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    Anti-inflammatory and anti-fibrotic effects of sirolimus on bleomycininduced pulmonary fibrosis in rats
    (2011) Tulek B.; Kiyan E.; Toy H.; Kiyici A.; Narin C.; Suerdem M.
    Purpose: Pulmonary fibrosis is a devastating disease with a poor prognosis. Although the diagnosis and pathophysiology of this disease have been better characterized over the past few years, there is no effective therapy for the disease. The aim of this study was to evaluate the anti-inflammatory and anti-fibrotic effects of sirolimus (SRL), which is a potential anti-fibrotic agent, by using bleomycin (BLM)-induced pulmonary fibrosis model in rats. Methods: A single intra-tracheal injection of BLM (2.5 U/kg) was administered and sirolimus (2.5 mg/kg/day) was given orally, beginning either one day before (early SRL) or nine days after (late SRL) the BLM administration. The effect of SRL on fibrosis was studied by analysis of cytokine levels in BAL fluid, measurement of lung tissue hydroxyproline (HPL) content and histopathological examination. Results: Both early and late SRL administrations caused a decrease in the levels of IL-13, PDGF-A and TGF-?1 (p=0.001) and an increase in IFN-? levels (p=0.001) in BAL fluid. Early and late SRL also caused a decrease in HPL content (p=0.001). Early sirolimus caused a significant decrease in fibrosis score (p=0.001), while late SRL did not. Conclusion: Sirolimus was effective in BLM-induced pulmonary fibrosis model, especially in the early phases of the disease. © 2011 CIM.
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    The effects of medical ozone in rat heart exposed to ischemia-reperfusion injury: Experimental study
    (2012) Tanyeli Ö.; Yüksek T.; Görmüş N.; Ulu N.; Kiyici A.; Esen H.H.
    Objective: In this study, it was intended to investigate the effects of preconditioning with medical ozone on possible reperfusion injury, in which patients undergoing the operation due to coronary artery disease. Material and Methods: 37 female mature rats were categorized into 4 groups either as sham-control (Group I), ischemia (Group II), ischemic preconditioning by oxygen (Group III) or by medical ozone (Group IV). Through left thoracotomy, rats were subjected to 25 min of ischemia on left anterior descending (LAD) coronary artery and after that, reperfusion was provided for 75 min. At the end of this period, serum sampling for creatinine-kinase (CK)-MB, Troponin-I, superoxide dismutase (SOD) and malondialdehyde (MDA) and tissue sampling for histopathological examinations were performed. The results of pathological examination were divided into 3 groups according to cellular damage. Results: Statistically, there were no significant differences between the groups in case of CK-MB levels and SOD enzymatic activity (p>0.05). Nevertheless, Troponin-I was higher in Group III and MDA was meaningfully lower in Group IV in respect to control group (p=0.005). Moreover, MDA levels were significantly lower in Group IV, when compared to Group III. With these results, no significant differences were detected between ischemia and ozone group. Although it is important to detect lower MDA levels in ozone group when compared to oxygen group, it is hard to talk about protective effects of ozone just depending on this data. In histopathological examination, medical ozone had beneficial effects on cellular protection when compared to ischemic group; but when the groups were examined, no significant differences could be found between oxygen and ozone groups. Conclusion: Although the role of medical ozone on the prevention of reperfusion injury could not be demonstrated clearly, it might have some beneficial effects after biochemical and histopathological evaluation. To be able to show these effects precisely, more studies are needed. Copyright © 2012 by Türkiye Klinikleri.
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    Evaluation of adrenal function in chronic obstructive pulmonary disease patients receiving invasive and noninvasive mechanical ventilation
    (AVES, 2010) Atalay H.; Teke T.; Yavuz Z.; Maden E.; Kiyici A.; Solak Y.; Uzun K.
    Stress and severe disease states in the intensive care unit (ICU) cause release of adrenocorticoid hormone from the hypophysis and cortisol from the adrenal cortex by activating hypothalamo-pituitary adrenal axis. While adrenal insuffi ciency (AI) is seen in less than 0.01% of the normal population, its frequency is over 28% of cases in intensive care units (ICU). The aim of this study was to evaluate adrenal function in 36 cases with COPD, in pulmonary diseases ICU, receiving invasive mechanical ventilation (IMV) (n:23) and noninvasive mechanical ventilation (NIMV) (n:13). For this purpose, after obtaining a blood sample for baseline cortisol level, 1mg ACTH was given to patients in the fi rst day of admission to ICU. Cortisol levels were checked at the 30th and 60th minutes of ACTH test. Of all cases, mean age was 67.3±9.2, duration of hospitalization 12.9±9.3 days, APACHE II score 20.9±5.4, systolic blood pressure (bp) 103.5±28.2 mmHg, diastolic bp 64.6±19.2, mean arterial blood pressure 81.5±20.5 mmHg, sodium 138.3 ±6.3, potassium 4.3±1.2, urea 83.8±62.5 and creatinine was1.38±0.9 respectively. According to baseline cortisol levels, AI was present in 22 (45%) patients. Of these cases, 11 were in NIMV and 11 in IMV groups. When the baseline, 30th minute and 60th minute cortisol levels were compared, a statistically signifi cant difference was present (p<0.05, for all). In conclusion, we consider that adrenal insuffi ciency is encountered frequently in COPD patients with respiratory failure and further studies are needed tobetter delineate this association.
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    The relation among to mortality rate, hospitalization period and inflammatory mediators in patients with chronic obstructive pulmonary disease attack on admission to emergency department
    (Ondokuz Mayis Universitesi, 2015) Bayir A.; Buyukunaldi P.; Kiyici A.; Kara H.
    Chronic obstructive pulmonary disease (COPD) is characterized by a progressive and not completely reversible obstruction of the airways associated with an abnormal inflammatory response of the lungs to particles and noxious gases related to a systemic effect. Inflammatory processes are suggested to be involved in pathogenesis of COPD. The aim of the study was to investigate the relation among to the mortality rate, hospitalization period and inflammatory mediators of the patients with COPD attack on admission into the emergency department. A total of 87 subjects with COPD attack were contributed in this study. TNF-?, IL-6 and catalase were determined in addition to leucocyte count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). There was no significant difference between the deceased and discharged patients in terms of WBC, ESR, CRP, IL-6, and TNF-?. However, mean catalase levels of discharged patients were significantly higher than the deceased patients (p<0.05). Significant correlations were observed between WBC and hospitalization period, and CRP and follow up period in the intensive care unit. We can suggest that catalase activities on admission into the emergency service were decreased in deceased patients who were in follow up in intensive care unit with COPD attack. High CRP and WBC levels were also related with the hospitalization period of patients with COPD attack. © 2015 OMU.