Browsing by Author "Haberal, Cevahir"

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Association Between Vascular Access Type and Visceral and Peripheral Body Fat, Nutritional and Inflammatory Parameters in Incident Hemodialysis Patients
(2017) Birtay, Tayfun; Saba, Tonguc; Haberal, Cevahir; Genctoy, Gultekin; 0000-0002-5145-2280; AAJ-5551-2021
OBJECTIVE: Central venous catheters (CVCs) are preferred when a patent arteriovenous fistula (AVF) cannot be created. CVCs have been shown to be associated with increased inflammation and mortality. In the present study, we aimed to investigate a probable association between the vascular access type and BMI, total body fat, truncal fat, muscle mass, visceral (periaortic) fat, and the malnutrition inflammation atherosclerosis and calcification score (MIAC) in hemodialysis patients MATERIAL and METHODS: A total of 119 patients were involved. Ninety patients had patent AVF and 29 patients were undergoing hemodialysis via permanent jugular catheter. Two-dimensional echocardiography was performed to detect valvular calcification. Computed tomography was performed in all patients to detect the amount of thoracic periaortic fat tissue (T-PAFT). Biochemical analyses were performed using c8000 Architect. MIAC scores were calculated using valvular calcification, albumin, and CRP. Total body fat and truncal fat were detected using the bio impedance analysis method. Aortic calcification score (AoCS) was calculated using routine chest x-rays RESULTS: MIAC and AoCS was higher in patients with CVC (p=0.02 and 0.032). T-PA FT was higher in patients with AV (1631.5 +/- 645 vs 1112.2 +/- 606.8; p=0.035). CRP was higher in patients with CVC (p=0.04). Hemodialysis vintage, calcium and albumin were lower in patients with CVC Truncal fat (%), cholesterol and 25-OH vitamin D levels were lower in patients with CVC (p=0.04, p=0.02, p=0.03). T-PA FT was a significant predictor of vascular access type in favour of AVF (t=-2.17; p=0.04) CONCLUSION: The present study revealed that HI) patients with CVC had increased inflammation and decreased nutrition, visceral and truncal fat. Further prospective studies are needed to illuminate the relationship between vascular access type, nutritional parameters and body composition in HD patients.
Evaluation of the relationship between para-aortic adipose tissue and ascending aortic diameter using a new method
(2022) Adar, Adem; Onalan, Orhan; Cakan, Fahri; Keles, Hakan; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Muderrisoglu, Haldun; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; https://orcid.org/0000-0002-5711-8873; https://orcid.org/0000-0002-6496-5050; 36189879
Background Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds the aorta. It contributes significantly to aortic atherosclerosis and enlargement. Studies conducted with computed tomography and magnetic resonance have shown that individuals with aortic aneurysm had more PAT than healthy individuals. In this study, we measured PAT using transthoracic echocardiography (TTE). The aim of this study is to investigate the possible relationship of TTE measured PAT with ascending aortic width. Methods PAT was defined as the hypoechoic space in front of ascending aortic 2 cm above the sinotubular junction at the end of the systole. Patients were divided into 2 groups according to the presence of dilatation in the ascending aorta using Roman's classification (aortic size index, ASI). ASI of less than 21 was considered no aortic dilation and an ASI of 21 mm/m2 or greater was considered to have aortic dilation. Results A total of 321 unselected patients were divided into the ascending aortic dilatation (AAD) group (n = 96) and the normal ascending aorta diameter group (n = 225 patients). PAT was significantly higher in the AAD group compared with the non-ADD group (0.9 (0.48) vs. 0.7 (0.91) mm, p < 0.0001). Univariate and multivariate logistic regression analysis revealed that PAT (OR: 3.005, 95%CI (1.445-6.251)) were significantly associated with AAD. Conclusions This is the first study which evaluated PAT measured by TTE. We found a significant association between PAT measured by TTE and ascending aorta width.
A New And Simple Parameter For Diagnosis Pulmonary Edema: Expiratory Air Humidity
(2022) Adar, Adem; Can, Emine Yilmaz; Elma, Yusuf; Ferah, Meryem Akpolat; Kececi, Mete; Muderrisoglu, Haldun; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Cakan, Fahri; Onalan, Orhan; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; 35092906; AAD-5479-2021; AAD-5564-2021
Purpose: Acute pulmonary edema is characterized by increased levels of fluid in the interstitial and alveolar space of the lung and requires emergency treatment. In acute pulmonary edema, the amount of fluid in the intra-alveolar, interstitial space, and pleural space vary considerably and this fluid will evaporate in different amounts compared to the physiological fluid. The aim of this study was to compare the humidity rates of expiratory air measured before and after pulmonary edema induced by alpha-naphthylthiourea (ANTU) in rats. Methods: The study included twenty healthy adult rats divided equally into a healthy control group and a pulmonary edema group. Pulmonary edema was induced by administering ANTU intraperitoneally in the rats in the study group. Humidity, temperature, lung weight, pleural effusion, and histopathological changes in the respiratory system due to pulmonary edema were examined in the ANTU group. Control measurments were taken before administration of ANTU and again 4 h after administration of ANTU when lung damage was considred to be at maximum levels. Results: Mean expiratory air humidity was 71.22 +/- 3.59% before ANTU and 56.28 +/- 3.94% after administration of ANTU. The mean humidity difference of -14.94 +/- 5.96% was considered statistically different (p = 0.01). Conclusion: Humidity rate in expiratory air was significantly lower in rats with acute pulmonary edema compared to healthy rats. This result supports the hypothesis that humidity in expiratory air can be considered an important parameter in patients during clinical are follow-up for pulmonary edema. (C) 2022 Elsevier Inc. All rights reserved.
Servi kozalağı su ekstresiyle önkoşullandırma iskemik cilt fleplerinde sağkalımı arttırır
(Türk Plastik Rekonstrüktif ve Estetik Cerrahi Dergisi ,17 ,1 ,25-29, 2009) Ulusal, Betül Gözel; Tufan, Hale; Ulusal, Ali Engin; Haberal, Cevahir; Seyhan, Tamer; Borman, Hüseyin; Haberal, Mehmet
İskemik cilt flebi nekrozunun patofizyolojisi karmaşıktır ve öncelikle vasküler tromboz ve yetersiz anjiogenez sonucunda gerçekleşir. Nitrik oksit anjiogenik cevabı belirgin biçimde arttırarak endoteli iskemi-reperfüzyon hasarından korur. Aynı zamanda antikoagülanlar da cilt flep iskemisini önler ya da düzeltebilir. Servi kozalağı su ekstresiyle önkoşullandırma yapılmış sıçanlardan izole edilen aort halkalarının In vitro değerlendirilmesi endotel kökenli nitrik oksit üretiminde artış olduğunu ortaya koymuştur. Buna ilaveten önceki çalışmalarımızda ekstrenin antikogülan özelliği olduğunu da göstermiştik. Bu gözlemlere dayanarak servi kozalağının su ekstresiyle önkoşullandırmanın endotelyal nitrik oksit salınımında artış ve antikogülan özellikleriyle iskemik aksiyel fleplerin random uzantılarının sağkalımını arttırabileceği hipotezinde bulunduk. Yirmi dört adet Sprague-Dawley türü sıçan gelişigüzel şekilde önkoşullandırma grubu (n=12) ve kontrol grubu (n=12) olarak ayrıldı. Önkoşullandırma yapılmış grup %30'luk servi kozalağı ekstresini oral yoldan almaya flebin kaldırılmasından 7 gün evvel başladı ve operasyonu takiben 3 gün de almaya devam etti. Kontrol grubuna çeşme suyu verildi.Gözlem süresinin sonunda ortalama arter basıncı ve kalp hızını içeren hemodinamik değişkenler değerlendirildi. Flep sağkalım ve perfüzyon oranları mikroanjiografi ve lazer Doppler akım ölçerle çalışıldı. Vasküler cevabı saptamak için kontrol grubu ve önkoşullandırma yapılmış gruplardan izole edilen aort segmentlerin izometrik gerimleri in vitro koşullarda kaydedilerek değerlendirildi İzole dok banyosu kullanarak aortic segmentlerin asetilkoline karş oluşturdukları doz bağımlı cevapları saptandı ve iki grup arasında karşılaştırma yapıldı. Hemodinamik değişkenler arasında anlamlı far bulunamadı. Tedavi grubunda flebin sağ distal ve proksima kısımlarında artmış anjiogenez ve kapiller yoğunluğunu yanında artmış flep perfüzyonu saptandı (P < .05). Endote kökenli nitrik oksit bağımlı maksimum gevşeme cevab (Emax) ve EC50 değerleri kontrol grubunda anlam derecede yüksekti. Bu bulgular servi kozalağı su ekstresinin iskemik fleplerd sağkalımı arttırdığını desteklemektedir. The pathophysiology of ischemic skin flap necrosis is complex, due primarily to vascular thrombosis and insufficient angiogenesis. Nitric oxide can significantly increase angiogenic response and protect the endothelium from ischemia-reperfusion injury. Also, anticoagulants can prevent or reverse skin flap ischemia. In vitro assessment of endothelial cell function in isolated aortic rings of rats pretreated with cypress cones' water extract showed increased production of endothelium-derived nitric oxide. Additionally, we have shown its anticoagulant properties. Based on these observations, we hypothesized that pretreatment with cypress cones' water extract would enhance survival of random extensions of ischemic axial flaps via its increased endothelial nitric oxide release and its anticoagulant effect. Twenty four Sprague-Dawley rats were randomly assigned as pretreatment (n=12) and control (n=12) groups. The pretreated group received 30% of cypress cones' water extract treatment orally 7 days before flap elevation and for 3 days afterward. The control group received tap water. The ischemic target was a 6 × 7 cm islanded epigastric artery flap based on the right inferior epigastric pedicle. After the observation period, hemodynamic variables including mean arterial pressure and heart rate were assessed. Flap survival and perfusion rates were determined by microangiography and laser Doppler flowmetry. In twelve rats, in vitro isometric tension of the aortic segments isolated from the control and pretreated groups was monitored to reflect vascular responsiveness. Using isolated tissue baths, the dose- response relations to acetylcholine was determined and compared between the two groups. There were no significant differences between the hemodynamic variables. In the pretreated group, microangiograms revealed increased angiogenesis and capillary density and enhanced flap perfusion (as blood perfusion units) in the right distal and proximal parts (P < .05). Endothelium-derived nitric oxide - dependent maximal relaxation (Emax) and the EC50 value to Acetylcholine were significantly greater in the pretreated group compared to that of the controls. These data suggest that pretreatment with cypress water extract enhances the viability of ischemically challenged flaps.