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    Association between homocysteine level and intima-media thickness in patients with first ischemic stroke
    (UNIVERSITATSVERLAG ULM GMBH, 2005) Tas, Aysenur; Tas, Fikret; Candan, Ferda; Topaktas, Suat
    Objective - Elevated plasma homocysteine may be a causal risk factor for atherosclerosis but this remains controversial. We evaluated the relationship between intima-media thickness of carotid arteries and plasma level of homocysteine in first ischemic stroke patients. Methods and Results - In the patient group, 175 patients with ischemic stroke (89 men and 86 women; mean age 61.2years [SD 6.83]) and in the control group, 110 healthy subjects without ischemic stroke with healthy subjects (58 men and 52 women; mean age 59.8 years [SD 8.15]) were studied. There was not a statistical difference between two groups regarding age, sex, and conventional vascular risk factors between two groups. Logistic regression analysis was carried out by use of a backward selection strategy with continuous variables (age, homocysteine,folate) and categorical variables (hypertension, diabetes mellitus, hypercholesterolemia, history of previous vascular events and smoking) as independent variables and ischemic stroke as the dependent variable. Important independent risk factors for IMT were hypertension (OR 1.08; 95% Cl 1.03 to 1.13, p= 0.001), homocysteine level (OR 12.1; 95% Cl 2.8 to 55, p= 0.002), hypercholesterolemia (OR 2.26; 95% Cl 1.35 to 3.81, p= 0.002), diabetes mellitus (OR 8.01, 95% Cl 2.1 to 28.2, p=0.003), previous vascular events (OR 2.0 1; 95 % Cl 1.22 to 3.31, p=0.005), current smoker (OR 2.11, 95% Cl 1.01 to 3.74, p=0.03), serum folate (OR 7.06; 95%Cl 7.0 to 7.8 1, p=0.002). Conclusions - Finally, increased plasma homocysteine level was an independent risk factor for intima media thickness in first ischemic stroke. So, we think that further comprehensive and long-term studies necessary on this subject.
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    Evaluation of the effects of serum bilirubin levels on intimal medial hyperplasia of carotis vessels
    (Aves, 2005) Demirel, Yeltekin; Tas, Aysenur; Tas, Fikret; Bolayir, Ertugrul; Topaktas, Suat
    Purpose: To investigate whether there is an independent effect of serum total bilirubin level on carotid atherosclerosis. Material and Metods: A total number of 145 subjects was used in this case-control type study. While 75 of the subjects had intimal medial hyperplasia in their carotid arteries, 70 of subjects served as the control group who had the same risk factors without intimal medial hyperplasia. Intimal medial hyperplasia was used as a dependent variable whereas hypertension, diabetes, high cholesterol levels, smoking and serum bilirubin levels were used as independent variables. Results: There were no differences between groups when age and sex were compared. Low total bilirubin level was found to be a risk factor for intimal medial hyperplasia as a result of logistic regression analysis [OR: 1.57, confidential limit 95% (1.16-1.93)]. On the other hand, hypertension (OR: 0.28, CI 95 %) and, hypercholesterolemia (OR: 0.31, CI 95 %) were found to be risk factors for intimal medial hyperplasia. Diabetes (OR: 1.38, CI 95 %) and smoking (OR: 0.90, CI 95 %) were not found as risk factors for intimal medial hyperplasia. Conclusion: Low serum total bilirubin level could be suggested as a risk factor for carotid intimal medial hyperplasia.
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    Intracarotid L-arginine reverses motor evoked potential changes in experimental cerebral vasospasm
    (TURKISH NEUROSURGICAL SOC, 2007) Oezuem, Uenal; Aslan, Adem; Tas, Aysenur; Kars, H. Zafer
    OBJECTIVE: To investigate motor evoked potentials during short term L-arginine infusion in cerebral vasospasm after experimental subarachnoid hemorrhage. METHODS: Three groups were designated for this study: control group, subarachnoid hemorrhage-saline infusion group, and subarachnoid hemorrhage-L-arginine infusion group. A subarachnoid hemorrhage was created by intracisternal injection of autologous blood in New Zealand rabbits. At the fourth day of subarachnoid hemorrhage, latency and amplitude of motor evoked potentials were recorded during intracarotid saline and L-arginine infusion, and compared with motor evoked potential parameters of the control group. RESULTS: Motor evoked potential latencies were increased, and amplitudes were decreased in all animals before saline and L-arginine infusion on the fourth day of subarachnoid hemorrhage. A decrease in latencies as well as an increase in motor evoked potential amplitudes was observed with short-term intracarotid L-arginine infusion. CONCLUSION: Intracarotid short term L-arginine infusion significantly improves motor evoked potential parameters after experimental subarachnoid hemorrhage.
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    Intracisternal versus intracarotid infusion of L-arginine in experimental cerebral vasospasm
    (ELSEVIER SCI LTD, 2007) Oezuem, Uenal; Aslan, Adam; Karadag, Oezen; Guerelik, Mustafa; Tas, Aysenur; Kars, H. Zafer
    Aim: The effect of short term intracisternal and intracarotid L-arginine infusion on experimental cerebral acute phase vasospasm in a rabbit subarachnoid haemorrhage model is investigated, and the two groups compared. Materials and Method: Subarachnoid haemorrhage was produced by intracisternal injection of autologous blood in New Zealand rabbits. On the fourth day after subarachnoid haemorrhage, cerebral blood flow was monitored using transcranial Doppler ultrasonography during intracisternal and intracarotid saline and L-arginine infusions. Result: Cerebral blood flow measurements revealed resolution of vasospasm with short-term intracisternal and intracarotid L-arginine infusion. No significant difference was found between the effects of intracisternal and intracarotid L-arginine infusions, however intracarotid L-arginine infusion created a more potent vasodilatation towards the end of infusion. Conclusion: Both intracisternal and intracarotid short term L-arginine infusion significantly improve acute phase cerebral vasospasm after experimental subarachnoid haemorrhage. Intracarotid L-arginine infusion is more potent and safer as large amounts of intracisternal L-arginine may lead to overproduction of nitric oxide by inducible nitric oxide synthase with the production of free radicals. (c) 2006 Elsevier Ltd. All rights reserved.