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Stone HM, Unal E, Romano TA, Turner PE. Beluga whale and bottlenose dolphin ACE2 proteins allow cell entry mediated by spike protein from three variants of SARS-CoV-2. Biol Lett 2023; 19:20230321. [PMID: 38053365 PMCID: PMC10698476 DOI: 10.1098/rsbl.2023.0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/14/2023] [Indexed: 12/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viruses infect numerous non-human species. Spillover of SARS-CoV-2 into novel animal reservoirs may present a danger to host individuals of these species, particularly worrisome in populations already endangered or threatened by extinction. In addition, emergence in new reservoirs could pose spillback threats to humans, especially in the form of virus variants that further mutate when infecting other animal hosts. Previous work suggests beluga whales (Delphinapterus leucas) and bottlenose dolphins (Tursiops truncatus) may be at risk owing to their formation of social groups, contact with humans, exposure to contaminated wastewater, and structure of their angiotensin-converting enzyme 2 (ACE2) proteins, which SARS-CoV-2 uses as a cellular receptor. We examined marine-mammal susceptibility to virus infection by challenging 293T cells expressing beluga or dolphin ACE2 with pseudovirions bearing the SARS-CoV-2 spike protein. Beluga and dolphin ACE2 were sufficient to allow cell entry by an early pandemic isolate (Wuhan-Hu-1) and two evolved variants (Delta B.1.617.2 and Omicron BA.1 strains). We conclude that SARS-CoV-2 poses a potential threat to marine mammal reservoirs that should be considered in surveillance efforts.
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Affiliation(s)
- H. M. Stone
- Graduate Program in Microbiology, Yale School of Medicine, New Haven, CT 06520, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT 06520, USA
| | - E. Unal
- Sea Research Foundation, Inc. d/b/a Mystic Aquarium, Mystic, CT 06355, USA
- Department of Marine Sciences, University of Connecticut Avery Point Campus, Groton, CT 06340, USA
| | - T. A. Romano
- Sea Research Foundation, Inc. d/b/a Mystic Aquarium, Mystic, CT 06355, USA
- Department of Marine Sciences, University of Connecticut Avery Point Campus, Groton, CT 06340, USA
| | - P. E. Turner
- Graduate Program in Microbiology, Yale School of Medicine, New Haven, CT 06520, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT 06520, USA
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Schuetz C, Gerke J, Ege M, Walter J, Kusters M, Worth A, Kanakry JA, Dimitrova D, Wolska-Kuśnierz B, Chen K, Unal E, Karakukcu M, Pashchenko O, Leiding J, Kawai T, Amrolia PJ, Berghuis D, Buechner J, Buchbinder D, Cowan MJ, Gennery AR, Güngör T, Heimall J, Miano M, Meyts I, Morris EC, Rivière J, Sharapova SO, Shaw PJ, Slatter M, Honig M, Veys P, Fischer A, Cavazzana M, Moshous D, Schulz A, Albert MH, Puck JM, Lankester AC, Notarangelo LD, Neven B. Hypomorphic RAG deficiency: impact of disease burden on survival and thymic recovery argues for early diagnosis and HSCT. Blood 2023; 141:713-724. [PMID: 36279417 PMCID: PMC10082356 DOI: 10.1182/blood.2022017667] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Patients with hypomorphic mutations in the RAG1 or RAG2 gene present with either Omenn syndrome or atypical combined immunodeficiency with a wide phenotypic range. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but data are scarce. We report on a worldwide cohort of 60 patients with hypomorphic RAG variants who underwent HSCT, 78% of whom experienced infections (29% active at HSCT), 72% had autoimmunity, and 18% had granulomas pretransplant. These complications are frequently associated with organ damage. Eight individuals (13%) were diagnosed by newborn screening or family history. HSCT was performed at a median of 3.4 years (range 0.3-42.9 years) from matched unrelated donors, matched sibling or matched family donors, or mismatched donors in 48%, 22%, and 30% of the patients, respectively. Grafts were T-cell depleted in 15 cases (25%). Overall survival at 1 and 4 years was 77.5% and 67.5% (median follow-up of 39 months). Infection was the main cause of death. In univariable analysis, active infection, organ damage pre-HSCT, T-cell depletion of the graft, and transplant from a mismatched family donor were predictive of worse outcome, whereas organ damage and T-cell depletion remained significant in multivariable analysis (hazard ratio [HR] = 6.01, HR = 8.46, respectively). All patients diagnosed by newborn screening or family history survived. Cumulative incidences of acute and chronic graft-versus-host disease were 35% and 22%, respectively. Cumulative incidences of new-onset autoimmunity was 15%. Immune reconstitution, particularly recovery of naïve CD4+ T cells, was faster and more robust in patients transplanted before 3.5 years of age, and without organ damage. These findings support the indication for early transplantation.
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Affiliation(s)
- C. Schuetz
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Gerke
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M. Ege
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
| | - J. Walter
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - M. Kusters
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - A. Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - J. A. Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - D. Dimitrova
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - B. Wolska-Kuśnierz
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - K. Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - E. Unal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - M. Karakukcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - O. Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - J. Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
| | - T. Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - P. J. Amrolia
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - D. Berghuis
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - D. Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
| | - M. J. Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. R. Gennery
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - T. Güngör
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
| | - J. Heimall
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - M. Miano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - I. Meyts
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
| | - E. C. Morris
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
| | - J. Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S. O. Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - P. J. Shaw
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
| | - M. Slatter
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - M. Honig
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - P. Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Fischer
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
| | - M. Cavazzana
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - D. Moshous
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - A. Schulz
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - M. H. Albert
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
| | - J. M. Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. C. Lankester
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - L. D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - B. Neven
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
| | - Inborn Errors Working Party (IEWP) of the European Society for Immunodeficiencies (ESID) and European Society for Blood and Marrow Transplantation (EBMT) and the Primary Immune Deficiency Treatment Consortium (PIDTC)
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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Gulle H, Yuceturk H, Sakar C, Joyner C, Marsh W, Unal E, Morrissey D, Yet B. Can Bayesian statistical approaches reduce the questionnaire burden for respondents when PROMs and PREMs are administered electronically? Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Soran O, Karadeniz PG, Uygunlar M, Hengirmen B, Durak T, Tibet BN, Inan MF, Cepik EH, Unal E, Saglam BA. The gender differences in the implementation and maintenance of a structured-enhanced education and follow-up program in primary prevention for coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Primary prevention programs for coronary artery disease (CAD) may be effective in improving health-related behavioral outcomes. However, successful implementation and maintenance of these programs can vary amongst genders. The primary aim of this study is to assess the gender differences in a structured, enhanced education and follow-up program for CAD prevention in an area where the diverse population and economy are major problems.
Methods
SANKO CAD Prevention Project (SCAD-PPI) was designed as a longitudinal study and utilized medical school students to conduct the project under the supervision of professors. It began in 2014 and had two different education and training phases. In the first phase, every school year for second year Medical students underwent a year-long, especially designed training program on primary prevention for CAD. In the second phase, which took place in the second year of the study, a series of conferences regarding the primary prevention for CAD were organized by the University and local municipalities for underserved populations. Participants were prospectively assigned to an intervention where pre- and post-conference knowledge was collected and assessed. Every intervention was conducted by specially trained third year Medical students and an education booklet, which was specially designed for the study, was given to the participants. Every other month thereafter, for 6 months, each participant was followed-up via phone calls. At the 6 months follow -up, data was collected to assess the impact of the program on behavioral outcomes. Every year a new class assigned to undergo the same training program and serve to the local population at different locations within the same city and suburbs.
Results
A total of 172 participant were enrolled; 61% were women, mean age was 40±11.9 years with no significant difference in between the groups.; 67% of women were not working (p<0.001). While BMI rates were higher in women (27.9±5.5 kg/m2, p<0.016), smoking rates were higher in men (p<0.001). Overall, knowledge on CAD risk factors, primary prevention measures, diet, and daily exercise habits were poor in both groups. After the enhanced education and follow-up program there was a significant improvement on the knowledge of CAD risk factors and primary prevention measures in both groups (p<0.001). Importantly, the follow-up program led both groups to implement those positive changes into their lives and maintain a healthy lifestyle.
Conclusion
This is the first study which showed that a longitudinally structured training program of medical students could be utilized to implement an enhanced education and follow–up program for primary prevention of CAD in an economically challenged, underserved population with successful outcomes in both genders. This model program is not only beneficial for public interest, but also enhances active interaction of medical students with patients at a very early stage of their career.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- O Soran
- Cardiovascular Institute,University of Pittsburgh, Pittsburgh, United States of America
| | | | | | | | - T Durak
- SANKO University, Gaziantep, Turkey
| | | | - M F Inan
- SANKO University, Gaziantep, Turkey
| | | | - E Unal
- SANKO University, Gaziantep, Turkey
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Unal E, Karakaya AA, Beştaş A, Yıldırım R, Taş FF, Onay H, Özkınay F, Haspolat YK. Identification of four novel variant in the AMHR2 gene in six unrelated Turkish families. J Endocrinol Invest 2021; 44:1301-1307. [PMID: 33025551 DOI: 10.1007/s40618-020-01437-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/26/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Persistent Müllerian duct syndrome (PMDS) is characterized by the persistence of Müllerian structures in male with normal phenotype. Most cases occur as a result of mutations in the anti-Müllerian hormone (AMH) or AMHR2 genes. In this study, we aim to discuss the results of clinical, laboratory, and molecular genetic analysis of cases detected to have AMHR2 gene mutation. METHODS A total of 11 cases from 6 families were included in the study. AMHR2 gene mutation analyses were performed by sequencing of the coding exons and the exon-intron boundaries of the genes. The American College of Medical Genetics guidelines were used for the classification of the detected variants. RESULTS Six of the 11 cases were admitted due to bilateral undescended testes and five cases due to inguinal hernia (three transverse testicular ectopia and two hernia uterus inguinalis). All cases had normal AMH levels. Seven different variants were identified in the six families. The variants detected in four cases were considered novel (c.78del, c.71G > A, c.1460dup, c.1319A > G). Two of the novel variants were missense (exon 2 and exon 10) mutations, one was deletion (exon 2), and one duplication (exon 11). CONCLUSION We identified four novel mutations in the AMHR2 gene resulting in PMDS. Duplication mutation (c.1460dup) in the AMHR2 gene causing PMDS was demonstrated for the first time. The most important complications of PMDS are infertility and malignancy. Early diagnosis is vital to preventing malignancy. Vas deferens and vascular structures may be injured during orchiopexy. Therefore, patients should always be referred to experienced clinics.
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MESH Headings
- Anti-Mullerian Hormone/blood
- Child, Preschool
- Consanguinity
- Disorder of Sex Development, 46,XY/diagnosis
- Disorder of Sex Development, 46,XY/genetics
- Disorder of Sex Development, 46,XY/physiopathology
- Early Diagnosis
- Humans
- Infertility, Male/diagnosis
- Infertility, Male/etiology
- Male
- Mutation
- Neoplasms/diagnosis
- Neoplasms/etiology
- Neoplasms/prevention & control
- Pedigree
- Receptors, Peptide/genetics
- Receptors, Transforming Growth Factor beta/genetics
- Turkey
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Affiliation(s)
- E Unal
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
| | - A A Karakaya
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - A Beştaş
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - R Yıldırım
- Department of Pediatric Endocrinology, Diyarbakır Children's Hospital, Diyarbakir, Turkey
| | - F F Taş
- Department of Pediatric Endocrinology, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | - H Onay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - F Özkınay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Y K Haspolat
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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Arslankoylu AE, Unal E, Kuyucu N, Ismi O. Anterior laryngofissure approach in type III laryngotracheal cleft: a case report. Acta Otorhinolaryngol Ital 2017; 36:431-434. [PMID: 27070536 PMCID: PMC5225801 DOI: 10.14639/0392-100x-636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/24/2015] [Indexed: 11/23/2022]
Abstract
Laryngeal and laryngotracheal clefts are rare congenital malformations of the laryngobronchial tree. Their symptoms vary from mild cough to life threatening pulmonary aspiration and cyanosis. Type I and II clefts can be observed without surgical intervention, whereas type III and IV clefts usually require an anterior or lateral cervical approach. We present a case of type III laryngotracheal cleft seen in a 3-monthold male infant who died during revision surgery after an anterior laryngofissure approach. We discuss the difficulties in diagnosis, management and importance of anaesthesia for these rare anomalies in light of the current literature.
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Affiliation(s)
- A E Arslankoylu
- Department of Pediatric Intensive Care, Faculty of Medicine, University of Mersin, Turkey
| | - E Unal
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Turkey
| | - N Kuyucu
- Department of Pediatric Infectious diseases, Faculty of Medicine, University of Mersin, Turkey
| | - O Ismi
- Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Turkey
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Unal E, Lotti J, Fioranelli M, Roccia MG, Lotti T, Guarneri C, Parlak N. Duncan’s dermatosis: from the “terra firma-forme” to a possible syndromic condition. The story of a dirty disease. J BIOL REG HOMEOS AG 2017; 31:39-44. [PMID: 28702963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Since its first description by Duncan, Tschen and Knox in 1987 in the former Archives of Dermatology (1), “Terra firma-forme dermatosis” has been variously described in medical literature, representing a strange, probably underestimated, cutaneous disease. During the last 40 years, the condition has been recorded as an undesirable as well as unexplained event, occurring mainly in childhood, characterized by a brownish-black appearance of the whole skin, resembling dirt. Recently, authors described several cases of atypical patterns of the disease, sometimes with impressing topographic clinical pictures, evocative for syndromic phenotypes. Thanks to more careful examination of the tegument, often with the aid of non-invasive diagnostic tools, attention to this disease is growing. This brief review summarizes the state of the art on the topic, through an historical overview of what is known of this ‘dirty’ dermatosis.
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Affiliation(s)
- E Unal
- Department of Dermatology, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - J Lotti
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - M Fioranelli
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - M G Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | - T Lotti
- Dermatology, University of Rome “G. Marconi”, Rome, Italy
| | - C Guarneri
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - N Parlak
- Department of Dermatology, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, Turkey
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Unal E, Isik S, Gurbuz M, Kilic K. P16.30 4th ventricle glioblastoma. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Unal E, Antar V, Hasanov T, Guzel A, Kilic K. P16.32 Primary cerebral lymphomas. Case report and review of the literature. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Unal E, Kilic K, Ozdemir N, Gunver F, Isik S, Can S. P16.29 Malignant craniopharyngioma. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ihvan A, Acar A, Topal C, Canbak T, Aktas S, Unal E. Clinical significance of D2-40 and CD31, lymphatic and blood vessel invasion markers, in gastric cancer. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30331-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ozpek A, Unal E, Canbak T, Acar A, Ozbagriacik M. The incidence of occult level VI lymp node metastasis in cN0 thyroid papillary carcinoma. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Unal E, Gokler ME, Metintas S, Kalyoncu C. Effect of anti-smoking advertisements on Turkish adolescents. East Mediterr Health J 2016; 22:654-661. [PMID: 27966766 DOI: 10.26719/2016.22.9.654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 07/26/2016] [Indexed: 11/09/2022]
Abstract
The aim of the present study was to determine the perception of 10 anti-smoking advertisements in 1434 Turkish adolescents. We used the Effectiveness of the Anti-smoking Advertisements Scale, which included 6 items for each advertisement; each item was assessed on a 5-point Likert-type scale. Multiple logistic regression analysis was used to determine the factors associated with the impact of the advertisements. All the advertisements were more effective for adolescents who had never smoked compared to ex-smokers and current smokers. We also noted that, regardless of age, smoking status decreased the effectiveness of all the advertisements. Previous studies have shown that smokers have a negative attitude towards anti-smoking messages. In the present study, the most effective advertisements among adolescents were those with "Sponge and tar", "Smoking harms in every breath" and "Children want to grow". In conclusion, although anti-smoking campaigns are targeted towards adults, they also have a strong influence on adolescents. The main target population for advertisements should be individuals aged < 15 years who have not yet started smoking.
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Affiliation(s)
- E Unal
- Department of Public Health, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - M E Gokler
- Department of Public Health, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - S Metintas
- Department of Public Health, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - C Kalyoncu
- Department of Public Health, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Arin G, Kisacik P, Akdogan A, Kilic L, Berberoglu U, Karabulut E, Dogan O, Unal E. AB1099-HPR Comparison of The Effect of Daily Living Activities and Depression on Quality of Life in Patients with Ankylosing Spondylitis and Rheumatoid Arthritis: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kisacik P, Arin G, Oksuz S, Berberoglu U, Arın G, Akdogan A, Akdogan A, Dogan O, Dogan O, Karabulut E, Karabulut E, Unal E, Unal E. FRI0636-HPR Effects of Clinical Pilates Exercises Combined with Dancetherapy on Mood in Patients with Rheumatic Diseases: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kisacik P, Oksuz S, Oksuz S, Arın G, Arın G, Akdogan A, Akdogan A, Dogan O, Dogan O, Karabulut E, Karabulut E, Unal E, Unal E. FRI0637-HPR The Effects of Clinical Pilates Exercises on Kinestesia and Position Sense in Patients with Osteoarthritis of The Knee: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Unal E, Kısacık P, Oksuz S, Arın G, Dogan O, Karabulut E. FRI0619-HPR Investigating The Effects of A Multidimensional Exercise Program on Symptoms and Antiinflammatory Status in Oa Patients of The Knee: Table.1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sert D, Kervan U, Kocabeyoglu S, Unal E, Kavasoglu K, Ozatik M, Pac F, Kucuker S, Pac M. Early and Long Term Results of Heart Transplantation after Reoperative Sternotomy. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kocabeyoglu S, Kervan U, Unal E, Sert D, Koca S, Kavasoglu K, Bagrul D, Pac F, Pac M. Pediatric Implantable Left Ventricular Assist Device Experience. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Aydin R, Unal E, Gokler M, Metintas S, Emiral G, Ozay O, Onsuz F, Isikli B. An evaluation of home health care needs and Quality of Life among the elderly in a semi-rural area of Western Turkey. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Patiroglu T, Akar HH, Unal E, Chiang SC, Schlums H, Tesi B, Ozkars MY, Karakukcu M. PARTIAL OCULOCUTANEOUS ALBINISM AND IMMUNODEFICIENCY SYNDROMES: TEN YEARS EXPERIENCE FROM A SINGLE CENTER IN TURKEY. Genet Couns 2016; 27:67-76. [PMID: 27192893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND AIM Partial oculocutaneous albinism and immunodeficiency (OCA-ID) diseases are autosomal recessive syndromes characterized by partial hypopigmentation and recurrent infections. Moreover, some OCA-ID syndromes confer susceptibility to develop a life-threatening hyperinflammatory condition called hemophagocytic lymphohistiocytosis (HLH). We investigated the genetic, clinical and immunological characteristics of 20 OCA patients. MATERIAL AND METHODS Herein, we present the clinical and immunological characteristics of 20 OCA patients who referred to the Department of Pediatric Immunology, Erciyes University Medical Faculty in Kayseri, Turkey between 2004 and 2014. RESULTS Of the 20 OCA patients, 7 fulfilled diagnostic criteria for HLH, 9 showed defective functions of CD8 T cells and natural killer cells, and 8 received a definitive molecular diagnosis. Among the patients, we also report a patient diagnosed with two different genetic defects, in TYR and JAK3 genes, causing, respectively, OCA and ID. CONCLUSION Our results illustrate the variability of clinical presentations and disease severity in OCA-ID patients, with consequent challenges in diagnosing and treating these patients.
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Patiroglu T, Klein C, Gungor HE, Ozdemir MA, Witzel M, Karakukcu M, Sawalle-Belohradsky J, Conca R, Unal E. CLINICAL FEATURES AND GENETIC ANALYSIS OF SIX PATIENTS WITH WISKOTT-ALDRICH SYNDROME REPORTING TWO NOVEL MUTATIONS: EXPERIENCE OF ERCIYES UNIVERSITY, KAYSERI, TURKEY. Genet Couns 2016; 27:9-24. [PMID: 27192888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The Wiskott-Aldrich syndrome (WAS) is an X-linked immunodeficiency characterized by micro-thrombocytopenia, eczema, and recurrent infections. We aimed to share our experience with six children with WAS, including two patients with two novel mutations. MATERIAL AND METHOD We present phenotypical and laboratory description of six patients with WAS. The initial clinical presentation, biochemical and radiological features, molecular diagnosis together with long-term follow-up data are provided. RESULTS The patients showed increased serum levels of IgE; otherwise the serum levels of IgM were decreased. The percentages of CD3+ T cells were decreased or within lower limit. Four patients underwent molecular genetics analysis and Western blot studies; two of them showed unpublished mutations: a hemizygous splice site mutation in intron 8 (c.778-2A>T), and a hemizygous deletion in exon10 of the WASP gene (c.1017delT; p.S339fsX444) were detected. Western blot studies confirmed the reduced WAS protein expression in peripheral mononuclear blood cells in four studied patients. CONCLUSIONS The major characteristics of patients were thrombocytopenia with decreased mean platelet volume and bleeding. All patients had been previously misdiagnosed as idiopathic thrombocytopenic purpura, demonstrating the importance of a careful differential diagnosis, and intense evaluation.
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Unal E, Ataly BI, Onsuz MF, Isikli B, Metintas S. Seat-belt use among high school students in a semi-rural area of Western Turkey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Atalay B, Unal E, Onsüz FM, Işıklı B, Metintaş S, Yenilmez C. Violence and related factors among high school students in semirural areas of Eskişehir, Turkey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kisacik P, Devesan G, Arin G, Unal E. AB1240-HPR Turkish Version of the Short Version of the Pain Anxiety Symptom Scale (PASS-20) and its Test-Retest Reliability and Validity: Preliminary Report. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bingöl R, Kocabasoglu N, Sen E, Algedik P, Cakabay S, POYRAZ B, Unal E, Erdal T. Tattooing and Different Personalities; a Comparison Study of Turkish Criminals and Control Sample. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31092-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zeyneloglu H, Onalan G, Durak T, Alyazici I, Unal E. Granulocyte macrophage colony stimulating factor (G-CSF) administration for art patients with repeated implantation failure (RIF): which route is best? Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dizmek P, Unal E, Akdodan A, Kiraz S. AB1453-HPR Investigation of clinical pilates exercises on disease activity, functional status and mobility in female patients with ankylosing spodylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Unal E, Atasavun Uysal S, Dizmek P, Bilginer Y, Çelebi Tayfur A, Özen S. AB1444-HPR Does effect clinical pilates therapy on daily living avtivities and motor function in children with juvenile idiopathic arthritis in two weeks? A pilot study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kara M, Demir F, Ata P, Ozel L, Gumrukcu G, Unal E, Canbakan M, Gucun M, Esadoglu V, Ozdemir E, Cemel H, Titiz MI. The impact of C4d staining as a humoral injury marker. Transplant Proc 2013; 44:1694-6. [PMID: 22841245 DOI: 10.1016/j.transproceed.2012.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Acute and chronic humoral injuries in renal transplant recipients are the main reasons for graft rejection and failure. Histological and clinical characteristics of humoral rejection and symptoms are variable and not always helpful for differential diagnosis. Clinical monitoring of the allograft, an elevated serum panel-reactive antibody (PRA), and the presence of donor-specific antibody (DSA) during immune monitoring as well as C4d staining of biopsy material can establish the differential diagnosis. Even without a cellular component, humoral rejection reaction is serious because the target tissue is the graft endothelium. Because the kidney graft has a rich vascular structure this attack causes permanent injury to the kidney in the long term. Graft dysfunction in this setting is usually more severe, requiring dialysis therapy, compared with acute cellular reactions. Positive C4d staining of peritubular capillaries in biopsy material represent a hallmark of complement-dependent cytotoxicity, supporting the diagnosis of humoral rejection. We analyzed C4d staining as a hallmark of humoral rejection. METHODS From 2009 to 2011, we analyzed the relationship between pathological findings of C4d immunohistochemistry staining and the clinical outcomes of 45 kidney transplant recipients who underwent a kidney biopsy because of graft dysfunction due to possible humoral rejection. RESULTS Biopsy specimens of 15 patients stained C4d positive; the remaining 30 showed negative results. Intravenous steroids, PP + IVIG with or without antithymocyte globulin (ATG), was administered for treatment. Sixty six percent (n = 10) of patients were C4d positive with 16% (n = 5) of those showing C4d-negative biopsy results, losing their grafts, and returning to hemodialysis. CONCLUSIONS C4d staining refractory humoral rejection injury was related to poor graft outcomes.
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Affiliation(s)
- M Kara
- First General Surgery, Transplantation and Genetics Units, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
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Patiroglu T, Gungor HE, Unal E, Koker Y. The clinical features and genetic mutations of chronic granulomatous disease: results from a reference centre at middle Anatolia. Genet Couns 2013; 24:327-335. [PMID: 24341149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Chronic granulomatous disease (CGD) is a rare innate immune deficiency with neutrophil function disorder. In this retrospective study, we aimed to evaluate the clinical features of the patients with CGD. MATERIAL AND METHOD We presented eight patients (6 boys, 2 girls) with CGD which were evaluated at Erciyes University Medical Faculty hospital between 1996 and 2012. The initial complaints, age at diagnosis, consanguinity of the parents, similar disease history or death of the siblings, physical examination, diagnostic tests, clinical courses, and genetic characteristics were analyzed. RESULTS The initial complaints were started before the age of one in four patients; whereas only two patients diagnosed before the first birth day. Lymphadenomegally, suppurative infections, pneumonia, diarrhea were the most noted initial complaints. All parents were consanguineous. The clinical features were mild; and the ages of diagnosis were late in patients with p47 and p67 defect. The patient with X linked CGD was diagnosed when he was 3 months old; his clinical course was complicated with chronic otitis media, zygomatic abscess, lung abscess, and facial paralysis. The patient with p22 defect was diagnosed at two months of age; and gastric wall granuloma, inflammation in proximal femur was detected. CONCLUSIONS The awareness of the clinicians about CGD will result in early diagnosis and consequently reduce the mortality and morbidity of this disease.
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Affiliation(s)
- T Patiroglu
- Erciyes University,Medical Faculty, Department of Pediatrics, Division of Pediatric Immunology, Kayseri, Turkey
| | - H Eke Gungor
- Erciyes University,Medical Faculty, Department of Pediatrics, Division of Pediatric Immunology, Kayseri, Turkey
| | - E Unal
- Erciyes University, Medical Faculty, Department of Pediatrics, Division of Pediatric Hematology Oncology, Kayseri, Turkey
| | - Y Koker
- Erciyes University, Medical Faculty, Department of Immunology and GenKök Laboratory of Immunology, Kayseri, Turkey
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Patiroglu T, Gungor HE, Triot A, Unal E. Severe congenital neutropenia in two siblings related to HAX1 mutation without neurodevelopmental disorders. Genet Couns 2013; 24:253-258. [PMID: 24341138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Severe congenital neutropenia (SCN) is a rare primary myelopoiesis disorder, characterized by reduced absolute neutrophil counts from birth, increased susceptibility to recurrent and life-threatening infections, and a preleukemic predisposition. Herein, we describe two siblings with SCN born from consanguineous parents who were referred for complaints of recurrent cutaneous infections, gingivitis, purulent otitis media, and both lower and upper respiratory tract infections. Bone marrow aspiration of one patient demonstrated a maturation arrest in the myeloid lineage at the promyelocyte-myelocyte stages. Genetic analysis revealed a homozygous mutation in exon 2 c.130-131insA; p.W44X in the HAX1 gene. Although identical mutations were detected in both siblings, there was a clear discrepancy between the clinical course of the brother, who eventually required granulocyte colony stimulating factor (G-CSF) therapy, and the sister, who did not. Although SCN is a rare disorder, the early onset of recurrent infections and severe neutropenia, especially in children born from consanguineous parents, should always raise suspicion and warrant further evaluation.
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Affiliation(s)
- T Patiroglu
- Erciyes University, Medical Faculty, Department of Pediatrics, Division of Pediatric Immunology, Kayseri, Turkey
| | - H Eke Gungor
- Erciyes University, Medical Faculty, Department of Pediatrics, Division of Pediatric Immunology, Kayseri, Turkey
| | - A Triot
- Munich University Hospital, Department of Pediatric Hematology and Oncology, Munich, Germany
| | - E Unal
- Erciyes University, Medical Faculty, Department of Pediatrics, Division of Pediatric Hematology Oncology, Kayseri, Turkey
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Ozel L, Marur T, Unal E, Kara M, Erdoğdu E, Demir T, Berber I, Gurkan A, Kiliçoğlu G, Bakal N, Titiz M. Avoiding Abdominal Flank Bulge after Lumbotomy Incision: Cadaveric Study and Ultrasonographic Investigation. Transplant Proc 2012; 44:1618-22. [DOI: 10.1016/j.transproceed.2012.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tacyildiz N, Ozyoruk D, Ozelci Kavas G, Dincaslan H, Yavuz G, Unal E, Atalay S, Ikinciogullari A, Ucar T, Doganay B, Oktay G, Cavdar A, Kucuk O. Effect of selenium supplemantation on anthracycline-induced cardiac toxicity in children treated for cancer: Correlation with pro-brain natriuretic peptide levels. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kucuk O, Tacyildiz N, Kose K, Dincaslan H, Yavuz G, Unal E, Ozyoruk D, Karatepe M, Suskan E, Sahin K. Carotenoid and vitamin E levels in children with cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e20004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tacyildiz N, Ozyoruk D, Yavuz G, Unal E, Dincaslan H, Dogu F, Sahin K, Kucuk O. Effects of soy isoflavenes (genistein) on chemotherapy and radiotherapy toxicities in childhood cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e20008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tacyildiz N, Ucar T, Ozyoruk D, Yavuz G, Unal E, Atalay S, Ozelci Kavas G, Aribal P, Dincaslan H, Cavdar A. Effect of selenium on anthracycline induced cardiotoxicity in children that treated for cancer: Correlation with pro-brain natriuretic peptide levels. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10061 Background: High cumulative doses of an anthracyclin (300–500 mg/m2) are used in the several treatment protocols of children with Cancer. Probrain natriuretic peptit (Pro-BNP), is relased by cardiac cells and elevated even before overt cardiac distress symptoms. Selenium, is an antioxidant which its’ absence cause cardiomyopathy in people living in the poor selenium soil area. Aim 1: Assesment of anthracycline-induced cardiotoxicity with Pro-BNP levels, correlated with echo-cardiographic (ECHO) findings. Aim 2: Determine possible effects of selenium levels and supplemantation on cardiac toxicity. Methods: Plasma levels of Pro-BNP have been measured in 58 pediatric cancer patients (leukemias, lymphomas,solid tumors; 38 boys, 20 girls; between 2–18 years, median:12) after completed their anthracycline containing regimens. Serum selenium levels examined in 12 patients (six patients were with high and other six with normal pro-BNP levels). Three of four Patients with low level of selenium showed cardiac failure according to ECHO and supplemanted with selenium besides digoxine, ACE inhibitors. Results: Eleven patients have found with high pro-BNP levels (120–8022 pg/ml; normal: lower than 120 pg/ml).Six of these patients (with 170–8022 pg/ml, median:798pg/ml pro-BNP) and other six patients with normal levels of pro-BNP (10–74pg/ml, median: 67pg/ml) examined for their serum selenium levels. All patients with normal pro-BNP levels have found in normal levels of selenium levels (71–150 μg/L,median:125 μg/L). Four patients in high pro-BNP group showed low levels of selenium (52–129 μg/L; median:67.5 μg/L). Since three of that four patients have cardiac failure, treated accordingly and supplemented with 100 μg/day selenium to maintain normal levels. During follow-up periods of 27; 8 and 2 months, all 3 patients are doing well with normal ECHO finding. Two patients reached normal Pro-BNP levels while one of them has 80 % decrease. Conclusions: Serum Pro-BNP levels can be used as a marker for anthracycline toxicity and as follow-up marker for protective agents. Selenium suplemantation may have a potential role to protect and/or overcome the difficulties related anthracyclin-induced toxicities. No significant financial relationships to disclose.
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Affiliation(s)
- N. Tacyildiz
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - T. Ucar
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - D. Ozyoruk
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - G. Yavuz
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - E. Unal
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - S. Atalay
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - G. Ozelci Kavas
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - P. Aribal
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - H. Dincaslan
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
| | - A. Cavdar
- Ankara University Medical School, Ankara, Turkey; Turkish Academia of Science, Ankara, Turkey
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Neslihan K, Unal E, Pinar O, Metin H, Duygu Y. Recurrent colorectal carcinoma with negative PET-scan. JBR-BTR 2009; 92:166-167. [PMID: 19670581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- K Neslihan
- Department of Radiology, Bezm-i Alem Valide Sultan Vakif Gureba Training and Research Hospital, Fatih, Istanbul
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Lavie O, Nezhat F, Unal E, Liedstrand B, Nezhat C, Nezhat C. Robot-Assisted Laparoscopic Surgery in Gynecology: Scientific Dream or Reality? J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tacyildiz N, Ozdemir H, Yavuz G, Unal E, Ergun H, Erden E, Dincaslan H, Heper A, Gunduz K. Comparison of histopathologic risk factors in enucleated eyes with retinoblastoma treated with chemoreduction versus no therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cetin MT, Unal E, Kadayifci O. Comparison of the modified McIndoe and modified laparoscopic Vecchietti techniques for the creation of a neovagina in Rokitansky syndrome. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/s10397-008-0371-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Krand O, Unal E. Management of enema tip-induced rectourethral fistula with gluteus maximus flap: report of a case. Tech Coloproctol 2007; 12:131-3. [PMID: 18060353 DOI: 10.1007/s10151-007-0390-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Accepted: 05/11/2007] [Indexed: 11/28/2022]
Abstract
Rectourethral fistulas are uncommon and pose a challenging treatment problem. We report the case of 68-year-old man with rectourethral fistula following enema tip-induced rectal injury. We treated the patient with an alternative surgical method used to close poorly healing defects between the urethra and rectum, by means of a muscular flap of the gluteus maximus muscle. The postoperative course was uneventful. He remained well and asymptomatic 6 months after the surgery. This technique is superior to gracilis muscle transposition, regarding the richer blood supply, anatomic neighborhood, technical simplicity, and avoidance of unnecessary incisions. Gluteus maximus muscle flap seems to be a good alternative technique in the treatment of iatrogenic rectourethral fistula.
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Affiliation(s)
- O Krand
- General Surgery Department, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey,
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Unal E, Turkmen F, Sevinc C, Kiziler AR, Aydemir B, Titiz I. Outcome of Renal Allograft in Turkish Patients With Pretransplantation Hepatitis C Virus Infection. Transplant Proc 2006; 38:3448-50. [PMID: 17175299 DOI: 10.1016/j.transproceed.2006.10.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the impact of hepatitis C virus (HCV) infection on the long-term survival of renal transplant recipients. METHODS Outcomes and survivals among 325 patients who received renal allografts from July 1991 to September 2005 were compared between those known to have pretransplantation HCV infection (Group I, HCV+ group, n = 33) versus a matched cohort of those without this infection (Group II, HCV- control group, n = 33). Allograft performance, liver function, cholesterol, and glucose levels were determined both at transplantation and at a mean of postgrafting year 8. A one-way analysis of variance (ANOVA) statistical method was used for multivariate analysis. RESULTS Thirty-three patients (10.15%, 19 women and 14 men) were positive for HCV antibody. The mean follow-up period was 8 years (range, 0.5-14 years). The mean survival rates were similar in Groups I and II (96.6% and, 100%, respectively). Although the allograft survival rate was lower in Group I (84.8% vs 90.9%), the rejection rate among the HCV- group was 6%; only 1 patient died of hepatic failure. In spite of a significant rise in both total and direct bilirubin values (P < .01) in both groups, we failed to observe an adverse effect on graft survival. A significant rise in the fasting glucose level was seen in both HCV+ and HCV- patients. CONCLUSIONS Chronic HCV infection before transplantation did not have a significant impact on graft survival or mortality compared with noninfected patients.
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Affiliation(s)
- E Unal
- Department of General Surgery and Transplantation Unit, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
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Zengin K, Taskin M, Cicek Y, Unal E, Ferahman M, Dogusoy G. Primary Gastric Tuberculosis Mimicking Gastric Tumor That Results in Pyloric Stenosis. Eur Surg 2003. [DOI: 10.1007/s10353-003-0014-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ikincioğullari A, Doğu F, Ciftci E, Unal E, Ertem M, Reisli I, Adiyaman S, Yildiran ST, Erekul S, Babacan E. An intensive approach to the treatment of disseminated BCG infection in a SCID patient. Bone Marrow Transplant 2002; 30:45-7. [PMID: 12105777 DOI: 10.1038/sj.bmt.1703578] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2001] [Accepted: 01/24/2002] [Indexed: 11/09/2022]
Abstract
There is an appreciable mortality associated with BMT in patients with SCID and advanced BCG infection. We present a girl with T-B+ SCID complicated by spina ventosa and disseminated BCG osteitis after receiving a fully matched sibling marrow transplant. Considerable progression characterised by two clinical activations and multiple pleural and perivertebral abscess formations occurred with conventional anti-mycobacterial chemotherapy. She finally recovered with full immune reconstitution after BMT and intensive treatment comprising five conventional and alternative agents that she received for 36 months. No side-effects and/or complications have been seen other than hearing loss.
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Affiliation(s)
- A Ikincioğullari
- Ankara University Medical School, Pediatric Bone Marrow Transplantation Unit, Ankara, Turkey
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Gözdaşoğlu S, Yavuz G, Unal E, Taçyldz N, Cavdar AO. Orbital granulocytic sarcoma and AML with poor prognosis in Turkish children. Leukemia 2002; 16:962; author reply 963. [PMID: 11986967 DOI: 10.1038/sj.leu.2402449] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2001] [Accepted: 12/19/2001] [Indexed: 11/09/2022]
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Abstract
Bochdalek and Morgagni hernias are the least common congenital diaphragmatic hernias, with the prevalence of Bochdalek hernia being 1/2200 births and the prevalence of Morgagni hernia being 1/1 million births. Although they are usually asymptomatic, congenital diaphragmatic hernias, especially Bochdalek and Morgagni hernias, are diagnosed in early childhood. In adulthood, they are diagnosed incidentally or when they become symptomatic. The repair of congenital diaphragmatic hernia is indicated in all children and symptomatic adults. We present three cases of congenital diaphragmatic hernia, two Morgagni and one Bochdalek hernias, repaired laparoscopically. We describe the operational methods. The results of the operations were satisfactory, with cure defined with radiological images after 1 month. We propose the use of laparoscopy in the repair procedure because it is a safe and effective method. Benefits include that it provides an excellent view of the surgical field, ease of execution, minimal surgical trauma, excellent cosmetic results, rapid recovery, and shorter hospitalization stay.
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Affiliation(s)
- M Taskin
- Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
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