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    Alterations of platelet function and coagulation parameters during acute pancreatitis
    (Lippincott Williams & Wilkins, 2013) Akbal, Erdem; Demirci, Selim; Kocak, Erdem; Koklu, Seyfettin; Basar, Omer; Tuna, Yasar
    Vascular thrombosis and systemic hypercoagulable states are known complications of pancreatitis. Higher levels of mean platelet volume (MPV) have been associated with thrombotic diseases. However, a few studies have investigated the association between acute pancreatitis and MPV. We aimed to investigate whether there is a difference of MPV and coagulation parameters in patients with active and remission in acute pancreatitis. We included 24 consecutive patients with biliary acute pancreatitis and 24 consecutive healthy age-matched and sex-matched controls. Full blood counts and other laboratory tests were collected at onset and remission. The MPV was significantly higher in patients with acute pancreatitis at admission 8.6 +/- 1.4 fl than controls 7.6 +/- 0.7 fl (P=0.005). We detected positive correlation between, aspartate aminotransferase, alanine aminotransferase, g-glutamyltransferase, amylase, lipase, and glucose, BMI, D-dimer and MPV. However, there was negative correlation between progression, thrombocyte counts, hemoglobin and MPV. As a result higher MPV levels in acute pancreatitis may reflect hypercoagulation associated with pancreatitis. Blood Coagul Fibrinolysis 24:243-246 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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    Evaluation of serum L-FABP levels in patients with acute pancreatitis
    (Turkish Assoc Trauma Emergency Surgery, 2015) Kocak, Erdem; Akbal, Erdem; Koklu, Seyfettin; Adam, Gurhan
    BACKGROUND: The aim of this study was to assess the serum L-FABP levels in patients with acute pancreatitis and compare with healthy subjects. METHODS: Thirty patients with acute pancreatitis and thirty consecutive healthy age-and sex-matched control subjects were included into the study. The serum levels of L-FABP were measured upon admission and at the remission period. RESULTS: Upon admission, serum L-FABP concentration was significantly higher in patients with acute pancreatitis compared to control subjects (41009.41 +/- 32401.31 pg/ml vs. 17057.00 +/- 5015.74 pg/ml, p=0.008). Serum L-FABP levels decreased after the remission period; however, the differences were not statistically significant. In addition, serum L-FABP levels showed significant correlation with AST and LDH levels. CONCLUSION: Increased serum L-FABP levels may be related to the mechanism of pancreatic microcirculatory disturbance in patients with acute pancreatitis, suggesting that serum L-FABP could be used for a potential biomarker of acute pancreatitis.
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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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    Liver Fatty Acid-binding Protein Is A Diagnostic Marker to Detect Liver Injury Due to Chronic Hepatitis C Infection
    (Elsevier Science Inc, 2013) Akbal, Erdem; Koklu, Seyfettin; Kocak, Erdem; Cakal, Basak; Gunes, Fahri; Basar, Omer; Tuna, Yasar
    Background and Aims. Liver fatty acid-binding protein (L-FABP) is a small molecule. The aim of this study was to examine L-FABP levels and to detect its diagnostic value in chronic hepatitis C (CHC). Methods. We studied 22 patients with CHC and 20 healthy control subjects. Patients with persistently elevated serum aminotransferases and positive HCV RNA were included in the study. Patients with CHC underwent percutaneous liver biopsy. Serum level of L-FABP was determined by ELISA method. Results. Patients with CHC had significantly increased levels of L-FABP compared to controls. A strong correlation between serum L-FABP concentrations and aspartate aminotransferases, alanine aminotransferases, HCV RNA levels and hepatic inflammation was found. When a cut-off value was 29,000 pg/mL for L-FABP, sensitivity and specificity were 75 and 100%, respectively. Positive and negative predictive values for L-FABP were 100 and 78%, respectively. Conclusions. Serum L-FABP is used as a new diagnostic marker to detect liver injury. (C) 2013 IMSS. Published by Elsevier Inc.
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    Oral High-Dose Ankaferd Administration Effects on Gastrointestinal System
    (Ivyspring Int Publ, 2013) Akbal, Erdem; Koklu, Seyfettin; Astarci, Hesna Muzeyyen; Kocak, Erdem; Karaca, Gokhan; Beyazit, Yavuz; Topcu, Guler
    Background and aims: Ankaferd Blood Stopper (ABS) is a herbal extract obtained from five different plants. It has a therapeutic potential for the management of external hemorrhage and controlling gastrointestinal bleeding. However, ABS's effects are not unknown on gastrointestinal systems. The aim of this study was to assess the effect of short-and long-term systemic exposure and gastrointestinal safety following the oral administration of high-dose ABS in rats. Methods: Eighteen healthy adult male rats were included into the study. The rats were divided into 4 groups: group A was fed with high dose ABS (2ml/Kg) for one week, group B for one month, group C for three months and group D's diet did not contain any ABS. On termination of the ABS treatment, the gastrointestinal system from the esophagus to the anus and the liver were surgically removed and histological investigated. Results: During the study period, there was no mortality; signs of intoxication in any of the studied groups. No gastrointestinal tissue fibrosis, dysplasia, or metaplasia was detectable in any of the groups. The stomach had a normal morphology in all groups. However, the other gastrointestinal tract sections showed mucosal inflammation, goblet cell decrements, and intra-epithelial lymphocyte infiltration. The most common changes were mucosal inflammation in all rats in group B and C. Frequency of inflammation was greater in groups B and C in comparison to group A (P=0.001). Loss of goblet cell and intra-epithelial lymphocyte infiltration were not significantly different between groups A and B (P=0.308 and P=0.189, respectively). However, there was significantly higher intra-epithelial lymphocyte infiltration in group C than in group A (P=0.04). Histopathological examination of the liver showed no inflammation, fibrosis, bile duct destruction or proliferation in any of the groups. However, each groups revealed vascular dilatation and erythrocyte accumulation at the sinusoidal structures of the liver. Conclusions: ABS seems to be a safe agent and it can be used for hemorrhage originated from gastric lesions. Further work needs to be done to establish whether ABS leads to be used to stop gastrointestinal bleeding.
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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.