Urinary tract reconstruction using bowel segments can result in complications such as electrolyte... more Urinary tract reconstruction using bowel segments can result in complications such as electrolyte abnormalities, infections, stones and cancer. Intestinal mucosa is the primary site responsible for these complications. De-epithelialization of the mucosa and subsequent urothelialization might alleviate these problems. We recently reported our success in de-epithelialization and subsequent uroepithelialization of intestinal segments using 10 g/100 ml AgNO 3 solution in a rat
Coronary slow flow (CSF) has been documented in 25% of patients evaluated for angina or angina-li... more Coronary slow flow (CSF) has been documented in 25% of patients evaluated for angina or angina-like chest pain, despite the presence of normal epicardial coronary arteries on angiography. The risk for the development of clinical events in patients with non-obstructive coronary artery disease (NOCAD) is higher than in patients with completely normal coronary arteries. The object of this study was to evaluate changes in blood and plasma viscosity in patients with CSF or NOCAD. The study included 147 subjects (CSF, n = 42, NOCAD, n = 42 and controls, n = 63). Blood and plasma viscosity, complete blood counts, fibrinogen, and high sensitivity C-reactive protein (hs CRP) levels were measured. There was no significant difference between the groups with respect to blood and plasma viscosity (p > 0.05). Hemoglobin, hematocrit, and erythrocyte counts were significantly higher in the CSF group compared to the NOCAD group (p = 0.017, p = 0.023 and p = 0.023 respectively) and the control gro...
PurposeThe aim of this study was to investigate whether polyunsaturated phosphatidylcholine. (PPC... more PurposeThe aim of this study was to investigate whether polyunsaturated phosphatidylcholine. (PPC) pretreatment has any protective effect on gastric mucosal damage induced by cold-restraint stress (CRS) in rats.
Background/purpose: Persistent inflammatory response secondary to congenital or acquired biliary ... more Background/purpose: Persistent inflammatory response secondary to congenital or acquired biliary choleastasis plays an important role in the pathophysiology of hepatic tissue damage. The polyunsaturated fatty acids (PUFA) have been shown to suppress the inflammatory reactions in vivo and in vitro. PUFA has been shown also to protect againts various types of experimental liver damage in animal models and isolated hepatocytes.
We aimed to compare the level of thrombocytopenia in cirrhotic patients with HBV and those with H... more We aimed to compare the level of thrombocytopenia in cirrhotic patients with HBV and those with HCV, and to investigate whether the reduced serum level of IL-6 in patients with HCV is responsible for the lower platelet count compared to those with HBV through the effect on serum thrombopoietin level. Fifty-three patients with liver cirrhosis, 28 of who were HBV- seropositive (Group A), 25 of who were HCV- seropositive (Group B) and 15 healthy controls were enrolled in this study. Platelet count in group B [75 (1.5-99) K/microL] were lower than those of group A [140 (62-374) K/microL] (p < 0.001). The median levels of serum thrombopoietin in patients [group A: 31.9 (31-113) pg/mL and group B: 38.0 (31.2-102) pg/mL] and controls [31.3 (31-153) pg/mL] did not show statistically significant difference. The patients compared to controls, had higher serum IL-6 levels [3.6 (2-1150) vs. 2.0 (2-9.9) pg/mL], (p < 0.01), which showed similarity in group A and B patients [3.65 (2-1150) vs...
Medical science monitor : international medical journal of experimental and clinical research, 2002
Dilated cardiomyopathy (DCM) is linked to inflammatory cardiomyopathy (InfCM). To gain a profound... more Dilated cardiomyopathy (DCM) is linked to inflammatory cardiomyopathy (InfCM). To gain a profound insight into the underlying mechanisms, we phenotypically characterized pan leukocytes (CD18), naive T-lymphocytes (CD3, CD2, CD4, CD8), activated lymphocytes (LFA-1, LFA-3, VLA-4, ICAM-1, CD69, CD45R0), macrophages (Mac-1, 27E10), B-lymphocytes (CD19) and NK-cells (CD57) in DCM and control hearts. Biopsies from DCM patients (n=164, LVEF&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;40%) and specimens from non-cardiac death causes (controls; n=17) were immunostained. Biopsies exceeding &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;2.0 CD3+ lymphocytes per high power field/hpf and/or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1.5 CD3+ lymphocytes/hpf with numerous foci and HLA class I/DR abundance were evaluated positive for InfCM. InfCM+ biopsies (n=102; 63%) demonstrated significantly increased infiltrates with respect to all studied phenotypes except for CD19 and CD57 when compared with both DCM biopsies negative for InfCM (n=62) and the controls, whereas the latter two groups did not differ (Tukey-Kramer analysis). Virtually all phenotypes correlated with one another in multivariate analysis (except for B-lymphocytes and NK cells). Whereas HLA class I/DR abundance was present in 14% of the controls and 26% of the DCM biopsies not yielding InfCM, InfCM+ biopsies demonstrated significantly (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) higher frequencies of HLA abundance (76%). The inflammatory process in InfCM comprises T-lymphocytes and macrophages, whereas B-lymphocytes and NK-cells are not significantly increased. InfCM is associated with HLA induction. CD69+, CD45R0+ and adhesion molecule bearing infiltrates indicate the activated state of lymphocytes, and 27E10 of macrophages in InfCM, respectively. Our data are in accordance with the hypothesis of a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;chronic active inflammatory process&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; involved in DCM.
Medical science monitor : international medical journal of experimental and clinical research, 2002
Nitric oxide (NO) is a biomediator believed to be synthesized primarily from extracellular argini... more Nitric oxide (NO) is a biomediator believed to be synthesized primarily from extracellular arginine. Various methodologies have been used to inhibit NO synthesis so as to elucidate its physiological and pathophysiological functions. Several investigators have utilized various argin ine degrading enzymes as a means of lowering extracellular arginine. Arginase, most commonly derived from mammalian sources, has been most often used. However, arginase has failed to inhibit NO synthesis. Therefore, a systematic biochemical characterization of arginase and arginine deiminase (ADI) derived from M. Hominus was undertaken. The murine macrophage cell line N-9 was treated with either arginase or arginine deiminase to determine the effect on intracellular and extracellular arginine and nitric oxide production. Arginase was found to have an alkaline pH optima(approximately 9.5) with little enzyme activity at physiological pH. In contrast, the pH optima of ADI was approximately 6.5, retaining >...
Clinical Chemistry and Laboratory Medicine (CCLM), 2014
Background: A nationwide multicenter study was organized to establish reference intervals (RIs) i... more Background: A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality. Methods: Blood samples were collected nationwide in 28 laboratories from the seven regions ( ≥ 400 samples/ region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the nonparametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA). Results: By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and γ -glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI > 28 kg/m 2 . Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI. Conclusions: With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.
In automated red cell exchange, about 60% of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;... more In automated red cell exchange, about 60% of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s red blood cells are exchanged via apheresis for those of the donor. We report the outcome of 83 patients with sickle cell anemia (48 women and 35 men; age range, 17-49 years) who underwent a total of 196 apheresis procedures between December 2003 and October 2006 at our institution. We found that automated red cell exchange involving a reduced citrate infusion rate may provide benefit in the prevention or treatment of vaso-occlusive complications in patients with sickle cell disease and may be associated with protean effects on biochemical dynamics.
Objectives: The potential influence of automated red cell exchange (ARCE) on endothelial activati... more Objectives: The potential influence of automated red cell exchange (ARCE) on endothelial activation is not well established. This study was intended to assess whether ARCE influences circulating endothelial cells (CECs) in patients with sickle cell disease. Background: Automated red cell exchange (ARCE) has been used to protect the patient from complications of sickle cell disease. However, the expected benefits vary in different patients. CECs reflect endothelial activation. We hypothesize that suppression of endothelial activation may be an important mechanism of ARCE. Methods: The study included 20 patients with sickle cell disease who underwent 30 apheresis procedures. We used flow cytometry to directly compare pre-and post-apheresis CEC number (prior to ARCE and 5 days after ARCE) during the steady state and painful crisis. We also determined if independent variables (the level of plasma nitrite concentration, the percentage of circulating hemoglobin S, and painful crisis) significantly contributed to the CEC level. Results: The mean CEC number decreased (P = 0.04), while progenitor CECs did not change in patients with sickle cell disease after ARCE compared with pre-ARCE values (P > 0.05). Clinical factors such as the volume of replacement fluid and the citrate infusion rate did not correlate with post-apheresis CECsand progenitor CEC numbers. The independent variables were not significantly associated with CEC and progenitor CEC numbers. Conclusions: ARCE can alter the CEC number, suggesting the possibility of suppression of endothelial activation. This may highlight the efficacy of ARCE for prevention or management of sickle cell vaso-occlusive crisis.
Activated platelets have been identified in patients with sickle cell disease. However, the assoc... more Activated platelets have been identified in patients with sickle cell disease. However, the association of platelet P-selectin expression and automated red cell exchange procedures in these patients is not well known. We hypothesized that altered whole platelet P-selectin expression is associated with automated red cell exchange. Flow cytometric quantification of platelet P-selectin expression was carried out in 23 patients with sickle cell disease before and after automated red cell exchange. P-selectin expression was quantified as a binding index for platelet P-selectin (the percentage of positive platelets multiplied by the mean fluorescence of positive platelets). The patients were divided into two groups: individuals with painful vaso-occlusive crises (four women and five men; group 1) and those in a steady state (six women and eight men; group 2). The 33 exchange procedures were evaluated prospectively and used acid-citrate-dextrose A solution
Epidural fibrosis (EF) is a part of the normal physiological tissue response to laminectomy and i... more Epidural fibrosis (EF) is a part of the normal physiological tissue response to laminectomy and it is an important cause of failed back surgery syndrome (FBSS). Osteoprotegerin (OPG) is a soluble member of the tumor necrosis factor receptor family, and is expressed in high concentrations by a variety of tissues and cell types. The objective of this study was to evaluate the relationship between serum OPG levels, and the existence of postoperative EF in patients with lumbar disc herniation. It has been suggested that cytokines and growth factors, which play a role in the wound healing, may enhance the expression of OPG. Forty women who underwent surgery for lumbar disc herniation were included in this study. Postoperative MRI was performed to assess EF in all patients. The serum OPG levels of subjects with postoperative EF were significantly higher than those of subjects without postoperative EF (4.72 +/- 0.27 versus 3.25 +/-0.41 pmol/l; p=0.005) Although the role of OPG in the development of EF is poorly understood, our results suggest that elevated levels of serum OPG are associated with and may play a role in the pathogenesis of fibrotic process.
Hyperhomocysteinemia is a risk factor for ischemic stroke. Hypothyroidism may cause hyperhomocyst... more Hyperhomocysteinemia is a risk factor for ischemic stroke. Hypothyroidism may cause hyperhomocysteinemia. To date, no works have examined the association between hypothyroidism and hyperhomocysteinemia in ischemic stroke. We aimed to investigate the roles of hypothyroidism and hyperhomocysteinemia in ischemic stroke, and whether any relationship exists between hypothyroidism and hyperhomocysteinemia in ischemic stroke patients. The study included 249 ischemic stroke patients and 102 patients with no history of stroke. Patients were evaluated for conventional risk factors and levels of homocysteine, thyroid-stimulating hormone, vitamin B12 and folic acid. Ten (4%) patients in the ischemic stroke group had subclinical hypothyroidism. We did not find any overt or subclinical hypothyroidism in the control group. Hypothyroidism was higher to a statistically significant degree in the ischemic stroke group (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Both hyperhomocysteinemia and hypothyroidism were associated with ischemic stroke patients. However, no association was found between hyperhomocysteinemia and hypothyroidism. Ischemic stroke patients with hypothyroidism had lower levels of HDL cholesterol and levels of total cholesterol/HDL-C and LDL-C/HDL-C were higher than those of ischemic stroke patients without hypothyroidism. Hypothyroidism is associated with ischemic stroke. Low HDL cholesterol, high total cholesterol/HDL-C and high LDL-C/HDL-C were associated in ischemic stroke patients with hypothyroidism. Hyperhomocysteinemia was not found to be associated with ischemic stroke patients with hypothyroidism.
The aim of this study was to investigate the effect of burn injury on bone metabolism and bone de... more The aim of this study was to investigate the effect of burn injury on bone metabolism and bone densitometry in the early period. Twenty-one patients with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;25% total body surface area (TBSA) burns and 20 healthy controls participated. TBSA burned, ambulation, and functional status were recorded. After 30 days, we measured bone mineral densities of the L1-L4 vertebrae, the left distal forearm, and the left proximal femur in the patients. At 1 and 4 weeks after the burn, changes in bone turnover were assessed in patients by changes in deoxypyridinoline levels in the urine and osteocalcin in the serum and compared with the values of control group. In patients, Z-scores &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; -1 were found in 71.42% of left distal forearm, 23.80% of left proximal femur, and in 42.85% of L1-L4 vertebrae measurements. No significant correlations existed between Z-scores and TBSA, Functional Ambulation Scale, or Functional Independent Measure. When compared with controls, there was no statistically significant decrease of osteocalcin (a marker of bone formation) levels in patients 1 and 4 weeks after burn injury. However, when compared with controls, a statistically significant difference was found regarding deoxypyridinoline (a marker for bone resorption) in patients 1 and 4 weeks after burn injury (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001 and P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001, respectively). Decreases in bone mineral density occurred during the first month following burn injury, which seemed to be linked with increases in bone resorption during this period. No correlation existed between reduction in bone mineral density and functional status.
Although uric acid (UA) is considered as an antioxidant, the relationship between serum UA levels... more Although uric acid (UA) is considered as an antioxidant, the relationship between serum UA levels and cardiovascular diseases is not clear yet. Higher brachial artery resting diameter (BD), impaired brachial artery flow-mediated dilatation (FMD), increased carotid intima-media thickness (IMT), decreased aortic distensibility (AoD), and increased aortic stiffness index (AoSI) and elastic modulus (AoEM) are predictors for development and/or progression of atherosclerosis. In this study, BD, FMD, carotid IMT, AoD, AoSI and AoEM were studied in healthy subjects with UA concentrations in physiological range. One hundred 24 healthy volunteers between 26 and 55 years of age were included in this study. Each subject had a serum UA levels in normal range. Carotid IMT, BD and brachial FMD were measured by means of high-resolution vascular ultrasound. AoD, AoSI, AoEM were examined by transthoracic echocardiography. Endothelium-dependent dilatation (EDD) was assessed by establishing reactive hyperemia and endothelium-independent dilatation (EID) was determined by using sublingual isosorbide dinitrate. Although carotid IMT and EDD were significantly correlated with UA concentrations (r = 0.346, p &lt; 0.0001; r = -0.255, p &lt; 0.05, respectively), EID measurements were not significantly correlated with serum UA concentrations (r = - 0.105, p &gt; 0.05). In addition, AoSI and AoEM were significantly correlated with serum UA levels (r = 0.368, p &lt; 0.0001; r = -0.366, p &lt; 0.0001, respectively), and there was a significant inverse correlation between AoD and serum UA concentrations (r = -0.366, p &lt; 0.0001). Furthermore, in multivariate analysis, we found that serum UA concentrations were correlated with increased carotid IMT, reduced FMD and increased aortic stiffness independent of other cardiovascular risk factor (beta = 256, p = 0.002; beta = -193, p = 0.03; beta = 0.295, p &lt; 0.0001, respectively). In healthy subjects, increased serum UA concentrations, even in physiological range, are a risk factor for increased carotid IMT, reduced FMD and increased aortic stiffness independent of other cardiovascular risk factor, and other factors related to the metabolic syndrome.
OBJECTIVE -To determine the prevalence of diabetes and glucose intolerance and their relationship... more OBJECTIVE -To determine the prevalence of diabetes and glucose intolerance and their relationship with risk factors in Adana, a southern province of Turkey, where risk factors are more prominent, probably because of social and economic reasons.
Background: The apoptosis of human polymorphonuclear leukocytes (PMNs) in patients with sickle ce... more Background: The apoptosis of human polymorphonuclear leukocytes (PMNs) in patients with sickle cell disease (SCD) is not well understood. The goal of this study was to examine the apoptosis of PMNs in patients with SCD and in controls.
The plasma concentrations of homocysteine and lipoprotein A are independent risk factors for athe... more The plasma concentrations of homocysteine and lipoprotein A are independent risk factors for atherosclerotic vascular disease. Nitric oxide (NO) and folate values are also important in atherogenesis. The authors aimed to evaluate these parameters in patients having coronary artery bypass surgery (CABS) before 50 years of age and in their children. In 31 patients having CABS, 47 children of these patients, and 28 normal control subjects, homocysteine, NO, vitamin B12, folate, lipoprotein A, triglyceride, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, apolipoprotein A1, and apolipoprotein B values were determined. Homocysteine values of the patients with premature coronary heart diseases and their children were significantly higher than those of controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.031 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.006, respectively). Also, NO levels were significantly higher in both groups than in controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.031, respectively). B12 values were significantly higher in both groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.033, respectively). Lipoprotein A levels were higher in both groups but not significantly so.
Urinary tract reconstruction using bowel segments can result in complications such as electrolyte... more Urinary tract reconstruction using bowel segments can result in complications such as electrolyte abnormalities, infections, stones and cancer. Intestinal mucosa is the primary site responsible for these complications. De-epithelialization of the mucosa and subsequent urothelialization might alleviate these problems. We recently reported our success in de-epithelialization and subsequent uroepithelialization of intestinal segments using 10 g/100 ml AgNO 3 solution in a rat
Coronary slow flow (CSF) has been documented in 25% of patients evaluated for angina or angina-li... more Coronary slow flow (CSF) has been documented in 25% of patients evaluated for angina or angina-like chest pain, despite the presence of normal epicardial coronary arteries on angiography. The risk for the development of clinical events in patients with non-obstructive coronary artery disease (NOCAD) is higher than in patients with completely normal coronary arteries. The object of this study was to evaluate changes in blood and plasma viscosity in patients with CSF or NOCAD. The study included 147 subjects (CSF, n = 42, NOCAD, n = 42 and controls, n = 63). Blood and plasma viscosity, complete blood counts, fibrinogen, and high sensitivity C-reactive protein (hs CRP) levels were measured. There was no significant difference between the groups with respect to blood and plasma viscosity (p > 0.05). Hemoglobin, hematocrit, and erythrocyte counts were significantly higher in the CSF group compared to the NOCAD group (p = 0.017, p = 0.023 and p = 0.023 respectively) and the control gro...
PurposeThe aim of this study was to investigate whether polyunsaturated phosphatidylcholine. (PPC... more PurposeThe aim of this study was to investigate whether polyunsaturated phosphatidylcholine. (PPC) pretreatment has any protective effect on gastric mucosal damage induced by cold-restraint stress (CRS) in rats.
Background/purpose: Persistent inflammatory response secondary to congenital or acquired biliary ... more Background/purpose: Persistent inflammatory response secondary to congenital or acquired biliary choleastasis plays an important role in the pathophysiology of hepatic tissue damage. The polyunsaturated fatty acids (PUFA) have been shown to suppress the inflammatory reactions in vivo and in vitro. PUFA has been shown also to protect againts various types of experimental liver damage in animal models and isolated hepatocytes.
We aimed to compare the level of thrombocytopenia in cirrhotic patients with HBV and those with H... more We aimed to compare the level of thrombocytopenia in cirrhotic patients with HBV and those with HCV, and to investigate whether the reduced serum level of IL-6 in patients with HCV is responsible for the lower platelet count compared to those with HBV through the effect on serum thrombopoietin level. Fifty-three patients with liver cirrhosis, 28 of who were HBV- seropositive (Group A), 25 of who were HCV- seropositive (Group B) and 15 healthy controls were enrolled in this study. Platelet count in group B [75 (1.5-99) K/microL] were lower than those of group A [140 (62-374) K/microL] (p < 0.001). The median levels of serum thrombopoietin in patients [group A: 31.9 (31-113) pg/mL and group B: 38.0 (31.2-102) pg/mL] and controls [31.3 (31-153) pg/mL] did not show statistically significant difference. The patients compared to controls, had higher serum IL-6 levels [3.6 (2-1150) vs. 2.0 (2-9.9) pg/mL], (p < 0.01), which showed similarity in group A and B patients [3.65 (2-1150) vs...
Medical science monitor : international medical journal of experimental and clinical research, 2002
Dilated cardiomyopathy (DCM) is linked to inflammatory cardiomyopathy (InfCM). To gain a profound... more Dilated cardiomyopathy (DCM) is linked to inflammatory cardiomyopathy (InfCM). To gain a profound insight into the underlying mechanisms, we phenotypically characterized pan leukocytes (CD18), naive T-lymphocytes (CD3, CD2, CD4, CD8), activated lymphocytes (LFA-1, LFA-3, VLA-4, ICAM-1, CD69, CD45R0), macrophages (Mac-1, 27E10), B-lymphocytes (CD19) and NK-cells (CD57) in DCM and control hearts. Biopsies from DCM patients (n=164, LVEF&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;40%) and specimens from non-cardiac death causes (controls; n=17) were immunostained. Biopsies exceeding &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;2.0 CD3+ lymphocytes per high power field/hpf and/or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1.5 CD3+ lymphocytes/hpf with numerous foci and HLA class I/DR abundance were evaluated positive for InfCM. InfCM+ biopsies (n=102; 63%) demonstrated significantly increased infiltrates with respect to all studied phenotypes except for CD19 and CD57 when compared with both DCM biopsies negative for InfCM (n=62) and the controls, whereas the latter two groups did not differ (Tukey-Kramer analysis). Virtually all phenotypes correlated with one another in multivariate analysis (except for B-lymphocytes and NK cells). Whereas HLA class I/DR abundance was present in 14% of the controls and 26% of the DCM biopsies not yielding InfCM, InfCM+ biopsies demonstrated significantly (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) higher frequencies of HLA abundance (76%). The inflammatory process in InfCM comprises T-lymphocytes and macrophages, whereas B-lymphocytes and NK-cells are not significantly increased. InfCM is associated with HLA induction. CD69+, CD45R0+ and adhesion molecule bearing infiltrates indicate the activated state of lymphocytes, and 27E10 of macrophages in InfCM, respectively. Our data are in accordance with the hypothesis of a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;chronic active inflammatory process&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; involved in DCM.
Medical science monitor : international medical journal of experimental and clinical research, 2002
Nitric oxide (NO) is a biomediator believed to be synthesized primarily from extracellular argini... more Nitric oxide (NO) is a biomediator believed to be synthesized primarily from extracellular arginine. Various methodologies have been used to inhibit NO synthesis so as to elucidate its physiological and pathophysiological functions. Several investigators have utilized various argin ine degrading enzymes as a means of lowering extracellular arginine. Arginase, most commonly derived from mammalian sources, has been most often used. However, arginase has failed to inhibit NO synthesis. Therefore, a systematic biochemical characterization of arginase and arginine deiminase (ADI) derived from M. Hominus was undertaken. The murine macrophage cell line N-9 was treated with either arginase or arginine deiminase to determine the effect on intracellular and extracellular arginine and nitric oxide production. Arginase was found to have an alkaline pH optima(approximately 9.5) with little enzyme activity at physiological pH. In contrast, the pH optima of ADI was approximately 6.5, retaining >...
Clinical Chemistry and Laboratory Medicine (CCLM), 2014
Background: A nationwide multicenter study was organized to establish reference intervals (RIs) i... more Background: A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality. Methods: Blood samples were collected nationwide in 28 laboratories from the seven regions ( ≥ 400 samples/ region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the nonparametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA). Results: By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and γ -glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI > 28 kg/m 2 . Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI. Conclusions: With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.
In automated red cell exchange, about 60% of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;... more In automated red cell exchange, about 60% of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s red blood cells are exchanged via apheresis for those of the donor. We report the outcome of 83 patients with sickle cell anemia (48 women and 35 men; age range, 17-49 years) who underwent a total of 196 apheresis procedures between December 2003 and October 2006 at our institution. We found that automated red cell exchange involving a reduced citrate infusion rate may provide benefit in the prevention or treatment of vaso-occlusive complications in patients with sickle cell disease and may be associated with protean effects on biochemical dynamics.
Objectives: The potential influence of automated red cell exchange (ARCE) on endothelial activati... more Objectives: The potential influence of automated red cell exchange (ARCE) on endothelial activation is not well established. This study was intended to assess whether ARCE influences circulating endothelial cells (CECs) in patients with sickle cell disease. Background: Automated red cell exchange (ARCE) has been used to protect the patient from complications of sickle cell disease. However, the expected benefits vary in different patients. CECs reflect endothelial activation. We hypothesize that suppression of endothelial activation may be an important mechanism of ARCE. Methods: The study included 20 patients with sickle cell disease who underwent 30 apheresis procedures. We used flow cytometry to directly compare pre-and post-apheresis CEC number (prior to ARCE and 5 days after ARCE) during the steady state and painful crisis. We also determined if independent variables (the level of plasma nitrite concentration, the percentage of circulating hemoglobin S, and painful crisis) significantly contributed to the CEC level. Results: The mean CEC number decreased (P = 0.04), while progenitor CECs did not change in patients with sickle cell disease after ARCE compared with pre-ARCE values (P > 0.05). Clinical factors such as the volume of replacement fluid and the citrate infusion rate did not correlate with post-apheresis CECsand progenitor CEC numbers. The independent variables were not significantly associated with CEC and progenitor CEC numbers. Conclusions: ARCE can alter the CEC number, suggesting the possibility of suppression of endothelial activation. This may highlight the efficacy of ARCE for prevention or management of sickle cell vaso-occlusive crisis.
Activated platelets have been identified in patients with sickle cell disease. However, the assoc... more Activated platelets have been identified in patients with sickle cell disease. However, the association of platelet P-selectin expression and automated red cell exchange procedures in these patients is not well known. We hypothesized that altered whole platelet P-selectin expression is associated with automated red cell exchange. Flow cytometric quantification of platelet P-selectin expression was carried out in 23 patients with sickle cell disease before and after automated red cell exchange. P-selectin expression was quantified as a binding index for platelet P-selectin (the percentage of positive platelets multiplied by the mean fluorescence of positive platelets). The patients were divided into two groups: individuals with painful vaso-occlusive crises (four women and five men; group 1) and those in a steady state (six women and eight men; group 2). The 33 exchange procedures were evaluated prospectively and used acid-citrate-dextrose A solution
Epidural fibrosis (EF) is a part of the normal physiological tissue response to laminectomy and i... more Epidural fibrosis (EF) is a part of the normal physiological tissue response to laminectomy and it is an important cause of failed back surgery syndrome (FBSS). Osteoprotegerin (OPG) is a soluble member of the tumor necrosis factor receptor family, and is expressed in high concentrations by a variety of tissues and cell types. The objective of this study was to evaluate the relationship between serum OPG levels, and the existence of postoperative EF in patients with lumbar disc herniation. It has been suggested that cytokines and growth factors, which play a role in the wound healing, may enhance the expression of OPG. Forty women who underwent surgery for lumbar disc herniation were included in this study. Postoperative MRI was performed to assess EF in all patients. The serum OPG levels of subjects with postoperative EF were significantly higher than those of subjects without postoperative EF (4.72 +/- 0.27 versus 3.25 +/-0.41 pmol/l; p=0.005) Although the role of OPG in the development of EF is poorly understood, our results suggest that elevated levels of serum OPG are associated with and may play a role in the pathogenesis of fibrotic process.
Hyperhomocysteinemia is a risk factor for ischemic stroke. Hypothyroidism may cause hyperhomocyst... more Hyperhomocysteinemia is a risk factor for ischemic stroke. Hypothyroidism may cause hyperhomocysteinemia. To date, no works have examined the association between hypothyroidism and hyperhomocysteinemia in ischemic stroke. We aimed to investigate the roles of hypothyroidism and hyperhomocysteinemia in ischemic stroke, and whether any relationship exists between hypothyroidism and hyperhomocysteinemia in ischemic stroke patients. The study included 249 ischemic stroke patients and 102 patients with no history of stroke. Patients were evaluated for conventional risk factors and levels of homocysteine, thyroid-stimulating hormone, vitamin B12 and folic acid. Ten (4%) patients in the ischemic stroke group had subclinical hypothyroidism. We did not find any overt or subclinical hypothyroidism in the control group. Hypothyroidism was higher to a statistically significant degree in the ischemic stroke group (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Both hyperhomocysteinemia and hypothyroidism were associated with ischemic stroke patients. However, no association was found between hyperhomocysteinemia and hypothyroidism. Ischemic stroke patients with hypothyroidism had lower levels of HDL cholesterol and levels of total cholesterol/HDL-C and LDL-C/HDL-C were higher than those of ischemic stroke patients without hypothyroidism. Hypothyroidism is associated with ischemic stroke. Low HDL cholesterol, high total cholesterol/HDL-C and high LDL-C/HDL-C were associated in ischemic stroke patients with hypothyroidism. Hyperhomocysteinemia was not found to be associated with ischemic stroke patients with hypothyroidism.
The aim of this study was to investigate the effect of burn injury on bone metabolism and bone de... more The aim of this study was to investigate the effect of burn injury on bone metabolism and bone densitometry in the early period. Twenty-one patients with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;25% total body surface area (TBSA) burns and 20 healthy controls participated. TBSA burned, ambulation, and functional status were recorded. After 30 days, we measured bone mineral densities of the L1-L4 vertebrae, the left distal forearm, and the left proximal femur in the patients. At 1 and 4 weeks after the burn, changes in bone turnover were assessed in patients by changes in deoxypyridinoline levels in the urine and osteocalcin in the serum and compared with the values of control group. In patients, Z-scores &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; -1 were found in 71.42% of left distal forearm, 23.80% of left proximal femur, and in 42.85% of L1-L4 vertebrae measurements. No significant correlations existed between Z-scores and TBSA, Functional Ambulation Scale, or Functional Independent Measure. When compared with controls, there was no statistically significant decrease of osteocalcin (a marker of bone formation) levels in patients 1 and 4 weeks after burn injury. However, when compared with controls, a statistically significant difference was found regarding deoxypyridinoline (a marker for bone resorption) in patients 1 and 4 weeks after burn injury (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001 and P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001, respectively). Decreases in bone mineral density occurred during the first month following burn injury, which seemed to be linked with increases in bone resorption during this period. No correlation existed between reduction in bone mineral density and functional status.
Although uric acid (UA) is considered as an antioxidant, the relationship between serum UA levels... more Although uric acid (UA) is considered as an antioxidant, the relationship between serum UA levels and cardiovascular diseases is not clear yet. Higher brachial artery resting diameter (BD), impaired brachial artery flow-mediated dilatation (FMD), increased carotid intima-media thickness (IMT), decreased aortic distensibility (AoD), and increased aortic stiffness index (AoSI) and elastic modulus (AoEM) are predictors for development and/or progression of atherosclerosis. In this study, BD, FMD, carotid IMT, AoD, AoSI and AoEM were studied in healthy subjects with UA concentrations in physiological range. One hundred 24 healthy volunteers between 26 and 55 years of age were included in this study. Each subject had a serum UA levels in normal range. Carotid IMT, BD and brachial FMD were measured by means of high-resolution vascular ultrasound. AoD, AoSI, AoEM were examined by transthoracic echocardiography. Endothelium-dependent dilatation (EDD) was assessed by establishing reactive hyperemia and endothelium-independent dilatation (EID) was determined by using sublingual isosorbide dinitrate. Although carotid IMT and EDD were significantly correlated with UA concentrations (r = 0.346, p &lt; 0.0001; r = -0.255, p &lt; 0.05, respectively), EID measurements were not significantly correlated with serum UA concentrations (r = - 0.105, p &gt; 0.05). In addition, AoSI and AoEM were significantly correlated with serum UA levels (r = 0.368, p &lt; 0.0001; r = -0.366, p &lt; 0.0001, respectively), and there was a significant inverse correlation between AoD and serum UA concentrations (r = -0.366, p &lt; 0.0001). Furthermore, in multivariate analysis, we found that serum UA concentrations were correlated with increased carotid IMT, reduced FMD and increased aortic stiffness independent of other cardiovascular risk factor (beta = 256, p = 0.002; beta = -193, p = 0.03; beta = 0.295, p &lt; 0.0001, respectively). In healthy subjects, increased serum UA concentrations, even in physiological range, are a risk factor for increased carotid IMT, reduced FMD and increased aortic stiffness independent of other cardiovascular risk factor, and other factors related to the metabolic syndrome.
OBJECTIVE -To determine the prevalence of diabetes and glucose intolerance and their relationship... more OBJECTIVE -To determine the prevalence of diabetes and glucose intolerance and their relationship with risk factors in Adana, a southern province of Turkey, where risk factors are more prominent, probably because of social and economic reasons.
Background: The apoptosis of human polymorphonuclear leukocytes (PMNs) in patients with sickle ce... more Background: The apoptosis of human polymorphonuclear leukocytes (PMNs) in patients with sickle cell disease (SCD) is not well understood. The goal of this study was to examine the apoptosis of PMNs in patients with SCD and in controls.
The plasma concentrations of homocysteine and lipoprotein A are independent risk factors for athe... more The plasma concentrations of homocysteine and lipoprotein A are independent risk factors for atherosclerotic vascular disease. Nitric oxide (NO) and folate values are also important in atherogenesis. The authors aimed to evaluate these parameters in patients having coronary artery bypass surgery (CABS) before 50 years of age and in their children. In 31 patients having CABS, 47 children of these patients, and 28 normal control subjects, homocysteine, NO, vitamin B12, folate, lipoprotein A, triglyceride, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, apolipoprotein A1, and apolipoprotein B values were determined. Homocysteine values of the patients with premature coronary heart diseases and their children were significantly higher than those of controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.031 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.006, respectively). Also, NO levels were significantly higher in both groups than in controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.031, respectively). B12 values were significantly higher in both groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.033, respectively). Lipoprotein A levels were higher in both groups but not significantly so.
Uploads
Papers by Nurzen Sezgin