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    Increase in the Risk of ST Elevation Myocardial Infarction Is Associated With Homocysteine Level
    (Elsevier Science Inc, 2014) Akyurek, Omer; Akbal, Erdem; Gunes, Fahri
    Background and Aims. The present study aimed to investigate the relationship between coagulation defects and ST elevation myocardial infarction (STEMI) in patients without any known coronary artery risk factors and considered low risk according to the Framingham risk classification. Methods. This study included 76 (73.6% male) STEMI patients without any known risk factors for coronary artery disease and 56 healthy controls (67.8% male) with similar characteristics. Results. Factor V Leiden mutation was noted in two patients and in one control. There were no significant differences in protein C, protein S, or antithrombin 3 values between the patient and control groups (p = 0.405, p = 0.476, and p = 0.221, respectively). None of the participants had antiphospholipid syndrome, factor V deficiency, or factor VII deficiency. Plasma homocysteine level was significantly higher in the patient group (19.0 +/- 3.6) mu mol/L than in the control group (15.8 +/- 4.2) mu mol/L (p = 0.008). Homocysteine levels in both groups were higher in males without a statistically significant difference. Vitamin B12 and folate levels, which are directly related to homocysteine metabolism, did not differ significantly between groups. Correlation analysis showed that the homocysteine level was not correlated with lipid parameters, folate, or vitamin B12. Conclusion. Homocysteine level was significantly higher in acute MI in patients without any risk factors and were considered low risk according to the Framingham risk score. The findings support the hypothesis that homocysteine level may be an independent risk factor for coronary artery disease. (C) 2014 IMSS. Published by Elsevier Inc.
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    Liver fatty acid-binding protein as a diagnostic marker for non-alcoholic fatty liver disease
    (Springer Wien, 2016) Akbal, Erdem; Kocak, Erdem; Akyurek, Omer; Koklu, Seyfettin; Batgi, Hikmetullah; Senes, Mehmet
    Liver fatty acid-binding protein (L-FABP) is a small cytoplasmic protein. The aim of the current study was to investigate L-FABP levels and to determine their diagnostic value for non-alcoholic fatty liver disease (NAFLD). We enrolled in this study 24 consecutive patients with NAFLD who were diagnosed with elevated transaminases and with steatosis by ultrasonograph. The control group consisted of 22 healthy control subjects matched for age and gender. Serum levels of L-FABP were determined by enzyme-linked immunosorbent assay. L-FABP levels in NAFLD patients were higher than in the control group (levels were 41,976 +/- 18,998 and 17048 +/- 5021 pg/mL, respectively). A strong correlation was found between serum L-FABP concentrations and aspartate aminotransferase, alanine aminotransferase, body mass index, glucose and gamma-glutamyltransferase levels. A level of 284,000 pg/mL L-FABP had 73 % sensitivity and 100 % specificity. Positive and negative predictive values for L-FABP were 100 and 79%, respectively. Serum L-FABP can be considered as a new diagnostic marker for detecting non-alcoholic fatty liver disease.
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    Perianal basal cell carcinoma: An uncommon localization
    (Aves, 2014) Bulus, Hakan; Akyurek, Omer; Akbal, Erdem; Yavuz, Alper; Aydin, Altan; Simsek, Gulcin
    [Anstract Not Available]
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    Peroxisome Proliferator-activated Receptor Gamma Concentrations in Newly Diagnosed Hypertension Patients and the Metabolic Effects of Olmesartan
    (Elsevier Science Inc, 2014) Akyurek, Omer; Akbal, Erdem; Gunes, Fahri; Akyurek, Nesibe
    Background and Aims. We undertook this study to investigate the effects of olmesartan treatment on PPAR-gamma (PPAR-gamma) concentrations and metabolic syndrome (MetS) components in hypertensive (HT) patients. Methods. The study included 46 newly diagnosed hypertensive patients and 30 healthy controls. All hypertensive patients were given 40 mg of olmesartan, and they were evaluated weekly in the first month and then twice weekly during follow-up visits. At the end of 3 months, MetS components were assessed and serum PPAR-gamma transcription factor concentrations were again measured. Results. MetS was noted in 80.4% of HT patients. Serum PPAR-gamma transcription factor concentration were significantly lower in those with HT compared with the controls (p = 0.005). PPAR-gamma concentrations of controls were 1.14-fold higher than hypertensive patients. HDL levels were significantly increased after treatment (p = 0.004), triglyceride, total cholesterol, fasting blood glucose (FBG), and LDL levels were significantly reduced (p <0.05). There was a tendency toward increased PPAR-gamma concentrations after treatment, but these were not statistically significant (p = 0.154). Conclusions. Olmesartan treatment was found to generate beneficial effects on MetS parameters in HT patients but did not produce any significant increases in serum PPAR-gamma transcription factor concentration. (C) 2014 IMSS. Published by Elsevier Inc.
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    The relationship between visfatin, liver inflammation, and acute phase reactants in chronic viral hepatitis B
    (Springer Wien, 2016) Yuksel, Enver; Akbal, Erdem; Kocak, Erdem; Akyurek, Omer; Koklu, Seyfettin; Ekiz, Fuat; Yilmaz, Baris
    Chronic viral hepatitis B (CHB) is an important cause of morbidity and mortality. Adipokine stimulation might play an important role in the pathogenesis of chronic inflammation. The aim of this study was to evaluate serum visfatin concentrations and the relationship between visfatin, fibrosis, liver inflammation, and acute phase reactants in CHB patients. The sampling universe of the study consisted of 41 CHB patients and 25 healthy controls. All patients had positive hepatitis B surface antigen (Hepatitis e antigen (HBeAg) positive n: 7, n: 34 HBeAg negative) for at least 6 months and detectable serum HBV DNA. Serum visfatin concentrations were significantly higher in the CHB patients [18.0 +/- 10.9 ng dL(-1)] than in the healthy controls [9.4 +/- 1.6 ng dL(-1)] [P < 0.001]. On the other hand, fibrinogen and haptoglobin concentrations were significantly lower in CHB patients. A strong negative correlation was observed between serum visfatin concentration, haptoglobin, and fibrinogen levels; however, there was no significant correlation between visfatin, glucose, alanine aminotransferase, aspartate aminotransferase, BMI, Knodell score, fibrosis score, hepatitis B virus DNA, sedimentation, and C-reactive protein. Visfatin concentrations were elevated and visfatin was negatively correlated with haptoglobin and fibrinogen levels in CHB patients.
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    Treatment of hemorrhagic gastritis by Ankaferd blood stopper versus Omeprazole: experimental randomized rat models
    (Springer Wien, 2016) Batgi, Hikmetullah; Akbal, Erdem; Kocak, Erdem; Akyurek, Omer; Koklu, Seyfettin; Donmez, Melahat; Gunes, Fahri
    Ankaferd blood stopper (ABS) is a herbal extract that enhances mucosal healing. It has therapeutic potential in the management of external hemorrhage and controlling gastrointestinal bleeding associated with various benign lesions refractory to conventional antihemorrhagic measures. The aim of this experimental study was to assess the effects of ABS on hemorrhagic lesions and compare them with omeprazole. The study was conducted on 30 rats. Rats were divided into five groups: group A (only indomethacin), group B (ABS administration 60 min before indomethacin-induced injury), group C (ABS administration 30 min after indomethacin-induced injury), group D (omeprazole administration 60 min before indomethacinaEuroinduced injury), group E (omeprazole administration 30 min after indomethacinaEuroinduced injury). Gastric mucosal lesions were produced by indomethacin in all three groups. The effect was studied morphologically 6 h after oral administration of the drug. Subsequently, affected tissue was examined histologically. Based on the number and the total size of hemorrhagic lesions, the hemorrhagic lesion scores were significantly better in Group C compared to other groups (p < 0.05). The hemorrhagic lesion score of Group B was significantly better than Group D and Group A (p < 0.05). Omeprazole groups (Group D, Group E) did not show significant improvement as indicated by macroscopic scores. There was no significant difference between the groups with respect to microscopic scores. These results indicate that ABS has a potent inhibitory action on indomethacin-induced gastric bleeding and mucosal lesions and it is useful in the treatment of acute gastric mucosal lesions.