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Öğe Acute myocardial infarction provoked by smoking and xylometazoline use in a patient with normal coronary arteries [Koroner arterleri normal olan bir hastada sigara ve ksilometazolin kullaniminin tetikledi?i akut miyokard infarktüsü](2006) Kayrak M.; Ülgen M.S.; Koç F.; Soylu A.Coronary vasospasm is a cause of acute coronary syndrome. Many factors, in particular smoking may induce vasospasm. Xylometazoline is a commonly used sympathomimetic to provide decongestive action with topical effect. A 50-year-old male patient was admitted with typical angina pectoris that developed after heavy smoking. Coronary angiography showed normal coronary anatomy. One month later, he presented with myocardial infarction of ST elevation following high dose of xylometazoline application. There was no other cause to provoke coronary vasospasm. This case underlines the need for a thorough investigation into drug use in young and relatively low-risk patients presenting with chest pain.Öğe Antidiabetic treatment in diabetic patients with coronary artery disease(2007) Soylu A.; Ülgen M.S.; Düzenli M.A.The prevalence of diabetes mellitus (DM) that is about 150 million today is estimated to exceed 300 million by the year 2025 (1). When considered that about half of the patients remain undiagnosed, it can be seen how serious the dimensions of the disease are (2). In the patients with DM more than 90% of whom are consisted by non-insulin dependent diabetes mellitus (NIDDM, Type 2 DM), the disease is a significant risk factor for the development of coronary artery disease (CAD) responsible for 75% of all deaths (3,4). In this group of the patients who generally require antidiabetic treatment inevitably, it is highly important to decide on an appropriate treatment due to the various cardiovascular (CV) effects of the anti-diabetics medications and drugs. In order to help establish this decision, in this review it was tried to investigate antidiabetic drugs after a general approach to CAD pathophysology in diabetic patients, especially in terms of their cardiovascular effects.Öğe Comparison between brachial blood pressures obtained by aneroid sphygmomanometer and central aortic pressures: Factors affecting the measurements [Aneroid sfigmomanometreyle ölçülen brakiyal arter basincinin santral aortik basinçla karşilaştirilmasi ve farka etki eden faktörler](2008) Kayrak M.; Ülgen M.S.; Yazici M.; Demir K.; Do?an Y.; Koç F.; Zengin K.Objectives: We compared brachial artery blood pressures (BP) measured by aneroid sphygmomanometer with ascending aortic blood pressures and evaluated the factors affecting the differences between the two methods. Study design: The study included 463 patients (177 women, 286 men; mean age 60±11 years) undergoing routine coronary angiography. Simultaneously, ascending aortic pressures were measured using a pigtail catheter and brachial artery pressures were measured from the right arm with an aneroid sphygmomanometer. Pulse pressure, fractional pulse pressure, and pulsatility index were calculated from systolic and diastolic BP values. Results: Overall, systolic (-3.1±10 mmHg) and diastolic (+3.0±7.1 mmHg) brachial pressures showed significant deviations from aortic pressures (p=0.001). Although systolic BP did not differ significantly in both methods for men and women, brachial diastolic BP was significantly different in women (+4.8 mmHg, p=0.0001). Brachial diastolic BP showed a greater deviation from the aortic diastolic pressure in patients ?60 years of age (+4.5 mmHg and +1.1 mmHg, respectively; p=0.0001). Deviation of systolic BP in hypertensive patients (-4 mmHg) was greater than that in normotensives (-2.0 mmHg, p=0.04). Deviation of brachial systolic BP was highly correlated with increases in aortic systolic pressure (p=0.0001). Differences between the two methods in systolic (-5.8 mmHg, p=0.01) and diastolic (+4.2 mmHg, p=0.03) BP were significant in patients with coexisting diabetes and hypertension. Body mass index and arm circumference were not correlated with deviations between the two methods. Conclusion: The main factors (female gender, age, hypertension, diabetes) affecting BP differences between the two methods should be considered in clinical practice.Öğe The investigation of the relationship among xanthine oxidase, interleukin-6 and body mass index in patients with an ischemic period of acute myocardial infarction: A novel correlation(2011) Mustafa B.K.; Yazar H.; Büyükbas S.; Kilinc C.; Sayin K.; Ülgen M.S.Some cardiovascular risk factors stimulate the entrance of inflammatory cells into the arterial wall; these cells are important sources for cytokines, including interleukine-6 (IL-6). For myocardial ischemia, a superoxide radical scavenger mechanism is conducted via xanthine oxidase (XO). In this study, the relationship among IL-6, XO, and body mass index (BMI) were studied in 45 patients with acute myocardial infarction (AMI) and 30 patients in a control group. Plasma IL-6 was measured using a sandwich enzyme-linked immunoabsorbent assay (ELISA) test; XO activity was measured using Prajda's method. The mean XO levels in the patient and control groups were 0.25 ± 0.15 and 0.14 ± 0.06 U/mL, respectively. The mean IL-6 in the patient and control groups was 24.13 ± 14.8 and 14.98 ± 8.34 pg/mL, respectively. In comparison with the control group, both XO and IL-6 were significantly higher (p<0.005). In correlation analysis for the patient group, a significant correlation was found between XO and BMI (r:0.3, p<0.05). However, no correlation existed among IL-6, XO, and BMI in either the patients with AMI, or the control group. IL-6 and XO increased in patients with AMI, but no correlation existed between them, indicating that IL-6 and XO are independent markers for insufficient endothelial function in ischemic myocardium. The correlation between XO and BMI in patients with AMI is a new finding requiring further investigation.Öğe Isolated mitral valve prolapsus does not affect left ventricular function [İzole mitral kapak prolapsusu sol ventrikül fonksiyonunu etkilemez](2011) Demir K.; Koc F.; Can I.; Vatankulu M.A.; Yazici M.; Ülgen M.S.Aim: Idiopathic mitral valve prolapsus (MVP) is characterized by myxomatous degeneration of mitral valve. The most common determinant of cardiovascular mortality in patients with MVP is left ventricular (LV) dysfunction. Therefore we aimed to evaluate LV functions of cases with isolated MVP by tissue Doppler echocardiography (TDE). Method: Twenty five patients with MVP (mean age, 31±12 years) were enrolled the study as MVP group. Control group was consisted 20 age and sex matched patients (mean age, 34±9 years) were enrolled to this study. LV functions were detected by using conventional echocardiography and TDE. Myocardial peak systolic (Sm), early (Em) and late (Am) diastolic filling velocities, Em/Am, isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT) and ejection time (ET) were obtained in the basal segments of the inferior-septal and lateral wall. Myocardial performance index (MPI) was calculated. Result: Mild degree mitral regurgitation was present in 10 (40%) of patients with MVP, and moderate degree mitral regurgitation was present in 2 (8%) of patients. No difference was found between the two groups with regard to diastolic parameters. TDE-derivated MPI values were similar in all segments in two groups. There was significant difference between the two groups with regard to LV mean Sm and lateral wall Sm (11.6±2.8 vs. 9.4±1.0, p=0.001; 13.0±3.9 vs. 9.2±2.3, p=0.001 respectively). Conclusion: Isolated MVP without significant mitral regurgitation does not affect LV diastolic functions and MPI. However, Sm of late ral wall and LV mean was higher in patients with MVP than patients without MVP.Öğe A lethal but treatable complication: Free wall rupture after acute myocardial infarction(2006) Ülgen M.S.; Öztürk Ö.; Kayrak M.; Soylu A.; Düzenli M.A.; Koç F.A 43-year-old male patient was admitted to coronary intensive care unit with the diagnosis of acute inferolateral myocardial infarction and with a picture of cardiogenic shock. In physical examination, systolic blood pressure was 50 mmHg and diastolic blood pressure could not be taken. The patient was diagnosed with cardiogenic shock and was started on saline, dopamine and dobutamine infusion. His blood pressure did not increase although the dosage of positive inotropic agents was increased. A cardiac tamponade revealed with urgent echocardiographic evaluation and pericardiocentesis was carried out. Blood pressure returned to normal range within hours after pericardiosentesis. Echocardiographic examination performed on the second day of AMI on the asymptomatic patient revealed thrombosed myocardial rupture. The patient was referred to emergency surgery with the diagnosis of three-vessel disease and myocardial rupture according to urgent angiography. In the operation, the ruptured region in the ventricle free wall was primarily repaired. By-pass surgery was performed with saphenous vein graft to the LAD and CV-OM1 coronary arteries.Öğe Three-year follow up of recurrent cardiac echinococcosis simulating myxoma: Report of a rare case [Nadir görhülen bir olgu: Miksomayi taklit eden tekrarlayici kardiyak ekinokokozis ve 3 yillik takip](2007) Ülgen M.S.; Yazici M.; Kayrak M.; Düzenli M.A.; Koç F.[Abstract not Available]Öğe Thrombus entrapped in a patent foramen ovale presenting with acute pulmonary embolism [Akut pulmoner emboli ile ortaya çkan patent foramen ovale içine tuzaklanmış trombüs](AVES, 2010) Kayrak M.; Kaya Z.; Ülgen M.S.; Yazici M.; Karaaslan Ş.; Ayhan S.S.[Abstract not Available]
