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Yayın Cytokine profile in Behçet uveitis(AEPress, 2008) Nalbant, Selim; Şahan, Burak; Durna, Murat; Erşanlı, Dilaver; Kaplan, Mustafa; Karabudak, Özlem; Ünal, MelihObjectives: Investigate the role of cytokines in Behçet uveitis. Background: Cytokines may take part in this pathogenetic mechanism. Elevated and/or altered levels of specific cytokines have been found in patients with Behçet's disease in many studies. Methods: Twenty patients with Behçet uveitis and 20 patients with Behçet's disease without uveitis were included to the study in compliance with International Study Group Criteria. Twenty non-Behçet uveitis patients were included in the study. In this group, active uveitis was found in 30 % and arthritis in 35% of patients. Serum levels of cytokines (Interleukin-2-4-6-8, IL-2-4-6-8), tumor necrosis factor-alpha, TNF-alpha) and local growth factor (vascular endothelial growth factor, VEGF) were measured. Results: Levels of all cytokines were highest in Behçet patients without uveitis except for IL-2 and IL-6. These cytokines were also highest in patients with non-Behçet uveitis too. Despite the tendency of this distribution of cytokines, only three cytokines, TNF-alpha, IL-8 and IL-4 were significantly different from the controls. The levels of TNF-alpha, IL-8 and IL-4 were significantly lower in patients with Behçet uveitis than in Behçet patients without uveitis. Interestingly, the levels of IL-2 and IL-6 were statistically similar in all groups. VEGF showed no significant difference between the studied and control groups. However, in contrast to cytokines, only the levels of VEGF were correlated with the activity of uveitis (p<0.05). Conclusion: Consistent with previous reports of different immune effectors in Behçet uveitis, it may be suggested that its underlying immunopathogenesis may be much different from other causes of endogenous uveitis (Tab. 3, Fig. 1, Ref. 20). Full Text (Free, PDF) www.bmj.sk.Yayın Does rofecoxib increase TNF-alpha levels?(Clinical and Experimental Rheumatology, 2006) Nalbant, Selim; Akmaz, İbrahim; Kaplan, Mustafa; Avşar, K.; Solmazgül, Emrullah; Şahan, BurakObjective: Rofecoxib (Vioxx), the first COX-2 selective non-steroidal anti-inflammatory drug (NSAID), was recently withdrawn from the market due to the increased risk of acute myocardial infarction. The precise mechanism responsible for this phenomenon still remains unknown. Tumor necrosis factor alpha (TNF-alpha) is a cytokine, possibly most responsible for mortality in patients with acute myocardial infarction. However, this study was designed to study possible effects of rofecoxib on the level of TNF-alpha by using MSU crystal induced inflammation in the rat subcutaneous air pouch model. Methods: Rat subcutaneous air pouches were produced and examinations commenced 6 days later. Control groups received only MSU crystals, or no crystals or drugs. To begin with, rofecoxib (30 mg/kg), indomethacin (20 mg/kg) or diclofenac (3 mg/kg) were administered to groups of 5 rats each. Thirty minutes later, MSU crystals were injected into air pouches, except for the negative control group. Twenty-four hours later, the rats were sacrificed for aspiration of fluid and for the dissection of pouch walls to determine leukocyte counts, pouch wall histology, and to assay IL-10 and TNF-alpha. Results: Intra-pouch injection of MSU crystals, compared to non-injected pouches, caused an increase in white blood cell count (WBC) (30 +/- 44.7 versus 4508 +/- 792.3 cells/mm3), in the numbers of pouch wall vessels (vascular index) (4.8 +/- 0.3 versus 11.4 +/- 1.5 vessels/high-power field) and in TNF-alpha (50.0 +/- 13.4 versus 70.34 +/- 20.9 ng/mL), but not in interleukin-10 (IL-10) (60.6 +/- 63.0versus 61.48 +/- 7.1). WBC and vascular index were significantly reduced in all study groups compared to the control group (p < 0.05). Levels of TNF- in fluids were unexpectedly and significantly (p < 0.05) increased in all cases. The highest level of TNF-alpha was found in the rofecoxib group. In contrast to TNF-alpha, IL-10 levels were significantly (p < 0.05) decreased in all three drug groups. Indomethacin tended to suppress inflammation more effectively. However, there was no significant difference between the groups for IL-10 (p > 0.05). Conclusion: All three NSAIDs exhibited anti-inflammatory activity against MSU crystal induced inflammation. The difference in anti-inflammatory effects of these three non-steroidal drugs is seen not only in the anti-inflammatory effect on MSU induced inflammation but also in the nature of the effects. Refocoxib tended to increase the TNF-alpha level. Whether increased TNF-alpha levels can help explain the side effect of COX-2 specific inhibitors still requires further studies.Yayın Long term evaluation of adult onset Still’s disease in a hematology department(Turkish Society of Hematology, 2005) Erikçi, Alev; Sayan, Özkan; Kaplan, Mustafa; Öztürk, AhmetAdult onset Still`s disease (AOSD) is a rare disorder. We report a rare case of a 21 - year old male with AOSD. He was admitted to hospital with 31.000 WBC/mm3, fever and muscle weakness. He was referred to our clinic with a preliminary diagnosis of acute leukemia. Peripheral blood examination and bone marrow aspiration biopsies were performed. A detailed investigation was performed and finally he was diagnosed to be AOSD. Corticosteroid therapy of 60 mg total divided in two doses was started, his fever dropped to normal levels in the very first day, his leucocytosis and clinical symptoms resumed within a week. AOSD should be kept in mind in a hyperleucocytosis case with fever which cannot be explained otherwise.Yayın Prognostic value of mean platelet volume in patients with upper gastrointestinal bleeding(SpringerLink, 2008) Nalbant, Selim; Çağıltay, Eylem; Terekeci, Murat Hakan; Kaplan, Mustafa; Şahan, Burak; Sayan, Özkan; Öktenli, ÇağatayThis study included patients with upper gastrointestinal hemorrhage who were treated in intensive care unit of GATA Haydarpasa Training Hospital, Division of Internal Medicine during 1 year. Medical and demographic data of the patients were recorded. These patients were followed for 3 months after being discharged from the intensive care unit. Of the 50 patients in the study, 18 were female (36%), 32 were male (64%). The mean age was 47±2 years, and the ages ranged between 17 and 89 years. We did not find any statistically significant results in our evaluation of the relationship between the mean platelet volume and the number of transfusions, endoscopic findings, and prognosis after 3 months of follow-up. This is a preview of subscription content, log in to check access.Yayın A prospective randomized multicenter study of Turkish Society of Urooncology comparing two different mechanical bowel preparation methods for radical cystectomy(ELSEVIER SCIENCE INC, 2013) Aslan, Guven; Baltaci, Sumer; Akdogan, Bulent; Kuyumcuoglu, Ugur; Kaplan, Mustafa; Cal, Cag; Adsan, Oztug; Turkolmez, Kadir; Ugurlu, Ozgur; Ekici, Sinan; Faydaci, Gokhan; Mammadov, Elnur; Turkeri, Levent; Ozen, Haluk; Beduk, YasarObjective: To investigate the outcomes and complication rates of urinary diversion using mechanical bowel preparation (BP) with 3 day conventional and limited BP method through a standard perioperative care plan. Materials and methods: This study was designed as a prospective randomized multicenter trial. All patients were randomized to 2 groups. Patients in standard 3-day BP protocol received diet restriction, oral antibiotics to bowel flora, oral laxatives, and saline enemas over a 3-day period, whereas limited the BP arm received liberal use of liquid diet, sodium phosphate laxative, and self administered enema the day before surgery. All patients received same perioperative treatment protocol. The endpoints for the assessment of outcome were anastomotic leakage, wound infection, wound dehiscence, intraperitoneal abscess, peritonitis, sepsis, ileus, reoperation, and mortality. Bowel function recovery, including time to first bowel movement, time to first oral intake, time to regular oral intake, and length of hospital stay were also assessed. Results: Fifty-six patients in 3-day BP and 56 in limited BP arm were evaluable for the study end points. Postoperatively, 1 patient in limited BP and 2 patients in 3-day BP arm died. There was no statistical difference in any of the variables assessed throughout the study, however, a favorable return of bowel function and time to discharge as well as lower complication rate were observed in limited BP group. Conclusions: Regarding all endpoints, including septic and nonseptic complications, current clinical research offers no evidence to show any advantage of 3-day BP over limited BP. (C) 2013 Elsevier Inc. All rights reserved.Yayın The significance of coeliac disease antibodies in patients with ankylosing spondylitis: a case-controlled study(SageJournals, 2009) Togrol, Rıfat Erdem; Nalbant, Selim; Solmazgül, Emrullah; Özyurt, Mustafa; Kaplan, Mustafa; Kıralp, Mehmet Zeki; Dinçer, Ümit; Şahan, BurakThe presence of anti-gliadin antibodies (AGA) and their relationship with intestinal permeability and prevalence of undiagnosed coeliac disease (CD) in ankylosing spondylitis (AS) were investigated. Blood samples from 30 AS patients and 19 age- and sex-matched controls were analysed for human leucocyte antigen (HLA)-B27, AGA and endomysial antibodies (EMA). Immunoglobulin (Ig) A-type AGA and IgG-type EMA were determined by enzyme-linked immunosorbent assay. AGA-positive patients were examined by gastroduodenoscope and proximal small bowel mucosa biopsies were performed. Eleven (36.7%) AS patients were AGA positive (compared with none of the control subjects) and three (10.0%) of these AS patients were also EMA-positive. The presence of AGA was not associated with more severe AS. Mild-to-severe villous atrophy and hyperplasia of crypts with increased chronic inflammatory cells in the lamina propria, which is typical of CD, was only observed in one AGA/EMA positive AS patient; CD was subsequently diagnosed by histology. Although AGA positivity might contribute to the pathogenesis of AS by increasing intestinal permeability to micro-organisms or by modifying intestinal immune mechanisms, further work is required to clarify its role in AS.Yayın Successful treatment of two cases of resistant acquired angioedema(Wiley, 2005) Kaplan, Mustafa; Şahan, Burak; Özmen, Namık; Solmazgül, Emrullah; Süngün, Mutasim; Nalbant, SelimAngioedema has different causes and different clinical presentations that has two forms: acquired angioedema (types I and II) and hereditary angioedema. However, acquired angioedema type?II is a very rare disorder and there is no significant treatment. So, in this paper, we propose to report the successful use of combination therapy of deflazacort and danazol for two such cases.
