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Kanbay M.,Kayseri Training and Research Hospital | Huddam B.,Ankara Training and Research Hospital | Azak A.,Ankara Training and Research Hospital | Solak Y.,Selcuk University | And 5 more authors.
Clinical Journal of the American Society of Nephrology | Year: 2011

Background and objectives Endothelial dysfunction is an early manifestation of vascular injury and contributes to the development of atherosclerotic cardiovascular disease. Recent studies have implicated hyperuricemia as a risk factor for cardiovascular disease. We hypothesized that lowering uric acid in subjects with asymptomatic hyperuricemia with allopurinol might improve endothelial dysfunction, BP, estimated GFR (eGFR), and inflammatory markers. Design, setting, participants, & measurements Subjects with asymptomatic hyperuricemia and no history of gout and 30 normouricemic control subjects were enrolled in this 4-month randomized prospective study. Thirty hyperuricemic patients received 300 mg/d allopurinol and were compared with 37 hyperuricemic patients and 30 normouricemic subjects in matched control groups. Flow-mediated dilation (FMD), eGFR, ambulatory BP monitoring, spot urine protein-creatine ratio, and highly sensitive C-reactive protein were measured at baseline and at 4 months. Results Age, gender, lipid profile, eGFR, hemoglobin, glucose, and level of proteinuria were similar in hyperuricemic subjects and controls at baseline. As expected, hyperuricemic patients had higher levels of highly sensitive C-reactive protein and lower FMD compared with normouricemic patients. Allopurinol treatment resulted in a decrease in serum uric acid, a decrease in systolic BP, an increase in FMD, and an increase in eGFR compared with baseline. No significant difference was observed in the control hyperuricemic and normouricemic groups. In a multiple regression analysis, FMD levels were independently related to uric acid both before (beta = -0.55) and after (beta = -0.40) treatment. Conclusions Treatment of hyperuricemia with allopurinol improves endothelial dysfunction and eGFR in subjects with asymptomatic hyperuricemia. © 2011 by the American Society of Nephrology.


Kanbay M.,Kayseri Training and Research Hospital | Afsar B.,Konya Numune Hospital | Covic A.,Grigore T. Popa University of Medicine and Pharmacy
Contributions to Nephrology | Year: 2011

Most authorities do not consider hyperuricemia to be an important risk factor for cardiovascular or renal disease. However, emerging data suggest that elevated uric acid (UA) is actually one of the most important factors for cardiovascular disease and that it also plays a significant role in the development of renal disease and metabolic syndrome. In the current review, we will analyze the role of cardiometabolic disorders related to UA and briefly explain the pathogenetic mechanisms behind these relationships. Copyright © 2011 S. Karger AG, Basel.


Sagit M.,Kayseri Training and Research Hospital | Kavugudurmaz M.,Kayseri Training and Research Hospital | Guler S.,Kayseri Training and Research Hospital | Somdas M.A.,Kayseri Training and Research Hospital
The Journal of laryngology and otology | Year: 2013

OBJECTIVE: We aimed to determine: (1) whether mean platelet volume was elevated in patients with sudden sensorineural hearing loss, compared with healthy controls; and (2) whether mean platelet volume level was related to hearing loss severity.MATERIALS AND METHODS: The study included 31 patients with sudden sensorineural hearing loss and 31 age- and sex-matched, healthy controls. Peripheral venous blood samples were taken from subjects and mean platelet volume and levels of glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride were measured.RESULTS: Mean platelet volume was significantly greater in the sudden sensorineural hearing loss group compared with the control group. However, there was no significant correlation between mean platelet volume level and hearing loss severity.CONCLUSION: Mean platelet volume, a determinant of platelet activation, is elevated in patients with sudden sensorineural hearing loss. To our knowledge, this is the first report investigating mean platelet volume levels in such patients. Our findings indirectly support the hypothesis of vascular impairment as a pathogenetic factor in sudden sensorineural hearing loss.


Sagit M.,Kayseri Training and Research Hospital
The Journal of laryngology and otology | Year: 2011

To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss. A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality. Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.


Sagit M.,Kayseri Training and Research Hospital | Korkmaz F.,Kayseri Training and Research Hospital | Akcadag A.,Kayseri Training and Research Hospital | Somdas M.A.,Kayseri Training and Research Hospital
European Archives of Oto-Rhino-Laryngology | Year: 2013

The aim of this study was to investigate the potential protective effect of thymoquinone against cisplatin-induced ototoxicity. This study is a prospective, controlled experimental animal study. Experiments were performed on 30 healthy female Sprague-Dawley rats. Thirty animals were divided into three groups of 10 animals each. Group 1 received an intraperitoneal (i.p.) injection of cisplatin 15 mg/kg. Group 2 received i.p. thymoquinone 40 mg/kg/day for 2 days prior to cisplatin injection and third day i.p. cisplatin 15 mg/kg was administered concomitantly. Group 2 continued to receive i.p. thymoquinone until fifth day. Group 3 received i.p. thymoquinone 40 mg/kg/day for 5 days. Pretreatment distortion product otoacoustic emissions (DPOAE) and auditory brain stem responses (ABR) testing from both ears were obtained from the animals in all groups. After the baseline measurements, drugs were injected intraperitonally. After an observation period of 3 days, DPOAE measurements and ABR testing were obtained again and compared with the pretreatment values. There was no statistically significant difference between pre and post-treatment DPOAE responses and ABR thresholds group 2 and 3. However, group 1 demonstrated significant deterioration of the ABR thresholds and DPOAE responses. Our results suggest that DPOAE responses and ABR thresholds were preserved in the cisplatin plus TQ-treated group when compared with the group receiving cisplatin alone. According to these results, cisplatin-induced ototoxicity may be prevented by thymoquinone use in rats. © 2012 Springer-Verlag Berlin Heidelberg.


Yontar Y.,Kayseri Training and Research Hospital
Journal of Burn Care and Research | Year: 2016

Early tangential excision of the burn wound is essential for removal of necrotic tissue and promotion of burn wound healing process. However, the depth of the burn wound is not easily assessed during the tangential excision performed by hand-held dermatomes, and it may be possible to excise unburned vital dermis unnecessarily, which aids in primary epithelization of the burn wound by adnexal structures. We herein present early clinical results of steel wool-aided dermabrasion in patients with deep partial-thickness burns. This is a retrospective case study of 23 consecutive hospitalized patients with deep partial-thickness burns. All of the steel wool-aided dermabrasions were performed under general anesthesia within 48 hours after injury. Patients were excluded from the study if the admission was not within 24 hours after injury, and if the burn wound was entirely superficial partial- or full-thickness. Thirteen male and 10 female patients with a mean age of 26.2 ± 17.1 years were enrolled in the study. During the follow-up period, all of the patients had burn wounds primary epithelized on postburn day 15.1 ± 1.8, without any complications. None of the patients exhibited a mortal course, and redebridement or skin grafting of the previously dermabraded deep partial-thickness burn wounds were not required in any of the patients. Steel wool-aided dermabrasion is an easy, cost-effective, and reliable technique for the treatment of deep partial-thickness burns, which provides complete removal of necrotic tissue, preserves the vital dermis, reduces the requirement for skin grafting, and decreases length of hospital stay. © 2016 The American Burn Association


Benderli Cihan Y.,Kayseri Training and Research Hospital
Kulak burun boǧaz ihtisas dergisi : KBB = Journal of ear, nose, and throat | Year: 2011

This study aims to investigate whether propolis has a protective role in oral mucosal damage induced by radiotherapy applied to head-neck region, using quantitative, biochemical and histopathological approaches. Forty eight Wistar-Albino adult female rats at eight weeks of age and weighing 213±27 grams were included in this study and randomly divided into six groups: Group 1: control, group 2: only irradiated rats, group 3: irradiated rats with propolis administration at 50 mg/kg/day, group 4: irradiated rats with propolis administration at 100 mg/kg/day, group 5: only propolis administration at 50 mg/kg/day, group 6: only propolis administration at 100 mg/kg/day. The first dose of propolis was administered before 30 minutes irradiation and the other doses after irradiation once daily for seven days by topical application. Radiotherapy was applied to the total cranium by single fraction at a dose of 18 Gy. The mucositis degrees and body weights of the animals were measured throughout the experiment. On the 7th day of study, blood samples were taken from the rats under ketamine anesthesia and then the rats were sacrificed and tongue tissues samples were taken. Complete blood count and biochemical and antioxidant activities were analysed in the blood samples. The tongue samples were microscopically examined. Radiotherapy group had a decrease in body weight and neutrophil count, and an increase in oral mucositis as compared with the control group (p<0.001). Moreover, an increase in plasma malondialdehyde concentrations (p<0.001) and significant decreases in catalase and superoxide dismutase activities (p<0.001) were observed in irradiation-alone group when compared to the control group. Propolis administered irradiated rat groups showed a dose-dependent normalization in quantitative, biochemical and histopathological parameters when compared with the irradiation-alone group. The results showed that propolis is effective in reducing the severity of oral mucositis induced by head-and-neck irradiation.


Celikbilek A.,Kayseri Training and Research Hospital | Ismailogullari S.,Erciyes University | Zararsiz G.,Erciyes University
Journal of Clinical Laboratory Analysis | Year: 2014

Background: Inflammation plays a role in the pathogenesis of carotid atherosclerosis. Although previous data demonstrated an association between inflammatory biomarkers and stroke, there is no publication reporting the relation of neutrophil to lymphocyte (N/L) ratio with ischemic stroke. We aimed to analyze the predictive ability of N/L ratio in acute ischemic cerebrovascular disease. Methods: A total of 190 patients including 70 patients with first-ever atherothrombotic acute ischemic stroke (AAIS), 50 patients with transient ischemic attack, and 70 healthy subjects were enrolled in this study. We analyzed the values of white blood cell (WBC), N/L ratio, C-reactive protein (CRP), gamma-glutamyltransferase (GGT), homocysteine (HCY), mean platelet volume (MPV) in patients with ischemic group and compared those with control individuals. Results: WBC, CRP, HCY, N/L ratio were found to increase significantly in AAIS patients than the controls (P < 0.001). With respect to mortality, there were no significant differences between the values of CRP, GGT, HCY, and MPV in patients with AAIS. However, WBC and N/L ratio values were found to increase significantly in dead patients (P = 0.024 and P = 0.029, respectively). A comparison of receiver operating characteristic curves among WBC, CRP, GGT, HCY, MPV, and N/L ratio variables was made. No significant differences were obtained between area under curve values (P > 0.05). A cut-off value of 4.1 for N/L ratio was detected in predicting mortality with a sensitivity of 66.7% and a specificity of 74.1% (κ = 0.299, P = 0.006). Conclusions: These findings support the role of N/L ratio as a simple inexpensive and readily available marker of prognosis in acute ischemic stroke. © 2013 Wiley Periodicals, Inc.


Mutlu H.,Kayseri Training and Research Hospital | Artis T.A.,Erciyes University | Erden A.,Kayseri Training and Research Hospital | Akca Z.,Mersin Government Hospital
Clinical and Applied Thrombosis/Hemostasis | Year: 2013

Mean platelet volume (MPV) is an indicator of thrombocyte volume and tendency to thrombosis can be mentioned in case of MPV elevation. Cancers are one of the important groups of thrombotic diseases. In the present study, MPV value was scrutinized in patients with cancer that developed thrombosis. Totally 43 patients followed in Kayseri Training and Research Hospital, in who thromboembolus has been developed, were prospectively recruited in the study. Thrombocyte, MPV, and platicrit (PCT) values were recorded at the time of cancer diagnosis and thrombosis development. Frequency analysis, crosstabs, and paired samples t test were used. Analyses showed that MPV values at the time of thrombosis development were significantly low as compared to those at the time of cancer diagnosis (P =.041). Thrombocyte count and PCT values were also low but not significant. The result of the present study is likely to show that thrombocytes have ignorable effect on thrombosis development in patients with cancer. © The Author(s) 2012.


Kemaloglu C.A.,Erciyes University | Tekin Y.,Kayseri Training and Research Hospital
Aesthetic Plastic Surgery | Year: 2014

Abstract: Cartilage grafts are the most commonly used grafts for structural and aesthetic purposes. This study aimed to compare the viability of diced cartilage grafts wrapped in fascia with diced cartilage grafts wrapped in perichondrium. Approximately 2 × 2 cm cartilage grafts were harvested from the ears of seven New Zealand rabbits, diced to approximately 1-mm cubes, and then wrapped in perichondrium harvested from the ears or muscle fascia harvested from the right rear leg of the same rabbits. The wrapped grafts were then weighed and implanted into two paravertebral subcutaneous cavities created on the shaved backs of the donor rabbits. After 3 months, the rabbits were sacrificed and the grafts were removed, weighed and examined histopathologically. We found no statistically significant difference in the weights of the two graft types before and after embedding. The mean chondrocyte viability was 87.14 % in the perichondrium-wrapped cartilage grafts and 41.43 % in the fascia-wrapped grafts, which was determined to be statistically significant. Overall, our findings show that cartilage grafts wrapped in perichondrium led to higher chondrocyte viability and graft survival rates as compared with grafts wrapped in fascia. This method may be used as an alternative in clinical practice to provide patients requiring cartilage grafts with positive long-term effects, lower morbidity and lower costs associated with the procedure.No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2014, Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery.

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