Absence and Resolution of Fragmented QRS Predict Reversible Myocardial Ischemia With Higher Probability of ST Segment Resolution in Patients With ST Segment Elevation Myocardial Infarction

Mustafa Cetin,Sinan Altan Kocaman,Tuncay Kiris,Turan Erdogan,Aytun Canga,Murtaza Emre Durakoglugil,Yüksel Çiçek,Sitki Dogan,Omer Satiroglu 대한심장학회 2012 Korean Circulation Journal Vol.42 No.10

Background and Objectives: Fragmented QRS complexes (fQRS) are associated with increased morbidity and mortality. The causative relationship between fQRS and cardiac fibrosis has been shown, but whether the presence and the number of fQRS on admission of elec-trocardiogram (ECG) predicts ST segment resolution in patients undergoing primary percutaneous coronary intervention (p-PCI) has not been investigated until now. Subjects and Methods: This study included one hundred and eighty-four consecutive patients with ST elevation myocardial infarction (STEMI) who underwent p-PCI. The presence or absence of fQRS on pre and post-PCI ECG and their relation with myocardial infarction and reperfusion parameters were investigated. Results: Patients with fQRS on admission of ECG or newly developed fQRS after p-PCI had increased inflammatory markers, higher cardiac enzyme levels, increased pain to balloon time, prolonged QRS time, more extended coronary involvement and more frequent Q waves on ECG in comparison to patients with absence or resolved fQRS. The presence and higher number of fQRS on admission or post-PCI ECGs were significantly related with low percent of ST resolution and myocardial reperfusion parameters. The area under the receiver operating characteristics curve values for the presence and number of fQRS to detect Thrombolysis in Myocardial Infarction Blush Grade 0 and 1,were 0.682 and 0.703. Conclusion: In our study, fQRS was significantly related to infarction and myocardial reperfusion parameters before and after p-PCI. Successful myocardial reperfusion by p-PCI caused the reduction in number of fQRS and QRS time with higher ST resolution. fQRS may be useful in identifying the patients at higher cardiac risk with increased ischemic jeopardized or infarcted myocardium, and persistent or newly developed fQRS may predict low percent of ST segment resolution in patients undergoing p-PCI. Background and Objectives: Fragmented QRS complexes (fQRS) are associated with increased morbidity and mortality. The causative relationship between fQRS and cardiac fibrosis has been shown, but whether the presence and the number of fQRS on admission of elec-trocardiogram (ECG) predicts ST segment resolution in patients undergoing primary percutaneous coronary intervention (p-PCI) has not been investigated until now. Subjects and Methods: This study included one hundred and eighty-four consecutive patients with ST elevation myocardial infarction (STEMI) who underwent p-PCI. The presence or absence of fQRS on pre and post-PCI ECG and their relation with myocardial infarction and reperfusion parameters were investigated. Results: Patients with fQRS on admission of ECG or newly developed fQRS after p-PCI had increased inflammatory markers, higher cardiac enzyme levels, increased pain to balloon time, prolonged QRS time, more extended coronary involvement and more frequent Q waves on ECG in comparison to patients with absence or resolved fQRS. The presence and higher number of fQRS on admission or post-PCI ECGs were significantly related with low percent of ST resolution and myocardial reperfusion parameters. The area under the receiver operating characteristics curve values for the presence and number of fQRS to detect Thrombolysis in Myocardial Infarction Blush Grade 0 and 1,were 0.682 and 0.703. Conclusion: In our study, fQRS was significantly related to infarction and myocardial reperfusion parameters before and after p-PCI. Successful myocardial reperfusion by p-PCI caused the reduction in number of fQRS and QRS time with higher ST resolution. fQRS may be useful in identifying the patients at higher cardiac risk with increased ischemic jeopardized or infarcted myocardium, and persistent or newly developed fQRS may predict low percent of ST segment resolution in patients undergoing p-PCI.

The Association between Whole Blood Viscosity and Coronary Collateral Circulation in Patients with Chronic Total Occlusion

Mehmet Serkan Cetin,Elif Hande Ozcan Cetin,Kevser Gülcihan Balcı,Selahattin Aydin,Emek Ediboglu,Muhammed Fatih Bayraktar,Mustafa Mücahit Balcı,Orhan Maden,Ahmet Temizhan 대한심장학회 2016 Korean Circulation Journal Vol.46 No.6

Background and Objectives: Coronary collateral circulation (CCC) has been attributed as inborn bypass mechanisms supporting ischemic myocardium. Various factors have been postulated in CCC. Whole blood viscosity (WBV) has been an underappreciated entity despite close relationships between multiple cardiovascular diseases. WBV can be calculated with a validated equation from hematocrit and total plasma protein levels for a low and high shear rate. On the grounds, we aimed to evaluate the association between WBV and CCC in patients with chronic total occlusion. Subjects and Methods: A total of 371 patients diagnosed as having at least one major, chronic total occluded coronary artery were included. 197 patients with good CCC (Rentrop 2 and 3) composed the patient group. The poor collateral group consisted of 174 patients (Rentrop grade 0 and 1). Results: Patients with poor CCC had higher WBV values for a low-shear rate (LSR) (69.5±8.7 vs. 60.1±9.8, p<0.001) and high-shear rate (HSR) (17.0±2.0 vs. 16.4±1.8, p<0.001) than the good collateral group. Correlation analysis demonstrated a significant negative correlation between the grade of CCC and WBV for LSR (β=0.597, p<0.001) and HSR (β=0.494, p<0.001). WBV for LSR (β=0.476, p<0.001) and HSR (β=0.407, p<0.001) had a significant correlation with the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. A multivariate analysis showed that the WBV for both shear rates were independent risk factors of poor CCC (WBV at LSR, OR: 1.362 CI 95%: 1.095-1.741 p<0.001 and WBV at HSR, 1.251 CI 95%: 1.180-1.347 p<0.001). Conclusion: WBV has been demonstrated as the overlooked predictor of poor coronary collateralization. WBV seemed to be associated with microvascular perfusion and angiogenesis process impairing CCC development

Prognostic Factors for Overall Survival in Patients With Metastatic Colorectal Carcinoma Treated With Vascular Endothelial Growth Factor-Targeting Agents

Cetin, Bulent,Kaplan, Mehmet Ali,Berk, Veli,Ozturk, Selcuk Cemil,Benekli, Mustafa,Isikdogan, Abdurrahman,Ozkan, Metin,Coskun, Ugur,Buyukberber, Suleyman Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.3

Objective: Angiogenesis represents a key element in the pathogenesis of malignancy. There are no robust data on prognostic factors for overall survival (OS) in patients with metastatic colorectal cancer treated with vascular endothelial growth factor (VEGF)-targeted therapy. The present study was conducted to establish a prognostic model for patients using an oxaliplatin-based or irinotecan-based chemotherapy plus bevacizumab in metastatic colorectal cancer. Methods: Baseline characteristics and outcomes on 170 patients treated with FOLFIRI or XELOX plus anti-VEGF therapy-naive metastatic colorectal cancer were collected from three Turkey cancer centers. Cox proportional hazards regression was used to identify independent prognostic factors for OS. Results: The median OS for the whole cohort was 19 months (95% CI, 14.3 to 23.6 months). Three of the seven adverse prognostic factors according to the Anatolian Society of Medical Oncology (ASMO) were independent predictors of short survival: serum lactate dehydrogenase (LDH) greater than the upper limit of normal (ULN; p<0.001); neutrophils greater than the ULN (p<0.0014); and progression free survival (PFS) less than 6 months (p =0.001). Conclusion: Serum LDH and neutrophil levels were the main prognostic factors in predicting survival, followed by PFS. This model validates incorporation of components of the ASMO model into patient care and clinical trials that use VEGF-targeting agents.

Relation between Left Atrial Remodeling in Young Patients with Cryptogenic Stroke and Normal Inter-atrial Anatomy

Mustafa Gökhan Vural,Suha Cetin,Murat Yilmaz,Ramazan Akdemir,Huseyin Gunduz 대한뇌졸중학회 2015 Journal of stroke Vol.17 No.3

Background and Purpose To investigate an association between left atrial (LA) structural and P wave dispersion (PWD) during sinus rhythm, and electrical remodeling in cryptogenic stroke (CS) patients. Methods Forty CS patients and 40 age- and sex-matched healthy controls were enrolled. P wave calculations were based on 12-lead electrocardiography (ECG) at a 50-mm/s-paper speed with an amplitude of 10 mm/mV. Difference between the maximum and minimum P wave duration was the P wave dispersion (PWD=Pmax-Pmin). LA deformation was evaluated by speckle tracking echocardiography within 3 days of the acute event. Results PWD was 30.1±7.0 ms and 27.4±3.5 ms in CS and control group (P=0.02), whereas LA maximum volume index [LAVImax] was 20.4±4.5 mL/m2 and 19.9±2.4 mL/m2 in CS and control group, respectively (P=0.04). While global peak LA strain was [pLA-S] (LA reservoir function) 41.4±6.3% and 44.5±7.1% in CS and control group, (P=0.04), global peak late diastolic strain rate values [pLA-SRa] (LA pump function) were 2.5±0.4% and 2.9±0.5% in CS and control group, respectively (P=0.001). A mild and a strong negative correlation between global pLA-S and LAVImax (r=-0.49; P<0.01), and between PWD and global pLA-S (r=-0.52; P<0.01), respectively, was observed in CS. Conclusions Increased PWD is associated with impaired LA mechanical functions and enlargement, and involved in the pathophysiology of AF or an AF-like physiology in CS.

Plasmapheresis in a Patient With "Refractory" Urticarial Vasculitis

Ozgur Kartal,Mustafa Gulec,Zafer Caliskaner,Oral Nevruz,Turker Cetin,Osman Sener 대한천식알레르기학회 2012 Allergy, Asthma & Immunology Research Vol.4 No.4

Immune complexes are found in the circulation of 30%-75% of patients with urticarial vasculitis and much evidence supports the role of these immune complexes in the pathogenesis of urticarial vasculitis. Plasmapheresis is effective for removing these immune complexes; however, there are few reports on the use of plasmapheresis in the treatment of urticarial vasculitis. We describe a case of “refractory” urticarial vasculitis in which the symptoms improved after plasmapheresis treatment. We suggest that plasmapheresis be considered as an option in patients with severe or treatment-resistant urticarial vasculitis.

Effect of Hen Weight on Egg Production and Some Egg Quality Characteristics in Pheasants (Phasianus colchicus)

Kirici, Kemal,Cetin, Orhan,Gunlu, Aytekin,Garip, Mustafa Asian Australasian Association of Animal Productio 2004 Animal Bioscience Vol.17 No.5

A study was conducted to determine the effect of live weight of pheasants on egg production and egg quality characteristics. A total of 48 ring-necked pheasants were divided into control, heavy, middle and light BW groups. Live weights of the control were 1,187 g, 1,352.92 g for heavy group, 1,247.92 g for middle group and 1,003.33 g for light group. Egg production of groups were found as 47.32, 42.82, 45.79 and 46.51% respectively, in 10 weeks of period. There were no statistical differences on egg production among the groups. The effect of live weight on egg weight, shape index, specific gravity, shell weight, shell thickness, Haugh Unit, yolk weight and albumen weight were found statistically significant (p<0.05). The effect of live weight on albumen index, membrane weight and membrane thickness were found not important (p>0.05). On the other hand, other important factors to be effective on the egg quality of pheasants should be investigated. As a result of this study, live weight of pheasant hens is not an important factor to obtain high egg production in pheasants. But, body conformation of breeding materials should be in good conditions.

OPTIMIZATION-ORIENTED HIGH FIDELITY NFIR MODELS FOR ESTIMATING INDICATED TORQUE IN DIESEL ENGINES

Gokhan Alcan,Volkan Aran,Mustafa Unel,Metin Yilmaz,Cetin Gurel,Kerem Koprubasi 한국자동차공학회 2020 International journal of automotive technology Vol.21 No.3

In this paper, optimization-oriented high fidelity indicated torque models which cover the whole operating regions under both steady-state and transient cycles for heavy-duty vehicles are developed. Two different experiments are performed and their data are merged to be utilized in the training of the models. In the first experiment, all combustion input channels are excited by quadratic chirp signals with different sweeps in their frequency profiles. Different from the first experiment, the engine speed is excited by ramp-hold signals in the second experiment. The estimations of friction, pumping and inertia torques in addition to the torque measured from the engine dynamometer are utilized in the indicated torque calculations. In order to model the calculated indicated torque, a nonlinear finite impulse response (NFIR) model with a single layer sigmoid neural network has been designed. A sensitivity analysis is performed by generating several models with different number of input regressors and neurons. Experimental results show that the majority of the models in a selected wide range of the model parameters are validated with fit accuracies higher than 90 % and 85 % on the World Harmonized Stationary Cycle (WHSC) and the World Harmonic Transient Cycle (WHTC), respectively.

Cytotoxic effects of different self-adhesive resin cements: Cell viability and induction of apoptosis

Sismanoglu, Soner,Demirci, Mustafa,Schweikl, Helmut,Ozen-Eroglu, Gunes,Cetin-Aktas, Esin,Kuruca, Serap,Tuncer, Safa,Tekce, Neslihan The Korean Academy of Prosthodonitics 2020 The Journal of Advanced Prosthodontics Vol.12 No.2

PURPOSE. The effects of four different self-adhesive resin cement materials on cell viability and apoptosis after direct and indirect exposure were evaluated using different cell culture techniques. MATERIALS AND METHODS. Self-adhesive cements were applied to NIH/3T3 mouse fibroblasts by the extract test method, cell culture inserts, and dentin barrier test method. After exposure periods of 24 h and 72 h, the cytotoxicity of these self-adhesive materials was evaluated using the MTT assay (viability) and the Annexin-V-FITC/PI staining (apoptosis). RESULTS. The lowest cell viability was found in cells exposed to BeautiCem SA for 24 h in the extract test method. Cell viability was reduced to 70.6% compared to negative controls. After the 72 h exposure period, viability rate of cell cultures exposed to BeautiCem SA decreased more than 2- fold (29.5%) while cells exposed to RelyX U200 showed the highest viability rate of 71.4%. In the dentin barrier test method, BeautiCem SA induced the highest number of cells in apoptosis after a 24 h exposure (4.1%). Panavia SA Cement Plus was the material that caused the lowest number of cells in apoptosis (1.5%). CONCLUSION. The used self-adhesive cements have showed different cytotoxic effects based on the evaluation method. As exposure time increased, the materials showed more cytotoxic and apoptotic effects. BeautiCem SA caused significantly more severe cytotoxic and apoptotic effects than other cements tested. Moreover, cements other than BeautiCem SA have caused necrotic cell death rather than apoptotic cell death.

Lymphoproliferative Disorders in Multiple Primary Cancers

Demirci, Umut,Ozdemir, Nuriye,Benekli, Mustafa,Babacan, Nalan Akgul,Cetin, Bulent,Baykara, Meltem,Coskun, Ugur,Zengin, Nurullah,Buyukberber, Suleyman Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

Background: Cancer survivors are at increased risk of second cancers. Lymphoproliferative disorders (LPD) are common neoplasms that are primary or subsequent cancers in cases of multiple primary cancer. We here analyzed metachronous or synchronous LPD in multiple primary cancers. Methods: Between 2001 and 2010, LPD were assessed retrospectively in 242 multiple primary cancers patients. Results: Forty nine (20.2%) patients with LPD were detected. Six patients had two LPD where one patient had three LPD. The median age of patients was 60.5 years (range: 28-81). LPD were diagnosed in 29 patients as primary cancer, in 23 patients as second cancer, and in three patients as third cancer in multiple primary cancers. Primary tumor median age was 56 (range: 20-79). Diffuse large B cell lymphoma (n=16), breast cancer (n=9), and lung cancer (n=6) were detected as subsequent cancers. Alklylating agents were used in 19 patients (43.2%) and 20 patients (45.5%) had received radiotherapy for primary cancer treatment. The median follow-up was 70 months (range: 7-284). Second malignancies were detected after a median of 51 months (range: 7-278), and third malignancies with a median of 18 months (range: 6-72). Conclusions: In this study, although breast and lung cancer were the most frequent detected solid cancers in LPD survivors, diffuse large B cell lymphoma was the most frequent detected LPD in multiple primary cancers.

Increased Incidence of Carotid Artery Wall Changes and Associated Variables in Hemodialysis Patients without Symptomatic Cardiovascular Disease

Ahmet A. Kiykim,Ahmet Camsari,Serkan Kahraman,Mustafa Arici,Bulent Altun,Dilek Cicek,Yunus Erdem,Unal Yasavul,Cetin Turgan,Sali Caglar,Aytekin Oto 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.2

Cardiovascular disease (CVD) is still the major cause of the morbidity and mortality in hemodialysis (HD) patients. The characteristics of major arterial changes, atherosclerosis and related risk factors in HD patients remain unclear. We aimed to evaluate the atherosclerotic process in asymptomatic HD patients and healthy volunteers, and to determine the association between the risk factor(s) and the atherosclerotic process in these groups. 92 HD patients (female: 43, male: 49) and 62 age and sex matched healthy volunteers (female: 27, male: 35) were enrolled in this study. Diabetics, smokers, and patients with symptomatic CVD were excluded. The right and left carotid intima-media thicknesses (CIMTs) were measured and plaque structures were studied by B-mode ultrasound. The mean CIMT in patients and control group were 0.79±0.16 mm and 0.54±0.09mm, respectively. Mean CIMT in HD patients was thicker (p<0.001) and the presence ratio of plaque was higher in patients group (n=38, %61.2 vs n=9, %17.3) (p<0.001). Calcified type of plaque was more frequent in HD patients than control group. Age (r=0.48, p<0.001), left ventricular mass (r=0.42, p<0.05), and homocysteine (r=0.46, p<0.01), mean hematocrit (r=-0.36, p<0.05), plasma CRP (r=0.50, p<0.001), ESR (r=0.43, p<0.01) and albumin (r= -0.34, p<0.05) levels were correlated with the CIMT measurements and plaque presence, significantly. -CIMT as an atherosclerotic process indicator is thicker in asymptomatic HD patients than healthy subjects. We concluded that in addition to various classical risk factors, uremic environment may also contribute to acceleration of the atherosclerotic process.