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Öğe Are amniotic fluid C-reactive protein and glucose levels, and white blood cell counts at the time of genetic amniocentesis related with preterm delivery?(Walter De Gruyter & Co, 2005) Tarim, E; Bagis, T; Kiliçdag, EB; Sezgin, N; Yanik, FObjective: To compare women with spontaneous preterm delivery before 37 weeks and women who delivered at term with respect to amniotic fluid C-reactive protein (CRP), glucose levels, and white blood cell counts at the time of genetic amniocentesis. Study design: The study was conducted on 216 pregnant women who underwent genetic amniocentesis between the 15(th) and 18(th) weeks of gestation at Baskent University Obstetrics and Gynecology Department. All patients were followed until delivery for the occurrence of pregnancy complication. Indications for amniocentesis included abnormal triple test results showing increased risk for Down's syndrome, advanced maternal age and sonographic findings indicative for chromosomal abnormalities. The samples were carried immediately to the laboratory for cytogenetic and biochemical examination. Women with spontaneous preterm delivery before 37 weeks (n=20) and those who delivered at term (n=196) were compared with respect to some maternal and infant characteristics, amniotic fluid C-reactive protein, glucose levels, and amniotic fluid white blood cell counts. Results: During the study period 244 patients underwent amniocentesis. A chromosomal abnormality was present in 11 patients. 1 patient had a spontaneous pregnancy loss within 3 weeks after the procedure and 16 patients were delivered for fetal or maternal indications (preeclampsia, fetal growth restriction, placenta previa). The remaining 216 women were included in the study and investigated for the risk of preterm delivery. The prevalence of spontaneous preterm delivery before 37 weeks was 9.3% (20/216). There were no significant differences between the preterm delivery and the term delivery groups with respect to C-reactive protein levels and white blood cell counts. Mean amniotic glucose levels were significantly lower in the preterm delivery group (P < 0.05). Amniotic fluid glucose levels of <= 46 mg/dL had a sensitivity of 100% and NPV of 100%. Conclusion: Amniotic fluid glucose levels at the time of genetic amniocentesis are lower in women with spontaneous preterm delivery before 37 weeks compared to those who delivered at term. Amniotic fluid glucose levels of <= 46 mg/dL at the time of genetic amniocentesis may be more sensitive, cheaper and have higher negative predictive value than C-reactive protein levels and white blood cell counts for the prediction of patients in spontaneous preterm labor. The greatest benefit of amniotic fluid glucose testing might be when the physician judges the patient to be at low risk for preterm delivery.Öğe Complement and immunoglobulin levels in serum and ascitic fluid of patients with spontaneous bacterial peritonitis, malignant ascites, and tuberculous peritonitis(Lippincott Williams & Wilkins, 2002) Yildirim, B; Sari, R; Sezgin, N; Sevinc, A; Hilmioglu, EBackground. We determined complement and immunoglobulin levels in ascitic-fluid and serum of 47 patients with spontaneous bacterial peritonitis, malignant ascites, or tuberculous ascites. Methods. Paracentesis was done to confirm the underlying cause of ascites. Biochemical, hematologic, and microbiologic investigations were also done. Results. The highest serum and ascitic fluid C3 and C4 levels and ascitic fluid IgM, IgA, and IgG levels were found in patients with tuberculosis. Ascitic fluid C3 level was found to be higher in the tuberculous group than in the patients with spontaneous bacterial peritonitis or malignant ascites. Ascitic fluid C4 levels were higher in patients with tuberculosis than in those with spontaneous bacterial peritonitis. Conclusion. We believe that further studies of the in vivo kinetics of immunoglobulins and complement in ascitic fluid of various causes are necessary for a better understanding of the host defense mechanisms of these fluids.Öğe Decreased serum lipoprotein levels as a guide for clinical severity in patients with idiopathic dilated cardiomyopathy(Tohoku Univ Medical Press, 2005) Sezgin, N; Sezgin, AT; Gullu, H; Karabulut, A; Barutcu, I; Topal, E; Yalcintas, DHyperlipidemia is a cardiovascular risk factor. In patients with idiopathic dilated cardiomyopathy (IDC), prognostic roles of endogenous lipoproteins are not fully clarified. It has been known that there is a direct relationship between the levels of cytokines (tumor necrosis factor-alpha [TNF-alpha] and interleukin-6 [IL-6]) and deteriorating functional classes of heart failure and mortality. The present study compared the levels of circulating TNF-alpha, IL-6, lipoproteins, and apolipoproteins in patients with stable IDC (n = 28) with those of patients with unstable IDC (n = 26) and controls (n = 24). Mean serum total. cholesterol (TC) was significantly lower in stable IDC patients than controls (p < 0.05). In unstable IDC patients, mean serum TC was also lower than controls but not statistically significant. The IDC patients had significantly higher concentrations of IL-6 and TNF-alpha than the controls (p < 0.01). Serum IL-6 and Apo AI levels were significantly different between stable and unstable IDC patients (p = 0.021 and p = 0.012, respectively). Increased levels of IL-6 were associated with decreased levels of TC (r = -0.266, p = 0.019), LDL-C (r = -0.376, p = 0.001) and apolipoprotein AI (apo AI) (r = -0.495, p < 0.001) in all IDC patients. TNF-a was also inversely related to apo AI (r = -0.455, p < 0.001) and LDL-C (r = -0.364, p = 0.001) in all patients. Thus, elevated serum levels of cytokines in patients with IDC are associated with decreased lipoprotein concentrations, which may indicate impaired prognosis. (c) 2005 Tohoku University Medical Press.Öğe Determination of risk factors in obese and non-obese patients with coronary artery disease(Acta Cardiologica, 2005) Yologlu, S; Sezgin, AT; Sezgin, N; Ozdemir, R; Yesilada, E; Topal, EObjective - Obesity is a complex multifactorial chronic disorder recently classified by the American Heart Association (AHA) as a modifiable risk factor for coronary artery disease (CAD). This study was designed to assess conventional and novel risk factors in obese and non-obese patients with CAD. Methods and results - This study evaluates the association between conventional and novel coronary risk factors and CAD in obese and non-obese patients by using multivariate stepwise logistic regression analysis. The obese CAD group was identified by the following predictors of CAD: age, sex, hypertension, diabetes mellitus, smoking, family history of CAD, low level of HDL cholesterol, high LDL cholesterol, high C-reactive protein, high homocysteine. In a non-obese CAD group, the identified predictors of CAD were age, sex, hypertension, smoking, family history of CAD, levels of high C-reactive protein, and high homocysteine. Hypertension was found to be the strongest predictor for both obese (OR: 39.91, 95% confidence intervals (Cl): 5.51-280.3, p < 0.001) and non-obese (OR: 14.39, 95% CI: 4.4-25.8, p < 0.001) patients with CAD. Conclusions - From our data, we conclude that hypertension appears to be the strongest independent predictor of CAD regardless of body mass index (BMI).Öğe Effect of caffeic acid phenethyl ester on survival of axial pattern flaps in rats with ischaemia-reperfusion injuries(Taylor & Francis As, 2006) Bilen, BT; Kilinç, H; Alaybeyoglu, N; Çelik, M; Iraz, M; Sezgin, N; Gültek, AOxygen-derived free radicals have been implicated in the pathogenesis of tissue injury after ischaemia-reperfusion. Caffeic acid phenethyl ester ( CAPE), an active ingredient of honeybee propolis, has been identified as having potent antioxidant and anti-inflammatory properties. We evaluated the ability of CAPE applied intraperitoneally in reducing tissue injury after ischaemia-reperfusion. To investigate whether treatment with CAPE modifies the concentrations of the endogenous indices of oxidant stress, we examined its effects on a model of flap ischaemia-reperfusion injury in rats. CAPE (10 mu mol/ kg) was given through the peritoneum before reperfusion. CAPE given intraperitoneally had an inhibitory effect on tissue injury after ischaemia-reperfusion comparable to that of a control group. The anti-inflammatory and antioxidant properties of CAPE may contribute to its suppression of tissue injury.Öğe The effects of aprotinin and steroids on generation of cytokines during coronary artery surgery(W B Saunders Co-Elsevier Inc, 2001) Türköz, A; Çigli, A; But, K; Sezgin, N; Türköz, R; Gülcan, Ö; Ersoy, MÖObjectives: To compare the efficacy of aprotinin and methylprednisolone in reducing cardiopulmonary bypass (CPB)-induced cytokine release, to evaluate the effect of myocardial cytokine release on systemic cytokine levels, and to determine the influence of cytokine release on perioperative and postoperative hemodynamics. Design: Prospective, randomized clinical trial. Setting: University teaching hospital and clinics. Participants: Thirty patients undergoing elective coronary artery bypass graft surgery. Interventions: Patients were randomly allocated into groups treated with aprotinin (n = 10) or methylprednisolone (n = 10) or into an untreated control group (n = 10). Aprotinin-treated patients received aprotinin as a high-dose regimen (6 x 10(6) KIU), and methylprednisolone-treated patients received methylprednisolone (30 mg/kg intravenously) before CPB. Measurements and Main Results: Patients were analyzed for hemodynamic changes and alveolar-arterial PO2 difference (AaDO(2)) until the first postoperative day. Plasma levels of proinflammatory cytokines (tumor necrosis factor [TNF]a, interleukin [IL]-1 beta, IL-6, and IL-8) were measured in peripheral arterial blood immediately before the induction of anesthesia, 5 minutes before CPB, 3 minutes after the start of CPB, 2 minutes after the release of the aortic cross-clamp, 1 hour after CPB, 6 hours after CPB, and 24 hours after CPB; and in coronary sinus blood immediately before CPB and 2 minutes after the release of the aortic cross-clamp. The hemodynamic parameters did not differ among the groups throughout the study. After CPB, AaDO(2) significantly increased (p < 0.05) in all groups. A significant decrease in AaDO(2) was observed in aprotinin-treated patients at 24 hours after CPB compared with the other groups (p < 0.05). TNF-a level from peripheral arterial blood significantly increased in control patients 1 hour after CPB (p < 0.01) and did not significantly increase in methylprednisolone-treated patients throughout the study. In all groups, IL-6 levels increased after the release of the aortic cross-clamp and reached peak values 6 hours after CPB. At 6 hours after CPB, the increase in IL-6 levels in methyl prednisolone-treated patients was significantly less compared with levels measured in control patients and aprotinin-treated patients (p < 0.001). In control patients, IL-8 levels significantly increased 2 minutes after the release of the aortic cross-clamp (p < 0.05), and peak values were observed 1 hour after CPB (p < 0.01). IL-8 levels in control patients were significantly higher compared with patients treated with aprotinin and patients treated with methylprednisolone 1 hour after CPB (p < 0.05). Conclusion: This study showed that methylprednisolone suppresses TNF-, IL-6, and IL-8 release; however, aprotinin attenuates IL-8 release alone. Methylprednisolone does not produce any additional positive hemodynamic and pulmonary effects. An improved postoperative AaDO(2) was observed with the use of aprotinin. Copyright (C) 2001 by W.B. Saunders Company.Öğe Elevated plasma homocysteine level in slow coronary flow(Elsevier Ireland Ltd, 2005) Barutcu, I; Sezgin, AT; Sezgin, N; Gullu, H; Esen, AM; Topal, E; Ozdemir, RBackground: Slow flow velocity of dye in coronary arteries is not an infrequent finding during routine coronary angiography and its precise mechanism is unknown. In this study, we measured the plasma homocysteine level in patients with slow coronary flow (SCF) in comparison with subjects having normal coronary flow (NCF). Method: The study consisted 39 patients (mean age, 47 +/- 8 years) with angiographically diagnosed SCF. SCF was defined according to TIMI frame count (TFC) method. Thirty subjects (mean age 46 8 years) with NCF served as control group. Plasma homocysteine levels were measured after 12 h fasting period in each subject. Results: Baseline demographic properties were similar in both groups. In patients with SCF, TFC was significantly higher than those with NCF. Similarly, in patients with SCF plasma homocysteine level was significantly higher than that of control group (14.1 +/- 2.2 vs. 5.5 +/- 1.3 mu mol/l, respectively p < 0.001). Conclusion: Elevated plasma homocysteine level supports the hypothesis that endothelial function is impaired in slow coronary flow. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Endothelial function and slow coronary flow(Elsevier Science Inc, 2003) Sezgin, A; Sigirci, A; Barutcu, I; Topal, E; Sezgin, N; Ozdemir, R; Gullu, H[Abstract Not Available]Öğe Homocysteine, lipid profile, nitric oxide, vitamin B12, and folate values in patients with premature coronary artery disease and their children(Sage Publications Inc, 2005) Pac, FA; Ozerol, E; Ozerol, IH; Temel, I; Ege, P; Yologlu, S; Sezgin, NThe 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 B 12, 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 < 0.031 and p < 0.006, respectively). Also, NO levels were significantly higher in both groups than in controls (p < 0.001 and p < 0.031, respectively). B12 values were significantly higher in both groups (p < 0.05 and p < 0.033, respectively). Lipoprotein A levels were higher in both groups but not significantly so.Öğe Identifying risk factors in a mostly overweight patient population with coronary artery disease(Westminster Publ Inc, 2003) Yologlu, S; Sezgin, AT; Ozdemir, R; Sezgin, N; Colak, C; Topal, E; Barutcu, IOverweight/obesity is a complex multifactorial chronic disorder, and the American Heart Association (ANA) has recently classified as a modifiable risk factor for coronary heart disease (CAD). This study (1) evaluates the association between CAD in a patient population mostly overweight (MOP) and conventional and novel coronary risk factors by using univariate and multivariate logistic regression analysis and (2) seeks to find the best model by comparing univariate and multivariate logistic regression analysis algorithms, which were systematically applied to risk factors by using Hosmer-Lemeshow statistic test. In univariate analysis, there were significant associations between CAD in MOP and conventional and novel risk factors. However, the model's sensitivity, specificity, and accuracy levels were weak. In multivariate analysis, although some risk factors were not found as predictors of coronary artery disease, the model showed good fit to data and had high sensitivity, specificity, and accuracy levels. This was also confirmed by using the Hosmer-Lemeshow goodness of fit test, more specifically.Öğe Protective effect of melatonin on random pattern skin flap necrosis in pinealectomized rat(Blackwell Munksgaard, 2004) Gurlek, A; Aydogan, H; Parlakpinar, H; Bay-Karabulut, A; Celik, M; Sezgin, N; Acet, ARandom pattern skin flaps are still widely used in plastic surgery. However, necrosis in the distal portion resulting from ischemia is a serious problem, increasing the cost of treatment and hospitalization. Free oxygen radicals and increased neutrophil accumulation play an important role in tissue injury and may lead to partial or complete flap necrosis. To enhance skin flap viability, a variety of pharmacological agents have been intensively investigated. The aim of this study is to test the effects of melatonin, the chief secretory product of the pineal gland and a highly effective antioxidant, on random pattern skin flap survival in rats. Herein, to investigate the physiological and pharmacological role of melatonin on dorsal skin flap survival. Pharmacological (0.4, 4 and 40 mg/kg) levels of melatonin were given intraperitoneally (i.p.). For this, pinealectomized (Px) and sham operated (non-Px) rats were used. The effects of melatonin on levels of malondialdehyde (MDA), nitric oxide (NO), glutathione (GSH) and the activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were measured in the skin flap. The ratio of skin flap necrosis was compared among the experimental groups by using planimetry. MDA and NO levels were found to be higher in Px than non-Px rats; while GSH levels and GSH-Px, and SOD activities were reduced. Melatonin administration to Px rats reduced MDA and NO levels and increased GSH, GSH-Px, SOD levels. Melatonin also reduced the ratio of flap necrosis determined by using planimetry and supported through the photography. In conclusion, these results show that both physiological and pharmacological concentrations of melatonin improve skin flap viability.Öğe Protective effect of polyunsaturated phosphatidylcholine on liver damage induced by biliary obstruction in rats(W B Saunders Co-Elsevier Inc, 2003) Karaman, A; Demirbilek, S; Sezgin, N; Gürbüz, N; Gürses, IBackground/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. Therefore, the aim of this study was to investigate the protective effect of PUFA administration on liver damage using the rat chronic biliary obstruction model. Methods: Swiss albino rats of either sex were divided into 4 groups as follows: control group (group 1, 10 rats); rats with sham operation and treated with saline group 2, 10 rats); rats with biliary obstruction (group 3, 15 rats); and polyunsaturated phophatidylcholine (PPC)-treated rats with biliary obstruction (Group 4, 15 rats). Biliary obstruction was induced by double ligation and division of the common bile duct. PUFA treatment was started 2 weeks later from biliary obstruction in doses of 50 mg/d per rat and continued for 2 weeks. All animals were killed after 4 weeks of common bile duct ligation or sham operation. Liver damage and cholestasis were determined by biochemical and histologic examinations. Results: The data showed a decrease in plasma bilirubin level (both conjugated and unconjugated) and liver enzyme levels (AST, ALT, AP, GGT, 5'-NT) in group 4, when compared with group 3 (P < .05). Tissue levels of malondialdehyde (MDA) in group 4 was 20.00 +/- 2.93 compared with that in group 3, 27.12 +/- 2.96 (P < .05). Administration of PUFA to the biliary obstructed rats resulted in inhibition of collagen accumulation (P < .05) and ductal proliferation (P < .05). Conclusions: PUFA reduced liver damage, ductular proliferation, and fibrosis in biliary obstructed rats. These effects suggest that it might be a useful agent to preserve liver function in patients with biliary obstruction such as biliary atresia. (C) 2003 Elsevier Inc. All rights reserved.Öğe Protective effect of polyunsaturated phosphatidylcholine pretreatment on stress ulcer formation in rats(W B Saunders Co-Elsevier Inc, 2004) Demirbilek, S; Gürses, I; Sezgin, N; Karaman, A; Gürbüz, NPurpose: The 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. Methods: Forty swiss albino rats were divided into 3 groups. Group 1 (n = 10) was control, group 2 (n = 15) was stress ulcer, and group 3 (n = 15) was PPC-treated rats with stress ulcer. Stress ulcer was induced by the cold-restraint method for 4 hours at 4degreesC after a starvation period of 72 hours. In the group 3 rats, PPC treatment was started 10 days before stress at a dose of 100 mg/d by oral route. Rats were terminated, stomachs were excised. Macroscopic ulcer index (UI), gastric tissue malondialdehyde (MDA) and superoxide dismutase (SOD) activities, plasma total nitrite, and erythrocyte catalase (CAT) concentrations were assayed. Results: Histopathologic examination showed a stress ulcer index of 0.12 +/- 0.19 mm in the treatment group and 23.6 +/- 8.97 mm in the stress ulcer group (P < .001). Tissue MDA and SOD concentrations were higher in the stress ulcer group than in the treatment group, the differences were statistically significant (P < .001). Plasma NO3- + NO2- levels were higher (P < .005) and CAT levels were lower (P < .001) in the nontreatment group. There were no significant differences with respect to UI, MDA, and SOD levels among the control and treatment groups (P > .05). Conclusions: These results suggest that pretreating rats with PPC inhibits cold-restraint stress-induced gastric mucosal injury and might be useful in preventing stress-induced stomach ulcers. (C) 2004 Elsevier Inc. All rights reserved.Öğe The use of silver nitrate for chemical de-epithelialization and urothelialization of intestine in a rabbit model of augmentation cystoplasty(Springer, 2003) Demirbilek, S; Uguralp, S; Gürbüz, N; Sezgin, N; Kirimlioglu, HUrinary 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 AgNO3 solution in a rat model of augmentation. In this study, chemical de-epithelialization of a colonic segment was attempted using 10 g/100 ml AgNO3 solution in a rabbit model of augmentation. Sigmoid cystoplasty was performed in 20 male New Zealand rabbits using a 6 cm patch of sigmoid colon. There were two groups, including one group of five rabbits (control, group 1) that underwent augmentation alone, while another group (15 rabbits, treatment group or group 2) was treated with 10g/100 ml AgNO3 solution before augmentation. Control rabbits were killed at the week 8 of experimentation. Treatment rabbits were killed at 2-, 4-, 6- and 8-week intervals. Immediately before augmentation and at the end of the 8 week experimental period each rabbit underwent cystometry. De-epithelialization of the bowel epithelium without urothelialization was apparent in the treatment rabbits killed at 2 and 4 weeks. Histological analysis revealed almost complete urothelialization of the augmented sections treated with 10 g/100 ml AgNO3 solution at the end of the 6 and 8 week of experimental periods. The preoperative and postoperative bladder capacities increased substantially in all groups. There was no obvious histologic difference in the amount of collagen present in the augmented tissues in any of the experimental groups. The present study confirmed that the treatment of intestinal segments with 10g/100 ml AgNO3 solution led to chemical de-epithelialization and urothelialization of the augmented segments. This procedure could, theoretically, have applications to human surgery.Öğe Vascular endothelial function in patients with slow coronary flow(Lippincott Williams & Wilkins, 2003) Sezgin, AT; Sigirci, A; Barutcu, I; Topal, E; Sezgin, N; Ozdemir, R; Yetkin, EBackground Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. Design The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery. Methods Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 476 8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 475 74 years). Results The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48 +/- 0.10% compared with 9.11 +/- 0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8 +/- 1.1% compared with 171 +/- 1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFCm) was strongly and inversely related to the percentage of FMD (r = -0.29, P < 0.01) in all participants. When the patients with SCIF were excluded, CTFC, was still inversely related to the percentage of FMD (r = -0.36, P < 0.05). CTFC, was also inversely related to NTG-induced dilatation in the 57 participants (r = -0.23, P < 0.05). Multiple regression analysis showed that CTFC, was inversely related to the percentage of FMD only (r = -0.37, P < 0.05). Conclusions These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.
