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Öğe Changes in serum CA-125 levels after laparotomy?(I R O G Canada, Inc, 2004) Atmaca, R; Balat, O; Cekmen, M; Ugur, MG; Kutlar, AI; Aksoy, FThere is no adequate data in the medical literature defining serum CA-125 levels after laparotomy. Therefore we designed this prospective study to evaluate the effects of laparotomy for hysterectomy on serum CA-125 levels. Ninety-four women (mean age 44.6 +/- 6.9 years) were included in the study between January, 2001 and April, 2003. Hysterectomies were performed in patients with chronic pelvic pain, dysfunctional uterine bleeding and myoma uteri. Mean serum CA-125 levels of the patient, before and after laparotomy were 16.29 +/- 8.11 U/ml and 16.37 +/- 8.05 U/ml, respectively. The change in serum CA-125 levels prior to the operation was statistically insignificant when compared with the levels obtained at 24 hours after laparotomy (p > 0.05). We found that laparotomy for hysterectomy did not change the levels of CA-125 at the 24th hour after the operation, indicating either serum CA-125 levels are not correlated, at least within 24 hours, with peritoneal irritation or peritoneal irritation was minimal or absent in our operations.Öğe Effects of L-NAME and timolol on aqueous IL-1?, IL-6 IL-8, TNF-? and NO levels after Nd:YAG laser iridotomy in rabbits(Sage Publications Ltd, 2002) Er, H; Doganay, S; Evereklioglu, C; Cekmen, M; Daglioglu, MC; Isci, NPURPOSE. Pro-inflammatory cytokines are produced by tissues and play a vital role in the host inflammatory response and uveitis. Nitric oxide (NO) can be produced in large amounts as a response to experimentally-induced uveitis or cytokines. In this study, we measured the levels of pro-inflammatory cytokines such as interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor (TNF)-alpha and free-radical in aqueous humor after Nd:YAG laser iridotomy in rabbits, and investigated whether timolol maleate an anti-glaucoma drug, or a NO synthase inhibitor, NG-nitro-L-arginine methyl esther (L-NAME) had an inhibitory effect on these molecules, since L-NAME is a known anti-inflammatory agent in rabbits. METHODS. Bilateral experimental Nd:YAG laser iridotomy (power 7.5 mJ, mode single burst, aiming beam 4) was performed on 18 rabbits under general plus topical anesthesia. Aqueous humor samples were taken by clear corneal paracentesis preoperatively, and 1 and 24 h postoperatively. Six rabbits (12 eyes) were given bilateral topical timolol maleate 0.5% (Timoptic(R)) drop b.i.d (group 1), six rabbits (12 eyes) received bilateral 0.1 ml subconjuntival injections of L-NAME (150 mg/kg) (group 2), and six rabbits (12 eyes) were treated with topical balanced salt solution (BSS) b.i.d. (control). RESULTS. Preoperative cytokine and NO levels were comparable in the three groups, with no significant differences. In addition, there was no significant difference in baseline cytokine levels between the right and left eyes. In all groups, pre- and postoperative mean IL-1beta levels were below the:detection limit of the assay (< 5.0 pg/ml). In the control group, postoperative mean IL-6, IL-8 and NO levels were significantly higher after Nd: YAG laser iridotomy than before (for each, p < 0.01). Timolol and L-NAME both inhibited the rise in IL-8 and TNF-alpha levels. Timolol also inhibited the rise in IL-6 but not NO. L-NAME had an inhibitory effect against NO, but not IL-6. CONCLUSIONS. L-NAME has an inhibitory effect on IL-8, TNF-alpha and NO, but not on IL-6. Timolol had inhibitory effects on IL-6, IL-8 and TNF-alpha. but not on NO. These preliminary experimental results might help in assessing the effect of Nd: YAG laser iridotomy in aqueous humor, and to understand the inhibitory effects of timolol and L-NAME against these molecules.Öğe Effects of shock wave lithotripsy on plasma and urinary levels of nitrite and adrenomedullin(Springer-Verlag, 2003) Sarica, K; Balat, A; Erbagci, A; Cekmen, M; Yurekli, M; Yagci, FPurpose: In this prospective clinical study, we aimed to determine whether shockwave lithotripsy (SWL) has any specific effect on plasma as well as urinary nitrite, a stabile metabolite of nitric oxide (NO) and adrenomedullin (AM) concentrations, and to investigate whether these variables can be used as a marker for detecting shockwave-induced impairment of renal tubular and glomerular cells. Material and Methods: A total of 20 patients with renal pelvic or caliceal stones less than or equal to2 cm undergoing anesthesia-free SWL without auxiliary measures and a control group of ten patients without any urological symptoms were included in this study. The plasma and urinary concentrations of nitrite and AM were measured before, 24 h, and 7 days after SWL. Nitrite levels were measured by Griess reaction. Reverse-phase high-performance liquid chromatography (HPLC) was used to determine AM levels. Results: Application of high-energy shock waves (HESW) in our study caused a statistically significant increase in plasma levels of both NO and AM, which reflected an organized response of the kidney to this type of trauma in an attempt to maintain normal renal hemodynamics. Mean plasma nitrite concentration before SWL application was 29.9+/-7.6 mumol/l and this value was found to be 39.02+/-8.45 mumol/l at 24-h follow-up. Comparative evaluation of the plasma concentrations of AM revealed a significant increase at the 24-h examination: 20.51+/-3.0 pmol/ml and 32.54+/-4.3 pmol/l, respectively. On the other hand, comparative evaluation of urinary levels of both nitrite and AM levels before as well as 24 h after SWL application revealed a statistically significant increase related to markers. Conclusion: This first clinical study on plasma-urinary nitrite and AM levels in patients undergoing the SWL procedure indicated that plasma and urine levels of both peptides were increased. Our findings in turn suggested that SWL application to kidneycan stimulate the NO-cGMP signalling pathway to increase NO production in the kidney. Our findings also indicated that the increased levels of NO and AM secretion during renal parenchymal ischemia may be protective enough for renal pathological alterations resulting from SWL-induced renal trauma. We suggest that this increase may be a compensatory response to SWL induced injury.Öğe Increased nitric oxide production in patients with Behcet's disease: Is it a new activity marker?(Mosby, Inc, 2002) Evereklioglu, C; Turkoz, Y; Er, H; Inaloz, HS; Ozbek, E; Cekmen, MBackground. The origin of Behcet's disease (BD) is unclear. One of the prominent features of BD is vasculitis and thrombosis as a result of endothelial dysfunction. Because nitric oxide (NO) is synthesized by endothelium, we considered it as an interesting target of investigation in BD. Objective: Our purpose was to define the level of NO in the serum of patients with BD and its relation with disease activity. Methods: As an indicator for NO, serum total nitrite levels (end product of NO) were measured by Griess reaction in 52 consecutive patients with BD and compared with 32 age- and sex-matched healthy staff volunteers. Serum NO levels of active and inactive patients were compared. Results: The overall serum nitrite levels in patients with BD (40.25 +/- 10.51 mumol/L) were significantly higher (P < .001) than those in healthy volunteers (25.09 +/- 5.33 mumol/L). The difference in serum total nitrite levels among patients with active BD (46.74 +/- 10.62 mumol/L) and inactive BD (33.24 +/- 3.73 mumol/L) was significant (P < .001). Significant differences were observed in serum nitrite between patients in the inactive period of BD and the control group (P < .001). Conclusion: Increased NO production might be responsible for the inflammatory process of BD, NO seems to be related to disease activity.Öğe Increased plasma adrenomedullin levels in patients with Behcet's disease(Karger, 2000) Evereklioglu, C; Yurekli, M; Er, H; Ozbek, E; Hazneci, E; Cekmen, M; Inaloz, HSBackground: Behcet's disease (BD) is a chronic systemic inflammatory disorder affecting multiple organs with a generalized vasculitis of arteries and veins. Endothelial dysfunction is one of the prominent features of ED. Adrenomedullin (AM) is a peptide produced not only in normal adrenal medulla but also in the vascular smooth muscle cells and endothelial cells, and its role in the course of ED has not been previously described. Objective: To detect changes of plasma AM concentrations in patients with ED compared with age- and sex-matched healthy subjects by using high-performance liquid chromatography (HPCL). We also investigated if disease activity or the duration of ED correlates with ANT levels. Methods: Forty-two consecutive patients with ED (38.5 +/- 11.1 years, 19 male and 23 female) and 20 healthy age- and sex-matched control subjects (39.5 +/- 10.9 years, 8 male and 12 female) were included in this study. We measured plasma AM levels by HPCL, and acute-phase reactants including alpha (1)-antitrypsin and alpha (2)-macroglobulin, neutrophil count and the erythrocyte sedimentation rate. Results: Mean +/- SD plasma AM levels in patients with ED (73.22 +/- 25.55 pmol/l) were significantly higher (p < 0.001) than in healthy control volunteers (21.35 12.37 pmol/l). Patients with active ED had similar plasma AM concentrations (79.32 +/- 21.89 pmol/l) with patients with inactive disease (67.44 +/- 29.92 pmol/l). On the other hand, patients with longer duration of the disease (mean duration, 13.9 +/- 3.8 years) had significantly higher plasma AM levels (83.99 +/- 19.71 pmol/l; p = 0.005) than patients (62.45 +/- 26.57 pmol/l) with shorter duration of the disease (mean duration, 5.5 +/- 2.3 years). All acute-phase reaction parameters were found to be significantly increased in the active disease. Conclusion: Considering its endothelial cell implications, AM may be involved in reparatory vessel endothelium mechanisms, especially in the chronic disease. Copyright (C) 2000 S. Karger G, Basel.Öğe The levels of cytokines and nitric oxide in rabbit vitreous humor after retinal laser photocoagulation(Slack Inc, 2000) Er, H; Doganay, S; Turkoz, Y; Cekmen, M; Daglioglu, MC; Gunduz, A; Evereklioglu, COBJECTIVE: To determine the levels of nitric oxide (NO) and cytokines such as interleukin 1-beta (IL-1 beta), interleukin G (IL-6), interleukin 8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha) on vitreous humor following retinal laser photocoagulation. MATERIALS AND METHODS: The rabbits were divided into 3 groups of 4 animals (8 eyes) each. Twelve pigmented rabbit eyes underwent modified grid pattern photocoagulation with a power of 240 mW (group I); 300 mW (group II); and 360 mW (group III). The eyes received 200 burns using a spot size of 200 mu, and duration of 0.2 s. Vitreous humor samples were collected from each eye preoperatively and at 24 and 72 hours after the laser. RESULTS: When compared to preoperative levels, IL-6 levels were increased in all groups; IL-1 beta levels were increased significantly only in group III. IL-8 levels were high in groups II and III only at 72 hours (P <0.05). TNF levels were elevated significantly in group II and III only at 24 hours (P <0.05). NO levels were significantly higher than preoperative values in all groups at all times. CONCLUSION: Our results support that especially IL-6, IL-8, and NO levels increase significantly following laser photocogulation. This preliminary study suggests that IL-6, IL-8, and NO might be dominant contributing factors in the occurrence of the inflammation postoperatively.Öğe Nitric oxide and lipid peroxidation are increased and associated with decreased antioxidant enzyme activities in patients with age-related macular degeneration(Springer, 2003) Evereklioglu, C; Er, H; Doganay, S; Cekmen, M; Turkoz, Y; Otlu, B; Ozerol, EBackground: Nitric oxide (NO), hydroxyl radical (OH.), superoxide anion (02) and hydrogen peroxide (H2O2) are free-radicals released in oxidative stress. Superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase (CAT) are antioxidant enzymes, mediating defense against oxidative stress. Excess NO and/or defective antioxidants cause lipid peroxidation, cellular dysfunction and death. Age-related maculopathy (ARM) or degeneration (ARMD) is the leading cause of irreversible blindness in developed countries. The etiology is unclear and the molecular factors contributing this disease remain to be specified. Aims: This multicenter, double-blind, cross-sectional study aimed to investigate plasma NO and lipid peroxidation levels with relation to antioxidant enzyme activities in erythrocyte and plasma of patients with ARMD compared with healthy control subjects. Methods: NO, lipid peroxidation (measured as plasma malondialdehyde [MDA] levels) and the catalytic activity of SOD, GSHPx and CAT were measured in a group of 41 patients with maculopathy (19 men, 22 women; 67.12 +/- 3.70 years) and compared with 25 age- and sex-matched healthy control subjects without maculopathy (12 men, 13 women; 68.04 +/- 3.02 years). NO and MDA levels were measured in plasma, CAT in red blood cells (RBCs), and SOD and GSHPx in both plasma and RBCs. Color fundus photographs were used to assess the presence of maculopathy, and the patients were divided into two groups using clinical examination and grading of photographs; early-ARM (n = 22) and late-ARMD (n = 19). Results: All patients with maculopathy had significantly (p < 0.001) higher plasma NO levels over control subjects (mean +/- SD, 48.58 +/- 8.81 vs. 28.22 +/- 3.39 mu mol/l). Plasma MDA levels in patients and control subjects were 4.99 +/- 1.00 and 2.16 +/- 0.24 mu mol/l, respectively, and the difference was significant (p < 0.001). On the other hand, SOD and GSHPx activities were significantly lower in both RBCs and plasma of patients with maculopathy than in control subjects (RBCs-SOD, 3509.30 +/- 478.22 vs. 5033.30 +/- 363.98 U/g Hb. p < 0.001; plasma-SOD, 560.95 +/- 52.52 vs. 704.76 +/- 24.59 U/g protein, p < 0.001; RBCs-GSHPx, 663.43 +/- 41.74 vs. 748.80 +/- 25.50 U/g Hb, p < 0.001; plasma-GSHPx, 98.26 +/- 15.67 vs. 131.80 +/- 8.73 U/g protein, p < 0.001). RBCs-CAT levels were not different between groups (131.68 +/- 12.89 vs. 133.00 +/- 13.29 k/g Hb, p = 0.811). Late-ARMD patients had significantly lower antioxidant enzyme levels and higher MDA levels when compared with early-ARM patients (for each, p < 0.001). In addition, plasma NO and MDA levels were negatively correlated with SOD and GSHPx activities. Conclusions: This study demonstrated for the first time that NO, the most abundant free-radical in the body, might be implicated in the pathophysiology of ARMD in association with decreased antioxidant enzymes and increased lipid peroxidation status.Öğe Quantification of nitric oxide and cytokines in rabbit aqueous humor after neodymium:YAG laser capsulotomy(Karger, 2000) Er, H; Gündüz, A; Çigli, A; Turkoz, Y; Cekmen, MPurpose: The purpose of this study was to evaluate the presence of nitric oxide (NO) and cytokines such as interleukin 1 beta, interleukin 2 receptor (IL-2R), interleukin 6 and tumor necrosis factor a on aqueous humor after neodymium:YAG (Nd:YAG) laser posterior capsulotomy, Methods: Fifteen rabbits (30 eyes) with dense posterior capsule opacities underwent Nd:YAG capsulotomy 4 months after phacoemulsification cataract surgery. After general and topical anesthesia, Nd:YAG capsulotomy was performed using an equal number of shots and power setting on all eyes. Aqueous humor specimens were collected from each eye preoperatively and at 12, 24 and 48 h after the surgery to determine NO and cytokine levels. Results: The levels of NO and cytokines except IL-2R were significantly high as compared to preoperative levels in all eyes at 12 and 24 h postoperatively (p<0.05). Although the levels of NO and cytokines were higher than preoperative levels at 48 h, the differences were not statistically significant (p > 0.05), Conclusion: These findings suggest that NO and cytokines appear to be potential inflammatory mediators in the occurrence of early inflammation following Nd:YAG posterior capsulotomy. Copyright (C) 2000 S. Karger AG, Basel.
