Etlik Training and Research Hospital

Ankara, Turkey

Etlik Training and Research Hospital

Ankara, Turkey
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Taslipinar A.,Gulhane Military Medical Academy | Yaman H.,Gulhane Military Medical Academy | Yilmaz M.I.,Gulhane Military Medical Academy | Demirbas S.,Gulhane Military Medical Academy | And 9 more authors.
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2011

Objectives. Diabetic nephropathy (DN) is a major manifestation of microangiopathy in patients with Diabetes Mellitus (DM). Inflammation is one of the major factors in the formation of endothelial dysfunction. Endothelial dysfunction is a major contributor to the complications of DM. The aim of the present study was to investigate the possible relationship between inflammation, endothelial dysfunction and proteinuria in patients with diabetic nephropathy. Materials and methods. Plasma TNF-α and IL-6, pro-inflammatory cytokines, concentrations were measured in 25 patients with DN and in 30 diabetic control subjects. Also, we evaluated the markers of endothelial dysfunction such as flow mediated dilatation (FMD), nitrate-mediated dilatation (NMD) and carotid intima-media thickness (CIMT). Results. TNF-α, IL-6 and high-sensitivity C-reactive protein concentrations were significantly higher (p = 0.012, p = 0.006 and p < 0.001, respectively) in the patients with DN than the controls. And, urinary protein concentrations were significantly higher (p < 0.001) but eGFR levels were significantly lower (p < 0.001) in the patients with DN. FMD was significantly lower in DN patients (p < 0.001). We have observed that FMD correlated negatively with body mass index (r = -0.424, p < 0.05). And there was also a positive correlation between TNF-α and urinary protein concentrations in the patients with DN (p < 0.05). Conclusion. TNF-α, IL-6, hsCRP and urinary protein concentrations are higher in the DN patients. There were no correlations among pro-inflammatory cytokines concentrations and markers of vascular endotelial disfunction. These findings did not show vascular endothelial dysfunction, but may indicate glomerular endothelial dysfunction. © 2011 Informa Healthcare.


Kursun O.,Etlik Training and Research Hospital | Unal N.,Etlik Training and Research Hospital | Cesur S.,Ankara Nuclear Research And Training Center | Altin N.,Etlik Training and Research Hospital | And 4 more authors.
Mikrobiyoloji Bulteni | Year: 2012

Pantoea species, which are the members of Enterobacteriaceae family are gram-negative bacilli that are frequently found on many plants and in soil. They may lead to localized infections in healthy subjects and systemic infections in immunosuppressed patients. In this case report a ventilator-associated pneumoniae due to Pantoea agglomerons was presented. A 55 year-old male patient with chronic renal failure was hospitalized in intensive care unit following cardiopulmonary arrest. The patient developed fever (38.8°C), had pulmonary infiltrations in chest X-ray and leucocytosis. Treatment with piperacillin-tazobactam was initiated upon diagnosis of nosocomial pneumoniae. Bacterial growth from the deep tracheal aspirate of the patient was identified as P.agglomerans by VITEK2 automated system (bioMéri-eux, France) and the identification was confirmed by conventional microbiological methods. Since the strain was susceptible to the cephoperazon-sulbactam, tobramycin, tetracycline, gentamicin and levof-loxacine, the treatment was changed to levofloxacine and cephoperazon-sulbactam and the patient improved. This case was presented to withdraw attention to rare opportunistic pathogens that may lead to nosocomial infections particularly in patients with underlying diseases.


Bulus H.,Kecioren Training and Research Hospital | Mahmoud H.,TOBB University of Economics and Technology | Altun H.,Etlik Training and Research Hospital | Tas A.,Osmaniye Public Hospital | Karayalcin K.,Ankara University
Journal of the Korean Surgical Society | Year: 2013

Purpose: Laparoscopic techniques have gained wide clinical acceptance in surgical practice today. The laparoscopic approach has been established as the technique of choice for elective splenectomies performed on normal sized spleens. The purpose of this study was to evaluate the outcome of patients undergoing laparoscopic splenectomy (LS) at the TOBB University of Economics and Technology (ETU) Hospital and Kecioren Training and Research Hospital. Methods: One hundred and thirty-five patients underwent splenectomy between January 2000 and July 2010. For comparison, the records of 130 patients undergoing splenectomy were evaluated for age, gender, hospital stay, time to start of diet, conversion rate, operation time and wound infection. Results: Mean operation time means the time interval between surgeon commencing operation to end of operation. Mean operation time in patients treated by LS was 132 minutes and 121 minutes in open splenectomy (OS). Mean hospital stay was 5.65 days in patients undergoing LS and starting of diet was 1.21 days. In patients treated by OS, mean hospital stay was 9.17 days, starting of diet was 2.37 days. Four patients were converted to open surgery. Conversion rate was 6.4 percent. In the early post operative period (within 10 days of surgery) 9.2%, LS group had lower incidences of wound infection rate after surgery than OS group (4.8%, 7.4%, respectively; P = 0.06). Conclusion: LS is a safe and effective alternative to OS for treatment of splenic diseases in patients of all ages. © 2013, the Korean Surgical Society.


Aim: Computerized tomography (CT) examination of temporal bone is a routine procedure in the diseases of the middle ear. The aim of this study is to establish the efficacy of CT in the diagnosis of the complications due to inflammatory pathologies of middle ear. Method: Patients with suspected middle ear pathology were undergone temporal CT examination between August 2006- June 2008. 56 patients who underwent operation with various complications due to chronic otitis media and choleostatoma were included in the study group. Complications that developed chronic inflammation secondary were established as tympanosclerosis, ossicle erosion, scutum erosion, tegmen erosion, irregularity in mastoid bone cortex and contour of facial nerve, semicircular canal defect and chronic mastoiditis. Result: Sensitivity, specificty, positive and negative predictive value of complications were 84.6%, 88.3%, 68.7% and 95% for timpanosclerosis, 80%, 46.1%, 83.3% and 42% for ossicle erosion, 80%, 90.4%, 84.8% and 73.7% for scutum erosion, 0%, 97.7%, 0% and 80% for tegmen erosion, 40%, 97.8%, 80% and 88.2% for irregularity in mastoid bone cortex, 66.6%, 98%, 80% and 96.07% for irregularity in bone contour of facial nerve, 45.4%, 95.5%, 71.4% and 87.7% for SSC defect, 0.02%, 100%, 100% and 27.2% for chronic mastoiditis. Conclusion: In the evaluation of the complications, surgical findings were highly compatible with tympanosclerosis, ossicle erosion, scutum erosion, irregularity in bone contour of facial nerve. However, CT findings were inconsistent with surgical findings in terms of tegmen erosion, irregularity in mastoid bone cortex, chronic mastoiditis, SSC defects. We suggest that these inconsistencies were related to the surgical technique and CT limitations.


Kahveci V.,Etlik Training and Research Hospital | Ogur T.,Etlik Training and Research Hospital | Cipe G.,Ankara University | Ozdemir S.,Etlik Training and Research Hospital | Hazinedaroglu S.,Ankara University
Iranian Journal of Radiology | Year: 2013

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC.


Ozkan E.,Etlik Training and Research Hospital | Yaman H.,Gulhane Military Medical Academy | Cakir E.,Gulhane Military Medical Academy | Deniz O.,Gulhane Military Medical Academy | And 10 more authors.
Inflammation | Year: 2012

Tuberculosis (TB) is the second most frequent cause of death in the world, after AIDS. Delay in diagnosing TB is an important worldwide problem. It seriously threatens public health. Cell-mediated immune responses play an important role in the pathogenesis of TB infection. The course of Mycobacterium tuberculosis (MTb) infection is regulated by two distinct T cell cytokine patterns. Melatonin is a biomolecule (mainly secreted by the pineal gland) with free radical scavenging, antioxidant and immunoregulatory properties. Melatonin has both its direct and indirect immunomodulatory effects on the immune system. In this study, we measured plasma melatonin and urine 6-hydroxy melatonin sulphate (6-HMS) concentrations in patients with newly diagnosed TB for the purpose of investigating whether there was a relationship between their levels and MTb infection. Thirty-one newly diagnosed patients presenting with active TB and 31 healthy subjects as the control group were included in this study. Blood and 24-h urine samples were collected from all individuals. Plasma melatonin levels and urine 6-HMS were measured. Our results show that in patients with TB, mean melatonin and 6-HMS concentrations were significantly lower than in the control subjects (p=0.037, p<0.001, respectively). We believe that the treatment of TB patients with melatonin might result in a wide range of health benefits including improved quality of life and reduced severity of infection in these patients. Supplementation with melatonin may be considered as an adjunctive therapy to classic treatment of pulmonary TB, especially during the acute phase of infection. © 2012 Springer Science+Business Media, LLC.


Simsek K.,Gulhane Military Medical Academy | Yildirim A.O.,Gulhane Military Medical Academy | Demirbas S.,Gulhane Military Medical Academy | Oztosun M.,Turkish Armed Forces | And 6 more authors.
Journal of Medical Biochemistry | Year: 2013

Background: Studies with single-session hyperbaric oxygen exposures have shown that HBO-induced oxidative stress is proportional to exposure pressure and duration. Since the efficacy of hyperbaric oxygen mainly depends on repetitive exposures, this study aimed to investigate the oxidative effect of hyperbaric oxygen administered for 5 to 40 sessions. Methods: Sixty rats were divided into one control and 6 study groups. Study groups were exposed to 5, 10, 15, 20, 30, and 40 daily consecutive 2.8 atm/90 min hyperbaric oxygen sessions. Animals were sacrificed 24 h after the last hyperbaric oxygen administration. Malondialdehyde and carbonylated protein levels as well as superoxide dismutase activities were determined in isolated rat erythrocytes. Results: Carbonylated protein levels increased significantly after just 5 hyperbaric oxygen exposures; reached a peak level with 10 exposures; were still significantly higher than controls after 15 sessions; and decreased to normal limits after 20 exposures. Malondialdehyde levels were found to be significantly increased in the 10 to 30, but not in the 5 and 40-session groups. Superoxide dismutase activity showed elevated levels only in the 5 and 10 times hyperbarical oxygen-exposed groups. Conclusions: The suppressed oxidative stress level after 40 exposures suggests an effective endogenous antioxidant defense in repetitive HBO administrations.


PubMed | Etlik Training and Research Hospital
Type: Journal Article | Journal: Inflammation | Year: 2012

Tuberculosis (TB) is the second most frequent cause of death in the world, after AIDS. Delay in diagnosing TB is an important worldwide problem. It seriously threatens public health. Cell-mediated immune responses play an important role in the pathogenesis of TB infection. The course of Mycobacterium tuberculosis (MTb) infection is regulated by two distinct T cell cytokine patterns. Melatonin is a biomolecule (mainly secreted by the pineal gland) with free radical scavenging, antioxidant and immunoregulatory properties. Melatonin has both its direct and indirect immunomodulatory effects on the immune system. In this study, we measured plasma melatonin and urine 6-hydroxy melatonin sulphate (6-HMS) concentrations in patients with newly diagnosed TB for the purpose of investigating whether there was a relationship between their levels and MTb infection. Thirty-one newly diagnosed patients presenting with active TB and 31 healthy subjects as the control group were included in this study. Blood and 24-h urine samples were collected from all individuals. Plasma melatonin levels and urine 6-HMS were measured. Our results show that in patients with TB, mean melatonin and 6-HMS concentrations were significantly lower than in the control subjects (p = 0.037, p < 0.001, respectively). We believe that the treatment of TB patients with melatonin might result in a wide range of health benefits including improved quality of life and reduced severity of infection in these patients. Supplementation with melatonin may be considered as an adjunctive therapy to classic treatment of pulmonary TB, especially during the acute phase of infection.


Kizilgun M.,Oncology Training and Research Hospital | Poyrazoglu Y.,Elazig Military Hospital | Oztas Y.,Hacettepe University | Yaman H.,Gulhane Military Medical Academy | And 11 more authors.
Renal Failure | Year: 2011

Introduction: It has been demonstrated that peroxynitrite accompanies acute renal ischemia and contributes to the pathophysiology of renal damage. Therefore, we aimed to investigate the roles of N-acetylcysteine (NAC), a well-known powerful antioxidant, and ebselen (E), a scavenger of peroxynitrite, on renal injury induced by renal ischemia/reperfusion injury (IRI) of rat kidney. Materials and methods: Forty male Sprague-Dawley rats were divided into five groups: sham, renal IRI, renal IRI+NAC, renal IRI+E, and renal IRI+NAC+E. IR injury was induced by 60 min of bilateral renal ischemia followed by 6h of reperfusion. After reperfusion, kidneys and blood samples were obtained for histopathological and biochemical evaluations. Results: Renal IR resulted in increased malondialdehyde and nitrite/nitrate levels suggesting increased lipid peroxidation and peroxynitrite production and decreased superoxide dismutase and glutathione peroxidase activities. Both NAC and E alone significantly decreased malondialdehyde and nitrite/nitrate levels and increased superoxide dismutase and glutathione peroxidase activities. Additionally in the renal IRI+NAC+E group, all biochemical results were quite close to those of sham group. Histopathologically, the kidney injury in rats treated with combination of NAC and E was found significantly less than the other groups. Conclusions: Both NAC and E are able to ameliorate IRI of the kidney by decreasing oxidative and nitrosative stresses and increasing free radical scavenger properties. Additionally, combination of NAC and E prevents kidney damage more than when each drug is used alone, suggesting that scavenging peroxynitrite nearby antioxidant activity is important in preventing renal IRI. Copyright © 2011 Informa Healthcare USA, Inc.


PubMed | Etlik Training and Research Hospital
Type: Journal Article | Journal: Iranian journal of radiology : a quarterly journal published by the Iranian Radiological Society | Year: 2013

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC.

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