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    Evaluation of the role of Nrf2/Keap1 pathway-associated novel mutations and gene expression on antioxidant status in patients with deep vein thrombosis
    (Spandidos Publ Ltd, 2020) Akin-Bali, Dilara Fatma; Eroglu, Tamer; Ilk, Sedef; Egin, Yonca; Kankilic, Teoman
    Deep vein thrombosis (DVT) is a type of venous thromboembolism and a clinically complex vascular disease. Oxidative stress serves a key role in the pathogenesis of numerous cardiovascular diseases, particularly in endothelial dysfunction-associated syndromes. Nuclear factor erythroid-2-like 2(Nrf2) transcription factor is the primary regulator of antioxidant responses. The levels of reactive oxygen species (ROS) are regulated by Nrf2 and its suppressor protein Kelch-like ECH-associated protein 1 (Keap1). However, to the best of our knowledge, genetic abnormalites in the Nrf2/Keap1 pathway in DVT syndrome have not been thoroughly investigated. The aim of the present study was to investigate the association between the Nrf2/Keap1 pathway and antioxidant responses in DVT. Mutations and expression levels of genes involved in the Nrf2/Keap1 pathway were measured in 27 patients with DVT via DNA sequencing analysis and reverse transcription-quantitative PCR, respectively. The Polymorphism Phenotyping v2 program was used to identify the pathogenic mutations. Total antioxidant activity levels were determined by measuring the effect of serum samples from 27 patients with DVT on oxidation of the 2,2'-azino-bis (3-ethylbenz-thiazoline-6-sulfonic acid) system. A total of 23 mutations, including seven novel mutations, were detected in the Nrf2/Keap1 pathway in 24 (89%) of the 27 patients with DVT. Keap1 mRNA expression levels were significantly higher compared with Nrf2 expression levels in patients with DVT (P=0.02). Analysis of molecular characteristics and gene expression levels demonstrated that Nrf2/Keap1-associated mutations and total antioxidant levels can be used as precursor markers in the diagnosis of DVT.
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    Impact of Single versus Double Clamp Technique on Blood Lactate Levels and Postoperative Complications in Coronary Artery Bypass Surgery
    (Soc Brasil Cirurgia Cardiovasc, 2022) Ozmen, Rifat; Bozguney, Muhammet; Tekin, Ali Ihsan; Eroglu, Tamer; Tuncay, Aydin
    Introduction: Cardiopulmonary bypass (CPB) is associated with hyperlactatemia, which leads to adverse clinical outcomes. No study has examined the effect of different clamping techniques on postoperative hyperlactatemia (PHL). Thus, we aimed to evaluate the impact of two different techniques on PHL and the clinical outcomes in patients undergoing isolated coronary artery bypass surgery. Methods: This retrospective study included 100 patients who underwent isolated CPB either with single clamp technique (SCT, n=47) or double clamp technique (DCT, n=53). Demographic and preoperative laboratory data, as well as operative features and arterial blood lactate levels at the onset and at the end of CPB, were collected from patient charts. Results: Blood lactate levels collected at the end of CPB did not differ significantly between groups whereas intraoperative lactate increased significantly in both groups (P<0.005). PHL developed in 16 patients (32%). There was no meaningful difference in SCT and DCT in this regard. Left internal mammary artery was used more frequently in the DCT group than in the SCT group. While the cross-clamp time was significantly longer in the SCT group, there was no difference regarding CPB time. Among postoperative complications, only the incidence of stroke was significantly higher in the DCT group than in the SCT group (10.6% vs. 0%, P=0.020). CPB time, cross-clamp time and numbers of proximal saphenous graft and distal anastomosis showed a significant positive correlation with the postoperative lactate level. In the regression analysis, CPB time emerged as the only independent predictor of PHL (OR 1.04, CI 95% 1.01-1.07, P=0.011). Conclusion: There was no difference in postoperative blood lactate levels between SCT and DCT groups.
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    Overview of Treatment Methods in Peripheral Major Vascular Injuries: A Retrospective Study
    (Erciyes Univ Sch Medicine, 2020) Ozmen, Rifat; Bozguney, Muhammet; Eroglu, Tamer; Tekin, Ali Ihsan; Tuncay, Aydin; Elcik, Deniz
    Objective: Vascular injuries are observed in 0.2-4% of all traumas and can be life-threatening or difficult when not properly treated. In this study, we aimed to present our experience in the treated vascular injury cases. Materials and Methods: This retrospective and descriptive study covered the period between May 2014 and December 2018. Medical records of patients with vascular injuries were evaluated concerning demographic and trauma-related parameters. Results: In this study, 73.1% of 93 patients were male, and the average age was 27.44 +/- 6.70 years. In the majority of the patients, it was observed that vascular injuries occurred as a result of penetrating traumas, and mainly radial and superficial femoral arteries were affected. Nerve injuries were found to be accompanied in 16.1% of the patients. The concomitant nerve injuries were also present in 16.1% of the patients. End-to-end anastomosis was used in 73.3% of the injuries. Mortality and amputation rates were 1.1% and 3.2%, respectively. Conclusion: Demographic and clinical parameters in vascular injury cases were found to be compatible with the previous studies. By collecting the correct data obtained from this study and the other studies, the medical needs of patients with vascular injuries could be better evaluated and clinical services could be planned in advance by conducting a medical approach accordingly.
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    Pathogenic Ala303Val Mutation in the PROS1 Gene is Associated with the Pathogenesis of Deep Vein Thrombosis
    (Erciyes Univ Sch Medicine, 2022) Bali, Dilara Fatma Akin; Eroglu, Tamer; Ozkan, Didem Torun
    Objective: The aim of this study was to predict the functional impact of pathogenic mutations and the mRNA expression profiles of the platelet endothelial aggregation receptor 1 (PEAR1), protein S (alpha) (PROS1), and adrenoceptor alpha 2A (ADRA2A) genes in deep vein thrombosis (DVT), as well as to examine the effects of these genes on the pathogenesis of DVT. Materials and Methods: Patients diagnosed with DVT were selected for the study and healthy individuals were used as controls. Mutations in the PEAR1, PROS1, and ADRA2A genes were determined by DNA sequencing analysis and gene expressions were determined using quantitative real-time polymerase chain reaction testing. Polymorphism Phenotyping v2 (Polyphen-2: http://genetics.bwh.harvard.edu/pph2/), SNAP2 (https://rostlab.org/services/snap2web/) and MutationTaster (https://www.mutationtaster.org/) software were used to define the pathogenic effects of mutations detected by sequencing the selected genes in hotspot regions. Mutation and gene expression analyses were noted in the results and clinical data. Results: A total of 27 patients with DVT and 10 healthy individuals were included in the study. Twenty-one mutations were detected in the 27 patients, most often in the PROS1 gene. A p.Ala303Val mutation is located on the human sex hormone-binding globulin (SHBG) domain of mutation PROS1 and is pathogenic. A p.A303V mutation is associated with premature termination in codon 303 of the SHBG domain. Examination of the effect on the mRNA expression level of wild-type versus mutant genotypes revealed that the mutant PROS1 p.A303V expression was significantly lower (p=0.041). Conclusion: A p.A303V mutation in PROS1 might be an independent risk factor for DVT, which could provide helpful insight into the pathogenesis of DVT.
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    Surgical treatment of a calcified amorphous tumor originating from left atrium
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Eroglu, Mehtap; Bozguney, Muhammet; Eroglu, Tamer; Acikgoz, Burak
    Calcified amorphous tumor is a non-neoplastic tumor or intracavitary cardiac mass which is rarely seen in heart. It is frequently associated with left ventricle and mitral valve. Clinical symptoms varies from asymptomatic status to serious neurological and cardiopulmonary symptoms. Imaging studies such as echocardiography, computed tomography, or magnetic resonance imaging can reveal the mass preoperatively, although the exact diagnosis is done by pathological inspection of the specimen. Follow-up is recommended by echocardiography after surgical treatment due to its recurrence potential. Herein, we present a mass attached to the mitral valve posterior leaflet causing rather silent symptoms such as dyspnea and fatigue on exertion.