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Öğe Association between the ACE I/D gene polymorphism and physical performance in a homogeneous non-elite cohort(Human Kinetics Publishers Inc., 2005) Cam F.S.; Colakoglu M.; Sekuri C.; Colakoglu S.; Sahan Ç.; Berdeli A.Background: I/D polymorphism of the ACE gene may be associated with better endurance performance and a stronger response to exercise training. The aim of this study was to investigate the association between ACE gene polymorphism and athletic performance in a homogeneous cohort. Methods: Eighty-eight male non-elite Caucasian Turkish athletes with similar training backgrounds for at least for 6 months were studied for ACE gene polymorphisms by PCR analysis. Performance on the 60-meter sprint and middle-distance running tests were evaluated. Results: The distributions of the ACE I/D genotypes were 20.5%, 40.9%, and 38.6% for II, ID, and DD polymorphisms in the whole group (N = 88), respectively. The ACE DD genotype frequency was significantly higher in the superior group (56.7%) than in the poor (37.9%) and mediocre (20.7%) group in middle-distance running performance (?2 = 11.778; p = 0.019). Conclusion: The ACE DD genotype may be related to better short-duration aerobic endurance performance. Larger homogeneous cohorts may help clarify the association between ACE I/D polymorphism and physical performance. © 2005 Canadian Society for Exercise Physiology.Öğe Association between the eNOS (Glu298Asp) and the RAS genes polymorphisms and premature coronary artery disease in a Turkish population(2005) Berdeli A.; Sekuri C.; Sirri Cam F.; Ercan E.; Sagcan A.; Tengiz I.; Eser E.; Akin M.The renin-angiotensin system (RAS) and endothelial nitric oxide (NO) affect the pathogenesis of atherosclerosis and prognosis of coronary artery disease (CAD). Previous epidemiologic data suggested that genetic factors are more likely to affect young rather than old people. Our objective was to investigate the association between the polymorphisms of eNOS (Glu298Asp) and the RAS genes and premature CAD in a Turkish population. A total of 115 Turkish patients with premature CAD and 83 controls were included in the study. ACE I/D, AT1R A/C, AGT T/M and eNOS Glu298Asp gene polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). It was found that increased premature CAD risk is associated with higher frequencies of the ACE DD [OR: 2.600 (CI 95% 1.395-4.847, p=0.002)], AGT MM [OR=2.407 (CI 95% 1.267-4.573, p=0.007)] and eNOS 894TT [OR=17.000 (CI 95% 3.952-73.125, p<0.001)] genotypes. Carriers of ACE DD+eNOS 894TT (p=0.002), AGT MM+eNOS 894TT (p=0.001), AT1R AA+eNOS 894TT and AT1R non-AA+eNOS 894TT (p=0.002) genotypes were significantly associated with the risk of premature CAD. This study indicates a synergistic contribution of RAS genes (ACE I/D, AGT T/M, AT1R T/C) and eNOS Glu298Asp polymorphisms to the development of the premature CAD. © 2004 Elsevier B.V. All rights reserved.Öğe Atorvastatin treatment decreases inflammatory and proteolytic activity in patients with hypercholesterolemia(Klinika Kardiologii CMKP, 2004) Ercan E.; Tengiz I.; Altuglu I.; Sekuri C.; Aliyev E.; Ercan H.E.; Akin M.Background. Statins have anti-inflammatory and anti-platelet effects, which are known as non-lipid effects. Statin treatment can decrease endogenous inflammatory response. Aim. To study the effects of atorvastatin on matrix metalloproteinase-9 (MMP-9) and high sensitive C-reactive protein (hs-CRP) - markers of the proteinolytic and inflammatory activity. Methods. In this prospective study 44 patients with hypercholesterolemia were randomly assigned into 2 groups; Group 1 (n=22) treated with atorvastatin and diet for 2 months, and Group 2 (n=22) - diet alone. MMP-9 and hs-CRP were measured at baseline and two months later. Results. Groups were matched for age, sex and baseline characteristics. Lipid levels decreased by 32% (LDL from 153.9±26.6 to 94.5±20.8 mg/dl, p<0.005) in the atorvastatin group and by 9% in the diet alone group. Atorvastatin lowered plasma CRP from 5.16±1.9 to 2.88±1.06 mg/L (p<0.001) and MMP-9 activity from 64.3±28.1 to 35.4±20.0 ng/ml (p<0.0001). Atorvastatin-induced reductions in CRP and MMP-9 were greater than in the diet alone group. MMP-9 levels did not show significant changes in Group 2 after two months of diet. Conclusions. Atorvastatin treatment decreases inflammatory and proteolytic activity in patients with hypercholesterolemia.Öğe Cardiac thrombi in a patient with protein-C and S deficiencies: A case report(2004) Ercan E.; Tengiz I.; Sekuri C.; Sahin F.; Aliyev E.; Akin M.; Ac Kel U.We report a case of multiple mobile intra-cardiac thrombi accompanying recurrent pulmonary embolism that has been successfully treated by fibrinolytic therapy. Control transesophageal echocardiographic examination showed that prolonged thrombolytic treatment completely removed the thrombi. Surgical removal of emboli has been validated but cannot be proposed to all patients since it is a high-risk intervention. Fibrinolysis is generally efficient but exposes the patient to risk of migration of the intra-cavity thrombus, with occasionally deleterious evolution. Systemic thrombolytic therapy is usually recommended if (a) it is not contraindicated and (b) the thrombi are demonstrated in more than one cardiac chamber, entailing a higher risk of surgical intervention. However, the infusion rate and duration of thrombolytic therapy are important determinants of successful and uncomplicated lysis. Low dose and long infusion time should be chosen to avoid fragmentation of the thrombus and related complications. © 2004 Ercan et al; licensee BioMed Central Ltd.Öğe Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris(2004) Ercan E.; Bozdemir H.; Tengiz I.; Sekuri C.; Aliyev E.; Akilli A.; Akin M.Aim: The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1) in patients with unstable angina pectoris (AP). Methods: Thirty-five patients with unstable AP (Group I), ten patients with stable AP (Group II) and ten subjects who had angiographycally normal coronary arteries (Group III) were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15) received tirofiban and Group IB (n = 20) did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h) in all patients and at 72 h in Group I. Results: The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion: The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point. © 2004 Ercan et al; licensee BioMed Central Ltd.Öğe Elevated levels of matrix metalloprotein-3 in patients with coronary aneurysm: A case control study(2004) Tengiz I.; Ercan E.; Aliyev E.; Sekuri C.; Duman C.; Altuglu I.Background: Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of arterial aneurysms through increased proteolysis of extracellular matrix proteins. Increased proteolysis due to elevated matrix degrading enzyme activity in the arterial wall may act as a susceptibility factor for the development of coronary aneurysms. The aim of this study was to investigate the association between MMPs and presence of coronary aneurysms. Methods: Thirty patients with aneurysmal coronary artery disease and stable angina were enrolled into study (Group 1). Fourteen coronary artery disease patients with stable angina were selected as control group (Group 2). MMP-1, MMP-3 and C-reactive protein (CRP) were measured in peripheral venous blood and matched between the groups. Results: Serum MMP-3 level was higher in patients with aneurismal coronary artery disease compared to the control group (20.23 ± 14.68 vs 11.45 ± 6.55 ng/ml, p = 0.039). Serum MMP-1 (13.63 ± 7.73 vs 12.15 ± 6.27 ng/ml, p = 0.52) and CRP levels (4.78 ± 1.47 vs 4.05 ± 1.53 mg/l, p = 0.13) were not significantly different between the groups. Conclusion: MMPs can cause arterial wall destruction. MMP-3 may play role in the pathogenesis of coronary aneurysm development through increased proteolysis of extracellular matrix proteins. © 2004 Tengiz et al; licensee BioMed Central Ltd.Öğe The G894T polymorphism on endothelial nitric oxide synthase gene is associated with premature coronary artery disease in a Turkish population(2005) Cam S.F.; Sekuri C.; Tengiz I.; Ercan E.; Sagcan A.; Akin M.; Berdeli A.Introduction: The aim of the present study was to investigate the association between premature coronary artery disease and Glu298Asp polymorphism of the endothelial nitric oxide synthase gene. Materials and methods: The eNOS gene polymorphism was analysed in 115 (mean age, 48.1±7.9 years) Turkish patients with a diagnosis of premature coronary artery disease and 83 (mean age, 44.6±1.4 years) control subjects. The Glu298Asp polymorphism of the endothelial nitric oxide synthase gene was determined by polymerase chain reaction and restriction fragment length polymorphism. Results: The patients group showed an increase in the frequency of the T allele compared to controls (0.456 versus 0.169, p=0.0001). There was a significant association between the TT genotype and premature coronary artery disease [eNOS TT vs. TG and GG; OR=17.000 (CI 95% 3.952-73.125, p=0.0001)]. The eNOS T/G genotypes were not associated with the number of affected vessels (p>0.05). In addition, the family history of premature coronary artery disease, smoking, diabetes, obesity, dyslipidemia and eNOS TT genotype were independent risk factors of coronary artery disease. The patients with eNOS TT genotype had 15 fold risk of coronary artery disease compared with the control group [OR=15.356(CI 95% 3.262-77.289, p=0.001)]. Conclusions: These results suggest that premature coronary artery disease is associated with the Glu298Asp polymorphism of the endothelial nitric oxide synthase gene in our population. © 2004 Elsevier Ltd. All rights reserved.Öğe In-Vitro-Response of Platelet Aggregation Induced by Various Agonists in Chronic Smoking Coronary Artery Disease Patients(2003) Sagcan A.; Nalbantgil S.; Sekuri C.; Omay S.B.; Akin M.Background: Chronic cigarette smoking (CCS) is known as one of the major risk factors in the development of atherosclerosis. The relationship between smoking and coronary artery disease (CAD) has been established by epidemiological studies. Smoking has also been shown to have negative effects on haemostatic balance especially on platelet function. Aim: In this study, the effect of CCS on in-vitro-platelet-aggregation induced by various agonists was investigated in coronary artery disease patients. Methods: One hundred and twenty-one patients with stable angina pectoris and controlled unstable angina pectoris were included in the study. Patients were divided into two groups: Group I consisted of 53 CCS patients and Group II consisted of 68 non-smokers. Agonist induced platelet aggregation (PA) waves were measured by turbidometric method of Born. Maximum amplitude and duration of aggregation waves for each of the agonists were calculated. Results: Maximum amplitude and duration of ADP, collagen, and epinephrine induced in vitro PA response were significantly higher in Group I (p-values respectively: p < 0.05, p < 0.0001, p < 0.0001). Conclusion: In vitro PA response is increased despite antiaggregant therapy in CAD patients who are chronic smokers. Further studies are needed to establish the effect of smoking cessation on PA and progression of CAD. We also believe that prospective studies are needed to show the effect of more efficient antiaggregant therapy for CAD patients who are chronic smokers.Öğe Renin-angiotensin system gene polymorphisms and premature coronary heart disease(JRAAS Limited, 2005) Sekuri C.; Cam F.S.; Ercan E.; Tengiz I.; Sagcan A.; Eser E.; Berdeli A.; Akin M.Introduction: Experimental and clinical studies demonstrated that the renin-angiotensin system (RAS) affects the pathogenesis of atherosclerosis and prognosis of coronary heart disease (CHD). The aim of this study was to investigate the genotype distribution and the allele frequencies of three RAS genes polymorphisms and their effects on premature CHD in a Turkish population. Materials and methods: One-hundred and fifteen Turkish patients with premature CHD and 128 controls were included into the study. Angiotensin-converting enzyme (ACE), angiotensin II type 1 (AT1) receptor and angiotensinogen (AGT) gene polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Results: The patients group showed an increased frequency of the ACE D allele compared with controls (65% vs. 35%, p-0.0001). There was a significant association between the DD genotype and premature CHD (ACE DD vs. ID and II; odds ratio [OR]=2.82 [CI 95% 1.33-2.91, P=0.002]). Also, we observed increased premature CHD risk associated with higher frequencies of the AGT MM genotype in patients when compared with controls (AGT MM vs. TT and MT, OR=1.92 [CI 95% 1.11-3-33, p=0.018]). We found a significant association between AT1-receptor AA genotype and decreased risk of premature CHD (AT1R AA vs. AC and CC, OR=0.57[CI 95% 0.34-0.95, p=0.03]). Conclusions: We demonstrated that increased premature CHD risk is associated with higher frequencies of the ACE DD and AGT MM genotypes. These findings indicate a synergistic contribution of ACE DD and AGT MM polymorphisms to the development of premature CHD. Also, our results suggest that family history, smoking, diabetes, hypertension, obesity and ACE DD genotype were independent risk factors for premature CHD.Öğe Transbrachial Coil Occlusion of the Large Branch of an Internal Mammary Artery Coronary Graft(2004) Ercan E.; Tengiz I.; Sekuri C.; Aliyev E.; Etemoglu M.; Sari S.; Akin M.Percutaneous transbrachial insertion of two complex coils into the intercostal branch of the left internal mammary artery resulted in the relief of severe angina in a 45-year-old man who had coronary artery bypass surgery 2 years before. The diagnosis of coronary artery steal was made clinically. This case illustrates the importance of recognizing coronary steal in patients who redevelop angina after coronary artery surgery with the use of an incompletely prepared left internal mammary artery as a conduit. Brachial or radial artery should be preferred to reach left internal mammary artery (LIMA) for cannulation easily. The preoperative angiographic imaging of LIMA is important to detect the side branches and their sizes. The patient was treated without the need for further surgery.
