Browsing by Author "Dülger, H"

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Alterations in the Biochemical Markers of Renal Function After Sevoflurane Anaesthesia
(Wiley, 2005) Sekeroglu, MR; Kati, I; Noyan, T; Dülger, H; Yalçinkaya, A
Aim: This study has been carried out to see whether renal function is acutely altered in patients undergoing sevoflurane anaesthesia. For this purpose, the urinary levels of markers of renal tubular function, namely leucine amino peptidase (LAP), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and beta-2 microglobulin (beta-2M), and urinary albumin as a predictor of renal glomerular function were measured before and after sevoflurane anaesthesia. Methods: This study was comprised of 20 patients (11 males and nine females) aged 18-55, who underwent various elective surgical procedures under general anaesthesia. Urine samples of all patients were collected before and 1, 2 and 8 h after the anaesthesia. The levels of LAP, GGT, beta-2M, and albumin were then expressed as factored by urinary creatinine. In all patients, the anaesthesia was maintained with sevoflurane (2% end-tidal) at a high flow-rate (6 L/min). Results: Urinary beta-2M and LAP levels after anaesthesia were unchanged (P > 0.05). While urinary GGT and ALP levels were found elevated in the first hour, LDH levels were higher in the second hour (P < 0.05). They returned to normal levels in the later periods after the anaesthesia. Urinary albumin excretion (UAE) was significantly elevated in the second hour after the anaesthesia (P < 0.001). Although UAE was decreased in the eighth hour after the anaesthesia, it still remained higher than the pre-anaesthesia level (P < 0.001). Conclusion: These results suggest that a 2% end-tidal concentration of sevoflurane at a high flow-rate (6 L/min) acutely alters renal glomerular function but does not have a significant acute effect on biochemical markers of renal tubular damage.
The Antioxidant Paradox or Antioxidant Damage
(Springer, 2004) Bakan, V; Demirtas, I; Dülger, H
Cardiac Troponin I Levels in Patients With Left Heart Failure and Cor Pulmonale
(Westminster Publ inc, 2001) Güler, N; Bilge, M; Eryonucu, B; Uzun, K; Avci, ME; Dülger, H
Cardiac troponin levels are regarded as the most specific of currently available biochemical markers of myocardial damage. Elevated levels of troponin have been previously reported in patients with left heart failure, reflecting small areas of undetected myocardial cell death. The aim of this study was to compare the levels of the cardiac troponin I (cTnI) in patients with left- and right-sided heart failure. Cardiac troponin I levels were studied with immunochemical methods in patients with right heart failure (n = 17) resulting from chronic obstructive pulmonary disease, ischemic left heart failure (n = 23), and nonischemic left heart failure (n = 18) who were admitted to departments of cardiology and chest diseases. Also, cTnI levels were measured in 32 healthy subjects as control group. Protein markers of myocardial injury (cTnI and myoglobin) in patients with left and right heart failure were collected approximately 12 to 36 hours after onset of obvious symptoms. Serum creatine kinase MB band was determined on admission and thereafter twice a day during the first 3 days. Elevated levels of serum cTnI were found in patients with nonischemic (0.83 +/-0.6 ng/mL, p < 0.01) and ischemic left heart failure (0.9 +/-0.5 ng/mL, p < 0.01) when compared to healthy subjects, whereas serum cTnI levels in patients with right heart failure due to chronic obstructive pulmonary disease were not significantly different from those of control subjects (0.22 0.1 vs 0.16 +/-0.1 ng/mL, p > 0.05). In addition, creatine kinase MB band and myoglobin levels were not significantly different between patient and healthy groups. The mean of cTnI levels in ischemic and even nonischemic left heart failure were increased compared to the mean of values in healthy individuals but without significant creatine kinase MB band and myoglobin elevations. But cTnI levels were not increased in patients with right heart failure due to chronic obstructive pulmonary disease. These data indicate that the cTnI levels are abnormal in left heart failure but not in cor pulmonale.
Diagnostic Value of Cytokeratin-18 as a Tumor Marker in Bladder Cancer
(Pergamon-elsevier Science Ltd, 2002) Sekeroglu, MR; Aydin, S; Dülger, H; Yilmaz, Y; Bayrakli, H; Noyan, T
Objectives: The aim of the study was to compare serum levels of cytokeratin-18 of patients with bladder cancer with those of the healthy controls, and to investigate the relation between cytokeratin level and the tumor stage. Design and methods: Serum cytokeratin-18 levels of 38 patients with bladder cancer and of 25 healthy people were determined. Tumor stage was T-1 in 12 patients, T-2 in 9 patients, T-3 in 10 patients and T-4 in 7 patients. The serum cytokeratin-18 levels in these cases were analyzed with respect to the stage of the tumor. Results: Cytokeratin- 18 level in the patient group was found to be significantly higher than that of the control group (p < 0.010) when the groups were totally compared. However, when the levels in patients with different tumor stages were compared with that of the controls, the difference was not significant in patients with stage I and 2 tumors (p > 0.05). Regarding the cut off value as 4.0 ng/mL, sensitivity and specificity for serum cytokeratin-18 were found to be 53% and 72% respectively. When sensitivity was calculated with respect to tumor stages, it was 8% for T-1, 33% for T-2, 90% for T-3 and 100% for T-4. On the other hand, considering higher stage (T-3 and T-4) tumors only, the sensitivity was calculated as 94%, but the sensitivity for lower stage (T-1 and T-2) tumors was 19%. Conclusions: It is clear that serum cytokeratin- 18 level increases in patients with bladder cancer. However, it can only be useful as a tumor marker in the diagnosis of T-3 and higher staged tumors. This study indicated that cytokeratin- 18 does not have any diagnostic value in lower stage bladder cancers. (C) 2002 The Canadian Society of Clinical Chemists. All rights reserved.
Effect of Cyproheptadine on Serum Leptin Levels
(Springer, 2005) Çalka, Ö; Metin, A; Dülger, H; Erkoç, R
Leptin is a 167 amino acid protein encoded by the obesity gene that is synthesized in adipose tissue and interacts with receptors in the hypothalamus linked to the regulation of appetite and metabolism. It is known to suppress appetite and increase energy expenditure. Cyproheptadine is a piperidine antihistamine that increases appetite through its antiserotonergic effect on 5-HT2 receptors in the brain. Although both leptin and cyproheptacline are effective in controlling appetite, their interaction has not been addressed in clinical studies. This study evaluated serum leptin concentrations in patients who received cyproheptadine to treat a variety of disorders. Sixteen patients aged 7 to 71 years (mean, 26.25 years) were given cyproheptacline 2 to 6 mg/day for a minimum of 7 days. Body weight was measured and blood samples were obtained at baseline and after 1 week of treatment. Serum leptin levels were determined by leptin radioimmunoassay. The mean body weight at baseline (52.59 kg) did not differ significantly from that at 1 week after treatment (52.84 kg; P >.05), but the mean leptin level after 1 week of treatment with cyproheptacline (3.14 ng/mL) was 14.2% higher than that at baseline (2.75 ng/mL; P <.05). This increase may suggest that both leptin and cyproheptacline may affect appetite via similar receptors and that cyproheptacline does not impair leptin activity through these receptors. Further study will be necessary to clarify this relationship.
The Effect of High Dose Digoxin on Cytokines in Healthy Dogs
(Hindawi Ltd, 2002) Dülger, H; Sekeroglu, MR; Eryonucu, B; Noyan, T; Alici, U
Background: Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta are pro-inflammatory cytokines, causing myocardial dysfunction and a negative inotropic effect. The drugs used to treat heart failure affect the production of cytokines. Digoxin, on which this study was focused, is one of the drugs for the treatment of heart failure. Aim: The present study was designed to examine the early effects of high doses of digoxin on the production of cytokines in healthy dogs. Methods: Digoxin was given parenterally to dogs at 0.15 mg/kg. IL-1beta and TNF-alpha production and levels of digoxin in the serum were measured 0, 12, 24, 48, and 72 h following administration of digoxin. Results: As the levels of serum digoxin taken at 12, 24, 48, and 72 h of administration were considered significantly high compared with preceding values (p<0.001), no notable change in serum IL-1 beta and TNF-alpha levels was observed. Conclusions: These results suggest that high doses of digoxin do not cause a significant cytokine production in heart muscle in the early phase.
Effects of Erythropoietin and Pentoxifylline on the Oxidant and Antioxidant Systems in the Experimental Short Bowel Syndrome
(Wiley, 2003) Noyan, T; Onem, O; Sekerglu, MR; Köseoglu, B; Dülger, H; Bayram, I; Bakan, V
In this study, we investigated the effects of erythropoietin (Epo), and pentoxifylline (Ptx) on the oxidant and antioxidant systems in the experimental short bowel syndrome. Spraque-Dawley rats were divided into four groups and all animals underwent 75% small bowel resection. Group E was treated with 500 IU kg(-1) Epo subcutaneously (s.c.), group P with 50 mg kg(-1) day(-1) s.c. Ptx and group E + P with 500 IU kg(-1) s.c. Epo plus 50 mg kg(-1) day(-1) s.c. Ptx for a period of 28 days. In group C, which is the control group, no drug treatment was given. At the end of 28 days the experimented rats were killed and ileum samples excised for biochemical and histopathological testing. Malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were determined in ileum homogenates. When compared to group C, the MDA and GSH-Px levels were significantly decreased (p < 0.05), but SOD activitiy was not changed (p > 0.05) in groups P and E + P, whereas both MDA and SOD and also GSH-Px activities were not changed significantly in group E (p > 0.05). The average villous length, crypt depth, muscular thickness and mucosal length were measured in all groups. The average crypt depth and mucosal length were statistically higher in the group P than group C (p < 0.001, p < 0.01, respectively). In addition, the crypt depth was statistically higher in both E and E + P groups as compared to group C (p < 0.001, p < 0.01, respectively). Therefore, our study indicates that Ptx may be more effective than Epo in reducing lipid peroxidation. Moreover, we considered that Ptx may give this protective effect by inhibiting the free oxygen radicals to a greater extent than developing the antioxidant capacity. Copyright (C) 2002 John Wiley Sons, Ltd.
Evaluation of Thyroid and Parathyroid Functions in Children Receiving Long-Term Carbamazepine Therapy
(Taylor & Francis Ltd, 2003) Çaksen, H; Dülger, H; Cesur, Y; Atas, B; Tuncer, O; Odabas, D
We studied serum calcium, phosphorus, alkaline phosphatase (ALP), thyroid hormones (total thyroxine [TT4], free thyroxine [FT4], thyroid-stimulating hormone [TSH]), parathyroid hormone (PH), and osteocalcine levels in children with epilepsy who had been receiving long-term carbamazepine (CBZ) therapy to determine whether there was any effect of CBZ therapy on these hormones. The study included 18 patients with epilepsy receiving CBZ and 16 healthy age-matched controls. The age ranged from 4-18 years (11.26 +/- 3.59 years) and 4.5-17 years (11.16 +/- 3.13 years) in the study and control group, respectively. The duration of CBZ use was between 10 months-5 years (3.12 +/- 1.09 years). When comparing the results we did not find any significant difference in serum calcium, phosphorus, ALP, osteocalcine and TSH and PH levels between the groups (p > .05). However, serum TT4 and FT4 levels were found to be significantly lower in the study group than those of control group (p < .05). However, we observed no clinical signs of hypothyroidism in all subjects. To these findings we suggest that serum thyroid hormone levels should be monitored in children receiving long-term CBZ therapy.
Hepatoprotective and Anti-Inflammatory Activities of Ballota Glandulosissima
(Elsevier Ireland Ltd, 2004) Özbek, H; Çitoglu, WS; Dülger, H; Ugras, S; Sever, B
Water extract of Ballota glandulosissima Hub.-Mor & Patzak (Lamiaceae) (BG) was investigated for anti-inflammatory activity using the carrageenan-induced rat paw oedema test and for hepatoprotective effect on carbon tetrachloride (CCl4)-induced hepatotoxicity in rats. Biochemical parameters of hepatic damage such as serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin concentrations were determined. CCl4 (0.8mL/kg i.p. for 7 days) treatment increased the serum AST, ALT, ALP and bilirubin levels significantly as compared to controls. Treatment of animals with BG (100 mg/kg, i-p.) +CCl4 (0.8 mL/kg i.p.) for 7 days significantly ameliorated the levels of AST, ALT and ALP elevated by the CCl4 treatment alone. The results of biochemical tests were also confirmed by histopathological examination. BG together with CCl4 treatment decreased the balloning degeneration but did not produced apoptosis of hepatocytes, centrilobular and bridging necrosis observed in the CCl4 treatment alone. BG, at 100 mg/kg per os, showed a significant reduction (34.22%) in rat paw oedema induced by carrageenan. The reference anti-inflammatory drugs etodolac (50 mg/kg, p.o.) and indomethacin (3 mg/kg, i.p.) significantly reduced the oedeme by 43.42 and 95.70%, respectively. The present study reveals that the water extract of Ballota glandulosissima possesses promising protective activity against CCl4 induced hepatic damage and anti-inflammatory activity in rats. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
Hepatoprotective Effect of Foeniculum Vulgare Essential Oil
(Elsevier Science Bv, 2003) Özbek, H; Ugras, S; Dülger, H; Bayram, I; Tuncer, I; Öztürk, G; Öztürk, A
Hepatoprotective activity of Foeniculum vulgare (fennel) essential oil (FEO) was studied using carbon tetrachloride (CCl4) induced liver injury model in rats. The hepatotoxicity produced by acute CCl4 administration was found to be inhibited by FEO with evidence of decreased levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin. The results of this study indicate that FEO has a potent hepatoprotective action against CCl4-induced hepatic damage in rats. (C) 2003 Elsevier Science B.V. All rights reserved.
The Importance of Rigid Nasal Endoscopy in the Diagnosis and Treatment of Rhinolithiasis
(Elsevier Sci Ltd, 2006) Yuca, K; Çaksen, H; Etlik, Ö; Bayram, I; Sakin, YF; Dülger, H; Kiris, M
Objectives: Rhinolithiasis is the presence of mineralized and calcareous formations located in the nasal cavity. They have rare occurrence and can be easily confused with infection or obstruction of tipper airways. If they are undetected for a long time, they may grow large enough to cause of nasal obstruction, mimicking sinusitis. Seven cases of rhinolithiasis were presented, and their diagnosis was made by rigid endoscopic nasal examination. Also computerized tomography scan was used to describe the size and site of the rhinoliths accurately. Our purpose was to determine the role of rigid nasal endoscopy in the diagnosis and the treatment of rhinolithiasis. Methods: In this study, seven cases of rhinolithiasis, who were diagnosed and treated by rigid nasal endoscopy were presented. Results: Between January 2000 and November 2004, seven cases (Four males and three females: age ranged front 8 to 45 years) with rhinolithiasis were diagnosed. The most frequent symptoms were nasal obstruction With purulent rhinorhea. nasal and oral malodor. As complementary examinations, computerized tomography and simple X-ray of paranasal sinuses were used to locate and measure the dimension of calcareous mass, and to reveal possible invasion of the adjacent structures. The removal of rhinolithiasis was done with rigid nasal endoscopy under topical anesthesia in six cases and general anesthesia in one case. Conclusion: Rhinolithiasis is a rare condition but must always be suspected in patients with long standing nasal obstruction, nasal and oral malodor, purulent rhinorrhea and chronic headache. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
Investigation of Antioxidant Status in Children With Acute Otitis Media and Tonsillitis
(Elsevier Ireland Ltd, 2004) Cemek, M; Çaksen, H; Cemek, F; Bayiroglu, F; Dede, S; Dülger, H; Ustün, R
Objective: Antioxidant enzymes status was investigated in children with acute otitis media (AOM) and acute tonsillitis. The aim was to determine the effect of oxidative damage due to free radicals on the antioxidant enzymes status in children with AOM and acute tonsillitis. Methods: We measured erythrocyte levels of superoxide dismutase and glutathione peroxidase (GPx) and activity of serum catalase, ceruloplasmin, albumin and total bilirubin in 23 children with AOM, 27 with acute tonsillitis and 17 control subjects. Results: There was statistically significant difference between the groups for all parameters. ALL antioxidant activities except for albumin Level were increased in the studies groups. When the values of AOM and acute tonsillitis were compared, there was statistically significant difference between the groups for erythrocyte GPx. Conclusion: Our findings indicate that not only a few antioxidant enzymes but almost all antioxidant activities showed a significant enhancement in children with AOM and acute tonsillitis. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
Lipid Peroxidation and Antioxidant Enzymes in Turkish Population
(Tohoku Univ Medical Press, 2002) Özbay, B; Dülger, H
OZBAY, B. and DULGER, H. Lipid Peroxidation and Antioxidant Enzymes in Turkish Population: Relation to Age, Gender, Exercise, and Smoking. Tohoku J. Exp. Med., 2002, 197 (2), 119-124 - The purpose of this study was to examine the change in lipid peroxidation and antioxidant enzyme activities in healthy subjects and to evaluate the concentrations of superoxide dismutase, glutathione peroxidase and malondialdehyde, an end product of lipid peroxidation in exercise and smoking. Study included 257 appearently healthy individuals, 133 males and 124 females. In all subjects, malondialdehyde (MDA) levels were analyzed as an indicator of the lipid peroxidation activities. Superoxide dismutase, glutathione peroxidase activities were measured as an indicator of antioxidant activities. Oxidative stress was estimated by the method based on thiobarbituric acid reactivity. Erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were estimated on hemolysates by use of commercial available kits (Randox lab., Dublin, Ireland). For all groups serum lipid peroxidation and erythrocyte SOD and GSH-Px were obtained at the initial and the following periods. Serum MDA level was higher in the elderly than in the children and in the adults. MDA levels were higher in the smoking, acute exercise than their counterparts in the control groups. GSH-Px activity was significantly lower in the acute exercise group, and higher in the trained group than those as controls. SOD decreased in the elderly, smoking and acute exercise groups and increased in trained individuals. There was a significant increase in lipid peroxidation activity and a significant decrease in antioxidant enzyme activity in cases of acute exercise and smoking as well as the elderly - lipid peroxidation; antioxidants; smoking; exercise. (C) 2002 Tohoku University Medical Press.
No Effect of Long-Term Valproate Therapy on Thyroid and Parathyroid Functions in Children
(Taylor & Francis Ltd, 2002) Çaksen, H; Dülger, H; Cesur, Y; Odabas, D; Tuncer, O; Atas, B
In this study, we studied serum calcium, phosphorus, alkaline phosphatase, thyroid hormones (total thyroxine, free thyroxine, thyroid-stimulating hormone), parathyroid hormone, and osteocalcine levels in children with epilepsy who had been receiving long-term valproate (VPA) therapy in order to determine whether there was any effect of VPA therapy on these hormones. The study included 31 patients with epilepsy receiving VPA and 22 healthy age-matched controls. The age ranged from 15 months to 16 years and 18 months to 17 years in the study and control group, respectively. The duration of VPA use was between 12 months and 5 years (1.93 +/- 1.90 years). When comparing the results, we did not find any significant difference in any of the parameters, including serum calcium, phosphorus, alkaline phosphatase, osteocalcine, and thyroid and parathyroid hormone levels, between the study and control group. We suggest that VPA can safely be used with regard to thyroid and parathyroid dysfunction in childhood epilepsy.
Pro-Inflammatory Cytokines in Turkish Children With Protein-Energy Malnutrition
(Carfax Publishing, 2002) Dülger, H; Arik, M; Sekeroglu, MR; Tarakçioglu, M; Noyan, T; Cesur, Y; Balahoroglu, R
BACKGROUND: Protein-energy malnutrition (PEM) results from food insufficiency as well as from poor social and economic conditions. Development of PEM is due to insufficient nutrition. Children with PEM lose their resistance to infections because of a disordered immune system. It has been reported that the changes occurring in mediators referred to as cytokines; in the immune system may be indicators of the disorders associated with PEM. Aims: To determine the concentrations of pro-inflammatory cytokines in children with PEM, and to find out whether there was an association with the clinical presentation of PEM. Methods: The levels of serum total protein, albumin, tumour necrosis factor-a, and interleukin-6 were measured in 25 patients with PEM and in 18 healthy children as a control group. PEM was divided into two groups as kwashiorkor and marasmus. The kwashiorkor group consisted of 15 children and the marasinus group consisted of 10 children. Results: Levels of serum total protein and albumin of the kwashiorkor group were significantly lower than both the marasmus group and controls (p < 0.05). In view of tumour necrosis factor-a levels, there was no difference between groups (P > 0.05). While levels of interleukin-6 in both the marasmus group and the kwashiorkor group were significantly higher compared with controls (p < 0.05), there was no significant difference between the groups of marasmus and kwashiorkor (p > 0.05). Conclusions: It was observed that the inflammatory response had increased in children with malnutrition.
Serum Levels of Leptin and Proinflammatory Cytokines in Patients With Gastrointestinal Cancer
(Blackwell Publishing Ltd, 2004) Dülger, H; Alici, S; Sekeroglu, MR; Erkog, R; Özbek, H; Noyan, T; Yavuz, M
The aim was to investigate the serum levels of leptin, TNFalpha, IL-1 beta, IL-6, insulin, and growth hormone in patients with upper gastrointestinal cancer and cachexia. A total of 39 patients with various advanced stage (stage IV) gastrointestinal malignancies were enrolled. These cancer patients were divided into two groups according to the presence or absence of cachexia. Fifteen healthy adults were recruited as the control group. Body mass index (BMI; kg/m(2)) was calculated. Serum leptin, turnout necrosis factor (TNF)-alpha interleukin (IL)-1 beta, interleukin (IL)-6, growth hormone, insulin, glucose, triglyceride, total protein, albumin, erythrocyte sedimentation rate, and CRP were measured. In both cancer groups (cachectic and non-cachectic) body mass index and serum leptin levels were lower than controls (p < 0.001). Serum IL-1 beta, IL-6, and growth hormone levels were higher in both cachectic and non-cachectic groups than those of controls (p < 0.05). Serum TNF-alpha level in non-cachectic group was also significantly higher than in control group (p < 0.01). There is no significant difference between three groups in terms of insulin resistance as assessed by HOMA index. Our results showed that some proinflammatory cytokine levels were increased and leptin level was decreased due to upper gastrointestinal cancers. Increased cytokine levels may lead to decreased food intake and caused a weight loss. (C) 2004 Blackwell Ptiblishing Ltd.
The Serum Vitamin C Levels in Behcet's Disease
(Yonsei Univ Coll Medicine, 2003) Noyan, T; Sahin, I; Sekeroglu, MR; Dülger, H
Behcet's disease (BD) is a chronic inflammatory disorder of unknown aetiology, and recognised as a multi-system vasculitis. It has been postulated that an imbalance of the oxidant and antioxidant systems related to the disease are important in its pathogenesis. Previous publications have reported increased levels of enzymatic antioxidant defence systems in patients with BD. The non-enzymatic antioxidant systems, including vitamin C and uric acid, were looked for in the present study. For this aim, the serum malondialdehyde (MDA), an end product of lipid peroxidation, and vitamin C and uric acid, as endogenous antioxidants, were determined in 20 patients with BD (11 in active and 9 in inactive periods) and 20 healthy subjects. The MDA level was significantly higher in both the active and inactive period patients compared with the control group (p < 0.001, p < 0.05, respectively). The MDA level was also significantly higher in the active period patients compared with the inactive period patients (p < 0.05). The vitamin C levels were significantly lower in both the active and inactive period patients compared with the control group (p < 0.001, p < 0.05, respectively). There was no significant difference in the vitamin C level between the active and inactive period patients (p > 0.05). There was also no significant difference in uric acid levels between the groups (p > 0.05). In the patients group, a negative correlation was found between the levels of serum MDA and vitamin C (r=-0.517; p < 0.05). Our results indicate that decreased vitamin C and increased MDA levels reflect the increased levels of oxidative stress in BD patients, and this situation may be important in relation with its pathogenesis.