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Cicek Y.,Recep Tayyip Erdoğan University | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Kocaman S.A.,Rize Education and Research Hospital | Guveli H.,Rize Education and Research Hospital | And 5 more authors.
Journal of Psychosomatic Research | Year: 2012

Objective: Acute and chronic mental stress and many psychiatric disorders have been accepted as a cause of cardiovascular disease. Panic disorder, a subtype of anxiety disorder, has been associated with increased risk of fatal myocardial infarction and sudden cardiac death in epidemiological studies. Carotid-femoral pulse wave velocity (CF-PWV) is currently the gold standard measurement of arterial stiffness. CF-PWV is a well-recognized predictor of an adverse cardiovascular outcome with higher predictive value than classical cardiovascular risk factors. The aim of our study is to measure PWV as the surrogate of arterial stiffness and vascular involvement in patients with panic disorder. Methods: Forty-two patients with PD, and 30 control participants were included in the study. Patients with hypertension, diabetes mellitus, or the history of any cardiovascular disease were excluded from study. Results: Baseline characteristics were not significantly different between the two groups, except carotid-femoral pulse wave velocity (PD vs. control; 7.51 ± 2.02 vs. 6.24 ± 1.09. m/s, p=0.001), heart rate, and smoking status. Additionally, CF-PWV positively correlated with age (r=0.250, p=0.034), heart rate (r=0.284, p=0.017), systolic and diastolic blood pressure (r=0.393, p=0.001 and r=0.286, p=0.015, respectively) significantly. However, only the presence of panic disorder was independently related to PWV (βeta: 0.317, p=0.011) in the multivariate analysis including age, heart rate, smoking status and blood pressure measurements. Conclusion: Increased pulse wave velocity in patients with panic disorder may justify the associated risk as documented in previous studies, and may be useful in identifying the patients with higher risk of future cardiovascular complications. © 2012 Elsevier Inc.

Kocaman S.A.,Rize Education and Research Hospital | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Cetin M.,Rize Education and Research Hospital | Erdogan T.,Recep Tayyip Erdoğan University | And 2 more authors.
Blood Pressure Monitoring | Year: 2013

BACKGROUND: Hypertension, identifiable by elevated blood pressure (BP), is a heterogeneous multifactorial disorder. Epicardial adipose tissue (EAT), a special fat depot that is related to visceral fat rather than total adiposity, shares the same microcirculation with myocardial tissue and coronary vessels. Recent studies have identified EAT as an active organ, which secretes several mediators, called adipokines, affecting the vascular system. The aim of this study was to evaluate the potential association between EAT and BP, endothelial function, carotid intima-media thickness (CIMT), and pulse wave velocity (PWV) independent of conventional and novel metabolic risk factors in patients with previously untreated hypertension. PATIENTS AND METHODS: Our study, which has a cross-sectional design, included 107 consecutive untreated hypertensive patients. Vascular status and functions were evaluated using CIMT, PWV, and flow-mediated dilation (FMD) of the brachial artery. The values of BP were obtained both by the traditional auscultatory method using a sphygmomanometer in an office and by ambulatory BP measurement. RESULTS: When we stratified the patients into three groups according to increased EAT values, CIMT (P<0.001), presence of carotid plaque (P=0.026), and BP values (P=0.001) were increased in the higher tertile compared with the lower tertile. FMD of the brachial artery decreased significantly with increasing EAT thickness (P<0.001). There was a significant, strong, and negative association between CIMT and FMD (r=-0.604, P<0.001). CIMT correlated positively to age (r=0.404, P<0.001), EAT (r=0.517, P<0.001), office systolic BP (r=0.241, P=0.016), ambulatory systolic BP (r=0.419, P<0.001), and diastolic BP (r=0.360, P=0.002). FMD correlated negatively to age (r=-0.390, P<0.001), EAT (r=-0.495, P<0.001), ambulatory systolic (r=-0.338, P=0.006), and diastolic BP (r=-0.281, P=0.024). Multivariate linear regression analyses, carried out to identify predictors of CIMT and FMD, showed only age, EAT, and mean ambulatory BP as independent predictors of both CIMT and FMD. CONCLUSION: Our study showed that EAT is an independent factor of adverse changes in CIMT, FMD, and PWV. Future studies, investigating the vascular influence of EAT at the molecular level, may provide therapeutic options to prevent its adverse vascular interactions. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Tomak Y.,Recep Tayyip Erdoğan University | Yalmaz A.,Recep Tayyip Erdoğan University | Bostan H.,Recep Tayyip Erdoğan University | Tumkaya L.,Recep Tayyip Erdoğan University | And 3 more authors.
Anaesthesia | Year: 2012

We investigated the effect of rocuronium- and sugammadex-induced mast cell increase and degranulation in rat portal triads. Forty-two rats, in six groups, received either rocuronium 1 mg.kg -1; sugammadex 15 mg.kg -1; sugammadex 100 mg.kg -1; rocuronium 1 mg.kg -1 and 5 min later, sugammadex 15 mg.kg -1; rocuronium 1 mg.kg -1 and 5 min later, sugammadex 100 mg.kg -1; or isotonic saline. Total mast cell numbers were significantly higher with rocuronium only, than in all other groups (p < 0.003), although in all active groups, the number was greater than the control. Total mast cell number was significantly higher with rocuronium and low-dose sugammadex compared with low-dose sugammadex only. The number of tryptase-positive mast cells with rocuronium only was significantly higher than in all other groups (p < 0.003). Tryptase-positive mast cell numbers in both groups receiving both rocuronium and sugammadex were significantly higher compared with both groups receiving sugammadex only. Rocuronium increased mast cell numbers, and degranulation was mitigated by sugammadex. These results suggest that sugammadex may be beneficial in treatment of rocuronium-induced anaphylaxis. © Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

Gucer H.,Recep Tayyip Erdoğan University | Bagci P.,Recep Tayyip Erdoğan University | Coskunoglu E.Z.,Rize Education and Research Hospital | Karadag C.,Unye State Hospital
Journal of the Pancreas | Year: 2011

Context Heterotopia of the pancreas can be defined as the presence of pancreatic tissue in an abnormal location without any continuity with the main body of the pancreas. Heterotopic pancreatic tissue located in the gallbladder is a rare entity. Despite being a congenital condition, it takes years for heterotopic pancreas to become symptomatic. Case report An 80-year-old male patient presented to our hospital with a two-week history of abdominal pain, nausea and vomiting aggravated after meals. Abdominal ultrasonography revealed minimal wall edema and small grain-sized gallstones in the gallbladder. The patient was hospitalized and laparoscopic cholecystectomy was performed for acute cholecystitis. Pathologic examination showed a 6 mm nodular mass of pancreatic tissue in the gallbladder wall, comprised mainly of ductal and acinic structures and a few endocrine cells. Conclusion We found this case of pancreatic heterotopia worth reporting because of its rare incidence.

Uzun H.,Recep Tayyip Erdoğan University | Cicek Y.,Recep Tayyip Erdoğan University | Kocaman S.A.,Rize Education and Research Hospital | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Zorba O.U.,Recep Tayyip Erdoğan University
Scandinavian Journal of Urology | Year: 2013

Objective.Vascular risk factors frequently coexist with lower urinary tract symptoms (LUTS) in both men and women, suggesting that atherosclerosis and endothelial dysfunction may play a major role in the development of LUTS. Arterial stiffness owing to decreased arterial compliance is one of the major signs of vascular ageing, and carotid intima-media thickness (CIMT) can be used in establishing the extent and severity of vascular impairment. This study investigated the association of arterial stiffness and vascular atherosclerotic involvement with LUTS in men and overactive bladder (OAB) in women. Material and methods.This study was prospective and cross-sectional, consisting of 66 patients with LUTS (38 men with LUTS, 28 women with OAB) and 62 controls without LUTS or OAB. Carotid-femoral pulse-wave velocity (CF-PWV) was measured as an index of arterial stiffness. CIMT was measured with B-mode ultrasonography to assess vascular impairment. Results.Patients with LUTS had significantly higher CF-PWV (9.8 ± 2.6 vs 7.0 ± 1.4 m/s, p < 0.001) and CIMT (0.89 ± 0.16 and 0.56 ± 0.31 mm, p < 0.001) compared with controls. Age and glucose were also different between LUTS and control groups (p < 0.001 and p = 0.003, respectively). In the multivariate analyses, both CIMT (= 0.429, p < 0.001) and PWV (= 0.451, p < 0.001) were related to LUTS. Conclusions.Vascular impairment was found to be associated with LUTS in both men and women. Atherosclerosis-related vascular risk factors are also known to be related to LUTS and both disorders may have pathogenic interactions. © 2013 Informa Healthcare.

Akdogan R.A.,Recep Tayyip Erdoğan University | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Kocaman S.A.,Rize Education and Research Hospital | Cicek Y.,Recep Tayyip Erdoğan University | And 3 more authors.
Digestive Diseases and Sciences | Year: 2013

Background: Ulcerative colitis (UC) is characterized with chronic, progressive inflammation of the gastrointestinal tract. The association of UC with cardiovascular disease is still a matter of debate. Aim: The aim of this study was to investigate whether carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) as surrogates of atherosclerosis and arterial stiffness are increased in patients with UC. Methods: Our study was cross-sectional and observational in design. Baseline characteristics were recorded during interview with the patient. Patients with previous cardiovascular disease, rheumatoid arthritis, chronic renal failure, and infectious and inflammatory disorders other than UC were excluded. Thirty-seven consecutive patients with UC and 30 control participants underwent cf-PWV assessment and CIMT measurement. The diagnosis of UC was based on clinical, radiologic, endoscopic, and histological findings. Results: CIMT, cf-PWV, and C reactive protein were significantly higher in patients with UC. Although linear regression analyses identified UC as an independent predictor of CIMT (β ± SE, 0.39 ± 0.08; p < 0.001), only age independently predicted cf-PWV (β ± SE, 0.08 ± 0.03; p = 0.003) in our study population. Moreover, we revealed higher CIMT and PWV values in patients with higher disease activity and more extensive involvement, compared to patients with mild activity and limited disease. Conclusion: We revealed increased pulse wave velocity and CIMT in patients with UC. UC appears to be associated with arterial stiffness and atherosclerotic burden, but the underlying mechanisms require further studies to be identified. © 2013 Springer Science+Business Media New York.

Cetin M.,Rize Education and Research Hospital | Kocaman S.A.,Rize Education and Research Hospital | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Erdogan T.,Recep Tayyip Erdoğan University | And 3 more authors.
Journal of Cardiology | Year: 2013

Background: Adipose tissue is the source of many adipokines affecting the cardiovascular system either locally or systemically. Although hypertension is one of the most important factors in diastolic dysfunction (DD), the exact cause of this relationship is unknown. There is no specific study in the current literature regarding the association of epicardial adipose tissue (EAT) with left ventricular DD in patients with essential hypertension. Methods: The present study was cross-sectional and observational, including 127 patients with untreated hypertension who underwent a complete transthoracic echocardiographic examination as well as measurements of EAT and diastolic parameters. Results: EAT was significantly correlated with left atrial dimension, DD parameters, and left ventricular (LV) mass as well as age and blood pressure measurements. EAT was also correlated with Framingham risk score (p< 0.001). Age and EAT were significantly increased in patients with high grades of DD compared to those with low values (p< 0.001 and p= 0.001, respectively). Linear regression analyses revealed EAT as an independent predictor of all DD parameters. The area under the curve values of EAT were similar to age and higher than those of LV mass and mean BP for both the presence of DD and grade two DD. Conclusion: Based on our findings, increased EAT may be associated with diastolic dysfunction and left atrial dilatation due to local or systemic effects in untreated hypertensive patients. This relationship is independent of and stronger than abdominal obesity, implicating the clinical importance of measuring EAT thickness. © 2013 Japanese College of Cardiology.

Cicek Y.,Recep Tayyip Erdoğan University | Durakoglugil M.E.,Recep Tayyip Erdoğan University | Kocaman S.A.,Rize Education and Research Hospital | Cetin M.,Rize Education and Research Hospital | And 4 more authors.
Blood Pressure | Year: 2013

Background. Non-dipper pattern, characterized by diminished nocturnal decline in blood pressure (BP), is associated with an increase in cardiovascular events. Carotid-femoral pulse wave velocity (CF-PWV) has been accepted as the gold standard measurement of arterial stiffness. CF-PWV is a well-recognized predictor of an adverse cardiovascular outcome with higher predictive value than classical cardiovascular risk factors. In this study, we investigated the association between PWV as the surrogate of arterial stiffness and non-dipper pattern in untreated hypertensive patients. Methods. The present study was cross-sectional and observational. Hypertensive patients were diagnosed according to ambulatory BP measurements (mean BP 130/80 mmHg). Eighty-four hypertensive patients, consulted for initial evaluation of hypertension, were enrolled. CF-PWV as the indicator of arterial stiffness was measured by a validated tonometry system (SphygmoCor). Patients with the history of any cardiovascular disease were excluded from the study. Results. Fifty-six patients had non-dipper pattern and 28 patients had dipper pattern in the study. Baseline characteristics were not significantly different between the two groups, except the CF-PWV (non-dipper vs dipper; 8.91±2.53 vs 7.66±1.08 m/s, p =0.002), female gender (55% vs 32%, p =0.045) and nocturnal BP measurements (for mean BP; 106±11 vs 92±8 mmHg, p <0.001). Multiple logistic regression analysis including age, gender, BP and PWV measurements, revealed female gender (odds ratio, OR =5.112, 95% confidence interval, CI 1.282-20.4, p =0.021), nocturnal mean BP (OR =1.243, 95% CI 1.107-1.396, p <0.001) and CF-PWV (OR =1.992, 95% CI 1.240-3.198, p =0.004) as the independent predictors of non-dipper hypertensive pattern. Conclusion. Our results suggest that diminished nocturnal decline in BP is independently associated with PWV and nocturnal BP rather than daytime BP. Non-dipper pattern, mainly related to increased PWV and impaired modulation of vascular smooth muscle tone during the night, may justify an increased cardiovascular risk in these patients. © 2013 Scandinavian Foundation for Cardiovascular Research.

PubMed | Atatürk University, Recep Tayyip Erdoğan University, Erzurum Training and Research Hospital, Mengucek Gazi Education and Research Hospital and 2 more.
Type: | Journal: Clinical and experimental otorhinolaryngology | Year: 2016

The objective of this study is to investigate and evaluate the effect of Hippophae rhamnoides extract (HRE) on oropharyngeal mucositis induced in rats with methotrexate (MTX) through biochemical, gene expression, and histopathological examinations.Experimental animals were divided into a healthy group (HG), a HRE+MTX (HREM) group, HRE group (HREG), and a control group that received MTX (MTXG). The HREM and HREG groups of rats was administered 50 mg/kg HRE, while the MTXG and HG groups were given an equal volume distilled water with gavage. Then, the HREM and MTXG rat groups were given oral MTX at a dose of 5 mg/kg 1 hour after HRE and distilled water was administered. This procedure was repeated for 1 month. At the end of this period, all of the animals were sacrificed with a high dose of anesthesia. Then, the amounts of malondialdehyde (MDA) and total glutathione (tGSH) were determined in the removed oropharyngeal tissues. Interleukin-1 (IL-1) and tumor necrosis factor- (TNF-) gene expressions were measured, and all the tissues were studied histopathologically.The amount of MDA was significantly increased in the MTXG group compared to the HREM, HREG, and HG groups (P<0.001). MTX significantly decreased the amount of tGSH in the MTXG group compared to the HREM, HREG, and HG groups (P<0.001). In this study, there were no visible ulcers in the animal group in which the levels of MDA, IL-1, and TNF- were high and the level of tGSH was low. However, histopathologic examination revealed mucin pools in wide areas due to ruptured oropharynx glands, and proliferated, dilated, and congested blood vessels and dilated ductal structures in some areas.HRE protected oropharyngeal oxidative damage induced by MTX. As an inexpensive and natural product, HRE has important advantages in the prevention of oropharyngeal damage induced by MTX.

PubMed | Istanbul University, Training and Research Hospital and Rize Education and Research Hospital
Type: Journal Article | Journal: Acta Cardiologica Sinica | Year: 2016

Uric acid (UA) is an independent risk factor for the development of coronary heart disease. Serum UA levels have been correlated with all major forms of death from cardiovascular disease, including acute, subacute, and chronic forms of coronary artery disease (CAD), heart failure, and stroke. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of UA in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).We prospectively enrolled 434 consecutive Turkish STEMI patients (mean age 55.4 12.4 years, 341 male, 93 female) undergoing primary PCI. The study population was divided into tertiles based on admission UA values. The high UA group (n = 143) was defined as a value in the third tertile (> 5.7 mg/dl), and the low UA group (n = 291) included those patients with a value in the lower two tertiles ( 5.7 mg/dl). Clinical characteristics, in-hospital and six-month outcomes of primary PCI were analyzed.Compared to the low UA group, only Killip class > 1 at admission was more prevalent in the high UA group (3.4% vs. 17.5%, p < 0.001, respectively). Higher in-hospital cardiovascular mortality and six-month all-cause mortality rates were observed in the high UA group than in the lower group (12.6% vs. 1.7%, respectively, p < 0.001) and (19.6% vs. 4.1%, respectively, p < 0.001). In Cox multivariate analysis; a high admission UA value (> 5.7 mg/dl) was found to be a powerful independent predictor of six-month all-cause mortality (hazard ratio: 5.57, 95% confidence interval: 1.903-16.3, p = 0.002).These results suggest that a high level of UA on admission was associated with increased in-hospital cardiovascular mortality, and six-month all-cause mortality in Turkish patients with STEMI undergoing primary PCI.Primary angioplasty; ST elevation myocardial infarction; Uric acid.

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