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- ArticleAçık Erişim2022Serviks Dokularında HPV DNA Pozitifliği ve Osteopontin Düzeyi Arasındaki İlişkinin Araştırılması
Arslan, Yusuf Kemal; Mertoglu, Cuma; Sayar, Ilyas; Aydın, Merve; Çıkman, Aytekin; Kulhan, Mehmet; Gülhan, Barış; Demir, Esra Tuba; Kulhan, Nur Gözde
Amaç: Çalışmamızda, HPV pozitif ve HPV negatif serviks dokularında osteopontin düzeyinin araştırılması, prognostik bir biyobelirteç olarak tanıda klinik öneminin değerlendirilmesi amaçlandı. Yöntem: Haziran 2015-Nisan 2017 tarihleri arasında Erzincan Binali Yıldırım Üniversitesi, Mengücek Gazi Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Polikliniği’ne başvuran ve serviks kanseri taramasına katılan 82 kişi çalışmaya alındı. Servikovajinal sürüntü örnekleri, standart işlem prosedürüne göre toplandı. Geleneksel Pap sitolojisi için slayt hazırlanarak, standart protokollere göre boyandı ve sonuçlar 2004 Bethesda sınıflandırma sistemine göre derecelendirildi. Digene konik fırça örnekleyicisi ile serviksten örnek alındı. Tüm servikal örnekler, Digene® HC2 High-Risk HPV DNA Kiti ile analiz edildi. HPV DNA pozitifliği saptanan örneklere CLART kit ile genotipleme yapıldı. 41 HPV pozitif hasta ve 41 HPV negatif kontrolün doku örneklerinde osteopontin düzeyleri ELISA kiti ile araştırıldı. Bulgular: Osteopontin düzeyleri hasta grubunda 31.55±7.11 ng/ml, kontrol grubunda ise 28.81±5.44 ng/ml olarak saptandı. Hasta grubu ile kontrol grubu arasında istatistiksel olarak anlamlı fark saptandı (p=0.048). Osteopontin düzeyi ile yaş, doğum şekli, hastalık öyküsü, operasyon yöntemi, HPV tipi, preoperatif ve postoperatif patoloji, gravida ve parite arasında istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Sonuç: Çalışmamızda, HPV pozitif 41 hastadan yalnızca 5’inde servikal intraepitelyal neoplazi saptanması çalışmamızın kısıtlayıcı yanını oluşturmaktadır. Osteopontin düzeyi, HPV pozitif hastalarda yüksek bulunmasına rağmen, daha geniş sayıda servikal intraepitelyal neoplazi olguları üzerinde yapılacak olan çalışmalara gereksinim olduğunu düşünmekteyiz.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2022Gebeliğin Intrahepatik Kolestazı ve Maternal-Fetal Sonuçları
Arslan, Yusuf Kemal; Astepe, Bahar Sarıibrahim; Kiremitli, Tunay; Ulug, Pasa; Uzel, Kemine; Bilir, Filiz
Amaç: Sıklıkla ikinci trimesterin sonlarından itibaren ortaya çıkan intrahepatik gebelik kolestazı, gebelik döneminde görülen yaygın bir karaciğer hastalığıdır. Coğrafi varyasyonlara bağlı olarak genel insidansı %1 -%27,6 arasında değişmektedir. Bu çalışma, üniversite hastanemizde Gebeliğin İntrahepatik Kolestazı tanılı kadınların maternal ve fetal sonuçlarını bildirmeyi amaçladı. Materyal ve Metot: Çalışma Eğitim ve Araştırma Hastanemizde, Haziran 2018-Aralık 2020 tarihleri arasında Gebeliğin İntrahepatik Kolestazı (GİK) ile komplike olan 44 gebede retrospektif olarak yapıldı. Çalışmaya dahil edilen olguların (n=44) demografik özellikleri, karaciğer enzimleri, tanı aldığı gebelik haftası, doğum şekli ve zamanı, doğumda APGAR skorları, yenidoğanın kilosu ve hasta bilgileri hastane kayıtlarından alındı. Bulgular: Primipar kadın sayısı 27 (%61) idi. 4 (%9,1) kadında preeklampsi ve 4 (%9,1) kadında gestasyonel diabetes mellitus (GDM) izlendi. Yenidoğanlardan sadece birinde doğumda 1. ve 5. dakika APGAR scorları sırasıyla 0 ve 0 idi.Sonuç: Çalışmamızda herhangi bir olumsuz maternal sonuç gözlenmemesine rağmen, bir perinatal ölüm izlendi. GİK'nin bireysel olarak yönetilmesini öneririz. Komplikasyonların önlenmesinde yakın takip ve aktif yönetim gereklidir.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2022Uzaktan Eğitimde Bilgisayar Uyarlamalı Test ve Kağıt-Kalem Testi ile\rYetenek Düzeylerinin Belirlenmesi: Çok Merkezli Gerçek Veri\rUygulaması
Arslan, Yusuf Kemal; Çolak, Mergül; Bilgin, Ülviye
Amaç: İçinde bulunduğumuz Covid-19 pandemi sürecinde uzaktan eğitimin popüler hale gelmesi ile\ryapılan çevrimiçi sınavlarda kişilerin yetenek düzeyini daha doğru şekilde belirlemek ve sınav\rstratejilerini çözümlemek için bilgisayar uyarlamalı test kullanımı giderek önem kazanmaktadır. Bu\rçalışmada, uzaktan eğitim sürecinde öğrencilerin yetenek düzeylerinin\rbilgisayar uyarlamalı test ve kağıt-kalem testi ile kestirimlerinin\rkarşılaştırılması amaçlanmıştır.\rYöntem: Araştırma, Mart 2020 – Aralık 2020 tarihleri arasında\rgerçekleştirilen kesitsel ve metodolojik bir araştırmadır. Araştırmanın\rçalışma evrenini Erzincan Binali Yıldırım Üniversitesi, Gazi Üniversitesi,\rErciyes Üniversitesi ve Kastamonu Üniversitesi Spor Bilimleri\rFakültelerinde öğrenim gören beden eğitimi ve spor öğretmenliği 4. sınıf\röğrencileri oluşturmaktadır. Bu çalışmada R programlama dili (ver. 3.6.2)\rve RStudio (ver. 1.2.5033) yazılımı kullanılarak analizler\rgerçekleştirilmiştir. Kişi sayısı 176; madde bankasındaki madde sayısı 80 (4\rfarklı alanın (egzersiz fizyolojisi, psikomotor gelişim, antrenman bilgisi,\regzersiz ve beslenme) her birinden uzmanlar tarafından hazırlanan 20’şer\rsoru ile oluşturulmuştur); bilgisayar uyarlamalı test durdurma kriteri için\rstandart hata <0,5 olarak alınmıştır. Kağıt-kalem testi ve bilgisayar\ruyarlamalı test θ değerlerinin uyumları sınıf içi korelasyon katsayısı ile\rdeğerlendirilmiştir. Kişilere ait bilgisayar uyarlamalı test kestirimleri catR paketindeki “randomCAT”\rfonksiyonu ile gerçekleştirilmiştir. Bilgisayar uyarlamalı testten elde edilen kişinin yetenek düzeyi, θ’ya\rait standart hata ve kullanılan madde sayısı analiz sonucunda sunulmuştur. Bilgisayar uyarlamalı testte\rmadde seçimi için maksimum Fisher bilgi kriteri kullanılmıştır. Yetenek düzeyi kestirimlerinde iteratif\ryaklaşımlar için en çok olabilirlik kestirimi kullanılmıştır. Bulgular: Klasik test skoru (0-100 skalasında) ve bilgisayar uyarlamalı test arasında orta düzeyde uyum\rsaptanmıştır (sınıf içi korelasyon katsayısı:0,682, güven aralığı %95GA=0,594-0,765, F(175,175)=17,1;\rp<0.001). Çalışmada, kağıt kalem testinden elde edilen cevaplardan madde yanıt teorisi doğrultusunda\relde edilen yetenek düzeyleri ve bilgisayar uyarlamalı test ile yetenek düzeyi kestirimleri incelendiğinde\ruyumun mükemmel düzeyde (sınıf içi korelasyon katsayısı:0,90; %95GA:0,866-0,924) olduğu\rgörülmüştür. Ayrıca bilgisayar uyarlamalı testin kağıt-kalem testine göre soru sayısını %80 oranında\razalttığı bulunmuştur.\rSonuç: Bu çalışmadan elde edilen sonuçlar, bilgisayar uyarlamalı test uygulaması ile daha kısa sürede,\rdaha az madde sayısı ile güvenli sonuçlar elde edilebileceğini ve testin tamamlanmasından kısa süre sonra\rsonuçların izlenebileceğini göstermektedir.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2022Evaluation of Visceral Adiposity Indexes Associated with Atherogenic Plasma Index in Individuals with Type 2 Diabetes; [Tip 2 Diyabetli Bireylerde Aterojenik Plazma İndeksi ile İlişkili Visseral Adipozite İndekslerinin Değerlendirilmesi]
Karahan Yilmaz, Sevil; Özçiçek, Fatih; Mertoğlu, Cuma; Arslan, Yusuf Kemal
Aim: This study was aimed to investigate visceral adiposity indicators and the atherogenic index of plasma (AIP) in type 2 diabetes mellitus (T2DM) patients. Material and Methods: A total of 353 adults aged between 18 and 74 years were included in this study. Bodyweight, height, waist, and hip circumference were measured; fasting blood glucose, HbA1c, and lipid profile (total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) values were analyzed. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), body shape index (ABSI), body roundness index (BRI), conicity index (CI), and AIP levels were calculated. Results: The study included 116 (32.9%) males and 237 (67.1%) females, with a mean age of 57.8±11.5 years. AIP z-scores were found to be directly related to T2DM (OR, 5.03; 95% CI: 1.95-13.01), while VAI z-scores were less associated with T2DM (OR, 1.10; 95% CI: 1.03-1.18). According to the ROC curve analysis, although the area under the curve (AUC) is weak to distinguish diabetic patients with VAI, LAP, and AIP, it is statistically significant (p<0.001, AUC: 0.619, cut-off= 5.1, 95% CI: 0.561-0.677; p=0.007, AUC: 0.583, cut-off= 63.2, 95% CI: 0.523-0.642; and p=0.001, AUC: 0.606, cut-off= 0.4, 95% CI: 0.547-0.665, respectively). Conclusion: VAI, LAP, and AIP are strong predictors of diabetes, AIP is a better predictor of predicting diabetes than VAI and LAP.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim202217-Hydroxyprogesterone Response to Standard Dose Synacthen Stimulation Test in CYP21A2 Heterozygous Carriers and Non-carriers in Symptomatic and Asymptomatic Groups: Meta-analyses
Polat, Seher; Arslan, Yusuf Kemal
Objective: Standard dose synacthen stimulation test (SDSST) is a gold standard screening test for evaluating adrenal gland function. Despite studies using SDSST to identify heterozygosity in CYP21A2, the reliability of the test for this purpose is still controversial. Therefore, the meta-analyses were performed to determine the differences in 17-hydroxyprogesterone (17-OHP) responses to standard dose (0.25 mg) SDSST in the diagnosis of CYP21A2 heterozygous individuals, with or without clinical signs of androgen excess disorders. Methods: PubMed and MEDLINE databases were searched. A total of 1215 subjects (heterozygous carriers n=669, mutation-free controls n=546) were included in the meta-analyses. Results: Basal 17-OHP median/mean levels were 4.156 (3.05-10.5)/5.241 (±2.59) nmol/L and 3.90 (2.20-9.74)/4.67 (±2.62) nmol/L in symptomatic heterozygous carriers and symptomatic mutation-free controls, respectively. Stimulated 17-OHP median/mean levels were 17.29 (14.22-37.2)/19.51 (±7.63) nmol/L and 9.27 (7.32-15.9)/10.77 (±3.48) nmol/L in symptomatic heterozygous carriers and symptomatic mutation-free controls, respectively. Basal 17-OHP median/mean levels were 3.21 (2.64-4.78)/3.33 (±0.84) nmol/L and 3.12 (1.82-3.6)/2.83 (±0.71) nmol/L in asymptomatic heterozygous carriers and asymptomatic mutation-free healthy controls, respectively. Stimulated 17-OHP median/mean levels were 14.16 (12.73-16.37)/14.16 (±1.37) nmol/L and 6.26 (4.9-8.23)/6.48 (±1.2) nmol/L in asymptomatic heterozygous carriers and asymptomatic mutation-free healthy controls, respectively. The cut-off levels for stimulated 17-OHP were 10.48 nmol/L and 13.48 nmol/L for asymptomatic heterozygous and symptomatic heterozygous, respectively. Conclusion: The meta-analyses support the idea that stimulated 17-OHP level has potential for use in identifying CYP21A2 carriers. Besides, considering differences in the basal and stimulated 17-OHP levels in symptomatic heterozygous individuals compared to those who were asymptomatic heterozygous could increase the accuracy of the test.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2022Qualification and quantification of plasma cell-free DNA after long-term storage conditions in patients with benign prostatic hyperplasia (BPH): A pilot study
Bozkurt, Aliseydi; Gürbüzel, Mehmet; Sayar, Ilyas; Baydeniz, Soner; Arslan, Yusuf Kemal
Objectives: Free DNA is used as a cancer biomarker due to its low cost, high applicability, and fast, reliable results compared to invasive methods. This study aimed to evaluate the quantification of plasma-free DNA after long-term storage conditions and perform qualification through single nucleotide polymorphism (SNP) screening based on this DNA. Methods: Plasma-free DNA samples were quickly isolated from the peripheral blood of both the benign prostatic hyperplasia (BPH) and control group participants and then maintained at -80 °C for four years. Upon thawing, first, free DNA was purified and fluorometric measurements were taken to determine the amount of DNA. Subsequently, the rs6983267, rs12628, and rs1799939 SNPs were screened in the CCAT2, HRAS, and RET genes, respectively. Results: Significant results were obtained from the fluorometric measurements in terms of single-stranded DNA (ssDNA) (p<0.001). However, there was no significant difference in SNPs rs6983267, rs12628, and rs1799939 in the BPH group compared to the healthy individuals. Conclusions: The data show that fluorometric ssDNA measurements are suitable for quantifying free DNA. The fact that SNP screening can be done successfully in both healthy people and BPH patients suggests that plasma-free DNA can be stored in the laboratory under appropriate conditions.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2022Effect of Fluid Therapy on Coagulation in COVID-19 Patients in the Intensive Care Unit
Onk, Didem; Işik, Onur; Akyol, Fethi; Karaca, Nurcan Kutluer; Arslan, Yusuf Kemal; Kuyrukluyildiz, Ufuk
Study Objectives: Several studies have evaluated CT pulmonary angiography of COVID-19 patients and reported a 7%–30% increase in the incidence of pulmonary embolism. In this study, it was aimed to investigate the effect of fluid therapy on coagulation in COVID-19 patients in the intensive care unit. Methods: This retrospective study included 120 patients hospitalized in the COVID-19 Intensive Care Unit for more than one week, between August 2020 and February 2021. Blood prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), fibrinogen, troponin, D-dimer levels, platelet count measured at the time of admission (T1, baseline) and one week after admission (T2), and the fluid treatments administered during this period were recorded. Patients were divided into the saline solution (SS) group (n=75), 0.45% saline solution group (0.45%, n=30), and combined fluid therapy group (SS+0.45%, n=15). Results: The change in PT was statistically significant for the SS group (p = 0.005), but not for the 0.45% and SS+0.45% groups (p = 0.625, p = 0.262, respectively). In the SS group, the aPTT levels increased posttreatment (p = 0.005). INR levels were significantly different between SS and SS+0.45% groups (p = 0.008). In the SS group, the INR levels increased between T1 and T2 (p = 0.014). In the SS group, the D-dimer levels significantly increased posttreatment. Conclusion: The D-dimer levels were prominent in the follow-up of the COVID-19 patients. Accordingly, using SS for fluid therapy may increase hypercoagulation and the risk of an embolism when compared to the SS, 0.45%, and combined (SS+0.45%) treatment.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2022Evaluation of the effects of total intravenous anesthesia and inhalation anesthesia on postoperative cognitive recovery; [Bewertung der Auswirkungen einer totalen intravenösen Anästhesie und einer Inhalationsnarkose zur postoperative kognitive Erholung]
Ölmeztürk Karakurt, Tülay Ceren; Kuyrukluyıldız, Ufuk; Onk, Didem; Ünver, Süheyla; Arslan, Yusuf Kemal
Objective: To compare the effects of total intravenous anesthesia (TIVA) and inhalation anesthesia (IA) used in lumbar disc herniectomy on postoperative cognitive recovery based on the mini-mental state examination (MMSE) score and neuron-specific enolase (NSE) levels. Material and methods: The study sample consisted of 80 patients aged 18–65 years who were scheduled for elective lumbar disc herniectomy. The patients were divided into two groups according to the anesthesia technique applied, such as TIVA or IA. The patients in the TIVA group were administered remifentanil and propofol and those in the IA group were administered sevoflurane for maintenance. The MMSE was applied to the patients before the operation and 1h and 24 h postoperatively. Venous blood samples were obtained for the measurement of NSE before the operation and on the 24 h postoperatively. Results: The mean preoperative MMSE scores were similar in the two groups. In the TIVA group, the preoperative and postoperative MMSE scores at 1 h were similar but were higher at 24 h postoperatively compared to the previous two scores (p = 0.001 and p < 0.001, respectively). In the IA group, the preoperative and postoperative 24 h MMSE scores were similar but lower at 1h postoperatively than the other two scores (p = 0.006 and p < 0.001, respectively). In the TIVA group, there was a significant decrease in the postoperative serum NSE levels than the preoperative values (p = 0.038). Conclusion: The use of IA may result in higher cognitive dysfunction 1h after the operation compared to TIVA. The effects of both methods on cognitive functions were similar at 24 h postoperatively.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Validation and Cross-cultural Adaptation and Reliability ofthe Turkish Version of the Michigan Neuropathy ScreeningInstrument in the Eastern Anatolia Region of Turkey
Arslan, Yusuf Kemal; Düzgün, Eren; Tanoglu, Ceyda; Baday-Keskin, Dilek
Aim: Distal symmetric polyneuropathy is a common complication causing foot ulcers and amputations in diabetic patients. TheMichigan Neuropathy Screening Instrument (MNSI) is one of the screening methods of diabetic neuropathy, which also providesa comprehensive foot evaluation. The aim of this study was to evaluate the validation, cross-cultural adaptation, and reliability ofTurkish Version of the MNSI in the Eastern Anatolia region of Turkey.Materials and Methods: One hundred twenty-six patients with diabetes mellitus were randomly assigned to the study. Thequestionnaire section of the MNSI was completed by the patients, and the physical examination section was evaluated by healthprofessionals. Nerve conduction studies were performed to 123 patients as the gold standard for diabetic neuropathy. All nerveconduction studies and patients were evaluated by a neurologist.Results: The inter-rater agreement of questionnaire section [ICC: 0.957 (95% CI: 0.940-0.969), p<0.001] and physical examinationsection [ICC: 0.917 (95% CI: 0.884-0.941), p<0.001] were excellent. The intra-rater agreement of the questionnaire section [ICC: 0.880(95% CI: 0.833-0.914), p<0.001] and physical examination section [ICC: 0.920 (95% Cl: 0.889-0.943), p<0.001] showed a high stability.The area under curve (AUC) for the questionnaire section and physical examination section of the MNSI were 0.588 (p=0.205) and0.880 (p<0.001), respectively. The optimum cut-off value of the physical examination section determined using both Youden’s indexand Index of Union as >3, with the sensitivity of 76.2%, specificity of 91.2%, positive predictive value of 64%, negative predictive valueof 94.9%. Conclusion: The physical examination section of Turkish version of the MNSI is valid and reliable.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Lomber Disk Hernisi Tanısı Alan Türk Hastalarda Genetik Polimorfizim
Arslan, Yusuf Kemal; Ekinci, Bilge; Polat, Seher; Özener, Barış
1930'ların başından itibaren tanımlanan ve tedavi edilen bel fıtığı (LDH), beyin cerrahlarının ilgilendiği ve en yaygın ameliyat nedeni olan hastalıktır. LDH patogenezi hala bilinmemektedir. Bu çalışma kaspsamında hastalıkla ilişkili olduğu belirlenen beş adet tek nükleotid gen polimorfizmlerinin(SNPs) LDH etiyolojisine olan katkısının araştırılması amaçlanmıştır. Çalışmaya LDH tanısı alan erkek ve kadın gönüllüler dahil edimiştir. Polimorfizimlerin tamamı (SOD1 IVS3+35 A>C; SOD2 c.*3409T>A; c.*441A>G; MTHFR p.Ala222Val (c.677C>T) ve PAI-1-844 G>A polimeraz zincir reaksiyonu ve kesim parçası uzunluk polimorfizm (PCR– RFLP) yöntemi kullanılarak analiz edilmiştir. MTHFR677C> T polimorfizminde, “T” editif modelde CC’ye göre CT (OR: 5.69 Cl: 2.4-13.4 p<0.001) ve “T” baskın modelde CC’ye göre TC + TT (OR: 5.69 Cl: 2.4-13.4 p<0.001) genotiplerine sahip olmanın LDH riskini yaklaşık 6 kat artırdığı, “C” resesif modellde ise CT + TT'ye karşı CC genotipine sahip olmanın LDH riskini yaklaşık 6 kat (OR: 5.68 Cl: 2.4-13.5 p<0.001) azalttığı belirlenmiştir. MTHFR c.677C>T/PAI-1- 844G>A genotiplerinin ikili analizlerinde, CC genotipinin, koruyucu etkisinin AG genotipi ile birlikteliğinde arttırdığı (OR: 8.4 Cl:2.2-3.1 P<0.001), buna karşın TG genotipinin neden olduğu LDH riskini azalttığı (OR: 4.4 Cl: 1.5-12.1 P=0.005) belirlenmiştir. Benzer bir sonuç araştırılan SOD1 ve SOD2 varyantları için belirlenmemiştir. Çalışma grubumuzda MTHFR677C> T polimorfizmine bağlı olarak artan LDH riski ilk defa bu çalışma ile belirlenmiştir.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2021Quantification of cell-free DNA from bladder cancer patients after long-term storage and its use in determining CCAT2, HRAS, and RET polymorphism: A pilot study
Arslan, Yusuf Kemal; Sayar, Ilyas; Gürbüzel, Mehmet; Bozkurt, Aliseydi; Baydeniz, Soner Baydeniz
Aim: The level of free DNA is used as a cancer biomarker due to having several advantages related to lower cost, easy applicability, and rapid results compared to invasive methods. Materials and Methods: This study investigated whether or not free DNA functions as intended when stored. The free DNA isolated for this purpose was kept at –80 degrees for four years. Then, the level of free DNA was measured in patients with bladder cancer by both photometric and fluorometric methods, and it was investigated whether this biomarker was effective in determining Single Nucleotide Polymorphisms (SNP). The gene names and the reference numbers of the locations where polymorphism was expected were as follows: CCAT2 (rs6983267), HRAS (rs12628), and RET (rs1799939). Results: According to the results, having the T allele at rs12628 increases the risk of disease by 2.6 times (OR: 2.60; 95% CI: 1.10– 6.10) and having the G allele at rs1799939 increases the risk of disease 2.7 times (OR: 2.70; 95% CI: 1.12–6.69). Conclusions: The general findings showed that fluorometric measurements were more advantageous when considering the sensitivity of free DNA measurements. It was also concluded that, if treated rapidly and conserved in appropriate laboratory conditions, free DNA can be effectively used in SNP studies. This study provides important data to demonstrate the quality of free DNA.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Evaluation of peripheral nerves in patients receiving anti-tumor \rnecrosis factor-alpha drug therapy
Arslan, Yusuf Kemal; Ekinci, Bilge; Yaşar, Hasan
Aim: Anti-tumor necrosis factor-alpha (TNF-α) drug treatments are widely used in many inflammatory diseases. \rNeurological complications have rarely been reported in these treatments. Our aim in this study was to \rinvestigate the neurological findings that occurred in our patients receiving this treatment.\rMethods: A case-control study conducted in (institutional information was blinded) between September 2018-\rSeptember 2019. The study included 35 patients receiving tumor necrosis factor-alpha blocker drug, and 37 \rhealthy control subjects with similar demographic characteristics. The disease activity scores of the patient \rgroup and physical function scores of the patient and control groups were questioned. All patients underwent a \rdetailed physical and neurological examination. Afterward, peripheral nerves were evaluated \rneurophysiologically. According to distribution Mann-Whitney U test or independent samples t-test was used \rwhen comparing groups. The relationship between Short Form-36 and age or body mass index was determined \rby using Spearman’s rank correlation coefficient.\rResults: The results obtained in sensory and motor nerve conduction examinations were compared between \rgroups. Patients using anti-tumor necrosis factor-alpha had peripheral sensory neuropathy. Examination of \rperipheral motor nerves was within normal limits.\rConclusions: Anti-tumor necrosis factor-alpha drugs have good effects in inflammatory diseases. These patients \rshould be carefully monitored for neurological findings.\r
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Ischemia-Reperfusion Injury of Sciatic Nerve in Rats and Protective Role of Benidipine Hydrochloride
Çakir, Tayfun; Yücetas, Seyho Cem; Yazici, Gulce Naz; Sunar, Mukadder; Arslan, Yusuf Kemal; Kayaci, Selim; Süleyman, Halis
Objective: Benidipine is an antihypertansive agent which elicits vasodilatation of arteries by blocking Ca2+. The aim of this study is to investigate the neuroprotective effects of benidipine on rat sciatic nerves exposed to ischemia and reperfusion (I/R). Method: 30 male Wistar Albino rats were used in this study. The rats were divided into three groups(n=10 per group). I/R procedure was administered to the IR group, 10 mu g/kg/day, i.v. benidipine was given for 2 hours (h) to the BIR group before I/R procedure. And a sham group (SG) was created. Next, histopathological and biochemical investigations were performed on sciatic nerve tissues. Superoxide dismutase (SOD), Malondialdehyde (MDA) and glutathione (GSH) were analyzed as oxidative stress markers; interleukin 1 beta (IL-1 beta) and tumor necrosis factor alpha (TNF-alpha) were analyzed as inflammatory stress markers in biochemical tests. Results: Axonal swelling, myelin loss and disorganisation were seen in the IR group. Schwann cells showed hypertrophy, hyperplasia, blood vessels were seen as congested. But these results were under normal values and almost similiar between BIR and SG groups. In the BIR group ischemic fibere degeneration score was significiantly lower than IR group. And MDA, TNF-alpha, IL-1 beta values higher, GSH and SOD values were lower in the IR group, but in the BIR group all these values were kept within normal limits. Conclusion: This study showed that benidipine reduced oxidative stress and inflammation in rat sciatic nerve after I/R injury.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Bayesian estimation of diagnostic accuracy measures when there is no gold standard: a Helicobacter Pylori data application
Arslan, Yusuf Kemal
Purpose: Diagnostic tests are used for defining the disease status of person in a heterogeneous population which consists of healthy and diseased people. In this study, it was aimed to obtain the accuracy measures of the diagnostic test with the Bayesian approach when there was no gold standard test, and to compare it with other methods. Materials and Methods: In the diagnosis of Helicobacter Pylori, different tests are used such as HpSA, Culture, CLO, Histology and PCR. In this study, models containing a priori information (prevalence, sensitivity, etc.) were created to obtain parameter estimations with the Bayesian approach. Bayesian methods were used to correct the imperfect gold standard bias that may occur in determining the accuracy of these diagnostic tests. For this purpose, the data of a medical thesis on H. Pylori were analyzed with the help of WinBUGS and R package programs. Results: When Bayesian inference is made, the results of the positive and negative predictive values of the diagnostic test were found to be more reliable, since the prevalence and a priori information about the disease were taken into account. Similar to the predictive values, reliable results were obtained for sensitivity and specificity values. The credible interval obtained by using Bayesian approach is narrowed when a prior information is used. Conclusion: In the absence of a gold standard, Bayesian approaches using a prior information such as prevalence and diagnostic test information could facilitate diagnosis for clinicians.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021The effect of adenosine triphosphate on propofol-induced myopathy in rats: A biochemical and histopathological evaluation
Erdem, Kezban Tuna Ozkaloglu; Bedir, Zehra; Ates, Irem; Kuyrukluyildiz, Ufuk; Coban, Taha Abdulkadir; Yazici, Gulce Naz; Arslan, Yusuf Kemal; Suleyman, Zeynep; Suleyman, Halis
Propofol infusion syndrome characterized by rhabdomyolysis, metabolic acidosis, kidney, and heart failure has been reported in long-term propofol use for sedation. It has been reported that intracellular adenosine triphosphate (ATP) is reduced in rhabdomyolysis. The study aims to investigate the protective effect of ATP against possible skeletal muscle damage of propofol in albino Wistar male rats biochemically and histopathologically. PA-50 (n = 6) and PA-100 (n = 6) groups of animals was injected intraperitoneally to 4 mg/kg ATP. An equal volume (0.5 ml) of distilled water was administered intraperitoneally to the P-50, P-100, and HG groups. One hour after the administration of ATP and distilled water, 50 mg/kg propofol was injected intraperitoneally to the P-50 and PA-50 groups. This procedure was repeated once a day for 30 days. The dose of 100 mg/kg propofol was injected intraperitoneally to the P-100 and PA-100 groups. This procedure was performed three times with an interval of 1 days. Our experimental results showed that propofol increased serum CK, CK-MB, creatinine, BUN, TP I, ALT, AST levels, and muscle tissue MDA levels at 100 mg/kg compared to 50 mg/kg and decreased tGSH levels. At a dose of 100 mg/ kg, propofol caused more severe histopathological damage compared to 50 mg/ kg. It was found that ATP prevented propofol-induced muscle damage and organ dysfunction at a dose of 50 mg/kg at a higher level compared to 100 mg/kg. ATP may be useful in the treatment of propofol-induced rhabdomyolysis and multiple organ damage.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Effects of Benidipine Hydrochloride on Ischemia Reperfusion Injury of Rat Brain
Cakir, Tayfun; Yucetas, Seyho Cem; Yazici, Gulce Naz; Sunar, Mukadder; Arslan, Yusuf Kemal; Suleyman, Halis
AIM: To evaluate the neuroprotective effects of benidipine hydrochloride on the cerebral cortex tissues in rats exposed to cerebral ischemia-reperfusion (I/R) injury. MATERIAL and METHODS: Twenty-four male Wistar albino rats were randomly divided into three groups, and administered benidipine hydrochloride (10 µg/kg/day) orally through a catheter for 2 h to form the study group (BIR group, n=8). The I/R procedure was performed in the rats of the IR group (n=8), and a sham group was formed to determine the normal structure of the cerebral cortex (n=8). Transient ischemia was performed by clamping the left common carotid artery for 2 h. Subsequently, reperfusion was applied for 12 h. Cerebral infarct volumes were measured and cerebral cortex tissue samples were analyzed histopathologically and biochemically by measuring malondialdehyde (MDA), total glutathione, cyclooxygenase 1 (COX-1), COX-2 and superoxide dismutase (SOD) RESULTS: The infarct area was markedly reduced in the BIR group vs. the IR group. Histopathologically, neuroprotective effects of benidipine hydrochloride were observed in the cerebral cortex tissues. The mean malondialdehyde and COX-2 levels were statistically higher in the IR group; however, in the BIR group, these levels were within the normal limits. Furthermore, the mean total glutathione, COX-1 and SOD levels were markedly lower in the IR group, and within the normal limits in the BIR group. CONCLUSION: Benidipine hydrochloride may play a certain protective role in cerebral I/R injury. This effect may be related to improvement in the antioxidant capacity of brain tissue, and the inhibition of overproduction of inflammatory cytokines.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2021Valeriana officinalis is Effective on Stress-Induced Infertility, Delayed Maternity, and Intrauterine Growth Restriction of the Fetus in Female Rats
Uzel, Kemine; Turkler, Can; Mammadov, Renad; Yazici, Gulce Naz; Arslan, Yusuf Kemal; Coban, Taha Abdulkadir; Suleyman, Zeynep; Gursul, Cebrail; Suleyman, Halis
SUMMARY. Infertility is a tragic option for reproductive-aged women. About 20 % of lost ability to conceive are caused by unexplained etiology. Some of these cases are linked with psychological stress. It can cause depression and anxiety, and the latter can cause infertility. The therapy with sedative, antidepressant, anxi-olytic and antioxidant effects may be beneficial in preventing infertility caused by psychological disorders and maintaining normal intrauterine physical development of the fetus. The aim of our study is to investi-gate the protective effect of Valeriana plant root extract against stress-induced reproductive disorders. The protective effect of Valeriana plant root extract against infertility and delayed maternity was investigated in a stress model induced by the forced immobilization method in albino Wistar female rats and compared with ascorbic acid. Valeriana officinalis plant root extract was effective against psychological stress-related infertility and delayed maternity, ascorbic acid was found to be ineffective. This information suggests that psychological stress-related ovarian damage, infertility, delayed maternity, and great obstetric syndromes are based on the role of psychological disorders such as anxiety and depression rather than oxidative stress. Our experimental results indicate that Valeriana officinalis plant root extract can be useful in the treatment of stress-related ovarian damage and reproductive disorders.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2021Effect of diazepam, sertraline and melatonin on the stress-induced reproductive disorders and intrauterine growth restriction in female rats
Aynaoglu Yildiz, Gulsah; Yildiz, Duran; Yapca, Omer Erkan; Suleyman, Bahadir; Arslan, Yusuf Kemal; Kurt, Nezahat; Suleyman, Halis
Objective: Psychological stress is an important factor triggering depression and anxiety. Infertility is known to cause stress; however, it is not clearly known whether stress causes infertility as well. In addition, there are different opinions accounting for the relation of stress-induced oxidative stress to infertility and intrauterine growth restriction. The aim of the study is to examine the effect of sertraline, diazepam and melatonin on the infertility, intrauterine growth restriction and oxidative stress that can be caused by forced immobilization stress management (FISM) in female rats. Materials and methods: Wistar rats were grouped as healthy rats (HG) applied distilled water, stress treated control group (SC), and 20 mg/kg sertraline + stress (SS), 2 mg/kg diazepam + stress (DS) and 10 mg/kg melatonin + stress (MS) treated rats. The medicines were administered orally once a day for 30 days. At the end of this period, oxidant/antioxidant parameters were measured through the blood samples collected from the tail veins of all rats. Then the rats were kept in a suitable environment for 2 months for breeding. Results: FISM caused oxidative stress in blood serum of animals, infertility and intrauterine growth restriction (decrease in birth weight of the baby). Best medicines to suppress FISM-related oxidative stress are melatonin > diazepam > sertraline respectively, while sertraline > diazepam > melatonin were most successful in terms of preventing infertility. The best medicines preventing the FISM-caused intrauterine growth restriction were found to be melatonin > diazepam > sertraline, respectively. Conclusion: FISM causes oxidative stress in animals. Oxidative stress is understood to affect the intrauterine growth negatively although it is not a major component in the pathogenesis of infertility. While melatonin is only effective in preventing the oxidative stress-related intrauterine growth restriction, antidepressants and anxiolytic treatment were found to be helpful in preventing both infertility and intrauterine growth restriction.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Artifacts in cranial MRI caused by extracranial foreign bodies and analysis of these foreign bodies
Kayaci, Selim; Tabak, Ahmet; Durur-Subasi, Irmak; Eldes, Tugba; Koksal, Vaner; Sirin, Murat; Arslan, Yusuf Kemal
Purpose: The purpose of our study was to conduct a chemical analysis of extracranial foreign bodies (FBs) causing artifacts in cranial magnetic resonance imaging (MRI) and to investigate the association between chemical composition, magnetic susceptibility, and artifact size. Materials and Methods: A total of 12 patients were included in the study. The FBs responsible for the artifacts were visualized using cranial computed tomography (CT). Artifact-causing FBs were removed from the scalps of 10 patients and analyzed using scanning electron microscope with energy dispersive spectroscopy (SEM-EDS), X-ray diffraction spectroscopy (X-RD), and Fourier-transform infrared spectroscopy (FT-IR). The magnetic susceptibility of the samples was determined using the reference standard material MnCl2.6H2O. The volume of the MRI artifacts was measured in cubic centimeters (cm3). Results: EDS results demonstrated that the mean Fe ratio was 5.82% in the stone samples and 0.08% in the glass samples. Although no phase peaks were detected in the X-RD spectra of the glass samples, peaks of Fe2O3, Al2Ca (SiO4) were detected in the X-RD spectra of the stone samples. The FT-IR spectra revealed metal oxide peaks corresponding to Fe, Al, in the stone samples and peaks confirming Al2SiO5and Na2SiO3structures in the glass samples. The mean volumes of the MRI artifacts produced by the stone and glass samples were 5.9 cm3 and 2.5 cm3, respectively. Conclusions: Artifacts caused by extracranial FBs containing metal/metal oxide components are directly associated with their chemical composition and the artifact size are also related to element composition and magnetic susceptibility.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2021Oxidative and pro-inflammatory lung injury induced by desflurane inhalation in rats and the protective effect of rutin
Tosun, Mustafa; Olmez, Hasan; Unver, Edhem; Arslan, Yusuf Kemal; Cimen, Ferda Keskin; Ozcicek, Adalet; Aktas, Mehmet; Suleyman, Halis
Background. Desflurane is a mainstay of general inhaled anesthetics with a methyl ethyl ether structure and is widely used in clinical practice. It has been reported to induce inflammation and lipid peroxidation in rat pulmonary parenchyma, to increase alveolar macrophages, and to cause peribronchial infiltration and edema. Rutin, a flavonoid vitamin P1, is known to have biological properties including acting as an antioxidant, an anti-inflammatory, and an inhibitor of bronchoalveolar polymorphonuclear leukocyte (PNL) infiltration. Objectives. The aim of this study is to examine the effects of rutin on desflurane-induced pulmonary injury using biochemical and histopathological methods. Materials and methods. The rats were divided into 3 groups (n = 6 each): healthy control (HC), rutin+desflurane-treated (DRT) and desflurane-only (DSF). Briefly, 50 mg/kg of rutin was given orally to the DRT group and an equal volume of normal saline was given to the DSF and HC groups. After 1 h, anesthesia was induced and maintained in the DRT and DSF groups for 2 h. After the rats had been sacrificed, the lungs were removed. Malondialdehyde (MDA), total glutathione (GSH), tumor necrosis factor alpha (TNF-α), and nuclear factor kappa B (NF-κB) levels were measured in the excised lung tissue. The removed tissues were also fixed in 10% formalin, and the obtained sections were stained with hematoxylin and eosin (H&E) and evaluated under light microscopy. The biochemical and histopathological results of the DRT group were compared with those obtained from the DSF and HC groups. Results. Desflurane increased MDA, TNF-α and NF-κB, and decreased GSH in lung tissue. The PNL infiltration, alveolar macrophages, hemorrhage, alveolar damage, and edema were observed in the lung tissue of the DSF group. Rutin was histopathologically shown to protect lung tissue from oxidative stress by preventing an increase in oxidant parameters and a decrease in antioxidants. Conclusions. The results suggest that rutin may be useful in the treatment of desflurane-associated lung injury.
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