Amac: Obstruktif Uyku Apne Sendromu (OUAS)’u olan hastalarda C-Reaktif Protein (CRP)’in erken ate... more Amac: Obstruktif Uyku Apne Sendromu (OUAS)’u olan hastalarda C-Reaktif Protein (CRP)’in erken ateroskleozun saptanmasinda kullanilmasi. Yontemler: Calismaya Dokuz Eylul Universitesi Tip Fakultesi uyku bozuklugu poliklinigine basvuran, yaslari 20-66 arasinda olan toplam 45 obez hasta alindi. Hastalarin cinsiyet, yas, boy, kilo degerleri saptandi. Vucut kitle indeksleri, bel / kalca oranlari hesaplandi. Polisomnografi tetkiki yapildi. OUAS’u olan hasta grubu ve OUAS’u olmayan kontrol grubu olarak iki gruba ayrildi. Her iki grup hastadan aclik venoz kan ornegi alinarak yuksek duyarlilikli CRP duzeyleri ve lipid profilleri calisildi. B-mode dopler ultrasonografiyle karotis intima madia kalinliklari olculdu. Bulgular: Kontrol grubunda yd-CRP duzeyleri 0,22 (0,01-0,57) mg/dl, OUAS’li hasta grubundaysa 0,30 (0,05-1,52) mg/dl olarak bulundu, iki grup arasinda istatiksel olarak anlamli fark saptanmadi (p=0,300). Karotis Intima Media Kalinligi (KIMK) olcumleri degerlendirildiginde her iki gru...
It has been hypothesized that treating hypercholesterolemic patients with statins will lead not o... more It has been hypothesized that treating hypercholesterolemic patients with statins will lead not only to a reduction in cholesterol, but also to inhibited synthesis of other compounds that derive from the synthetic pathway of cholesterol. One important by-product is ubiquinone (CQ), which has a pivotal role in mitochondrial electron transport and antioxidant activity. We therefore investigated the effect of 2 months of simvastatin treatment (20 mg/day) on blood ATP concentration, plasma total antioxidant capacity and ubiquinone levels in 17 hypercholesterolemic patients (age range: 40 to 65). To evaluate the possible musclerelated side effects, plasma CK activity and myoglobin concentrations were compared before and after therapy. We observed decreased plasma ubiquinone levels and total antioxidant capacity after two months of therapy. CK activity and myoglobin concentrations were increased in the treated group. There was not statistically significant difference for whole blood ATP levels. It may be concluded that simvastatin lowers plasma ubiquinone concentrations. The possible adverse effect of simvastatin on ubiquinone metabolism may be clinically important and requires further study.
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2021
Büyük veri analizleri ile kendi kendine öğrenen sistemler geliştirebilen makine öğrenimi yaklaşım... more Büyük veri analizleri ile kendi kendine öğrenen sistemler geliştirebilen makine öğrenimi yaklaşımı günümüzde birçok alanda olduğu gibi laboratuvar tıbbında da kullanıma girmiştir. Gerçek-zamanlı ters transkripsiyon polimeraz zincir reaksiyonu (rRT-PCR) testi, COVID-19 tanısında altın standart metot olmasına rağmen, hassas preanalitik evre, uzun turnaround time ve sürekli sarf ihtiyacı gibi birçok dezavantaja sahiptir. Günlük hayatımızın bir parçası olan makine öğrenim algoritmaları COVID-19 pandemisinde mevcut tanı yöntemlerine alternatif maliyetsiz bir metot olarak denenmiştir. Bu konuda yapılan çalışmalara bakıldığında rutin biyokimya testleri ile oluşturulan makine öğrenim modelleri tanıyla beraber hızlı dışlama, prognoz, klinik ilişkili testlerin karşılaştırılması gibi birçok farklı açıdan başarılı bir performans göstermiştir. Biyokimyasal testlerin yaygın klinik kullanımı ve tıbbi laboratuvarların rutininde yer alan otoanalizörler ve laboratuvar bilgi sistemlerinin uygun yazılım altyapıları göz önüne alındığında ve bunlara artan sağlık maliyetleri ve mevcut yöntemlerin dezavantajları eklendiğinde makine öğrenimi-biyokimya laboratuvarı ilişkisinin gelecekte de gelişmeye açık popüler bir konu olmaya devam edeceği öngörülmektedir. Bu derlemede COVID-19 tanısında kullanılan yöntemler özetlenmiş, makine öğrenim modellerinin temel prensipleri anlatılmış ve biyokimya testleri ile makine öğrenim modellerinin kullanımlarına örnek verilmiştir.
In the present study, the effects of dexmedetomidine on secondary lung and kidney injuries were s... more In the present study, the effects of dexmedetomidine on secondary lung and kidney injuries were studied in the rat model of intra-abdominal sepsis by immunohistological and biochemical examinations. We measured serum creatinine, kidney tissue malondialdehide and plasma neutrophil gelatinase-associated lipocalin levels. In order to evaluate tissue injury we determined kidney tissue mononuclear cell infiltration score, alveolar macrophage count, histological kidney and lung injury scores and kidney and lung tissue immunoreactivity scores. We demonstrated that dexmedetomidine attenuates sepsis-induced lung and kidney injuries and apoptosis in the rat model of sepsis. There is still need for comparative studies in order to determine the effects of dexmedetomidine on organ functions in early human sepsis.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
man›n birbirine kilitlenmesini sa¤lar. Kilitlenme ifllemi hem el ile hissedilir, hem de bir "klik... more man›n birbirine kilitlenmesini sa¤lar. Kilitlenme ifllemi hem el ile hissedilir, hem de bir "klik" sesi duyulur. Kapama ifllemi tamamland›ktan sonra da öncelikle distal pozisyon kontrol edici saat yönünde çevrilerek kontrol edici t›kaçtan ayr›l›r. Daha sonra proksimal pozisyon kontrol edici saat yönünün aksi yönünde çevrilerek t›kaçtan ayr›l›r (fiekil 2). ‹fllemin her aflamas›nda, k›lavuz tel yerinden ç›kmad›¤› sürece açma ya da kapama ifllemi yinelenebilir. Cihaz›n avantajlar› düflük metal yük, non-toksik alafl›m, düflük profil, uzun k›l›fa gereksinimi olmamas›, öncelikle istenen tarafa yaman›n yerlefltirilmesi, "self-centering" özellik ve yuvarlat›lm›fl teller nedeni ile düflük travma beklentisi iken dezavantajlar› 10F k›sa k›l›f kullan›m› ve azami 22 mm'ye kadar olan defektleri kapayabilecek ölçüde ürün olmas›d›r.
Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apn... more Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apnea patients. Methods: Ages between 20-66, 45 obese patient who was have application to D.E.Ü. Medical Faculty sleep laboratory recruited to study. We determine sex, age, height and weight for all patients and calculate body mass index, waist / hip raito. Polisomnographia was done. Patient’s divided in to two group’s, whose PSG detected OSA constitute patients group and whose PSG not detected OSA constitude control group. We obtained fasting venous blood sample and measure HSCRP and lipid profiles. Carotis intima media thickness measured with B-mode doppler ultrasonography. Results: HSCRP found 0,22 (0,01-0,57) mg/dl in control group and 0,30 (0,05-1,52) mg/dl in OSA patients group, we didn’t detect statistical significancy (p=0,300). When Carotid İntima Media Thickness (CIMT) measurements evaluated for each group, statistical significancy find (p=0,01). WHR determined and evaluated for a...
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient diet (CDD) was used. For the rats assigned to receive UDCA, a 1.5% UDCA solution was administered at a dose of 25 mg/kg/day using an oral feeding tube. Assesment of HS was based on the quantification of percentage of hepatocytes containing lipid vacuoles. Forty-three male Wistar rats were randomly divided into two protocols. In protocol I, 7 rats were fed a standard diet (SD) plus UDCA for 30 days (control group). In protocol II, 19 rats were fed CDD and 17 rats were fed CDD plus UDCA for 30 days. At the end of this period, after performing liver biopsies, either SD or SD plus UDCA was started in both CDD-fed rats and CDD plus UDCA-fed rats for 30 days in a random order without the knowledge of the degrees of steatosis developed. At the end of this period, liver biopsies were repeated in order to evaluate whether UDCA has an effect on the regression of HS. In protocol I, there were no specific findings on the histological examination of the livers at 30 days. In protocol II, the percentage of HS in CDD plus UDCA-fed rats was significantly lower than CDD-fed rats at the end of the same period (percentage of steatosis, mean Ϯ SD: 12.2 Ϯ 29.6 to 23.2 Ϯ 34.1 respectively, P ϭ 0.0201); after starting either SD or SD plus UDCA, steatosis was almost completely regressed at 30 days in all rats that developed that steatogenic changes. UDCA seems to prevent HS in rats; addition of UDCA to SD does not cause a further contribution in regressing HS.
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient
Percutaneous transluminal coronary angioplasty (PTCA) has been recognized as a reliable treatment... more Percutaneous transluminal coronary angioplasty (PTCA) has been recognized as a reliable treatment procedure for acute reversible ischemia and reperfusion. Ischemic reperfusion cycle in PTCA leads to the systemic inflammation and extensive tissue injury by the production of reactive oxygen species including nitric oxide (NO) radicals. In patients with coronary artery disease, undergoing PTCA, the effects of trimetazidine (TMZ), a piperazine-derivative anti-anginal drug, were studied on several indirect markers of systemic inflammatory response: tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP) and NO products (nitrite and nitrate). Patients (n = 11 each group) were untreated or pre-treated with TMZ (20 mg per orally three times a day), begun three days prior to PTCA, and marker levels were measured before the start of TMZ therapy (baseline), just before PTCA (0 hr), and 4, 24, and 48 hrs after PTCA. The baseline levels of markers were not significantly different between the untreated and pre-treated patients. In contrast, all parameters were lower in the TMZ-treated group than those in the matched control group in the pre- and post-angioplasty periods. Interestingly, in the TMZ group, CRP and nitrite levels were significantly lower than in the control group at each time point of the pre- and post-angioplasty periods, but the TNF-alpha levels were significantly decreased only in the post-angioplasty period. Pre-procedural treatment with oral TMZ for three days significantly suppressed the elevation of inflammatory markers before and shortly after PTCA. We suggest the usefulness of TMZ in preventing inflammatory cardiovascular events after PTCA.
To determine the changes in levels of urinary NTx at the end of the 6th month of oral and transde... more To determine the changes in levels of urinary NTx at the end of the 6th month of oral and transdermal hormone replacement therapy (HRT) and the effects of additional alendronate therapy for osteoporotic women. Of 66 postmenopausal women 23 were treated with oral estradiol+norethisterone acetate (E+P), and 22 were treated with transdermal estradiol+norethisterone acetate. The third group consisted of 21 women with osteoporosis (bone mineral density < 100 mg/cm(3)) and treated with oral E+P plus alendronate 10 mg/day. Significant decreases of urinary NTx levels were seen after HRT in all study groups (P < 0.05). But the decline of NTx levels was not different between the oral and transdermal HRT groups (P > 0.05). There was no additional decrease in the levels of NTx with alendronate therapy (P > 0.05) but NTx excretion diminished more in patients with high baseline levels. The decline of NTx at the end of the 6th month of HRT reflects the decrease of bone resorption and it is not related to the route of administration.
Journal of Trace Elements in Medicine and Biology, 2005
Previous studies have demonstrated increased serum copper and iron levels and decreased selenium ... more Previous studies have demonstrated increased serum copper and iron levels and decreased selenium and zinc levels in patients with myocardial infarction. Furthermore, the prognostic value of the levels of trace elements in myocardial infarction has been stressed. We examined serum levels of Cu, Fe, Zn and Se, as well as glutathione peroxidase (GPx), a selenoenzyme with antioxidant properties, and C-reactive protein (CRP), a marker of inflammation, in acute coronary syndromes (ACS) regarding their relationship to cardiac troponins and creatine kinase-MB mass (CK-MBm), important prognostic markers. Serum trace elements, GPx activity and CRP were determined in 70 patients with ACS who were admitted within 12 h after the onset. Differences in these parameters were evaluated in three groups of patients divided according to the levels of cardiac markers: group III consisted of patients with high increases in cTnT, cTnI and CK-MBm (X0.9 ng/mL, X1.0 ng/mL, X30 ng/mL, respectively), patients with milder increases in these markers were included in groups II and I consisted of patients with values just above the upper reference limits. Serum Fe levels increased significantly in group II and even more prominently in group III compared to group I (p ¼ 0:04; 0:002; respectively). There was no significant difference between groups II and III. The increase in serum Cu was significant in group III compared to both groups II and I (p ¼ 0:04; 0:001; respectively). There was no significant difference between groups I and II regarding Cu and Zn. The decrease in serum Se and GPx levels was significant only between groups III and I (p ¼ 0:004 for Se and p ¼ 0:0001 for GPx). CRP levels showed a significant increase in group III compared to groups II and I (p ¼ 0:03 and 0.001). CRP showed a significant positive and GPx a significant negative correlation to the cardiac markers cTnT, cTnI and CK-MBm. Cu was positively correlated to all cardiac markers, while the positive correlation between Fe and cardiac markers was significant only for cTnI. Both Zn and Se were negatively correlated to cTnT, and Se was also to cTnI. In conclusion, the increase in serum levels of Cu and Fe and the decrease in serum levels of Zn and Se in patients with higher levels of troponins and CK-MBm imply that trace element levels are related to the degree of myocardial damage and thus may play a role in the pathogenesis of ischemic heart disease. The strong correlations between cardiac markers and both CRP and GPx suggest that these parameters are promising prognostic factors in acute coronary syndromes.
Objective: To evaluate the cardiotoxicity of LV5FU2 regimen (bolus plus infusional 5-fluorouracil... more Objective: To evaluate the cardiotoxicity of LV5FU2 regimen (bolus plus infusional 5-fluorouracil/folinic acid) treatment by non-invasive methods such as echocardiography, plasma troponin I (TnI) level, QT interval and QT dispersion on ECG. Methods: Twenty-two patients with gastrointestinal cancer who received LV5FU2 chemotherapy were evaluated prospectively during 12 cycles of chemotherapy. Plasma TnI assay and ECG recording analyses were performed before the first cycle, at 24 h, before each cycle until cycle 6 and every three cycles thereafter. The longest QT interval measurement on each recording corrected with Bazzett's formula was considered as QTmax and the difference between the QTmax and the shortest corrected QT interval was considered as QT dispersion (QTd). A complete M-mode, 2D and color Doppler echocardiogram was performed at baseline and at the first, third and sixth months of treatment. Results: Echocardiography did not show any significant change in either systolic or diastolic functions. Also, TnI measurements were found to be below detectable level in all patients and in all measurements. Meanwhile, significant prolongations of QTmax and QTd were observed as early as 24 h after first administration of chemotherapy. These events persisted and became more important over the duration of chemotherapy (P < 0.05).
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient diet (CDD) was used. For the rats assigned to receive UDCA, a 1.5% UDCA solution was administered at a dose of 25 mg/kg/day using an oral feeding tube. Assesment of HS was based on the quantification of percentage of hepatocytes containing lipid vacuoles. Forty-three male Wistar rats were randomly divided into two protocols. In protocol I, 7 rats were fed a standard diet (SD) plus UDCA for 30 days (control group). In protocol II, 19 rats were fed CDD and 17 rats were fed CDD plus UDCA for 30 days. At the end of this period, after performing liver biopsies, either SD or SD plus UDCA was started in both CDD-fed rats and CDD plus UDCA-fed rats for 30 days in a random order without the knowledge of the degrees of steatosis developed. At the end of this period, liver biopsies were repeated in order to evaluate whether UDCA has an effect on the regression of HS. In protocol I, there were no specific findings on the histological examination of the livers at 30 days. In protocol II, the percentage of HS in CDD plus UDCA-fed rats was significantly lower than CDD-fed rats at the end of the same period (percentage of steatosis, mean Ϯ SD: 12.2 Ϯ 29.6 to 23.2 Ϯ 34.1 respectively, P ϭ 0.0201); after starting either SD or SD plus UDCA, steatosis was almost completely regressed at 30 days in all rats that developed that steatogenic changes. UDCA seems to prevent HS in rats; addition of UDCA to SD does not cause a further contribution in regressing HS.
Objective: The examination of the urine remains to be one of the most commonly performed tests in... more Objective: The examination of the urine remains to be one of the most commonly performed tests in laboratory practice. Currently, laboratories also need to accredit their urine diagnostics by comparing their measurement methods to acceptable references. In this study we compared particle counts obtained by new generation automated technique, image capture analysis (IQ-200) with those of a standardized chamber counts. Design and Methods: The same 258 urine samples from different departments of a hospital assayed by IQ-200 were analyzed in parallel with the KOVA cell chamber system. Clinically significant discrepancy results (positive vs. negative) for red blood cell (RBC) and white blood cell (WBC) were also compared with those obtained by dipstick testing. Results: There was a good agreement between the automated system and sediment microscopy for RBCs, WBCs, and squamous epithelial cells (SCs) (r 5 0.90; r 5 0.80; r 5 0.72, respectively: Po0.001). The IQ-200 was more sensitive for determining RBCs, WBCs, and SCs than other formed elements. Conclusions: IQ-200 can perform accurate quantification of microscopic element in urine. However, automated techniques are not completely free of error. Therefore, by adopting an appropriate algorithm and combining the results with stript analysis and other laboratory tests allows further reduction of clinically important errors.
Amac: Obstruktif Uyku Apne Sendromu (OUAS)’u olan hastalarda C-Reaktif Protein (CRP)’in erken ate... more Amac: Obstruktif Uyku Apne Sendromu (OUAS)’u olan hastalarda C-Reaktif Protein (CRP)’in erken ateroskleozun saptanmasinda kullanilmasi. Yontemler: Calismaya Dokuz Eylul Universitesi Tip Fakultesi uyku bozuklugu poliklinigine basvuran, yaslari 20-66 arasinda olan toplam 45 obez hasta alindi. Hastalarin cinsiyet, yas, boy, kilo degerleri saptandi. Vucut kitle indeksleri, bel / kalca oranlari hesaplandi. Polisomnografi tetkiki yapildi. OUAS’u olan hasta grubu ve OUAS’u olmayan kontrol grubu olarak iki gruba ayrildi. Her iki grup hastadan aclik venoz kan ornegi alinarak yuksek duyarlilikli CRP duzeyleri ve lipid profilleri calisildi. B-mode dopler ultrasonografiyle karotis intima madia kalinliklari olculdu. Bulgular: Kontrol grubunda yd-CRP duzeyleri 0,22 (0,01-0,57) mg/dl, OUAS’li hasta grubundaysa 0,30 (0,05-1,52) mg/dl olarak bulundu, iki grup arasinda istatiksel olarak anlamli fark saptanmadi (p=0,300). Karotis Intima Media Kalinligi (KIMK) olcumleri degerlendirildiginde her iki gru...
It has been hypothesized that treating hypercholesterolemic patients with statins will lead not o... more It has been hypothesized that treating hypercholesterolemic patients with statins will lead not only to a reduction in cholesterol, but also to inhibited synthesis of other compounds that derive from the synthetic pathway of cholesterol. One important by-product is ubiquinone (CQ), which has a pivotal role in mitochondrial electron transport and antioxidant activity. We therefore investigated the effect of 2 months of simvastatin treatment (20 mg/day) on blood ATP concentration, plasma total antioxidant capacity and ubiquinone levels in 17 hypercholesterolemic patients (age range: 40 to 65). To evaluate the possible musclerelated side effects, plasma CK activity and myoglobin concentrations were compared before and after therapy. We observed decreased plasma ubiquinone levels and total antioxidant capacity after two months of therapy. CK activity and myoglobin concentrations were increased in the treated group. There was not statistically significant difference for whole blood ATP levels. It may be concluded that simvastatin lowers plasma ubiquinone concentrations. The possible adverse effect of simvastatin on ubiquinone metabolism may be clinically important and requires further study.
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2021
Büyük veri analizleri ile kendi kendine öğrenen sistemler geliştirebilen makine öğrenimi yaklaşım... more Büyük veri analizleri ile kendi kendine öğrenen sistemler geliştirebilen makine öğrenimi yaklaşımı günümüzde birçok alanda olduğu gibi laboratuvar tıbbında da kullanıma girmiştir. Gerçek-zamanlı ters transkripsiyon polimeraz zincir reaksiyonu (rRT-PCR) testi, COVID-19 tanısında altın standart metot olmasına rağmen, hassas preanalitik evre, uzun turnaround time ve sürekli sarf ihtiyacı gibi birçok dezavantaja sahiptir. Günlük hayatımızın bir parçası olan makine öğrenim algoritmaları COVID-19 pandemisinde mevcut tanı yöntemlerine alternatif maliyetsiz bir metot olarak denenmiştir. Bu konuda yapılan çalışmalara bakıldığında rutin biyokimya testleri ile oluşturulan makine öğrenim modelleri tanıyla beraber hızlı dışlama, prognoz, klinik ilişkili testlerin karşılaştırılması gibi birçok farklı açıdan başarılı bir performans göstermiştir. Biyokimyasal testlerin yaygın klinik kullanımı ve tıbbi laboratuvarların rutininde yer alan otoanalizörler ve laboratuvar bilgi sistemlerinin uygun yazılım altyapıları göz önüne alındığında ve bunlara artan sağlık maliyetleri ve mevcut yöntemlerin dezavantajları eklendiğinde makine öğrenimi-biyokimya laboratuvarı ilişkisinin gelecekte de gelişmeye açık popüler bir konu olmaya devam edeceği öngörülmektedir. Bu derlemede COVID-19 tanısında kullanılan yöntemler özetlenmiş, makine öğrenim modellerinin temel prensipleri anlatılmış ve biyokimya testleri ile makine öğrenim modellerinin kullanımlarına örnek verilmiştir.
In the present study, the effects of dexmedetomidine on secondary lung and kidney injuries were s... more In the present study, the effects of dexmedetomidine on secondary lung and kidney injuries were studied in the rat model of intra-abdominal sepsis by immunohistological and biochemical examinations. We measured serum creatinine, kidney tissue malondialdehide and plasma neutrophil gelatinase-associated lipocalin levels. In order to evaluate tissue injury we determined kidney tissue mononuclear cell infiltration score, alveolar macrophage count, histological kidney and lung injury scores and kidney and lung tissue immunoreactivity scores. We demonstrated that dexmedetomidine attenuates sepsis-induced lung and kidney injuries and apoptosis in the rat model of sepsis. There is still need for comparative studies in order to determine the effects of dexmedetomidine on organ functions in early human sepsis.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
man›n birbirine kilitlenmesini sa¤lar. Kilitlenme ifllemi hem el ile hissedilir, hem de bir "klik... more man›n birbirine kilitlenmesini sa¤lar. Kilitlenme ifllemi hem el ile hissedilir, hem de bir "klik" sesi duyulur. Kapama ifllemi tamamland›ktan sonra da öncelikle distal pozisyon kontrol edici saat yönünde çevrilerek kontrol edici t›kaçtan ayr›l›r. Daha sonra proksimal pozisyon kontrol edici saat yönünün aksi yönünde çevrilerek t›kaçtan ayr›l›r (fiekil 2). ‹fllemin her aflamas›nda, k›lavuz tel yerinden ç›kmad›¤› sürece açma ya da kapama ifllemi yinelenebilir. Cihaz›n avantajlar› düflük metal yük, non-toksik alafl›m, düflük profil, uzun k›l›fa gereksinimi olmamas›, öncelikle istenen tarafa yaman›n yerlefltirilmesi, "self-centering" özellik ve yuvarlat›lm›fl teller nedeni ile düflük travma beklentisi iken dezavantajlar› 10F k›sa k›l›f kullan›m› ve azami 22 mm'ye kadar olan defektleri kapayabilecek ölçüde ürün olmas›d›r.
Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apn... more Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apnea patients. Methods: Ages between 20-66, 45 obese patient who was have application to D.E.Ü. Medical Faculty sleep laboratory recruited to study. We determine sex, age, height and weight for all patients and calculate body mass index, waist / hip raito. Polisomnographia was done. Patient’s divided in to two group’s, whose PSG detected OSA constitute patients group and whose PSG not detected OSA constitude control group. We obtained fasting venous blood sample and measure HSCRP and lipid profiles. Carotis intima media thickness measured with B-mode doppler ultrasonography. Results: HSCRP found 0,22 (0,01-0,57) mg/dl in control group and 0,30 (0,05-1,52) mg/dl in OSA patients group, we didn’t detect statistical significancy (p=0,300). When Carotid İntima Media Thickness (CIMT) measurements evaluated for each group, statistical significancy find (p=0,01). WHR determined and evaluated for a...
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient diet (CDD) was used. For the rats assigned to receive UDCA, a 1.5% UDCA solution was administered at a dose of 25 mg/kg/day using an oral feeding tube. Assesment of HS was based on the quantification of percentage of hepatocytes containing lipid vacuoles. Forty-three male Wistar rats were randomly divided into two protocols. In protocol I, 7 rats were fed a standard diet (SD) plus UDCA for 30 days (control group). In protocol II, 19 rats were fed CDD and 17 rats were fed CDD plus UDCA for 30 days. At the end of this period, after performing liver biopsies, either SD or SD plus UDCA was started in both CDD-fed rats and CDD plus UDCA-fed rats for 30 days in a random order without the knowledge of the degrees of steatosis developed. At the end of this period, liver biopsies were repeated in order to evaluate whether UDCA has an effect on the regression of HS. In protocol I, there were no specific findings on the histological examination of the livers at 30 days. In protocol II, the percentage of HS in CDD plus UDCA-fed rats was significantly lower than CDD-fed rats at the end of the same period (percentage of steatosis, mean Ϯ SD: 12.2 Ϯ 29.6 to 23.2 Ϯ 34.1 respectively, P ϭ 0.0201); after starting either SD or SD plus UDCA, steatosis was almost completely regressed at 30 days in all rats that developed that steatogenic changes. UDCA seems to prevent HS in rats; addition of UDCA to SD does not cause a further contribution in regressing HS.
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient
Percutaneous transluminal coronary angioplasty (PTCA) has been recognized as a reliable treatment... more Percutaneous transluminal coronary angioplasty (PTCA) has been recognized as a reliable treatment procedure for acute reversible ischemia and reperfusion. Ischemic reperfusion cycle in PTCA leads to the systemic inflammation and extensive tissue injury by the production of reactive oxygen species including nitric oxide (NO) radicals. In patients with coronary artery disease, undergoing PTCA, the effects of trimetazidine (TMZ), a piperazine-derivative anti-anginal drug, were studied on several indirect markers of systemic inflammatory response: tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP) and NO products (nitrite and nitrate). Patients (n = 11 each group) were untreated or pre-treated with TMZ (20 mg per orally three times a day), begun three days prior to PTCA, and marker levels were measured before the start of TMZ therapy (baseline), just before PTCA (0 hr), and 4, 24, and 48 hrs after PTCA. The baseline levels of markers were not significantly different between the untreated and pre-treated patients. In contrast, all parameters were lower in the TMZ-treated group than those in the matched control group in the pre- and post-angioplasty periods. Interestingly, in the TMZ group, CRP and nitrite levels were significantly lower than in the control group at each time point of the pre- and post-angioplasty periods, but the TNF-alpha levels were significantly decreased only in the post-angioplasty period. Pre-procedural treatment with oral TMZ for three days significantly suppressed the elevation of inflammatory markers before and shortly after PTCA. We suggest the usefulness of TMZ in preventing inflammatory cardiovascular events after PTCA.
To determine the changes in levels of urinary NTx at the end of the 6th month of oral and transde... more To determine the changes in levels of urinary NTx at the end of the 6th month of oral and transdermal hormone replacement therapy (HRT) and the effects of additional alendronate therapy for osteoporotic women. Of 66 postmenopausal women 23 were treated with oral estradiol+norethisterone acetate (E+P), and 22 were treated with transdermal estradiol+norethisterone acetate. The third group consisted of 21 women with osteoporosis (bone mineral density &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 100 mg/cm(3)) and treated with oral E+P plus alendronate 10 mg/day. Significant decreases of urinary NTx levels were seen after HRT in all study groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). But the decline of NTx levels was not different between the oral and transdermal HRT groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). There was no additional decrease in the levels of NTx with alendronate therapy (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05) but NTx excretion diminished more in patients with high baseline levels. The decline of NTx at the end of the 6th month of HRT reflects the decrease of bone resorption and it is not related to the route of administration.
Journal of Trace Elements in Medicine and Biology, 2005
Previous studies have demonstrated increased serum copper and iron levels and decreased selenium ... more Previous studies have demonstrated increased serum copper and iron levels and decreased selenium and zinc levels in patients with myocardial infarction. Furthermore, the prognostic value of the levels of trace elements in myocardial infarction has been stressed. We examined serum levels of Cu, Fe, Zn and Se, as well as glutathione peroxidase (GPx), a selenoenzyme with antioxidant properties, and C-reactive protein (CRP), a marker of inflammation, in acute coronary syndromes (ACS) regarding their relationship to cardiac troponins and creatine kinase-MB mass (CK-MBm), important prognostic markers. Serum trace elements, GPx activity and CRP were determined in 70 patients with ACS who were admitted within 12 h after the onset. Differences in these parameters were evaluated in three groups of patients divided according to the levels of cardiac markers: group III consisted of patients with high increases in cTnT, cTnI and CK-MBm (X0.9 ng/mL, X1.0 ng/mL, X30 ng/mL, respectively), patients with milder increases in these markers were included in groups II and I consisted of patients with values just above the upper reference limits. Serum Fe levels increased significantly in group II and even more prominently in group III compared to group I (p ¼ 0:04; 0:002; respectively). There was no significant difference between groups II and III. The increase in serum Cu was significant in group III compared to both groups II and I (p ¼ 0:04; 0:001; respectively). There was no significant difference between groups I and II regarding Cu and Zn. The decrease in serum Se and GPx levels was significant only between groups III and I (p ¼ 0:004 for Se and p ¼ 0:0001 for GPx). CRP levels showed a significant increase in group III compared to groups II and I (p ¼ 0:03 and 0.001). CRP showed a significant positive and GPx a significant negative correlation to the cardiac markers cTnT, cTnI and CK-MBm. Cu was positively correlated to all cardiac markers, while the positive correlation between Fe and cardiac markers was significant only for cTnI. Both Zn and Se were negatively correlated to cTnT, and Se was also to cTnI. In conclusion, the increase in serum levels of Cu and Fe and the decrease in serum levels of Zn and Se in patients with higher levels of troponins and CK-MBm imply that trace element levels are related to the degree of myocardial damage and thus may play a role in the pathogenesis of ischemic heart disease. The strong correlations between cardiac markers and both CRP and GPx suggest that these parameters are promising prognostic factors in acute coronary syndromes.
Objective: To evaluate the cardiotoxicity of LV5FU2 regimen (bolus plus infusional 5-fluorouracil... more Objective: To evaluate the cardiotoxicity of LV5FU2 regimen (bolus plus infusional 5-fluorouracil/folinic acid) treatment by non-invasive methods such as echocardiography, plasma troponin I (TnI) level, QT interval and QT dispersion on ECG. Methods: Twenty-two patients with gastrointestinal cancer who received LV5FU2 chemotherapy were evaluated prospectively during 12 cycles of chemotherapy. Plasma TnI assay and ECG recording analyses were performed before the first cycle, at 24 h, before each cycle until cycle 6 and every three cycles thereafter. The longest QT interval measurement on each recording corrected with Bazzett's formula was considered as QTmax and the difference between the QTmax and the shortest corrected QT interval was considered as QT dispersion (QTd). A complete M-mode, 2D and color Doppler echocardiogram was performed at baseline and at the first, third and sixth months of treatment. Results: Echocardiography did not show any significant change in either systolic or diastolic functions. Also, TnI measurements were found to be below detectable level in all patients and in all measurements. Meanwhile, significant prolongations of QTmax and QTd were observed as early as 24 h after first administration of chemotherapy. These events persisted and became more important over the duration of chemotherapy (P < 0.05).
Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver dise... more Ursodeoxycholic acid (UDCA) has been shown to have hepatoprotective effects in various liver diseases. This drug has also been found to be effective in patients with nonalcoholic steatohepatitis, improving hepatic steatosis (HS) significantly. The aim of this study was to evaluate whether UDCA has an effect on both preventing and regressing HS in rats. To induce fatty liver, a choline-deficient diet (CDD) was used. For the rats assigned to receive UDCA, a 1.5% UDCA solution was administered at a dose of 25 mg/kg/day using an oral feeding tube. Assesment of HS was based on the quantification of percentage of hepatocytes containing lipid vacuoles. Forty-three male Wistar rats were randomly divided into two protocols. In protocol I, 7 rats were fed a standard diet (SD) plus UDCA for 30 days (control group). In protocol II, 19 rats were fed CDD and 17 rats were fed CDD plus UDCA for 30 days. At the end of this period, after performing liver biopsies, either SD or SD plus UDCA was started in both CDD-fed rats and CDD plus UDCA-fed rats for 30 days in a random order without the knowledge of the degrees of steatosis developed. At the end of this period, liver biopsies were repeated in order to evaluate whether UDCA has an effect on the regression of HS. In protocol I, there were no specific findings on the histological examination of the livers at 30 days. In protocol II, the percentage of HS in CDD plus UDCA-fed rats was significantly lower than CDD-fed rats at the end of the same period (percentage of steatosis, mean Ϯ SD: 12.2 Ϯ 29.6 to 23.2 Ϯ 34.1 respectively, P ϭ 0.0201); after starting either SD or SD plus UDCA, steatosis was almost completely regressed at 30 days in all rats that developed that steatogenic changes. UDCA seems to prevent HS in rats; addition of UDCA to SD does not cause a further contribution in regressing HS.
Objective: The examination of the urine remains to be one of the most commonly performed tests in... more Objective: The examination of the urine remains to be one of the most commonly performed tests in laboratory practice. Currently, laboratories also need to accredit their urine diagnostics by comparing their measurement methods to acceptable references. In this study we compared particle counts obtained by new generation automated technique, image capture analysis (IQ-200) with those of a standardized chamber counts. Design and Methods: The same 258 urine samples from different departments of a hospital assayed by IQ-200 were analyzed in parallel with the KOVA cell chamber system. Clinically significant discrepancy results (positive vs. negative) for red blood cell (RBC) and white blood cell (WBC) were also compared with those obtained by dipstick testing. Results: There was a good agreement between the automated system and sediment microscopy for RBCs, WBCs, and squamous epithelial cells (SCs) (r 5 0.90; r 5 0.80; r 5 0.72, respectively: Po0.001). The IQ-200 was more sensitive for determining RBCs, WBCs, and SCs than other formed elements. Conclusions: IQ-200 can perform accurate quantification of microscopic element in urine. However, automated techniques are not completely free of error. Therefore, by adopting an appropriate algorithm and combining the results with stript analysis and other laboratory tests allows further reduction of clinically important errors.
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Papers by Emel Altekin