The Independent Relationship of Systemic Inflammation With Fragmented QRS Complexes in Patients With Acute Coronary Syndromes

Mustafa Çetin,Sinan Altan Kocaman,Turan Erdog˘ an,Aytun Çanga,Murtaza Emre Durakog˘ lugil,Ömer S¸atırog˘ lu,Özgür Akgül, MD,Tuncay Kırıs,Yüksel Çiçek,Barıs¸ Yaylak,Sıtkı Dog˘ an,smail S¸ahin,Mehmet Bo 대한심장학회 2012 Korean Circulation Journal Vol.42 No.7

Background and Objectives: QRS complex fragmentations are frequently seen on routine electrocardiograms with narrow or wide QRS complex. Fragmented QRS complex (fQRS) is associated with increased morbidity and mortality, sudden cardiac death and recurrent car-diovascular events. In this study, we aimed to interrogate the relationship of systemic inflammation with the presence of fQRS in patients with acute coronary syndromes (ACS). Subjects and Methods: Two-hundred and twenty eligible patients with ACS that underwent coronary angiography were enrolled con-secutively in this study. Patients with significant organic valve disease and those with any QRS morphology that had a QRS duration ≥120 ms as well as patients with permanent pacemakers were excluded from this study. Results: Patients with fQRS were of a higher age (p=0.02), had increased C-reactive protein (CRP) levels (p<0.001), prolonged QRS time (p<0.001), extent of coronary artery disease (CAD) (p<0.001), creatine kinase-MB (CK-MB) levels (p=0.006) and Q wave on admission elec-trocardiography (p<0.001) in comparison to patients with non-fragmented QRS. When we performed multiple logistic regression analysis,fQRS was found to be related to increased CRP levels {odds ratio (OR): 1.2, 95% confidence interval (CI): 1.045-1.316, p=0.007}, QRS du-ration (OR: 1.1, 95% CI: 1.033-1.098, p<0.001), extent of CAD (OR: 1.5, 95% CI: 1.023-2.144, p=0.037), Q wave (OR: 2.2, 95% CI: 1.084-4.598, p=0.03) and CK-MB levels (OR: 1.0, 95% CI: 1.001-1.037, p=0.04) independently. Conclusion: In our study, we found that fQRS was independently related to increased CRP. Fragmented QRS that may result as an end effect of inflammation at cellular level can represent increased cardiac risk by different causative mechanisms in patients with ACS. Background and Objectives: QRS complex fragmentations are frequently seen on routine electrocardiograms with narrow or wide QRS complex. Fragmented QRS complex (fQRS) is associated with increased morbidity and mortality, sudden cardiac death and recurrent car-diovascular events. In this study, we aimed to interrogate the relationship of systemic inflammation with the presence of fQRS in patients with acute coronary syndromes (ACS). Subjects and Methods: Two-hundred and twenty eligible patients with ACS that underwent coronary angiography were enrolled con-secutively in this study. Patients with significant organic valve disease and those with any QRS morphology that had a QRS duration ≥120 ms as well as patients with permanent pacemakers were excluded from this study. Results: Patients with fQRS were of a higher age (p=0.02), had increased C-reactive protein (CRP) levels (p<0.001), prolonged QRS time (p<0.001), extent of coronary artery disease (CAD) (p<0.001), creatine kinase-MB (CK-MB) levels (p=0.006) and Q wave on admission elec-trocardiography (p<0.001) in comparison to patients with non-fragmented QRS. When we performed multiple logistic regression analysis,fQRS was found to be related to increased CRP levels {odds ratio (OR): 1.2, 95% confidence interval (CI): 1.045-1.316, p=0.007}, QRS du-ration (OR: 1.1, 95% CI: 1.033-1.098, p<0.001), extent of CAD (OR: 1.5, 95% CI: 1.023-2.144, p=0.037), Q wave (OR: 2.2, 95% CI: 1.084-4.598, p=0.03) and CK-MB levels (OR: 1.0, 95% CI: 1.001-1.037, p=0.04) independently. Conclusion: In our study, we found that fQRS was independently related to increased CRP. Fragmented QRS that may result as an end effect of inflammation at cellular level can represent increased cardiac risk by different causative mechanisms in patients with ACS.

Long Non-coding RNA CASC15 Promotes Intrahepatic Cholangiocarcinoma Possibly through Inducing PRDX2/PI3K/AKT Axis

Yuan Zhang,Lufei Zhang,Sinan Lu,Yucheng Xiang,Cheng Zeng,Tianyu He,Yuan Ding,Weilin Wang 대한암학회 2021 Cancer Research and Treatment Vol.53 No.1

Purpose Intrahepatic cholangiocarcinoma (ICC) is one of the most common liver primary tumors but its treatments are limited. Bioinformatics showed that the expression level of long non-coding RNA cancer-associated susceptibility 15 gene (CASC15) is correlated with ICC progression, but its functional mechanism remains unclear. Materials and Methods Tissues from ICC patients, tumor and adjacent tissue, were used for detection of the expression of CASC15. Clinical data were also collected for clinicopathologic and survival analysis. Short interfering RNA and lentiviral short hairpin RNA were used to knock down CASC15 and PRDX2 expression in ICC cell lines, for the analysis of changes of cell function and xenografts. RNA-pulldown and RNA immunoprecipitation assays were used to detect RNA-binding protein, PRDX2. Male nude mice were used for ICC xenografts, and livers were collected after 4 weeks for immunohistochemistry. Results CASC15 is highly expressed in ICC tissues and is related to higher TNM stage. Knockdown of CASC15 in ICC cells reduced cell proliferation, migration, invasiveness and increased apoptosis, and G1/S block. PRDX2 bound to CASC15. Knockdown of CASC15 decreased PRDX2 expression which was rescued by the inhibition of proteasome formation. Downregulation of PRDX2 resulted in G1/S block, reduced ICC cell invasion. Downregulation of CASC15 inhibited phosphoinositide 3-kinase (PI3K)/AKT/c-Myc pathway through downregulating of PRDX2 and overexpressed PRDX2 rescued the block. CASC15 knockout in ICC xenografts suppressed tumor development in vivo, decreased the expression of PRDX2 and Ki67 and inhibited PI3K/AKT pathway. Conclusion CASC15 promotes ICC possibly by targeting PRDX2 via the PI3K/AKT pathway, indicating poor prognosis and high degree of malignancy of ICC.

Bilirubin Level is Associated with Left Ventricular Hypertrophy Independent of Blood Pressure in Previously Untreated Hypertensive Patients

Teslime Ayaz,Murtaza Emre Durakog˘lugil,Sinan Altan Kocaman,Tug˘ba Durakog˘lugil,Turan Erdog˘an,Osman Zikrullah S¸ahin,Serap Baydur S¸ahin,Yüksel C¸ic¸ek,Ömer S¸atirog˘lu 대한심장학회 2014 Korean Circulation Journal Vol.44 No.5

Background and Objectives: Left ventricular hypertrophy (LVH), a sign of subclinical cardiovascular disease, is an important predictor of cardiovascular morbidity and mortality. The aim of our study was to determine the association of left ventricular mass (LVM) with possible causative anthropometric and biochemical parameters as well as carotid intima-media thickness (CIMT) and brachial flow-mediated dilation (FMD) as surrogates of atherosclerosis and endothelial dysfunction, respectively, in previously untreated hypertensive patients. Subjects and Methods: Our study included 114 consecutive previously untreated hypertensive patients who underwent echocardiography and ultrasonography to evaluate their vascular status and function via brachial artery CIMT and FMD. Results: Among all study parameters, age, systolic blood pressure (BP), diastolic BP, pulse pressure, plasma glucose, uric acid, total bilirubin, direct bilirubin, hemoglobin, and CIMT were positively correlated with the LVM index. Multiple logistic regression analysis revealed that office systolic BP, age, male gender, and total bilirubin were independent predictors of LVH. Conclusion: Bilirubin seems to be related to LVM and LVH. The positive association of bilirubin with these parameters is novel and requires further research.

Thiol/Disulfide Homeostasis in Bipolar and Unipolar Depression

Gamze Erzin,Güven Özkaya,Canan Topçuoğlu,Rabia Nazik Yüksel,Özcan Erel,Emine Feyza Yurt,Erol Göka,Sinan Gülöksüz 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.3

Objective: Bipolar disorder and unipolar depressive disorder are complex phenotypes. There appear to be phenotypical, mechanistic, and therapeutic differences between bipolar depression (BD) and unipolar depression (UD). There is a need for understanding the underlying biological variation between these clinical entities. The role of oxidative processes underlying bipolar disorder and depression has been demonstrated. Thiol-disulfide homeostasis (TDH) is a recent oxidative stress marker. In this study, we aimed to inspect patients with bipolar depression and unipolar depression in terms of thiol-disulfide balance and to compare them with healthy controls. Methods: Patients admitted to the outpatient clinic of Ankara Numune Training and Research Hospital and diagnosed either as a depressive episode with bipolar disorder (n = 37) or unipolar depression (n = 24) according to DSM-5 criteria, along with healthy controls (HC) (n = 50), were included in the study. Native thiol, total thiol, and disulfide levels were compared across the groups. Results: In comparison to HC, both BD and UD groups had higher disulfide levels, disulfide/native thiol ratio, and disulfide/total thiol ratio. No significant differences between BD and UD were detected in terms of disulfide level, disulfide/ native thiol ratio, and disulfide/total thiol ratio. Conclusion: Increased levels of disulfide, native thiol, and disulfide/total thiol ratios compared to healthy controls in both UD and BD groups may be indicative of the presence of oxidative damage in these two clinical conditions. To clarify the role of oxidative stress in the pathophysiology of depressive disorders and investigate TDH, longitudinal studies in patients with medication-free UD and BD are required.

Shall We Resect the Tip of Manubrium Mallei in Tympanoplasty?

Ahmet Kutluhan,Gökhan Yalçıner,Gülnur Güler,Kemal Kösemehmetog(lu,Kazım Bozdemir,Akif Sinan Bilgen 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.1

Objectives. In tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not. Methods. The 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens. Results. Squamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens. Conclusion. In tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.