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    Anal atresia, abnormal genitalia, and absent thumb : congenital malformations associated with mosaic ring chromosome 13
    (Medecine Et Hygiene, 2013) Ocak, Zeynep; Özlü, Tülay; Vural, Mehmet
    Anal atresia, abnormal genitalia, and absent thumb: congenital malformations associated with mosaic ring chromosome 13: Because of the deletion of a segment of the chromosome during the formation of a ring, several clinical findings may be associated with ring chromosomes. Ring chromosome 13 is one of such disorders in which the genotype-phenotype correlation is stronger by virtue of the accumulating literature. It can be associated with multiple congenital abnormalities and severe mental retardation. We report a case with mosaic ring chromosome 13 whose prenatal ultrasound revealed bilateral ventriculomegaly. Anal atresia, unidentifiable external genitalia, and an absent thumb were observed in the postmortem examination.
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    Anal atresia, abnormal genitalia, and absent thumb: Congenital malformations associated with mosaic ring chromosome 13
    (2013) Ocak, Zeynep; Ozlu, T.; Vural, M.
    Because of the deletion of a segment of the chromosome during the formation of a ring, several clinical findings may be associated with ring chromosomes. Ring chromosome 13 is one of such disorders in which the genotype-phenotype correlation is stronger by virtue of the accumulating literature. It can be associated with multiple congenital abnormalities and severe mental retardation. We report a case with mosaic ring chromosome 13 whose prenatal ultrasound revealed bilateral ventriculomegaly. Anal atresia, unidentifiable external genitalia, and an absent thumb were observed in the postmortem examination.
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    Are there any genotoxic effects of laser epilation applications on human? an observational study
    (Mrs Deepika Charan, 2014) Ocak, Zeynep; Özlü, Tülay; Taşdemir, Şener; Bilen, Handan; Kocaman, Ertuğrul Mevlüt
    Background: Laser epilation is a method of removal of unwanted hair from the body and its use for this cosmetic purpose is gaining increasing popularity. Sister chromatid exchange (SCE) is a critical method for determining genotoxicity caused by several mutagens and carcinogens under in vivo and in vitro conditions. Aims & Objective: In this study, we aimed to determine whether removal of unwanted hair by laser epilation causes genotoxicity in women undergoing this procedure. Materials and Methods: 40 voluntary women who admitted to the dermatology clinics for the removal of unwanted hair by laser epilation were included. Skin types of all patients were classified according to Fitzpatrick Scale. Laser epilation was applied by Alexandrite (Light Age Epicare Duo) at a 755 nm wavelength laser. The possible genotoxic effects in women who had laser epilation to the whole leg (upper and lower leg) and face was investigated by the SCE method. Results: The blood samples that were drawn before and 24 hours after the laser application showed no significant differences between the SCE frequencies (p>0.05). Conclusion: We could not find any significant genotoxic effect of laser epilation in women undergoing this procedure. As far as we know, this is the first study that investigates the relationship between laser applications and genotoxic effects.
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    Association of recurrent pregnancy loss with chromosomal abnormalities and hereditary thrombophilias
    (Makerere Univ, Fac Med, 2013) Ocak, Zeynep; Özlü, Tülay; Özyurt, Osman
    Background: Recurrent pregnancy loss (RPL) which is generally known as > 3 consecutive pregnancy losses before 20 weeks' gestation is seen in 0.5-2% of women Objective: To evaluate the association of parental and fetal chromosomal abnormalities with recurrent pregnancy loss in our area and to analyze the frequency of three types of hereditary thrombophilia's; (MTHFR C677T polymorphisms, FV Leiden G1691A mutation and Prothrombin (factor II) G20210A mutation) in these female patients. Methods: The present case-control retrospective study was performed between February 2007 and December 2011 on 495 couples, who had two or more consecutive pregnancy losses before 20 weeks' gestation. We used conventional cytogenetic analysis and polymerase chain reaction-restriction fragment length polymorphism. Results: Parental chromosomal abnormality was detected in 28 cases (2.8% of all cases, 5.7% of the couples) most of which (92.9%) were structural abnormalities. All of the structural abnormalities were balanced chromosomal translocations. Chromosomal analysis performed from the abortion materials detected a major chromosomal abnormality in 31.9% of the cases. The most frequently observed alteration in the hereditary thrombophilia genes was heterozygote mutation for the MTHFR C677T polymorphisms (n=55). Conclusion: Balanced translocations are the most commonly detected chromosomal abnormalities in couples being evaluated for recurrent pregnancy loss and these patients are the best candidates for offering prenatal genetic diagnosis by the help of which there is a possibility of obtaining a better reproductive outcome.
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    Association of toll-like receptors 2, 3, and 4 genes polymorphisms with periapical pathosis risk
    (Medicina Oral S L, 2016) Özan, Ülkü; Ocak, Zeynep; Özan, Fatih; Oktay, Elif-Aybala; Toptaş, Orçun; Şahman, Halil; Yıkılgan, İhsan; Oruçoğlu, Hasan
    Background: The aim of this study was to investigate the role of gene variations of Toll-like receptors (TLR) 2, 3, and 4 on genetic susceptibility to periapical pathosis. Material and Methods: One hundred patients were included in the study and divided into two groups as follows; Control Group (n=50) that have root canal treatment and no periapical lesion, Patient Group (n=50) that have root canal treatment and periapical lesion. TLR2 Arg753Gln, TLR3 (c.1377C/T) and TLR4 Asp299Gly and Thr399Ile polymorphisms were genotyped by using PCR-RFLP. Genotypical analysis of control and patient groups were investigated to disclose whether there is any association between periapical lesions and gene variations. Results: There are no significant statistical differences between control and patient groups according to TLR 2 and 4 gene sequence. On the contrary, CC allele detected 74% for TLR 3 in patient group, and this difference was found to be statistically significant (p < 0.005). Conclusions: According to these results, it can be suggested that patients with Toll-like receptor 3 gene polymorphisms could be susceptible to periapical pathosis.
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    Becker musküler distrofili geniş bir ailede moleküler ve klinik değerlendirme
    (2010) Tuğ, Esra; Atasoy, Halil İbrahim; Aydın, Hatip; Ocak, Zeynep
    Amaç: Becker Müsküler Distrofi (BMD), sıklıkla distrofin geni içindeki fonksiyonel proteinin kısmen değişmesine neden olan mutasyonlar sonucu oluşur. Hipospadias nedeniyle cerrahi operasyon planlanan 9 yaşında bir erkek çocuk rutin kan testleri sırasında artmış serum kreatin kinaz (CK) aktivitesi nedeniyle değerlendirilmek üzere kliniğimize sevk edildi. Probandın 11 yaşındaki kardeşinin serumunda yüksek CK tespit edilmesi ve 2., 3. ve 5. dereceden akrabalarında yüksek CK ve kas güçsüzlüğü bulgularının olması nedeniyle probanda ve kardeşine distrofin geninin moleküler analizi yapılması planlandı. Yöntem: Probanda ve erkek kardeşine distrofin geninin 3, 4, 8, 12, 17,19, 32, 34, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51 ve 52 ekzonları için moleküler genetik analiz yapıldı. DNA 'larının izolasyonu sonrasında multipleks PCR uygulandı ve ürünler agaroz jelde görüntülendi. Bulgular: Bu moleküler analiz ile, probandın ve erkek kardeşinin distrofin geninin 13-19 ekzonlarını içeren bir delesyon taşıyıcısı oldukları gösterildi. Yaş ortalamaları 9-25 arasında değişen ve artmış CK aktivitesi gösteren aile üyelerinin hiçbirinde klinik bulgu mevcut değildi. Probandın 40 yaşında olan dayısı orta derecede kas güçsüzlüğü, annesinin dayısı (60) ise ciddi kas güçsüzlüğü göstermekteydi. Sonuçlar: Moleküler bulgulara dayanılarak, klinik semptomların gelişimi BMD tanısı ile açıklanabilir; ayrıca, ailenin ilk dekadlarda asemptomatık olduğu söylenebilir. Bu rapor, presemptomatik BMD vakalarında, biyokimyasal belirteçler ışığında yapılan moleküler çalışmalar ve ayrıntılı ailesel sorgulanmaların erken tanısal değerini ortaya koymaktadır.
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    Clinical and cytogenetic results of a large series of amniocentesis cases from Turkey: report of 6124 cases
    (Wiley, 2014) Ocak, Zeynep; Özlü, Tülay; Yazıcıoğlu, Hasan Fehmi; Özyurt, Osman; Aygün, Mehmet
    AimThe aim of this study was to document the clinical and cytogenetic results of a large series of amniocentesis (AS) cases from Turkey. Material and MethodsSecond-trimester amniocentesis cases performed in Suleymaniye Maternity Hospital for Research and Training between January 2007 and December 2011 were included. ResultsDuring this period, 6124 AS were performed. Indications were increased risk in maternal serum screening (MSS) (56%), advanced maternal age (29%) and pathologic ultrasound finding (11.5%). Most frequent MSS abnormality was abnormal triple test result (58%). Overall culture success rate was 98.8%. Chromosomal abnormality was detected in 215 (3.6%) of the 6052 cytogenetic results (74.9% numerical, 25.1% structural). Most frequent numerical chromosomal abnormality was trisomy 21 (61.9%). Clinically insignificant polymorphisms were the most frequent structural changes (n=571). Most frequent polymorphism was increase in heterochromatin region in the 1st chromosome (n=158). Advanced maternal age had a positive predictive value of 5.2%. Among the MSS tests, the combined test had the highest positive predictive value (5.2%). ConclusionsIn our study, abnormal MSS (and among these, abnormal triple test result) was the most frequent indication for amniocentesis. Our overall culture success rate was 98.8%. Frequency of major chromosomal abnormality was 3.2% and trisomy 21 was the most frequent abnormality.
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    Clinical and prognostic importance of chromosomal abnormalities, Y chromosome microdeletions, and CFTR gene mutations in individuals with azoospermia or severe oligospermia
    (Tubitak Scientific & Technical Research Council Turkey, 2014) Ocak, Zeynep; Üyetürk, Uğur; Dinçer, Muhammet Murat
    Aim: To illustrate the importance of genetic screening in the assessment of fertility and the correct diagnosis in patients with azoospermia or severe oligospermia. Materials and methods: This study examined 500 patients with reproductive failure, having fewer than 5 million sperm/mL detected in at least 2 consecutive spermiograms, who presented at a medical genetics polyclinic between 2008 and 2012. Metaphase preparations obtained from cell cultures were stained by trypsin-Giemsa banding. After DNA isolation, Y chromosome loci, including AZFa (SY84, SY86), AZFb (SY127, SY134), AZFc (SY254 SY255), and AZFd, were amplified by polymerase chain reaction using specific primers. Thirty-five patients with congenital unilateral absence of the vas deferens or congenital bilateral absence of the vas deferens (CBAVD) and a positive cystic fibrosis family history were evaluated for cystic fibrosis transmembrane conductance regulator gene mutations. Results: No chromosomal abnormalities were noted in 440 (88%) of the 500 patients, whereas structural or numerical chromosomal abnormalities were detected in 60 patients (12%). Individuals with Y deletions made up 5.6% (n = 28) of the study sample. Three patients with no AZF deletion or chromosomal abnormality, but with CBAVD, were heterozygous for I148T, G1130A, or IVS3 406-3T> C mutations. Conclusion: This study shows that genetic testing can make an important contribution to the treatment of patients planning in vitro fertilization due to azoospermia or severe oligospermia.
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    CLINICAL AND PROGNOSTIC SIGNIFICANCE OF GENETIC FACTORS IN RECURRENT IN-VITRO FERTILIZATION FAILURES
    (Galenos Yayincilik, 2013) Ocak, Zeynep; Ozlu, Tulay
    In 1978, a new era has started in the treatment of infertility by the birth of the first baby from a pregnancy achieved by in-vitro fertilization. Following this, healthy pregnancies have been achieved by assisted reproductive techniques such as in-vitro fertilization by an important percentage of the childless couples. Despite all developments in assisted reproductive techniques, pregnancy rates haven't increased as expected, and unfortunately the rate of implantation success of transferred embryos remained at low levels (15%). Similar to recurrent pregnancy loss in which the etiology is not clear yet and the causes are probably multifactorial, evaluation of patients with recurrent implantation failure is difficult and complex. Genetic risk factors such as genomic rearrangements in the couples and the embryo, sperm DNA damage and imprinting defects have been considered among the causes of recurrent implantation failure. Genetic screening is an integral part of providing good medical care of patients and families receiving a diagnosis of a genetic disorder. The aim of preconceptional genetic screening is to asses the fertility, to be able to increase success rate of infertility treatments and to detect the healthy carriers who may have a baby with the risk of fatal and/or multiple congenital anomalies. In this review, possible genetic factors associated with recurrent implantation failure are discussed in the light of the current literature.
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    Dirençli epilepsi olgusunda mozaik ring kromozom 6 ve klinik önemi
    (2012) Ocak, Zeynep; Göksügür, Sevil Bilir; Kocaman, Ertuğrul Mevlüt
    Epilepsi, merkezi sinir sisteminde (MSS) bir grup nöronun ani, anormal, aşırı ve senkronize deşarjları sonucu ortaya çıkan nöbetlerle seyreden nörolojik bir hastalıktır (1). Epilepsili hastaların yaklaşık %40’ının etiolojisinde monojenik, kromozomal ve çok etmenli kalıtımlı genetik hastalıklar bulunmaktadır (2). Epilepsi ile birliktelik gösteren kromozomal bozuklukların çoğunda çok önemli dismorfik özellikler bulunmaktadır (3). Biz tedaviye dirençli epilepsi ile kliniğimize yönlendirilen periferik kandan kromozom analizi sonucu mos 47,XY,+r(6)[3]/ 46,XY, r(6)[40]/ 45,XY,-6[7] olarak bulunan yedi yaşındaki erkek hastayı sunduk. Bu olgu üzerinden epilepside klinik ve temel mekanizmaların anlaşılmasında sitogenetik tekniklerin kullanımı ve çok disiplinli çalışmanın önemini tartışmayı amaçladık.
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    Effect of hypericin on the ADAMTS-9 and ADAMTS-8 gene expression in MCF7 breast cancer cells
    (Verduci Publisher, 2013) Ocak, Zeynep; Acar, Muradiye; Gündüz, E.; Gündüz, Mehmet; Demircan, Kadir; Üyeturk, Ümmügül; Özlü, Tülay
    AIM: To investigate the effects of hypericin which is obtained from the plant Hypericum perforatum on the expression and the regulation of ADAMTS8 and ADAMTS9 genes in MCF7 breast cancer cells and on the viability of these cells. MATERIALS AND METHODS: MCF7 cells were cultured and were separately exposed to 2, 10 and 50 mu l/mL of hypericin. After 24 hours, RNA was isolated from these cells and converted to cDNA. The expression levels of ADAMTS8 and ADAMTS9 genes were evaluated using the Reverse Transcription Polymerase Chain Reaction. XTT (2,3-bis-( 2-methoxy-4-nitro-5-sulfophenyl)-2Htetrazolium-5-carboxanilide, disodium salt) cell viability assay was used to determine cytotoxicity. RESULTS: ADAMTS9 expression in MCF7 cells were increased 1.8 and 3.6 fold with the use of 2 and 10 mu l/mL of hypericin, respectively; and decreased 0.7 fold with the use of 50 mu l/mL of hypericin. There was no significant change in the ADAMTS8 expression. Rapid cell death was observed in the cancer cells when hypericin was used at a dose of >= 50 mu l/mL. CONCLUSIONS: The increase in ADAMTS9 expression can be a useful factor in the prevention of possible metastasis in breast cancer and for the occurrence of a tumor suppressive effect. Hypericin increases the expression of ADAMTS9, therefore, it may show its antitumoral and anti-apoptotic effects by means of ADAMTS9.
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    The effects of hypericin on ADAMTS and p53 gene expression in MCF-7 breast cancer cells
    (Imprimatur Publications, 2014) Acar, Muradiye; Ocak, Zeynep; Erdoğan, Kübra; Çetin, Elif Nihan; Hatipoğlu, Ömer Faruk; Üyetürk, Ümmügül
    Purpose: The purpose of this study was to determine the effects of hypericin on MCF-7 (Michigan Cancer Foundation-7) breast cancer cells, as it is known to exert an antitumor effect on the expression and regulation of ADAMTS1, 3, 10 and the p53 gene in breast cancer cells. Methods: MFC-7 cells were cultured and subjected separately to various doses (1, 5 and 7.5 mu g/mL) hypericin. After 24 hrs, RNA was isolated and transcribed into cDNA. Expression analysis was performed by real time (RT)-PCR and cell survival was determined by the XTT assay. Results: While the expression of ADAMTS1 in MFC-7 cells decreased to 0.04-fold after exposure to 1 mu g/mL hypericin, the expression increased by 5.6- and 36-fold with 5 and 7.5 mu g/mL, respectively. Furthermore, ADAMTS3 expression in MCF7 cells increased 3.9-fold with the use of 5 mu g/mL of hypericin. These concentrations of hypericin did not lead to significant changes in the expression of ADAMTS10 and the p53 gene. Viability of cancer cells as evaluated by the XTT assay showed that hypericin concentration of 7.5 mu g/mL led to increased apoptosis of cancer cells. Conclusion: The increase in ADAMTS1 expression may prevent metastasis or facilitate the development of an adjuvant factor with tumor-suppressive effects. Hypericin may therefore exert its antitumor and apoptotic effects in MFC-7 cells via ADAMTS1 and ADAMTS3.
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    Frequency of MEFV mutation and genotype-phenotype correlation in cases with dysmenorrhea
    (Wiley-Blackwell, 2013) Ocak, Zeynep; Ocak, Tarık; Duran, Arif; Özlü, Tülay; Kocaman, Ertuğrul Mevlüt
    AimWe aimed to investigate the relation between mutations and polymorphisms playing roles in the onset of clinical findings of Familial Mediterranean Fever (FMF) and clinical phenotypic reflections manifesting with painful episodes, such as dysmenorrhea. Material and MethodsA total of 1000 female patients who had not responded well to non-steroidal anti-inflammatory drugs in the menstrual period, and who had presented to the emergency room with the complaint of recurrent pain episodes were included in the study. All the patients were Turkish women living in Istanbul. In this study, the mutations most frequently seen in the Mediterranean Fever Gene (MEFV), namely M694V, E148Q, M680I(G/C), V726A, P369S, R761H, A744S, M694I, K695R, F479L, M680I(G/A), and I692del were examined using the DNA sequence analysis following DNA isolation. ResultsThe number of individuals who had a mutation in at least one allele for FMF was 511 out of 1000 patients. Of these 511 patients, homozygous mutations were found in 21% (n=109), compound heterozygous mutations were found in 27% (n=136), and heterozygous mutations were found in 52% (n=266). The most frequent homozygous genotype seen in our study population was M694V/M694V. The most common compound heterozygote genotypes were M694V/M680I, M694V/V726A, M694V/E148Q, and M680I/V726A; and 11.7% (n=60) of the families in whom mutations were found had consanguinity. ConclusionWomen who present to the emergency room with the complaint of dysmenorrhea that is irresponsive to non-steroidal anti-inflammatory drugs may have several types of MEFV mutations that are responsible for FMF.
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    Mosaic ring chromosome 6 and clinical significance in resistant epilepsy
    (Turkish Pediatrics Assoc, 2012) Ocak, Zeynep; Goksugur, Sevil Bilir; Kocaman, Ertugrul Mevlut
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    Polymorphisms of toll-like receptors 2, 3 and 4 in patients that do and do not enter labour spontaneously at term
    (Taylor & Francis Inc, 2014) Özlü, Tülay; Ocak, Zeynep; Simavlı, Serap Aynur; Karataş, Ahmet
    To assess the association of polymorphisms of toll-like receptors (TLRs) 2, 3 and 4 with the delay in onset of labour at term pregnancies, patients delivering at >37 weeks and without pre-eclampsia, IUGR or a history of preterm delivery were prospectively evaluated. TLR2 Arg753Gln, TLR3 (c.1377C/T) and TLR4 Asp299Gly and Thr399Ile polymorphisms were genotyped by using PCR-RFLP. Patients labouring spontaneously before the 41st week were compared with those who did not labour spontaneously until this week in terms of baseline characteristics, TLR 2, 3 and 4 polymorphisms. The same comparisons were also performed by using a 40th week cut-off. Chi-square test, two-sample t-test or Mann-Whitney U tests were used for comparisons, as appropriate. In total, 79 patients delivering after 37 weeks were evaluated. All had CC genotype for TLR2 Arg753Gln and TLR4 Thr399Ile. There were no significant differences for TLR4 Asp299Gly GA and TLR3 (c.1377C/T) polymorphisms between patients spontaneously entering or not entering labour until the 41st week; the same was true when the 40th week cut-off was used. Delay in onset of labour at term pregnant women does not seem to be affected by the presence of TLR 2, 3 or 4 polymorphisms. Further studies are needed.
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    Prenatal detection of pai syndrome without cleft lip and palate : a case report
    (Medecine Et Hygiene, 2013) Ocak, Zeynep; Yazıcıoğlu, Hasan.Fehmi; Aygün, Mehmet; İlter, M. K. İnan; Özlü, Tülay
    Prenatal detection of Pal syndrome without cleft lip and palate: a case report: Pai syndrome is a rarely encountered disease characterized by findings of median cleft lip, facial skin polyps, nasal mucosal polyps and midline central nervous system lipoma. We report a case with prenatal detection of a pericallosal lipoma and a skin tag on the forehead. After delivery, the diagnosis was confirmed as a case of Pai syndrome.
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    Prenatal detection of Pai syndrome without cleft lip and palate: A case report
    (2013) Ocak, Zeynep; Yazicioglu, H.F.; Aygun, M.; Ilter, M.K.I.; Ozlu, T.
    Pai syndrome is a rarely encountered disease characterized by findings of median cleft lip, facial skin polyps, nasal mucosal polyps and midline central nervous system lipoma. We report a case with prenatal detection of a pericallosal lipoma and a skin tag on the forehead. After delivery, the diagnosis was confirmed as a case of Pai syndrome.
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    Protective effects of montelukast and Hypericum perforatum against intestinal ischemia-reperfusion injury in hamsters
    (2014) Ocak, Tarık; Duran, Arif; Özyalvaçlı, Gülzade; Ocak, Zeynep; Terzi, Elçin Hakan; Tosun, Mehmet; Erdem, Kemalettin
    Aim: To evaluate the effects of montelukast and Hypericum perforatum against ischemia/reperfusion (I/R)-induced intestinal damage. Materials and methods: Twenty-eight hamsters were divided into 4 groups following midline abdominal laparotomy: control group (n = 7), I/R group (n = 7), montelukast and I/R (MIR) group (n = 7), and Hypericum perforatum and I/R (HPIR) group (n = 7). After 60 min of ischemia through obstruction of the superior mesenteric artery, 24 h of reperfusion was maintained. Ten minutes prior to the reperfusion period, the MIR group received 7 mg/kg of intraperitoneal montelukast and the HPIR group received 7 mg/kg of intraperitoneal Hypericum perforatum. Malondialdehyde, glutathione, myeloperoxidase, and cardiotrophin-1 levels were measured from blood samples. A semiquantitative histological evaluation was performed. Results: Montelukast and Hypericum perforatum significantly reduced malondialdehyde levels and increased glutathione levels compared to the I/R group (P < 0.008). A statistically significant difference was also found between the I/R group and MIR and HPIR groups in terms of myeloperoxidase levels (P < 0.008). The MIR and HPIR groups showed increased cardiotrophin-1 levels compared to the control and I/R groups (P < 0.008 for all). The MIR and HPIR groups showed significantly lower histological scores compared to the I/R group (P = 0.03 and P = 0.007, respectively). Conclusion: This study demonstrated the preventive effects of montelukast and Hypericum perforatum on I/R-induced intestinal injury
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    Serum and aqueous xanthine oxidase levels, and mRNA expression in anterior lens epithelial cells in pseudoexfoliation
    (Springer, 2015) Simavlı, Hüseyin; Tosun, Mehmet; Bucak, Yasin Yücel; Erdurmuş, Mesut; Ocak, Zeynep
    The aim of this study was to determine serum and aqueous xanthine oxidase (XO) levels, and mRNA expression in anterior lens epithelial cells in pseudoexfoliation (PEX). In this prospective study, serum, aqueous and anterior lens capsules were taken from 21 patients with PEX and 23 normal subjects who had undergone routine cataract surgery. Serum and aqueous XO levels were analyzed using the colorimetric method. mRNA expression of XO in anterior lens epithelial cells was evaluated using reverse transcription polymerase chain reaction analysis. Serum XO levels (means +/- standard deviations) were 207.0 +/- 86.1 IU/mL and 240.6 +/- 114.1 IU/mL in the normal and PEX groups, respectively (p = 0.310). Aqueous XO levels (means +/- standard deviations) were 65.5 +/- 54.3 IU/mL in the normal group and 130.5 +/- 117.4 IU/mL in the PEX group (p = 0.028). There was a 2.9 fold decrease in mRNA expression in anterior lens epithelial cells of PEX, which is significantly lower than the normal group (p = 0.01). Higher aqueous XO levels lacking associated different serum XO suggests higher oxidative stress in the aqueous. Higher aqueous XO levels in PEX with decreased mRNA expression in anterior lens epithelial cells indicate possible overexpression of XO in other structures related to the aqueous.