Erkan Iriz

Gazi University, Engüri, Ankara, Turkey

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Publications (51)77.23 Total impact

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    ABSTRACT: The aim of this study was to evaluate the histological and immunohistochemical effects of levosimendan on liver injury induced by myocardial ischemia and reperfusion (I/R) in a rat model. Twenty-four male Wistar Albino rats were randomly divided into the four groups: Group C (Control, n = 6), Group I/R (n = 6), Group BI (I/R group treated with levosimendan before ischemia, n = 6), and Group AI (I/R group treated with levosimendan after ischemia, n = 6). Myocardial I/R was induced by ligation of the left anterior descending coronary artery for 30 min followed by two hours of reperfusion in I/R and I/R+Levosimendan groups. At the end of the study, liver tissue samples were obtained for histopathological and immunohistochemical examination. Masson Trichrome staining revealed significant hepatocyte degeneration and necrosis most marked in portal acinus Zone 3, especially around the central veins in Group I/R. Histopathological changes in Group AI were more similar to the changes in Group I/R. Milder hepatocellular degeneration was found in Group BI, when compared to groups I/R and AI. Immunohistochemical score was found to be significantly higher in Group I/R compared to groups C, BI and AI (p < 0.0001). The scores in groups BI and AI were found to be similar (p = 0.068). Levosimendan ameliorates liver injury induced by myocardial IR, especially when administered before induction of ischemia (Fig. 9, Ref. 37).
    No preview · Article · Mar 2015 · Bratislavske lekarske listy
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    ABSTRACT: OBJECTIVE: The aim of this study was to evaluate antioxidant and cytoprotective effects of iloprost and Vitamin C in a distant organ after abdominal aorta ischemia reperfusion injury. MATERIALAND METHODS: Twenty-eight New Zealand rabbits weighing 2,400-2,800 g were used for this study. The rabbits were divided into four equal groups. These groups are control group, sham group, iloprost group, and iloprost + vitamin C group. Suprarenal aorta was occluded with a vascular clamp. Following 30 minutes of ischemia, the vascular clamp was removed. Rabbits in group 3 received 10 ng/kg/min iloprost and those in group 4 received 10 ng/kg/min iloprost and 10 mg/kg vitamin C. At the end of the reperfusion period, the rabbits were sacrificed by a high intraperitoneal dose of xylazine + ketamine injection. Myocardial tissue samples were taken for electron microscopic analysis. We evaluated SOD, MDA and catalase in myocardial tissue samples. RESULTS: Iloprost and iloprost + vitamin C groups significantly reduced the oxidative stress markers in tissue samples (p < 0.05) and significantly decreased the myofibrillar injury and mitochondrial morphology changes in the myocardial tissue as shown with electron microscopy (p < 0.05). Myocardial edema was significantly alleviated by iloprost and iloprost + vitamin C administration (p < 0.05). CONCLUSIONS: This study clearly showed that myocardial injury and edema occurred after ischemia reperfusion of abdominal aorta and that groups administered with iloprost and iloprost + vitamin C showed an attenuation of ischemia reperfusion injury in distant organs (Tab. 3, Fig. 4, Ref. 30). Text in PDF www.elis.sk.
    No preview · Article · Jan 2015
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    ABSTRACT: Purpose: The aim of this study was to investigate the effects of iloprost (I) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model. Materials and methods: Twenty-four Wistar Albino rats were randomized into four groups (n = 6). Laparotomy was performed in all groups under general anesthesia. Only laparotomy was applied in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes. Group iloprost (Group I) received intravenous infusion of iloprost 0.5 ng/kg/min, without ischemia and reperfusion. Group I/R/I received intravenous infusion of iloprost 0.5 ng/kg/min immediately after 2 hours of ischemia. At the end of the study, lung tissue was obtained for determining total oxidant status (TOS) and total antioxidant status (TAS) levels, histochemical and immunohistochemical determination. Results: Diffuse lymphocyte infiltration was detected in immunohistochemical examination of lung tissue in Group I/R. The connective tissue around bronchi, bronchioles and vessel walls was found to be increased. Although minimal local lymphocyte infiltration was detected in some fields in Group I/R/I, the overall tissue was found to be similar to Group S. iNOS expression was significantly higher in Group I/R, when compared with Group S and significantly lower in Group I/R/I compared to Group I/R.TOS levels were significantly higher in Group I/R, when compared with groups S and I (p = 0.028, p = 0.016, respectively) and significantly lower in group I/R/I, when compared with Group I/R (p = 0.048). TAS levels were significantly higher in Group I/R, when compared with groups S, I (p = 0.014, p = 0.027, respectively) and significantly lower in Group I/R/I, when compared with Group I/R (p = 0.032). Conclusion: These results indicate that administration of iloprost may have protective effects against ischemia reperfusion injury (Fig. 8, Tab. 1, Ref. 30)
    No preview · Article · Aug 2014 · Bratislavske lekarske listy
  • D Erer · A Ozer · M Arslan · G L Oktar · E Iriz · C Elmas · M H Zor · T Tatar · G Goktas
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    ABSTRACT: Purpose: The aim of this study was to evaluate the effect of dexmedetomidine (100 µg/kg-ip) on liver injury-induced myocardial ischemia and reperfusion (IR) in rats. Materials and methods: Twenty-four Wistar Albino rats were separated into four groups. There were four experimental groups (Group C (Control; n = 6), Group IR (ischemia-reperfusion, n = 6), Group D (Dexmedetomidine; n = 6) that underwent left thoracotomy and received ip dexmedetomidine without IR administered via 100 µg/kg ip route 30 minutes before ligating the left coronary artery, and Group IR-D (IR-Dexmedetomidine; n = 6). A small plastic snare was threaded through the ligature and placed in contact with the heart. To produce IR, a branch of the left coronary artery was occluded for 30 min followed by two hours of reperfusion. However, after the above procedure, the coronary artery was not occluded or reperfused in the control rats. At the end of the study, liver tissue was obtained for histochemical and immunohistochemical determination.Some part of tissue samples were stained with Masson-trichrome for the evaluation of ultrastructural changes and inducible nitric oxide synthase (iNOS) expression was evaluated in other part of samples for immunohistochemical examination. Results: Histopathological changes were detected in Group IR when compared with Group C. iNOS expression was found to be increased and stronger particularly in the vascular wall, perisinusoidal space and hepatocytes around vena centralis in this group compared to the control group. Perivascular oedema was detected to be decreased in Group IR-D compared to Group IR. It was also observed that the impairment in the radial arrangement of hepatocytes significantly recovered in Group IR-D. The immunoreactivity was found to be significantly decreased in the assessment of iNOS expression in the same group when compared with Group IR. Conclusion: Administration of dexmedetomidine ameliorates liver injury induced by myocardial ischemia and reperfusion (Fig. 8, Ref. 33).
    No preview · Article · Aug 2014 · Bratislavske lekarske listy
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    ABSTRACT: Purpose: The aim of this study was to investigate the effects of adrenomedullin (AM) and vascular endothelial growth factor (VEGF) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model. Materials and methods: Thirty-six Wistar rats were randomized into six groups (n=6). Laparotomy was performed in all groups under general anesthesia. Nothing else was done in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes, respectively. Group VEGF and Group AM received intravenous infusion of VEGF (0.8 μg/kg) or AM (12 μg /kg) respectively, without ischemia and reperfusion. Group IR+VEGF and Group IR+AM received intravenous infusion of VEGF (0.8 μg/kg) or AM (12 μg /kg) respectively immediately after 2 hours period of ischemia. At the end of reperfusion period. Lung tissue samples were taken for biochemical examination. Total oxidant status (TOS) and total antioxidant status (TAS) levels in lung tissue were determined by using a novel automated method. p<0.05 was considered as statistically significant. Results: TOS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.004, p=0.011, p=0.017, respectively) and significantly lower in groups I/R+AM and I/R+VEGF, when compared with Group I/R (p=0.018, p=0.006, respectively). TAS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.006 p=0.016, p=0.016, respectively) and significantly lower in Group I/R+AM, when compared with Group I/R (p=0.016). Conclusion: These findings indicate that AM and VEGF acted effectively on the prevention of lung injury induced by skeletal muscle ischemia-reperfusion injury in a rat model (Fig. 2, Ref. 30).
    No preview · Article · Nov 2013 · Bratislavske lekarske listy
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    ABSTRACT: The aim of this study was to investigate the effects of iloprost (IL) on ischemia-reperfusion injury in a rodent model. Twenty-four Wistar Albino rats were randomized into four groups (n = 6). Laparotomy was performed in all groups under general anesthesia. Only laparotomy was applied in group S (Sham). Ischemia-reperfusion group (group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 min. The iloprost group (group IL) received intravenous infusion of IL 0.5 ng/kg/min, without I/R. Group I/R + IL received intravenous infusion of IL 0.5 ng/kg/min immediately after 2 h period of ischemia. At the end of the reperfusion period, all rats were killed under anesthesia and skeletal muscle samples of lower extremity were harvested for biochemical and histopathologic analyses. Tissue levels of endothelial nitric oxide were significantly higher in I/R groups than those in groups S and IL. The heat shock protein 60 levels were higher in group I/R than the other groups. But the heat shock protein 60 levels in group I/R + IL were found to be similar with the groups S and IL. Malondialdehyde levels were significantly higher in group I/R. On the other hand, in group I/R + IL, malondialdehyde levels were higher than those in groups S and IL but lower than those in group I/R. Superoxide dismutase (SOD) enzyme activities were found to be significantly lower in group I/R than the other groups. Also in group I/R/I, the SOD enzyme activities were higher than those in group I/R. But, in group I/R + IL, SOD levels were found to be higher than those in group I/R but lower than those in groups S and IL. These results indicate that IL has protective effects on I/R injury in skeletal muscle in a rodent model.
    Full-text · Article · Sep 2013 · Journal of Surgical Research
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    ABSTRACT: Background: We studied the existence of agents in aorta biopsies, such as Chlamydia pneumoniae, cytomegalovirus, and Mycoplasma pneumoniae, that are thought to have a role in atherosclerosis etiopathogenesis role, and their association with peripheral artery disease. Materials and methods: We examined aorta wall and internal mammarian artery (IMA) biopsies taken from two different places in 63 patients in whom coronary artery bypass was performed. In these biopsies, we evaluated the deoxyribonuclease (DNA) of these microorganisms using polymerase chain reaction. From the same patients, we recorded the ankle brachial index, road walking distance information, lipid profile, C-reactive proteins, blood parameters such as fibrinogen, and the patient's operation data. Results: In the nine aorta biopsies taken from 63 patients, we isolated C pneumoniae DNA. In IMA biopsies taken from the same patients, we detected no microorganism DNA (P < 0.001). In the same aorta biopsies, we found no cytomegalovirus or M pneumoniae DNA. We examined 12 patients using an index value of 0.9 in the ankle brachial index evaluation; eight had C pneumoniae in the aorta biopsies (P < 0.001). Conclusions: We found a significant relationship between C pneumoniae DNA and the existence of peripheral artery disease. In the development of atherosclerosis with C pneumoniae, there may be a determinant pathogen in both the aorta and the peripheral arteries. The nonexistence of C pneumoniae DNA in the IMA biopsies may indicate infectious agents because of the predominant endothelial functions in this artery, and thus its resistance to atherosclerosis.
    No preview · Article · Feb 2013 · Journal of Surgical Research
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    ABSTRACT: Background: In the present study, we aimed to investigate the effects of off-pump coronary artery bypass grafting and on-pump cardiopulmonary bypass on the serum S-100 beta (S-100B) protein levels and neurocognitive functions of the patients. Materials and methods: Sixty-four patients undergoing coronary artery bypass grafting (CABG) were enrolled in the study and were divided into two groups: off-pump (group I, n = 24) and on-pump CABG (group II, n = 40) group. Serum S-100B levels were measured before and 0, 6, and 24 h after the operation. Neurocognitive function tests were done preoperatively and were repeated in the postoperative period as well. Results: Serum S-100B levels were similar between the two groups preoperatively. However, median S-100B levels at 0, 6, and 24 h after the surgery were found to be significantly lower in the off-pump CABG group than in the on-pump group. The preoperative neurocognitive functions of the patients were similar between the two groups, whereas neurocognitive function was found to be significantly impaired postoperatively in the on-pump group in comparison with the off-pump CABG group. Conclusion: We concluded that off-pump CABG is associated with decreased serum S100 protein levels and less impairment on neurocognitive functions compared with the on-pump group.
    No preview · Article · Nov 2012 · Journal of Surgical Research
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    ABSTRACT: Pediatric heart transplantation is indicated with end-stage heart failure or complex inoperable congenital heart defects. In this article, we report the first youngest (2 years old) successfully pediatric heart transplantation after 25 years compared to literature indicating limited pediatric donor pool and trained surgeon team. Our experience suggests that heart transplantation of pediatric patients requires multidisciplinary collaboration.
    No preview · Article · Oct 2012 · Turkish Journal of Thoracic and Cardiovascular Surgery

  • No preview · Article · Aug 2012 · Circulation
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    ABSTRACT: We aimed to investigate the effects of off-pump coronary artery bypass grafting (CABG), pulsatile cardiopulmonary bypass (CPB), and non-pulsatile CPB techniques on oxidative stress and the respiratory system in the current study. The patients were allocated into three different groups according to perfusion techniques, as follows: off-pump CABG group (n=10); pulsatile CPB (n=11); and non-pulsatile CPB group (n=11). Serum carbonyl level was measured and a pulmonary function test was performed preoperatively and postoperatively. The postoperative increase in the carbonyl level was significantly lower in the off-pump CABG group compared to the other two groups, while there was no significant difference between the pulsatile and non-pulsatile CPB groups with respect to carbonyl levels. Arterial partial pressure of oxygen, forced expiratory volume in one second, and forced vital capacity were significantly higher in the off-pump CABG group compared to other two groups in the postoperative period. We found that off-pump CABG had less negative effects on oxidative stress and the respiratory system compared to pulsatile CPB and non-pulsatile CPB techniques. Additionally, there was no significant difference between pulsatile and non-pulsatile CPB.
    No preview · Article · May 2012 · Perfusion
  • H Bayram · D Erer · E Iriz · M H Zor · O Gulbahar · M E Ozdogan
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    ABSTRACT: Background: We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study. Methods: A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively. Results: The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100β levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05). Conclusion: We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.
    No preview · Article · Jan 2012 · Perfusion
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    ABSTRACT: Objective: To assess the toxic remote organ damage in the cochlea due to ischemia-reperfusion injury following descending aorta surgery, and to investigate the protective effect of iloprost and ascorbic acid. Materials and Methods: Twenty-one New Zealand rabbits were divided in to 3 groups. In group 1 and 2, a remote injury was created in the cochlea after ischemia-reperfusion injury in spinal cord, renal and lower extremities caused by clamping the descending aorta. In group 1, no additional medications were given. In group 2, iloprost and ascorbic acid were infused 30 minutes before and two hours after the surgical procedure. A sham operation was performed in group 3. The cochlear function was tested using Otoacoustic Emission (OAE) testing before and after the operation. In addition, the cochlea was examined using electron microscopy. Results: OAE amplitudes decreased postoperatively in group 1 (p<0.05). In group 2, pre- and postoperative OAE results were not significantly different (p>0.05). In group 3, a postoperative decrease was encountered at only 4 kHz after the operation (p<0.05). The morphological changes were more prominent in group 1 when compared to group 2. Conclusion: Cochlear remote organ damage can occur after ischemia-reperfusion injury in spinal cord, renal and extremities. Iloprost and ascorbic acid has a protective effect against this injury.
    No preview · Article · Jan 2012 · Journal of International Advanced Otology
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    ABSTRACT: Background: In this study, we compared the pericardial structure and intraoperative pericardial changes between patients undergoing cardiac surgery for the first time and patients who had previously undergone at least one cardiac surgery. Methods: Thirty-six patients (19 males, 17 females; mean age 61.2+/-16.1 years; range 47 to 85 years) who underwent surgery in our clinic between January 2005 and April 2006 were enrolled in this study. The patients were divided into two groups. Group I consisted of 20 patients who underwent surgery for the first time whereas group 2 consisted of 16 patients who had previously undergone at least one cardiac surgery. Two biopsies were obtained in both groups one immediately after opening the pericardium and the other 60 minutes after the first biopsy. A portion of the biopsies that were obtained was fixed in neutral formalin by the TUNEL method for uPAR (urokinase plasminogen activator receptor) and FGF-2 (fibroblast growth factor-2) immunostaining, and it was also used to detect cells with DNA fragmentation. The other tissue samples were examined by the transient electromagnetic (TEM) method and stained with toluidine blue. Results: No statistically significant differences were found between the groups either in the preoperative risk factors or the demographic characteristics of the patients. However, there were marked differences in the tissues between the first and second biopsies in group I regarding the uPAR and FGF-2 levels. Moreover, at the ultrastructural level, superficial microvilli and deep basal interdigitations of cells were identified in the first biopsy, while microvilli disappeared and basal interdigitations smoothed out in the second biopsy, and in both biopsies of group 2. No important differences were found between the first and second biopsies in group 2. There was no statistically significant difference between the groups with respect to apoptosis. Conclusion: In conclusion, the fact that the reactions seen in the pericardium of patients undergoing cardiac surgery for the first time are absent in patients undergoing cardiac surgery for the second time suggests that the structure of the pericardium deteriorates as a whole.
    No preview · Article · Oct 2011 · Turkish Journal of Thoracic and Cardiovascular Surgery
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    Preview · Article · Nov 2010 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
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    ABSTRACT: The purpose of this retrospective study was to determine the results of coronary artery surgery in the elderly patients and to compare the outcome with a younger group. Two hundred thirteen patients aged 70 years and older who underwent on-pump coronary artery surgery were retrospectively studied and data were compared with those of 524 patients aged 50–69. The groups were similar with respect to preoperative characteristics except for sex distribution and the incidences of peripheral vascular disease and prior cerebrovascular accident. The use of internal mammarian artery grafts was significantly lower in the elderly patients (80.3% versus 91.6%, p<0.001). The 30-day mortality for the elderly group was 4.7% while that of younger group was 2.3%. The elderly patients had a significantly higher incidence of postoperative low cardiac output, pulmonary complications and acute renal failure. The elderly group also had also significantly longer intensive care unit length of stay (1.9 versus 1.7 days, p=0.006) and postoperative length of stay (10.1 versus 7.4 days, p<0.001). Although mortality and complication rates are higher, coronary artery surgery can be performed with acceptable risk in the elderly patients. Old age alone should not be a deterrent factor for surgical revascularization in coronary artery disease.
    Preview · Article · Jun 2009 · Central European Journal of Medicine
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    Full-text · Article · May 2009 · Asian cardiovascular & thoracic annals
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    ABSTRACT: To investigate the effects of lidocaine on the morphology of saphenous veins (SVs) harvested during coronary artery bypass graft (CABG) surgery. This experimental study was conducted at the Cardiovascular Surgery Department, Gazi University, Ankara, Turkey, between May and September 2007. The SVs from 11 patients who underwent CABG surgery were divided into 3 segments. Each segment from the same location of the grafts was allocated into 3 groups as control group (group C), physiologic saline group (group PS), and lidocaine group (group L). Nitric oxide synthase (NOS), nitric oxide (NO) pool, super oxide dismutase (SOD), and thiobarbituric acid reactive substances (TBARS) levels were measured in the samples from the groups. Histologic specimens were evaluated according to previously defined criteria, and scored accordingly. Histological examination of the grafts in groups L and C were similar, but histological scoring of grafts in group PS were statistically higher than group C (p=0.008). Nitric oxide synthase activity and NO pool were higher in groups L and PS than in group C (p=0.010). Super oxide dismutase activity was higher in group L than in group PS (p=0.008). Super oxide dismutase activity was lower in group PS than in group C (p=0.047). There was no significant difference between TBARS level in all groups. Our results indicate that primary damage might occur during surgery due to traumatic handling of the graft, and succeeding injuries could occur due to ischemia-reperfusion injury during the waiting period. Adding lidocaine to the preservation solution will protect later injury.
    Full-text · Article · Mar 2009 · Saudi medical journal
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    ABSTRACT: Introduction: Behçet's syndrome (BS) is a vasculitis characterized with oral and genital ulcers and uveitis. Vascular involvement is a serious cause for mortality and morbidity including both arteries and veins of all sizes. The aim of this study was to determine, the prevalence of BS among patients presenting with deep vein thrombosis (DVT) in routine cardiovascular surgery outpatient clinic. Material and methods: One hundred and sixteen patients presenting with signs and symptoms of DVT in our cardiovascular surgery outpatient unit were reviewed between 2005 and 2007. All the patients were searched for the symptoms of BS: history or presence of oral aphthae, genital ulcers, uveitis, erythema nodosa, arthritis or arthralgia, and thrombophlebitis. Routine laboratory blood tests as well as specific thrombotic markers were checked. Pathergy skin test was performed and evaluated at 48 h in suspected individuals. Results: Nine patients were diagnosed with BS. The prevalence of BS among patients presenting with a clinic of DVT in our cardiovascular outpatient unit was 7.5%. Only one of the patients with BS was female. The mean age of the patients was 38.9 years (range: 29-62 years). The patients with BS were significantly younger than the non-BS patients (p < 0.05). Interestingly, only one patient with DVT was previously diagnosed as BS. Conclusions: It is important to keep in mind the differentital diagnosis of Behçet's syndrome in a cardiovascular outpatient clinic.
    No preview · Article · Jan 2009 · Archives of Medical Science
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    Full-text · Article · Jan 2009