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Yayın Akut inferior miyokard infarktüsünde infarktan sorumlu arteri elektrokardiyografik olarak tahmin edebilme(Kare Publishing, 2001) Özmen, Namık; Top, Cihan; Us, Melih Hulusi; Cebeci, Bekir Sıtkı; Demiralp, ErgünAmaç: Akut inferior miyokard infarktüsü geçiren hastalarda elektrokardiyografik olarak infarktan sorumlu arterin (‹SA) saptanabilmesi amac›yla bu çal›flmay› planlad›k. Yöntem: Akut inferior miyokard infarktüsü tan›s› ile koroner yo¤un bak›m ünitesinde takip ve tedavi edilen toplam 40 hasta çal›flmaya al›nm›flt›r. Hastalar›n 36’s› erkek, 4’ü kad›n olup yafl ortalamalar› 62.1 y›l (29-85) idi. EKG kay›tlar›ndan aVL’deki R/S oran›, ST depresyonu, prekordiyal resiprokal de¤iflikliklerle 1-7. günlerde yap›lan koroner anjiografilerden saptanan ‹SA aras›ndaki iliflkiyi araflt›rd›k. Bulgular: Koroner anjiyografide 40 hastan›n 20’sinde sa¤ koroner arter, 15’inde sirkumfleks arter ve 5 hastada hem sa¤ koroner arter hem de sirkumfleks arterin infarktan sorumlu arter oldu¤u saptand›. Elektrokardiyografik olarak ise infarktan sorumlu arteri sirkumfleks arter olan hastalarda aVL’de R/S>1 (%82 duyarl›l›k, %81 özgüllük) iken, sa¤ koroner arter olanlarda R/S<1 (%81 duyarl›l›k, %83 özgüllük) bulundu (p<0.05). Sirkumfleks arter lezyonlar›nda aVL’de ST segment depresyonu ? 2mm (%70 duyarl›l›k, %81 özgüllük ) iken, sa¤ koroner arter lezyonlar›nda ST segment depresyonu > 2mm (%80 duyarl›l›k, %71 özgüllük) olarak belirlendi (p<0.05). Prekordiyal resiprokal de¤ifliklikler aç›s›ndan infarktan sorumlu arterler aras›nda istatistiksel olarak anlaml› ba¤lant› saptanmad›. Sa¤ koroner lezyonlular›n %75’inde, sirkumfleks arter lezyonlular›n %26’s›nda, sirkumfleks+sa¤ koroner arter lezyonlular›n %100’ünde sa¤ ventrikül infarktüsü saptand›. Amaç: Akut inferior miyokard infarktüsü geçiren hastalarda elektrokardiyografik olarak infarktan sorumlu arterin (‹SA) saptanabilmesi amacıyla bu çalışlmayı planladık. Yöntem: Akut inferior miyokard infarktüsü tanısı ile koroner yoğun bakım ünitesinde takip ve tedavi edilen toplam 40 hasta çalıflmaya alınmıfltır. Hastaların 36’sı erkek, 4’ü kadın olup yafl ortalamaları 62.1 yıl (29-85) idi. EKG kayıtlarından aVL’deki R/S oranı, ST depresyonu, prekordiyal resiprokal değiflikliklerle 1-7. günlerde yapılan koroner anjiografilerden saptanan ‹SA arasındaki iliflkiyi arafltırdık. Bulgular: Koroner anjiyografide 40 hastanın 20’sinde sağ koroner arter, 15’inde sirkumfleks arter ve 5 hastada hem sağ koroner arter hem de sirkumfleks arterin infarktan sorumlu arter olduğu saptandı. Elektrokardiyografik olarak ise infarktan sorumlu arteri sirkumfleks arter olan hastalarda aVL’de R/S>1 (%82 duyarlılık, %81 özgüllük) iken, sağ koroner arter olanlarda R/S 2mm (%80 duyarlılık, %71 özgüllük) olarak belirlendi (pYayın Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes(Elsevier, 2010) Önem, Yalçın; Terekeci, Murat Hakan; Küçükardalı, Yaşar; Şahan, Burak; Solmazgül, Emrullah; Şenol, Mehmet Güney; Nalbant, Selim; Sayan, Özkan; Top, Cihan; Öktenli, ÇağatayThe aim of this study is to produce the relation between cognitive and functional performance and some biochemical parameters in elderly population. So, we searched for the correlation between the activities of daily living (ADL), mini-mental state examination (MMSE) and body weight, age, hemoglobin, albumin, serum sodium level of 180 elderly people in five nursing homes. Face-to-face interviews and questionnaires were applied to evaluate ADL. To evaluate the cognitive function we used the MMSE. The average age of 180 people contacted was 71.5+/-5.1 (+/-S.D.), ranging 65-91 years; 112 of them were women (62.2%), 68 were men (37.8%). Of these elderly people, 25% had no medically diagnosed illnesses, whereas 17 of them (9.4%) were bedridden. There was a positive correlation between ADL and hemoglobin, albumin, body weight, cognitive function parameters and a negative one with age and serum sodium. There was a positive correlation between cognitive functions and hemoglobin, body weight, ADL and a negative one with serum sodium. Hemoglobin concentrations indicating anemia were observed in 30% of subjects, 3.9% of them had hyponatremia and 26.7% displayed a hypernatremia. There was a positive correlation between cognitive and physical function scores and hemoglobin, albumin levels in elderly patients. These results suggest that restoration of hemoglobin and albumin levels could improve cognitive and physical functional status in the elderly population.Yayın Are increased carotid artery pulsatility and resistance indexes early signs of vascular abnormalities in young obese males?(WILEY-BLACKWELL, 2012) Ozari, H. Onur; Oktenli, Cagatay; Celik, Serkan; Tangi, Fatih; Ipcioglu, Osman; Terekeci, Hakan M.; Top, Cihan; Uzun, Mehmet; Sanisoglu, Yavuz S.; Nalbant, SelimPurpose: To provide insight into the factors by which obesity in itself may directly lead to early arterial damage, we aimed to determine early sonographic markers of obesity-related vascular dysfunction in young obese males. Methods: Thirty-five young obese males and 23 age-matched healthy male volunteers were recruited into the study. Common carotid artery pulsatility index and resistance index were calculated from blood flow velocities curves obtained by pulsed Doppler ultrasonography. Results: The mean pulsatility index, resistance index, body mass index, waist circumference, systolic and diastolic blood pressure, homeostasis model assessment for insulin resistance, plasma fasting glucose, insulin, C-peptide, triglycerides, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were statistically higher in obese subjects than in healthy controls. Conclusions: Our results suggest that depressed vessel compliance and increased vascular resistance are features of young, obese, normotensive subjects independently of and in addition to cardiovascular risk factors. As changes in arterial wall properties may be incipient in young obese subjects, future studies will be required to demonstrate whether early intervention such as diet and exercise in this population can improve vascular functions. (C) 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012Yayın Comparison of the therapeutic efficacy of 4-methylpyrazole and N-acetylcysteine on acetaminophen (paracetamol) hepatotoxicity in rats(Taylor & Francis Online, 2002) Küçükardalı, Yaşar; Cinan, U; Acar, H. Volkan; Özkan, Sezai; Top, Cihan; Nalbant, Selim; Çermik, Hakan; Çankır, M. Salih Zeki; Danacı, MustafaObtaining effective analgesia with a minimal erosive effect on gastric mucosal tissue has increased the consumption of acetaminophen (paracetamol), especially among the elderly. However, the hepatotoxic effects of acetaminophen have also increased. We aimed to compare the effects of 4-methylpyrazole (4-MP), N-acetylcysteine (NAC) and their combined use on the hepatotoxicity of acetaminophen in a rat model. Male Wistar Albino rats were divided into six groups. Groups 1-5 received 2,000 mg/kg acetaminophen by gavage while the control group was group 6. Group 2 animals were given NAC (loading dose 140 mg/kg followed by seven doses at 4 h intervals); group 3 received 50 mg/kg 4-MP; group 4 received 200mg/kg 4-MP; and group 5 received NAC as in group 2 plus 200 mg/kg 4-MP. Blood samples were taken for measurements of serum AST and ALT levels. The livers of the rats were removed for microscopic examination and grading of hepatic necrosis. AST and ALT levels in groups 2-5 were lower than that of group 1 (p < 0.001), although no significant difference was noted between groups 2-5 (p > 0.05). Higher levels of ALT were found in group 5 than in group 2 (p < 0.05), and higher levels of AST were found in group 5 than in group 3 (p < 0.01). Median necrosis scores were 3.36 for rats receiving acetaminophen alone (p < 0.001, compared with groups 2-6), 1.45-1.81 for groups 2-5 (p > 0.05, compared with each other), and 0.18 for control rats (p < 0.001, compared with groups 1-5). In conclusion, the administration of 4-MP and/or NAC after 4 h of administering toxic dose of acetaminophen, inhibits hepatotoxicity in rats. There was no difference between the 4-MP and NAC-treated groups as reflected by comparable levels of serum transaminases and the degree of hepatic necrosis. Combining of 4-MP and NAC offers no benefit.Yayın Hipertansif hastalarda sol ventrikül hipertrofisi gelişmesine leptin düzeylerinin etkisi(Nobel İlaç San. ve Tic A.Ş., 2006) Kardeşoğlu, Ejder; Demiralp, Ergün; Cebeci, Bekir Sıtkı; Özmen, Namık; Çelik, Turgay; Top, Cihan; Yalçın, MuratAmaç: Leptin, yağ dokusunda sentez edilen ve başta sempatik sinir sistemi aktivasyonu olmak üzere birçok sisteme etkisi olan bir hormondur. Hipertansif hastalarda leptin düzeylerinin yüksek olduğu bilinmektedir. Amacımız, hipertansif hastalarda sol ventrikül hipertrofisi (SVH) gelişmesinde leptin düzeylerinin etkisi olup olmadığını belirlemektir. Materyal ve Metot: Çalışmaya hipertansif 40 hasta alındı. Hastalar, ekokardiyografik olarak belirlenen sol ventrikül kitle ve kitle indeksine göre iki gruba ayrıldı. Birinci grup, SVH olan 27 hasta (18?i kadın, 9?u erkek ve yaş ortalaması 59,1±7,2 yıl) ve 2. grup ise SVH olmayan 13 hastadan (5?i kadın, 8?i erkek ve yaş ortalaması 62,4±4,9 yıl) oluşturuldu. Hastalardan, ayrıntılı ekokardiyografi incelemesinden sonra, aç durumda kan alındı. Serumları çalışma zamanına kadar -80 0C derin dondurucuda saklandı. Plazma leptin düzeyleri, ?ELİSA? yöntemi kullanılarak belirlendi. İki grubun klinik, ekokardiyografik parametreleri ve plazma leptin düzeyleri karşılaştırıldı. Bulgular: İki grup arasında kullanılan ilaçlar, hipertansiyon süresi, vücut kitle indeksi bakımından anlamlı fark tespit edilmedi. Birinci grubun plazma leptin düzey ortalaması 33,3 ± 15,3 ngr/ml iken, 2. grupta bu değer, 28,3 ± 17,6 ngr/ml şeklindeydi. İki değer karşılaştırıldığında istatistiksel olarak anlamlı fark tespit edilmedi (p>0,05). Sonuç: Sonuç olarak, SVH mevcut olan hipertansif hastalarda leptin düzeyi SVH olmayan hipertansif hastalardan farklı değildir. Bu sonuç, leptinin hipertansif hastalarda SVH gelişmesinde belirgin rolünün olmadığını düşündürmektedir.Yayın Homocysteine and Behçet disease(Wolters Kluwer, 2003) Nalbant, Selim; Aktay, Derya; Cingözbay, Yılmaz; Top, Cihan; Küçükardalı, Yaşar; Avşar, Kadir; Danacı, MehmetThree of the five patients with seriously complicated Behçet disease had uveitis and two had high homocysteine levels. Gastrointestinal and central nervous system involvement were the other two serious complications. The highest level of plasma homocysteine level (50 mmol/L) in this study belonged to a patient with Behçet disease, Budd-Chiari Syndrome, and factor V Leiden mutation. There is growing evidence that hyperhomocystinemia is an independent risk factor for premature arteriosclerotic disease, including cerebral, peripheral, and coronary vascular diseases (2,6). Therefore, vascular events in autoimmune disease have also been investigated. Systemic lupus erythematosus (SLE) is the first autoimmune disease that was investigated. Raised homocysteine concentrations were found in 51 (15%) SLE patients. After adjustment for established risk factors, total plasma homocysteine concentrations remained an independent risk factor for stroke [2.44], and arterial thromboses [3.49] (7).Yayın Hospital-acquired infections following the 1999 Marmara earthquake(Healthcare Infection Society, 2002) Öncül, Ö.; Keskin, O; Acar, H. V.; Küçükardalı, Yaşar; Evrenkaya, R.; Atasoyu, E M; Top, Cihan; Nalbant, Selim; Özkan, S; Emekdaş, G; Çavuşlu, S; Pahsa, A.; Gökben, M; Us, M.H.In this study, medical records of all casualties admitted to our hospital following the Marmara earthquake, which struck northwest Turkey and resulted in the destruction of several towns in the Marmara region, were evaluated retrospectively. The time buried under the rubble, demographic data, type of medical and surgical therapies performed, type of injury and data on infection were analysed. Between 17 August and 25 September 1999, 630 trauma victims were received at our hospital and 532 (84%) of them were hospitalized. The mean age of hospitalized patients (312 males, 220 females) was 32 years (2-90 years). Two hundred and twenty patients were hospitalized for more than 48 h. Forty-one of them (18.6%) had 43 hospital-acquired infection (HAI) episodes, which were mostly wound infections (46.5%). A total of 143 culture specimens was collected and 48 yielded the following potential pathogens: 15 Acinetobacter baumanii (31.2%), nine Staphylococcus aureus (18.7%), seven Pseudomonas aeruginosa (14.6%), six Escherichia coli (12.5%), six Klebsiella pneumoniae (12.5%), two Stenotrophomonas maltophilia (4.2%) and three various Pseudomonas spp. (6.3%). All S. aureus strains were found to be resistant to methicillin in vitro. Two strains of A. baumannii and one P. aeruginosa were found to be resistant to all antimicrobials including carbapenems. Fifty-three victims died (10%) and 36 of those died during the first 48 h because of severe injuries and multi-organ failure. After 48 h of hospitalization, the mortality rate was significantly higher in those patients with HAI (14/41) than those without (3/179) (34.1% vs. 1.7%, P<0.05). In conclusion, trauma is the significant factor associated with HAI and a high incidence of Acinetobacter strains was responsible for HAI in trauma patients.Yayın Hypersensitivity vasculitis and cytokines(PubMed, 2002) Nalbant, Selim; Koç, Bayram; Top, Cihan; Küçükardalı, Yaşar; Baykal, Yavuz; Danacı, Mehmet; Koçer, İsmail HakkıObjective Hypersensitivity vasculitis (HSV) is secondary vasculitis due to an immune response to exogenous substances. Because of the relative rarity of the vasculitides there are no reports on the role cytokines. This report evaluates some of cytokines which might be involved in pathophysiological events of HSV. Material and methods Patients with HSV (n=20) were classified as active (n=12) ornd inactive (n=8) according to a vasculitis activity index for systemic necrotizing vasculitis (VAI). All the patients were males. A control group was formed from 20 healthy male employees of our department. We performed tests for serum interleukins 6, IL-10, sIL-2 receptor, tumor necrosis factor (TNF) a, C-reactive protein (CRP) levels using enzyme-linked immunosorbent assay and erythrocyte sedimentation rate (ESR). Results The mean ESR value, CRP, and fibrinogen levels were significantly different in both active and inactive HSV from those in the healthy group; they were also significantly higher in the active than in the inactive group. There was no significant difference between healthy and inactive groups for serum IL-10, IL-6, sIL- 2 receptor, and TNFa levels. However, it was also significantly higher for in active HSV patients than in the healthy group. Similar results were obtained comparing active and inactive groups, namely, all cytokine levels were significantly higher for all patients. The most striking finding is the high correlation of ESR also for CRP, fibrinogen) with serum levels of TNFa and IL-10, but not with IL-6 and IL2R. Conclusions These data show that serum TNFa and IL-10 levels can be studied in comparison to traditional markers of inflammation such as sedimentation rate or C-reactive protein. This may lead to new approaches to treating or managing HSV.Yayın Increased asymmetric dimethylarginine levels in young men with familial Mediterranean fever (FMF): is it early evidence of interaction between inflammation and endothelial dysfunction in FMF?(The Journal of Rheumatology Publishing Co. Ltd., 2008) Terekeci, Murat Hakan; Öktenli, Çağatay; Özgürtaş, Taner; Nalbant, Selim; Top, Cihan; Çelik, Serkan; Tapan, Serkan; Küçükardalı, Yaşar; Sanisoğlu, Yavuz S.; Solmazgül, Emrullah; Şahan, Burak; Sayan, ÖzkanObjective: Unlike in many other chronic inflammatory rheumatic diseases, studies investigating endothelial dysfunction and atherosclerosis in familial Mediterranean fever (FMF) are limited, and the results are controversial. Asymmetric dimethylarginine (ADMA) is considered an indicator for endothelial dysfunction and a sensitive marker for cardiovascular risk. There have been no reports on serum ADMA levels in patients with FMF. Methods: We aimed (1) to determine serum ADMA concentrations in 38 young male patients with FMF and 23 age- and body mass index-matched healthy volunteers; (2) to evaluate its correlations with MEFV mutations, C-reactive protein (CRP) levels, and lipid profile; and (3) to compare effects of colchicine on circulating ADMA concentrations. Results: In patients with FMF, ADMA and CRP levels were higher than in healthy controls. The mean levels of ADMA and CRP were higher during acute attacks than in attack-free periods. Patients taking colchicine had lower serum ADMA levels than non-colchicine users. There was a positive strong correlation between ADMA and CRP in patients with FMF. Stepwise linear regression analysis in patients with FMF revealed that age and CRP levels were independently associated with serum ADMA levels. Conclusion: Our data imply that higher serum ADMA levels in FMF may indicate inflammation-related "endothelial dysfunction." It seems likely that regular use of colchicine is effective in preventing the development of and reversing not only amyloidosis but also endothelial dysfunction in patients with FMF.Yayın Increased circulating asymmetric dimethylarginine (ADMA) levels in active stage of Behçet’s Syndrome(Thieme Publishing Group, 2009) Terekeci, Murat Hakan; Nalbant, Selim; Özgürtaş, Taner; Çelik, Serkan; Tapan, Serkan; Sanisoğlu, Yavuz S.; Şahan, Burak; Sayan, Özkan; Küçükardalı, Yaşar; Top, Cihan; Öktenli, ÇağatayThere is little evidence in the literature about circulating asymmetric dimethylarginine (ADMA) levels in Behçet's syndrome (BS). The aim of the present study was 1. to measure the levels of ADMA in male patients with BS, 2. to compare ADMA levels with healthy volunteers, and 3. to evaluate whether there is any difference between patients both with / without thrombosis and in active / inactive stage. In patients with BS, CRP levels were higher than controls. The mean ADMA and C-reactive protein (CRP) levels were significantly higher in active stage patients and patients with thrombosis than in patients during the inactive stage and without thrombosis. In conclusion, we did not find any significant difference in ADMA levels between patients with BS and healthy controls. Serum ADMA concentrations, however,Yayın Kikuchi's disease: Report of one case and an overview(Internet scientific publications, 2002) Küçükardalı, Yaşar; Çankır, M. Salih Zeki; Top, Cihan; Özkan, Sezai; Nalbant, Selim; Baloğlu, Hüseyin; Danacı, Mehmet; Öncül, OralWe describe , to our knowledge, the first Turkish patient with Kikuchi’s disease which is characterized by histiocytic necrotizing lymphadenitis with skin, liver, and lymph node involvement. The diagnosis was based on histopathological findings in open biopsy. Our patient was a young man, who had bilaterally, tender axillary lymphadenopathy, fever, arthralgia, cutaneous rash, and fatigue. Laboratory analyses identified an elevation of C-reactive protein 96 mg/L, lactate dehydrogenase 2558 U/L, aspartate transaminase 404 U/L, alanine transaminase up to 196 U/L. The erythrocyte sedimentation rate was 80 mm/h. Hematologic investigations revealed mild leukopenia, 3.4 x 109 /L, neutropenia, 1.4 x 109 / L, and hemoglobin 99 g/L. Viral, Toxoplasma, Mcoplasma, Brucella, and syphilis serology were negative. Also immunological and rheumatological tests were normal. A biopsy from an axillary lymph node findings confirmed the diagnosis of Kikuchi’s diseases. After the diagnosis, the patient received oral corticosteroid therapy, and one month after the onset of therapy he was totally symptomless and lymph nodes was normal. The cause of Kikuchi’s disease is unknown. A viral or postviral hyperimmune reaction has been proposed as its etiology. It is uncommon cause of fever of unknown origin. Malignant lymphoma and systemic lupus erythematosus should be considered differential diagnosis. Early recognition of Kikuchi’s disease will minimize potentially harmful and unnecessary evaluations and treatments.Yayın Normoglisemik obez hastalarda prolaktin ve insülin direnci ilişkisi(Uludağ Üniversitesi Tıp Fakültesi, 2002) Top, Cihan; Keskin, Özcan; Terekeci, Hakan; Önde, Mehmet EminBu çalışmada; normoglisemik obez hastalarda, insülin duyarlılığı ile serum prolaktin düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. VKİ değişen oranlarda olan (VKİ=39,7±5,4) 36 olgu (22 obez ve 14 morbid obez) çalışmaya dahil edildi. Tüm olgulara; insülin duyarlılık indeksi, serum prolaktin düzeyleri ve antropometrik ölçümlerden oluşan tanısal protokol uygulandı. İnsülin duyarlılığı HOMA skoru ile ölçüldü. Korelasyon analizi, serum prolaktin düzeyleri ile HOMA-IR arasında (r=-0.25, p=0.27) herhangi bir ilişki olmadığını gösterdi. Serum prolaktin düzeyleri ile VKİ arasında (r=0.52, p<0.05) anlamlı bir bağlantı mevcuttu. Obez ve morbid obez hastalar arasında serum prolaktin düzeyleri yönünden anlamlı farklılık saptandı (p<0.05). Bu sonuçlar göstermiştir ki, vücut kitlesi arttıkça gözlenen dolaşımdaki prolaktin yüksekliği, insülin direncini yansıtmamaktadır. Obezite patogenezinde prolaktinin rolünün araştırıldığı daha ileriki çalışmalara ihtiyaç duyulmaktadır.Yayın Relationship between anaemia and cognitive functions in elderly people(Elsevier, 2010) Terekeci, Hakan Murat; Küçükardalı, Yaşar; Önem, Yalçın; Erikçi Akyol, Alev; Küçükardalı, Betül; Şahan, Burak; Sayan, Özkan; Çelik, Serkan; Güleç, Mahir; Sanisoğlu, Yavuz S.; Nalbant, Selim; Top, Cihan; Öktenli, ÇağatayBackground The primary goal of the present study was to investigate the effects of anaemia on the cognitive functions and daily living activities in elderly people. Methods This sectional study was performed using 180 elderly people. Face-to-face interviews and questionnaires were conducted to evaluate daily activities. To evaluate cognitive functions we used the Folstein's Mini-Mental State Examination (MMSE). Results The mean age of the anaemic group and the nonanaemic group were 76.0 ± 11.7 and 72.5 ± 15.2 years, respectively. The average haemoglobin level among the anaemic population was 10.4 g/dL compared with 13.6 g/dL among the nonanaemic population; a statistically significant difference. There was more impairment in functional status (Katz ADL) (6.8 ± 4.3 vs 9.3 ± 3.7) and cognition (MMSE) (17.9 ± 6.4 vs 21.7 ± 6.7) in anaemic than nonanaemic groups, respectively. Albumin and body mass index were lower and the percentage of two or more comorbidities was higher in anaemic group compared to the nonanaemic group, which was a statistically significant variation. The anaemic group was more dependent in terms of bathing, dressing, toileting and transferring. Conclusion In the elderly anaemic group, the dependency for daily activities that require physical effort was higher compared to the nonanaemic group. The MMSE score in the elderly anaemic group was lower than subjects who had normal haemoglobin levels. We conclude that anaemia may impair cognitive functions and some daily living activities in the elderly.Yayın Results of combination therapy with amifostine, pentoxifylline, ciprofloxacin and dexamethasone in patients with myelodysplastic syndrome and acute myeloid leukemia(Taylor and Francis Online, 2008) Akyol Erikçi, Alev; Öztürk, Ahmet; Karagöz, Bülent; Bilgi, Oğuz; Top, Cihan; Kandemir, E. GökhanMyelodysplastic syndrome (MDS) is a clonal disease of the bone marrow characterized by abnormal hematopoiesis and cytopenias. It has been shown that abnormal cytokine production together with apoptosis are major contributors to the cytopenias associated with the disorder. As the interaction of cytokines plays a role in the pathogenesis, suppression of the cytokine production by the administration of the combination of pentoxyfilline, ciprofloxacin, and dexamethasone (PCD combination) has resulted in the correction of at least some aspects of the cytopenias in the majority of patients and in complete hematologic remission in a small percentage. The aminothiol prodrug amifostine, a compound to protect tissues from cytotoxic drugs and radiotherapy has been found to stimulate proliferation of normal hematopoesis and suppress apoptosis in patients with MDS. In this study we report the results of combination therapy of amifostine and PCD in 12 patients with MDS and acute myeloid leukemia (AML). Amifostine was given in a dose of 200 mg/m2, as an i.v. infusion administered in 10 min, three times a week; pentoxyfilline 2400 mg/day, (3 × 800 mg) p.o.; ciprofloxacine, 1 g/day p.o.; dexamethasone 4·5 mg/day p.o. We achieved 66% response rate in our patients. In some cases responses were achieved in only thrombocytopenia or anemia whereas in others responses were achieved in multiple series. As a result it was found that amifostine + PCD combination may be beneficial in reversing cytopenias in the treatment of MDS and AML and is worth further study.Yayın Romatoid artritli hastalarda serum interleukin 1? düzeyleri ile insülin direnci arasındaki ilişki(Uludağ Üniversitesi Tıp Fakültesi, 2002) Top, Cihan; Keskin, Özcan; Tuncel, Altuğ; Önde, Mehmet EminDolaşımdaki normal düzeylerde insüline hedef hücrenin cevabında bozulma olarak tanımlanan insülin direnci, sık rastlanan patolojik bir durumdur. Sitokinlerin insülin duyarlılığı üzerindeki potansiyel etkileri yoğun araştırmalara konu olmuştur. Bu çalışmanın amacı, romatoid artritli hastalarda insülin direnci gibi glukoz metabolizma anormallikleri ile serum interleukin 1? düzeyleri arasındaki bağlantıyı araştırmaktır. Çalışmaya değişik derecelerde hastalık aktivitesine sahip romatoid artritli 36 hasta (22 kadın ve 14 erkek, ortalama yaş: 51.5 ±17.1 yıl (21-80 yaş arası), ortalama VKİ: 27.1±5.0 kg/m²) ve yaş, cinsiyet, VKİ olarak benzer özelliklere sahip 20 sağlıklı kontrol dahil edilmiştir. Açlık serum IL-1? ve insülin düzeyleri ölçüldü. İnsülin duyarlılığı HOMA yöntemiyle hesaplandı. Romatoid artritli hastalarda kontrollere oranla açlık serum insülin düzeyleri, HOMA skorları ve serum IL-1? düzeyleri anlamlı derecede yüksekti (14.7±6.7, 8.7±1.9 µIU/ml, p
