Browsing by Author "Erkoç, R"
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Article Brachial Artery Blood Flow Velocity Pattern in Patients With Congestive Heart Failure(Sage Publications inc, 2000) Güler, N; Bilge, M; Eryonucu, B; Erkoç, R; Ipeksoy, ÜThe purpose of this study was to determine whether there are abnormalities in blood flow velocity pattern of the brachial artery in patients with congestive heart failure (CHF). Brachial artery blood flow velocities were measured with duplex Doppler ultrasonography in 12 normal subjects, 31 patients with congestive heart failure (CHF), and 26 patients with coronary artery disease (CAD). None of the patients had clinical evidence of arterial disorders at upper extremities. In both patient groups, the presence of hypertension was correlated with the peak systolic velocity (r=0.48, p<0.05). Patients with heart failure had significantly larger (p<0.0001) peak reverse velocity (20 +/-6 m/sec) than healthy subjects (5 +/-4 m/sec) and patients with CAD (7 +/-3 m/sec). Peak reverse velocity did not differ significantly between normal subjects and CAD group. These data indicate that the blood flow velocity pattern at brachial artery is abnormal in CHF. The simple measurement of brachial artery flow velocity suggests changes in peripheral vasculature related to CHF.Article Coexistence of Subacute Thyroiditis and Renal Cell Carcinoma(Canadian Medical Association, 2003) Algün, E; Alici, S; Topal, C; Ugras, S; Erkoç, R; Sakarya, ME; Özbey, NRENAL CELL CARCINOMA IS CHARACTERIZED by varied manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. We describe the case of a 57-year-old man who presented with high fever, weight loss, palpitations and a tender goitre. We suggest that, in this patient, subacute thyroiditis manifested as a paraneoplastic syndrome of renal cell carcinoma.Article Does Acute-Phase Beta Blockade Reduce Left Atrial Appendage Function in Patients With Chronic Nonvalvular Atrial Fibrillation(Mosby-elsevier, 2001) Bilge, M; Güler, N; Eryonucu, B; Erkoç, RTo investigate whether acute-phase beta-blocker therapy has a harmful effect on left atrial appendage (LAA) function in patients with chronic nonvalvular atrial fibrillation by transesophageal echocardiography (TEE), we evaluated 21 patients with normal left ventricular systolic function and a poorly controlled ventricular rate, despite the use of digoxin. Baseline parameters that were obtained included heart rate, blood pressure, LAA emptying velocities, and left atrial spontaneous echo contrast intensity. Then, each patient was given a bolus dose of 5 mg metoprolol. Ten minutes later, a second set of assessments was performed. After the first TEE studies, each patient began treatment with metoprolol (50 ms orally twice daily for 1 week). A second TEE study was performed after 1 week of continuous oral metoprolol therapy at maintenance dose, and values were again determined. The average resting apical heart rate was 91 +/- 7 bpm. As expected, beta-blocker therapy showed a marked decrease in heart rate at 10 minutes (79 +/- 6 bpm P < .001) and at 1 week (71 +/- 4 bpm, P < .001). Beta-blocker therapy caused a significant reduction in systolic and diastolic blood pressures (144 +/- 16 / 93 +/- 6 mm Hg at baseline, 137 +/- 16 / 87 +/- 9 mm Hg at 10 minutes, and 135 +/- 12 / 86 +/- 8 mm Hg at 1 week, P < .001). With the beta-blocker therapy, the baseline transesophageal Doppler parameter of LAA emptying velocities (at baseline 24 +/- 7 cm/s) fell significantly at 10 minutes (19 +/- 7 cm/s, P < .001) and at 1 week (17 +/- 6 cm/s, P < .001) after initiation of beta-blocker therapy. After a bolus of metoprolol, spontaneous echo contrast intensity did not change in any patients, but 1 week later, it increased in 1 patient. In 2 patients who had not been found to have an LAA thrombus at baseline TEE study, the second TEE examination demonstrated new thrombi in the LAA. In conclusion, our endings suggest that in patients with chronic nonvalvular atrial fibrillation who have normal left ventricular systolic function and a poorly controlled ventricular rate despite the use of digoxin, acute-phase beta blockade may have a harmful effect on LAA function.Article Effect of Cyproheptadine on Serum Leptin Levels(Springer, 2005) Çalka, Ö; Metin, A; Dülger, H; Erkoç, RLeptin 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.Article The Effect of Electroconvulsive Therapy on Qt Dispersion(Acta Cardiologica, 1998) Güler, N; Bilge, M; Eryonucu, B; Kutanis, R; Erkoç, RElectroconvulsive therapy (ECT) is used frequently in psychiatric practice and various electrocardiographic (ECG) changes have been described during ECT. QT dispersion (defined as maximal QT interval minus minimal QT interval) as assessed on the surface electrocardiogram has been demonstrated to reflect regional inhomogeneity of ventricular repolarization. The aim of this study is to examine the effect of electroconvulsive therapy on QT dispersion. We studied 27 patients (age range 24-42 y, mean age 34 y, II men) without heart disease who were treated with ECT. Structural heart disease was eliminated with routine clinical examination and laboratory tests, echocardiography, and exercise treadmill test, QT interval and corrected QT (QTc) dispersion was measured on a 12- lead ECG before and just after ECT. QTc dispersion increased from 25.9 +/- 7.4 ms at baseline to 81.4 +/- 12.8 ms after the procedure (P < 0.0001). This result demonstrated that QTc dispersion increased significantly during ECT. This finding may explain that increased inhomogeneity of ventricular repolarization is associated with enhanced vulnerability to arrhythmias during ECT.Article Late Systolic Wave on Brachial Artery Blood Flow Velocity Pattern in Patients With Coronary Artery Disease and Its Relation To Vascular Stiffness(Westminster Publ inc, 2001) Güler, N; Eryonucu, B; Bile, M; Etlik, Ö; Erkoç, R; Sakarya, MEDuplex-Doppler study typically exhibits triphasic brachial artery blood flow velocity pattern in subjects classified as normal without clinically evident atherosclerotic complications, heart disease, hypertension, or diabetes mellitus. In this study, the authors described the late systolic wave on the brachial artery blood flow velocity pattern in patients with coronary artery disease and investigated the relation between late systolic wave and vascular stiffness. Blood flow profile and velocity of the brachial artery were determined noninvasively by ultrasound pulsed-Doppler technique under the guidance of a B-mode ultrasound image in 96 patients with coronary artery disease (CAD). The control group consisted of 23 healthy subjects with no or maximally 2 risk factors (only among age, cigarette smoking, obesity, and gender) for vascular disease. None of the patients and controls had clinical evidence of arterial disorders at upper extremities. In 32 patients (33%) with CAD, a late systolic wave was observed in the brachial artery Doppler study. On the other hand, no late systolic wave was observed in the healthy subjects. In addition, multivessel disease, hypertension, advanced age, diabetes, and smoking were significantly more frequent in patients with the late systolic wave. In conclusion, peripheral arterial abnormalities induced by vascular stiffness may produce alterations in regional wave reflections, and the normal triphasic pattern of the brachial artery blood flow may change by the appearance of the late systolic wave.Article Microalbuminuria in Hodgkin's Disease(Wiley, 2005) Dilek, I; Demir, C; Üstün, Y; Erkoç, RIn some malignant disorders, it was reported that urinary albumin excretion (UAE) was correlated with the prognosis and the extent of the disease. In this study, 24-h UAE was determined in 34 Hodgkin's disease patients without prior treatment and 19 healthy controls. Microalbuminuria (MAU) was defined as UAE >= 20 mu g/min. In patients with MAU, UAE was determined again after the treatment. Mean UAE was 31.2 mu g/min in the patient group and 5.6 mu g/min in the controls (p = 0.005). Whereas MAU frequency was 47% in the patients, there was no MAU in the controls. Mean UAE tended to be higher in advanced stage patients compared to early stage patients (p = 0.051). Also, MAU frequency tended to be higher in the advanced stage group compared to the early stage group (p = 0.196). In four patients in whom remission could not have been achieved, although UAE was reduced, MAU did not disappear. In conclusion, UAE was increased in Hodgkin's disease. However, there is no significant correlation between UAE and the disease extent.Article Relation Between Left Ventricular And/Or Left Atrial Thrombus and Anticardiolipin Antibodies in Patients With Acute Myocardial Infarction(Excerpta Medica inc-elsevier Science inc, 2000) Güler, N; Bilge, M; Eryonucu, B; Erkoç, R; Sayarlioglu, MThis study was designed to determine the relation between anticardiolipin antibodies and left atrial and/or left ventricular thrombus detected by transthoracic and/or transesophageal echocardiography in patients with acute myocardial infarction, Patients with acute myocardial infarction who had positive anticardiolipin immunoglobulin G and/or immunoglobulin M antibodies appeared to be at higher risk for thrombus formation in the left atrium and/or left ventricle.Article Right Atrial Appendage Function in Patients With Chronic Nonvalvular Atrial Fibrillation(Japan Heart Journal, Second dept of internal Med, 2000) Bilge, M; Eryonucu, B; Güler, N; Erkoç, RTo assess right atrial appendage (RAA) flow and its possible relationship to left atrial appendage (LAA) flow in chronic nonvalvular atrial fibrillation (AF), transesophageal echocardiography (TEE) was performed in 26 patients with chronic nonvalvular AF (group I). For the purpose of comparison, an additional group of 27 patients with chronic valvular AF due to mitral stenosis (group II) was analyzed. The clinically estimated duration of AF in group I was significantly longer than that of group II (8.7 +/- 3.4 versus 2.7 +/- 1.1 years). Although right atrial size and RAA maximal area were larger in group I than those in group II, left atrial size was larger in group II than that in group I. Group II had larger LAA maximal areas than group I, but this difference did not reach statistical significance. The two groups were not different with respect to the RAA or LAA emptying velocities. Significant correlations were observed between echocardiographic parameters of the two atria in patients with nonvalvular AF (r range, 0.4 to 0.7). In contrast, in patients with valvular AF, no correlation was observed between the echocardiographic parameters of the two atria (appendage emptying velocity, r = 0.38, p = 0.051; atrial size, r = - 0.03, p = 0.89; maximal appendage area, r = 0.07, p = 0.75, respectively). There were no significant differences in the presence of right and left atrial spontaneous echo contrast and thrombus between the groups. All of the right and left atrial thrombi were confined to their respective appendages and were found in the atria with spentaneous echo contrast. Both RAA and LAA thrombi were present in one patient. In conclusion, our findings suggest that AF could affect both atria equally in nonvalvular AF, in contrast to valvular AF. Therefore, the assessment of RAA function as well as LAA may be important in patients with chronic nonvalvular AF.Article Wolff-Parkinson Syndrome Mimicking Acute Anterior Myocardial Infarction in a Young Male Patient -: a Case Report(Westminster Publ inc, 2001) Güler, N; Eryonucu, B; Bilge, M; Erkoç, R; Türkoglu, CA young male with Wolff-Parkinson-White syndrome whose electrocardiographic pattern was suggestive of acute anterior myocardial infarction is described. A 21-year-old male with a history of ventricular fibrillation after being successfully resuscitated was admitted to the coronary care unit. His electrocardiogram showed ST elevation in the precordial leads (V-1-V-6). This condition was erroneously interpreted as an acute myocardial infarction. At the fourth day, while ST elevations returned to baseline, short PR interval and delta waves were observed on the ECG. Myocardial infarction was excluded by biochemical tests, echocardiography, and coronary angiography. Electrophysiologic study confirmed Wolff-Parkinson-White syndrome with two accessory pathways.