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Atasoy M.M.,Maltepe University | Oren N.C.,Sarikamis Military Hospital | Ilica A.T.,GATA Medical Faculty | Guvenc I.,GATA Medical Faculty | And 2 more authors.
Journal of Clinical Ultrasound | Year: 2013

Fat necrosis (FN) of the breast is a benign nonsuppurative inflammatory process of the adipose tissue. The radiologic appearance ranges from benign to suspicious for malignancy; therefore, it is very important to know the distinguishing radiologic features of FN on different modalities. Mammography is more helpful in identifying FN than ultrasonography in most of the cases, and MRI may also be used to rule out malignancy as an adjunct to mammography and sonography. Even when modern diagnostic modalities are used, biopsy may still be unavoidable for some cases. In conclusion, an accurate history and familiarity with the radiologic findings are crucial to recognizing FN and avoiding unnecessary interventions. © 2013 Wiley Periodicals, Inc.


Cekmez F.,GATA Medical Faculty | Cekmez Y.,Goztepe Hospital | Pirgon O.,GATA Medical Faculty | Canpolat F.E.,GATA Medical Faculty | And 3 more authors.
European Cytokine Network | Year: 2011

Aim. The aim of this study was to investigate the relationship between four circulating adipocytokines (apelin, vaspin, visfatin, adiponectin) and markers of insulin sensitivity, in the context of polycystic ovary syndrome (PCOS) in adolescents. Subjects and methods. 48, obese, adolescent girls (mean age: 15.6±3.4 years, mean body mass index standard deviation score (BMI-SDS): 2.31±0.1), and 37 control subjects (mean age: 16.2±3 years, mean BMI-SDS: 2.17±0.05) were enrolled the study. The diagnosis of PCOS was established according to the Rotterdam criteria. Hyperinsulinism and insulin resistance was evaluated using the homeostasis model assessment (HOMA-IR) from fasting samples. Plasma adiponectin and vaspin levels were determined by radioimmunoassay. Determination of visfatin and apelin levels was performed by enzyme immunoassay. Results. HOMA-IR, apelin and visfatin levels (4.9±2 versus 1.4±0.7, p<0.001; 2.2±1.1 versus 0.58±0.16, p<0.001; 31.3±11.1 versus 18.5±10.7, p<0.001; respectively) were significantly elevated, and adiponectin levels (2.01±1.02 versus 12.5±6.2, p<0.001) were significantly lower in the PCOS group. Vaspin levels were higher in the PCOS group than in the control group, but the differences were not significant. Apelin and visfatin correlated positively and adiponectin correlated negatively with BMI-SDS and HOMA-IR. Conclusion. Based on the findings of this study, apelin, visfatin and adiponectin levels can be used as specific markers for insulin sensitivity, and these adipocytokines might play a part in the pathogenesis of PCOS.


Boyraz M.,Sisli Etfal Education and Training Hospital | Cekmez F.,GATA Medical Faculty | Karaoglu A.,GATA Medical Faculty | Cinaz P.,Gazi University | And 2 more authors.
Biomarkers in Medicine | Year: 2013

Aim: To investigate the relationship between serum adiponectin, resistin and RBP4 levels and the components of metabolic syndrome. Patients & methods: Serum adiponectin, resistin and RBP4 levels were detected and analyzed in 148 8-18-year-old Turkish obese pubertal children with/without metabolic syndrome. Results: Adiponectin and resistin concentrations were significantly inversely correlated with BMI standard deviation score, homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and were directly correlated with high-density lipoprotein cholesterol. RBP4 concentrations were directly correlated with homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and inversely correlated with high-density lipoprotein cholesterol. Conclusion: Adiponectin, RBP4 and, in particular, resistin levels may be used as suitable predictive biomarkers of metabolic syndrome. © 2013 Future Medicine Ltd.


Boyraz M.,Fatih University | Pirgon O.,Suleyman Demirel University of Turkey | Akyol B.,Sadi Konuk Training and Research Hospital | Dundar B.,Izmir Kâtip Celebi University | And 2 more authors.
European Review for Medical and Pharmacological Sciences | Year: 2013

AIM: The aim of the present study was to analyze the relationship between epicardial adipose tissue thickness (EATT) and echocardiographic parameters, such as carotid intima-media thickness (cIMT), myocardial performance index (MPI), left ventricular (LV) systolic and diastolic function, and LV mass index in adolescents with obesity. PATIENTS AND METHODS: One hundred and thirty eight obese adolescents and 63 lean subjects were enrolled in the study. The body mass index standard deviation scores (BMI-SDS) between 1.65-2.49 and 2.50-2.99 were considered as mild-moderate and severe obesity, respectively. All of the subjects underwent transthoracic echocardiographic examination for determination of LV function, LV structure, LV mass index, and MPI. Epicardial adipose tissue thickness and cIMT were also measured during echocardiography. RESULTS: The EATT measurements were increased significantly in patients with severe obesity compared to lean subjects (7.38±1.76 vs 4.28±0.79 mm, respectively; p = 0.001), but there was no significant difference between the obesity groups. The average LV mass index measurements were higher in both mild-moderately and severely obese patients in comparison with the lean children (87.5±34.8, 88.5±23.0, and 62.4±18.2 g/m2, respectively; p < 0.01), but there was no significant difference between the obesity groups. EATT was positively correlated with BMI-SDS, waist and hip circumference, blood pressure, fasting glucose, insulin, HOMA-IR, hs-CRP (high-sensitivity C-reactive protein), triglyceride levels, cIMT, LV mass index, and MPI in the severe obesity group. EATT was the only independent predictor of cIMT in the multivariate analysis (standardized β coefficient = 0.70, p < 0.001). CONCLUSIONS: The present study demonstrates a close relationship between EATT and cIMT, and LV functions and LV mass index in obese adolescents. Assessments of EATT and cIMT in particular during routine echocardiographic examinations might be used as a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood.


Pirgon O.,Konya Research Hospital | Cekmez F.,GATA Medical Faculty | Bilgin H.,Konya Research Hospital | Eren E.,Konya Research Hospital | Dundar B.,Suleyman Demirel University of Turkey
Obesity Research and Clinical Practice | Year: 2013

Aim: The aim of this study was to investigate the relationships between 25-hydroxy-vitamin D (25(OH)D) and insulin resistance in obese adolescents with non-alcoholic fatty liver disease (NAFLD). Patients and methods: Eighty-seven obese adolescents (45 girls and 42 boys, mean age: 12.7 ± 1.3 years, mean body mass index standard deviation score (BMI-SDS): 2.1 ± 0.3) and 30 lean subjects (15 girls and 15 boys, mean age: 12.3 ± 1.45 years, mean BMI-SDS: 0.5 ± 0.7) were enrolled for the study. The obese subjects were divided into two subgroups based on the presence or absence of fatty liver with high transaminases (NAFLD group and non-NAFLD group). Fasting blood samples were assayed for 25(OH)D, transaminases, glucose, and insulin levels. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR). Results: 25(OH)D measurements were decreased in both obese groups (NAFLD and non-NAFLD) in comparison with the lean group (29.5 ± 18.4 vs. 41.0 ± 17.9 vs. 48.1 ± 22.2 ng/mL). However; the NAFLD group had significantly lower measurements of 25(OH)D than the non-NAFLD group (p < 0.001) and lean group (p < 0.001). 25(OH)D was negatively correlated with HOMA-IR (r = -0.158, p = 0.01) and with alanine aminotransferase (r = -0.794, p = 0.03) in the NAFLD obese group. There was no significant associations between fasting insulin, BMI-SDS and 25(OH)D in obese groups. Conclusion: We suggest that low 25(OH)D occurs commonly in obese adolescents with NAFLD and we demonstrated an association between insufficient vitamin D status and low insulin sensitivity in obese adolescents with NAFLD. © 2013 Asian Oceanian Association for the Study of Obesity.


Cekmez F.,GATA Medical Faculty | Aydemir G.,GATA Medical Faculty | Aydinoz S.,GATA Medical Faculty | Pirgon O.,Suleyman Demirel University of Turkey | And 3 more authors.
Cytokine | Year: 2012

Objective: To investigate the relationship between adipokines (visfatin, adiponectin) and 25-hydroxyvitamin D (25(OH)D), and markers of insulin sensitivity in large for gestational age (LGA) infants. Patients and methods: Forty LGA infants (25 LGA born to diabetic mothers and 15 LGA born to non-diabetic mothers) and 34 appropriate for gestational age (AGA) infants were recruited. Results: FGIR, QUICK-I, adiponectin and 25(OH)D levels were significantly lower in LGA with diabetic mother group than AGA and LGA with non-diabetic mother group. HOMA-IR, fasting insulin, visfatin and parathormone (PTH) levels were significantly higher in LGA with diabetic mother group than AGA and LGA with non-diabetic mother group. Conclusion: Based on the findings of this study, visfatin, adiponectin and 25(OH)D levels can be used as specific markers for insulin sensitivity and may help advance new therapies for glucose intolerance spectrum. © 2012 Elsevier Ltd.


Cekmez F.,GATA Medical Faculty
European review for medical and pharmacological sciences | Year: 2012

Listeria monocytogenes is a very important life-threatening bacteria in certain risk groups such as neonates, pregnant women, elderly people, transplant recipients and others with impaired cell-mediated immunity. However, its infections are very rare in healthy children. Reports of listeriosis in newborn period are limited. We report a case of neonatal listeriosis with erythematous rash, intractable convulsions, severe early neonatal sepsis, disseminated intravascular coagulation, multiple organ dysfunction syndrome and death. Although an empirical antibiotic therapy including ampicillin (semisentetic penicillin) and aminoglycoside combination is effective by the means of a probable Listeria infection, the progression of the very early-onset disease may be fatal, despite vigorous treatment efforts as in our case.


Meral C.,GATA Medical Faculty | Cekmez F.,GATA Medical Faculty | Pirgon O.,GATA Medical Faculty | Tanju I.A.,GATA Medical Faculty | And 3 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2011

Aim. The aim of this study was to assess the adiponectin and visfatin concentrations in small-for-gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) newborns and their mothers. Sixty parturients giving birth to 20 term AGA singleton infants, 20 term singleton SGA infants, and 20 term singleton LGA infants were included into the study. Results. Mean visfatin levels were found significantly higher in the SGA (p < 0.001) and LGA (p < 0.001) groups, and adiponectin levels were found significantly lower in the SGA group (p < 0.001) when compared with the AGA group. The SGA and LGA groups had higher insulin concentrations and HOMA-IR in comparison with the AGA group. The visfatin, glucose levels, and HOMA-IR (p < 0.001, p < 0.001, and p: 0.002, respectively) were higher in the LGA group than SGA group. Conclusion. We found significantly higher insulin and visfatin levels in LGA neonates and lower adiponectin levels in SGA neonates. We concluded that the relationship between adiponectin and visfatin and insulin sensitivity (metabolic disturbances) is very complex with little evidence of correlation in SGA and LGA neonates. © 2011 Informa UK, Ltd.


Cekmez F.,GATA Medical Faculty | Canpolat F.E.,GATA Medical Faculty | Cetinkaya M.,GATA Medical Faculty | Aydinoz S.,GATA Medical Faculty | And 4 more authors.
European Cytokine Network | Year: 2011

Aim. The aim of this study was to evaluate the predictive value of resistin and visfatin in neonatal sepsis, and to compare these adipocytokines with C-reactive protein (CRP), procalcitonin and interleukin 6 (IL-6). Donors and methods. A total of 62 term or near term infants with sepsis proven by positivity of blood culture, and 43 healthy infants were included in this study. Results. There were no statistically significant differences between the two groups as regards birthweight and gestational age. White blood cell count (p= 0.039), CRP levels (p=0.01), procalcitonin levels (p=0.01), IL-6 levels (p= 0.01), visfatin levels (p=0.01) and resistin levels (p=0.01) were significantly higher in septic infants. There was a positive correlation between visfatin, resistin and other markers (WBC, CRP, procalcitonin and IL-6). A cut-off value of 10 ng/mL for visfatin, showed 92% sensitivity and 94% specificity, and a cut-off value of 8 ng/mL for resistin showed 93% sensitivity and 95% specificity for neonatal sepsis. Conclusion. In the light of these results, visfatin and resistin can be used as a diagnostic marker similar to CRP, procalcitonin and IL-6 in neonatal sepsis. Further studies are needed to better understand the role and predictive value of these molecules in neonatal sepsis.


Cekmez F.,GATA Medical Faculty | Canpolat F.E.,GATA Medical Faculty | Pirgon O.,GATA Medical Faculty | Cetinkaya M.,GATA Medical Faculty | And 4 more authors.
Cytokine | Year: 2011

Objective: To investigate the relation of circulating four adipokines (apelin, vaspin, visfatin, adiponectin) with markers of insulin sensitivity in large for gestational age (LGA) infants. Patients and methods: Forty LGA infants (20 LGA born from diabetic mothers and 20 LGA born from non-diabetic mothers) and 34 appropriate for gestational age (AGA) infants were recruited. Hyperinsulinism and insulin resistance was evaluated using the homeostasis model assessment (HOMA-IR), fasting glucose-to-insulin ratio (FGIR), quantitative insulin-sensitivity check index (QUICK-I) from fasting samples. Plasma adiponectin and vaspin levels were determined by radioimmunoassay. Determination of visfatin and apelin levels was performed by enzyme immunoassay. Results: HOMA-IR, apelin and visfatin levels (p<0.001, p<0.001, p<0.001, respectively) were significantly elevated and adiponectin levels, FGIR and QUICK-I values. (p<0.001, p<0.001, p<0.05, respectively) were significantly lower in the LGA group. Vaspin levels were higher in the LGA group than AGA neonates without a significance. The LGA infants with diabetic mother had significantly higher visfatin, apelin, HOMA-IR values, fasting insulin levels and significantly lower adiponectin, FGIR, QUICK-I values. Apelin and visfatin were correlated positively, and adiponectin was correlated negatively with birthweight, HOMA-IR values and fasting insulin levels. Conclusion: Based on the findings of this study, it is too difficult to explain relation between birthweight and these adipocytokines, but findings of high insulin, HOMA-IR, visfatin, apelin and low adiponectin levels in the LGA neonates showed that these adipocytokines can be used as a good predictor for metabolic syndrome. © 2011 Elsevier Ltd.

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