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Öğe The effect of intra-abdominal insufflation pressure on liver function in adult patients undergoing laparoscopic cholecystectomy(2005) Özpolat Z.; Durmuş M.; Toprak H.I.; Öztürk E.; Temel I.; Ersoy M.Ö.Aim: The relation between age and the effect of laparoscopic cholecystectomy on hepatocellular integrity has not been evaluated. We aimed to compare conventional liver function tests in two groups of adults of differing age undergoing elective laparoscopic cholecystectomy. Materials and Methods: We studied 43 patients divided into two groups according to age: Group 1, age 18-60 years (n=22) and Group 2, over 65 years (n=21). All patients received general anesthesia. CO2 was used to insufflate the peritoneal cavity, and intraperitoneal pressure was maintained at 10-14 mmHg during cholecystectomy. Reverse Trendelenburg position was maintained after CO2 insufflation. Arterial blood was sampled before the induction of anesthesia, at the end of surgery, and 1, 3, 6 and 24h after surgery for determination serum alanine aminotransferase (ALT) aspartate aminotransferase (AST), alpha-glutathione S-transferase (alpha-GST), and ganima-glutamyl transpeptidase (GGT) concentrations. Results: Baseline values of alpha-GST were within normal limits in both groups. Alpha-GST increased significantly in two groups at the end of surgery and at 1st hour after surgery. The increase of alpha-GST in Group 2 was higher than Group 1. Alpha-GST returned to normal values at 3,6 and 24h after surgery in both groups. Alpha-GST returned to the preoperative value at 24th h after surgery in Group 1 but not in Group 2. Conclusion: We conclude that elderly patients undergoing laparoscopic cholecystectomy have more hepatocellular injury when intraperitoneal pressure is greater than 10 mmHg.Öğe The effect of moxonidine on endothelial dysfunction in metabolic syndrome(2006) Topal E.; Cikim A.S.; Cikim K.; Temel I.; Ozdemir R.Background: Endothelial dysfunction has been reported in patients with type 2 diabetes mellitus and even in healthy obese individuals with a normal metabolic profile. Sympathetic activity commonly is increased in obese hypertensive patients, and moxonidine is effective in lowering BP and improving insulin sensitivity. Objective: To evaluate the effect of moxonidine on endothelial dysfunction in patients with metabolic syndrome. Methods: Twenty-six patients with mild hypertension were treated with moxonidine and a hypocaloric diet for 3 months, while a second normotensive group (n = 26) were followed-up with calorie restriction alone. Anthropometric (body mass index, waist and hip circumferences, and waist-to-hip ratio) and metabolic features (fasting plasma glucose and insulin, aminotransferases, ?-glutamyl transpeptidase, triglycerides, and cholesterol levels) and flow-mediated dilatation (FMD) were evaluated. Insulin resistance was calculated by using the homeostasis model assessment formula. Insulin sensitivity was calculated according to the quantitative insulin-sensitivity check index (QUICKI). Results: SBP and DBP (both p < 0.001) and waist circumference (p = 0.02) were higher, and QUICKI (p = 0.043) and FMD (p = 0.01) were lower in the hypertensive group at baseline. After 3 months, nearly all the study parameters improved in both treatment groups. The decrease in BP, increase in FMD, and improvements in metabolic and anthropometric parameters were significantly greater in the moxonidine-treated group than in those treated with diet alone. Conclusion: Moxonidine is proposed as a valuable option for treating mild-to-moderate hypertension in obese and insulin-resistant patients with metabolic syndrome as it appears to improve endothelial dysfunction in these patients. © 2006 Adis Data Information BV. All rights reserved.Öğe The effects of Gingko biloba extract on acetic acid-induced colitis in rats(2006) Harputluo?lu M.M.M.; Demirel U.; Yücel N.; Karada? N.; Temel I.; Firat S.; Ara C.Background/aims: Gingko biloba is an antioxidant substance which has antagonistic activity on platelet-activating factor. We aimed to investigate the antioxidant effect and the histopathologic changes caused by Gingko biloba on acetic acid-induced colitis. Methods: Totally 22 rats were divided into three groups. Group 1 (n=7) served as the control group. Group 2 (n=7) and Group 3 (n=8) were given 2 ml/day of 4% acetic acid by intracolonic instillation for three days. Gingko biloba (100 mg/kg) was then given only to Group 3 intraperitoneally for three days. Oxidative stress was assessed by determinate tissue and serum malondialdehyde (MDA) levels, and colonic damage was assessed by histologic examination. Results: Depth of necrosis, extent of necrosis, degree of inflammation, extent of inflammation, fibrosis and total histologic scores in Group 2 were significantly higher than in the control group (p<0.05). The same parameters were lower in Group 3 versus Group 2, but the difference was not significant. Tissue and serum MDA levels in Group 2 were significantly higher than Group 1 (p<0.01 and 0.05, respectively). Again, the same parameters in Group 3 were lower than in Group 2, but the difference was not significant statistically. Conclusions: Gingko biloba did not significantly affect histopathological and oxidative stress parameters in experimental colitis.Öğe Plasma endothelin-1, homocysteine and serum nitric oxide values in patients with left-to-right shunt(2004) Ozerol I.H.; Pac F.A.; Ozerol E.; Ege E.; Yologlu S.; Temel I.; Pac M.Background: This study aimed to evaluate the effect of pulmonary blood flow and pulmonary hypertension on plasma endothelin-1, homocysteine and serum nitric oxide levels in patients with left-to-right shunt lesions with pulmonary hypertension and also with normal pulmonary arterial pressure. Methods and Results: Plasma endothelin-1, homocysteine and nitric oxide levels were measured in 44 patients (Group 1) with left-to-right shunt and normal pulmonary arterial pressure (Qp/Qs: 2.1), 65 patients (Group 2) with left-to-right shunt and pulmonary hypertension (Qp/Qs: 2.4), 20 healthy control subjects (Group 3), and 17 post-operative patients (Group 4). Plasma endothelin-1 and serum nitric oxide levels were significantly higher in Group 2 than in groups 1, 3, and 4 (p<0.001). Plasma homocysteine levels were significantly higher in Group 2 than in Groups 1 and 4 (p<0.001 and p<0.01, respectively). Conclusions: The increase in serum nitric oxide levels in patients with left-to-right shunt and pulmonary hypertension may be attributed to the compensatory mechanism. However, this increase does not improve pulmonary hypertension because of increased endothelin-1 and homocysteine levels. In the light of present study, we conclude that vascular changes caused by increased homocysteine and endothelin-1 may provoke pulmonary hypertension in patients with left-to-right shunt.Öğe The relationships between plasma and erythrocyte antioxidant enzymes and lipid peroxidation in patients with rheumatoid arthritis(Elsevier Masson SAS, 2001) Akyol Ö.; Işçi N.; Temel I.; Özgöçmen S.; Uz E.; Murat M.; Büyükberber S.Objective. The present study was undertaken to evaluate the activities of some key erythrocyte and plasma enzymes participating in free radical metabolism and the end product of lipid peroxidation in rheumatoid arthritis, and whether there are any differences for these parameters between newly diagnosed untreated patients and rheumatoid arthritis patients on drug therapy. Patients and methods. Superoxide dismutase and catalase activities, and malondialdehyde levels were determined in erythrocytes and plasma samples from 54 patients with rheumatoid arthritis (21 of whom without any treatment and 33 on classical therapy regimens) and from 33 healthy controls. Results. There were no statistically significant differences in mean values of activities of the erythrocyte enzymes between the patients and controls. Malondialdehyde levels were significantly increased in both newly diagnosed untreated patients and patients on drug therapy compared to control subjects. Malondialdehyde levels were lower in the treated group than the newly diagnosed untreated group (0.214 ± 0.111 ?mol/L and 0.388 ± 0.075 ?mol/L, respectively) (P < 0.0001). Mean plasma superoxide dismutase activity was lower in the group of newly diagnosed untreated patients compared to those of the treated and control groups (1.31 ± 0.069 U/mL, 1.79 ± 0.94 U/mL and 2.48 ± 0.94 U/mL, respectively) (P < 0.0001, untreated vs control groups). Conclusions. These results suggest sufficient antioxidant enzyme activities in erythrocytes in patients with rheumatoid arthritis and also increased lipid peroxidation end products in newly diagnosed untreated patients compared to control group and patients on drug therapy. © 2001 Éditions scientifiques et médicales Elsevier SAS.Öğe Serum nitrite and nitrate levels in epileptic children using valproic acid or carbamazepine(Elsevier B.V., 2004) Karabiber H.; Yakinci C.; Durmaz Y.; Temel I.; Mehmet N.In experimental epilepsy studies, nitric oxide was found to act as both proconvulsant and anticonvulsant. The objective of this study was to investigate the effects of valproic acid and carbamazepine on serum levels of nitrite and nitrate, which are the metabolites of nitric oxide. To achieve this goal, serum nitrite and nitrate levels were determined in active epileptic 34 children using valproic acid and 23 children using carbamazepine and in non-active epileptic 38 children (control group) not using any antiepileptic drug. In the valproic acid group serum nitrite and nitrate levels were 2.66±2.11?mol/l and 69.35±23.20?mol/l, 1.89±1. 01?mol/l and 49.39±10.61?mol/l in the carbamazepine group, and 1.22±0.55?mol/l, 29.53±10.05?mol in the control group, respectively. Nitrite and nitrate levels were significantly high in both valproic acid and carbamazepine groups compared to the control group (P<0.01). When valproic acid and carbamazepine groups were compared to each other, level of nitrate was found statistically higher in the valproic acid group in relation to the carbamazepine group (P<0.01), however, there was no statistically significant difference in the levels of nitrite (P>0.05). No relation could be found between serum drug levels and nitrite and nitrate levels. According to these results, it can be suggested that valproic acid and carbamazepine might have antiepileptic effects through nitric oxide. © 2003 Elsevier B.V. All rights reserved.Patients:95 children (52 boys, 43 girls) with an age range of 2 to 17 were included in the study. 23/95 were given Tegretol (13 boys, 10 girls) with a mean age of 9.45 ± 3.73, 34/95 were given valproic acid (17 boys, 17 girls) with a mean age of 7.90 ± 3.93 and 38/95 served as controls (epileptic children who had take antiepileptic drugs previously but were followed up without any medication) (22 boys, 16 girls) with a mean age of 9.01 ± 3.57TypeofStudy:The objective of this comparative, controlled clinical study was to investigate the effects of valproic acid (VPA) and Tegretol on the levels of nitrite and nitrate as an indicator of nitric oxide (NO) level in epileptic children.DosageDuration:Dosage not stated. Duration of treatment at least 6 months.ComparativeDrug:Valproic acid (dose not stated, duration of treatment was for at least 6 months).Results:In the valproic acid group serum nitrite and nitrate levels were 2.66 ± 2.11 mcmol/l and 69.35 ± 23.20 mcmol/l, 1.89 ± 1.01 mcmol/l and 49.39 ± 10.61 mcmol/l in the Tegretol group, and 1.22 ± 0.55 mcmol/l, 29.53 ± 10.05 mcmol in the control group, respectively. Serum nitrite and nitrate levels of both VPA and Tegretol groups were found to be significantly higher than the control group statistically (P < 0.01). When VPA and Tegretol groups were compared to each other, no statistically significant difference could be found in the nitrite levels (P > 0.05), however, nitrate levels of VPA group were found to be statistically significantly higher than the Tegretol group (P < 0.01). Routine biochemical parameters (fasting glucose level, urea, creatinine, AST, ALT, ALP) and complete blood count values were in normal ranges both in antiepileptic users and the control group and no difference could be found between the groups statistically. When NO and drug levels in the blood were compared, there was no statistically significant correlation between them.AdverseEffects:No adverse events were mentioned.AuthorsConclusions:Although carbamazepine and VPA are effective in different ways, nitrite and nitrate levels were found to be higher in both groups in our study when compared to the control group. Since liver, kidney and heart diseases that could elevate nitrite and nitrate levels were excluded previously, the results obtained reflect the data of epileptic patients. With reference to the fact that high levels of nitric oxide have an anticonvulsive effect, the antiepileptic effect of VPA and carbamazepine might be through elevating the level of NO directly or indirectly. When VPA and carbamazepine groups were compared to each other, there were no statistical differences between nitrite levels, however, nitrate levels in the VPA group were found to be significantly higher. VPA may have a stronger effect on NO synthesis than Tegretol and may use NO synthesis pathway more in demonstrating its anticonvulsive effect. Even though the cause of increase in the level of NO cannot be explained clearly, it can be suggested that VPA and carbamazepine might have antiepileptic effects through nitric oxide. Further studies dealing with antiepileptic drugs and NO levels and a more clear demonstration of the relation may lead to new treatment methods in refractory epileptics.FreeText:The children had been diagnosed as having epilepsy according to the clinical and electroencephalographic (EEG) findings and had been followed at least for 6 months. Treatment group included children taking Tegretol or VPA regularly at least for the last 6 months and the control group comprised of children who had taken antiepileptic medication previously and did not get any treatment at least for the last 6 months and had no convulsion as well. All children were evaluated in the aspects of mental-motor retardation, renal or hepatic disorders, heart diseases and hypertension. After getting consent of the families, systemic complaints of the children were inquired prior to the study and physical examinations, complete blood count, hepatic and renal function tests were carried out and Tegretol or VPA levels in the blood were measured as well. Fasting blood glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), urea, creatinine, Na, K, Cl , Ca and other routine biochemical analyses were also determined. Following the deproteinization of all samples by adding NaOH/ZnSO4, nitrite and nitrate levels were analyzed together. Nitrite was analyzed directly, however, nitrate was first transformed to nitrite by cadmium reduction and then analyzed by the same method. Results were analyzed using statistical analysis. Serum nitrite and nitrate levels were compared among VPA, Tegretol and control groups by one-way analysis of variance (ANOVA).Indications:23 patients with epilepsy (2/23 tonic, 3/23 atonic, 4/23 complex partial and 14 generalized tonic clonic seizures).
