brachial artery FMD by ultrasonography. Main Outcome Measure(s): Serum ADMA levels, serum PON1 activity, brachial artery FMD, hormonal and biochemical parameters. Result(s): Patients with PCOS had higher levels of free testosterone and insulin, and higher waist-hip ratio and Ferriman Gallwey scores when compared with the controls. Fasting glucose and homeostasis model assessment of insulin resistance were not different between the groups. There was no statistically significant difference in ADMA levels between two groups. Serum PON1 activity and brachial artery FMD were statistically significantly lower in women with PCOS. There was negative correlation between ADMA and PON1 in patients with PCOS. Conclusion(s): Serum PON1 activity and brachial artery FMD, as markers of endothelial dysfunction and cardiovascular risk, were statistically significantly lower in women with PCOS compared with healthy controls matched for age and BMI. Endothelial dysfunction may be seen at earlier ages in patients with PCOS. (Fertil Steril (R) 2011;95:1067-72. (C) 2011 by American Society for Reproductive Medicine.)
THE EFFECTS OF THE COMBINED ORAL CONTRACEPTIVES ON THE BONE MINERAL DENSITY OF REPRODUCTIVE AGE WOMEN
(Galenos Yayincilik, 2005) Yucer, Gokcen; Yucel, Aykan; Noyan, Volkan; Bostanci, M. Suhha; Sagsoz, Nevin
Objective: To determine the effects of combined oral contraceptives (COC's) on bone mineral density of women after 12 month treatment. Design: Comparison of the Bone Mineral Density (BMD) and serum Ca+2, osteocalcin, alkaline phosphatase, Vitamin D3 and urinary OH-proline levels. Setting: Kirikkale University Medical Faculty Hospital. Patients: Fifty patients of ages < 40 years who took combined oral contraceptive for 12 months. Intervention: Bone Mineral Density Measurements and comparison of these values at the beginning and after 12 month of COC treatment. Results: The serum level of Ca+2 significantly increased [p<0.05] at the time of observation in comparison to the basal level. The urinary excretion of OH-proline over 12 months significantly decreased [p<0.05] at the end of study. At 12th month, no significant difference was detected in lumbar, femur, and distal ulna-radius BMD values in comparison with basal values. The BMD of proximal ulna-radius significantly increased [p<0.05] at the end of twelve months in comparison to basal content. Conclusions: The contraceptive pill containing 20 mu g Ethinyl estradiol + 100 mu g Levonorgestrel has beneficial effects on the bone turnover and bone mineral density at proximal ulna-radius.

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