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    The association between NT-proBNP levels, functional capacity and stage in patients with heart failure
    (Taylor & Francis Ltd, 2005) Karabulut, A; Kaplan, A; Aslan, C; Iltumur, K; Toprak, G; Toprak, N
    Objective - Amino-terminal probrain natriuretic peptide (NT-proBNP), a biologically inactive derivative of BNP, is clinically more useful owing to its longer half-life, higher plasma concentrations, lesser variation among individuals, and higher in vitro stability. In this regard, NT-proBNP may be a better indicator of the severity of ventricular dysfunction. In this study, the association of NT-proBNP levels with functional capacity and stage of heart failure was explored in patients with CHF Also, we particularly focused on the presence and significance of neurohormonal activation in the group of patients classified as stage-A according to ACC/AHA guidelines. Methods and results - 64 patients with CHF (31 men, 33 women; mean age 58.26 +/- 10.59 y) and 36 healthy controls (24 men, 12 women; mean age 57.47 +/- 10.83) were included in this study. The New York Heart Association (NYHA) classification system (I, II, III, IV) was used to define the functional capacity; and the stage of the heart failure was based on the ACC/AHA guidelines (A, B, C, D). Healthy female participants had higher NT-proBNP levels compared to their male counterparts (p < 0.001). Left ventricular ejection fraction (LVEF) did not correlate significantly with functional capacity and stage of the disease. CHF patients had higher NT-proBNP compared to controls (p < 0.001). There was a positive correlation between NT-proBNP and functional capacity in patients, and NT-proBNP increased significantly with each increasing class of the disease. Similarly, a positive correlation existed between the stage of heart failure and NT-proBNP levels, which increased significantly with increasing stages of the disease. Patients with NYHA I and stage A disease had higher NT-proBNP levels compared to controls (p = 0.04). Conclusions - The severity of CHF can be objectively assessed by measuring the circulating levels of NT-proBNP. Even in NYHA I and stage A disease, NT-proBNP levels are higher compared to controls (p = 0.04). NT-proBNP can provide objective information regarding the severity of the disease and also aid in treatment decisions in patients with CHF.
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    In vitro NMR proton T-1 measurements in peritoneal ascites
    (Iop Publishing Ltd, 1996) Yilmaz, A; Tez, M; Goral, V; Boylu, S; Kaplan, A; Kavak, G
    The proton spin-lattice relaxation rate (1/T-1) in malignant and non-malignant ascites was measured with an FT NMR spectrometer operating at 60 MHz. The mean relaxation rate in non-malignant ascites was significantly smaller than that of malignant ascites. However, the 1/T-1 of malignant ascites overlaps with that of non-malignant ascites over all concentrations of total protein (TP) in samples. The 1/T-1 in non-malignant ascites correlates strongly with TP, whilst the 1/T-1 in malignant ascites shows only a moderate correlation. T-1 measurements before and after addition of ascorbic acid (reductant) suggest that there is a small paramagnetic contribution of ions to the 1/T-1 in malignant ascites. The least-squares fitting of 1/T-1 versus TP for non-malignant data gives a linear relationship, and suggests that the T-1 mechanism in non-malignant ascites is caused by a fast chemical exchange of water molecules between protein-bound water and free water.
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    In vitro NMR proton T-1 measurements in peritoneal ascites.
    (W B Saunders Co-Elsevier Inc, 1997) Goral, V; Yilmaz, A; Tez, M; Boylu, S; Kaplan, A; Kavak, G
    [Abstract Not Available]
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    Insulin response to oral glucose loading and coronary artery disease in nondiabetics
    (Int Heart Journal Assoc, 2005) Karabulut, A; Iltumur, K; Toprak, N; Tuzcu, AK; Kara, IH; Kaplan, A; Aksu, Y
    Hyperinsulinemia is related to coronary artery disease (CAD), as an indication of decreased insulin sensitivity. Although there are man), Studies showing the relation between fasting insulin levels and insulin resistance. there are fewer studies on postprandial insulin levels. The aim of the present Study was to investigate the relationship between postprandial insulin levels and CAD and its extent in our patients. For this purpose, oral glucose tolerance testing was performed in 222 patients with no known diabetes and who were scheduled to undergo diagnostic coronary angiography. The patients were first separated into two groups, one group (group I) having an insulin response within reference values to oral glucose loading, and the other group (group II) with a higher than normal insulin response. The presence and extent of CAD in the two groups were compared. While 65% of the patients in group I had CAD, this rate increased to 79% in group 2 patients (P = 0.02). The mean vessel scores were 0.92 +/- 0.78 in group I and 1.67 +/- 0.99 (P < 0.0001) in group 2 patients. The stenosis scores were 2.192 +/- 2.077 in group I and 5.588 +/- 3.519 (P < 0.001) in group 2, while the extent scores were 1.230 +/- 1.292 in group I and 2.729 +/- 1.847 in group 2 (P < 0.0001). The differences between the two groups were significant. Postprandial insulin values were positively correlated with CAD (P = 0.001, r = 0.214), vessel scores (P < 0.0001, r = 0.326), stenosis scores (P < 0.0001. r = 0.261), and extent scores (P < 0.0001, r = 0.419). Logistic regression analysis revealed hyperinsulinemia increased CAD independent from the other risk factors (OR = 5.742 CI 95%: 1.809-18.227, P = 0.003).
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    Serum levels of carnitine, apolipoprotein A I, and apolipoprotein B in children with nephrotic proteinuria
    (Springer Verlag, 1996) Bircan, Z; Kaplan, A; Soker, M; Batun, S; Sahin, A; Soran, M
    [Abstract Not Available]
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    Sialic acid in childhood renal diseases: Correlation with clinical and laboratory indices
    (Blackwell Science, 1998) Bircan, Z; Batun, S; Kervancioglu, M; Soran, M; Kaplan, A; Onur, H; Demir, F
    There are many kinds of glycoproteins that have sialic acid residues and it has been reported that these are elevated in some renal diseases and their significance in the pathogenesis of several renal diseases has been investigated. In the present study the serum and urine levels of sialic acid were measured in healthy controls and in children with either poststreptococcal acute glomerulonephritis (PSAGN) or minimal change nephrotic syndrome (MCNS) to test if there is any correlation with clinical and laboratory indices. In PSAGN and MCNS patients the serum and urine sialic acid concentrations at onset and relapse were significantly different from healthy controls (Mann-Whitney U-test P < 0.005). There was not a significant correlation between the clinical severity, serum creatinine and complement C-3 levels and serum sialic acid concentrations in PSAGN patients. Also there was not a significant correlation between edema, serum albumin, IgG, transferrin, alpha-1-antitrypsin and serum sialic acid concentrations in MCNS patients. Although high serum and urine sialic acid levels were found in both PSAGN and MCNS patients, it does not have any clinical significance nor is it important as a diagnostic or prognostic marker.