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Acute myocardial infarction with normal coronary arteries in a young man with the Behcet's disease
(Elsevier Ireland Ltd, 2005) Kosar, F; Sahin, I; Gullu, H; Cehreli, S
Behcet's disease (BD) is an inflammatory disorder of unknown origin, which usually presents with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. Although cardiac involvement is not infrequent as a manifestation of Behcet's disease, coronary arteritis is very rarely reported. We suggest that the diagnosis of coronary arteritis should be considered in patients presenting acute myocardial infarction especially in young patients as underlying cause. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
Brain natriuretic peptide and its relationship to left ventricular hypertrophy in patients on peritoneal dialysis or hemodialysis less than 3 years
(Taylor & Francis Ltd, 2006) Taskapan, MC; Ulutas, O; Aksoy, Y; Senel, S; Sahin, I; Kosar, F; Taskapan, H
An increase of brain natriuretic peptide (BNP) levels is commonly observed in patients on dialysis. Increased circulating levels of BNP are related to future cardiac events and associated with shorter survival in patients on chronic hemodialysis (HD). During the first I or 2 years on dialysis, patients on peritoneal dialysis (PD) have been shown to have an improvement in left ventricular hypertrophy, blood pressure, and volume status. This study compares BNP levels and cardiac status of PD and HD patients without cardiovascular disease and on dialysis for less than 36 months. The correlation between plasma BNP concentration and findings of echocardiography before HD scans were examined and compared with findings of PD. Twenty-two HD patients (15 men, 7 women; mean age, 52.5 +/- 13.9 years) and 19 PD patients (10 men, 9 women; mean age, 47.6 +/- 11.3 years) were studied. There were no significant differences between HD and PD patients with regard to age, gender, duration of dialysis, left ventricular mass, left ventricular mass index (p > 0.05). Plasma BNP levels were markedly greater in HD patients (467.8 +/- 466.5 pg/ mL) than those of PD patients (143.1 +/- 165.2 pg/mL). Urine output was significantly higher in PD patients compared with HD patients (p < 0.05). A positive correlation between systolic blood pressure, diastolic blood pressure, and plasma BNP in HD patients (r: 0.653, p: 0.001; r: 0.493, p: 0.023, respectively) was detected. Additional studies are needed to investigate whether lower BNP level in PD patients is an advantage.
Cardiac tamponade as initial presentation of Sheehan's Syndrome
(Elsevier Ireland Ltd, 2004) Sahin, I; Taskapan, H; Yildiz, R; Kosar, F
[Abstract Not Available]
A case of left atrial myxoma associated with atrial septal defect
(Wiley, 2005) Kosar, F; Erdil, N; Gullu, H; Sahin, I; Nisanoglu, V; Battaloglu, B
Cardiac myxoma is the most frequent primary tumor of the heart. However, it is rarely associated with congenital cardiac anomalies such as atrial septal defect in the literature. We present a 72-year-old woman referred to the emergency department with loss of consciousness and finally diagnosed as a pedinculated mobile left atrial myxoma and concomitant occurrence of an ostiurn secundum type atrial septal defect. The mass was successfully excised, and atrial septal defect was safely repaired by primary suture, The patient is currently well after surgery. Atrial myxoma should be considered in the differential diagnosis when patients present with neurological consequences of systemic embolization.
A case of rhabdomyolysis accompanying acute renal failure secondary to weight lifting
(Dustri-Verlag Dr Karl Feistle, 2003) Baysal, O; Taskapan, H; Taskapan, C; Kaya, E; Sahin, I; Kirimlioglu, H; Karakas, N
[Abstract Not Available]
A case of vasospastic angina resulting from coronary emboli in a patient with prosthetic valves
(Int Heart Journal Assoc, 2004) Kosar, F; Gullu, H; Sahin, I; Acikgoz, N; Topal, E; Erdil, N
In addition to coronary atherosclerotic disease, coronary thromboembolisin can also lead to acute coronary syndromes. However, coronary thromboembolism due to prosthetic heart valves is very rare and not very well-known. It has Only a few cases have been reported. In this paper, we present a rare case with vasospastic angina pectoris secondary to coronary thromboembolism in a patient with prosthetic heart valves.
CRP and depression in patients on chronic dialysis
(Dustri-Verlag Dr Karl Feistle, 2003) Taskapan, H; Ates, F; Kaya, B; Kaya, M; Emul, M; Taskapan, Ç; Sahin, I
[Abstract Not Available]
Effect of ectasia size or the ectasia ratio on the thrombosis in myocardial infarction frame count in patients with isolated coronary artery ectasia
(Springer, 2005) Kosar, F; Acikgoz, N; Sahin, I; Topal, E; Aksoy, Y; Cehreli, S
Coronary blood flow was quantified using the thrombosis in myocardial infarction (TIMI) frame-count method. This measurement has been significantly correlated with flow velocity measured invasively by use of a Doppler flow wire. Coronary artery ectasia or aneurysm (CEA) is thought to be present in patients with a slow blood flow. In this study, we aimed to assess the relationship between the ectasia size or ectasia ratio and TIMI frame count in patients with CEA. The study population included 58 patients with isolated CEA of the right coronary artery. In patients with CEA, an ectasia ratio was calculated as diameter of the ectatic segment/diameter of the adjacent normal segment. According to the ectasia ratio, ectatic vessels were divided into two groups: ectasias with a 1.5- to 2.0-fold increase (group A) and more than 2.0-fold increase (group B) in normal vessel diameter. Patients with a significant stenotic lesion (> 50%) in the ectatic vessel were excluded. The control group was formed from a matched population of 35 patients with angiographically proven normal coronary arteries. Characteristics of the ectasia and control groups are similar. The TIMI frame counts for the right coronary artery (RCA) were significantly higher in the ectasia group as compared with the control group (43 +/- 12 vs 23 +/- 8, P < 0.001). The ectasia group had 38 patients in group A and 20 patients in group B. The TIMI frame counts were significantly higher in group B than in group A (43 +/- 10 vs 51 +/- 15, P < 0.05). The TIMI frame count of the RCA showed a significant correlation with the ectasia ratio and the maximum diameter of the ectatic segment (r = 0.578, P < 0.001 and r = 0.435, P < 0.001, respectively). Our data suggest that TIMI frame count measurement depends on the ectasia size or ectasia ratio, and an increased ectasia ratio is markedly associated with decreased TIMI frame counts in patients with CEA.
The effect of glycemic control on lymphocyte neural cell adhesion molecule (CD 56) expression in patients with type 2 diabetes mellitus
(Springer, 2005) Senel, S; Sahin, I; Kaya, E; Taskapan, C; Aydogdu, I
[Abstract Not Available]
Effects of co-existence of coronary stenosis and the extent of coronary ectasia on the TIMI frame count in patients with coronary artery ectasia
(Int Heart Journal Assoc, 2005) Kosar, F; Acikgoz, N; Sahin, I; Topal, EU; Gunen, H; Ermis, N; Cehreli, S
The measurement of the thrombosis in myocardial infarction (TIMI) frame count is a simple method for evaluating coronary blood flow. Although it is well known that slow coronary flow is present in patients with coronary artery ectasia (CAE), the effects of coexisting stenosis and the severity of ectatic involvement on coronory flow have not been adequately studied. Thus, we examined (1) the effect of coexistence of obstructive coronary artery disease on TIMI frame count (TFC) and (2) the relation between the severity of ectatic involvement and TFC in patients with CAE. Ninety-seven study patients with CAE were examined in two steps to determine if they were appropriate in terms of the aim of this study. In the first step, ectasias were divided into three groups: an isolated CAE group, a CAE group with coexisting nonsignificant stenosis, and CAE with coexisting significant stenosis. In the second step, ectasias were subdivided into three groups: CAE with one segment, two segments, and three segments (or diffuse) involvement. The TIMI frame counts for the right coronary artery (RCA), the left circumflex coronary artery (LCx), and the left anterior descending artery (LAD) in the ectasia,roup were significantly higher than that of the control group (P < 0.001 P < 0.05, P < 0.05, respectively). The presence of coexisting nonsignificant stenosis or coexisting significant stenosis in patients with CAE did not influence TFC (P > 0.05, For all). In addition, the severity of ectasia involvement, regardless of the localization of ectatic segments and the type of the affected vessel. did not change the TFC (P > 0.05, for all). These results suggest that neither the coexisting stenosis nor the extent of involvement significantly affect TFC in patients with coronary ectasia.
Effects of pregnancy and lactation on bone mineral density, and their relation to the serum calcium, phosphorus, calcitonin and parathyroid hormone levels in rats
(Springer, 2005) Gonen, E; Sahin, I; Ozbek, M; Kovalak, E; Yologlu, S; Ates, Y
The aim of this study was to evaluate the net changes in bone mineral density (BMD) during the reproductive cycle, and their relation with changes in serum calcium (Ca), phosphorus (P), PTH and calcitonin levels in rats. Twenty-seven female Wistar rats were included in this study. They were divided into three groups as pregnant, lactating and control groups. BMDs of lumbar vertebrates, femoral and tibial bones, and Ca, P, calcitonin and PTH levels were measured at the end of pregnancy, at the end of lactation and in nulliparous controls. In the pregnant group, the BMDs of rats were significantly higher in lumbar vertebrates, femoral and tibia bones than those of the control group (p < 0.05). Their PTH and Ca levels were significantly lower than the control group (p < 0.05). However, no statistically significant difference was found regarding P and calcitonin levels when compared to those of the control group. In the lactating group, the BMDs were significantly lower in lumbar vertebrates, femoral and tibia bones than those seen in the control and pregnant groups (p < 0.05). Ca and PTH levels were significantly higher in lactating rats than in those of pregnant rats (p < 0.005). Normal pregnancy increases BMD in rats, whereas lactation decreases it. Change in PTH levels is supposed to contribute to the mineralization and demineralization of the skeleton during pregnancy and lactation, respectively. (c) 2005, Editrice Kurtis.
Effects of pregnancy and lactation on the microhardness of rat incisor dentine and enamel
(Pergamon-Elsevier Science Ltd, 2004) Ozbek, M; Kanli, A; Dural, S; Sahin, I; Gonen, E; Tulunoglu, I
Pregnancy and lactation affect the rate of maternal dentine apposition and mineralization in the rat. In this study we have measured the effects of pregnancy and lactation on the degree of mineralization of dentine and enamel by using the microhardness method in rat incisors. At incisal. sections, pregnant and lactation group enamel values were increased compared to that of a control group; the pregnancy and post-lactation period dentine values decreased slightly compared to the control group. At neck sections, pregnant and lactation group enamel values were decreased compared to that of the control group; the pregnancy and post-lactation period dentine values were also decreased slightly compared to the control group. At the post-lactation period neck section dentine mineralization was decreased compared with the incisal section. As a result, enamel. and dentine layers of rat incisors are affected to varying degrees by these changes in mineralization levels during the maternal period. (C) 2004 Elsevier Ltd. All rights reserved.
Evaluation of autonomic activity in patients with subclinical hypothyroidism
(Springer, 2005) Sahin, I; Turan, N; Kosar, F; Taskapan, C; Gunen, H
It has been shown that impaired cardiac autonomic activity is closely related with lethal arhythmias. Heart rate variability (HRV), analysis of beat-to-beat variations, is an important and widely used non-invasive method to assess autonomic function. Impaired cardiac autonomic activity and altered sympathovagal balance were previously documented in patients with hypothyroidism. However, the effect of subclinical hypothyroidism (SH) on autonomic function has not been studied yet. We aimed to investigate the effect of SH on sympathovagal balance using the HRV method. The study included 31 patients with SH and 28 healthy volunteer controls. Patients with cardiac, metabolic, neurological disease or any other systemic disease that could affect autonomic activity were excluded from the study. HRV time domain and frequency domain parameters were determined over a period 24 h. All time and frequency domain measures of HRV in patients with SH were not significantly different compared to those of healthy control group (p > 0.05). Additionally, we compared SH subgroups (TSH level >= 10 and TSH level < 10 mU/l) with each other and the controls. A statistically significant difference was observed only in time domain parameters of SD of normal-to-normal intervals (SDNN) and SD of all 5-min mean normal NN intervals (SDANN) between subgroup with TSH level >= 10 and controls (p < 0.05, p < 0.05, respectively). In correlation analysis with TSH, there was positive relationship between TSH and the root mean square of successive differences between adjacent R-R intervals (rMSSD). These findings indicate that SH may affect cardiac autonomic activity in correlation with TSH levels. (c) 2005, Editrice Kurtis.
Evaluation of right and left ventricular function using pulsed-wave tissue Doppler echocardiography in patients with subclinical hypothyroidism
(Springer, 2005) Kosar, F; Sahin, I; Turan, N; Topal, E; Aksoy, Y; Taskapan, C
Previous studies showed that subclinical hypothyroidism (SH) was associated with cardiovascular disorders, such as endothelial dysfunction, atherosclerosis and myocardial dysfunction. Only one study investigated left ventricular (LV) function using pulsed tissue Doppler echocardiography (TDE) in patients with SH. However, no study has used this technique in the identification of right ventricular (RV) function in these patients. We aimed to investigate the effect of SH on RV and LV function using TDE technique. The present study included 36 newly diagnosed SH patients and 28 healthy controls. For each subjects, serum free T-3 (FT3), free T-4 (FT4), total T-3 (TT3), total T-4 (TT4), TSH, peroxidase antibody (TPOab) and thyroglobulin antibody (TGab) levels were measured, and standard echocardiography and TDE were performed. In patients with SH, TSH levels were significantly higher, and TPOab and TGab levels were significantly higher when compared to healthy controls. TDE showed that the patients had significantly lower early diastolic mitral and tricuspid annular velocity (Ea) and early/late (Ea/Aa) diastolic mitral and tricuspid annular velocity ratio (p < 0.05, p < 0.05 and p < 0.001, p < 0.001, respectively), and significantly longer isovolumetric relaxation time (IRT) of left and right ventricles (p < 0.001 and p < 0.001, respectively). However, Aa, Sa, and isovolumetric contraction time (ICT) and ET (ejection time) of left and right ventricle did not significantly differ (p=ns for all). In addition, a negative correlation between TSH and TD-derived tricuspid Ea velocity and Ea/Aa ratio, and a positive correlation between TSH and IRT of right ventricle were observed. Our findings demonstrated that SH is associated with impaired RV diastolic function in addition to impaired LV diastolic function.
Factors affecting survival of hospitalised patients with COPD
(European Respiratory Soc Journals Ltd, 2005) Gunen, H; Hacievliyagil, SS; Kosar, F; Mutlu, LC; Gulbas, G; Pehlivan, E; Sahin, I
Factors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short- and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (Pa,O-2), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2- and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR)=1.158), lower albumin (RR=0.411), lower Pa,O-2 (RR=0.871) and lower body mass index (RR=0.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR=1.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short- and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.
Increased micronucleus frequencies in peripheral blood lymphocytes in women with polycystic ovary syndrome
(Bio Scientifica Ltd, 2006) Yesilada, E; Sahin, I; Ozcan, H; Yildirim, IH; Yologlu, S; Taskapan, C
Objective: We aimed to assess possible genomic instability in women with polycystic ovary syndrome (PCOS). Design: The frequency of micronuclei in cultured peripheral lymphocytes was used as a biomarker of genomic instability in somatic cells. Methods: Nineteen women, diagnosed with PCOS and 19 healthy female volunteers of corresponding ages and body-mass index (BMI) were included in the study. Micronuclei frequencies were assessed in cytokinesis-blocked lymphocytes. Results: The frequency of micronucleated cells (per thousand) was 9.00 (5.00) (interquartile range in parentheses) for patient group and 3.0 (3.0) for the control group (P < 0.0001, Mann-Whitney U-test). The serum levels of follicle-stimulating hormone (FSH), estradiol, prolactin, glucose and dehydroepiandrosterone sulfate (DHEAS) and the homeostasis model of assessment of insulin resistance (HOMA-IR) were not different between the two groups (P > 0.05). Serum total testosterone, luteinizing hormone (LH) and insulin levels and hirsutism score in the PCOS group were significantly (P = 0.007, P < 0.0001, P = 0.009 and P < 0.0001 respectively) higher than those of the control group (2.3 (2.1) nmol/l vs 1.7 (0.4) nmol/l; 8.5 (5.88) mU/ml vs 4.8 (4.4) mU/ml; 6.8 (5.1.) mu U/ml vs 9.7 (4.2) mu U/ml; 19.5 (6.5) vs 4.0 (2.5) respectively). However, the mean level of sex hormone-binding globulin (SHBG) in PCOS group was significantly (P = 0.004) lower than in control group (36.4(22.6) nmol/l vs 48.6(25.2) nmol/l respectively). Conclusion: These findings suggest that women with PCOS have a high incidence of genomic instability, and this condition is positively correlated with the hirsutism score, BMI. LH and serum total testosterone and insulin levels, and is negatively correlated with SHBG.
Interval analysis in patients with acute biliary pancreatitis
(Lippincott Williams & Wilkins, 2005) Ates, F; Kosar, F; Aksoy, Y; Yildirim, B; Sahin, I; Hilmioglu, F
Background: It has been previously proposed that electrocardiographic abnormalities may be associated with acute pancreatitis. However, there is a lack of data on the QT interval and dispersion value in patients with acute pancreatitis, and no data are also available concerning QT interval and QT dispersion in acute biliary pancreatitis ( ABP). Aims: We aimed to investigate the QT parameters in patients with ABP, to compare them with those of healthy controls, and to analyze the relationship between QT parameters and Ranson score. Methods: The present study included 32 patients with acute biliary pancreatitis and 35 healthy controls. The severity of the pancreatitis was determined by Atlanta criteria: fewer than 3 Ranson criteria or fewer than 8 APACHE II ( the Acute Physiology and Chronic Health Evaluation) points indicated the mild disease ( group 1); 3 or more Ranson criteria or 8 or more APACHE II points or organ failure or systemic complications or local complications indicated the severe disease ( group 2). On admission, all patients underwent a standard 12-lead electrocardiogram, and corrected maximum QTc interval (QTc(max)), corrected minimum QT interval (QTc(min)), and corrected QTc dispersion (QTcd) values of the subjects were measured according to the Bazett formula in this study. Results: QTc(max) and QTcd were significantly longer in patients with ABP than in healthy controls ( 442 6 38 milliseconds versus 413 6 34 milliseconds, P< 0.05; and 67 +/- 21 milliseconds versus 42 +/- 18 milliseconds, P< 0.001, respectively). Similarly, QTc(max) and QTcd were significantly longer in group 2 than in group 1 ( 440 6 38 milliseconds versus 450 +/- 34 milliseconds, P< 0.01; and 66 +/- 9 milliseconds versus 71 +/- 11 milliseconds, P< 0.01, respectively). Correlation analysis showed that there is a significant positive relationship between Ranson scores of patients and QTcmax and QTcd ( P< 0.01 and P< 0.001, respectively). Conclusion: The effect of acute biliary pancreatitis on QT intervals and dispersion appears to be dependent not only on the disease but also on its severity, and these parameters may give additional prognostic information in ABP patients, even in the initial evaluation.
IS THERE A RELATIONSHIP BETWEEN SERUM IGF-1 AND THYROID NODULE, THYROID OR OVARIAN VOLUME IN POLYCYSTIC OVARIAN SYNDROME?
(Editura Acad Romane, 2021) Topaloglu, O.; Evren, B.; Uzun, M.; Yologlu, S.; Guldogan, E.; Sahin, I
Context. Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. Objective. We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. Design. The study was performed between June 2017 and August 2019 as prospective design. Subjects and Methods. Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/>= 10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. Results. Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. Conclusion. Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.
Is there association between QRS-T angle, and hormonal and sonographic features in polycystic ovarian syndrome?
(Verduci Publisher, 2020) Topaloglu, O.; Cimci, M.; Yologlu, S.; Sahin, I
OBJECTIVE: Polycystic ovary syndrome (PCOS) is a complex disorder comprising ovulatory dysfunction, hyperandrogenism, and polycystic ovaries (PCO). Several studies have used electrocardiography (ECG) to assess PCOS patients. We aimed to analyze the associations among QRS-T angle, hormonal parameters, and ovarian and thyroid sonography in PCOS. PATIENTS AND METHODS: Adult females with PCOS, but without comorbid illness, were included in our study. Demographic and clinical features (body mass index, Ferriman-Gallwey score, phenotype) were analyzed, as well as laboratory test results. Based on standard 12-lead ECGs, frontal plane QRS-T angles were calculated, defined as the angle between the mean QRS and the mean T vector, and verified with automatic instrument measurements. Values within the range -46 to + 59 degrees were classified as normal, and those out of this range as abnormal. Patients were divided into groups according to the presence of thyroid nodules, echogenicity (normal/decreased), and vascularity (normal/increased) based on thyroid sonography, and by mean ovarian volume (MOV = 10/< 10 mL) or apparent PCO based on ovarian sonography. RESULTS: The mean age of the 92 patients was 22.68 +/- 4.58 years; 11 patients (11.9%) had abnormal QRS-T angles. Demographic, clinical, electrocardiographic, and laboratory parameters were similar between the normal and abnormal QRS-T angle groups, with the exception of MOV, which was higher in the latter group (p=0.032). Among all clinical and laboratory parameters, only MOV was a strong predictor of abnormal QRS-T angle (p= 0.016). CONCLUSIONS: Our study is the first to analyze the association between the QRS-T angle and hormonal and sonographic features of patients with PCOS. A small percentage of patients had abnormal QRS-T angles, and a large MOV was a strong predictor of this abnormality.
Isolated large true contractile left ventricular diverticulum mimicking ischemia in an adult patient: a case report
(Springer, 2005) Kosar, F; Sahin, I; Gullu, H
Congenital diverticulum of the ventricle is a rare cardiac abnormality that is characterized by local embryo-logic development failure of the ventricular muscle. It can be found as an isolated form or associated with other cardiac abnormalities. Clinically, it has been reported that it can lead to heart failure, arrhythmia, or chest pain, although frequently the course is asymptomatic. We present a patient who was referred to our clinic with chest pain due to isolated left ventricular diverticulum mimicking myocardial ischemia.

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