Amaç: Bronkopulmoner displazi (BPD), prematüre doðan bebeklerde en sýk görülen komplikasyonlarýndan biridir ve yüksek morbidite ve mortalite oranlarýyla iliþkilidir. Akut böbrek hasarý (ABH), prematüre bebeklerde oldukça yaygýndýr. ABH prematüre bebeklerde morbidite ve mortaliteyi önemli ölçüde artýrýr. Çalýþmalar ABH’de görülen sistemik deðiþikliklerin akciðer hasarýný tetikleyebileceðini göstermiþtir.
Yöntemler: Bu çalýþmada, gestasyon haftasý ≤32 hafta ve/veya doðum tartýsý ≤1500 gram olan prematüre bebeklerde ABH’nin BPD geliþimine etkisinin belirlenmesi amaçlanmýþtýr. Bu hastalarýn demografik özellikleri ile eþlik eden perinatal ve postnatal morbiditeler arasýndaki iliþki araþtýrýlmýþtýr.
Bulgular: ABH’li bebeklerde BPD görülme oraný %52,6 (19 bebekten 10’u), ABH olmayan bebeklerde ise %38,3 (140 bebekten 61’i) idi. BPD geliþen bebeklerde ABH görülme oraný, ≤28 hafta doðan bebekler ile >28 hafta doðan bebekler [sýrasýyla n=9, %17,3 (52 bebekten 9’u) ve n=1, %5,3 (19 bebekten 1’i)] kýyaslandýðýnda anlamlý farklýlýk göstermedi (p>0,05).
Sonuçlar: ABH, doðumda daha fazla resüsitasyon ihtiyacý, daha fazla invaziv mekanik ventilasyon ihtiyacý, daha az ventilatörsüz gün ve prematüre bebeklerde daha yüksek sepsis, patent duktus arteriozus ve nekrotize enterokolit insidansý ile iliþkiliydi. Bununla birlikte ABH; doðum sonrasý ilk haftalarda sývý-elektrolit dengesizliði, kan basýncý ve hemodinamik bozukluklarla daha sýk iliþkili bulundu. ABH geliþen bebeklerde BPD geliþme oraný daha fazla olmakla birlikte bu fark istatistiksel olarak önemli deðildi (p>0,05).

Objective: Bronchopulmonary dysplasia (BPD) is among the most common complications of prematurity and is associated with high morbidity and mortality rates. Acute kidney injury (AKI) is also commonly observed in premature infants and significantly increases morbidity and mortality. Studies have shown that systemic changes in AKI may also trigger lung damage.
Methods: This study aimed to determine the effects of AKI on the development of BPD in preterm infants with a postconceptional age of ≤32 weeks and/or birth weight of ≤1500 grams. The relationship between demographic features and accompanying perinatal and postnatal morbidities among the patients was investigated.
Results: The incidence of BPD in infants with AKI was 52.6% (10 of 19 infants) and 38.3% (61 of 140 infants) in infants without AKI. In infants who developed BPD, the rate of AKI did not vary notably between babies born at ≤28 weeks and those born at >28 weeks [n=9, 17.3% (9 of 52 infants) and n= 1, 5.3%, (1 of 19 infants) respectively] of gestation (p>0.05).
Conclusions: AKI was associated with a greater need for resuscitation at birth, a greater need for invasive mechanical ventilation, fewer ventilatorfree days, and a higher incidence of sepsis, patent ductus arteriosus, and necrotizing enterocolitis in premature infants. It was also more frequently associated with fluid-electrolyte imbalance, blood pressure, and hemodynamic disorders in the first postnatal week. The rate of BPD development was higher in infants with AKI, but this disparity was not statistically notable (p>0.05).

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Amaç: Metabolik yeniden programlama, kanser hücrelerinin ayýrt edici bir özelliðidir. Kanser hücreleri, hayatta kalmak ve çoðalmak için tümör mikroçevresinden glukoz ve glutamin alýmýný artýrýr. Glutamin de novo sentezlenebilmesine raðmen, birçok kanser hücresi hayatta kalabilmek için hücre dýþý glutamine baðýmlýdýr. DNA demetilasyonunda görev alan TET2 geni, ayný zamanda bir tümör baskýlayýcý gen olarak bilinir. TET2 geni, akut miyeloid lösemi (AML) dahil olmak üzere çeþitli kanserlerde sýklýkla mutasyona uðrar. Çalýþmamýz, TET2 geni baskýlanmýþ AML hücre hattý HL-60 hücreleri ile glutamin metabolizmasý arasýndaki iliþkiyi araþtýrmayý amaçladý.
Yöntemler: TET2 ekspresyonu ile glutamin sýnýrlamasý arasýndaki iliþkiyi deðerlendirmek için TET2 geni, shRNA plazmitleri kullanýlarak HL-60 hücrelerinde baskýlandý. TET2-baskýlanmýþ HL-60 hücrelerinin hücre proliferasyonu, normal ve düþük glutamin ortamýndaki hücre sayýlarý ile hesaplandý. mRNA ekspresyonlarýndaki deðiþiklikler, kantitatif ters transkriptaz kullanýlarak araþtýrýldý. GLUL, AMPK-α ve P-AMPKα protein ekspresyonu immünoblotlama ile deðerlendirildi.
Bulgular: Düþük glutamin ortamýnda TET2-baskýlanmýþ HL-60 hücrelerinin hücre sayýlarý ve hücre canlýlýðý azaldý. TET2-baskýlanmýþ HL-60 hücrelerinin hücre canlýlýðýnýn kontrol hücrelerinden daha yüksek olduðu bulundu. Düþük glutaminde TET2-baskýlanmýþ hücrelerde GLUL mRNA ekspresyonunun arttýðý bulundu. Ayrýca, düþük glutamin ortamýnda TET2- baskýlanmýþ HL-60 hücrelerinde P-AMPKα protein ekspresyonunun arttýðý bulundu.
Sonuçlar: Bulgularýmýz, TET2-baskýlanmýþ HL-60 hücrelerinin, glutamin yoksunluðuna karþý daha dirençli olabileceðini ve düþük glutamin ortamýnýn, HL-60 hücrelerinin glutamin baðýmlýlýðý ile baðlantýlý olarak, glutamin metabolizmasýnda belirli genlerin ekspresyonunu artýrdýðýný göstermektedir. Ek olarak, düþük glutamin ortamý, TET2-baskýlanmýþ HL-60 hücrelerinde P-AMPKα protein seviyesini artýrdý.

Objective: Metabolic rewiring is a characteristic of cancer cells. Cancer cells require more nutrients for survival and proliferation. Although glutamine can be produced in cells via a series of enzymatic reactions, a group of cancer cells are dependent on extracellular glutamine for survival. TET2 plays a role in DNA demethylation and is a tumor suppressor gene. The TET2 gene is frequently mutated in various cancers, including acute myeloid leukemia (AML). Our study aimed to investigate the association between TET2-knockdown AML cell line HL-60 cells and glutamine metabolism.
Methods: To evaluate the association between TET2 expression and glutamine limitation, TET2 was downregulated in HL 60 cells using shRNA plasmids. The proliferation of TET2-knockdown HL-60 cells was calculated in normal and glutamine deficient medium. GLUL mRNA expression was investigated using quantitative reverse transcription polymerase chain reaction and protein levels were evaluated using immunoblotting.
Results: The numbers and viability of TET2-knockdown HL-60 cells were decreased in low glutamine-containing medium, but the viability of TET2-knockdown HL-60 cells was higher than that of control cells. GLUL mRNA expressions were increased in TET2- knockdown cells in low glutamine. In addition, P-AMPKα protein expression was increased in TET2-knockdown HL-60 cells in low glutamine-containing medium.
Conclusions: Our findings indicate that TET2-knockdown HL-60 cells may be more resistant to glutamine deprivation. In glutamine-deficient medium, the mRNA expression of glutamine synthetase is increased, which could be related to glutamine addiction in cells. In addition, low-glutamyl medium increased the P-AMPKα protein level in TET2-knockdown HL-60 cells.

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Amaç: Bu çalýþma yeni bir glutaminaz (GLS) baskýlayýcý olan IN-3’ün prostat kanseri hücrelerinde kanser karþýtý etkisini deðerlendirmeyi amaçlamaktadýr.
Yöntemler: IN-3’ün hücre canlýlýðýna etkisi kristal viyole boyamasý ile incelenerek PC-3 ve LNCaP prostat kanseri hücrelerinde ve normal fibroblastik CCD1072sk hücrelerinde IC50 deðerleri hesaplanmýþtýr. GLS izoformlarýnýn ekspresyon düzeyleri gerçek zamanlý polimeraz zincir reaksiyonu ile belirlenmiþtir. C-Bioportal veri bankasýndan metastatik prostat kanseri verileri indirilerek GLS izoformlarýnýn ekspresyonlarý analiz edilmiþtir.
Bulgular: LNCaP, PC-3 ve CCD1072sk için IC50 deðerleri sýrasýyla 2,13, 6,14 ve 15,39 μM’dýr. LNCaP hücrelerinde 1 ve PC3 hücrelerinde 2 μM gibi düþük dozlarda bile IN-3’ün doz baðýmlý etkisi belirgindir ve IN-3’ün büyüme karþýtý etkisi 0,0001’in altýnda p-deðeri ile yüksek derecede anlamlýdýr. PC-3 hücrelerinin 10 μM IN-3 ile muamelesi sonrasý GLS1’in böbrek tipi GLS izoformunun ekspresyonu artarken GLS2 ekspresyonu deðiþmemiþtir. Metastatik ve lokalize prostat kanseri örneklerinin karþýlaþtýrýlmasý göstermiþtir ki; GLS1 sadece primer prostat kanseri örneklerinde deðil metastatik prostat kanseri örneklerinde de yüksek düzeyde eksprese edilmektedir. GLS1 ekspresyonu 0,001’in altýnda p-deðeri ile GLS2 ekspresyonundan anlamlý þekilde yüksektir.
Sonuçlar: GLS baskýlayýcý IN-3 normal ve kanser hücrelerinde farklý etki göstermesi sebebiyle önemli bir kanser karþýtý ajan olabilir. Prostat kanserinde ilaç olma potansiyelinin ortaya çýkarýlmasý için daha ileri çalýþmalar yapýlmasý gerekmektedir.

Objective: This study aimed to evaluate anti-cancer potential of a novel glutaminase (GLS) inhibitor IN-3 in prostate cancer cells.
Methods: The cell viability upon IN-3 treatment was examined using crystal violet staining and IC50 values were calculated for cancer cell lines PC-3 and LNCaP and normal fibroblasts CCD1072sk. The expression levels of GLS isoforms were determined by real-time polymerase chain reaction after IN-3 treatment. The metastatic prostate cancer dataset was downloaded from C-Bioportal and the expressions of GLS isoforms were analyzed.
Results: The IC50 values of IN-3 for LNCaP, PC-3 and CCD1072sk were 2.13, 6.14 and 15.39 μM respectively. The dose dependent effect of IN-3 was evident even in low concentration with 1 μM in LNCaP and 2 μM in PC-3 and these anti-proliferative effects of IN-3 were highly significant with p-values lower than 0.0001. The treatment of PC-3 cells with 10 μM IN-3 elevated the expression of kidney type GLS isoform of GLS1 but not GLS2. Comparison of metastatic and localized prostate cancer tissues showed that GLS1 was highly expressed not only in primary but also in metastatic prostate cancer tissues. GLS1 expression was significantly higher than GLS2 expression with p-values lower than 0.001.
Conclusions: The GLS inhibitor IN-3 may be a potent anti-cancer agent in prostate cancer by demonstrating its differential effect between cancer and normal cells. Further studies are warranted to elucidate its drug potential in prostate cancer.

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Amaç: Bu çalýþmada, non-ST yükselmeli miyokard enfarktüsü (NSTEMI) geçiren hastalarda koroner arter hastalýðýnýn (KAH) yaygýnlýðýný ve þiddetini belirlemede, nötrofil-lenfosit oraný (NLO) ve C-reaktif protein (CRP)-albümin oraný gibi diðer enflamatuvar belirteçlerle karþýlaþtýrýldýðýnda, modifiye Glasgow prognostik skorunun (mGPS) öngörü deðerini araþtýrmayý amaçladýk.
Yöntemler: Çalýþma, koroner anjiyografi yapýlan 295 ardýþýk NSTEMI hastasýný içermekteydi. Her hasta için, KAH þiddeti ve yaygýnlýðýný belirlemek amacýyla Taxus ile Perkütan Koroner Giriþim ve Kardiyak Cerrahi Arasýndaki Sinerji Skoru (SYNTAX) skoru hesaplandý. Çalýþma örneði, SYNTAX skoruna göre orta-yüksek SYNTAX (>22) ve düþük SYNTAX (≤22) olarak iki gruba ayrýldý.
Bulgular: Ýki yüz doksan beþ hastanýn (%23,1 kadýn, %76,9 erkek) yaþ ortalamasý 61,2±10,9 yýl olup, ortalama SYNTAX skoru 7,3±10,4 (aralýk: 0-40) idi. SYNTAX skoru >22 olan hastalarýn CRP düzeyleri, CRP/albümin oraný ve ortalama mGPS 1-2 oranlarý, SYNTAX skoru ≤22 olanlara göre anlamlý derecede yüksekti (hepsi p<0,001). Sigara içme [olasýlýk oraný (OO): 3,341, %95 güven aralýðý (GA): 1,531-7,294; p=0,002], CRP/albümin oraný (OR: 4,958, %95 GA: 1,335-18,418; p=0,017) ve mGPS skoru 1-2 (OR: 3,121, %95 GA: 1,430-6,814; p=0,004), yüksek SYNTAX skorunun baðýmsýz öngördürücüleriydi.
Sonuçlar: Yüksek bir SYNTAX skoru ile iliþkili olduðu görülen mGPS, NSTEMI hastalarýnda KAH yaygýnlýðýný ve karmaþýklýðýný tahmin etmek için kullanýlabilir.

Objective: This study investigated the modified Glasgow prognostic score (mGPS) to determine its predictive value and how it could be compared with various inflammatory markers, including C-reactive protein (CRP) to albumin ratio and neutrophil-to-lymphocyte ratio, for determining the extent and severity of coronary artery disease (CAD) in patients with non-ST-elevated myocardial infarction (NSTEMI).
Methods: This study analyzed the cases of 295 patients with NSTEMI who had undergone coronary angiography. In an effort to determine the seriousness and scope of CAD in each patient, the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was calculated and then assessed. The study sample was divided into two separate groups based on the SYNTAX score: moderate to high SYNTAX (>22) and low SYNTAX (≤22).
Results: There were 295 patients (23.1% female, 76.9% male) included in the research, with an average age being 61.2±10.9 years, and the mean SYNTAX score being 7.3±10.4 (range: 0-40). Those with a SYNTAX score >22 were observed to possess significantly higher levels of CRP, CRP/albumin ratio, and mean mGPS 1-2 ratios compared with those with a SYNTAX score ≤22 (all p<0.001). Smoking [odds ratio (OR): 3.341, 95% confidence interval (CI): 1.531-7.294; p=0.002], CRP/albumin ratio (OR: 4.958, 95% CI: 1.335-18.418; p=0.017), and mGPS score of 1-2 (OR: 3.121, 95% CI: 1.430-6.814; p=0.004) were independent factors used to help predict a high SYNTAX score.
Conclusions: It seems possible to make use of the mGPS when estimating the degree and intricacies of CAD in patients with NSTEMI, as there appears to be a connection with higher SYNTAX scores.

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Amaç: Romatoid artritli (RA) hastalarda sistemik enflamatuvar duruma göre düzenlenmiþ sistemik immün-enflamasyon (SII) indeksini deðerlendirmektir.
Yöntemler: Seropozitif RA hastalarý (n=58) serum hs-C-reaktif protein (hs-CRP) düzeylerine göre iki gruba ayrýldýlar: hs-CRP düzeyleri 3 mg/L veya üzerinde olan RA hastalarý (yüksek sistemik enflamatuvar durum; n=38) ve hs-CRP düzeyleri 3 mg/L’nin altýnda olan RA hastalarý (düþük sistemik enflamatuvar durum; n=20). Kontrol grubu 31 saðlýklý bireyden oluþtu. Kan örnekleri þu parametreler açýsýndan test edildi: lökositler (beyaz kan hücresi), nötrofilik granülositler, lenfositler, trombositler [platelet (PLT)], yüksek hassasiyetli hs-CRP, sedimantasyon hýzý [eritrosit sedimantasyon hýzý (ESR)], nötrofil-lenfosit oraný (NLR), platelet-lenfosit oraný (PLR) ve monosit-lenfosit oraný (MLR). SII endeksi Neu x PLT/Lym olarak elde edildi.
Bulgular: RA’lý hastalarda, SII endeksi saðlýklý bireylere kýyasla yüksekti ve hs-CRP, eritrosit sedimantasyon hýzý, NLR, MLR, PLR, hassas eklem sayýsý ve þiþmiþ eklem sayýsýnýn hassas eklem sayýsýna oraný ile pozitif korelasyon gösterdi. Hs-CRP düzeyleri 3 mg/L’nin üzerinde olan RA’lý hastalar, hs-CRP düzeyleri 3 mg/L’nin altýnda olanlara kýyasla SII’de istatistiksel olarak anlamlý bir artýþ sergilediler. Ayrýca, hs-CRP düzeyleri 3 mg/L veya üzerinde olan RA hastalarý kohortunda, SII endeksi ile hem NLR hem de PLR arasýnda pozitif bir korelasyon bulundu. SII indeksi, hs-CRP düzeyleri 3 mg/L’nin altýnda olan RA hastalarýnda NLR, MLR ve PLR ile pozitif korelasyon gösterdi. SII endeksinin hs-CRP düzeyi 3 mg/L olan RA olgularý ile hs-CRP düzeyi 3 mg/L veya daha yüksek olan olgularý ayýrt etmek için kesme noktasý ≥323,4 olup, duyarlýlýðý %77,6 ve özgüllüðü %54,8 idi.
Sonuçlar: Serum SII indeksi, RA’nýn enflamatuvar sürecini ve klinik ilerlemesini deðerlendirmek için potansiyel olarak yararlý bir belirteç olabilir.

Objective: To evaluate the systemic immune-inflammation (SII) index in patients with rheumatoid arthritis (RA) stratified by systemic inflammatory status.
Methods: Seropositive patients with RA (n=58) were divided into two groups based on serum hs-C-reactive protein (hs-CRP) levels: RA patients with hs-CRP levels of at or 3 mg/L or above (high systemic inflammatory status; n=38) and RA patients with hs-CRP levels of less than 3 mg/L (low systemic inflammatory status; n=20). The control group comprised 31 healthy individuals. Blood samples were tested for the next parameters: leukocytes, neutrophilic granulocytes, lymphocytes, thrombocytes [platelet (PLT)], high-sensitivity hs-CRP, sed rate [erythrocyte sedimentation rate (ESR)], neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). The SII index was derived as Neu x PLT/Lym.
Results: In patients with RA, the SII index was elevated compared with that of healthy individuals and positively correlated with hs-CRP, erythrocyte sedimentation rate, NLR, MLR, PLR, tender joint count, and swollen-to-tender joint count ratio. Patients with RA who had hs-CRP levels of 3 mg/L above exhibited a statistically significant increase in the SII compared with those with hs-CRP levels below 3 mg/L. Additionally, within the cohort of RA patients with hs-CRP levels at or above 3 mg/L, a positive correlation was found between the SII index and both NLR and PLR. The SII index was positively correlated with NLR, MLR, and PLR in RA patients with hs-CRP levels below 3 mg/L. The cut-off point of the SII index for distinguishing between RA cases with hs-CRP levels 3 mg/L and those with hs-CRP levels 3 mg/L or higher was ≥323.4, with a sensitivity of 77.6% and a specificity of 54.8%.
Conclusions: The serum SII index can be a potentially useful marker for evaluating the inflammatory process and clinical progression of RA.

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Amaç: Ana amacýmýz 2007 ile 2023 arasýnda bir üçüncü basamak merkezde tedavi edilen baþ ve boyun paragangliomu olgularýný araþtýrmaktýr. Daha önce yayýnlanmýþ tek merkezli ve uzun takip süreli çalýþmalarýn detaylý bir þekilde incelenmesini içerir. Ýkincil amacýmýz, özellikle taný algoritmasýnýn, tedavi seçiminin ve takip prosedürlerinin geliþtirilmesine odaklanmaktýr.
Yöntemler: Kýrk dört hasta retrospektif olarak analiz edildi. Otuz dokuz hasta çalýþmaya dahil edildi. Demografik bilgiler, semptomlar, radyolojik muayeneler, paraganglioma tipleri, evreler ve ameliyat sonrasý komplikasyonlar kaydedildi. 2010’dan bu yana yayýnlanmýþ uzun takip süresi olan ve farklý tedavi yöntemlerini kullanan tek merkez deneyimlerini rapor eden makaleleri seçmek için bir literatür taramasý da yapýldý.
Bulgular: Hastalarýn ortalama yaþý 54 ve kadýn/erkek oraný 3,55: 1 olarak bulundu. Ýncelenen 39 olgudan 18’i servikal paraganglioma ve 19’u temporal kemik paraganglioma olarak tanýmlandý. Tüm olgular baþlangýçta cerrahi rezeksiyon geçirdi. Ortalama takip süresi 5,42 yýl idi. Ameliyat sonrasý dört kalýntý ve iki nüks tanýmlandý ve ek tedavi olarak Gamma Knife kullanýldý. Daha sonra 17 makale seçildi ve özetlendi, ardýndan taný, tedavi ve takip için bir akýþ þemasý hazýrlandý.
Sonuçlar: Preoperatif evreleme, cerrahi planlamada ve potansiyel intraoperatif komplikasyonlarý öngörmede esastýr. Bulgularýmýza ve makalelerin gözden geçirilmesine dayanarak, teþhis, tedavi ve baþ boyun paragangliomalarýnýn takibine yardýmcý olmak için bütün olasýlýklarý aðýrlýklandýran, tümör evresine baðlý bir akýþ þemasý hazýrladýk.
Anahtar kelimeler: Baþ boyun paragangliomu, cerrahi, radyaterapi, glomus tümörleri, paraganglioma evrelemesi

Objective: To investigate head and neck paraganglioma cases treated at a tertiary center from 2007 to 2023. The research includes a thorough examination of published studies that have focused on long-term outcomes. The additional goal is to contribute to the existing knowledge on head and neck paraganglioma, with a particular emphasis on refining diagnostic algorithms, treatment selection, and follow-up procedures.
Methods: A total of 44 patients were retrospectively analyzed, and 39 were included. Demographic information, symptoms, radiological examination results, types, stages, and postoperative complications were recorded. A review was conducted to select articles that reported single-center experiences with large cohorts, long follow-ups, and different treatment modalities since 2010.
Results: The mean age of the patients was 54 years, and the female/male ratio was 3.55: 1. Among the 39 cases examined, 18 and 19 were identified as cervical paraganglioma and 19 as temporal bone paraganglioma. All patients initially underwent surgical resection. The mean follow-up duration was 5.42 years. Four residual cases and two recurrences were identified postoperatively, and a Gamma Knife was used as additional treatment. Subsequently, 17 articles were selected and summarized, and then a flowchart was prepared showing the possible options for diagnosis, treatment, and follow-up.
Conclusions: Preoperative staging is essential for surgical planning and predicting potential intraoperative complications. Based on our findings and review of the articles, we have prepared a flowchart that includes all possibilities depending on the tumor stage to help in the diagnosis, treatment, and follow-up of head and neck paragangliomas.

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Amaç: Apelin ve visfatin, yað dokusundan salgýlanan ve kan basýncýnýn düzenlenmesinde önemli rol oynayan adipokinlerdir. Bu nedenle, bu çalýþmada hipertansif hastalarda kandesartan ve enalaprilin apelin, visfatin ve lipid profilleri üzerindeki etkilerinin araþtýrýlmasý amaçlanmýþtýr.
Yöntemler: Bu olgu-kontrol çalýþmasýnda 120 katýlýmcý dört gruba ayrýldýlar; saðlýklý kiþiler, yeni taný konmuþ hipertansif hastalar, enalapril ile tedavi gören hastalar ve kandesartan ile tedavi gören hastalar.
Bulgular: Yeni taný konmuþ hipertansif hastalarda, kontrol grubuna kýyasla, serum apelin düzeyleri anlamlý derecede düþük ve visfatin düzeyleri anlamlý derecede yüksekti (sýrasýyla p=0,0015, p=0,0175). Ayrýca, kandesartan ile tedavi edilen hastalarda, apelin düzeyleri yeni taný konulan gruba kýyasla daha yüksek ve visfatin düzeyleri daha düþüktü (sýrasýyla p=0,0487, p<0,0001). Ýlginç bir þekilde, yeni taný konulan grup ile kýyaslandýðýnda, enalapril ile tedavi edilen hastalarda apelin düzeyleri anlamlý olmayan bir þekilde daha yüksek ve visfatin düzeyleri anlamlý bir þekilde daha düþüktü (p<0,0001).
Sonuçlar: Düþük apelin ve yüksek visfatin düzeyleri yeni taný konmuþ hipertansiyon hastalarýyla iliþkili bulunmuþtur. Ýlginç bir þekilde, bulgular sýrasýyla enalapril ve kandesartan ile ACE inhibisyonu ve anjiyotensin reseptör blokajýnýn, hipertansiyonda apelin ve visfatin seviyelerini olumlu yönde düzenlediðini göstermektedir. Özellikle, kandesartan bu adipokinleri enalaprilden daha çok düzenlemektedir.

Objective: Apelin and visfatin are adipokines secreted from adipose tissue that play important roles in regulating blood pressure. Therefore, the current study aimed to investigate the effects of candesartan versus enalapril on apelin, visfatin, and lipid profiles in hypertensive patients.
Methods: In this case-control study, 120 participants were enrolled in four groups; Healthy people, newly diagnosed hypertensive patients, and enalapril- and candesartan-treated patients.
Results: Serum apelin levels were significantly lower and visfatin levels were significantly higher in newly diagnosed hypertensive patients compared with the control group (p=0.0015, p=0.0175 respectively). Moreover, apelin levels were higher and visfatin levels were lower in the candesartan-treated patients compared with the newly diagnosed group (p=0.0487, p<0.0001 respectively). Interestingly, apelin levels were nonsignificantly higher and visfatin levels were significantly lower in enalapriltreated patients compared with the newly diagnosed group (p<0.0001).
Conclusions: Lower apelin and higher visfatin levels are associated with newly diagnosed patients with hypertension. Interestingly, the findings suggest that ACE inhibition and angiotensin receptor blockade by enalapril and candesartan, respectively, positively regulate apelin and visfatin levels in hypertension. Specifically, candesartan regulates these adipokine to a greater extent than enalapril.

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Amaç: Ýskemi-reperfüzyon (IR) aortasý, abdominal aort cerrahisi sonrasý akut akciðer hasarýnýn önemli bir nedenidir. Çalýþmamýzýn amacý, sýçanlarda abdominal aort IR tarafýndan indüklenen akciðer hasarý üzerine küçük ýsý þok proteinlerinden biri olan alfa B-kristalinin (HspB5 olarak da bilinir) etkisini incelemektir.
Yöntemler: Erkek Sprague Dawley sýçanlarý üç gruba ayrýldý: kontrol, IR (IR, 90 dakika iskemi ve 180 dakika reperfüzyon) ve alfa B-kristalin+IR. Alfa B-kristalin (50 μg/100 g), IR’den bir saat önce intraperitoneal olarak verildi. Akciðer dokusu örnekleri histolojik analiz ve oksidatif stres parametreleri, sitokinler, apoptoz parametreleri açýsýndan biyokimyasal analiz için alýndý. Plazma, akciðer dokusu ve bronkoalveoler lavaj (BAL) sývýsýnda parametreler incelendi.
Bulgular: Aortik IR, akciðer dokularýnda malondialdehit, reaktif oksijen türleri, toplam oksidan durum, tümör nekroz faktörü-alfa (TNF-α), interleukin-1 beta (IL-1β), nükleer faktör kappa B (NFKβ), kaspaz-9 (CASP-9), 8-hidroksi-2’-deoksiguanozin, total antioksidan durum, süperoksit dismutaz, interleukin-10 seviyelerini anlamlý olarak artýrýrken (p<0,05, kontrol grubuna göre), alfa B-kristalin, plazma, akciðer dokusu ve BAL sývýsýndaki oksidatif, enflamatuar ve apoptotik parametreleri anlamlý olarak azalmýþtýr (p<0,05, aortik IR’ye göre). Histopatolojik deðerlendirme, alfa B-kristalinin akciðer hasarý ile iliþkili morfolojik deðiþiklikleri iyileþtirdiðini göstermiþtir (p<0,001).
Sonuçlar: Alfa B-kristalin, IR’ye maruz kalan sýçanlarda bozulmuþ redoks dengesi, enflamasyon ve apoptotik parametreleri önemli ölçüde düzeltmiþtir. Bu antioksidan etki, alfa B-kristalinin akciðer hasarý üzerindeki koruyucu etkisine baðlanabilir.

Objective: Ischemia-reperfusion (IR) of the aorta is a significant contributor to the development of postoperative acute lung damage after abdominal aortic surgery. The aim of the present study was to examine the effect of alpha B-crystallin, a small heat shock protein (known as HspB5), on lung injury induced by abdominal aortic IR in rats.
Methods: Male Sprague-Dawley rats were divided into three groups: control, ischemia-reperfusion (IR, 90 min ischemia and 180 min reperfusion), and alpha B-crystallin +IR. Alpha B-crystallin (50 μg/100 g) was intraperitoneally administered 1 h before IR. Lung tissue samples were obtained for histological and biochemical analyses of oxidative stress and cytokine and apoptosis parameters in plasma, lung tissues, and bronchoalveolar lavage (BAL) fluid.
Results: The levels of malondialdehyde, reactive oxygen species, total oxidant status, tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), nuclear factor kappa B (NFKβ), caspase-9 (CASP-9), 8-hydroxy-2’-deoxyguanosine, total antioxidant status, superoxide dismutase, and interleukin-10 levels in lung tissues, plasma, and BAL fluid (p<0.05 versus control) increased in Aortic IR. However, alpha B-crystallin significantly reduced the lung tissue levels of oxidative, inflamatuvar, and apoptotic parameters in the plasma, lung tissues, and BAL fluid (p<0.05 versus aortic IR). Histopathological results showed that alpha B-crystallin ameliorated the morphological changes related to lung injury (p<0.001).
Conclusion: Alpha B-crystallin substantially restored disrupted the redox balance, inflammation, and apoptotic parameters in rats exposed to IR. The cytoprotective effect of alpha B-crystallin on redox balance might be attributed to improved lung injury.

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Amaç: Akut post-streptokokal glomerülonefrit (APSGN) çocuklar arasýnda akut glomerülonefritin önde gelen nedenidir. Akut nefritik sendrom, nefrotik sendrom ve hýzlý ilerleyen glomerülonefrit þeklinde ortaya çýkabilir. ChatGPT (OpenAI, San Francisco, California, Amerika Birleþik Devletleri) yapay zeka destekli bir sohbet robotu olarak geliþtirilmiþtir. Bu çalýþmada, yapay zekanýn APSGN’nin taný, tedavi ve takibinde kullanýlýp kullanýlamayacaðý ilk kez deðerlendirilmiþtir.
Yöntemler: APSGN tanýsý alan hastalarýn klinik özellikleri hasta dosyalarýndan not edildi. APSGN hakkýnda genel bilgileri sorgulayan on iki soru ChatGPT 3.5’e yöneltildi. Cevaplarýn doðruluðu iki araþtýrmacý tarafýndan deðerlendirildi. Daha sonra hastalarýn klinik ve laboratuvar özellikleri ChatGPT 3.5’e aktarýlarak hastalarýn takibinin yapay zeka tarafýndan nasýl yönetileceði incelendi.
Bulgular: Çalýþmaya toplam 11 hasta dahil edildi. Hastalarýn yaþ ortalamasý 9,08±3,96 yýldý. Sekiz (%72,7) hastada kreatinin yüksekliði ve 10 (%90,9) hastada hematüri ve/veya proteinüri vardý. Anti-streptolisin O tüm hastalarda yüksek (955±353 IU/mL) ve C3 9 (%81,8) hastada düþüktü (0,56±0,34 g/L). Üç farklý hastada hipertansif ensefalopati, nefrotik sendrom ve hýzlý ilerleyen glomerülonefrit gözlendi. Tüm hastalarda normal kreatinin deðerlerine ulaþýldý. APSGN’nin tanýmý, epidemiyolojik özellikleri ve patofizyolojik mekanizmalarý, taný ve tedavisini deðerlendiren sorular chatGPT 3.5 tarafýndan doðru yanýtlandý. Ayrýca, tüm hastalara APSGN tanýsý konmuþ ve klinisyenler tarafýndan uygulanan tedavi adýmlarý ChatGPT 3.5 tarafýndan benzer þekilde önerilmiþtir.
Sonuçlar: ChatGPT tarafýndan APSGN için saðlanan bilgi ve rehberlik, hastalarýn bakým ve yönetiminde deðerli bir kaynak olabilir. Yapay zeka uygulamalarý ile klinisyenler kararlarýný gözden geçirebilir ve daha etkili tedavi planlarý oluþturabilirler.

Objective: Acute post-streptococcal glomerulonephritis (APSGN) is a common cause of acute glomerulonephritis in children. The condition may present as acute nephritic and/or nephrotic syndrome and rarely as rapidly progressive glomerulonephritis. ChatGPT (OpenAI, San Francisco, California, United States of America) has been developed as a chat robot supported by artificial intelligence (AI). In this study, we evaluated whether AI can be used in the follow-up of patients with APSGN.
Methods: The clinical characteristics of patients with APSGN were noted from patient records. Twelve questions about APSGN were directed to ChatGPT 3.5. The accuracy of the answers was evaluated by the researchers. Then, the clinical features of the patients were transferred to ChatGPT 3.5 and the follow-up management of the patients was examined.
Results: The study included 11 patients with an average age of 9.08±3.96 years. Eight (72.7%) patients had elevated creatinine and 10 (90.9%) had hematuria and/or proteinuria. Anti-streptolysin O was high in all patients (955±353 IU/mL) and C3 was low in 9 (81.8%) patients (0.56±0.34 g/L). Hypertensive encephalopathy, nephrotic syndrome, and rapidly progressive glomerulonephritis were observed in three patients. Normal creatinine levels were achieved in all patients. Questions assessing the definition, epidemiologic characteristics, pathophysiologic mechanisms, diagnosis, and treatment of APSGN were answered correctly by ChatGPT 3.5. All patients were diagnosed with APSGN, and the treatment steps applied by clinicians were similarly recommended by ChatGPT 3.5.
Conclusions: The insights and recommendations offered by ChatGPT for patients with APSGN can be an asset in the care and management of patients. With AI applications, clinicians can review treatment decisions and create more effective treatment plans.

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Kol bölgesinin ön kompartmanýnýn rutin disseksiyonu sýrasýnda, kadavranýn sað üst ekstremitesinde kas ve sinir yapýlarý ile ilgili birkaç varyasyonla karþýlaþýldý. Biceps brachii (BB) ve coracobrachialis’den (CB) köken alan bir adet üst konumlu ekstra kas baþý ve sadece BB kasýndan liflerle köken alan bir adet alt konumlu ekstra kas baþý gözlemlendi. Nervus musculocutaneus CB kasýný delmiyordu, ancak bu kasa bir dal verdikten sonra ve nervus medianus’a (NM) baðlandý. Hem NM hem de arteria brachialis (AB) ekstra baþlarýn altýndan geçiyordu. Bu olguda, tanýmlanan bu varyasyonlarýn MN ve AB tuzaklanmasýna katkýda bulunabileceði düþünülmektedir. Bu varyasyonlarýn anlaþýlmasý, cerrahi giriþimler öncesinde kritiktir. Anatomideki bu varyasyonlarýn tanýnmamasý, iyatrojenik sinir yaralanmasýna veya vasküler perfüzyonun bozulmasýna yol açabilir, bu da cerrahi giriþim öncesi planlamanýn önemini vurgular.

During routine dissection of the anterior compartment of the arm region, we encountered several variations in the muscular and neural structures in the right upper extremity of a female cadaver. We observed one superiorly positioned extramuscular head with fibers originating from both the biceps brachii (BB) and coracobrachialis (CB) muscles and one inferiorly positioned extramuscular head with fibers solely from the BB muscle. The musculocutaneous nerve did not penetrate the CB muscle, but instead provided a muscular branch that communicated with the median nerve (MN). Both the MN and brachial artery (BA) flow beneath the extra head. This case suggests that the described variations may contribute to the entrapment of the MN and compression of the BA. Understanding these variations is crucial before surgical intervention. The failure to recognize such anatomical nuances could lead to inadvertent nerve injury or compromised vascular perfusion, emphasizing the need for preoperative planning and intraoperative vigilance.

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