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    Relationship between raised intraocular pressure and ischemia-modified albumin in serum and humor aqueous: a pilot study in rabbits
    (Ijo Press, 2014) Comez, Arza Taskiran; Cakir, Dilek Ulker; Tutunculer, Funda Kirtay; Gencer, Baran; Tufan, Hasan Ali
    AIM: To evaluate the relationship between increased intraocular pressure (IOP), ischemia-modified albumin levels in serum (IMA-s) and in humor aqueous (IMA-(HA)) in rabbits. METHODS: Twenty-five albino New Zealand rabbits weighing between 2.0 and 2.8 kg were used in this pilot study. With permission from Canakkale Onsekiz Mart University Animal Ethics Committee, the 10P of both eyes of each rabbit were recorded with a Tonopen (Tono-Pen XL, Reichart Inc., Depew, NY, USA) after the application of topical proparacaine 0.5% HCI anesthesia. Blood (4 mL) was collected from the marginal ear vein and an intracameral injection of 2.3 mg/mL sodium hyaluronate and subconjunctival dexamethasone was given in the right eye. Anterior chamber aqueous fluid was obtained using a timbal approach with a 27 gauge needle from both eyes. The left eyes were used as controls. 10P was measured on the 1st, 3rd and 10th day after the initial injection, with Tonopen, IMA -s levels and IMA -(HA) examined simultaneously. RESULTS: Before the injections, 10P was 11.4 +/- 3.0 mm Hg in the right eye and 11.3 +/- 3.1 mm Hg in the left eye (P> 0.05). There was a statistically significant difference between IMA-s levels before the IOP increase (IMA-s(o)) and IMA-s levels on the 1st and 3rd days after the increase in 10P (P=0.012 and P=0.01, respectively). No difference was observed between IMA -s(o) and serum IMA levels on the 10th day (IMA-s10) after IOP increase (P=0.989). IMA-HA in the right eye in the first day after the injection was positively correlated with 10P(gamma =0.748; P=0.02).No other correlation is found between any other parameter With IMA-Fik levels at any test time. A statistically significant positive correlation was observed between IMA-s values and 10P on the 1st and 3rd days(r =0.398, P =0.04 and r = 0.382, P =0.04, respectively). There was no correlation between IMA-s levels and increased 10P on the 10th day after kW increase (r =0.026, P =0.902). CONCLUSION: IMA may be an important indicator of acute damage caused by diseases involving ischemic damage to the eye, especially in case of increased intraocular pressure.
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    SERUM ISCHEMIA MODIFIED ALBUMIN LEVELS IN SUBCLINICAL CUSHING'S SYNDROME
    (Carbone Editore, 2016) Ozku, Faruk; Turkon, Hakan; Cakir, Dilek Ulker; Eroglu, Mustafa; Tutunculer, Funda Kirtay; Faydaci, Umut; Ukinc, Kubilay
    Introduction: Subclinical Cushing's syndrome (SCS) is defined as biochemical overt cortisol excess in the absence of the classical signs and symptoms of Cushing's disease. The prevalence of SCS is reported as between approximately 5% and 24% in patients with adrenal incidentalomas (AI). SCS has increased cardiovascular and metabolic risk factors, and metabolic syndrome. Recently some studies demonstrated oxidative stress enhancement in Cushing's disease. Ischemia-modified albumin (IMA) is a marker of ischemia and oxidative stress and is increased in different clinical conditions such as cardiovascular diseases and metabolic syndrome. However, it has not been investigated in the patients with SCS. We aimed to evaluate serum IMA levels in the patients with SCS. Materials and methods: A total of 128 patients with AI were included in this study (17 patients with SCS and 111 patients with non-functional adenomas (NFA)). All patients were evaluated for the presence of adrenal masses using adrenal computed tomography (CT) scans. Serum IMA levels were measured by using a calorimetric method. Results: Serum IMA levels were significantly higher in SCS patients than in NFA patients (p < 0.05). Serum IMA was significantly correlated with waist circumference, low-density lipoprotein (LDL) levels and SCS. Furthermore, regression analysis revealed that serum IMA levels are independent and positively associated only with SCS. Conclusion: We concluded that elevated serum IMA levels might be accepted as a useful marker in patients with SCS. In order to reveal the pathological role of IMA levels in patients with SCS more studies are required.
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    Serum ischemia modified albumin levels in subclinical cushing's syndrome
    (A. CARBONE Editore, 2016) Ozkul, Faruk; Turkon, Hakan; Cakir, Dilek Ulker; Eroglu, Mustafa; Tutunculer, Funda Kirtay; Faydaci, Umut; Ukinç, Kubilay
    Introduction: Subclinical Cushing's syndrome (SCS) is defined as biochemical overt cortisol excess in the absence of the classical signs and symptoms of Cushing's disease. The prevalence of SCS is reported as between approximately 5% and 24% in patients with adrenal incidentalomas (AI). SCS has increased cardiovascular and metabolic risk factors, and metabolic syndrome. Recently some studies demonstrated oxidative stress enhancement in Cushing's disease. Ischemia-modified albumin (IMA) is a marker of ischemia and oxidative stress and is increased in different clinical conditions such as cardiovascular diseases and metabolic syndrome. However, it has not been investigated in the patients with SCS. We aimed to evaluate serum IMA levels in the patients with SCS. Materials and methods: A total of 128 patients with AI were included in this study (17 patients with SCS and 111 patients with non-functional adenomas (NFA)). All patients were evaluated for the presence of adrenal masses using adrenal computed tomography (CT) scans. Serum IMA levels were measured by using a colorimetric method. Results: Serum IMA levels were significantly higher in SCS patients than in NFA patients (p < 0.05). Serum IMA was significantly correlated with waist circumference, low-density lipoprotein (LDL) levels and SCS. Furthermore, regression analysis revealed that serum IMA levels are independent and positively associated only with SCS. Conclusion: We concluded that elevated serum IMA levels might be accepted as a useful marker in patients with SCS. In order to reveal the pathological role of IMA levels in patients with SCS more studies are required.
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    The effect of anaesthesia technique on maternal and cord blood ischaemia-modified albumin levels during caesarean section: A randomized controlled study
    (Sage Publications Ltd, 2013) Omur, Dilek; Hacivelioglu, Servet Ozden; Oguzalp, Huseyin; Uyan, Berna; Kiraz, Hasan Ali; Duman, Can; Tutunculer, Funda Kirtay
    Objective: Ischaemia-modified albumin (IMA) is an early marker for various ischaemic events, including cardiac ischaemia. This study determined variations in IMA levels during caesarean section, performed under general anaesthesia or with combined spinal epidural anaesthesia. Methods: Full-term, healthy pregnant women were allocated to undergo caesarean section, using either general anaesthesia or combined spinal epidural anaesthesia. IMA and albumin levels were measured in maternal serum samples taken immediately prior to caesarean section and 30min into the procedure, as well as from serum taken from cord blood after double clamping. Results: At total of 51 healthy pregnant women underwent either general anaesthesia (n=28) or combined spinal epidural anaesthesia (n=23). Within-group analysis of the general anaesthesia group showed that both IMA levels and IMA/albumin ratios were significantly higher at 30min of surgery compared with the immediate preoperative period. Conclusions: Lower IMA levels in the combined spinal epidural anaesthesia group may have been due to improved balancing of oxidative stress during caesarean section. Further research on IMA levels during caesarean section should take into account the method of anaesthesia used.
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    The reference values of ischemia modified albumin levels in healthy people admitted to a university hospital
    (Walter De Gruyter Gmbh, 2014) Duman, Can; Bakar, Coskun; Essizoglu, Ertan; Tutunculer, Funda Kirtay; Demircan, Elif
    Objectives: The Ischemia Modified Albumin (IMA) test is a myocardial ischemia marker which may have potential use for the diagnosis of Acute Coronary Syndrome. The aim of this study was determine reference values of IMA test on the healthy people over the age of 15 who's admitted to canakkale Onsekiz Mart University. Methods: This study was performed on 582 people over 15 years old and healthy in appearance who had presented at the canakkale Onsekiz Mart University Faculty of Medicine Research and Application Hospital. The year 2011 population of Turkey was taken as the reference in the distribution of the study group according to age group and gender. A survey which queried the demographic features and health problems was administered to the participants of the study and 9 cc venous blood was drawn. IMA levels were measured by using the spectrophotometric method defined by Bar-Or. The mean, standard deviation, median, minimum, maximum, and 2.5 % - 97.5 % interval were used in order to detect the IMA reference values. Results: A total of 274 males (47.1 %) and 308 women (52.9 %) were studied. The mean IMA value of the examined group was 0.339 +/- 0.093, and the median was 0.343 (Min-Max: 0.053 - 0.631), while the 2.5 % - 97.5 % percentil values were 0.145 - 0.530. Conclusion: Studies that indicate the reference levels of the IMA for the diagnosis of ischemic conditions are insufficient. Our study is expected to contribute to closing this gap.