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    Butyrylcholinesterase as an additional marker in the diagnostic network of acute myocardial infarction
    (Walter De Gruyter Gmbh, 2016) Kocabaş, Ramazan; Erenler, Ali Kemal; Yetim, Mücahit; Doğan, Tolga; Erdemli, Hacı Kemal
    Background: Acute coronary syndrome defines a broad spectrum of complaints from angina to irreversible myocardial damage. There is an ongoing need for a biomarker to predict and diagnose acute myocardial infarction (AMI) in the early stage. In this study, our aim was to reveal early diagnostic value of butyrylcholinesterase (BChE) in discrimination of healthy subjects and patients with AMI. Methods: Eighty-five patients admitted to our hospital due to AMI and 45 healthy subjects were involved in the study. Patients and controls were compared according to BChE, lipid profiles and biochemical parameters. Results: The serum BChE activity was significantly lower in patients with AMI than in the controls (p < 0.001). After correlation analysis, while a negative correlation was determined between the serum BChE concentrations and AMI presence (r = -0.363, p < 0.001); a positive correlation was determined between the serum BChE and cholesterol (r = 0.443, p < 0.001), HDL (r = 0.243, p = 0.006) and LDL (r = 0.369, p < 0.001) levels. The data indicate that BChE is associated with AMI and a subsequent receiver operating characteristic curve (ROC) analysis revealed that BChE, as an independent indicator, may differentiate AMI patients from controls. A cut-off point set at = 7.15 kIU/L, BChE showed a sensitivity of 51.2% and a specificity of 84.4% (AUC = 0.719, p < 0.001). Conclusions: Low BChE level was significantly associated with AMI when compared to healthy subjects. Even though it has low sensitivity, plasma levels of BChE might represent an additional marker in the diagnostic network of AMI.
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    Evaluation of ovarian reserve in women with overt or subclinical hypothyroidism
    (Termedia Publishing House Ltd., 2018) Küçükler, Ferit Kerim; Görkem, Ümit; Şimşek, Yasin; Kocabaş, Ramazan; Güler, Serdar
    Introduction: Thyroid dysfunction is among the most common autoimmune disorders in women of reproductive age. Previous studies have shown the association between autoimmune thyroid disease (AITD) and infertility. Anti-Müllerian hormone (AMH) is secreted by granulosa cells and is a useful marker for assessment of ovarian reserve. In the present study, we sought to evaluate the ovarian reserves of women with autoimmune thyroid disorder by measurement of AMH values. Material and methods: This prospective study included women with newly diagnosed AITD aged between 20 and 40 years. Patients were divided into three groups: Subclinical hypothyroidism (SCH, n = 21), overt hypothyroidism (OH, n = 21) and controls (CG, n = 32). Study parameters included serum free T4, free T3, thyroid-stimulating hormone, anti-thyroglobulin, anti-thyroid peroxidase antibodies, follicle-stimulating hormone, luteinizing hormone, estradiol and AMH concentrations measured in the early follicular phase. Antral follicle count (AFC) was assessed with ultrasound. Body mass index (BMI) and waist circumference of the patients were noted. Results: No significant difference was found among SCH, OH and CG in regard to ovarian reserves measured by AMH values (p = 0.19) and AFC (p = 0.80). A significant negative correlation was found between AMH and BMI (r = -0.382, p = 0.001). Anti-Müllerian hormone and waist circumference (r = -0.330, p = 0.004) were also negatively correlated. Conclusions: Although AMH values were not significantly different among groups, AMH values were lower in OH and SCH patients, indicating a possible need for close monitoring of these patients. © 2016 Termedia & Banach.
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    Increased serum heme oxygenase-1 levels as a diagnostic marker of oxidative stress in preeclampsia
    (Informa Healthcare, 2014) Erdemli, Hacı Kemal; Yıldırımlar, Pınar; Alper, Tayfun Yaşar; Kocabaş, Ramazan; Salış, Oman; Bedir, Abdülkerim
    Objective: To evaluate the utility of serum biomarkers in the diagnosis of preeclampsia (PE) and also investigate possible correlation with pathogenesis of PE. Methods: Maternal serum concentrations of heme oxygenase-1 (HO1) and N-myc downstream-regulated gene 1 (NDRG1) were measured at 27-34 weeks of gestation in a case-control study of 33 pregnant women diagnosed with PE and in 43 normotensive pregnant women without proteinuria. The Mann-Whitney U test and Spearman's correlation were used for statistical analysis. Results: The median serum HO1 level was found to be significantly higher in the PE group [76.7 ng/ml (23.4-445.7)] than control group [55.9 ng/ml (3.7-354.3)] (p = 0.006). Positive correlation was found between HO1 levels with presence of PE (r = 0.316, p = 0.005). There was no significant difference in NDRG1 values between the two groups (p = 0.226). Conclusions: Serum HO1 levels were found to be increased in patients with PE compared with normotensive pregnant women. © Informa Healthcare USA, Inc.
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    Is median value of double screening test regional?
    (Turkish Biochemistry Society, 2015) Erdemli, Hacı Kemal; Kocabaş, Ramazan; Özdemir, Tülay; Bedir, Abdülkerim
    Objective: The median values of double test which is commonly used for Down Syndrome screening show diversity between countries. In this study, we aimed to investigate the possible differences in corrected multiplies of median (MoM) values of individiuals between the two cities of the same geographic region. Methods: Blood samples for double test analysis, sent from Corum and Samsun, were studied in the same laboratory. Results of double test analyses were retrospectively evaluated. Mann-Whitney U test was used for comparison of corrected MoM values of free human chorionic gonadotropin (f-? hCG) and pregnancy-specific plasma protein-A (PAPP-A) according to gestational age. Results were given as median (minimum-maximum) values. The p <0.05 was considered significant. Results: The corrected f-? hCG values obtained from Corum and Samsun were as follows: 0.75 (0.24-2.11, n=28), 0.85 (0.21-2.95, n=143) (p=0.378) in 10th gestational week; 0.75 (0.17-4.15, n=349), 0.84 (0.14-4.76, n=672) (p=0.005) in 11th gestational week; 0.81 (0.15-5.15, n=542), 0.86(0.19-5.18, n=946) (p=0.014) in 12th gestational week; 0.77 (0.20-6.32, n=365), 0.87 (0.20-5.54, n=327) (p=0.054) in 13th gestational week, respectively. Corrected PAPP-A values from Qorum and Samsun were as follows: in 10th gestational week 0.94 (0.41-5.57), 0.87(0.19-3.53) (p=0.425); in 11th gestational week 0.88 (0.21-3.61), 0.89 (0.19-3.70) (p=0.963); in 12th gestational week 0.89 (0.22-4.24), 0.90 (0.15-4.99) (p=0.704); in 13th gestational week 0.93 (0.19-2.70), 0.90 (0.09-2.80) (p=0.952) respectively. Conclusion: The MoM values of f-? hCG tests, derived from individuals from Çorum and Samsun, both located in the Central Black Sea Region, were found to be different. This finding indicates that for double test analysis, different median values may be used for patients from different cities. © 2015 Turkish Biochemistry Society. All rights reserved.
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    Is Serum Caveolin-1 a Useful Biomarker for Progression in Patients with Colorectal Cancer?
    (Verlag Klinisches Labor GmbH, 2016) Erdemli, Hacı Kemal; Kocabaş, Ramazan; Şaliş, Osman; Karagöz Şen, Fatma; Akyol, Sümeyya; Eskin, Fatih; Akyol, Ömer; Bedir, Abdülkerim; Şahin, Abdullah Fahri
    Background: Colorectal cancer (CRC) is the third most common cause of cancer diagnosed in males and the second in females. Survival is strongly related to stage at diagnosis. There is an urgent need to find a noninvasive biomarker that can be commonly applied for screening diagnosis, early detection of recurrence, and monitoring of metastatic CRC. Protein caveolin-1 (CAV-1) has been known to be expressed abnormally in colon cancer and appears to contribute to aberrant signaling and protein trafficking. There are controversial results regarding the role of CAV-1 in cancer. We hypothesized that levels of CAV-1 in serum of patients with CRC might be important to estimate the progression of the disease. Therefore, the purpose of this study is to investigate whether serum CAV-1 might be used as a factor determining progression of CRC. Methods: A total of 61 patients with CRC (26 male, 35 female) and 46 controls (38 male, 8 female) were enrolled. Serum CAV-1 levels were measured by ELISA. The relationship between CAV-1 and progression-free survival (PFS) was analyzed with use of receiver operating characteristic (ROC) and Kaplan-Meier analysis. Results were given as median (95% CI). Mann-Whitney test was used for the comparison of groups. Results: CAV-1 levels were found to be 11.5 ng/mL (10.4-12.9) in CRC and 11.9 ng/mL (10.7-14.4) in controls (p = 0.465). The serum CAV-1 levels in CRC patients with disease progression and without progression were respectively 10.0 ng/mL (8.5-11.3) and 12.2 ng/mL (11.1-14.8) (p = 0.023). In ROC analysis, if CAV-1 levels are equal or lesser than 10.73 ng/mL, it might show presence of progression with a sensitivity 73.3% and specificity 66.7% in patients with CRC (area under the ROC curve (AUC) = 0.697, p = 0.005). The mean PFS time was found to be 29.7 months (19.8 - 39.7, 95% CI for the mean) in patients who have CAV-1 level<10.73 ng/mL and 61.9 months (44.2 - 79.6) in patients who have CAV-1 level>10.73 ng/mL [hazard ratios (HR) with 95% CI = 3.49 (1.26 - 9.68) (p = 0.017)]. Conclusions: Our results strongly suggest that CAV-1 levels might be used as a marker to determine progression of CRC. When considered in combination with other biomarkers of CRC, CAV-1 is clinically informative and instructive.
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    Ischemia-modified albumin is not elevated in deep venous thrombosis
    (Verlag Klinisches Labor GmbH, 2015) Ereren, Emrah; Erenler, Ali Kemal; Karavelioğlu, Yusuf; Kocabaş, Ramazan; Erdemli, Hacı Kemal
    Background: In this article, we aimed to determine the diagnostic role of ischemia-modified albumin (IMA) in the evaluation of patients with deep venous thrombosis (DVT). Methods: Fifty-five patients with a diagnosis of DVT and 47 healthy subjects as the control group were included in the study. Blood samples of the patients were obtained within the first 24 hours after DVT diagnosis for IMA analysis. Patient and control groups were compared with respect to IMA levels. Results: We found that HDL and albumin levels were significantly higher in the control group. However, we could not determine a significant increase in IMA levels in patients with DVT when compared to the control group. Conclusions: Our study revealed that IMA is not a useful marker in the diagnosis of DVT.
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    Kan alma tüplerinin folat ölçümlerine etkisi
    (Türk Klinik Biyokimya Derneği, 2016) Erdemli, Hacı Kemal; Kocabaş, Ramazan; Akyol, Sümeyya
    Amaç: Pıhtı aktivatörlü kan alma tüpleri klinik laboratuvarlarda yaygın olarak kullanılmaktadır. Siemens Advia Centaur XP cihazındaki sıra dışı yüksek folat sonuçları kan alma tüplerinin folat ölçümleri üzerine etkisini araştırmamıza sebep oldu. Gereç ve Yöntem: Pıhtı aktivatörlü üç plastik tüp tipi, potansiyel ölçüm interferansı açısından değerlendirildi; Vacutest REF11030 (Grup A), Becton Dickinson (BD) Vacutainer CAT REF367896 (Grup B) ve BD Vacutainer SSTTM II Advance REF367953 (jelli) (Grup C). Görünürde sağlıklı 13 bireyden farklı tüplere alınan kanlarda serum folat konsantrasyonları Siemens Advia Centaur XP, Roche E-170 ve Beckmann Unicell DXI800 cihazlarında ölçüldü ve sonuçlar karşılaştırıldı. İstatistiksel olarak p<0.05 anlamlı kabul edildi. Bulgular: Folat düzeyleri Siemens AdviaCentaur XP cihazı ile ölçüldüğünde; Grup A'da (13.44 ± 4.56 ng/mL) Grup B (8.82 ± 3.33 ng/mL) ve Grup C (8.58 ± 2.83 ng/mL) tüplerinden anlamlı derecede daha yüksekti (p<0.001). Roche E-170 ve Beckmann UniCel DXI800 cihaz sonuçlarında tüp grupları arasında bir farklılık görülmedi (p>0.05). Grup A tüplerine alınmış, farklı cihazlardan elde edilen serum folat düzeyleri karşılaştırıldığında, Siemens Advia Centaur XP cihaz sonuçları (13.44 ± 4.56 ng/mL), Roche E170 (9.15 ± 2.25 ng/mL) ve Beckmann Unicell DXI800 (8.70 ± 3.00 ng/mL) cihaz sonuçlarına göre anlamlı derecede daha yüksekti (p<0.001). Sonuç: Siemens folat kiti, pıhtı aktivatörlü Vacutest tüpünün içeriğinden anlamlı derece etkilenmekte ve sonuçların yüksek çıkmasına sebep olmaktadır. Klasik kalite kontrol programları ile kan alma tüplerinden kaynaklanan ölçüm interferansları tespit edilememektedir. Bundan dolayı her bir yeni kullanıma başlanan kan alma tüpü, ölçüm interferansı açısından özellikle de immünoassay sistemlerinde test edilmelidir
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    Low level of Nesfatin-1 is associated with gestational diabetes mellitus
    (Taylor and Francis Ltd, 2016) Küçükler, Ferit Kerim; Görkem, Ümit; Şimşek, Yasin; Kocabaş, Ramazan; Gülen, Şebnem; Güler, Serdar
    Introduction: Gestational diabetes mellitus (GDM) occurs in similar to 10-25% of pregnancies. Nesfatin-1, plays a role in carbohydrate metabolism by inhibiting glucagon secretion, besides has a glucose-dependent insulinotropic effect. Explanation of the GDM pathogenesis is important due to preventing gestational complications. We aimed to investigate relationship between GDM and Nesfatin-1. Material and methods: Seventy-nine pregnant subjects were randomly allocated to either GDM group (GDG, n = 38) or control group (CG, n = 41). For GDM diagnosis, 50 and 100 g oral glucose tolerance test (OGTT) were used. Nesfatin-1, insulin and other parameters were measured for all subjects. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.Results: Nesfatin-1 was found lower and insulin was found higher in GDG than CG. Negative correlation has been founded between Nesfatin-1 with weight, BMI, fasting glucose, serum glucose level at first hour of the 50 g OGTT and HOMA-IR.Conclusion: In this study, patients with GDM had lower Nesfatin-1 levels than without GDM. Therefore, when the Nesfatin-1 effects on the GDM pathogenesis is clear, it may be contributed to diagnosis and treatment of the GDM.
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    Onkoloji Hastalarında Hiponatremi Sıklığı ve Sağ Kalımla İlişkisi
    (2014) Şen, Fatma; Çiftçi, Rumeysa; Erdemli, Hacı Kemal; Kocabaş, Ramazan; Kılıç, Leyla; Bozbey, Hamza Uğur; Zobacı, Ethem; Zorlu, Musa; Yıldız, İbrahim
    Amaç: Hiponatremi; asemptomatik seyredebilen, birçok hastalıkla birlikte bulunabilen nörolojik bozukluklara yol açarak mortalite hızını arttırabilen bir klinik durumdur. Kanser hastalarında kanserin kendisine ya da tedavisine bağlı olarak hiponatremi görülebilmektedir. Bu çalışmada onkoloji hastaları ile dahiliye kliniğine başvuran bireyler arasında hiponatremi görülme oranının karşılaştırılması ve hiponatremi varlığının sağ kalımla ilişkisinin araştırılması amaçlandı. Gereç ve Yöntem: Retrospektif çalışmamıza 01.05.2012-13.2.2013 tarihleri arasında Hitit Üniversitesi Çorum Eğitim ve Araştırma Hastanesi Dahiliye Kliniği'ne başvuran bireylerden sodyum düzeyi ölçülmüş olan 2025 kişi ile, Onkoloji Kliniği'ne başvuran ve sodyum düzeyi ölçülmüş 583 hasta dahil edildi. Serum sodyum düzeyleri iyon selektif elektrot yöntemi ile çalışıldı. Merkezimizde sodyum için kullanılan referans aralığı 134-148 mmol/L'di. Serum sodyum düzeyi?133 mmol/L değerler “hiponatremi” olarak değerlendirildi. İstatistiksel analizlerinde Ki-kare testi ve Mann-Whitney U testleri kullanıldı. Sonuçlar medyan (minimum-maksimum) veya % değerler olarak verildi. Hiponatremi varlığının sağkalımla ilişkisi incelendi. Bulgular: Dahiliye kliniğine başvuran 2025 (Erkek/Kadın: 772/1253) bireyin 141'inde (%6.96), onkoloji kliniğine başvuran 583 (Erkek/Kadın: 283/300) bireyin ise 70'inde (%12.01) hiponatremi saptandı (Kikare testi, X2 =14.817, df-=1, p=0.0001). Onkoloji grubundaki hiponatremik erkeklerin [130 (111.0- 133; n=45) mmol/L] dahiliye grubundaki hiponatremik erkeklere [132 (115-133; n=77) mmol/L] kıyasla serum sodyum düzeyleri daha düşük bulundu (p=0.0066). Hiponatremisi olan bayan hastaların sodyum düzeylerinin karşılaştırılmasında gruplar arasında anlamlı bir farklılık izlenmedi (p=0.18). Onkoloji hastalarında hiponatremi varlığı sağ kalımda belirgin kısalmaya neden oldu (p<0.001). Hiponatremisi olan kanser hastalarında cinsiyet, 70 yaş altı ve üstü olmak, performans skorunun düşük veya yüksek olması sağ kalımı değiştirmedi. Sonuç: Hiponatremi, onkoloji hastalarında genel dahiliye hastalarına göre daha sık görülmektedir. Hiponatremi saptanan hastalarda sağ kalımın hiponatremi saptanmayan hastalara göre azaldığı gösterilerek, onkoloji hastalarının yönetiminde serum sodyum düzeyi takibinin önemli olduğuna dikkat çekilmiştir.
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    Paraoxanase as an indicator of myocardial ischemia and its utility in determining extension of ischemia
    (W.B. Saunders, 2016) Erenler, Ali Kemal; Kocabaş, Ramazan; Doğan, Tolga; Erdemli, Hacı Kemal; Yetim, Mücahit
    Background The aim of this study was to investigate Paraoxanase 1 (PON-1) activity in patients with ST-elevated and non-ST-elevated acute myocardial infarction (AMI) and to determine its correlation with Gensini scores (GSs). Methods A total of 109 patients with AMI and 58 healthy subjects as control group were included in the study. Patients were divided into 2 subgroups as ST-elevated and non-ST-elevated AMI patients (Group I and II, respectively). Controls were named as Group III. PON-1 activity was determined on admission to emergency department for each group. In addition, GSs for patient groups were determined. Then, groups were compared according to their results. Results PON-1 levels in Group I and II were significantly lower when compared to Group III. Median GSs for Group I and II were 60 and 64, respectively. The cut-off value of PON-1 for diagnosis of AMI was ? 180 U/L, which was identified by receiver characteristics receiver curve analysis. However, we could not determine a significant relationship between serum PON-1 levels and GSs in patients with AMI. Conclusion PON-1 levels measured on admission to emergency department may be used to rule out AMI. PON-1 levels in AMI patients are found to be inefficient in determining extension of ischemia measured by GS. © 2015 Elsevier Inc. All rights reserved.
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    The acute effects of interval exercise on oxidative stress and antioxidant status in volleyball players
    (Edizioni Minerva Medica, 2018) Kocabaş, Ramazan; Namıduru, Emine Sibel; Bagçeci, Ahmet M.; Erenler, Ali Kemal; Karakoç, Önder; Örkmez, Mustafa; Akan, Müslüm; Erdemli, Hacı Kemal; Taysi, Seyithan; Tarakçıoğlu, Mehmet
    BACKGROUND Volleyball is briefly described as an "interval" sport with both aerobic and anaerobic components. Exercise may influence antioxidant/prooxidant balance, which leads to differences in oxidative stress status between athletes in different sport disciplines, but the results of the previous studies are inconsistent. In this study, we aimed to determine the acute effects of exercise on oxidative stress parameters such as serum total oxidant status (TOS) and total antioxidant status (TAS) levels in volleyball players. METHODS Thirteen male volleyball players from the same team participated in this study. The volleyball game lasted approximately 95 minutes including warm-up and cool-down periods. Blood samples were taken before the warm-up and after the cool down. Serum TOS and TAS levels were measured. Oxidative stress index (OSI), a predictor of antioxidant/prooxidant balance (TOS/TAS), was also calculated. RESULTS The following data were revealed as median: TOS 6.84 ?mol H2 O2 Eq/L(95% CI: 5.80-8.13) and 5.15 (95% CI: 4.20-6.02); TAS 1.96 mmol Trolox Eq/L(95% CI: 1.91-2.08) and 1.95 (95% CI: 1.86-2.00); and OSIindexes, 3.31 (arbitrary unit) (95% CI: 2.84-4.00) and 2.64 (95% CI: 2.26-3.18) before and after the match with respectively. Serum TOS and OSI levels were significantly lower after volleyball match when compared to before (P<0.05). There was no significant difference in serum TAS levels (P>0.05). CONCLUSIONS In individuals who exercise active sports, TOS level has been found to be decreased while TAS level has not been affected significantly after volleyball match. Our results suggested that volleyball training may not cause oxidative stress in these players. Regular physi-cal exercise especially, volleyball training may provide adequate protection against exercise-induced oxidative stress. COPYRIGHT © 2018 EDIZIONI MINERVA MEDICA.
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    The water-soluble iodinated contrast medium used for hysterosalpingography might increase the probability of development of subclinical thyroid diseases
    (E-Century Publishing Corporation, 2016) Görkem, Ümit; Küçükler, Ferit Kerim; Kocabaş, Ramazan; İnal, Hasan Ali; Yılmaz, Nafiye; Sargın Oruç, Ayla; Güngör, Tayfun
    Objective: Sudden exposure to high iodide levels may cause thyroid dysfunction. Although the iodinated contrast medium used for computed tomography and coronary angiography is known to alter thyroid function, the water-soluble iodinated contrast medium (ICM) used for hysterosalpingography (HSG) has not been investigated comprehensively. In the present study, we aimed to investigate the effect of the water-soluble iodinated contrast medium used for HSG on thyroid functional tests in euthyroid infertile women. Materials and methods: A total of 87 euthyroid infertile women with normal thyroid stimulating hormone (TSH), triiodothyronin (fT3) and free thyroxine (fT4) levels were included in the study. Serum TSH, fT4, and fT3 levels were measured before the study and one week, one month, and three months after HSG. Patients underwent a thyroid ultrasonography to reveal the occurrence of any change. Results: Mean TSH levels did not change significantly until the 3rd month (P=0.03). Mean fT4 levels were significantly lower (P<0.001) from baseline in each of the measurements performed after HSG. None of the patients had clinical hyperthyroidism or hypothyroidism during follow-up. Conclusion: The iodinated contrast medium used for HSG may be associated with the development of subclinical hyper- or hypothyroidism in euthyroid infertile women. Further study is warranted to confirm the effects of ICM on thyroid function. © 2016, E-Century Publishing Corporation. All rights reserved.