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Katrancioglu N.,Cumhuriyet University | Karahan O.,Cumhuriyet University | Kilic A.T.,Cumhuriyet University | Altun A.,Cumhuriyet University | And 2 more authors.
Microvascular Research | Year: 2012

Background: There is a physiological balance between the stimulatory and inhibitory signals for blood vessel growth. In many symptomatic patients with peripheral artery disease, coronary artery disease, and ischemic chronic wounds, there is a pathological insufficiency of angiogenesis. Therefore, determining the angiogenic or antiangiogenic effects of molecules currently used in cardiovascular treatment is crucial. Although levosimendan is the most well studied calcium sensitizer in preclinical and clinical practice, to the best of our knowledge, there are no previous studies investigating its angiogenic or antiangiogenic effects. In the present study, we aimed to investigate the effects of levosimendan on angiogenesis. Methods: The antiangiogenic efficacy of levosimendan was examined in vivo in the chick chorioallantoic membrane (CAM) model by using 20 fertilized eggs and drug solutions of 1 and 10 μmol/L concentrations. Decreases in the density of the capillaries were assessed and scored. Results: Significant antiangiogenic effects were observed at 1 and 10 μmol/L concentrations of levosimendan. The antiangiogenic scores of levosimendan at 1 and 10 μmol/L concentrations were 0.6 and 1.10, respectively. The antiangiogenic score of bevacizumab, used as a positive control, was 0.95 at 1.0 μmol/L concentration. No significant difference was found between the antiangiogenic scores of levosimendan and bevacizumab (p = 0.54). Conclusions: Our results indicate that levosimendan has antiangiogenic effects on the chorioallantoic membrane. However, these findings must be confirmed in future studies on humans. © 2012 Elsevier Inc.

Ciftci S.,Sivas Numune State Hospital | Yilmaz H.,Kocaeli University | Ciftci E.,Cumhuriyet University | Simsek E.,Kocaeli University | And 4 more authors.
Prostate | Year: 2015

Background We aimed to evaluate the relationship between perineural invasion (PNI) and bone metastasis in prostate cancer (PCa). Methods We retrospectively reviewed the data of 633 PCas who had whole-body bone scan (WBBS) between 2008 and 2014. We recorded the age, clinical T-stage, total PSA (tPSA) prior to biopsy, Gleason sum (GS), and PNI in transrectal ultrasound guided biopsy (TRUS-Bx) and digital rectal examination findings. Bone metastases were assessed with WBBS and magnetic resonance image if WBBS was suspicious. We divided the patients into two groups according to NCCN criteria: (Group 1) bone scan not indicated, (Group 2) bone scan indicated. Results There were 262 patients in Group 1 and 371 in 2. There is not significant relationship between PNI and bone metastasis in Group 1. However, there is very limited number of metastatic patients (n = 12) in this group. There is a strong relationship between PNI and bone metastasis in Group 2 (P = 0.001). Sensitivity, specificity and positive predictive value of PNI for bone metastasis were 72.4%, 81.7%, and 77.7%, respectively. In this group, tPSA, GS, positive DRE, and PNI were significant covariates for prediction of bone metastasis in univariate and multivariate analysis (except age). The most powerful predictor was PNI, and it increased the risk of bone metastasis 11-fold. Conclusions PNI in the TRUS-Bx specimens is the most powerful predictive histopathological feature for bone metastasis, by increasing the risk of bone metastasis 11-fold in NCCN bone scan indicated patients (Group 2). © 2015 Wiley Periodicals, Inc.

Tatlisu M.A.,Sivas Numune State Hospital | Ozcan K.S.,Sina | Gungor B.,Dr Siyami Ersek Cardiovascular Surgery Education And Research Hospital | Zengin A.,Dr Siyami Ersek Cardiovascular Surgery Education And Research Hospital | And 2 more authors.
Journal of Geriatric Cardiology | Year: 2015

Background: Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods: The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function (ejection fraction < 45%) who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results: Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow thera-peutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions: Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines. © 2015 JGC All rights reserved; www.jgc301.com.

Divrik R.T.,Mh Tepecik Research And Training Hospital | Turkeri L.,Marmara University | Sahin A.F.,Sivas Numune State Hospital | Akdogan B.,Ankara University | And 3 more authors.
Urologia Internationalis | Year: 2012

Purpose: We tried to establish the predictive factors influencing the initial response, as well as its duration, and time to castration resistance (CR) for primary advanced prostate cancer (PC) with bone metastasis. Methods: We evaluated all patients initially receiving androgen deprivation therapy (ADT) for primary advanced PC with bone metastasis. A total of 982 patients with complete medical records available for analysis from 18 centers were included in this study. Age, initial PSA, Gleason score (GS) and extent of bone involvement (EBI) were recorded in a database. Results: Among all the patients, 896 (91.2%) responded to ADT initially. Pretreatment PSA and EBI were significant predictors in the multivariate model. Among the 659 patients who progressed into a CR state, the mean duration of response was 22.4 months. There was a significant correlation between the CR state and nadir PSA (nPSA) level and time to nPSA. Pretreatment PSA, EBI, GS, highest tumor volume in biopsy cores (%), number of positive biopsy cores, percent positive biopsy cores and time to nPSA were proven to be significant to predict a nPSA. Pretreatment PSA, GS and EBI were statistically significant predictors of PSA normalization in multivariate analysis. The limitation of the study depends on the retrospective design and a model was developed for low standardization as a result of using multicenter data. The patients enrolled in this study were from a relatively long period of time (1989-2008). Conclusions: The results of this study indicate that it is possible to predict the initial response to ADT by pretreatment PSA levels and EBI, while the duration of response can be reflected by a multitude of clinical factors including nPSA, TTnPSA, percent positive cores, biopsy GS and EBI. Copyright © 2011 S. Karger AG, Basel.

Yucel B.,Cumhuriyet University | Okur Y.,Ankara Numune Education and Research Hospital | Akkas E.A.,Sivas Numune State Hospital | Eren M.F.,Cumhuriyet University
Asian Pacific Journal of Cancer Prevention | Year: 2013

Aim: The aim of this study was to determine the impact of age on the occurrence, severity, and timing of acute side effects related to radiotherapy. Materials and Methods: We analysed the data of 423 patients. Results: Of the patients, 295 (70%) were under the age of 65 (group 1) and 128 (30%) were over the age of 65 (group 2) The frequencies of radiotherapy-induced side effects were 89% in group 1 and 87% in group 2 (p=0.286). The mean times to occurrence were 2.5±0.1 weeks in group 1 and 2.2±0.1 weeks in group 2 (p=0.013). Treatment was ended in 2% of patients in group 1 and 6% of those in group 2 (p=0.062). Treatment interruption was identified in 18% of patients in group 1 and 23% in group 2 (p=0.142) Changes in performance status were greater in older patients (p=0.013). There were no significant differences according to the frequency or severity of side effects, except skin and genitourinary complications, between the groups. Conclusions: Early normal tissue reactions were not higher in older versus younger patients, though there was a tendency towards an earlier appearance.

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