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Biomedical subjects

Okan Erdogan

Publications and source records attributed to Okan Erdogan.

At least 19 recordsLinked to original sources
PubMed2006

Electrocardiographic prediction of left ventricular geometric patterns in patients with essential hypertension.

BACKGROUND: The present study sought to determine the diagnostic value of electrocardiographic voltage criteria in predicting geometry patterns in patients with essential hypertension. METHODS: Patients with essential hypertension (n=125) according to left ventricular mass index and relative wall thickness as determined by echocardiography were assigned in the following groups: normal geometry (N, n=50), concentric remodeling (CR, n=12), concentric hypertrophy (CH, n=28) and eccentric hypertrophy (EH, n=35). Each patient underwent 12-lead ECG followed by determination of conventional voltage criteria as well as peak to peak QRS lengths in each lead. RESULTS: Voltage criteria such as Sokolow-Lyon, Cornell, Cornell product >2440, D1R+D3S >25 mm, and AVL R >11 mm could not significantly predict and discriminate geometric patterns of LVH. However, they all were very specific (range 97-100%) and showed very high positive predictive values (range 94-100%) for detecting abnormal geometry. DI peak >12 mm had a sensitivity 61%, specificity 67%, accuracy 63%, positive predictive value 81%, and negative predictive value 42% in predicting to differentiate CH from CR. Sum of the calculated values from the peak of the R to the nadir of the S wave in all limb leads >60 mm had sensitivity 68%, specificity 75%, accuracy 70%, positive predictive value 86% and negative predictive value 50% in predicting to differentiate CH from CR. CONCLUSIONS: Conventional ECG voltage criteria could not significantly discriminate specific geometry patterns observed in patients with essential hypertension.

Echocardiography↗
PubMed2006

Contrast-induced nephropathy: preventive and protective effects of melatonin.

Infusion of contrast agents increases osmotic load, viscosity, hypoxemia of the renal medulla and renal free radical production through post-ischemic oxidative stress. The present experimental study sought to determine whether melatonin, because of its anti-oxidant properties might have a preventive and protective role against the development of contrast-induced nephropathy (CIN). Twenty-four adult male rats were divided into four experimental groups: healthy control rats (CR), rats with CIN (CINR), rats with CIN pretreated with melatonin (CINR1M), and rats with CIN pre- and post-treated with melatonin (CINR2M). In CINR, both serum creatinine (Cr) level and fractional excretion of sodium (FE-Na) significantly increased, whereas Cr clearance decreased at post-CIN compared with pre-CIN period. Rats in CINR1M did not show any improvement in renal function. Cr clearance decreased, whereas both serum Cr level and FE-Na increased in rats pretreated with melatonin. In contrast, significant improvements were observed in CINR2M. Serum Cr and Cr clearance did not change, whereas FE-Na significantly reduced in rats pre- and post-treated with melatonin. In conclusion, the present experimental study clearly demonstrated the preventive and protective role of melatonin against the development of CIN.

Animals↗
PubMed2005

Effect of renal transplantation on endothelial function in haemodialysis patients.

BACKGROUND: Haemodialysis patients (HD) have been characterized by a high incidence and prevalence of atherosclerotic cardiovascular disease. Based on the traditional cardiovascular risk factors in this population, we cannot explain this high incidence and prevalence. One of the mechanisms contributing to cardiovascular risk in HD patients may be to uraemic toxins. Cardiovascular risk factors and uraemic toxins themselves may cause endothelial dysfunction, which may play a pivotal role in the development and progression of atherosclerosis in this population. We hypothesized that elimination of uraemic toxins in response to renal transplantation (RTx) can improve endothelial function as assessed by flow-mediated dilatation of brachial artery in haemodialysis (HD) patients. METHODS: Endothelial function measured by flow-mediated dilatation of the brachial artery (FMD) and glyceryltrinitrate-induced dilatation of the brachial artery (NMD) were assessed twice, during haemodialysis treatment and after RTx in 30 chronic haemodialysis patients. All patients were characterized by absence of known atherosclerotic disease and traditional cardiovascular risk factors. We also studied age- and gender-matched 20 normotensive healthy controls. RESULTS: FMD values significantly improved after RTx (6.69+/-3.1% vs 10.50+/-3.0%, P<0.001) in HD patients. FMD of patients both during haemodialysis and after RTx was lower than in healthy controls (6.69+/-3.1%, 10.50+/-3.0% vs 14.02+/-2.3%, P<0.001 and P<0.01, respectively). There was no change in NMD values after RTx in HD patients (16.27+/-1.9% vs 16.30+/-1.8%, P>0.05). Also, NMD values in all patients were similar to healthy control values. CONCLUSIONS: There is an improvement of endothelial function as assessed by FMD of the brachial artery after RTx in HD patients. This may be attributed to the elimination of uraemic toxins by successful RTx.

Adult↗
PubMed2004

Acute effect of DDD versus VVI pacing on arterial distensibility.

UNLABELLED: Pulse wave velocity (PWV) is a new technique and frequently used today to determine the elastic distensibility of great arteries. Increased arterial stiffness and PWV have been proposed as possible mechanisms in the initiation and/or progression and/or complications of atherosclerosis and cardiovascular disease. We evaluated the acute effect of two frequently used pacing modes (DDD vs. VVI) on arterial distensibility using PWV. METHODS: Seventeen patients (age, 56 +/- 14 years) implanted with DDD pacemakers were included in the study. All patients were pacemaker dependent and continuously paced at the programmed rate. PWV was measured first in DDD mode, and then the mode was switched to VVI, and PWV was measured again at the same programmed heart rate as in the DDD mode. RESULTS: Although systolic blood pressure significantly decreased from 129 +/- 18 to 119 +/- 16 mm Hg (p = 0.001) after switching the mode from DDD to VVI, diastolic blood pressure (81 +/- 12 vs. 80 +/- 13 mm Hg; p = 0.38) did not change. In addition, PWV significantly increased from 11 +/- 2.46 m/s in DDD mode to 11.29 +/- 2.43 m/s (p = 0.01) after having been programmed to VVI mode. CONCLUSIONS: Our results suggest that VVI pacing increases PWV, and therefore decreases arterial distensibility, and thus may contribute to the development and progression of atherosclerosis.

Adult↗
PubMed2004

Loratidine improves ischemic parameters of exercise stress test in patients with acute myocardial infarction.

BACKGROUND: This study sought to determine whether adding an anti-histaminic medication, loratidine, to anti-ischemic treatment would ameliorate or improve ischemic parameters induced by exercise stress test in patients who suffered an acute myocardial infarction. METHODS: Twenty stable patients with acute inferior myocardial infarction who had a positive EST were randomly allocated into 2 groups, A and B. Patients in group A and B received a 10 mg loratidine tablet added daily to their anti-ischemic regimen for 7 days during the second and third week post-event, respectively. At the end of each period they underwent an exercise stress test (EST). Exercise parameters in each group were then compared before and after loratidine therapy. RESULTS: Both groups showed improvements in exercise parameters after loratidine therapy compared to basal EST results. ST(max) ( group A: 1.9 +/- 0.74 vs 0.9 +/- 1.29 mm, P = .046; group B: 2.5 +/- 0.71 vs 1.4 +/- 1.17 mm, P = .041), ST(lead) ( group A: 3.4 +/- 1.08 vs 1.5 +/- 2.12, P = .027; group B: 4.6 +/- 1.71 vs 2.22 +/- 2.25, P = .011), ST(total) ( group A: 4.7 +/- 2.18 vs 2.1 +/- 3.11 mm, P = .024; group B: 7.9 +/- 2.92 vs 3.33 +/- 3.81 mm, P = .005). CONCLUSION: Our study revealed that loratidine, a histamine-1 receptor blocker, improves ischemic parameters of EST when given as additive therapy to a routine anti-ischemic regimen during the sub-acute phase of myocardial infarction.

Adrenergic beta-Antagonists↗
PubMed2003

Management of a patient with active rheumatoid arthritis and suspected tuberculosis causing effusive-constrictive pericarditis.

In the following case report we present a patient who has been admitted for pericardial effusion causing cardiac compression with active rheumatoid arthritis and suspected tuberculosis. The patient was successfully treated with intravenous pulse steroid for active rheumatoid arthritis, with prophylactic anti-tuberculosis agents for suspected tuberculosis and with surgical pericardiectomy for the thickened pericardium as well as recurrent pericardial effusion.

Antitubercular Agents↗
PubMed2003

Increased immunoglobulin E response in acute coronary syndromes.

The role of inflammation and mast cell activation has been implicated in atherosclerotic plaque destabilization and rupture. To investigate the role of immunoglobulin E (IgE) in acute coronary syndrome, a prospective clinical study was conducted in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP), and healthy controls. IgE levels were serially measured and compared in consecutive patients with AMI (n = 16) and UAP (n = 14) on days 1, 3, 7, 21 after admission and 3 months later and only once in stable angina pectoris (n = 15) and healthy controls (n = 14). In addition, blood eosinophil and basophil levels on admission were measured in all groups and compared. Initial IgE levels determined at admission in patients with AMI, UAP, and SAP were significantly higher than levels in the control group (p = 0.002). Initial high IgE level in AMI on day 1 increased to a peak by day 7 (p = 0.024), then gradually decreased by day 21 and at 3 months (p = 0.052). High IgE level in UAP persisted by day 7 and gradually decreased by day 21 and 3 months (p = 0.037 and p = 0.018, respectively). Blood eosinophil count on admission was significantly higher in UAP than in the control group (p = 0.005). Basophil levels of both AMI and UAP groups on admission were found to be elevated as opposed to control group (p = 0.02 and p = 0.012, respectively). This study demonstrates that the level of IgE significantly increased during the acute phase of acute coronary syndromes and gradually decreased, supporting the role of acute inflammatory response and mast cell involvement in plaque rupture.

Acute Disease↗
PubMed2003

C-reactive protein and immunoglobulin-E response to coronary artery stenting in patients with stable angina.

Recent reports indicate that inflammatory mechanisms play a crucial role in the pathogenesis of atherosclerosis and neointimal proliferation as well as coronary restenosis. To provide baseline data for further studies regarding stenting, restenosis and inflammatory response. we prospectively conducted a clinical study to investigate the time related response of plasma levels of immunoglobulin-E (IgE) and C-reactive protein (CRP) which are two different inflammatory markers mediated by different cytokines in stable patients who underwent elective coronary artery stenting. Thirteen consecutive stable patients who underwent coronary artery stenting were included in the study. Levels of IgE and CRP were determined pre- and poststent implantation on four consecutive days and at the end of the first as well as third month. Levels of these two markers were gradually elevated on postprocedure days while reaching peak values on the second and third days for IgE (initial 278 +/- 335 IU/mL vs peak 350 +/- 489 IU/mL, P = 0.01) and CRP (initial 0.5 +/- 0 mg/dL vs peak 2.7 +/- 3 mg/dL, P = 0.002), respectively. High levels gradually returned to baseline values determined at the end of the first and even third months after stent implantation implying an acute inflammatory reaction. Stent implantation seems not to cause any persistent and ongoing inflammatory response in the long-term.

Aged↗
PubMed2003

Symmetrical peripheral gangrene and dopamine.

We describe a case of a 55-year-old man with hypovolemic shock who developed a symmetrical peripheral gangrene (SPG) on hands and feet. The SPG syndrome consists of sudden onset of symmetrical gangrene of the fingers, toes and rarely, the nose, upper lip, ear lobes or genitals without large vessel obstruction or vasculitis. Vasopressors have been implicated directly or as a contributory cause in many cases. In this case, dopamine was used with high dose (> 20 microg/kg/min) which is inappropriate in hypovolemic shock states. SPG might be a severe and rare complication of dopamine. Care should be taken with the use of dopamine in patients with shock.

Blood Transfusion↗
PubMed2002

Electromagnetic interference on pacemakers.

External sources, either within or outside the hospital environment, may interfere with the appropriate function of pacemakers which are being implanted all around the world in current medical practice. The patient and the physician who is responsible for follow-up of the pacing systems may be confronted with some specific problems regarding the various types of electromagnetic interference (EMI). To avoid these unwanted EMI effects one must be aware of this potential problem and need to take some precautions. The effects of EMI on pacemaker function and precautions to overcome some specific problems were discussed in this review article. There are many sources of EMI interacting with pacemakers. Magnetic resonance imaging creates real problem and should be avoided in pacemaker patients. Cellular phones might be responsible for EMI when they were held on the same side with the pacemaker. Otherwise they don't cause any specific type of interaction with pacemakers. Sale security systems are not a problem if one walks through it without lingering in or near it. Patients having unipolar pacemaker systems are prone to develop EMI because of pectoral muscle artifacts during vigorous active physical exercise.

Journal Article↗
PubMed2002

Acute short-term effect of VVI pacing mode on P wave dispersion in patients with dual chamber pacemakers.

The acute or chronic effect of VVI pacing on P wave duration in the same patient with dual chamber pacemaker has not been studied before. Hence, with the purpose of determining whether VVI pacing increases dispersion of atrial refractoriness, we undertook a comparative study with the aid of a simple noninvasive approach, namely P wave dispersion (PWD) determined from surface electrocardiogram in the same patients who were implanted with dual chamber pacemakers. Pmax duration calculated in VVI paced mode was significantly higher than in VDD paced mode (121+/-21 vs. 111+/-17 ms, P=0.021). PWD (33+/-15 vs. 40+/-23 ms, P=0.062) did not demonstrate any significant difference between VDD and VVI paced modes, respectively. In conclusion, the findings of our study suggest that short-term VVI pacing itself does not have any direct effect on PWD in patients with dual chamber pacemakers. Different pacing modes in the long term might be responsible for altering PWD and the occurrence of atrial fibrillation while affecting the autonomic nervous system.

Adolescent↗
PubMed2002

Lymphoepithelioma-like carcinoma of the breast.

Lymphoepithelioma-like carcinoma (LELC) of the breast is a rare, newly recognized subtype of breast carcinoma. Distinction from medullary carcinoma is important because of the difference in biologic behavior of these two neoplasms and LELC of the breast is regarded as an unusual form of lobular carcinoma. We present the case of a 56-year-old female with a breast mass measuring 2 cm in diameter, which was diagnosed as invasive lobular carcinoma with LELC pattern. This is the ninth case reported in the English literature and to the best of our knowledge the first one with lymph node metastasis.

Breast Neoplasms↗
PubMed2002

Electrocardiographic demonstration of intermittent left bundle branch block because of the "linking" phenomenon.

The authors describe a patient who showed intermittent left bundle branch block at a slow heart rate. The perpetuation of left bundle branch block is suggested because of rate dependent bundle branch block and trans-septal retrograde concealed penetration by the contralateral bundle as it is resolved by a premature ventricular extrasystole. This phenomenon is called "linking." This case report aims to present and emphasize this interesting phenomenon.

Bundle-Branch Block↗