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Akbulut S, Tamer M, Saritas S, Unal O, Akyuz M, Unsal S, Kucukakcali Z, Karabulut E, Usta S, Yilmaz S. Immunosuppressive Medication Adherence in Patients With Hepatocellular Cancer Who Have Undergo Liver Transplantation: A Case Control Study. Transplant Proc 2023:S0041-1345(23)00164-1. [PMID: 37080874 DOI: 10.1016/j.transproceed.2023.02.064] [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] [Received: 11/22/2022] [Revised: 01/08/2023] [Accepted: 02/22/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND We aimed to compare the adherence to immunosuppressive medication use in patients who underwent liver transplantation (LT) due to hepatocellular carcinoma (HCC) and non-HCC reasons. METHODS The study population was determined as 242 patients with HCC and 1290 patients with non-HCC who had LT performed in our institute between March 2002 and November 2021; all these patients were contacted by phone in March 2022. The sample size was calculated using the MedCalc software program, and the number of patients required in each group was determined as 111 patients. Furthermore, we used the sample.int function, a random integer generator in the R (version 4.1.2) software program. Whereas demographic and clinical parameters were determined as independent variables, the immunosuppressive medication adherence scale (IMAS) score was determined as a dependent variable. Patients were evaluated by the IMAS. This 11-item IMAS scale evaluates the lowest compliance score as 11 and the highest as 55. RESULTS Out of a total number of 221 patients, 161 (72%) were men and 60 (27.1%) were women, with a median age of 58 years (IQR: 14); one patient in the non-HCC group was excluded due to lack of data. Among the HCC and non-HCC groups, significant differences were found in terms of the variables of age (P = .003), IMAS score (P < .001), sex (P = .001), working status (P = .004), chronic diseases (P = .008), tacrolimus alone (P < .001), tacrolimus plus everolimus (P < .001), and often medication changes (P < .001). A statistically significant correlation was found between the IMAS score and whether the patients had HCC (P < .001) and frequently changing immunosuppressive drugs (P = .023). CONCLUSION This study showed that patients with frequent drug changes or non-HCC etiology had better adherence to immunosuppressive drug use.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey; Department of Public Health, Inonu University Faculty of Medicine, Malatya, Turkey; Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey.
| | - Murat Tamer
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Serdar Saritas
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Ozlem Unal
- Department of Internal Medicine Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Musap Akyuz
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Selver Unsal
- Department of Nursing Service, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Zeynep Kucukakcali
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sertac Usta
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Akbulut S, Barut B, Garzali IU, Sarici KB, Tamer M, Unsal S, Karabulut E, Baskiran A, Bayindir Y, Yilmaz S. Effect of Pre-Transplant COVID-19 Exposure On Post-Liver Transplant Clinical Outcomes. Transplant Proc 2023:S0041-1345(23)00089-1. [PMID: 36973149 PMCID: PMC9968604 DOI: 10.1016/j.transproceed.2023.01.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/21/2022] [Accepted: 01/04/2023] [Indexed: 03/01/2023]
Abstract
Background and Aim COVID-19 has led to an unprecedented global health crisis. This situation caused an immediate reduction in solid organ transplantation activity. The aim of this study was to present the follow-up results of patients with chronic liver disease (CLD) who underwent LT after a previous history of COVID-19 infection. Methods Socio-demographic characteristics and clinicopathological data of 474 patients who underwent LT at Inonu University Liver Transplant Institute between March 11, 2020, and March 17, 2022, were prospectively recorded and analyzed retrospectively. Among these, the data of 35 patients with CLD who were found to be exposed to COVID-19 infection in the pre-LT period were analyzed for this study. Results The median BMI, Child, and MELD/PELD scores of the 35 patients were calculated as 25.1 kg/m2 (IQR: 7.4), 9 (IQR: 4) and 16 (IQR: 10), respectively. Graft rejection occurred in four patients at a median of 25 days post-transplant. Five patients underwent retransplantation at median 25 days post-transplant. The most common cause of retransplantation is early hepatic artery thrombosis. There were 5 deaths during postoperative follow up. Mortality developed in 5 (14.3%) of the patients who were exposed to COVID-19 infection in the pre-transplant period, while mortality occurred in 56 (12.8%) of the patients who were not exposed to COVID-19 infection. There was no statistically significant difference in mortality between the groups (p=0.79). Conclusion The results of this study showed that exposure to COVID-19 before LT does not affect post-transplant patients and graft survival.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.
| | - Bora Barut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | | | - Kemal Baris Sarici
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Murat Tamer
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Selver Unsal
- Department of Nursing Service, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Adil Baskiran
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Yasar Bayindir
- and Department of Infectious Diseases and Clinical Microbiology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Akbulut S, Sarici KB, Toprak S, Tuncer A, Ciftci F, Karadag N, Gurluler E, Karabulut E, Colak C, Yilmaz S. Histopathological Evaluation of Gallbladder Specimens Obtained From Living Liver Donors. Transplant Proc 2023:S0041-1345(22)00868-5. [PMID: 36604250 DOI: 10.1016/j.transproceed.2022.11.010] [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] [Received: 10/14/2022] [Accepted: 11/19/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cholecystectomy is routinely performed during living donor hepatectomy both to see the structure of the biliary tract and to determine the demarcation line based on the biliary tract junction. This study aims to present the general histopathological features of the gallbladder specimen obtained from living liver donors (LLD). METHODS Data from 2577 LLDs who underwent living donor hepatectomy (n = 2511) or aborted living donor hepatectomy (n = 66) in our Liver Transplantation Institute between September 2005 and June 2021 were analyzed retrospectively. Age, gender, macroscopic (length, diameter, and wall thickness), and microscopic (histopathological) features of the gallbladder of the LLDs were recorded for use in this study. RESULTS A total of 2493 LLDs (men: 1486, women: 1007) with a median age of 29 years (interquartile range [IQR]: 13) met the inclusion criteria in this study. The median length, width and wall thickness of the gallbladder specimens were measured as 70 mm (IQR: 20), 50 mm (IQR: 20), and 2 mm (IQR: 1), respectively. The most common histopathological findings are normal structure (2026; 81.3%), chronic cholecystitis (n = 446; 17.9%), adenomyomatosis (n = 9), and papillary hyperplasia (n = 6), respectively. The most common pathologic findings in the gallbladder lumen are cholesterolosis (n = 207; 0.4%), cholelithiasis (n = 53), cholesterol polyp (n = 31), and noncholesterol polyp (n = 19), respectively. Significant differences were detected between the male and female genders in terms of age (P < .001), height (P < .001), weight (P < .001), body mass index (P < .001), gallbladder width (P = .001), gallbladder length (P < .001), histopathological finding (content) (P < .001), and lymph node around the gallbladder (P = .015). CONCLUSIONS The results we obtained in this study are true gallbladder pathologies that can be detected in healthy people. In this study, it was shown that the diameter and size of the gallbladder were larger in men, whereas the incidence of cholesterolosis and cholelithiasis was higher in women.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey; Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey.
| | - Kemal Baris Sarici
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Serhat Toprak
- Department of Pathology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Adem Tuncer
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Felat Ciftci
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Nese Karadag
- Department of Pathology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ercument Gurluler
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Koc C, Akbulut S, Sarici KB, Uremis MM, Dogan UG, Kucukakcali Z, Garzali IU, Karabulut E, Turkoz Y, Yilmaz S. Measurement of Heavy Metal and Antioxidant-Oxidant Levels in Tissues Obtained From Three Different Localizations of Explant Hepatectomy of Patients With Hepatocellular Carcinoma. Transplant Proc 2023:S0041-1345(22)00867-3. [PMID: 36604253 DOI: 10.1016/j.transproceed.2022.11.013] [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] [Received: 10/14/2022] [Accepted: 11/19/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND To reveal any difference in terms of heavy metal and antioxidant/oxidant levels of liver tissues obtained from 3 different locations of hepatectomy specimens of patients with hepatocellular carcinoma (HCC). METHODS Total hepatectomy materials of patients who underwent liver transplantation for HCC were objects of this study. Three liver tissue samples were obtained from each material, one from HCC tissue, one adjacent from the border of HCC, and one at least 3 cm distant from HCC, each 10 × 10 mm in diameter. Samples are preserved at -70°C. Levels of heavy metals (As, Cd, Cu, Mn, Pb, Se, and Zn) and oxidant-antioxidant parameters (catalase, glutathione peroxidase [GSHPx], superoxide dismutase [SOD], nitric oxide, prolidase, glutathione, malondialdehyde, total oxidant status, antioxidant status, oxidative stress index, total-thiol, native thiol, and disulphid) are measured. RESULTS This study included 22 patients (18 men, 4 women with an age range of 3 to 66 years. There were significant differences in terms of Cd, Pb, Zn, GSHPx, SOD, nitric oxide, and native thiol levels between liver tissues derived from 3 different locations. Cd, Pb, and Zn levels were significantly different in tumor tissues, whereas GSHPx and SOD levels were significantly different in tumor and neighboring tissues. Nitric oxide levels were relatively different in tumor tissues compared with tumor-neighboring tissues. Native thiol levels differed significantly in tumor tissues compared with tissues distant from tumor. CONCLUSIONS The aim of this study is unique in medical literature, which reveals that the amount of heavy metals and antioxidant/oxidant accumulation are variable in the same liver tissue in different locations because of multiple and yet unknown factors.
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Affiliation(s)
| | - Sami Akbulut
- Liver Transplant Institute, Malatya, Turkey; Department Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey.
| | | | - Muhammed Mehdi Uremis
- Department of Medical Biochemistry, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ufuk Gunay Dogan
- Fuel-Oil Analysis Laboratory, Inonu University Rectorate, Malatya, Turkey
| | - Zeynep Kucukakcali
- Department Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ibrahim Umar Garzali
- Liver Transplant Institute, Malatya, Turkey; Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Yusuf Turkoz
- Department of Medical Biochemistry, Inonu University Faculty of Medicine, Malatya, Turkey
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Akbulut S, Tamer M, Kucukakcali Z, Akyuz M, Saritas H, Bagci N, Ciftci F, Akbulut MS, Karabulut E, Yilmaz S. Factors affecting anxiety, depression, and stress among patients with hepatocellular carcinoma during COVID-19 pandemic. Eur Rev Med Pharmacol Sci 2023; 27:704-712. [PMID: 36734727 DOI: 10.26355/eurrev_202301_31073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure. PATIENTS AND METHODS 118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total. RESULTS There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total. CONCLUSIONS Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.
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Affiliation(s)
- S Akbulut
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey.
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Gonulal B, Bilgic Y, Akbulut S, Karabulut E, Samdanci ET. Management and Survival Analysis of Gastrointestinal Neuroendocrine Tumors by Different Tumor Characteristics: Tertiary Center Experience. J Gastrointest Cancer 2022; 53:915-920. [PMID: 34524616 DOI: 10.1007/s12029-021-00709-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastrointestinal neuroendocrine tumor (GI-NET) is a group of neoplasia consisting of amine and acid producing cells with different hormonal profiles. Although the entire GIS accounts for about 2% of tumors, recent research reveals that the incidence rate has increased. Given the increasing incidence in GI-NETs, more and more extensive research is needed on this subject. In this regard, the demographic and clinicopathological features of the patients diagnosed with GI-NET and their relationship with survival were investigated in the present study. METHODS Thirty-four patients diagnosed with GI-NETs between January 2009 and December 2019 at the Department of Gastroenterology, Inonu University Faculty of Medicine were analyzed retrospectively. Gender, age, tumor localization, metastasis status, tumor number, tumor diameter, tumor grade, Ki-67 index, and the relationships of these factors with overall survival were examined. RESULTS Of the patients, 61.8% included in the study were male and 38.2% were female. The average age of the patients was 60.74 years. The most common tumor location was in the stomach (26.5%) and liver (26.5%). Apart from this, 17.6% of NETs were seen in the pancreas, 11.8% in the colon, 8.8% in the rectum, 5.9% in the small intestine, and 2.9% in the appendix. No significant relationship was observed between tumor location and gender (p = .326) and age (p = .641). The tumor diameter ranged from 0.2 cm to 13.91 cm, but the average tumor diameter was 3.84 cm. Solitary tumor was found in 51.5% of cases and multiple tumors in 48.5% of cases. The most common grade was Grade 1 with 41.2% of occurrence. The average of Ki-67 index was 18.36%. There was metastasis in 52.9% of cases. The rate of medical treatment was 48.5%. The median overall survival time of the patients was 23.1 months. In addition, 1-year overall survival was 74.9%, 2-year overall survival was 44.6%, and 5-year overall survival was 35.7%. A statistically significant difference was found between tumor grade and the presence of metastasis, and the overall survival (p = .003 and p = .005). CONCLUSIONS The tumor grade and the presence of metastasis in gastrointestinal neuroendocrine tumors were found to be the most important prognostic factors affecting overall survival.
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Affiliation(s)
- Bedia Gonulal
- Department of Internal Medicine, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey
| | - Yilmaz Bilgic
- Department of Gastroenterology, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey.
| | - Sami Akbulut
- Department of Surgery, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey
| | - Ertugrul Karabulut
- Department of Surgery, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey
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Ates M, Akbulut S, Tuncer A, Sahin E, Karabulut E, Sarici KB. Squamous Cell Carcinoma Arising from Perianal Buschke-Lowenstein Tumor (Giant Condyloma Acuminatum): Comprehensive Literature Review. J Gastrointest Cancer 2022; 53:1083-1092. [PMID: 34694593 DOI: 10.1007/s12029-021-00713-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aims to provide an overview of the literature on carcinoma arising from giant perianal condyloma acuminatum. METHODS We present a new case of squamous cell carcinoma arising from giant perianal condyloma acuminatum. We also conducted a systematic search of the medical literature using PubMed, Medline, Google, and Google Scholar related to carcinoma arising from giant perianal condyloma acuminatum. The following search terms were used in various combinations: condyloma acuminatum, giant condyloma acuminatum, Buschke-Lowenstein tumor, squamous cell carcinoma, and verrucous carcinoma. The search included articles published before in the English language November 2020. RESULTS A total of 55 article concerning 97 patients with carcinoma (squamous cell carcinoma, verrucous carcinoma, basaloid cell carcinoma, carcinoma insitu) arising from giant perianal condyloma acuminatum meeting the aforementioned criteria were included. The patients were aged from 24 to 82 years (median: 49.6, IQR: 21); 20 were female (median age: 52.5, IQR: 20.5), and 75 were male (median age: 53, IQR: 17.5). The gender data of the remaining two patients could not be obtained. The histopathological features of tumors arising from giant condyloma acuminatum are as follows: squamous cell carcinoma (n = 56), squamous cell carcinoma in situ (n = 16), verrucous carcinoma (n = 19) and basaloid cell carcinoma (n = 1), squamous cell carcinoma + verrucous carcinoma (n = 1), squamous cell carcinoma + squamous cell carcinoma in situ (n = 1), squamous cell carcinoma + basaloid cell carcinoma (n = 1) and malignant behavior (n = 2). CONCLUSION Giant condyloma acuminatum is a rare variant of anogenital warts. It is known that this tumor, which is mostly thought to be benign, has a high potential for local recurrence and transformation into invasive cancer. Therefore, it is vital that the tumor is resected with clean surgical margins, even if it looks benign, and that aggressive treatment options are not avoided when necessary.
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Affiliation(s)
- Mustafa Ates
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey
| | - Sami Akbulut
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey.
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey.
| | - Adem Tuncer
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey
| | - Emrah Sahin
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey
| | - Kemal Baris Sarici
- Department of Surger, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey
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Akbulut S, Tuncer A, Ogut Z, Sahin TT, Koc C, Guldogan E, Karabulut E, Tanriverdi ES, Ozer A. Effect of the COVID-19 pandemic on patients with presumed diagnosis of acute appendicitis. World J Clin Cases 2022; 10:10487-10500. [PMID: 36312473 PMCID: PMC9602222 DOI: 10.12998/wjcc.v10.i29.10487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/16/2022] [Accepted: 09/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acute appendicitis (AAp) is the most frequent cause of acute abdominal pain, and appendectomy is the most frequent emergency procedure that is performed worldwide. The coronavirus disease 2019 (COVID-19) pandemic has caused delays in managing diseases requiring emergency approaches such as AAp and trauma.
AIM To compare the demographic, clinical, and histopathological outcomes of patients with AAp who underwent appendectomy during pre-COVID-19 and COVID-19 periods.
METHODS The demographic, clinical, biochemical, and histopathological parameters were evaluated and compared in patients who underwent appendectomy with the presumed diagnosis of AAp in the pre-COVID-19 (October 2018-March 2020) and COVID-19 (March 2020-July 2021) periods.
RESULTS Admissions to our tertiary care hospital for AAp increased 44.8% in the COVID-19 period. Pre-COVID-19 (n = 154) and COVID-19 (n = 223) periods were compared for various parameters, and we found that there were statistically significant differences in terms of variables such as procedures performed on the weekdays or weekends [odds ratio (OR): 1.76; P = 0.018], presence of AAp findings on ultrasonography (OR: 15.4; P < 0.001), confirmation of AAp in the histopathologic analysis (OR: 2.6; P = 0.003), determination of perforation in the appendectomy specimen (OR: 2.2; P = 0.004), the diameter of the appendix (P < 0.001), and hospital stay (P = 0.003). There was no statistically significant difference in terms of interval between the initiation of symptoms and admission to the hospital between the pre-COVID-19 (median: 24 h; interquartile range: 34) and COVID-19 (median: 36 h; interquartile range: 60) periods (P = 0.348). The interval between the initiation of symptoms until the hospital admission was significantly longer in patients with perforated AAp regardless of the COVID-19 or pre-COVID-19 status (P < 0.001).
CONCLUSION The present study showed that in the COVID-19 period, the ultrasonographic determination rate of AAp, perforation rate of AAp, and duration of hospital stay increased. On the other hand, negative appendectomy rate decreased. There was no statistically significant delay in hospital admissions that would delay the diagnosis of AAp in the COVID-19 period.
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Affiliation(s)
- Sami Akbulut
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Public Health, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Adem Tuncer
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Zeki Ogut
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Tevfik Tolga Sahin
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Cemalettin Koc
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Emek Guldogan
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Ertugrul Karabulut
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Elif Seren Tanriverdi
- Department of Medical Microbiology, Inonu University Medical Faculty, Malatya 44280, Turkey
| | - Ali Ozer
- Department of Public Health, Inonu University Faculty of Medicine, Malatya 44280, Turkey
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Yilmaz S, Akbulut S, Usta S, Ozsay O, Sahin TT, Sarici KB, Karabulut E, Baskiran A, Gonultas F, Ozdemir F, Ersan V, Isik B, Kutlu R, Dirican A, Harputluoglu M. Diagnostic and therapeutic management algorithm for biliary complications in living liver donors. Transpl Int 2021; 34:2226-2237. [PMID: 34510566 DOI: 10.1111/tri.14104] [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] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 02/05/2023]
Abstract
This study aimed to demonstrate the efficacy of our diagnostic and therapeutic management algorithm and catheter-assisted (percutaneous transhepatic biliary tract drainage [PTBD] or transanastomotic feeding tube) hepaticojejunostomy (HJ) procedures in living liver donors (LLDs) with biliary complications. Living donor hepatectomy (LDH) was performed between September 2005 and April 2021 in 2 489 LLDs. Biliary complications developed in 220 LLDs (8.8%), 136 of which were male, and the median age was 29 (interquartile range [IQR]: 12) years. Endoscopic sphincterotomy ± stenting was performed in 132 LLDs, which was unsuccessful in 9 LLDs and required HJ. Overall, 142 LLDs underwent interventional radiologic procedures. Fifteen LLDs with biliary complications underwent HJ (PTBD catheter = 6 and transanastomotic feeding tube = 9) at a median of 44 days (IQR: 82). Following HJ, 14 LLDs did not have any complications throughout the median follow-up period of 1619 days (IQR: 1454). However, percutaneous dilation for HJ anastomotic stricture was performed in one patient. Biliary complications are very common following LDH; therefore, surgeons in the field should have a low threshold to perform HJ for biliary complications that persist after other treatments. Our catheter-assisted HJ techniques demonstrated a high success rate and aided HJ in a hostile abdomen during revisional surgery.
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Affiliation(s)
- Sezai Yilmaz
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Sami Akbulut
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Sertac Usta
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Oguzhan Ozsay
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Tevfik Tolga Sahin
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Kemal Baris Sarici
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ertugrul Karabulut
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Adil Baskiran
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Fatih Gonultas
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Fatih Ozdemir
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Veysel Ersan
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Burak Isik
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ramazan Kutlu
- Department of Radiology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Abuzer Dirican
- Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Murat Harputluoglu
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Inonu University, Malatya, Turkey
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Gundogan E, Karabulut E, Ersan V, Kayaalp C. Dieulafoy lesion in a Hartmann stump. Asian J Endosc Surg 2020; 13:560-563. [PMID: 31943868 DOI: 10.1111/ases.12781] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/07/2019] [Accepted: 12/01/2019] [Indexed: 11/30/2022]
Abstract
A 70-year-old man underwent laparoscopic anterior resection for sigmoid carcinoma, and on postoperative day 4, he required an emergency Hartmann procedure for bowel ischemia and anastomotic leakage. Five days after the emergency procedure, there was a massive hemorrhage through the anus that appeared in the abdominal drain. During exploration, the origin of the bleeding could not be found, and the rectal stump was closed over a urinary Foley catheter (with an inflated balloon) with the help of a purse-string suture. In the intensive care unit, massive hematochezia continued. Emergency transanal colonoscopy to the Hartmann stump found the rectum full of clotted blood. Active pulsatile arterial bleeding of a rectal Dieulafoy lesion was detected. After endoscopic hemostasis efforts failed, bleeding was stopped successfully by transanal suturing. The patient was discharged without any other problems, and no recurrent bleeding occurred during the 18-month follow-up. Here, we report a rectal Dieulafoy lesion in a Hartmann stump for the first time.
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Affiliation(s)
- Ersin Gundogan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Veysel Ersan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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11
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Aktas A, Ozer T, Sen M, Turk M, Karabulut E. Comparison of the mechanical properties of platelet-rich fibrin and ankaferd blood stopper-loaded platelet-rich fibrin. Niger J Clin Pract 2018; 21:1087-1092. [PMID: 30156190 DOI: 10.4103/njcp.njcp_370_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background and Aim Platelet-rich fibrin (PRF) can be named as a natural fibrin-based biomaterial favorable to increasing vascularization and able to guide epithelial cell migration to its surface. The membrane has a significant positive effect on protecting open wounds and accelerating healing. Similar to PRF Ankaferd Blood Stopper (ABS) also has positive effects on wound healing. The aim of this study was to detect if we can improve known physical properties of PRF combining with ABS. This idea was based on the known mechanism of ABS in forming protein network without damaging any blood cells. Materials and Methods: A total of 25 adult rabbits used for collecting 5-7 ml of blood passively with the help of winged blood collection needle to the test tube. Collected samples were centrifuged at 3000 rpm for 10 min. Two similar samples obtained from each animal and one of the samples was placed in 20% ABS 80% saline solution for 5 min. Mechanical properties of the membrane samples were measured using Universal Testing Machine. Results: There is the statistically significant difference between PRF and ABS added PRF in elongation/mm (dL) and elongation/% at break values. Maximum force (fMax) and modulus values did not show any statistically significant differences. Conclusion ABS loaded PRF causes better physical properties. This combination seems to exhibit superior performance when used as a membrane barrier solely. Advanced studies can be done on biological properties of ABS loaded PRF, especially on tissue healing.
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Affiliation(s)
- A Aktas
- Department of Oral Maxillofacial Surgery, Hacettepe University, Faculty of Dentistry, Ankara, Turkey
| | - T Ozer
- Department of Oral Maxillofacial Surgery, Hacettepe University, Faculty of Dentistry, Ankara, Turkey
| | - M Sen
- Hacettepe University, Faculty of Chemistry, Polymer Chemistry Division, Ankara, Turkey
| | - M Turk
- Department of Bioengineering, Kİrİkkale University, Faculty of Engineering, Kİrİkkale, Turkey
| | - E Karabulut
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
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12
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Mocan M, Bozkurt B, Irkeç M, Orhan M, Karabulut E. Author Reply. Eur J Ophthalmol 2018. [DOI: 10.1177/112067210401400517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M.C. Mocan
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara - Turkey
| | - B. Bozkurt
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara - Turkey
| | - M. Irkeç
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara - Turkey
| | - M. Orhan
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara - Turkey
| | - E. Karabulut
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara - Turkey
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13
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Cetinkaya RA, Yilmaz S, Ünlü A, Petrone P, Marini C, Karabulut E, Urkan M, Kaya E, Karabacak K, Uyanik M, Eker I, Kilic A, Gunal A. The efficacy of platelet-rich plasma gel in MRSA-related surgical wound infection treatment: an experimental study in an animal model. Eur J Trauma Emerg Surg 2017; 44:859-867. [DOI: 10.1007/s00068-017-0852-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/25/2017] [Indexed: 11/28/2022]
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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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15
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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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16
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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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17
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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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Caglar M, Kupik O, Karabulut E, Høilund-Carlsen P. Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan? Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2015.12.009] [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: 10/22/2022]
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Caglar M, Kupik O, Karabulut E, Høilund-Carlsen PF. Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan? Rev Esp Med Nucl Imagen Mol 2015; 35:3-11. [PMID: 26514321 DOI: 10.1016/j.remn.2015.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/17/2015] [Accepted: 08/30/2015] [Indexed: 11/18/2022]
Abstract
AIM To examine the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of bone metastasis in breast cancer patients and assess whether whole body bone scan (BS) with (99m)Tc-methylene diphosphonate provides any additional information. MATERIAL AND METHODS Study group comprised 150 patients, mean age 52 years (range 27-85) with breast cancer, suspected of having bone metastases. All patients had undergone both FDG-PET/CT and BS with or without single photon emission tomography/computed tomography (SPECT/CT) within a period of 6 weeks. The final diagnosis of bone metastasis was established by histopathological findings, additional imaging, or clinical follow-up longer than 10 months. Cancer antigen 15-3 (CA15-3) and carcinoembryogenic antigen (CEA) were measured in all patients. RESULTS Histologically 83%, 7% and 10% had infiltrating ductal, lobular and mixed carcinoma respectively. Confirmed bone metastases were present in 86 patients (57.3%) and absent in 64 (42.7%). Mean CA15-3 and CEA values in patients with bone metastases were 74.6ng/mL and 60.4U/mL respectively, compared to 21.3ng/mL and 3.2U/mL without metastases (p<0.001). The sensitivity of FDG-PET/CT for the detection of bone metastases was 97.6% compared to 89.5% with SPECT/CT. In 57 patients, FDG-PET/CT correctly identified additional pulmonary, hepatic, nodal and other soft tissue metastases, not detected by BS. CONCLUSION Our findings suggest that FDG-PET/CT is superior to BS with or without SPECT/CT.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Bone Neoplasms/blood
- Bone Neoplasms/diagnostic imaging
- Bone Neoplasms/secondary
- Breast Neoplasms/pathology
- Carcinoembryonic Antigen/blood
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/blood
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Female
- Fluorine Radioisotopes/analysis
- Fluorodeoxyglucose F18/analysis
- Humans
- Middle Aged
- Mucin-1/blood
- Positron Emission Tomography Computed Tomography
- Positron-Emission Tomography
- Radiopharmaceuticals/analysis
- Retrospective Studies
- Single Photon Emission Computed Tomography Computed Tomography
- Technetium Tc 99m Medronate/analysis
- Whole Body Imaging
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Affiliation(s)
- M Caglar
- Hacettepe University Medical Faculty, Department of Nuclear Medicine, Sihhiye, Ankara 06100, Turkey.
| | - O Kupik
- Hacettepe University Medical Faculty, Department of Nuclear Medicine, Sihhiye, Ankara 06100, Turkey
| | - E Karabulut
- Hacettepe University Medical Faculty, Department of Biostatistics, Sihhiye, Ankara 06100, Turkey
| | - P F Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark
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Pınar G, Kaplan S, Kaplan B, Ayar B, Aslantekin F, Karabulut E, Dilmen U. The Prevalance of Consanguineous Marriage in Turkey And the Factors Contributing to This Condition. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.031] [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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Sarikaya D, Halil M, Kuyumcu M, Kiliç M, Yesil Y, Kara Ö, Öztürk S, Güngör E, Karabulut E, Yavuz B, Cankurtaran M, Arioğul S. PP158-MON: Validation of Short and Long form of Mini Nutritional Assessment Test in Turkish Elderly. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50492-x] [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: 10/24/2022]
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Somer D, Karabulut E, Cinar FG, Altiparmak UE, Unlu N. Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy. Eye (Lond) 2014; 28:1165-73. [PMID: 25033902 DOI: 10.1038/eye.2014.161] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 05/30/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECT To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR). METHODS Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period. RESULTS Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31 (48%) developed strabismus (Group 2B). The remaining 34 constituted Group 2A. Each of the three groups showed an overall reduction of hyperopia by 0.37±0.25 days per year, 0.50±0.28 days per year, and 0.60±0.20 days per year, respectively. Visual acuity assessments among Groups 1 and 2A revealed normal values (0.2-0.0 LogMAR); among Group 2B 19% were within normal range. CONCLUSIONS Binocular accommodative behavior at the initial visit seems to be one of the indicators for pointing out infants at risk of developing strabismus and amblyopia. Prescription of DR-based corrections to hyperopic orthotropic infants does not impede emmetropization and result in normal visual acuities after emmetropization period.
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Affiliation(s)
- D Somer
- Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey
| | - E Karabulut
- Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey
| | - F G Cinar
- Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey
| | - U E Altiparmak
- Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey
| | - N Unlu
- Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey
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Hurmuz P, Akyol F, Ozyigit G, Ozdemir Y, Karabulut E, Ozen H. EP-1300: Adjuvant and salvage conformal radiotherapy results after radical prostatectomy in patients with prostate cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31418-3] [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: 10/23/2022]
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Gülhan B, Orhan D, Karabulut E, Özaltın F, Topaloğlu R, Düzova A, Özen S. PReS-FINAL-2358: T helper cells in henoch-schönlein purpura/iga vasculitis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043832 DOI: 10.1186/1546-0096-11-s2-p348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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25
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Koc E, Topaloglu S, Calik A, Sokmensuer C, Abdullazade S, Karabulut E, Piskin B. Hepatic microcirculation in inflow and inflow-outflow occlusion of the liver. Transplant Proc 2013; 45:474-9. [PMID: 23498781 DOI: 10.1016/j.transproceed.2012.07.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 06/29/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Total vascular exclusion (TVE) causes warm liver ischemia. The aim of this study was to investigate the patterns of injury caused by inflow-outflow obstruction in the rat liver. MATERIALS AND METHODS Twenty-four Wistar-Albino rats were divided into three groups: liver inflow occlusion (Group A), inflow-outflow occlusion (Group B) and intermittent inflow-outflow occlusion applied for 15 minutes. Microcirculation was measured with laser Doppler flowmetry during the procedure. Samples for biochemical and histopathological analyses were collected at the end of the ischemia period. RESULTS Significant alterations in microcirculation were determined by application of vascular control maneuvers. Microcirculation in the central and dome segments were affected adversely compared with the dome segments in all experimental groups. TVE induced severe disturbances in hepatic microcirculation with more prominent hepatocellular damage. Damage to central segments of the rat liver was more prominent with inflow occlusion; whereas inflow-outflow occlusion produced more prominent damage to dome segments. Intermittent application of TVE clamping was associated with more hepatocellular damage compared with continuous TVE. CONCLUSION Our mapping methodology within the liver parenchyma suggested that hepatovenous back-perfusion is a principle source of continuity of microcirculation in the rat liver during inflow occlusion. Inflow-outflow occlusion caused more tissue damage compared with inflow occlusion. Ischemic preconditioning during TVE did not increase the tolerance of the liver against ischemia.
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Affiliation(s)
- E Koc
- Department of Surgery, Karadeniz Technical University, School of Medicine, Trabzon, Turkey
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Yaycioglu O, Eskicorapci S, Karabulut E, Soyupak B, Gogus C, Divrik T, Turkeri L, Yazici S, Ozen H. A Preoperative Prognostic Model Predicting Recurrence-free Survival for Patients With Kidney Cancer. Jpn J Clin Oncol 2012; 43:63-8. [DOI: 10.1093/jjco/hys192] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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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27
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Karabulut AB, Gül M, Karabulut E, Kiran TR, Ocak SG, Otlu O. Oxidant and antioxidant activity in rabbit livers treated with zoledronic acid. Transplant Proc 2011; 42:3820-2. [PMID: 21094863 DOI: 10.1016/j.transproceed.2010.06.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [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: 04/04/2010] [Revised: 05/21/2010] [Accepted: 06/18/2010] [Indexed: 12/20/2022]
Abstract
Zoledronic acid (ZA), a nitrogen-bearing bisphosphonate, is used to treat the hypercalcemia associated with cancer. In addition to its antiumor effects, it acts as an osteoclast inhibitor. To investigate the effects of ZA on oxidative stress and antioxidants, we studied reduced glutathione (GSH) and antioxidant gamma glutamate cysteine, including nitrite and nitrate, which are endproducts of nitric oxide (NO) as well as malondialdehyde (MDA) in rabbit liver tissue. In the study ZA (100 μg/kg) was administered to 7 rabbits that were fed ad libitum for comparison with untreated controls. MDA was studied using Thiobarbituric acid-reactive substance reduction, NO using cadmium reduction, GSH using an enzymatic method yielding dithinitrobenzene yellow substance. We observed significantly higher MDA and NO levels in the ZA group (P < .0001), whereas GSH levels were significantly lower (P < .0001). Tissues were examined histopathologically. According to our results we find ZA induced rabbit liver oxidative stress and decreases with antioxidant levels in liver tissue. Further studies are needed to explore the safe use of this agent.
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Affiliation(s)
- A B Karabulut
- Department of Clinical Biochemistry, Inonu University, Malatya, Turkey.
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Koksal G, Karaören G, Akarcay H, Karabulut E, Tunali Y, Vehid S, Oz H. Comparison of the effects of intravenous, enteral and enteral + intravenous supply of glutamine on malnutrition in sepsis. Crit Care 2011. [PMCID: PMC3068314 DOI: 10.1186/cc9805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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29
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Sackesen C, Birben E, Soyer OU, Sahiner UM, Yavuz TS, Civelek E, Karabulut E, Akdis M, Akdis CA, Kalayci O. The effect of CD14 C159T polymorphism on in vitro IgE synthesis and cytokine production by PBMC from children with asthma. Allergy 2011; 66:48-57. [PMID: 20608916 DOI: 10.1111/j.1398-9995.2010.02428.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Even though the genotype at the promoter region of the CD14 molecule is known to affect the atopic phenotypes, the cellular and molecular basis of this association is largely unknown. OBJECTIVE To investigate the effect of lipopolysaccharide (LPS) on IgE production and cytokine profile by peripheral blood mononuclear cells (PBMC) obtained from asthmatic children with the TT and the CC genotypes at position -159 of the CD14 gene. METHODS Peripheral blood mononuclear cells from asthmatic children with alternative genotypes at CD14 C159T locus were stimulated with 2 and 200 ng/ml LPS in vitro. The IgE, IgG and, IgM response was determined by ELISA and Ig έ-germline, IgG, and IgM transcription by real-time PCR. A cluster of cytokines was measured by cytometric bead array. RESULTS Asthmatic children with the TT genotype but not those with the CC genotype responded with increased IgE synthesis and germline transcription to LPS stimulation. There were no genotype-related differences in IgG and IgM. TT but not the CC genotype was associated with significantly increased interleukin (IL)-4/IL-12 and IL-4/interferon-gamma (IFN-γ) ratios in the culture supernatant. There were no genotype-related differences in IL-1β, IL-7, IL-10, IL-13, IL-17A, granulocyte colony stimulating factor, granulocyte macrophage colony stimulating factor, monocyte chemotactic protein, and tumor necrosis factor alpha. CONCLUSION Peripheral blood mononuclear cells from asthmatic children with the TT genotype at position -159 of the CD14 gene make more IgE than those with the CC genotype following LPS stimulation because of increased germline transcription and have an augmented Th2 cytokine profile.
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Affiliation(s)
- C Sackesen
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey.
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Kaya S, Barsbay S, Karabulut E. The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data. BMJ Qual Saf 2010; 19:572-7. [DOI: 10.1136/qshc.2008.032003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [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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Bay Karabulut A, Gül M, Yagmur J, Karabulut E, Kiran T. 593 Stressor effect of zoledronic acide in rabbit heart tissue. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71394-x] [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] Open
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Abstract
Our objective was to determine the factors that affect (i) the rectal-axillary temperature measurement difference (RATD) for digital and mercury-in-glass thermometers and (ii) the difference between mercury-in-glass and digital thermometer readings taken by the rectal and axillary routes. Children (between the ages of 2 and 48 months) who were admitted to Hacettepe University Children Hospital and Corum Children's Hospital in 2 months period were included in this study. Two measurements were taken from each patient within 2 days at two different occasions including day/night and sleep/awake by the same physician. A total of 135 patients were enrolled. RATD was 0.61 + 0.54 degrees C in the mercury-in-glass thermometer, and 0.81 +/- 0.57 degrees C in the digital thermometer. The mean differences between digital and mercury-in-glass thermometers were 0.16 degrees C for rectal routes and -0.02 degrees C for axillary routes. Children at older age with hypoalbuminemia and children exposed to higher ambient temperatures had lower values of RATD than others. Temperature recordings from different sites might change with ambient temperature and individual characteristics of children.
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Affiliation(s)
- S S Yalçin
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Oguz KK, Kurne A, Aksu AO, Karabulut E, Serdaroglu A, Teber S, Haspolat S, Senbil N, Kurul S, Anlar B. Assessment of citrullinated myelin by 1H-MR spectroscopy in early-onset multiple sclerosis. AJNR Am J Neuroradiol 2009; 30:716-21. [PMID: 19147724 DOI: 10.3174/ajnr.a1425] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Myelin instability and citrullinated myelin basic protein have been demonstrated in the brains of patients with chronic and fulminating forms of multiple sclerosis (MS). Our aim was to trace citrulline in the brains of patients with early-onset MS by using proton MR spectroscopy ((1)H-MR spectroscopy). MATERIALS AND METHODS A short-echo single-voxel (1)H-MR spectroscopy by using the point-resolved proton spectroscopy sequence was performed in 27 patients with MS and 23 healthy subjects. Voxels of interest were chronic demyelinating lesions (CDLs, n = 25) and normal-appearing white matter (NAWM, n = 25) on T2-weighted imaging, and when available in patients with MS, enhancing demyelinating lesions (EDLs, n = 8). Frontal white matter (WM) was studied in control subjects. N-acetylaspartate, choline, and myo-inositol (mIns)-creatine (Cr) ratios and the presence of a citrulline peak were noted. RESULTS Citrulline peaks were more frequently observed in patients with MS than in control subjects (P = .035), located in the NAWM in 8/25 (32%), in CDLs in 7/25 (28%), and in EDLs of 1/8 (12.5%) patients with MS. The presence of citrulline and measured metabolite/Cr ratios was not related to age at imaging, age at disease onset, duration of disease, or number of relapses. There was no significant metabolic difference between the NAWM of patients with MS and the WM of the control subjects. mIns/Cr was significantly greater in CDLs compared with the NAWM of patients with MS and the WM of healthy subjects. CONCLUSIONS Citrulline was more frequently identified in the brains of patients with early-onset MS than in healthy subjects by (1)H-MR spectroscopy, suggesting an association of increased citrullination of myelin proteins with demyelinating diseases.
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Affiliation(s)
- K K Oguz
- Department of Radiology, Hacettepe University, Ankara, Turkey.
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Tözüm TF, Turkyilmaz I, Yamalik N, Karabulut E, Türkyilmaz AS, Eratalay K. Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study. J Oral Rehabil 2008; 35:95-104. [PMID: 18197842 DOI: 10.1111/j.1365-2842.2007.01802.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n=15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n=16) and delayed (n=14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P<0.05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants.
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Affiliation(s)
- T F Tözüm
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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Guncu GN, Caglayan F, Dinçel A, Bozkurt A, Ozmen F, Karabulut E. Clinical and pharmacological variables as a risk factor for nifedipine-induced gingival overgrowth. Aust Dent J 2007; 52:295-9. [DOI: 10.1111/j.1834-7819.2007.tb00505.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
This study was planned and carried out as a pilot study to determine the life satisfaction of men from the Official Social Security Institutions in Turkey (n = 231). The Life Satisfaction Index was used as the measure. Among this group of retired men, the most popular leisure activities were audio-visual and reading. The strongest predictor of life satisfaction was the frequency of participation in leisure activities, followed by the level of satisfaction with health, income, and planning of leisure activities.
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Affiliation(s)
- A Sener
- Department of Family and Consumer Sciences, Hacettepe University, Merkez Kampüsü, 06100 Samanpazari, Ankara, Turkey.
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Sekerel BE, Civelek E, Karabulut E, Yildirim S, Tuncer A, Adalioglu G. Are risk factors of childhood asthma predicting disease persistence in early adulthood different in the developing world? Allergy 2006; 61:869-77. [PMID: 16792587 DOI: 10.1111/j.1398-9995.2006.01082.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Predictive factors of childhood asthma for favorable prognosis may differ between populations where a variety of genetic and environmental factors are present. OBJECTIVES To document the factors predicting disease persistence in early adulthood in Turkey. METHODS An outpatient cohort (n = 115) with a mean follow-up duration of 11.4 +/- 0.2 years was evaluated. Complete remission was defined as no asthma symptoms, no use of controller medication, no airflow limitation and no airway hyper-responsiveness, and clinical remission as no symptoms and no use of controller medication, within the past year. RESULTS The mean ages during referral and at the final visit were 5.8 +/- 0.2 and 17.1 +/- 0.2 years, respectively. Thirty-one (27%) were in complete remission, and a further 30 (26%) in clinical remission. In multivariate logistic models, diminished airflow [forced expiratory volume in 1 s (FEV1) < 80% vs > or = 80%] at the initial lung function test predicted current diminished airflow (8.422; 2.202-32.206) (odds ratio; 95% confidence interval), and presence of obstructive pattern (FEV1/forced vital capacity (FVC) < 80% vs > or = 80%) predicted current obstructive pattern (29.333; 3.022-284.724). Furthermore, female gender appeared to predict persistence of asthma symptoms (3.330; 1.250-8.333) and absence of clinical remission (2.398; 1.038-5.254); eosinophilia predicted persistence of symptoms (4.271; 1.080-16.889) and presence of airway hyper-responsiveness (3.723; 1.129-12.278). CONCLUSIONS Diminished airflow, female gender and eosinophilia appear to predict an adverse outcome of childhood asthma, supporting the concept that variability may exist between populations.
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Affiliation(s)
- B E Sekerel
- Pediatric Allergy and Asthma Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Abstract
INTRODUCTION The enamel in pits and fissures undergoing preventive or ultraconservative resin restorations may be affected by secondary caries. An antibacterial adhesive bond may be a useful choice to prevent and reduce demineralization. OBJECTIVES The purpose of this study was to determine the shear bond strength of an experimental antibacterial bond, a self-etch bond, and an ormocer-based adhesive bond using an ormocer-based fissure sealant and a composite resin on intact enamel. METHODS Twenty-four extracted human molars were sectioned bucco-lingually to obtain two flat and sound enamel surfaces. Forty-eight specimens were randomly assigned into four groups. The groups were prepared to receive the following treatments: (1) Admira Bond + Admira Seal (n = 10); (2) ABF Bond + Admira Seal (n = 11); (3) Clearfil SE Bond + Clearfil AP-X (n = 12); and (4) ABF Bond + Clearfil AP-X (n = 11). A cylindrical mould was placed over the bonded surface, and both materials were applied according to the instructions. The teeth were thermocycled 500 cycles between 5 and 55 degrees with a dwell time of 30 s. For shear bond strength testing, the load was applied vertically to the base of the mould. The cross-head speed was 5 mm min(-1). RESULTS The maximum load that a specimen can withstand until failure was determined and shear bond strength was calculated by dividing the load at failure by the surface area of the mould. The results (median, minimum and maximum, respectively) for the four groups were: (1) 7.9, 4.2 and 13.6 MPa; (2) 8.6, 2.6 and 15.9 MPa; (3) 5.9, 5.3 and 8.2 MPa; and (4) 8.8, 3.0 and 19.2 MPa. Kruskal-Wallis and Mann-Whitney U-tests were performed for the statistical analysis. Groups 3 and 4 were statistically significantly different (P = 0.005; P < 0.05). There was no statistically significant difference between the sealant and composite groups for ABF (P = 0.375). Fracture sites were viewed by microscope under x 16 magnification to determine if the mode of failure was adhesive or cohesive. The results (number of adhesive failed specimens and number of cohesive failed specimens, respectively) for the four groups were: (1) 7 and 3; (2) 3 and 8; (3) 2 and 9; and (4) 8 and 3. CONCLUSION The ABF bond has sufficiently physical qualities to be used under fissure sealant and composite resin on uncut enamel, its antibacterial efficiency notwithstanding.
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Affiliation(s)
- N Eminkahyagil
- Department of Conservative Dentistry, Faculty of Dentistry, Baskent University, Ankara, Turkey.
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Mocan MC, Bozkurt B, Irkeç M, Orhan M, Karabulut E. The evaluation of retinal nerve fiber layer in pigment dispersion syndrome and pigmentary glaucoma using scanning laser polarimetry. Eur J Ophthalmol 2003; 13:377-82. [PMID: 12872795 DOI: 10.1177/112067210301300408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To measure the retinal nerve fiber layer thickness in patients with pigment dispersion syndrome (PDS) using scanning laser polarimetry and to compare these measurements with those of normal subjects and patients with pigmentary glaucoma (PG). METHODS Age-, sex-, and refractive error-matched subjects--18 patients with PDS, 18 patients with PG, and 20 healthy subjects--were evaluated by scanning laser polarimetry (Nerve Fiber Analyzer [NFA] GDx). The NFA did not have a compensator for corneal polarization. One randomly selected eye from each patient was included in the statistical analysis. The NFA measurements of patients with PDS and PG and healthy subjects were compared statistically using analysis of variance, Tukey multiple comparisons, chi-square, and independent t-tests. RESULTS The mean values for average thickness, superior and inferior maximum, superior and inferior average, ellipse average thickness, and superior integral were found to be lower in the patients with PDS (p < 0.02) and PG (p < 0.005) compared to the normal subjects. The mean values for maximum modulation, superior ratio, inferior ratio, and superior/nasal ratio in PDS were in between those of the PG and control groups (p > 0.05). The ellipse modulation was significantly lower in the PG group when compared to the other two groups (p < 0.03). CONCLUSIONS Retinal nerve fiber loss is present to some extent in patients with PDS and this loss is not age or sex dependent. Parameters of modulation might be more representative of significant damage of the nerve fiber layer.
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Affiliation(s)
- M C Mocan
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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Aydemir A, Abbasoglu O, Topaloglu S, Ertoy D, Ayhan A, Kilinç K, Karabulut E, Sayek I. Protective effect of roscovitine on renal ischemia–reperfusion injury. Transplant Proc 2002; 34:2027-8. [PMID: 12270300 DOI: 10.1016/s0041-1345(02)02838-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Aydemir
- Hacettepe University School of Medicine, Ankara, Turkey
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