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Öğe Decreased nocturnal synthesis of melatonin in patients with coronary artery disease(Elsevier Sci Ireland Ltd, 2003) Yaprak, M; Altun, A; Vardar, A; Aktoz, M; Ciftci, S; Ozbay, GIn human beings, cardiovascular activity has a distinct circadian variation: Heart rate, blood pressure, and vascular tone decrease at night. Nocturnal cardiovascular blunting is at least partially linked to the autonomic activity and increased risk of cardiac and cerebral events. To assess whether decreased nocturnal melatonin synthesis and secretion in coronary artery disease (CAD), we investigated nocturnal secretion pattern of melatonin in patients with CAD and healthy subjects. The present study performed in 16 patients with angiographically documented CAD (aged 46-71 years) and in nine healthy controls (aged 36-66 years). Blood samples were collected every 2 h between 22:00 and 08:00 h. Melatonin levels were measured with a commercially available radioimmunoassay kit. We found large interindividual variation in the pattern of melatonin secretion in both groups. Patients with CAD secreted less nocturnal melatonin at 02:00, 04:00 and 08:00 h than control subjects (P=0.014, P=0.04 and P=0.025, respectively). Peak and A melatonin (peak-lowest melatonin) were found lower in patients with CAD (48.6 [19.1-75.4] vs. 131.4 [67.8-137.2] pg/ml, P=0.006 and 43 [10.5-68.5] vs. 107.6 [55.7-113.1] pg/ml, P=0.002, respectively). Peak time of melatonin secretion was observed earlier in patients with CAD (02:00 h [23:00-02:00 h] vs. 03:45 h [02:00-05:00 h], P=0.04). Our study provides useful and preliminary information about decreased nocturnal melatonin synthesis and release in patients with CAD might help physicians in managing these patients. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Impaired nocturnal synthesis of melatonin in patients with cardiac syndrome X(Elsevier Sci Ireland Ltd, 2002) Altun, A; Yaprak, M; Aktoz, M; Vardar, A; Betul, U; Ozbay, GWe investigated nocturnal secretion pattern of melatonin in patients with cardiac syndrome X and healthy subjects. The present study performed in five patients with cardiac syndrome X and in nine healthy controls. Blood samples from all subjects were collected every 2 h intervals between 22:00 and 08:00 h. Melatonin levels were measured with a radioimmunoassay kit. Patients with cardiac syndrome X secreted less nocturnal melatonin at 02:00 h than control subjects (P = 0.04). Peak and Delta melatonin (peak-lowest melatonin) were found lower in patients with cardiac syndrome X (P = 0.039 and P = 0.028, respectively). In conclusion patients with cardiac syndrome X show a markedly decreased nocturnal melatonin synthesis. Our study provides useful information about melatonin synthesis and release in patients with cardiac syndrome X might help physicians in managing these patients. (C) 2002 Published by Elsevier Science Ireland Ltd.Öğe Management of a patient with active rheumatoid arthritis and suspected tuberculosis causing effusive-constrictive pericarditis(Elsevier Sci Ireland Ltd, 2003) Yildiz, M; Erdogan, O; Aktoz, M; Gul, C; Ozbay, GIn the following case report we present a patient who has been admitted for pericardial effusion causing cardiac compression with active rheumatoid arthritis and suspected tuberculosis. The patient was successfully treated with intravenous pulse steroid for active rheumatoid arthritis, with prophylactic anti-tuberculosis agents for suspected tuberculosis and with surgical pericardiectomy for the thickened pericardium as well as recurrent pericardial effusion. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Mitral valve vegetation and cerebral emboli in a primary antiphospholipid syndrome patient who had hepatitis C virus infection(Springer-Verlag, 2003) Pamuk, ÖN; Çakir, N; Soy, M; Aktoz, M; Çelik, Y; Akdemir, OWe report the case of 36-year-old woman who came to us with a history of recurrent miscarriages and who was later diagnosed as having primary antiphospholipid syndrome (PAPS) and chronic hepatitis C virus (HCV) infection. The patient was referred to us with generalised seizures; cranial MRI revealed multiple embolic infarcts in both frontal lobes and a focal cortical infarct in the left frontoparietal lobe. Her echocardiography showed mitral valve vegetation and insufficiency. The patient was put on oral anticoagulant therapy and during her 8-month follow-up period no thrombotic events occurred. We report this case because it was the first in which PAPS, valvular disease, a cerebral embolic event and HCV infection were coexistent in the same patient. We also review other cases in which there was valvular vegetation and a cerebral ischaemic event associated with PAPS.Öğe Unexpected occurrence of ST segment elevation during administration of intravenous atropine(Kluwer Academic Publ, 2001) Erdogan, O; Altun, A; Akdemir, O; Aktoz, M; Ozbay, G[Abstract Not Available]
