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Öğe A 54-year-old male patient with amaurosis fugax(2008) Ebinç, Haksun; Sezikli, Mesut; Ebinç, Ayerden FatmaTakayasu arteritis is an idiopathic chronic large vessel vasculitis. It is a rare chronic disease of the aorta and its branches, and is mostly seen in children and young women. The clinical picture includes non-specific systemic symptoms along with those related to the problematic artery. However, patients can sometimes be asymptomatic at the time of diagnosis. The most common symptoms include upper extremity claudication, systemic hypertension, pain around the carotid artery, dizziness, and vision problems. Diagnosis is based on clinical criteria and the golden rule in identifying arterial lesions in Takayasu arteritis is angiography. Herein we report a 54-year-old male patient with amaurozis fugax, who was later diagnosed as Takayasu arteritisÖğe Coxiella burnetii seropositivity and coronary ectasia(Cardiology Academic Press, 2014) Doğru, Mehmet Tolga; Alpay, Yeşim; Şimşek, Vedat; Ünal, Nilgün; Askar, Şinasi; Ebinç, Haksun; Yıldırım, NesligülBacterial infections could contribute to atherosclerotic inflammation. We investigated the association of Coxiella Burnetii seropositivity with the atherosclerotic lesion types (obstructive and/or ectatic), serum lipid profile, nitric oxide (NO),total sulfhydryl (SH) groups and malonyldialdehyde (MDA) levels. A total of 150 participants (73 male, mean age: 56.6 ± 11.4 years; 77 female, mean age: 57.3 ± 13.0 years) were enrolled into the study. Coronary angiography was performed all the participants. We also performed serum lipid profile, NO, SH groups and MDA levels to determine the changes in chronic and acute Coxiella burnetii infections. The patients with obstructive and ectatic coronary artery lesions were of higher Coxiella phase I IgG titer (The marker of chronic Coxiella infection) than those of other coronary artery disease groups(One Way ANOVA, p=0.001). There were higher serum total cholesterol levels in the patients with chronic Coxiella infection than those of other patients. The chronic Coxiella Burnetii infection may be an important factor for the formation of coronary artery ectasia on basement of atherosclerotic coronary artery disease. Hyperlipidemia might also facilitate and augment this association.Öğe The effects of statin therapy on pulse wave velocity measurements(Cardiology Academic Press, 2014) Şimşek, Vedat; Doğru, Mehmet Tolga; Demir, V.; Şahin, Ö.; Tulmaç, Murat; Ebinç, Haksun; Yıldırım, NiyaziSeveral studies have shown that positive effects of statins on pulse wave velocity parameters. However, there is few study about the comparison of the effectivity of statins on pulse wave velocity parameters. In the present study, we aimed to show the difference about the effects of long term atorvastatin and rosuvastatin therapy on aortic stiffness in patients with hyperlipidemia. A total of 104 hyperlipidemic patients were enrolled into the study. There were 50 patients in Group 1 (The patients treated with Atorvastatin 20 mg/day) (23 male and 27 female, mean age: 55.8 ± 10.3 years;, mean age: 52.7 ± 9.4 years) and 54 patients in Group 2 (The patients treated with Rosuvastatin 10 mg/day) (23 male and 31 female, mean age: 52.7 ± 9.4 years). All patients followed up to 12 months about their lipid profile and pulse wave analysis data. After 12 months, we found that rosuvastatin was of higher positive effects on arterial stiffness and reflection index parameters (Student T test, p=0.049 and =0.041, respectively ) We considered that, rosuvastatin was of greater ameliorative effect on vascular stiffness than that of atorvastatin in the patients with hyperlipidemia.Öğe Fondaparinux used for severe heparin induced thrombocytopenia with subacute instent thrombosis(2008) Tulmaç, Murat; Ebinç, Haksun; Doğru, Mehmet Tolga; Özer, Murat; Çeneli, Özcan; Şimşek, VedatHeparin induced thrombocytopenia (HIT) is an immune mediated event that may result in life and limb threatening complications. We report a 52 year old diabetic woman with subacute instent thrombosis and severe heparin induced thrombocytopenia treated successfully with fondaparinux. Not only platelet count returned to normal but also thromboembolic or hemorrhagic events were prevented under treatment. The low rate of de novo antibody formation and the scarce cross-reactivity with HIT antibodies offer fondaparinux as a relatively safe alternative anticoagulant agent for use in patients with HIT. Fondaparinux should be kept in mind in severe HIT if direct thrombin inhibitors are unavailable.Öğe Glaucomatous risk factors in patients with ischemic heart disease(Gulhane Medical School, University of Health Sciences, 2007) Ergin, Ahmet; Ebinç, Haksun; Güllü, Reyhan; Durukan, A. HakanIt has been demonstrated that ischemia and systemic hypertension each are the risk factors for elevated intraocular pressure. In this study some of the risk factors important for glaucoma in patients with ischemic heart disease were evaluated. Otherwise healthy patients with age of >35 years and diagnosed to have ischemic heart disease by the Department of Cardiology were included in the study. Central corneal thickness measurements of the patients were made with Pacline Opticone Ultrasonic Pacimetry, and intraocular pressures were measured with Goldmann applanation tonometry. Retinal nerve fiber layer thickness measurements were made with NFA II (GDx VCC). A total of 90 eyes of 51 patients (39 male and 12 female) in the patient group and a total of 100 eyes of 50 cases (35 male and 15 female) in the control group were enrolled in the study. There were no significant differences between the control and study groups with respect to age and gender. Intraocular pressure was 16.58±2.92 mmHg in the patient group and 16.86±2.92 mmHg in the control group, and there was no statistically significant difference between the groups. Central corneal thickness was 538.97±36.23 in the patient group and 542.13±38.45 in the control group, and there was no significant difference between the groups. There were also no significant differences between the study and control groups with respect to parameters such as TSNIT, SA, IA and NFI in the measurement of retinal nerve fiber layer thickness. Intraocular pressure, central corneal thickness and retinal nerve fiber layer thickness measurements were not found as high enough to be risk factors for glaucoma in patients with ischemic heart disease. © Gülhane Askeri Tip Akademisi 2007.Öğe Glokomu olmayan hipertansif bireylerde dipper ve non-dipper kan basıncı paterninin retina sinir lifi kalınlığı üzerine etkisi(2014) Onaran, Zafer; Oğurel, Reyhan; Ebinç, Haksun; Usta, Gülşah; Şahin, Ömer; Örnek, KemalAmaç: Yirmi dört saat ayaktan kan basıncı izlemi sonucu kan basıncı seyri dipper ve non-dipper olarak saptanan hipertansif hasta- larda retina sinir lifi tabakası (RSLT) kalınlığının ölçülmesi ve farklı kan basıncı paternlerinin RSLT üzerine etkisinin araştırılması. Gereç ve Yöntem: Çalışmaya hipertansiyon tanısı almış 25 hasta ile 22 sağlıklı birey dahil edildi. Hipertansif hastalar 24 saatlik ayaktan kan basıncı ölçümü yapılarak 2 gruba ayrıldı. Arteriyel kan basınçlarının gece ortalaması gündüz ortalamasından %10 ve daha fazla düşük olanlar dipper hipertansiyon grubu (n13), düşüş olmayanlar ise non-dipper hipertansiyon grubu (n12) olarak belirlendi. Takiben çalışmaya katılan tüm bireylerin RSLT kalınlığı NFAII-GDx cihazı ile ölçüldü. Bulgular: Dipper ve non-dipper gruplarında gündüz ve gece ölçülen ortalama kan basıncı değerlerinin kontrol grubundan anlamlı derecede yüksek olduğu tespit edildi (p0.05). RSLT kalınlığının değerlendirilmesinde kullanılan GDx parametrelerinden TSNIT, superior average ve inferior average değerlerinin non-dipper grubunda hem kontrol grubundan hem de dipper grubundan daha düşük olduğu görüldü. En belirgin ve istatistiksel olarak anlamlı olan farkın da kontrol grubu ile non-dipper grubu arasındaki inferior average değerinde olduğu gözlendi (67.03 ?9.15 ve 59.31?6.38, p0.01). Sonuç: Gece boyunca çoğu kişide gözlenen kan basıncı düşüşünün olmadığı (non-dipper) hipertansif kişilerde hedef son organ hasarı- nın daha ciddi boyutlarda olduğu gösterilmiştir. Çalışmanın sonucunda saptanmış olan non-dipper paternde hipertansiyonun RSLT’da oluşturduğu incelme nedeniyle glokomatöz hasar için ek bir risk faktörü olarak geniş kapsamlı çalışmalarda incelenmesi faydalı olabilir.Öğe Massive Systemic Air Embolism During Aortic Root Angiography A Dire Complication(Lippincott Williams & Wilkins, 2012) Tulmaç, Murat; Şimşek, Vedat; Şahin, Ömer; Ebinç, Haksun…Öğe Relationship of left ventricular mass to insulin sensitivity and body mass index in healthy individuals(Taylor & Francis Ltd, 2006) Ebinç, Haksun; Ayerden Ebinç, Fatma; Nur Özkurt, Zübeyde; Doğru, Tolga; Yilmaz, MuratObjective-The objective of this study was to investigate the contribution of insulin resistance, hyperinsulinaemia and obesity, independently of other major factors, to changes in left ventricular mass a cardiovascular risk indicator, in a healthy population without co-morbid states such as diabetes or hypertension. Methods and results-This cross-sectional relational study was perfomed in 153 healthy subjects, comprising 76 men and 77 women with ages ranging from 23 to 67 years. All of them were normotensive and had a normal oral glucose tolerance test, none had cardiovascular disease and none were taking any medication. Weight, height and waist circumference were measured and BMI was calculated.A blood sample was drawn in the fasting state: plasma glucose, insulin, serum total and high density lipoprotein (HDL), low density lipoprotein cholesterol and triglycerides were measured. Insulin resistance was determined by the 'Homeostasis Assessment Model' (HOMA-IR). Subjects were studied by echocardiography. The left ventricular mass was calculated by using the anatomically validated formula of Devereux et al. Results - Left ventricular mass significantly and positively correlated with BMI, age, systolic and diastolic blood pressure and fasting blood glucose. The correlation of left ventricular mass with fasting blood glucose was not maintained after controlling for BMI. BMI, fasting blood glucose, HOMAIR, systolic and diastolic blood pressure showed significant differences with higher values for people with left ventricular hypertrophy. The logistic regression analysis showed a strong association between left ventricular hypertrophy and BMI (p < 0.05). Conclusion - Insulin resistance and fasting insulin is not associated with left ventricular hypertrophy in healthy people, independent of obesity. Obesity appears to be an independent risk factor for left ventricular hypertrophy.Öğe Serum orexin-a level and the severity of coronary artery disease: Original article(Cardiology Academic Press, 2014) Şimşek, Vedat; Doğru, Mehmet Tolga; Boyunağa, Hakan; Çağlayan, Osman; Yıldırım, Niyazi; Tulmaç, Murat; Ebinç, HaksunIn this study, we aimed to investigate the correlations of serum Orexin-A level (SOAL) and the severity of coronary artery disease (CAD). A total of 80 participants (mean age: 55.7±12.7 years) were enrolled into the study. SOAL, electrocardiography and transthoracic echocardiography and 24 Hour Holter monitoring (24HHM) and coronary angiography were performed in all participants. Autonomic functions were assessed using the data of Heart Rate Variability measurements. Patients were categorized into three groups according to their Gensini scores as: Group 1: The patients with normal coronary angiogram, Group 2: The patients with mild CAD (Gensini <20) and Group 3: The patients with severe CAD (Gensini ?20). A total of 28 patients were Group 1 (mean age 51.8±12.0 years), 25 patients were Group 2 (mean age 57.7±11.6 years) and 27 patients were Group 3 (mean age 57.6±13.6 years). There were statistically significant differences in SOAL (p=0.004) among the groups. We found that SOAL had statistically significant associations with Gensini score and LF/HF (Sympathetic activity) values. (F= 15.299; p=0.004 and F= 15.470; p=0.004, respectively). Serum Orexin-A levels are positively correlated with severity of CAD and sympathetic activity.Öğe Transient global amnesia after ventricular fibrillation during acute myocardial infarction(2013) Tulmaç, Murat; Şimşek, Vedat; Dağ, Ersel; Tireli, Emine; Eser, Özer; Ebinç, Haksun; Doğru, Mehmet TolgaBurada akut inferolateral miyokard infarktüsü seyrinde anında tedavi edilen ventrikül fibrilasyonu sonrası geçici global amnezi gelişen 48 yaşında bir erkek hastayı bildiriyoruz. Hekimler ventrikül fibrilasyonu ile komplike olan miyokard infarktüsü ile gelen hastalarda geçici global amnezi varlığını araştırmaya özellikle dikkat etmelidir.
