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Öğe 17p Deletion is associated with resistance of B-cell chronic lymphocytic leukemia cells to in vitro fludarabine-induced apoptosis(Taylor & Francis Ltd, 2007) Turgut, Burhan; Vural, Ozden; Pala, Funda S.; Pamuk, Gulsum E.; Tabakcioglu, Kiymet; Demir, Muzaffer; Ongoren, SenizWe explored the relationship between the cytogenetic/biologic characteristics of B-chronic lymphocytic leukemia (B-CLL) cells and their tendency to undergo spontaneous or fludarabine-induced apoptosis in vitro. B cells from 36 B-CLL patients were incubated with or without fluclarabine for 48 h. Apoptosis was determined by two assays: annexin V staining and DNA staining. Fluorescence in situ hybridization was used for detection of trisomy 12, 11q deletion, and 17p deletion. Bcl-2 and CD38 expressions were determined by flow cytometry. Five patients had 17p deletion, 6 had trisomy 12, and another 6 had 11q deletion. B-CLL cells with 17p deletion had significant resistance to apoptosis induced by fludarabine and a slight spontaneous resistance to apoptosis. Bcl-2 and CD38 were not associated with in vitro spontaneous and fludarabine-induced apoptosis. In conclusion, 17p deletion, which causes loss of p53 gene, is associated with resistance to fludarabine-induced apoptosis in vitro. New treatment modalities should be tried in B-CLL patients with 17p deletion.Öğe The association between DRESS and the diminished numbers of peripheral B lymphocytes and natural killer cells(Wiley, 2012) Yazicioglu, Mehtap; Elmas, Reyhan; Turgut, Burhan; Genchallac, TugbaDrug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced, severe multiorgan system reaction whose exact pathogenesis remains unknown. This study aimed at evaluating specific changes in peripheral blood lymphocyte subtypes associated with DRESS during antibiotic treatment. We analyzed six patients with DRESS. A complete blood count and peripheral blood lymphocytes immunophenotyping were carried out at symptom onset and at follow-up visits. Acute-phase reactants and liver enzymes were measured in all patients. Other tests viral serology, serum immunoglobulin levels, and skin tests were performed when possible. B-cell counts were low in all patients at the onset of DRESS, and natural killer (NK) cells were low in all cases except one. During recovery, B-cell numbers were within a normal range in five patients. In one, there was even a 10-fold increase in B-cell counts, although the level was mildly low after 3 months. NK-cell numbers were within a normal range in three patients. The mean numbers of B cells and NK cells were significantly higher in the second samples compared to the values on admission. Serum IgA and IgM levels were low in one patient. The drug provocation test was positive with cefotaxime in one patient. Viral serology, performed on five patients, was negative. A decrease in B-cell and NK-cell counts was the most consistent finding associated with the onset of antibiotic-induced DRESS in our patients. This immunologic alteration might be a useful predictor of DRESS development.Öğe BETA-GLOBIN GENE MUTATIONS AND MICRO-HAPLOTYPE POLYMOPHISMS OF BETA-THALASSEMIA PATIENTS IN TRAKYA POPULATION(John Wiley & Sons Inc, 2009) Gurkan, Hakan; Turgut, Burhan; Tozkir, Hilmi; Bozkurt, Gokay; Tekgunduz, Emre[Abstract Not Available]Öğe Chronic idiopathic demyelinating polyneuropathy (CIDP) associated with Kaposi's sarcoma(Springer, 2006) Celik, Yahya; Turgut, Nilda; Turgut, Burhan; Pamuk, Guelsuem E.; Demir, Muzaffer[Abstract Not Available]Öğe Cognitive dysfunction in patients with chronic obstructive pulmonary disease(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2018) Pekel, Nilufer Buyukkoyuncu; Turgut, Nilda; Altiay, Gundeniz; Demir, Muzaffer; Turgut, Burhan; Erbas, Hakan; Sut, NecdetObjective: Chronic obstructive pulmonary disease (COPD) is characterized with air flow limitation. Cognitive problems can appear in advanced stage of COPD. There is relationship between COPD and levels of homocystein (hcy) and total antioxidant capacity (TAC). There is also relationship between cognitive dysfunction and levels of hcy and TAC. We aimed evaluation of cognitive functions in patients with COPD, and demonstration of the relationship between cognitive function and hcy and TAC. Methods: Twenty-eight hypoxic (group 1), 28 non-hypoxic COPD patients (group 2) and 25 healthy people (control group, group 3) were included to study. Hcy and TAC levels were measured in all subjects. Cognitive functions were evaluated in all subjects with standardized mini mental test (SMMT), clock drawing test (CDT), Blessed orientation memory concentration test (BOMCT), Benton's facial recognition test (BFRT) and clinical dementia rating scale (CDRS). Results: Hcy levels were high in group 1 (p=0.004), TAC levels were high in group 1 and 2 (p=0.04). SMMT (p=0.000) and CDT values were low in group1 (p=0.000), CDRS values were high in group1 and 2 (p=0.000), BFRT values were low in group1 and 2 (p=0.000), BOMCT values were high in group1 (p=0.000). There were a correlation between TAC and SMMT (r=0.582, p=0.001) and CDRS (r=-0.384, p=0.044). Conclusions: We demonstrated presence of cognitive dysfunction in COPD patients. Patients with hypoxic had more profound cognitive dysfunction. In addition, we demonstrated a relationship between TAC and cognitive dysfunction.Öğe Cutaneous Kaposi sarcoma which developed in a patient with aplastic anaemia using immunosuppressive therapy - Description of the first adult case(Acad Medicine Singapore, 2007) Pamuk, Gulsum Emel; Kundak, Turker; Turgut, Burhan; Demir, Muzaffer; Vural, Ozden[Abstract Not Available]Öğe Differences in platelet-leukocyte aggregates among subtypes of acute cerebral ischemia(Elsevier, 2011) Turgut, Burhan; Turgut, Nilda; Celik, Yahya; Tekgunduz, Emre; Pamuk, Gulsum Emel; Demir, MuzafferBackground: Acute cerebral ischemia is caused by different pathophysiological mechanisms. The role of platelets and other blood cells can be different among the stroke subtypes. Methods: Seventy-two patients with acute ischemic cerebrovascular disease, including 31 patients with large vessel disease, 21 patients with cardioembolic disease, and 20 patients with small vessel disease, were evaluated. P-selectin (CD62P) expression and platelet leukocyte aggregates were measured with flow cytometry at the acute phase after the ischemic event. Markers were also measured in 37 control subjects. In all subjects, the serum high-sensitivity C-reactive protein (CRP) was also measured. Results: The platelet-monocyte aggregates (PMA) and platelet-granulocyte aggregates (PGA) in the large vessel disease group were higher than in control group (P=0.002, and P < 0.0001, respectively). The PMA and PGA in the small vessel disease group were also higher than in the control group (P=0.004 and P < 0.0001, respectively). In contrast, in the cardioembolic disease group, the PMA and PGA were not significantly different from the control group. CD62P expression was higher in all of the patient groups relative to the control group (P < 0.05 for all comparisons). Serum CRP levels were also higher in all of the patient groups than in the control group (P < 0.0001 for all comparisons). Conclusions: In contrast to large vessel and small vessel disease, it seems that platelet-leukocyte association does not play a crucial role in the pathogenesis of cardioembolic stroke. (C) 2011 Elsevier B.V. All rights reserved.Öğe Does anti-tnf therapy cause any change in platelet activation in ankylosing spondylitis patients?(Springer, 2012) Orum, Huseyin; Pamuk, Gulsum Emel; Pamuk, Omer Nuri; Demir, Muzaffer; Turgut, BurhanRecently, it has been reported that ankylosing spondylitis (AS) was characterised by endothelial dysfunction and the development of atherosclerotic complications. In this study, we evaluated platelet and endothelial activation parameters in AS patients. Fiftynine AS patients and 22 healthy controls were included. The clinical features and acute phase parameters were evaluated. In all patients and healthy controls, platelet-monocyte complexes (PMC), platelet-neutrophil complexes, basal and ADP-stimulated P-selectin (CD62P) expression were determined by flow cytometry; soluble E-selectin (sE-selectin) and soluble CD40L (sCD40L) were determined by ELISA. AS patients were divided into two groups as active and inactive by using BASDAI. In 15 AS patients, the evaluated parameters were assessed before and after 12 weeks of anti-TNF therapy. PMC and sCD40L levels in AS patients were significantly higher than in the control group (P values 0.013 and 0.016). The evaluated variables were similar in active and inactive AS groups (P > 0.05). There were no significant changes in platelet and endothelial activation parameters in AS patients after anti-TNF therapy (P > 0.05). Platelet activation which is reflected by high levels of PMC and sCD40L might be responsible for the increased frequency of atherosclerosis in AS. The platelet activation in our AS patients was not associated with disease activity and did not improve after anti-TNF therapy.Öğe Dorsal sural nerve conduction study in vitamin B12 deficiency with megaloblastic anemia(Blackwell Publishing, 2006) Turgut, Burhan; Turgut, Nilda; Akpinar, Seval; Balci, Kemal; Pamuk, Guelsuem E.; Tekguenduez, Emre; Demir, MuzafferPeripheral neuropathy is frequently observed in B-12 deficiency. In spite of this, there is little knowledge about peripheral neuropathy in B-12 deficiency because the severity of clinical involvement of the central nervous system clearly outweighs signs and symptoms due to peripheral nervous system involvement. We primarily investigated peripheral neuropathy with dorsal sural conduction study, which is a new method for detection of early peripheral neuropathy, in B-12 deficiency with megaloblastic anemia. Conventional nerve conduction studies and tibial sensory-evoked potential (SEP) recording were also performed. Twenty-eight B-12-deficient patients (15 male, 13 female, mean age 65.8 years) with megaloblastic anemia and 18 age- and sex-matched controls were included in the study. Although dorsal sural sensory nerve action potentials (SNAPs) were not recorded in 15 (54%) of 28 patients, only 9 (32%) of them were found to have polyneuropathy by conventional conduction studies. Furthermore, patients with dorsal sural SNAP had mean lower amplitude, mean longer latency, and slower velocity response when compared with controls. Twenty patients (71%) were diagnosed as having myelopathy by the combination of tibial SEP and neurological findings. Two patients whose dorsal sural SNAPs were not recorded had normal tibial SEP responses; therefore, these patients were considered to have isolated peripheral neuropathy. As a result, we conclude that dorsal sural nerve conduction study is a reliable method for detection of early peripheral neuropathy in B-12 deficiency.Öğe Effect of obesity on TAFI in postmenopausal period(Elsevier Sci Ltd, 2010) Taskiran, Bengur; Guldiken, Sibel; Demir, Ahmet M.; Okman, Tulay K.; Arikan, Ender; Turgut, Burhan; Tugrul, Ayse A.Aim: The aim of the study was to evaluate how obesity effects the coagulation and fibrinolytic system in the postmenopausal period. Method: Forty-eight obese (body mass index (BMI) >= 30 kg/m(2)) and 38 nonobese (BMI < 30 kg/m(2)) postmenopausal women were enrolled in the study. Fat mass and insulin resistance were calculated. Plasma levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA), D-dimer, thrombomodulin, and thrombin activatable fibrinolysis inhibitor (TAFI) antigen were determined by ELISA method. TAFI activity was measured using the chromogenic assay. Results: Obese subjects had higher PAI-1 (73.5 +/- 35.7 ng/mL vs. 57.1 +/- 34.2 ng/mL, p < 0.05) levels but lower tPA/PAI-1 ratio (0.59 +/- 0.50 vs. 38 +/- 0.21, p < 0.05) than their nonobese counterparts. Obesity was not statistically significant for other haemostatic variables. BMI and fat mass were positively correlated with PAI-1 (r = 0.312, p = 0.003; r = 0.381, p = 0.005, respectively) and negatively correlated with tPA/PAI-1 ratio (r = -0.273, p = 0.01; r = -0.545, p = 0.01, respectively). HOMA scores were also positively correlated with PAI-1 levels (r = 0.236, p = 0.04). Conclusion: We found that tendency to hypercoagulability in the postmenopausal women was due to increased PAI-1 rather than TAFI levels, which may contribute to adverse cardiovascular outcomes in this cohort. Further studies should be undertaken to evaluate effects of weight loss on the coagulation and fibrinolytic system. (C) 2010 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.Öğe Elevated platelet-monocyte complexes in patients with psoriatic arthritis(Taylor & Francis Ltd, 2009) Pamuk, Guelsuem Emel; Pamuk, Oemer Nuri; Orum, Hueseyin; Arican, Oezer; Turgut, Burhan; Demir, MuzafferWe evaluated platelet and endothelial activation parameters in psoriatic arthritis (PsA), a disease reported to be associated with the development of endothelial dysfunction and increased atherosclerotic complications. Twenty patients with PsA, eight psoriasis and 20 healthy controls were included into the study. The patients' clinical features and acute phase parameters were assessed. In all patients and controls, platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC), and basal and ADP-stimulated P-selectin expression were determined with flow cytometry; soluble E-selectin (sE-selectin) and soluble CD40L (sCD40L) were determined with ELISA. Patterns of joint involvement and degrees of skin involvement in PsA patients were assessed. PMC in PsA patients were significantly higher than in the control group (p = 0.02). PNC were not significantly different among the three groups (p values > 0.05). sE-selectin levels in both PsA and psoriasis groups were significantly higher than in healthy controls (p values, respectively, <0.001 and 0.023). Basal and ADP-stimulated CD62P expression and sCD40L level were similar in all groups (p values > 0.05). Polyarticular PsA patients had significantly higher sCD40L than oligoarticular plus spondylitic PsA groups (p = 0.04). sCD40L level was higher in active PsA group than in inactive PsA group (p = 0.03). Groups with limited and extensive skin involvement did not differ significantly in the evaluated parameters. C-reactive protein (CRP) level in PsA patients correlated with sCD40L (r = 0.69, p = 0.012), basal CD62P expression (r = 0.89, p < 0.001) and ADP-stimulated CD62P expression (r = 0.73, p = 0.001). Endothelial activation might be have a role in the pathogenesis of both psoriasis and PsA. Among parameters of platelet activation, only PMC might play a role in the pathogenesis of PsA.Öğe Endotoksin ile yaygın damar içi pıhtılaşma oluşturulan tavşanlarda heparin, indometasin ve pentoksifilinin etkileri(Trakya Üniversitesi, 2002) Turgut, Burhan; Vural, ÖzdenÖZET Yaygın damar içi pıhtılaşma, değişik hastalıkların klinik seyrinde ortaya çıkabilen, ölüm oranının çok yüksek olduğu bir sendromdur. Çalışmamızda, antienflamavar tedavilerin, YDP tedavisindeki etkinliğini değerlendirmek amacıyla, E. coli endotoksini ile oluşturduğumuz deneysel YDP modelinde, anti-TNF etkisi bilinen pentoksifîlin ve prostaglandin sentezinin güçlü bir inhibitörü olan indometasinin etkileri değerlendirilmiş ve klasik bir antikoagulan olan heparinin etkileri ile karşılaştırılmıştır. Çalışmaya 40 tane, erkek (2,1-3,4 kg ağırlığında), Yeni Zelanda tavşanı alındı. Kontrol grubu dahil her biri 8 tavşandan oluşan beş grup oluşturuldu. Gruplara alınacak tavşanlar randomize olarak belirlendi. Kontrol grubu hariç, bütün tavşanlara, 6 saat süre ile 100micgr/kg/saat dozunda, E. coli endotoksini, infüzyon şeklinde verilerek YDP oluşturuldu. Bu YDP modelinde, heparin, indometasin ve pentoksifilinin, trombosit sayısı, PT, aPTT, fıbrinojen, plazminojen, TAT, ve lökosit sayısı üzerine olan etkileri belirlendi. Bütün tavşanlara otopsi yapılarak akciğer, böbrek ve karaciğerleri histopatolojik değişiklikler acısından değerlendirildi. 24 saat sonundaki ölüm oranı hesaplandı. Oluşturulan YDP modelinde, heparin verilen tavşanlarda, koagulasyon testlerinde belirgin düzelme ve akciğer damarlarındaki fibrin birikimde tama yakın azalma gözlenirken, pentoksifîlin ve indometasin verilen tavşanlarda, koagulasyon testlerinde, sadece, istatistiksel öneme ulaşmayan hafif bir düzelme gözlendi ve akciğer damarlarında fibrin birikiminde, anlamlı azalma gözlenmedi. Heparin ve pentoksifilinin, bu modelde trombosit sayısındaki düşüşü istatistik olarak anlamlı derece azalttığı gözlendi. 24 saatin sonunda değerlendirilen ölüm oranı gruplar arasında farksızdı. 50Sonuç olarak, endotoksemi ve ona bağlı gelişen septik şok ve YDP'nın patogenezinde, çok sayıda sitokin, otokoid, kemokin ve oksidasyon ürünlerinin yer aldığı düşünüldüğünde, tek bir sitokin veya otokoidin sentezinin engellenmesi endotokseminin sonuçlarının kontrolünde yeterli olamamaktadır. 51Öğe EORTC QLQ-C30 assessment in Turkish patients with hematological malignancies(Springer, 2008) Pamuk, Guelsuem Emel; Harmandar, Ferda; Ermantas, Nilay; Harmandar, Orbay; Turgut, Burhan; Demir, Muzaffer; Vural, OezdenWe aimed to evaluate the prevalences of self-reported anxiety and depression symptoms in hematological malignancy patients and to determine the association between the presence of these disorders and the results of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30). One hundred and forty patients with a diagnosis of a hematological malignancy completed the Hospital Anxiety and Depression Scale (HADS) and the General Health Questionnaire. Patients with higher anxiety scores were more frequently inpatients, had higher EORTC general symptom scores, and they had lower cognitive, emotional, social functioning and global quality of life (QoL) scores (all p values < 0.05). Patients with higher depression scores had more frequently active disease and were inpatients; they had higher mean Eastern Cooperative Oncology Group performance scores, EORTC gastrointestinal system and general symptom scores, and significantly lower physical, role, emotional, social and cognitive functioning and global QoL scores (all p values < 0.01). During follow-up, it was observed that survival curves of patients with active disease who had higher HADS depression scores tended to be shorter than those with lower scores (p=0.1). Anxiety and depression are frequent in hematological malignancy patients and associated with poor QoL and performance status. In addition, the presence of self-reported depression might have a predictive value for poor prognosis.Öğe Esansiyel trombositemiye bağlı yaygın serebral venöz tromboz(2000) Turgut, Nilda; Aydın, Nurgül; Çelik, Yahya; Turgut, Burhan; Demir, Muzaffer; Utku, Ufuk; Vural, ÖzdenSerebral venöz tromboz etyolojisinde birçok neden bulunmakla birlikte, hiperkoagulabilite önemli rol oynamaktadır. Bu çalışmada son bir aydır giderek artan başağrısı, bulantı, kusma nedeni ile servisimize yatan, daha önce hiçbir yakınması olmayan 34 yaşındaki bayan hasta bildirilmiştir. Hastanın yapılan nörolojik muayenesinde bilateral grade IV papil ödem mevcut olup, nöroradyolojik inceleme sonucunda yaygın (superior sagittal sinüs, konfluen sinium, her iki transvers ve sigmoid sinüsler) serebral venöz tromboz tespit edilmiştir. Tam kan sayımında Hb 17.1 g/dl, Hct % 48.4, Lökosit 28 500 /mm3 , Plt 674 000 /mm3 bulunması nedeni ile yapılan kemik iliği incelemesinde hastaya esansiyel trombositemi tanısı konmuş olup, antikoagulan tedavi yanısıra ribonükleotid redüktaz inhibitörü de tedaviye eklenmiştir. Literatürde olgumuzda olduğu gibi yaygın serebral venöz tromboz olguları nadiren bildirilmiş olup, bazı hematolojik hastalıkların, endokrin bozuklukların ve anatomik varyasyonların etyolojide yer alabileceği ifade edilmiştir.Öğe The evaluation of Kaposi sarcoma patients diagnosed at a single center(Ortadogu Ad Pres & Publ Co, 2007) Pamuk, Guelsuem Emel; Doenmez, Salim; Yesil, Yusuf; Tekguenduez, Emre; Turgut, Burhan; Demir, MuzafferObjective: To determine the general clinical features, treatment modalities and response to treatment in 5 Kaposi sarcoma (KS) patients diagnosed at our center. Material and Methods: Five patients diagnosed with KS at Trakya University Medical Faculty, Department of Internal Medicine, Division of Hematology between October 2001-October 2006 were retrospectively evaluated. Results: KS developed secondary to immunosuppression in four of five patients, one had classical type KS. Four patients were males, and one was female. The diagnoses in patients who used immunosuppressive therapy were aplastic anemia, Hodgkin lymphoma, MDS-RAEB II, and chronic inflammatory demyelinating polyneuropathy (CIDP). We discontinued immunosuppressive therapy and administered vincristine in the aplastic anemia patient. KS lesions disappeared spontaneously although chemotherapy continued in the Hodgkin lymphoma case. KS lesions were present on initial presentation in the patient with MDS-RAEB H; there was prominent progression after chemotherapy and regression was achieved after paclitaxel. KS lesions disappeared spontaneously in the CIDP patient after discontinuation of corticosteroids. In the patient with classical type KS, KS lesions regressed after adriamycin and one persistent big lesion was surgically excised. Conclusion: There was partial or complete improvement of KS lesions after discontinuation of immunosuppressive drugs in some of our patients and with systemic chemotherapeutics in the others. As the diagnosis of this disease requires suspicion in especially early stages, hematologists should consider KS in the differential diagnosis of skin lesions in their immunosuppressive patients and a skin biopsy should be obtained.Öğe How Important is Anemia for the Clinician?(Aves Yayincilik, Ibrahim Kara, 2010) Turgut, BurhanAnemia is defined as an insufficient red blood cell mass to adequately deliver oxygen to peripheral tissues. It is the most common problem in the community. The first steps in the diagnosis of anemia include history, physical exam, complete blood count (CBC), reticulocyte count and examination of the peripheral blood smear. The most common anemia in the community is the iron deficiency anemia which is involved in microcytic anemias. The parameters showing iron status are important for the discrimination of iron deficiency anemia from other microcytic anemias. Chronic iron loss is the most common cause of iron deficiency anemia and therefore, every adult patient with iron deficiency must be evaluated for blood loss. Anemia of chronic disease which is associated with inflammation can be microcytic but more frequently normocytic. A large number of patients admitted to hospital in daily practice have anemia of chronic disease. Another important reason of normocytic anemia is the anemia due to renal failure. Hemolytic anemias which compose a heterogeneous group, are usually normocytic. Although nonmegaloblastic macrocytic anemias form a larger group, megaloblastic macrocytic anemias due to vitamin B12 or folic acid deficiency are more important in the clinical practice. Anemia is a frequent feature of cardiovascular diseases. It must be evaluated carefully in heart failure and coronary artery diseases. Anemia is not a disease, it must be evaluated as a feature of a disease, therefore the reasons of anemia must be investigated.Öğe Incidence of antiheparin-platelet factor 4 antibodies and heparin-induced thrombocytopenia in Turkish patients undergoing cardiac surgery(Sage Publications Inc, 2007) Demir, Muzaffer; Duran, Enver; Yigitbasi, Omer; Vural, Ozden; Kurum, Turhan; Yuksel, Mahmut; Turgut, BurhanThe frequency of antiheparin-platelet factor 4 antibodies by means of antigenic and functional assays (C-14-serotonin release assay and citrated plasma platelet aggregation) was determined in 115 Turkish patients undergoing cardiac surgery. Blood samples were taken immediately before surgery and on days 5 and 10 +/- 2. Platelet counts were recorded and thrombotic events were determined by clinical methods. Antibody generation measured by enzyme-linked immunosorbent assay before surgery (n = 44) and on days 5 (n = 44) and 10 (n = 115) was 15.9%, 34.1%, and 65.2%, respectively. Positive samples from functional assays were 4.4% on day 0 and 7.0% on day 10. All positive samples had been negative on day 0. A high frequency of antiheparin-platelet factor 4 antibody generation and a low frequency of clinical heparin-induced thrombocytopenia were determined in these patients. These results obtained for Turkish patients are similar to those of other studies of heparin-induced thrombocytopenia.Öğe Increased circulating platelet-leucocyte complexes in patients with primary Raynaud's phenomenon and Raynaud's phenomenon secondary to systemic sclerosis(Lippincott Williams & Wilkins, 2007) Pamuk, Gulsum Emel; Turgut, Burhan; Pamuk, Omer Nuri; Vural, Ozden; Demir, Muzaffer; Cakir, NecatiPlatelet activation and circulating platelet-leucocyte complexes increase in vascular ischemic events and autoimmune inflammatory diseases. Platelet activation markers and platelet-leucocyte complexes were evaluated in primary Raynaud's phenomenon (RP) and in RP secondary to systemic sclerosis (SSc). Whole-blood flow cytometry was utilized to quantify CD62P, platelet microparticles (PMP), platelet-monocyte complexes (PMC) and platelet- neutrophil complexes (PNC) in primary RP and in SSc patients with secondary RP. SSc patients with secondary RP had significantly higher platelet CD62P expression than primary RP patients and controls (P= 0.017 and 0.004, respectively). Primary and secondary RP patients had higher mean PMC and PNC levels than controls (all P <= 0.001). PMP level in SSc patients with pulmonary hypertension was significantly higher than in others (P= 0.048). All parameters were similar in SSc patients with and without digital ulcers, aspirin-users and nonusers (P > 0.05). CD62P level decreased significantly after iloprost administration in four patients with digital ulcers (116.+/- 17.4 vs 7.4 +/- 3.8%, P= 0.03). Our results suggest there is platelet- leucocyte complex formation in RP, and, despite antithrombotic therapy, platelet activation and platelet-leucocyte interaction are ongoing in SSc. This is important as it might have potential therapeutic implications with respect to using antiplatelet drugs in SSc.Öğe Increased circulating platelet-neutrophil, platelet-monocyte complexes, and platelet activation in patients with ulcerative colitis(Wiley, 2006) Pamuk, Gulsum E.; Vural, Ozden; Turgut, Burhan; Dernir, Muzaffer; Umit, Hasan; Tezel, AhmetIt is reported that the incidence of thromboembolism is increased in ulcerative colitis (UC), and hypercoagulability persists even when patients are in remission. We evaluated the association of inflammatory response parameters with UC activity, and activation parameters of the platelets, endothelium, and the coagulation system in UC. Eighteen UC patients and 19 healthy subjects were included in the study. The patients' clinical features were recorded down; whole blood counts and acute phase parameters were evaluated. UC patients were divided into two as active (9 patients) and inactive (9 patients) according to combined clinical activity index (CAI) and endoscopic activity index (EAI) scores. In all subjects, platelet CD62P expression, platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC), and platelet microparticles (PMP) were determined by flow cytometry. E-selectin, thrombin-antithrombin complex (TAT) levels in plasma, and sCD40L levels in serum were determined by ELISA. In both active and inactive UC patients, platelet CD62P expression, the percentages of PMC, and PNC were significantly higher than those in the control group (P < 0.01). PMP level was higher in the control group than in inactive UC patients (P = 0.001). sCD40L level was significantly higher in active UC group than in the control group (P < 0.01). EAI score correlated significantly with PMP (r = 0.5, P = 0.04) and sCD40L (r = 0.48, P = 0.044); CAI score had a negative correlation (r = -0.68, P = 0.002) with sE-selectin level. In addition to increased CD62P expression and sCD40L, increased formation of PMC and PNC suggests a role for platelet-leukocyte complex formation together with platelet activation in thromboembolic events observed in UC. (c) 2006 Wiley-Liss, Inc.Öğe Increased platelet activation markers in rheumatoid arthritis(Taylor & Francis Inc, 2008) Pamuk, Guelsuem Emel; Vural, Oezden; Turgut, Burhan; Demir, Muzaffer; Pamuk, Oemer Nuri; Cakir, NecatiAtherosclerotic cardiovascular mortality is increased in rheumatoid arthritis (RA) patients. We evaluated the association of inflammatory response with platelet, endothelial, coagulation activation parameters; and subclinical atherosclerosis in RA patients. We included 27 RA patients (21 female; six male) and 19 healthy subjects (14 female; five male). Disease activity score (DAS28) in RA patients was calculated; and patients were divided into two groups as active and inactive. Flow cytometry was used to determine platelet CD62P expression, platelet microparticles (PMP), platelet-monocyte (PMC) and platelet-neutrophil complexes (PNC). Plasma E-selectin, thrombin-antithrombin (TAT) complex, and serum sCD40L levels were determined by ELISA. The intima-media thickness (IMT) of carotid arteries was determined by B-mode ultrasonography. In RA patients, platelet CD62P expression (p< 0.001), PMC (p = 0.037) and sCD40L (p< 0.001) levels were increased when compared to the control group. PNC (p = 0.07) and TAT levels (p = 0.1) were non-significantly higher, and PMP level (p = 0.075) was nonsignificantly lower in RA patients. Soluble E-selectin level was significantly higher in the active RA group than in the inactive RA group (p = 0.009). There was no correlation between carotid IMT and activity markers, the evaluated parameters (p>0.05).The increase in markers of active platelets, CD62P and sCD40L, and PMC levels might be associated with the increased cardiovascular mortality in RA. Nevertheless, none of these parameters were associated with carotid IMT: this suggests that one cross-sectional value might not be a good marker for atherosclerosis.
