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Öğe Can long-term exposure to chromium improve insulin sensitivity in chromium mine workers?(Wiley-Liss, 2004) Tuzcu, Alpaslan; Bahçeci, Mithat; Dursun, Mehmet Emin; Parmaksız, Y.; Ertem, Melikşah; Dalgıç, A.; Turgut, Cengiz; Kale, EbruThe purpose of this work was to evaluate insulin sensitivity in chromium mine workers exposed to chromium chronically. Body mass index, waist circumference, fat mass and percent, lipid levels, serum glucose, insulin, leptin and chromium levels, HOMA (%S), and HOMA (%B) values were measured in 93 male workers and 94 age- and body mass index-matched healthy controls. Fat mass and fat percent of workers were higher than control subjects (P < 0;01 and P < 0.0001, respectively). Mean insulin level of the workers was lower than control subjects (6.2 +/- 4.9 muU/mL and 9.38 +/- 5, respectively, P < 0.0001). Mean serum leptin levels was also lower than the control group (8.47 +/- 6.5 ng/mL and 19.0 +/- 10.8, respectively, P < 0.0001). Serum chromium was higher than the control subjects (407.7 +/- 224.2 nmol/L and 4.45 +/- 3.9, respectively, P < 0.00001). Mean HOMA (%S) index of workers was higher than control subjects (114.4 +/- 55.6 and 55.7 +/- 40.6, P < 0.001). Serum high-density lipoprotein cholesterol levels of the workers were significantly higher than the control group (P < 0.02). In conclusion, long-term exposure to chromium may improve insulin sensitivity and beta-cell function. This improvement appears to be a result of low body fat mass and fat percent in body composition. In addition chromium usage may have useful effects in the insulin sensitivity and therefore in development of type 2 diabetes mellitus.Öğe Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome(AVES Yayıncılık, 2011) Üstündağ, Mehmet; Orak, Murat; Güloğlu, Cahfer; Sayhan, Mustafa Burak; Alyan, Ömer; Kale, EbruObjective: We measured the levels of neutrophil activating peptide-2 (NAP-2) and pentraxin-3 (PTX-3) in acute coronary syndromes (ACS) patients and compared their diagnostic accuracy with cardiac troponin I (cTnI). Methods: We conducted a prospective cohort study to determine the diagnostic accuracy of PTX-3, NAP-2 and cTnI for the prediction of ACS. Consecutively eighty-three patients with sudden chest pain admitted to Dicle University Emergency Department within the first six hours of symptom onset were included in our study. Mean serum levels of PTX-3, NAP-2 and cTnI were compared between control and patient groups and ACS subgroups. Their sensitivities and specificities in early diagnosis of ACS were identified. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic validity of the markers, and areas under the ROC curve (AUC) were compared. Results: In the patient group, mean serum concentrations of NAP-2 (53.03+22.77 ng/ml) and PTX-3 (1.73+0.82 ng/ml) were considerably higher than those of the control group (24.54+9.50 and 0.50+0.39 ng/ml, respectively) (p<0.01). When compared with the control group, PTX-3 levels of all three ACS subtypes (unstable angina pectoris (USAP) - 1.62+0.41 ng/ml, non-ST elevation myocardial infarction (NSTEMI) -1.63+0.31 ng/ml and ST-elevation myocardial infarction (STEMI) - 1.75+0.89 ng/ml) were higher, whereas NAP-2 levels were higher in USAP (56.29+22.60 ng/ml) and STEMI (52.05+20.99 ng/ml) patients (p<0.01). For diagnosing ACS within the first six hours of presentation, PTX-3 sensitivity was 98.5% and specificity was 92.3%, and NAP-2 sensitivity - 98.1% and specificity - 41.3%. The ROC curve AUC values were: 0.962 for PTX-3 (95% CI 0.802 - 1.073), 0.840 for NAP-2 (95% CI 0.684 - 0.991), and 0.683 for cTnI (95% CI 0.610 - 0.940). Conclusion: Pentraxin-3 is a sensitive and specific marker for ACS diagnosis when compared with cardiac markers in patients admitted to the emergency department (ED) within the first six hours of onset of chest pain.Öğe The distribution of telomerase activity in patients with helicobacter pylori positive gastritis(TÜBİTAK, 2010) Canoruç, Naime; Kale, Ebru; Yılmaz, Şerif; Bayan, Kadim; Dursun, Mehmet; Batun, Sabri; Kaplan, AbdurrahmanAim: Helicobacter pylori is considered a class I carcinogen by the World Health Organization. We aimed to determine whether H. pylori has an effect on telomerase activity in patients with H. pylori related non-specific gastritis, atrophy, and intestinal metaplasia. Materials and methods: One hundred and seventy-two adult patients who underwent upper gastroduodenoscopy were enrolled in the study. Three biopsy specimens were taken from the antrum: 1 from the incisura angularis and 2 from the mid-antrum. Biopsy specimens taken from the incisura angularis were evaluated using the urease test for detection of H. pylori. The mid-antrum specimens were sent for histopathology and tissue telomerase activity testing. The histopathologic evaluation was performed based on the updated Sydney system. Quantitative detection of hTERT mRNA was performed with the available method for telomerase activity. Results: Of the 172 patients, 119 were eligible for the study. H. pylori was positive in 68 (57.14%) and negative in 51 (42.85%) of the cases (P > 0.05). Of the 119 patients, 6 had intestinal metaplasia, 27 had glandular atrophy, 62 had neutrophilic activation, and 102 had chronic inflammation. The telomerase activity of the H. pylori positive and negative groups did not show a statistically significant difference in patients with intestinal metaplasia, glandular atrophy, neutrophilic activation, and chronic inflammation (P > 0.05, for each). hTERT activity was higher in H. pylori positive patients who had glandular atrophy and intestinal metaplasia than the negative group. However, the differences were insignificant. Conclusion: We could not find any significant relationship between telomerase activity and H. pylori related non-specific gastritis, atrophy, and intestinal metaplasia. hTERT activity was higher in patients who had glandular atrophy and intestinal metaplasia (early stages of gastric carcinogenesis) in the H. pylori positive group. However, these differences were not significant. H. pylori, which is considered an oncogenic agent, may influence telomerase activity of further stages of carcinogenesis, particularly those after intestinal metaplasia.Öğe Effect of a 50-Hz Sinusoidal Electromagnetic Field on the Integrity of Experimental Colonic Anastomoses Covered with Fibrin Glue(Wroclaw Medical Univ, 2009) Girgin, Sadullah; Ozturk, Hayrettin; Gedik, Ercan; Akpolat, Veysi; Kale, Ebru; Ozturk, HulyaBackground. Low-frequency magnetic fields have been shown to affect biological processes. In this article the effects of 50-Hz sinusoidal magnetic field (MF) stimulation and application of fibrin glue on the healing of experimental colonic anastomoses were investigated. Material and Methods. Twenty-eight rats were divided into four groups. Group 1 underwent 2-cm left colonic resection and primary anastomosis. Group 2 underwent normal resection anastomosis and the area was covered with fibrin glue. Group 3 underwent normal resection anastomosis and the rats were exposed to a 50-Hz sinusoidal MF. Group 4 underwent normal resection anastomosis, the anastomosis area was covered with fibrin glue, and the rats were exposed to a 50-Hz sinusoidal MF. Investigations included bursting pressure measurement, hydroxyproline content, and histopathological changes. Results. Tissue hydroxyproline levels and anastomotic bursting pressures of groups 2, 3, and 4 were significantly higher than in group 1. Collagen deposition and fibroblast infiltration in groups 2, 3, and 4 had higher scores than in group 1. Furthermore, these results were significantly higher in group 4 rats than in the other groups. Histopathological examination of the anastomosis revealed significantly better healing patterns for group 4 than for groups 1, 2, and 3. Conclusions. A50-Hz sinusoidal MF stimulation and application of fibrin glue provided a significant gain in anastomotic healing in the large intestine. A combination of a 50-Hz sinusoidal MF and fibrin glue has significantly favorable effects on healing of experimental colon anastomosis (Adv Clin Exp Med 2009, 18, 1, 13-18).Öğe Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats(Springer, 2009) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akbulut, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, SalihPurpose An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. Methods Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. Results The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. Conclusions In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.Öğe Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats (vol 54, pg 745, 2009)(Springer, 2010) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akpolat, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih[Abstract Not Available]Öğe Effects of melatonin and N-acetylcysteine on lung ischemia reperfusion injury(Bayrakol Medical Publisher, 2022) Durkan, Atilla; Çakmak, Muharrem; Ülkü, Refik; Özekinci, Selver; Kale, EbruAim: In our study, we aimed to determine the effects of using melatonin, N-acetyl cysteine, and low potassium dextran solution (LPDS) as a preservative solution on ischemia/reperfusion injury. Material and Methods: A total of 48 male Sprague-Downey rats were used. Rats were divided into 8 groups: group 1: ischemia, group 2: ischemia+melatonin, group 3: ischemia + N-acetylcysteine, group 4: ischemia+melatonin + N-acetylcysteine, group 5: ischemia + reperfusion, group 6: ischemia + reperfusion + melatonin, group 7; ischemia + reperfusion + N-acetyl cysteine, and group 8; ischemia+reperfusion+melatonin+N-acetyl cysteine. Total antioxidant capacity (TAOC), malondialdehyde (MDA) and neutrophil values of each group were determined. The TAOC was obtained by spectrophotometric measurement of the absorption level of the color formed by the hydroxylion formed by the Fenton reaction with orthodianisidine. The MDA value was obtained spectrophotometrically using the thiobarbituric acid method, and the Neutrophil count was obtained as cell count using Papanicolau Stain stain. Results: While the highest TAOC values were in groups 4, 2, 3, 1, the lowest TAOC values were in groups 5,7,6,8. The highest MDA values were in groups 5, 7, 6, 1, 8, whereas the lowest MDA were in groups 4, 2, 3 (p<0.05). Neutrophil in bronchoalveolar lavage increased in groups 5,7,6,3,2,8,4. Discussion: In lung ischemia reperfusion, the use of melatonin and/or N-acetyl cysteine, and LPDS decreases plasma MDA levels and increases TAOC values. Additionally, the use of these antioxidants and preservation solutions decreases cell damage immunohistochemically, the cytokines mediating inflammation, the PMNL, and the inflammatory response associated with them.Öğe Elektif sezaryenlerde genel ve spinal anestezinin anne ve yenidoğan kortizol düzeylerine etkisi(2006) Kale, Ahmet; Kale, Ebru; Canoruç, Naime; Erdemoğlu, Mahmut; Akdeniz, Nurten; Yayla, MuratAmaç: Elektif sezaryen nedeniyle spinal yada genel anestezi yapılan gebelerin, maternal ve yenidoğan kortizol seviyelerini ölçmek.Yöntem: Elektif sezaryen yapılacak gebeler rastgele olarak genel (n=32, Grup 1) ve spinal anestezi (n=39, Grup 2) şeklinde iki gruba ayrıldı. Maternal kortizol seviyeleri sezaryen operasyonun 5.dakikasında ve yenidoğan kord kanı kortizol seviyeleri doğumun 5.dakikasında alındı. İstatistiksel analizde student-t ve Pearson correlation coefficient testi kullanıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi.Bulgular: Maternal kortizol seviyeleri genel anestezi alan grupta (14.20± 2.45 µg/dl) spinal anestezi alan gruba (8.90± 2.18 µg/dl) göre daha yüksekti (p<0.001). Yenidoğan kord kanı kortizol seviyeleri genel anestezi alan grupta (12.88± 5.06 µg/dl) spinal anestezi alan gruba göre daha yüksekti (6.74± 2.61 µg/dl) (p<0.001). Genel ve spinal anestezi alan grupta maternal ve yenidoğan kortizol seviyeleri arasında pozitif korelasyon saptanmadı (p<.05).Sonuç: Spinal anestezi grubunda anne ve yenidoğan kortizol seviyelerini, genel anestezi grubuna göre daha düşük bulduk. Elektif sezaryen ile doğumlarda spinal anestezi anne ve bebeği daha az strese maruz bıraktığı için genel anesteziye göre daha çok tercih edilebilecek bir metod olarak düşünülenilir.Öğe Helicobacter pylorisi pozitif olan gastiritli vakalarda telomeraz aktivitesi(2017) Kale, Ebru; Canoruç, NaimeTelomerler, ökaryotik kromozomların uçlarında yer alan ardışık tekrar dizileridir. Telomerik diziler türden türe değişiklik göstermekte ve insanda TTAGGG tekrar dizilerinden oluşmaktadır. Telomerler yapısal proteinlere spesifik olarak bağlanarak ökaryotik kromozomların stabilitesinin korunmasında önemli bir görev üstlenmektedir. Bu yapısal proteinler, lineer kromozomların uçlarım kapatarak nükleozomlarla yıkılmasını, kromozomların uç-uca gelerek yapışmasını ve yeni düzenlemelerini engellemektedir (1). Bu korunma ile birlikte her hücre siklusunda; uç kısımlara replikasyon probleminden dolayı tekrar dizileri azalmaktadır. Bu işlem normal somatik hücrelerin sınırlı proliferasyon kapasitesi ile ilişkili olup telomeraz aktivitesinin ya hiç olmaması yada giderek azalmasıyla ortaya çıkmaktadır. Ancak yapılan çalışmalarda germ hücrelerinde, kök hücrelerde ve tümör hücrelerindeki ölümsüzlüğün telomeraz enziminin reaktivasyonu ile ilişkili olduğu gösterilmiştir (2). Helicobacter pylori (Hp) gram (-) spiral flajelli bir basildir. Non-invaziv bir bakteri olup gastrik mukozada yaşamaktadır (3). Dünyadaki en yaygın enfeksiyondur. Gelişmekte olan bir çok ülkede toplumun %70'mden fazlası bu ajanla enfektedir. HP'nin kronik süreçte gastrik kanser dahil bir çok hastalığa yol açabildiği rapor edilmektedir. Fakat yapılmış çok sayıdaki çalışmaya rağmen anlaşılamamış çok sayıda detay vardır. Bunlardan biride Hp'ye bağlı tümorogenezisin hangi aşamalar geçilerek oluştuğudur (4). Belki de Hp'ye bağlı öncelikle bir nonspesifik gastritis oluşmakta, daha sonra bazı bireylerde gastrik atrofi ve intestinal metaplazi meydana gelmekte ve bu son lezyonlardan da kanser gelişmektedir. Bu tanımlanan süreç henüz hipotetik aşamadadır, işte bu belirsizlikten yola çıkılarak onkojenik olarak kabul edilen Hp'nin telomeraz aktivitesi üzerine herhangi bir etkisinin olup olmadığım araştırmak istedik. Bu amaçla, Hp ilişkili nonspesifik gastritiste, atrofide ve intestinal metaplazide telomeraz aktivitesini kantitatif olarak ölçüldü ve Sydney sınıflamasına göre kategorize edilen histopatolojik değişiklerin telomeraz aktivitesi ile ilişkisine bakıldı. Bu çalışma Dicle Üniversitesi Tıp Fakültesi Gastroenteroloji Polikliniğine başvurup üst GİS endoskopisi yapılan 172 hasta dahil edildi. Endoskopi sırasında mid-antrumda aynı bölgeden 2 adet ve incisura angularisten 1 adet olmak üzere toplam 3 biyopsi alındı. İncisura angularisten alman biyopsi ile üreaz testi yapılıp, Hp varlığı ortaya kondu. Antrumdan alınan 2 biyopsiden birinde, Sydney sistemine göre histopatolojik inceleme yapıldı. Antrumdan alman diğer biyopsi de, PBS (Phosphate buffer şalin) ile yıkandıktan sonra süratle sıvı azot içeren termosa alınıp donduruldu ve -80°C'lik deepfreeze'e çalışmanın yapılacağı güne kadar 46 saklandı. Doku örneklerinden RNA izolasyonu yapıldıktan sonra elde edilen RNA'da telomeraz enzim (hTERT) düzeyi çalışılıdı. Endoskopi yapılıp biyopsi alınan 172 hastanın; 24'ü histopatolojik değerlendirilmesi sırasında Sydney sınıflaması yapılamadığı için, 29 tanesi ise PBGD ve hTERT düzeyi tespit edilemediği için çalışmaya dahil edilmedi. Geriye kalan 119 hasta çalışmanın temelini oluşturdu. 119 hastanın 75'i kadm, 44'ü erkekti. Yüzondokuz hastanın 51 tanesi Hp negatif (%42.85), 68 tanesi Hp pozitifti (%57.14) (p>0,05). intestinal metaplazi; 119 örneğin 6'sinde pozitif, 113'sinde negatif olarak değerlendirildi. Glandüler atrofi; 92'sinde negatif, 27'sinde olarak, nötrofil aktivasyonu; 57'sinde negatif, 62'sinde pozitif olarak, kronik inflamasyon; 17'sinde negatif, 102'sinde pozitif olarak izlenmiştir. Hp pozitif olan grupta, telomeraz aktivitesi varlığı bakımından kronik inflamasyonu, nötrofil aktivitesi, glandüler atrofisi, intestinal metaplazisi pozitif ile negatif olanlar arasında istatistiksel açıdan fark bulunamadı. Hp negatif olan grupta, telomeraz aktivitesi varlığı bakımından kronik inflamasyonu, nötrofil aktivitesi, glandüler atrofisi pozitif ile negatif olanlar arasında istatistiksel açıdan fark bulunamadı. Sonuç olarak çalışmamızda, gastritisli hastalarda nötrofil aktivitesi ve kronik inflamasyon varlığında Hp enfeksiyonu ile telomeraz aktivitesi arasında herhangi bir ilişkisi olmadığım saptadık. Gastrik karsinogenezisin erken basamakları olan intestinal metaplazili ve glandüler atrofili Hp pozitif örneklerde, ' Hp negatif olanlara göre daha yüksek hTERT aktivitesi saptanmasına rağmen istatistiksel olarak anlamlı bulunamamıştır. Belki de telomeraz aktivitesi değerinin hesaplanmasında değişik yöntemlerin kullanılması, diğer çalışmalara göre farklılığı yaratmaktadır. Bizim bulgularımız sonucunda, onkojenik bir bakteri olan helicobacter pylori'nin neden olduğu, nonspesifik gastritis, intestinal metaplazi ve glandüler atrofi ile telomeraz aktivitesi arasında bir bağlantı bulunamamıştır. Belki de onkojenik özelliği olan Hp, intestinal metaplaziden sonraki basamaklarda telomeraz aktivitesini artırarak kansere yol açmaktadır. Anahtar Kelimeler: Gastirit, Sydney Sınıflandırması, Helicobacter pylori, TelomerazÖğe The hepatoprotective effect of coumarin and coumarin derivates on carbon tetrachloride-induced hepatic injury by antioxidative activities in rats(Springer, 2011) Atmaca, Mukadder; Bilgin, Hakki Murat; Obay, Basra Deniz; Diken, Huda; Kelle, Mustafa; Kale, EbruCoumarins are a vast group of natural compounds and some of them possess antioxidant activities. The comparison of the antioxidant activity of some coumarins with various chemical molecular structure has not been investigated in previous studies. Therefore, this study was aimed to investigate the hepatoprotective effect against carbon tetrachloride (CCl4) -induced hepatic injury by coumarin (1,2-benzopyrone) and coumarin derivatives, esculetin (6,7-dihydroxycoumarin), scoparone (6,7-dimethoxycoumarin), and 4-methylumbelliferone (7-hyroxy-4-methyl) in male Sprague-Dawley rats. Product of lipid peroxidation, malondialdehyde (MDA), activities of antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) were evaluated for oxidative stress in hepatic injury. Gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) were detected in plasma as a biomarker of hepatic injury. Significantly elevated levels of MDA and lowered levels of SOD and CAT activities were observed in liver of rats exposed to CCl4, when compared to control values. Similarly, administration of CCl4 increased LDH and GGT levels in serum. Pre-treatment of rats with esculetin (35 mg kg(-1), orally) and scoparone (35 mg kg(-1), orally) significantly prevented CCl4-induced decrease in MDA levels and increase in SOD and CAT, whereas 4-methylumbelliferone (35 mg kg(-1)) and coumarin (30 mg kg(-1)) had no effect against CCl4-induced rise in serum enzymes. Esculetin and scoparone also showed protective properties as was evidenced in reduced LDH and GGT levels in serum. The results of this study indicate that the chemical structures of coumarins play an important role in the prevention of oxidative stress.Öğe İkinci trimester amniotik sıvı tiroid hormon düzeyleri ile gestasyonel hafta arasındaki ilişki(2006) Kale, Ahmet; Akdeniz, Nurten; Yakınkaya, Ahmet; Yayla, Murat; Kale, EbruAmaç : Amniosentez uygulanan gebelerin amnion mayilerindeki tiroid hormon düzeylerini ölçmek ve bu değerlerin gestasyonel hafta ile olan ilişkisini değerlendirmek. Yöntem : Çalışmaya,Mayıs 2004 ile Mayıs 2005 tarihleri arasında prenatal tanı amacıyla,kliniğimizde amniosentez yapılan toplam 125 gebe dahil edildi.Tiroid hormon analizleri,1ml amnion sıvısında,Roche E170 Modular analytics (Hitachi,Japan) cihazı ile,Roche marka ticari kit kullanılarak gerçekleştirildi.Veriler,istatistiksel olarak One-Way Anova testi kullanılarak karşılaştırıldı,p<0.05 değeri istatistiksel anlamlı olarak kabul edildi.Bulgular : Çalışmaya alınan hastaların ortalama yaşı,34.5 ± 5.6 (21-40) yıl idi.Amniosentez uygulanan olguların ortalama gebelik haftası,17.88 ± 1.58 (16-20) olarak bulundu.Tüm hastalarn amniosentez sonucu normal karyotip olarak tesbit edildi.Olguların amnion sıvısındaki total T4 ve serbest tiroksin (fT4) seviyeleri,gestasyonel hafta artıkça progresif olarak artış gösterdi(p<0.001).Buna karşılık total T4 , serbest triiodotronin (fT4) ve TSH seviyeleri gestasyonel hafta ile birlikte progresif olarak artış göstermedi(p>0.05).Sonuç : Amnion sıvısındaki tiroksin (T4) hormonun miktarının,T3 ve TSH’a göre daha fazla olduğunu bulduk ve bu hormona olan ihtiyacın gebelik haftası arttıkça belirginleştiğini düşünüyoruz.Öğe Karaciğer hastalarında (siroz veya hepatit) homosistein ve selenyum düzeyleri(Türk Gastroenteroloji Vakfı, 2006) Canoruç, Naime; Canoruç, Fikri; Aslan, Çetin; Yılmaz, Şerif; Turgut, Cengiz; Dursun, Mehmet; Akkuş, Zeki; Kale, EbruGiriş ve amaç: Homosisteinin sentezinde ve metabolizmas›nda karaciğer önemli bir rol oynar. Karaciğer hasar› oluştuğunda homosisteinin metabolizmas›nda önemli değişiklikler meydana gelmektedir. Selenyum düzeyinin karaciğer hasar›nda düştüğü rapor edilmektedir. Yine selenyum eksikliğinde karaciğerde önemli değişikliklerin olduğu ifade edilmekte ve patogenezdeki rolü araşt›r›lmaktad›r. Çal›şmam›zda karaciğer hasar›nda homosistein ve selenyum düzeylerinde meydana gelen değişiklikleri ve bu değişikliklere etki edebilecek faktörleri incelemeyi amaçlad›k. Gereç ve yöntem: Çal›şmaya 22 kronik hepatitli (E: 12, K: 10; yaş ortalamalar›: 43,90±15,02), 28 sirozlu (E: 25, K: 3; yaş ortalamalar›: 42,50±16,00) hasta ile, 20 sağl›kl› kontrol grubu (E: 12, K: 8; yaş ortalamalar›: 36.65±8.29) dahil edildi. Etyolojik dağ›l›m: 36’s› Hepatit B virusu, 7’si Hepatit C virusu, 3’ü Hepatit B virusu + Hepatit D virusu, 1’i Wilson hastas›yd›. Üç olgu kriptojenik sirozluydu. High Performance Liquide Chromotography (HPLC) cihaz›nda floresan dedektörle homosistein; atomik absorbsyon cihaz›nda grafit modunda selenyum; Abotte Aeroset otoanalizor cihaz›nda fotometrik yöntemle ALT, AST, GGT, albumin düzeyleri; Roche E170 modüler analitik sistem ile, kemiluminesans metodu kullan›larak B12 ve folat düzeyleri çal›ş›ld›. Metilen tetrahidrofolat redüktaz (MTHFR) geni ise, hastalardan al›nan tam kan örneklerinden elde edilen DNA’lar kullan›larak incelendi. Bulgular: Her 3 grubun yaşlar› aras›nda fark saptanmad›. Hem kronik hepatit hem de siroz grubundaki homosistein düzeylerinin kontrol grubundan istatistiksel olarak daha yüksek olduğu saptand› (p=0.001). Kronik hepatit grubu ile siroz grubunun homosistein düzeyleri aras›nda fark saptanmad›. Öte yandan, kronik hepatit ile kontrol grubu aras›nda vitamin B12 düzeyi aç›s›ndan fark yoktu. Siroz grubunda vitamin B12 düzeyinin kontrol grubundan istatistiksel olarak daha yüksek olduğu izlendi. Folat düzeyi bak›m›ndan gruplar aras›nda fark saptanmad›. MTHFR gen mutasyonu bak›m›ndan da hasta ve kontrol gruplar› aras›nda fark saptanmad›. Her iki hastal›k grubundaki selenyum düzeyinin kontrol grubundan daha düşük olduğu görüldü (p=0.001). Sonuç: Sonuçlar›m›z göstermektedir ki sirozlu ve kronik hepatitli hastalarda gözlenen hiperhomosisteinemi folat, vitamin B12 eksikliği ve MTHFR gen mutasyonu ile ilgili değildir. Homosistein metabolizmas›nda görev alan diğer enzimlerin rollerinin olabileceği anlaş›lmaktad›r. Kronik hepatit ve sirozlularda belirgin selenyum eksikliğinin varl›ğ› dikkat çekicidir.Öğe A New and Practical Aspartate Aminotransferase Test in Vaginal Washing Fluid for the Detection of Preterm Premature Rupture of Membranes(Karger, 2008) Kale, Ebru; Kuyumcuoglu, Umur; Kale, Ahmet; Guezel, Ali Irfan; Canoruc, NaimeObjectives: To determine whether measurement of aspartate aminotransferase (Ast) and alanine aminotransferase (Alt) levels in vaginal fluid is useful for the diagnosis of preterm premature rupture of membranes (PPROM). Study Design: The PPROM group and normal pregnancy group consisted of 36 and 48 pregnant patients between 26 and 36 weeks' gestation, respectively. Vaginal fluid Ast and Alt levels were measured in both groups. Results: Vaginal fluid Alt level was not statistically significant in the PPROM group as compared with the control group (p = 0.064). Vaginal Ast level was statistically significant in the PPROM (14.4 +/- 17.46 U/l) group as compared with the control group (3.08 +/- 7.8 U/l; p = 0.001). The optimal cutoff value of 3 IU/l for Ast gave a sensitivity level of 91% at a specificity of 83%, with positive and negative predictive values of 80 and 93%, respectively. Conclusion: Ast measurement from vaginal washing fluid appears to be a useful marker for the detection of PPROM. Copyright (C) 2008 S. Karger AG, BaselÖğe Plasma resistin and leptin levels in overweight and lean patients with rheumatoid arthritis(Tubitak Scientific & Technological Research Council Turkey, 2009) Canoruc, Naime; Kale, Ebru; Turhanoglu, Ayse Dicle; Ozmen, Sehmus; Ogun, Ceyla; Kaplan, AbdurahmanAim: Adipocytokines; are now considered important players in the etiopathogenesis of numerous metabolic and inflammatory disorders. However, plasma leptin and resistin levels in rheumatoid arthritis (RA) are still unclear. We aimed to investigate the plasma levels of leptin and resistin in patients with rheumatoid arthritis and to compare them with controls. Materials and Methods: Consecutive 52 patients with RA were compared with 52 control subjects in terms of mean leptin and resistin levels. Results: Patients with RA showed considerably higher plasma levels of leptin (34.3 +/- 27.9 vs. 11.1 +/- 4.1) and resistin (4.8 +/- 0.7 vs. 4.0 +/- 1.3) than healthy controls (P < 0.0001). There was no significant difference regarding age, duration of disease, sex, CRP, and leptin and resistin levels between overweight and lean RA Subjects. Plasma leptin level was significantly correlated with ESR (Erythrocyte Sedimentation Rate) (r = 0.287, P = 0.039) and swollen and tender joint count (r = 0.563, P < 0.0001) but not with resistin in subjects with RA. Measuring the plasma leptin level may be a potential marker of disease activity in RA. Conclusions: Studies including more RA patients might be needed to define the role of leptin and resistin in RA subjects.Öğe Preeklamptik gebelerde folik asit, vitamin B12, vitamin B6 ve homosistein düzeylerinin araştırılması(2006) Kale, Ahmet; Erdemoğlu, Mahmut; Akdeniz, Nurten; Yalınkaya, Ahmet; Yayla, Murat; Kale, EbruAmaç : Preeklampsi ile serum folik asit,serum vitamin B12,plazma vitamin B6 (piridoksal 5 fosfat) ve plazma homosistein düzeyleri arasındaki ilişkinin araştırılması. Yöntem : Eylül 2004-Ağustos 2005 tarihleri arasında,kliniğimize başvuran ve preeklampsi tanısı alan 100 gebe ile herhangi bir medikal problemi olmayan 74 sağlıklı gebe çalışmaya dahil edildi.Bütün hastalardan gebeliğin 3.trimesterinde serum vitamin B12,serum folik asit,plazma vitamin B6 ve plazma homosistein konsantrasyonları ölçüldü.Bulgular : Vitamin B12 serum düzeyleri preeklampsi ve kontrol grupları arasında benzerdi (sırası ile; 117.44±42.03 pg/ml,136.07±59.01 pg/ml,p>0.05).Vitamin B6 (piridoksal 5 fosfat) plazma düzeyi preeklampsi grubunda kontrol grubuna göre düşük bulundu (sırası ile; 6.40±2.91 µg/l,11.15±5.76 µg/l,p<0.001).Folik asit serum düzeyi preeklampsi grubunda daha düşük saptandı (sırası ile;5.43±3.08 ng/ml, 8.00±5.1 ng/ml, p<0.001).Homosistein plazma düzeyi ise preeklampsi grubunda kontrol grubuna göre anlamlı oranda yüksekti (sırası ile; 10.50±6.21 µmol/L, 6.54±2.64 µmol/L, p<0.001).Sonuç : Yüksek homosistein konsantrasyonu ile düşük folik asit ve vitamin B6 düzeyleri preeklampsinin patogenezinde rol oynayabilir.Öğe Preeklasmpside kardiyak troponin I, CK-MB ve myoglobin değerleri(2005) Kale, Ahmet; Kale, Ebru; Ecer, SultanPreeklamptik gebeliklerdeki troponin I, kreatin fosfokinaz ve myoglobin değerleri normal gebelerdeki değerlerle karşılaştırılarak preeklampsideki minör myokardiyal hasar araştırıldı. Çalışmaya; 45 gebeden oluşan preeklamptik grup (grup 1) ve 45 gebeden oluşan kontrol grubu (grup2) olmak üzere iki grup dahil edildi. Oluşturulan iki grup yaş, parite, troponin I, kreatin fosfokinaz, miyoglobin değerleri açısından karşılaştırıldı. İstatistiksel analizde student-t testi kullanıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Preeklamptik grupta; kardiak troponin I değerleri (0,97 ± 0,11ng/ml) kontrol grubuna (0,12 ± 0.09 ng/ml ) göre anlamlı derecede yüksek bulundu (p<0.001). Preeklamptik grupta kardiak kreatin fosfokinaz değeri; 16,1 ± 4,8 U/L , kontrol grubunda ise 14,8 ± 5,6 U/L olarak saptandı (p>0.05). Preeklamptik grupta myoglobin değeri 35,2 ± 6,1 mg/dl , kontrol grubunda ise 32,8 ± 7,3 mg/dl saptandı (p>0.05 ). Sonuç olarak; minor myokardiyal hasarın en iyi göstergelerinden biri olan troponin-I'in preeklamptik gebelerde yüksek saptanması, preeklamptik gebeliklerde kardiyak myofibriller hasarı düşündürmektedir.Öğe Proposal of a diagnostic test for the detection of preterm premature rupture of membranes based on the determination of thyroid hormones in vaginal washing fluid(Karger, 2007) Kale, Ahmet; Kale, Ebru; Akdeniz, Nurten; Kuyumcuoglu, U.; Canoruc, N.Objectives: To determine whether measurement of total T3 (triiodothyronine), total T4 (thyroxine), free T3 (free triiodothyronine) and free T4 (free thyroxine) levels in vaginal fluid is useful for the diagnosis of preterm premature rupture of membranes (PPROM). Study Design: The PPROM group and normal pregnancy group consisted of 30 and 30 pregnant patients between 26 and 36 weeks' gestation, respectively. Vaginal fluid total T4, free T4, total T3 and free T3 levels were measured in both groups. Results: Vaginal fluid total T3 and free T3 levels were not statistically significant in the PPROM group as compared with the control group (p = 0.087, p = 0.123, respectively). Vaginal fluid total T4 and free T4 levels were significantly higher in the PPROM group as compared with the control group (p = 0.002, p < 0.000, respectively). The optimal cut-off value for total T4 (0.866 mu g/dl) gave a sensitivity level of 83.3% (65.3-94.3, 95% CI) at a specificity of 60.0% (40.6-77.3, 95% CI) with positive and negative predictive values of 67.6 and 78.3%, respectively. The optimal cut-off value for free T4 ( 0.079 ng/dl) gave a sensitivity level of 90% (73.4-97.8, 95% CI) at a specificity of 70.0% (50.6-85.2, 95% CI) with positive and negative predictive values of 75.0 and 87.5%, respectively. Conclusions: Total and free T4 measurements from vaginal fluids appears to be a useful marker of PPROM. Copyright (c) 2007 S. Karger AG, Basel.Öğe The role of serum osteoprotegerin and S-100 protein levels in patients with acute ischaemic stroke: Determination of stroke subtype, severity and mortality(SAGE Publications Ltd, 2011) Üstündaǧ, Mehmet; Orak, Murat; Güloǧlu, Cahfer; Tamam, Yusuf; Sayhan, Mustafa Burak; Kale, EbruThis study investigated correlations between mortality, stroke subtype and stroke severity with serum osteoprotegerin (OPG) and S-100 protein levels prior to the treatment of patients admitted to the emergency department and diagnosed with ischaemic stroke. Pretreatment serum samples were collected from patients (n = 90) to determine OPG and S-100 protein levels. Age- and sex-matched healthy individuals (n = 16) served as controls. Compared with controls, OPG and S-100 protein levels were significantly higher in the cardioembolic and atherothrombotic stroke groups. Within the stroke group, OPG levels were significantly higher in the cardioembolic and atherothrombotic stroke groups compared with the transient ischaemic attack (TIA) group. S-100 protein levels were significantly higher in the atherothrombotic stroke group than in the lacunar stroke and TIA groups, and in the cardioembolic stroke group compared with the lacunar stroke group. Serum OPG and S-100 protein levels were significantly higher in patients who died compared with survivors. In predicting stroke subtype and severity, although both OPG and S-100 protein levels were indicators, S-100 protein was more valuable for mortality prediction.Öğe The role of the heart-type fatty acid binding protein in the early diagnosis of acute coronary syndrome and its comparison with troponin I and creatine kinase-MB isoform(W B Saunders Co-Elsevier Inc, 2010) Orak, Murat; Ustundag, Mehmet; Guloglu, Cahfer; Ozhasenekler, Ayhan; Alyan, Omer; Kale, EbruObjectives: The aim of this study was to research the effectiveness of the heart-type fatty acid binding protein (H-FABP) in the early diagnosis of acute coronary syndrome (ACS) in patients admitted to emergency service (ES) within 6 hours of onset of chest pain. Equipment and Method: A total of 83 patients admitted with chest pain to our ES were included in this study. The patients were divided into 2 groups: those with a diagnosed ACS and those diagnosed with non cardiac-related chest pain. Patients were also were divided into 2 groups according to the time of admission: those admitted within 0 to 3 hours and 3 to 6 hours of onset of chest pain. Peripheral venous blood samples were obtained from all patients for H-FABP, troponin I, and creatine kinase-MB (CK-MB) serum concentration measurements. Results: Of a total of 83 patients, 21.6% (n = 18) were in the control group and 78.3% (n = 65) were in the ACS group. The average H-FABP value for the patients in the control group was 0.86 +/- 0.54 ng/mL. When the ACS and control groups were compared in means of cardiac markers for CK-MB (P = .000) and H-FABP (P = .000), there was a statistically significant difference, whereas no difference was observed for troponin I (P = .013). In the ACS group, H-FABP sensitivity for diagnosis was found to be 98% and specificity was 71%; CK-MB sensitivity was 86% and specificity was 52%; and troponin 1 sensitivity was 77% and specificity was 20%. Conclusions: For patients admitted with chest pain to ES, H-FABP was found to be more sensitive and specific than troponin I and CK-MB in the early diagnosis of ACS. (C) 2010 Elsevier Inc. All rights reserved.Öğe Serum resistin and adiponectin levels in young non-obese women with polycystic ovary syndrome(Taylor & Francis Ltd, 2010) Arikan, Senay; Bahceci, Mithat; Tuzcu, Alpaslan; Kale, Ebru; Gokalp, DenizSubjects and methods. Newly diagnosed 31 young non-obese women with PCOS (mean age 21.8 +/- 5.4 years; body mass index (BMI): 23.8 +/- 6.6 kg/m
